Ethics in Psychiatric Practice: Essential Ethics Skills, Informed Consent, the Therapeutic Relationship, and Confidentiality

2002 ◽  
Vol 8 (5) ◽  
pp. 290-305 ◽  
Author(s):  
LAURA WEISS ROBERTS ◽  
CYNTHIA M. A. GEPPERT ◽  
ROBERT BAILEY
Keyword(s):  
Informed Consent ◽  
Therapeutic Relationship ◽  
Psychiatric Practice

scholarly journals Psychotherapy Ethics in Twentieth-Century Literature

2020 ◽  
Author(s):  
Anna Magdalena Elsner
Keyword(s):  
Twentieth Century ◽  
Informed Consent ◽  
Therapeutic Relationship ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Literary Texts ◽  
Twentieth Century Literature ◽  
Ethical Challenges ◽  
Key Characteristics ◽  
Century Literature

Ethical issues arising in the practice of psychotherapy, such as confidentiality, boundaries in the therapeutic relationship, and informed consent, figure prominently in a range of twentieth-century literary texts that portray psychotherapy. This chapter analyzes the portrayal of these conflicts, but also stresses that they are often marginal to the overall plot structures of these narratives and that literary depictions of psychotherapy are often vague or even inaccurate concerning key characteristics of psychotherapeutic practice. Focusing on examples that either illustrate professionalism and the absence of ethical challenges in psychotherapy, or take up the ethical reservations that fueled anti-Freudianism or the anti-psychiatry movement, the chapter proposes that selected literary depictions of psychotherapy can play a key role in sensitizing therapists to the complex make-up of ethical dilemmas as well as illustrating the cultural and historical contexts of these dilemmas.

Informed consent in psychiatric practice: where does the law now stand?

2011 ◽  
Vol 28 (2) ◽  
pp. 86-90
Author(s):  
Peter Leonard
Keyword(s):  
Informed Consent ◽  
Medical Profession ◽  
Case Law ◽  
Point Of View ◽  
Psychiatric Practice ◽  
Mental Health Legislation ◽  
Clinical Scenarios ◽  
Legal Duty ◽  
Legal Position ◽  
Health Legislation

AbstractThere is an established ethical and legal duty upon psychiatrists to obtain informed consent before treating a patient, although some exceptions do apply under Mental Health Legislation. The required standard for informed consent has been the subject of important case law in Ireland and other common law jurisdictions and this has caused some uncertainty for clinicians. The standard of informed consent can be viewed from the point of view of what the medical profession thinks is appropriate, or alternatively from the position of what a patient would reasonably expect to be told. These contrasting approaches are discussed in detail. A recent decision of the Irish Supreme Court establishes the ‘patient-centred’ standard for informed consent as the relevant standard in Irish law. The current legal position on informed consent is discussed in relation to common clinical scenarios in psychiatric practice.

Informed Consent: Legal Requirements in Psychiatric Practice

1979 ◽  
Vol 7 (4) ◽  
pp. 479-491 ◽  
Author(s):  
Mary C. Sherman ◽  
F.S. Abuzzahab
Keyword(s):  
Informed Consent ◽  
Psychiatric Patient ◽  
Psychiatric Treatment ◽  
Case Law ◽  
Test Methods ◽  
Psychiatric Practice ◽  
Systematic Research ◽  
Legal Requirements ◽  
Professional Groups ◽  
The Law

Psychiatry and the law interface on the issue of informed consent in a singular way, because of the nature of the psychiatric patient. In the 1970's, with the increase in societal consciousness about psychiatric treatment and commitment procedures, principles regarding informed consent in psychiatric practice have been enunciated in case law. Some fundamental conflicts between psychiatry and the law remain, however, leaving the patient in the middle. No methods of care have been designed by religious and professional groups who oppose psychiatric treatment for those patients who “refuse” treatment. Systematic research is needed to test methods of consent and contents of consent disclosure.

Psychodynamic Psychiatry and the Therapeutic Space in the Era of COVID-19

2021 ◽  
Vol 49 (3) ◽  
pp. 441-452
Author(s):  
Douglas H. Ingram
Keyword(s):  
Therapeutic Relationship ◽  
Natural Experiment ◽  
Psychiatric Practice ◽  
Power Dynamics ◽  
Online Environment ◽  
Digital Object ◽  
Treatment Approaches ◽  
Brick And Mortar ◽  
Therapeutic Space ◽  
Mental Contents

Psychodynamic psychiatric practice during the COVID-19 pandemic has required most clinicians to conduct treatment online or by telephone. The result is a natural experiment that appears to endorse the efficacy of distance therapy. Consequently, the brick-and-mortar consulting room is no longer the presumptive therapeutic space for the conduct of psychodynamic psychiatric or other treatment approaches. The therapeutic space is reconceived as the place or medium intended for treatment and is distinguished from both the therapeutic relationship and conduct of treatment that occurs within that space. How different therapeutic spaces impact treatment is discussed with specific application to psychodynamic psychiatry and virtual venues. The “digital object” becomes a new presence; the patient's freedom to disclose mental contents is retained though empathic attunement is diminished; a shift in power dynamics may occur; timing of sessions gains greater precision in the online environment. Beyond the pandemic, practicing online is likely to become an accepted supplementary therapeutic space for evaluation and treatment by psychodynamic psychiatrists.

