| A basic decision-making approach to common ethical issues in consultation-liaison psychiatry. | |
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MedLine Citation:
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PMID: 19486816 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Ethical dilemmas are found throughout the daily work of C-L psychiatrists. Unfortunately, most psychiatrists have no more training in ethics than their nonpsychiatric colleagues. Psychiatric consults spurred by ethical dilemmas can provoke anxiety in psychiatrists and leave anxious colleagues without the clear recommendations they seek. C-L psychiatrists, and probably all psychiatrists, need more training in clinical ethics. C-L psychiatrists do not need to become clinical ethicists, but competence in handling the ethical issues most commonly seen in C-L work is needed. The 2008 ABPN guidelines for specialists in psychosomatic medicine mention specific ethics topics important in C-L work, and ways of attaining competence in these areas have been discussed in the C-L literature. The four cases discussed here illustrate the high level of complexity often seen in situations in which ethical dilemmas arise in C-L psychiatry. Given the sometimes furious pace of hospital work, it can be easy for C-L psychiatrists to be seduced by the idea of the quick, focused consult that simply responds to a simple question with a simple answer. Because cases involving ethical dilemmas often involve multiple stakeholders, each with his or her own set of concerns, a brief consult focused only on the patient often leads to errors of omission. A wider approach, such as that suggested by the Four Topics Method, is needed to successfully negotiate ethical dilemmas. Busy C-L psychiatry services may struggle at first to find the time to do the type of global evaluations discussed here, but increasing familiarity with approaches such as the Four Topics Method should lead to quicker ways of gathering and processing the needed information. |
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Authors:
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Mark T Wright; Laura Weiss Roberts |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Psychiatric clinics of North America Volume: 32 ISSN: 1558-3147 ISO Abbreviation: Psychiatr. Clin. North Am. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-06-02 Completed Date: 2009-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708110 Medline TA: Psychiatr Clin North Am Country: United States |
Other Details:
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Languages: eng Pagination: 315-28 Citation Subset: IM |
Affiliation:
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Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. mwright@mcw.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Beneficence Decision Making / ethics* Ethical Analysis Ethics, Medical / education* Female Humans Informed Consent / ethics Male Mental Competency Mental Disorders / therapy Patient Satisfaction Practice Guidelines as Topic Psychiatry / education, ethics* Psychosomatic Medicine / ethics Quality of Life Referral and Consultation / ethics* Treatment Refusal / ethics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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