Ethical Dilemmas, Needs and Unmet Needs in European Psychiatry – A Survey Made by the European Psychiatric Association (EPA)

Abstract

During the present decade matters of ethics have been increasingly the focus of European National Psychiatric Associations and on the agenda of the European Psychiatric Association (EPA). Discussions in the association’s ethical committee have scrutinized the problems and elucidated the range of ethical dilemmas. A questionnaire sent by the Committee in 2011 to the National European Psychiatric Associations has given a panorama of the ethical problems in European Psychiatry and shown their diversity and even communalities. This overview has been presented at different meetings of the EPA and has recently been reviewed, updated and additionally commented by all committed European national associations. Hereby, new problems in European psychiatry have emerged or became again underlined e.g. the demand on psychiatry’s ethical involvement in end of life issues as well as the consequences of financing routines in times of resource limitations and changed prioritizations within medical care and mental health support systems implied by an ever more predominant market economy. Other re-emerged problems are questions and problems in contact with private sectors of users’ organizations, care providers or pharmaceutical industries and the need and strategies for multidisciplinary involvement in psychiatric education and research support. In this article these newly emerged ethical challenges will be elucidated and some positions of national psychiatric associations and their recently updated priorities regarding ethical challenges will be reviewed. Activities and structures regarding a continuous ethical sensitization as well as needs of a sustainable ethical agenda in European psychiatry are addressed.