‘To know before hand is to freeze and kill’ Commentary on… Should psychiatrists write fiction?

SummaryIn this article I argue that fictional accounts of mental illness should be unethically unobliged. I suggest that art is not generated with conscious ethical intent and provide evidence that art proceeding from an ethical agenda is more likely to be poor art. I also consider ways in which a writer-doctor might need to compromise what they articulate to maintain a professional ethical integrity.Declaration of interestNone.

Self-Other Relationship, History and Interpretation

This paper offers a critical appraisal of Gadamer’s dialogical philosophy of the self-other relationship within the context of interpretation and historical consciousness. According to Gadamer hermeneutics is a theory of interpretation or, rather, the art of interpretation. The task of philosophical hermeneutics is to narrate an ontology of human understanding with the ethical intent of restoring to interpretation a greater sense of “integrity.” The “hermeneutic universe” belongs to the individual worldviews whose structure and content are constructed on the basis of historical precedents. Gadamer situates these precedents in historicity and the tradition of culture, which are resources for their unique interpretations. Gadamer claims that interpretative understanding encounters the other in the dialogical “play” (Spiel) of an ever-unfinished event. The self and the other belong to the horizon of historical consciousness, and it is through this common horizon that the alterity of the other comes into expression.

Ethical behaviour of physicians and psychologists: similarities and differences

ObjectiveTo compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas.Population88 clinical psychologists and 149 family physicians in Israel.MethodSix dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists.ResultsPsychologists’ aggregated mean ethical intention score, as compared with the physicians, was found to be significantly higher (F(6, 232)=22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment (they would continue treating a non-paying patient while physicians would not) and dual relationships (they would avoid treating the son of a colleague). In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague’s inappropriate practice due to personal problems.ConclusionsResponses to the dilemmas by physicians and psychologists can be categorised into two groups: (1) similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and (2) different behaviours when confronting either payment issues or dual relationships.

Ethics in Autoethnography and Collaborative Autoethnography

Autoethnography as an approach to inquiry has gained a widespread following in part because it addresses the ethical issue of representing, speaking for, or appropriating the voice of others. In this article, I place the emergence of autoethnography within its historical context and discuss the contributions and limitations of autoethnography as an approach to inquiry. I examine ethical aspects of autoethnography, showing how the method is rooted in ethical intent, yet autoethnographers nevertheless face ethical challenges. I suggest that collaborative autoethnography, a multivocal approach in which two or more researchers work together to share personal stories and interpret the pooled autoethnographic data, builds upon and extends the reach of autoethnography and addresses some of its methodological and ethical issues. In particular, collaborative autoethnography supports a shift from individual to collective agency, thereby offering a path toward personally engaging, nonexploitative, accessible research that makes a difference.