Making a situational diagnosis. Psychiatrists at the interface of psychiatry and ethics in the consultation-liaison setting.
Psychiatrists bring a unique understanding to clinical ethics, but psychiatrists need a precise awareness of the difference between exercising their clinical expertise and facilitating ethical decisionmaking. The author outlines a schema for recognizing and honoring that distinction and illustrates "pseudoethics," "pseudopsychiatry," and "psychiatry/ethics" consultations. The author describes how to make a "situational diagnosis" that includes patient/family issues, staff issues, joint issues, legal/regulatory issues, and ethical issues, thus enabling the psychiatrist to institute an appropriate "hierarchy of interventions": educational, psychological, and ethical. The literature on ethics education for psychiatric practitioners is reviewed and a program is suggested.
Lederberg
M S
MS
Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
D000328:Adult; D001675:Bioethics; D026822:Ethicists; D033061:Ethics Consultation; D026690:Ethics, Clinical; D004992:Ethics, Medical; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D011570:Psychiatry; D012017:Referral and Consultation; D000078329:Workforce