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In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of Evidence-based medicine (EBM), and critically examines their applicability to psychiatry. Highlighting ethical tensions between psychiatry and EBM, she asks the controversial question - should psychiatrists practice evidence-based medicine at all?
In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of evidence-based medicine (EBM), and critically examines their applicability to psychiatry.
Since its addition to the medical lexicon in 1992, the concept of 'evidence-based medicine' (EBM) has captured the imagination of the medical world, attracting both passionate advocates and ardent opponents. EBM is defined clinically as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." Yet, its boldest claim is an ethical one: that EBM, rather than any other method, is the most effective way to fulfill our moral duty to help patients achieve better health. Academic debate on this point has been deeply polarized, from those who assert that ethical practice is evidence-based practice to those who argue that evidence-based practice impoverishes practice and robs it of ethical substance. Mainstream psychiatrists have endorsed EBM which holds out the promise of greater ethical legitimacy for psychiatric disorders and treatments through improved scientific substantiation. Evidence-based psychiatry arises through the straightforward application of EBM to the practice of psychiatry and thus shares the same ethical goal of EBM, to improve patients' health. Given the ethical debates that have framed psychiatry since its iii inception as a medical specialty, and the particular nature of mental disorders and their treatments, it is unclear if EBM can be applied to psychiatry, and therefore, whether it can deliver on its ethical promises. This thesis project involved two phases. The first, a conceptual phase, included an analysis of EBM's ethical commitments as they are represented in its two authoritative textbooks ('literal' EBM). This provisional analysis was then extended by a qualitative analysis of the views of three groups of participants concerning the ethics of EBM: (1) EBM developers; (2) mental health practitioners; and (3) philosophers or bioethicists. Combining the analyses from both phases, a more complete depiction of the ethics of EBM was developed in order to address the main thesis question. Evidence-based psychiatric practice cannot be ethical practice by itself. Instead, it can play a small ethical role in clinical practice, only if it is situated within the larger value structure of contemporary medicine and psychiatry.
Succinct, user-friendly, thoroughly referenced and prepared by leading experts in the field, this book is the only single textbook you will need to succeed in the Royal College of Psychiatrists' MRCPsych and other related higher examinations. Chapters follow the structure and syllabus of the examination ensuring that you receive the necessary essential information to pass and indeed succeed Approachable and succinct text with colour illustrations and key summary points further help to clarify complex concepts and provide you with useful revision tools The evidence-based approach used throughout is important to help you relate theory and research to clinical practice The book is carefully structured and sequenced to building upon the basic sciences underpinning psychiatry, through to an in-depth description of pharmacological and psychological treatments used.
Ethics in Psychiatry: (1) presents a comprehensive review of ethical issues arising in psychiatric care and research; (2) relates ethical issues to changes and challenges of society; (3) examines the application of general ethics to specific psychiatric problems and relates these to moral implications of psychiatry practice; (4) deals with recently arising ethical problems; (5) contains contributions of leading European ethicists, philosophers, lawyers, historians and psychiatrists; (6) provides a basis for the exploration of culture-bound influences on morals, manners and customs in the light of ethical principles of global validity.
Psychiatry presents a unique array of difficult ethical questions. A major challenge is to approach psychiatry in a way that does justice to the real ethical issues. This book show how ethics can engage more closely with the reality of psychiatric practice and how empirical methodologies from the social sciences can help foster this link.
The bestselling Psychiatric Ethics returns for its fifth edition and has been fully updated to reflect changes to the field in the past decade.
Writing with clarity, coherence, and optimism, the authors summarize fundamental principles, enumerate essential skills, and review recent empirical findings in the overlapping areas of clinical ethics and psychiatry. Case illustrations, tables, and strategic lists enhance the book's 17 informative chapters.
Based on extensive research, this book is a fundamental critique of psychiatry that examines the foundations of psychiatry, refutes its basic tenets, and traces the workings of the industry through medical research and in-depth interviews.
A contemporary case-based discussion of ethical dilemmas faced by researchers in forensic mental health, this book offers useful guidance to anyone planning research in this field. It focuses on problems frequently encountered, such as issues of capacity to consent in forensic settings and the meaning of consent to participate. Chapters cover issues such as the procurement of consent among incarcerated people; the ability of young people to provide consent; the effects of culturally specific lay beliefs about mental illness; confidentiality; multidisciplinary approaches; and ethics in risk assessment research. The contributors address questions such as whether research can be therapeutic, and whether it is ever reasonable to compromise patient confidentiality for the wider benefits of publishing research. Based on empirical data from researchers' own experiences, this comprehensive book will be essential reading for anyone planning research in the area of forensic mental health, and all whose work is in this area.