Chapter

A historical perspective

David F. Musto

in Psychiatric Ethics

Fourth edition

Published on behalf of Oxford University Press

Published in print January 2009 | ISBN: 9780199234318
Published online February 2013 | e-ISBN: 9780191754548 | DOI: http://dx.doi.org/10.1093/med/9780199234318.003.0002

Series: International Perspectives in Philosophy & Psychiatry

A historical perspective

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Three factors underlie the ethical questions, which at all times have pre-occupied those delegated to help the mentally ill: the role of the therapist, the nature of mental disease and the cultural, religious and even political environment in which patient and therapist coexist. Since the 1970s, these factors and the formal study of psychiatric ethics have been explicitly analysed and have become almost a new subspecialty. Before the mid-20th century, however, few such formal studies existed. This lack of attention is understandable, since the profession of psychiatry developed as a medical specialty only recently, and since for much of the last century, the codes discussed and adopted for general medicine appeared to have served psychiatry well. The dramatic changes in the scope of psychiatry since the Second World War, however, have brought ethical issues peculiar to it into sharp focus.

The governing factors listed above have varied widely in Western medical tradition since Hippocrates. What we call issues in psychiatric ethics during that time must represent the imposition of categories familiar to us, such as informed consent and ‘right to be treated’, onto a historical record for which these terms are not entirely appropriate. In reviewing the past we will be looking for ethical concepts deemed pertinent by medical or other cultural authorities when the behaviour of a person was judged to be grossly abnormal and to require treatment or limitation of freedom. Social control in a broad sense could be justified as the theme for a study of psychiatric ethics; but in this brief survey, the subjects will be studied in the traditional medical context. The realization that ethical issues transcend medicine – and therefore psychiatry – constitutes a fundamental change in the outlook that has marked the recent rise of interest. Restriction of the subject to the context of the history of medicine is a concession to space, not a judgment on its proper boundaries. A convenient starting-point is the Greco–Roman period.

Chapter.  8135 words. 

Subjects: Psychiatry

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