Ethics Primer of the American Psychiatric Association

Book excerpt: In questions of psychiatric ethics, simple "yes" or "no" answers are rare, yet questions arise frequently in the clinical setting. "Should I accept a patient's invitation to a party?" "Is it OK to tell a patient that I, too, have had a depression?" "Can I release sensitive information about my patient without the patient's consent?" "Can I give a psychiatric opinion about someone I've never examined?" A shortage of ethics instruction from medical school through residency has left many psychiatrists facing the increasingly complex field of ethics without a clear guide to ethical decision making and conduct until now. Informed by some of the formal proceedings of the APA Ethics Committee, Ethics Primer of the American Psychiatric Association presents today's ethical dilemmas in eleven informative chapters -- brought to life by the clinical vignettes based on actual cases seen by this primer's distinguished contributors. Boundary violations between the doctor -- patient relationship and any other relationship (e.g., social, sexual/romantic, business) Issues such as informed consent, psychopharmacology, hospitalization, and psychotherapy with children, adolescents, and families Issues such as confidentiality, competence and consent, quality of life, abuse and neglect, and use of restraints with geriatric populations Involuntary hospitalization rife with conflict and controversy where many ethical principles clash (e.g., beneficence, autonomy, informed consent) Reconciling ethical conduct (as delineated in guidelines of the AMA, APA, and Sabin) with managed care's cost containment and rationing of medical services Confidentiality, how this fundamental ethics principle can clash with the business ethics of managed care and insurance companies Gifts from patients and industry when and why they are or are not acceptable The often uncomfortable duty to report colleagues who engage in fraud or deception, from speaking privately with a colleague to referring a concern to a departmental committee, supervisor, or local APA ethics committee (and applicable legal mandates) Emergency care ethics how to ensure proper treatment for psychiatric patients who come to the emergency room with physical illnesses forensic psychiatry, including codes of ethics, boundary issues, and management of allegations of ethical misconduct When consultations and second opinions are needed Including an appendix with selected material from The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry, this clinical guide and reference is sure to stimulate the discussion so integral to maintaining the dynamic tradition of ethics. As such, it is essential reading for every psychiatrist -- whether in training or in established clinical practice -- who aspires to a richer appreciation for the wisdom and subtleties of the guidelines and principles of medical ethics.