Byline: Nimesh. Desai The etymological basis of 'responsibility' is to do with the 'ability to respond'. It may be added that the response be an able, adequate response and tailored to the 'need'. It is my contention that the increasing acceptance of mental health as a scientific discipline, and the potential it has for alleviation of human suffering, places the professionals of mental health in a situation wherein awareness about the responsibility is inescapable. Internationally, this has been the regular refrain most notably in the writings on ethical aspects of psychiatric practice. Paul Chodoff identified four major responsibilities of psychiatrists, viz. (i) the responsibility of competence or the need to master their task; (ii) the responsibility of ethical behaviour or to police their ranks; (iii) the responsibility of accountability or to be accountable to the public; and (iv) the responsibility of advocacy or to be advocates for the mentally ill persons.[1] Lazarus concurred with the views of Chodoff and, while saying that 'it is likely that the twenty-first century psychiatrist will occupy new roles but continue in the clinical treatment of the mentally ill', suggested the following guidelines to consider (both for psychiatrists and the system in which they work):[2] (i) psychiatrists have an ethical obligation to rise above any profit motive and serve as patient advocates; (ii) psychiatrists should provide treatments that are potentially beneficial and chosen by informed patients; (iii) beneficial psychiatric treatments should include those empirically demonstrated to provide benefit that is valued by patients, regarded as part of standard of care, and recommended by established practice guidelines; (iv) if allocation decisions are made, the manner in which these decisions are made and the influence of the treatment philosophy on patient care should be disclosed to patients in a clear manner in advance; (v) treatment decisions should, to as great an extent possible, continue to be a joint enterprise between psychiatrist and patient; (vi) psychiatrists serving in administrative roles have the same professional ethics as clinicians. If they choose to follow a different set of ethics, they are ethically obliged to disclose their ethical standards to other physicians and patients; (vii) organized systems of care should foster a spirit of patient advocacy by professionals who are treating patients; (viii) if there is an obligation assumed by a system of care to conserve society's resources, then all involved (patients, professionals, administrators and other stakeholders) should benefit, profit, or be adversely affected by making proportionate gains or sacrifices; (ix) psychiatrists must continue to behave in a manner that will maintain trust in the doctor-patient relationship and not engage in behaviour that will harm the patient; (x) psychiatrists should be actively involved in any social policy debates that affect psychiatric patients; (xi) psychiatrists must advocate for fair treatment of psychiatric patients in all healthcare systems. In the Indian context, concerns have been expressed by individual professionals and the Indian Psychiatric Society about the basic issues of ethics in psychiatric practice as well as the need to identify responsibilities of psychiatrists. The Indian Psychiatric Society had adopted a code of Ethics for Psychiatrists in 1992, outlining the major principles of (i) responsibility, (ii) competence, (iii) benevolence, (iv) moral standards, (v) patient welfare, and (vi) confidentiality. A number of Presidential Addresses have focused on various aspects of the subject.[3],[4],[5],[6] Professional Responsibilities The duty to be a competent professional is the most fundamental obligation, and yet is important enough to be stated in the context of India and many other developing countries. The need to emphasize it is in the context of the lack of uniform standards for obtaining the requisite qualification and the lack of monitoring of standards. …