Psychiatric Ethics

Psychiatric Ethics is one of the best collections of articles in its area.  Most of the authors are psychiatrists, and the book is aimed primarily at mental health professionals, but it is accessible to others as well.  Most of the authors are from the USA, but there are some international contributions, especially from the UK.  It compares well with the more patchy and diverse collection of articles edited by Rem Edwards in Ethics of Psychiatry. 

            It’s a large work, with 24 chapters and 550 pages.  Most of the articles appeared in the earlier second edition, but have been updated or even substantially rewritten for this third edition, and so the information in the book is still current.  There’s only a little discussion of legal issues, since the focus is very much on the ethical problems faced by mental health professionals, and especially psychiatrists.  The writing is mostly clear and the stances taken by the authors are mainstream: antipsychiatry and radical views are given very little space.

            Some chapters are of course better than others.  Glen Gabbard gives a very useful discussion of “Boundary violations” with several helpful cases to illustrate his points.  Bill Fulford gives one of the lengthiest papers, setting out the philosophical issues behind the definition of mental disorder; it is one of Fulford’s clearest pieces of work, and repays careful study. Paul Brown and Christos Pantelis give a very thorough discussion of “Ethical aspects of drug treatment,” covering different medications, assessing the risks and benefits, getting informed consent, patients’ rights, treatment refusal, and pharmacoeconomics.  One of my favorite chapters is on “Ethics and child psychiatry,” by Philip Graham, in which he outlines a number of important issues with great clarity and common sense. 

            The book has an appendix of codes of ethics, which is informative, but it would be a mistake to turn to this book with an expectation that it will provide the answer to all ethical problems, or even an algorithm for readers to find the right answer.  Rather, Psychiatric Ethics gives readers materials careful and serious discussions of most of the moral quandaries facing mental health practitioners today, together with some historical background.  Strongly recommended for anyone with a serious interest in this important area.. 

© 2002 Christian Perring. First Serial Rights.