Legal Liability for a Patient's Suicide

1986 ◽  
Vol 14 (3-4) ◽  
pp. 409-434 ◽  
Author(s):  
Elizabeth V. Swenson
Keyword(s):  
Informed Consent ◽  
Therapeutic Relationship ◽  
Strict Liability ◽  
Standard Of Care ◽  
Legal Liability ◽  
Fiduciary Duty ◽  
Traditional Theory ◽  
Contract Breach

Lawsuits alleging psychotherapist liability for a patient's suicide have increased in number recently. Although the traditional theory of negligence is still popular, issues involving the standard of care and proof of causation are particularly difficult when one of the parties to the therapeutic relationship is not living. These problems have different implications when failure to prevent suicide is alleged than when a psychotherapist is said to have caused the suicide. In the latter, the presence of informed consent and assumption of the risk must be carefully evaluated as defenses. Alternative theoretical bases for these suits include implied contract, breach of fiduciary duty, and strict liability.

Opinion: consentement éclairé et capacité en pratique clinique psychiatrique (une perspective québécoise)

1989 ◽  
Vol 34 (2) ◽  
pp. 110-114
Author(s):  
Denis Morrison
Keyword(s):  
Informed Consent ◽  
Fundamental Question ◽  
Psychiatric Practice ◽  
Consentement Éclairé ◽  
Final Answer ◽  
Pratique Clinique

This paper on informed consent and psychiatry, asks the fundamental question if informed consent doctrine applies or not to psychiatric practice. In a dialectic between systems of thought in psychiatry and law, the author stresses the importance of particular clinical situations which can be addressed or not in terms of application of informed consent doctrine. The purpose of the paper is not to give a final answer but to bring questions and stimulate thought.

A Virtue-Based Approach to Neuro-Enhancement in the Context of Psychiatric Practice

2015 ◽  
Author(s):  
Jennifer L. Hansen
Keyword(s):  
Case Studies ◽  
Therapeutic Relationship ◽  
Psychiatric Practice

By adopting a virtue-based approach to neuro-enhancement, I argue that facilitating neuro-enhancement within the therapeutic relationship may pervert the practice of psychiatry in so far as it risks corrupting virtues important to the healing project. I further argue that the neuro-enhancement question emerges more often when exclusively principle-based approaches, supported by market-oriented and technological trends in medicine, frame the debate. Finally, I draw on case studies to clarify some varieties of neuro-enhancement in the context of psychiatric practice as well as to specify the three most important virtues undermined by neuro-enhancement—trustworthiness, respect for the healing project, and engagement.

scholarly journals Consent in psychiatric biobanks for pharmacogenetic research

2013 ◽  
Vol 16 (3) ◽  
pp. 677-682 ◽  
Author(s):  
Frederieke H. van der Baan ◽  
Rose D. C. Bernabe ◽  
Annelien L. Bredenoord ◽  
Jochem G. Gregoor ◽  
Gerben Meynen ◽  
...  
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Psychiatric Patients ◽  
Psychiatric Practice ◽  
Pharmacogenetic Testing ◽  
Informed Consent Procedure ◽  
Pharmacogenetic Research ◽  
Consent Procedure ◽  
Opt Out ◽  
Increased Risk

Abstract In psychiatric practice, pharmacogenetics has the potential to identify patients with an increased risk of unsatisfactory drug responses. Genotype-guided treatment adjustments may increase benefits and reduce harm in these patients; however, pharmacogenetic testing is not (yet) common practice and more pharmacogenetic research in psychiatric patients is warranted. An important precondition for this type of research is the establishment of biobanks. In this paper, we argue that, for the storage of samples in psychiatric biobanks, waiving of consent is not ethically justifiable since the risks cannot be considered minimal and the argument of impracticability does not apply. An opt-out consent procedure is also not justifiable, since it presumes competence while the decisional competence of psychiatric patients needs to be carefully evaluated. We state that an enhanced opt-in consent procedure is ethically necessary, i.e. a procedure that supports the patients’ decision-making at the time when the patient is most competent. Nevertheless, such a procedure is not the traditional exhaustive informed consent procedure, since this is not feasible in the case of biobanking.

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