Psychiatric diagnosis

Prior discussions of ethics in psychiatric diagnosis have focused on the development of classifications of psychopathology and the social features and implications of the use of psychiatric diagnostic categories. This chapter focuses instead on the ethics and values involved in the conduct of psychiatric diagnostic assessment ethics in the practice of diagnosing in mental health. The authors build an account of ethics of diagnostic practice using virtue epistemology theory, undergirded by Pellegrino’s account of medical morality as helping, healing, caring, and curing. The authors develop a set of diagnostic virtues (receptivity, empathy, inquisitiveness, self-knowledge, rigour, resolve, fallibilism, fecundity, practical wisdom, and faithfulness) and apply them to an illustrative case scenario.

Christian Bioethics: Immanent Goals or a Transcendent Orientation?

This issue of Christian Bioethics explores foundational debates regarding the orientation and application of Christian bioethics. Should Christian bioethics be approached as essentially a human activity, grounded in scholarly study of theological arguments and religious virtues, oriented toward practical social ends, or should Christian bioethics be recognized as the result of properly oriented prayer, fasting, and asceticism leading to an encounter with God? The gulf between these two general perspectives—the creation of immanent human goods versus submission to a fully transcendent God—is significant and, as ongoing debate in Christian Bioethics: Non-Ecumenical Studies in Medical Morality over the past nearly three decades has made clear, the implications are both intellectually engaging and spiritually profound.

Ethics and Values in Diagnosing and Classifying Psychopathology

Psychiatric diagnosis poses ethical problems because of stigma, the close relationship between personal identity and mental illness, the legal sanctions associated with regulating mentally disordered individuals, and the value-diversity associated with judgments of psychopathology. The ethics of diagnosis can be split into two aspects: first, that of the individual practitioner working with a patient, and second, the developmental process involved in describing psychopathology and classifications of mental illness. The first half of this chapter describes the ethical and aesthetic values involved in good diagnostic practice by clinicians, in reference to Pellegrino’s medical morality of helping/healing/caring/curing. The second half considers the ethics of developing classifications of psychopathology, focusing primarily on the American Psychiatric Association’s DSM manuals and examining them under the ethics lenses of the social aspects of the conduct of science, the ethical aspects of managing a nosological effort, and addressing conflicts between professional/service-oriented interests and selfish/guild interests.

Toward a Directed Benevolent Market Polity: Rethinking Medical Morality in Transitional China

Healthcare systems in Singapore, Hong Kong, and mainland China are strikingly distinct from those in the West. Economically speaking, each of the aforementioned Eastern systems relies in great measure on private expenditures supplemented by savings accounts. Western nations, on the other hand, typically exhibit government funding and wariness about healthcare savings accounts. This essay argues that these and other differences between Pacific Rim healthcare systems and Western systems should be assessed in light of background Confucian commitments operating in the former. In the Confucian context, bioethics and healthcare policy have a unique content, texture, and set of implications that often affront Western assumptions about the appropriate individual autonomy of patients and the appropriate character of social safety nets for healthcare.