Ethical Commitments and Social Issues in Psychiatry

Abstract

Sound, ethical decision making is essential to astute and compassionateclinical care. Wisepractitioners readily identify and reflect on the ethical aspects of their work. They engage, often intuitively and without much fuss, in careful habits—in maintaining therapeutic boundaries, in seeking consultation from experts when caring for patients with difficult or especially complex conditions, in safeguarding against danger in highrisk situations, and in endeavoring to understand more about mental illnesses and their expression in the lives of patients of all ages, in all places, and from all walks of life. These habits of thought and behavior are signs of professionalism and help ensure ethical rigor in clinical practice. Psychiatry is a specialty of medicine that, by its nature, touches on big moral questions. The conditions we treat often threaten the qualities that define human beings as individual, autonomous, responsible, developing, and fulfilled. Furthermore, the conditions wetreat often are characterized by great suffering, disability, and stigma, and yet individuals with these conditions demonstrate such tremendous adaptation and strength as well. If all work by physicians is ethically important, then our work is especially so. As a service toFocusreaders,thiscolumn provides ethics commentary on topics in clinical psychiatry. It also offers clinical ethics questionsandexpertanswersinordertosharpenreaders’decisionmaking skills and to advance astute and compassionate clinical care in our field. Laura Weiss Roberts, M.D., M.A.