Psychiatry has not reached a consensus hitherto concerning an optimal
theoretical framework for ethical decision-making and corresponding action.
Various theories have been considered, but found wanting. Moreover, classic
theories may contradict one another, contribute to confusion and immobilise
the clinician. We have examined major theories commonly applied in
bioethics, conferred with moral philosophers and psychiatrists and striven
to apply more recent insights drawn from moral philosophy. We report that
instead of pursuing a single theoretical framework, we should garner the
strengths of compatible approaches in a synergistic way. We propose a
particular complementarity of principlism – with its pragmatic focus on
respect for autonomy, beneficence, non-maleficence and justice – and care
ethics, avariant of virtue theory, which highlights character traits
pertinent to caring for vulnerable psychiatric patients.