Abstract

This reflective paper focuses on the moral and ethical difficulties medical care providers meet in applying DSM-IV criteria of Post Traumatic Stress Disorder in therapy and in Compensation and Pension Examinations. Providers may be less interested in articulating a philosophy of life or their own ontology than about documenting care for the patient or providing effective management of symptoms of Post Traumatic Stress Disorder. The veteran comes for assessment or therapy after an embodiment of war conflicts. Examiners and therapists spend time in clinical judgments and ethical consideration. Ethical decisions involve the sanctity of human life and the distinction made between acceptable civil and war behavior. Insight into the conflicting values found in the veterans' struggle to cope with the stress of war is needed. The stress of sending young men into harm's way is an ethical issue for veterans and the society which sends them and thereby compromises the sanctity of human life. These ethical components require the doctor and the veteran to articulate their values within ontology or a personal philosophy of life. That exchange contributes to accurate assessment and adequate therapy. Not understanding the importance of personal ontologies in treatment may make the veteran's self-disclosure difficult. Self-disclosure of one's ontology is one side of coping with Post Traumatic Stress Disorder. The other side is for powerful decision-making groups to disclose to the young recruits the full and honest account of the human cost of war before sending them into harm's way.

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