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Book Forum: Ethics and Forensics   |    
Concise Guide to Ethics in Mental Health Care
Am J Psychiatry 2004;161:1937-1937. doi:10.1176/appi.ajp.161.10.1937
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Greenwood Village, Colo.

By Laura Weiss Roberts, M.D., and Allen R. Dyer, M.D., Ph.D. Arlington, Va., American Psychiatric Publishing, 2004, 354 pp., $29.95 (paper).

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It is no easy task to compile a theoretical, empirical, and clinical text on ethics that will be useful for psychiatrists, psychiatric residents, medical students, and other mental health professionals. However, Roberts and Dyer have ably provided an easy-to-read, lively, interesting, and comprehensive guide to ethics. Although it contains some of the necessary theoretical and empirical studies that underlie some of the assertions, it aims to be practical in nature and a ready reference for the reader confronted with the most common ethical dilemmas. There are thoughtful chapters on professionalism, confidentiality, informed consent, and ethical decision making. There are also very interesting and novel chapters on ethics in psychotherapy, high-risk situations, children, "difficult" patients, end-of-life issues, genetics research, managed care, and clinician health. Each chapter provides a good theoretical discussion of the critical issues, case vignettes, and useful tables, forms, or charts that amplify or simplify ethical decision making.

While covering most of the issues that affect practicing psychiatrists or residents, the book still has room for some additional ethical discussion topics that face physicians on an almost daily basis. Some of these include gifts to physicians from industry, involving patients in advocacy efforts, self or family treatment, accepting gifts from patients, confidentiality after a patient’s death, and working with other professionals and mental health professionals. The interested reader will find discussions of these topic areas in the Opinions of the American Medical Association Council on Ethical and Judicial Affairs and the American Psychiatric Association Ethics Committee and in the additional readings suggested by the authors.

This book also provides an interesting crosswalk between therapeutic dilemmas that have within them ethical conflicts. Sometimes good therapy solves ethical conflicts, but sometimes understanding an ethical conflict and a good ethical solution leads to better patient care. Raising awareness in the reader for what others have thought through in these topical chapters will be very useful to both novice and experienced psychiatrists. This book could also serve a beneficial purpose in ethics curricula for psychiatric residency, where core competency in professionalism is now recognized as an integral part of the necessary skills and knowledge to be a well-trained psychiatrist.




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