Document Detail

Many faces of the dual-role dilemma in psychiatric ethics.
MedLine Citation:
PMID:  18247198     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To identify the various potential manifestations of the dual-role dilemma in the psychiatric ethics literature. METHOD: The terms 'dual role', 'dual agency', 'overlapping roles', and 'double agency' were searched on the electronic databases PubMed, Medline, Embase and PsychInfo. Classic papers in the field of psychiatric ethics and their references were manually searched. Papers were selected for relevance to the topic of the dual-role dilemma in relation to psychiatry. RESULTS: The dual-role dilemma is most explicitly addressed in the literature on forensic psychiatry and military psychiatry. Review of the ethics literature in other fields of psychiatry indicates many instances of the dilemma of psychiatrists facing conflicting obligations akin to the dual-role problem identified in the literature on forensic psychiatry. Many of these dilemmas are characterized by the presence of a powerful third party to whom the psychiatrist has some perceived obligations. CONCLUSIONS: In psychiatric ethics, the dual-role dilemma refers to the tension between psychiatrists' obligations of beneficence towards their patients, and conflicting obligations to the community, third parties, other health-care workers, or the pursuit of knowledge in the field. These conflicting obligations transcend a conflict of interest in that the expectations of the psychiatrist, other than the patient's best interests, are so compelling. This tension illustrates how the discourse in psychiatric ethics is embedded in the social and cultural context of the situations encountered. It appears that as society changes in its approach to the value of liberal autonomy and the 'collective good', psychiatrists may also need to change.
Michael D Robertson; Garry Walter
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Australian and New Zealand journal of psychiatry     Volume:  42     ISSN:  0004-8674     ISO Abbreviation:  Aust N Z J Psychiatry     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-05     Completed Date:  2008-06-11     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0111052     Medline TA:  Aust N Z J Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  228-35     Citation Subset:  IM    
Discipline of Psychological Medicine, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia.
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MeSH Terms
Attitude of Health Personnel*
Child Psychiatry
Commitment of Mentally Ill
Forensic Psychiatry / ethics*,  methods*
Mental Disorders / diagnosis*,  therapy*
Physician's Practice Patterns*
Physician's Role*
Referral and Consultation

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