[Ethics in clinical psychiatry].
Although the significant influence of American bioethics on the Japanese medicine and medical education it does not mention however sufficiently on the psychiatric ethics, so we have to discuss once more what ethical issues stand in the area of clinical psychiatry. In this paper we point out the issues on freedom or restraint of patients, ability of working, psychotherapeutic ethics, informed consent and on using of psychotropic drugs, and comment upon the historical origin of these issues. Disregarding these special issues however, we will mention also the question what is fundamentally ethical in clinical psychiatry. This question relates very nearly with the opposition of materialism and spiritualism in the whole history of psychiatry, so we have to review how these oppositions such as body vs. soul, organic vs. psychogenic, biological vs. psychoanalytical, are treated in the history. As a result of the history it can be expressed that it may cause unethical occurrences if one extremely represents materialism or spiritualism, or reversely the holistic position of both of them to integrate and dissolve the contradiction of these alternative relations. Ethical is, rather, to stay in the middle or transitional area between materialism and spiritualism, and to retain this position always in our fundamental clinical attitude, even if it is very hard and stressful, for it demands to be tolerant of severe ambiguity.
D001675:Bioethics; D004992:Ethics, Medical; D007258:Informed Consent; D010686:Philosophy, Medical; D011570:Psychiatry; D011613:Psychotherapy