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Making psychiatry moral again: the role of psychiatry in patient moral development

Abstract:

Psychiatric involvement in patient morality is controversial. If psychiatrists are tasked with shaping patient morality, the coercive potential of psychiatry is increased, treatment may be unfairly administered on the basis of patients’ moral beliefs rather than medical need, moral disputes could damage the therapeutic relationship and, in any case, we are often uncertain or conflicted about what is morally right. Yet, there is also a strong case for the view that psychiatry often works through improving patient morality and, therefore, should aim to do so. Our goal is to offer a practical and ethical path through this conflict. We argue that the default psychiatric approach to patient morality should be procedural, whereby patients are helped to express their own moral beliefs. Such a procedural approach avoids the brunt of objections to psychiatric involvement in patient morality. However, in a small subset of cases where patients’ moral beliefs are sufficiently distorted or underdeveloped, we claim that psychiatrists should move to a substantive approach and shape the content of those beliefs when they are relevant to psychiatric outcomes. The substantive approach is prone to the above objections but we argue it is nevertheless justified in this subset of cases.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/jme-2022-108442

Authors

More by this author
Institution:
University of Oxford
Division:
HUMS
Department:
Uehiro Institute
Role:
Author
ORCID:
0000-0001-5813-0834
More by this author
Institution:
University of Oxford
Division:
HUMS
Department:
Uehiro Institute
Role:
Author
ORCID:
0000-0002-6963-8884
More by this author
Institution:
University of Oxford
Division:
HUMS
Department:
Uehiro Institute
Oxford college:
St Cross College
Role:
Author
ORCID:
0000-0003-1691-6403


More from this funder
Funder identifier:
https://ror.org/029chgv08
Grant:
WT203132/Z/16/Z


Publisher:
BMJ Publishing Group
Journal:
Journal of Medical Ethics More from this journal
Volume:
49
Issue:
6
Pages:
423-427
Publication date:
2022-08-19
Acceptance date:
2022-08-07
DOI:
EISSN:
1473-4257
ISSN:
0306-6800
Pmid:
35985805


Language:
English
Keywords:
Pubs id:
1275303
Local pid:
pubs:1275303
Deposit date:
2025-02-17
ARK identifier:

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