Overview of Ethics in Psychiatry

2017 ◽  
Author(s):  
Cheryl Erwin ◽  
Janeta Tansey

This review of psychiatry ethics is intended for residents, fellows, and practicing psychiatrists. We provide an overview of the historical sources of ethical reasoning and give practitioners a structured method for analysis of ethical dilemmas typically encountered in the practice of medicine. Through the use of case examples, we explain how difficult situations often challenge received knowledge and superficial opinion about the ethical options present and justifiable in real-life situations. This review will appeal to the higher callings and traditions of medicine and encourage the physician who is faced with ethical decisions about which reasonable practitioners may disagree. Tools of ethical reasoning provide a means for making ethical decisions that are grounded in history and tradition. This review contains 1 figure, 6 tables, and 30 references. Key words: confidentiality, decision making, doctor-patient relationship, ethics, informed consent, narrative, principles, professionalism, respect, virtue

Author(s):  
Nicholas A. Deakin ◽  
Antonio Ventriglio ◽  
Dinesh Bhugra

Ethical practice of medicine in general and psychiatry in particular form an integral part of medical professionalism in order to ensure that patients not only get the best treatments for their needs but also that these are delivered in an ethical framework. For centuries, doctors and psychiatrists have continued to rely on the four principles of autonomy, beneficence, non-maleficence and justice as critical components of decision-making in treating their patients. As the concepts of health have changed the basic principles remain the same. This “four principles” approach has much to offer medical professionals when they are faced with ethical dilemmas in clinical and non-clinical practice. In this chapter, we outline the basis of these principles and consider the key strengths while using this theory. For psychiatrists there is a major imperative as their actions can deprive patients of their liberty. The “four principles” should be considered when making ethical decisions, and in conjunction with professional judgement and wider ethical frameworks.


2011 ◽  
Vol 4 (7) ◽  
pp. 41
Author(s):  
Carlos B. Gonzalez ◽  
Agustin F. Zarzosa

In this paper we present the film Philadelphia as an exemplary text for teaching business ethics. For this purpose, we show students three scenes from the film and guide them as they engage in ethical reasoning. Through the exercise, students should: understand the nature of ethical dilemmas; understand a model for ethical decision-making and apply it to shed light on selected situations presented in the film; and lastly, understand ethical dimensions of discrimination. After engaging with the exercise, students should also develop a clear understanding of the difficulty of reaching ethical decisions in their professional careers. In addition, the exercise serves as an opportunity to discuss issues of HIV and AIDS in contemporary organizations.


Author(s):  
Julian C. Hughes

This chapter starts by reviewing four of the main ethical theories – consequentialism, deontology, principlism, and virtue ethics – looking at their relevance to old age psychiatry. Next comes a practical framework, which can be used to deal with particular ethical dilemmas. The chapter goes on to consider the report on dementia produced by the Nuffield Council on Bioethics in 2009, with its emphasis on the importance of personhood and solidarity. In the final section arguments around assisted dying are discussed. Throughout the chapter the aim is to locate clinical practice in the broader field of ethical concerns, in which the person’s inter-relatedness with the broader social context is emphasized. Clinical decisions need to be seen as ethical decisions, which are either right or wrong, and which reflect the fundamental nature of ethical reasoning.


1992 ◽  
Vol 20 (2) ◽  
pp. 191-206 ◽  
Author(s):  
A. Martin Lerner ◽  
Elliot D. Luby

Consumerism, patient rights legislation, and malpractice litigation have created a greater power symmetry between patient and physician. Patients read, question, and insist upon greater participation in decision-making involving treatment. The ideal patient is knowledgeable and an active negotiator in the physician/patient relationship. However, there are some patients who feel so empowered that they are determined to direct and control their treatment. They may request or refuse laboratory tests and attempt to dictate the terms under which diagnosis and treatment should be accomplished. There are as well some physicians who, as a result of conciliatory personal styles, are willing to accommodate to the demands of these patients. In this article, four cases are presented in which physicians have accepted those terms against their better judgment. In two cases malpractice suits followed, ultimately won by the defendant physician. In the last instance a physician patient committed suicide and a malpractice action was settled by mediation. These four case examples establish the principle that physicians, for whatever reason, cannot accommodate the demands of empowered patients that contradict clinical judgment and violate the scientific practice of medicine. Such accommodation may have disastrous results for both patient and physician. Physicians should listen compassionately to patients’ needs and desires, but they may have to refer a patient elsewhere when a negotiated consensus cannot be reached.


1995 ◽  
Vol 15 (3) ◽  
pp. 131-135 ◽  
Author(s):  
AL Gaul

Critical care nursing by definition focuses on human responses to life-threatening problems. An increasing number of ethical dilemmas confronts the critical care nurse. A traditional principled orientation to ethical reasoning requires detachment that does not acknowledge the special nature of the nurse-patient relationship and, by itself, does not give satisfactory direction in resolving ethical dilemmas. An ethic of care that acknowledges the special relationship and connection of one human being with another may provide the necessary guidance to assist the nurse in resolving these dilemmas. Critical care nursing practice based on an ethic of care acknowledges and legitimizes care for patients as well as oneself.


