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An ethical framework for psychiatry

Department of Psychiatry, University of Melbourne, Australia

STEPHEN A. GREEN, MD, MA

Department of Psychiatry, Georgetown University School of Medicine, Washington, District of Columbia, USA

Correspondence: Professor Sidney Bloch, Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Melbourne, Australia 3065. E-mail: s.bloch{at}unimelb.edu.au

Declaration of interest None.

Summary Psychiatry has not reached a consensus hitherto concerning an optimal theoretical framework for ethical decision-making and corresponding action. Various theories have been considered, but found wanting. Moreover, classic theories may contradict one another, contribute to confusion and immobilise the clinician. We have examined major theories commonly applied in bioethics, conferred with moral philosophers and psychiatrists and striven to apply more recent insights drawn from moral philosophy. We report that instead of pursuing a single theoretical framework, we should garner the strengths of compatible approaches in a synergistic way. We propose a particular complementarity of principlism - with its pragmatic focus on respect for autonomy, beneficence, non-maleficence and justice - and care ethics, a variant of virtue theory, which highlights character traits pertinent to caring for vulnerable psychiatric patients.

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