Document Detail

Stigma, conscience, and science in psychiatry: past, present, and future.
MedLine Citation:
PMID:  19318767     Owner:  NLM     Status:  MEDLINE    
In his response to Reynolds and colleagues' "The Future of Psychiatry as Clinical Neuroscience," the author considers three themes prominent in the history of psychiatry: stigma, conscience, and science, considering each in the past, present, and into the future. A series of conclusions follow these historical perspectives. One, unraveling the web of stigma in the future depends more on moral, educational, and political achievements than neuroscientific ones. Two, psychiatry's future depends upon the public trust, which has fluctuated over its history and into the present era, during which legacies of undue influence and failed regulation have damaged this trust. While explaining the mechanisms for mental disorders is crucial, the returns from these scientific investments are decades away, and failures of conscience today undermine the vital public trust and impede psychiatry's abilities to immediately address the plight of the mentally ill. Three, the researcher-entrepreneur in perennial search of funding has replaced the old model of the curious researcher-practitioner. This drive for funding promotes hubris and failures of conscience in psychiatric science. Moreover, the information explosion and superspecialization of contemporary academic medicine has led to an intellectual fragmentation analogous to the service fragmentation at the beginnings of psychiatry. Attention to integrative synthesis of research information, as well as conscientious moral reflection on scientific advances, will promote humility over hubris: enhancing the public trust, assuring public confidence in psychiatric science, and empowering patients.
John Z Sadler
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Publication Detail:
Type:  Comment; Historical Article; Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  84     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  413-7     Citation Subset:  AIM; IM    
Department of Psychiatry and Clinical Sciences, Division of Ethics and Health Policy, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9070, USA.
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MeSH Terms
Attitude to Health
Commitment of Mentally Ill / history,  trends
History, 15th Century
History, 18th Century
History, 19th Century
History, 20th Century
Hospitals, Psychiatric / history
Mental Disorders / therapy
Mentally Ill Persons
Psychiatry / trends*
Comment On:
Acad Med. 2009 Apr;84(4):446-50   [PMID:  19318776 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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