Establishing the validity of information gathered from patients with antisocial tendencies can be challenging, particularly when no immediate corroborative sources of information are available, and a long-term history of criminal activity is suspected. With the advent of technology such as the internet, other means of gathering information is at the treating clinician’s disposal. The handling of information gathered from non-certifi ed sources of information is a delicate matter, and care should be taken in how this information is verifi ed, disseminated (...) and used to optimize the outcomes for the patient and other parties involved. Further, the treating clinician may be faced with obstacles in determining the true risk of harm by such patients to themselves and others, and subsequently, a range of confl icting ethical issues involved in the patient’s management plan are raised. These include respect for the patient’s confi dentiality, maintaining equal treatment of the patient relative to other patients on the ward, ensuring that no harm comes to the patient, and a duty of care to external parties including the general public. (shrink)

In 1997 the FDA relaxed restrictions on the practice of direct-to-consumer pharmaceutical advertising . The subsequent increase in advertisements aimed at potential patients had a signifi cant impact on rates of drug prescription. This paper gives a brief history of visual representations of mental illness used by DTCA and examines ethical concerns raised by DTCA, specifi cally for psychotropic medications. Issues discussed include overestimation of symptoms and over-prescription of unnecessary drugs, modifi cation of social perception and the perpetuation of stigma, (...) and exploitation of vulnerable potential patient groups. (shrink)

Critics off er a number of objections against the use of physical restraints in psychiatric care. The objections typically cite the diffi culty in reconciling this treatment with trends towards increasing respect for patient autonomy and dignity. Critics also question whether the effi cacy of such treatments have been adequately studied, risks have been properly identifi ed, and so on. Although we should take these concerns seriously, they must be set against the sometimes ambiguous nature of the caregiver’s obligations, as (...) well as the perceived sophistication of alternative treatments. Restraint-use necessarily involves medical paternalism, and there are institutional safeguards should continually be reexamined in light of what we learn about patient care. Still, were we to deny caregivers the authority to restrain their patients we might create ethical problems at least as great as those that restraint-use is said to create. (shrink)

In recent years promoting forgiveness has become popular in mental health circles. Lending credence to its popularity is research suggesting that forgiveness improves mental health. Those who caution against universal forgiveness most often write from the vantage point of philosophy, where the emphasis is on forgiveness as an ethical issue, one concerning rights and duties, versus a psychological issue. In cases of trauma, issues of forgiveness are often of paramount concern – both forgiveness of others and self-forgiveness. Due to guilt (...) and shame over the trauma, individuals may engage in self-harm behavior as a form of self-punishment, which in turns refl ects damaged selfrespect. The paper focuses primarily on self-forgiveness and restoration of self-respect in situations of trauma. In order for self-forgiveness to occur, a moral community must take a role in providing safety and restorative love. The paper explores perspectives on forgiveness, self-forgiveness and trauma. (shrink)

Autism is currently one of the most pressing issues in healthcare. Scholarship on the topic is commonly found among psychologists, educators, and, to some extent, philosophers. Surprisingly little scholarship, however, has focused on the ethical issues relevant to autism. Bioethicists ought to give autism consideration, though this may prove to be more diffi cult than it seems at fi rst glance. The neurodiversity movement is likely to be credited with starting discussions on autism and related issues of justice and ethics, (...) but perhaps this movement has set its sights short. Rather than looking for recognition of neurological divergence, a society that is grounded in neurological pluralism may be better suited to reach this movement’s aims. (shrink)