2008 ◽  
Vol 18 (1) ◽  
pp. 31-37
Author(s):  
Stephen Parker

Any therapeutic profession, including Yoga therapy, must establish a systematic way to make ethical decisions. This article proposes a model of ethical decision-making drawn from psychotherapy, a field that—like Yoga therapy— recognizes relationship as a healing instrument. The model proposed is based on an easily remembered mnemonic that is both practical and easily internalized for real-life decision-making. A real case study using this method is presented and discussed, and hypothetical ethical dilemmas in Yoga therapy are offered for further consideration.


2019 ◽  
Vol 1 (1) ◽  
pp. 40-50
Author(s):  
Jose Luis Turabian

Psychology and sociology share a common object of study, human behaviour, but from different perspectives. Sociologists have focused on macro variables, such as social structure, education, gender, age, race, etc., while psychology has focused on micro variables such as individual personality and behaviours, beliefs, empathy, listening, etc. Despite the importance of interpersonal relationship skills, they depend on the community or social context in which communication takes place, and by themselves may have little relevance in the consultation. The purely psychological analysis of the doctor-patient relationship often leads to an idyllic vision, with the patient-centred consultation as the greatest exponent, which rarely occurs in real life. The purely sociological or community / social analysis of the doctor-patient relationship leads to a negative view of the consultation, which is always shown as problematic. But, the psychological system in the doctor-patient relationship cannot be neglected, and its study is of importance, at least as an intermediate mechanism that is created through socio-community relations. Although the same social causes are behind the doctor-patient relationship, when acting on psychological factors in the consultation, they act as an optical prism scattering socio-community relations that affect the doctor and the patient, giving rise to a beam of different colors of doctor-patient relationship. In doctor-patient relationship there is a modality of psychotherapy, where attitudes, thoughts and behaviour of the patient, can be change, as well as it can be extended on the way of understanding and therefore changing, his social context. Because of the distance between socio-community relations and the form of doctor-patient relations is growing in complex societies, under these conditions, the sociological factor gives the important place to the psychological factor. Given these difficulties of the doctor-patient relationship one may ask how general medical practice can persist with the usual model of doctor-patient relationship. Pain and the desire to relieve them are the basic reasons for the patient and the doctor, and they do not disappear due to the contradictions of the doctor-patient relationship. In this way, the confrontation between sociological and psychological vision is replaced by an alliance of both currents, and each of them takes on meaning only in the general vision.


Public Voices ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 7
Author(s):  
Kade R. Minchey

The article describes daily ethical decisions required of social workers. It presents two cases that called for ethical consideration.


2021 ◽  
Vol 27 (1) ◽  
pp. 1-13
Author(s):  
James J Delaney

Abstract The nature of the doctor–patient relationship is central to the practice of medicine and thus to bioethics. The American Medical Association (in AMA principles of medical ethics, available at: https://www.ama-assn.org/delivering-care/ethics/patient-physician-relationships, 2016) states, “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.” In this issue of Christian Bioethics, leading scholars consider what relevance (if any) Christianity brings to the relationship between physician and patient: does Christianity make a difference? The contributors consider this question from several different perspectives: the proper model of medicine, the role that the Christian moral tradition can play in medicine in a secular pluralistic society, how a Christian understanding of virtue can inform practices such as perinatal hospice and physician-assisted suicide, and whether or not appeals to Christian values can (or should) ground a physician’s right to conscientious objection.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibrahim El-Sayed Ebaid

Purpose Undergraduate accounting program at Umm Al-Qura University in Saudi Arabia is a unique case. The program includes 147 credit hours of which 28 credit hours are religious courses. This study aims to examine the effect of teaching these religious courses on students’ ethical perceptions and decisions. Design/methodology/approach A survey was conducted for a sample of accounting students at Umm Al-Qura University. The sample was divided into two groups; the first group includes students who did not study religious courses, while the second group includes students who study religious courses. The questionnaire contained three groups of questions that aimed to explore students’ perceptions of ethics in general, students’ perceptions of business ethics and explored their ethical attitudes regarding some accounting decisions that involve ethical dilemmas. Independent two-sample t-test and multiple regression analysis were used to determine whether the responses of the two groups were significantly different. Findings The findings of the study revealed that teaching religious courses led to an improvement in students’ perception of business ethics and an improvement in students’ ethical decision-making. However, the results of the independent sample t-test showed that this improvement was not significant. The results of the study also revealed that male students tend to make less ethical decisions than female students. Research limitations/implications The findings offer an indication for those responsible for managing the accounting program at Umm Al-Qura University to start developing the program so that some of the general religious courses are replaced with specialized courses in accounting ethics that focus directly on ethical dilemmas faced by the accountant when practicing the accounting profession. Originality/value This study contributes to the current literature related to examining the effect of teaching ethics courses on the ethical perception of accounting students by focusing on accounting students in Saudi Arabia as a context that has not been examined before.


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