ABC Radio National’s The Philosopher’s Zone had a fascinating discussion recently on the ethics of psychiatry, tackling some of the challenges of this unique medical speciality.
Perhaps the most obvious aspect of psychiatry which distinguishes it from other medical specialities is that it more commonly involves treating people against their will.
The laws on involuntary treatment vary, but most include the principle that someone who is judged to have their lost their insight into their own condition because of mental illness, is at risk to themselves or others, and who refuses voluntary treatment can be treated against their will.
Of course, this relies on a huge amount of other assumptions, such as the ability to distinguish between normal and abnormal mental states, and an idea of what constitutes insight.
It also relies on a presumption that psychiatrists can distinguish between potentially foolish but reasoned refusal of treatment, and a refusal driven by pathological thinking.
The programme tackles many of these issues and discusses how these decisions are affected by cultural norms and political influence, as well as how they fit in with the wider ethical approach of medicine.