Psychiatrists usually select therapeutic modalities for their patients
on the basis of empirical and theoretical considerations. Only in special
circumstances (e.g., psychosurgery) are ethical concerns primary. Yet every
therapeutic decision involves questions of value and requires ethical
justification. The author outlines four resources for ethical direction in
therapy: a general systems or biopsychosocial formulation of the clinical
problem, the historic ethical commitments of the medical profession, the
patient's informed perspective, and the psychiatrist's own values. Finally,
a method is proposed for the resolution of conflicts among these four
perspectives in individual cases.
Abstract Teaser