Volume 37 · Number 12
DECEMBER 2007

Care Ethics: What Psychiatrists have been Waiting for to Make Sound Ethical Decisions

By Sidney Bloch, MD, PhD

Psychiatrists have to contend with myriad ethical dilemmas in their clinical encounters, including such profound issues as suicide, patients threatening to harm others, impaired reasoning capacity to provide informed consent, involuntary treatment, therapists imposing their personal values on patients, the use of treatments with potentially irreversible side effects, and maintaining a person’s most intimate secrets. Furthermore, the profession has been buffeted by external pressures, which derive from its unique role in society in tandem with its blurred professional boundary and erratic diagnostic criteria. The place of the asylum as essentially a custodial institution and form of social control for more than three centuries, the abuse of psychiatry to suppress dissent as occurred in the former Soviet Union, the societal stigma of suffering from a mental illness, and psychiatry in Nazi Germany when it metamorphosed into a profession governed by an abhorrent ideology are but a few of the events or realities that have shaken the profession and all it stands for.

ABOUT THE AUTHOR

Sidney Bloch, MD, PhD, is Professor, Department of Psychiatry and Centre for Health and Society, University of Melbourne, Australia.

Address correspondence to: Prof. Sidney Bloch, Department of Psychiatry, University of Melbourne, St. Vincent’s Hospital, Melbourne, Australia 3065; or e-mail: s.bloch@unimelb.edu.au. Dr. Bloch has disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

1. Assess the limitations of current ethical theories applied to psychiatry.
2. Describe the care dimension to resolution of ethical dilemmas.
3. Summarize the potential contribution of care ethics to psychiatry.