Core ethical questions: what do you do when your obligations as a psychiatrist conflict with ethics?
Psychiatrists face many difficult ethical decisions in which they must exercise their discretion. In the most difficult decisions they confront, there are significant "harms," regardless of what they choose. The best they can do in these instance is to be as acutely aware of the most important pros and cons as they can. This article will discuss such pros and cons in regard to, particularly, informing patients when they may be dangerous to themselves or others, have dementia, and have genetic illness. This article will also discuss giving moral weight to the psychiatrist's own interests when making these ethical decisions.
Dr. Howe is Professor, Department of Psychiatry, Director, Programs in Medical Ethics, and Senior Scientist, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
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