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Psychiatric ethics
293
Book Reviews
following the average person in the street’s notion of how his or her mind works. It is not a return to radical behaviourism to suggest that the mind almost certainly works differently from how average people think it does. And if this is so, then the conventional ‘folk psychology’ categories of its events, i.e. its faculties-perception, belief, etc.-are artefacts. So too then are the psychopathological categories derived from these-hallucination, delusion. So too then are the concepts of mental disorder-schizophrenia, manic-depressive psychosis-further derived from different combinations of these psychopathological categories. In summary, this book contains an excellent account of current views on the nature of psychiatric disease categories. But who wants to discuss dinosaurs the day they become extinct, when some new life-form is crawling out of the mud? Dr JOHN CUTTING The Maudsley Hospital De Crespigny Park Denmark Hill London SE5
Psychiatric Ethics. Edited by SIDNEY BLOCH and PAUL CHODOFF. Oxford: Edition. Price f25.00. 560 pp.
O.U.P.,
1991.
Second
THE LAST decade in psychiatry has seen a rapid growth of interest in the ethical aspects of psychiatric practice both by society and by those professionally involved in psychiatry and the need for help in developing a cohesive approach to many of these dilemmas. The first edition of this book was an important stepping stone towards meeting this need and the expanded and updated second edition should prove of great benefit to the continuing debate. The areas covered include the credibility of psychiatry as a profession and the concept of disease. Both of these sections are important windows into the rest of the book since many of the ethical dilemmas in psychiatry relate to particular understandings of mental illness and the bases of diagnosis and treatment, which may be seen to invest great power in the role of the psychiatrist in the lives of individuals and society. The ethical implications of various forms of treatment are then examined such as: psychotherapy; drug treatment; surgery; sex therapy; involuntary commitment for treatment; child psychiatry; psychogeriatric care; forensic issues; and an examination of some of the abuses of psychiatry in various social and political settings. This latter area is clearly informed by the extensive experience of the editors in their own work relating to abuse within Soviet psychiatry and elsewhere and investigations into the underlying causes of the abuse. At first sight this very comprehensive work can look daunting. However, the editors have managed to achieve a very readable and uniform style throughout, which should make the material very accessible to the initiated and uninitiated alike. It should certainly be recommended reading for those studying for professional examinations as well as for those already well established in the profession and related professions. In the final chapter of the book Sidney Bloch concludes by saying ‘What we as a profession can, and should, strive for are two interrelated goals: to commit ourselves to the task of facing the ethical dimensions of our work, and to try to clarify as clearly as possible the nature of these ethical dimensions’ (p. 513). This book will continue to be an asset to those seeking to reach that joint goal.
Royal
Personality
and Disease.
Edited by H S FRIEDMAN. New York:
PETER W. SPECK MA BSc Chaplain and Hon. Senior Lecturer Free Hospital and School of Medicine London, NW3
Wiley,
1990, pp. 315. Price f28.30.
ONE OF the gulfs separating North American academics and their British counterparts is the unrestrained use of hyperbole on the other side of the Atlantic. In the preface of this collection of essays on the possibility that personality increases the risk of disease, the editor, Howard Friedman, described his contributors and contributions as follows. ‘Although I held high expectations for these renowned scientists, my expectations were repeatedly exceeded as I received a series of brilliant chapters.’ There follows a rather indigestible 93 pages on ‘General Conceptual Issues’ which omitted to discuss two important areas. The first is the nature of personality. Only passing reference was made to the extensive literature on
Book Reviews
following the average person in the street’s notion of how his or her mind works. It is not a return to radical behaviourism to suggest that the mind almost certainly works differently from how average people think it does. And if this is so, then the conventional ‘folk psychology’ categories of its events, i.e. its faculties-perception, belief, etc.-are artefacts. So too then are the psychopathological categories derived from these-hallucination, delusion. So too then are the concepts of mental disorder-schizophrenia, manic-depressive psychosis-further derived from different combinations of these psychopathological categories. In summary, this book contains an excellent account of current views on the nature of psychiatric disease categories. But who wants to discuss dinosaurs the day they become extinct, when some new life-form is crawling out of the mud? Dr JOHN CUTTING The Maudsley Hospital De Crespigny Park Denmark Hill London SE5
Psychiatric Ethics. Edited by SIDNEY BLOCH and PAUL CHODOFF. Oxford: Edition. Price f25.00. 560 pp.
O.U.P.,
1991.
Second
THE LAST decade in psychiatry has seen a rapid growth of interest in the ethical aspects of psychiatric practice both by society and by those professionally involved in psychiatry and the need for help in developing a cohesive approach to many of these dilemmas. The first edition of this book was an important stepping stone towards meeting this need and the expanded and updated second edition should prove of great benefit to the continuing debate. The areas covered include the credibility of psychiatry as a profession and the concept of disease. Both of these sections are important windows into the rest of the book since many of the ethical dilemmas in psychiatry relate to particular understandings of mental illness and the bases of diagnosis and treatment, which may be seen to invest great power in the role of the psychiatrist in the lives of individuals and society. The ethical implications of various forms of treatment are then examined such as: psychotherapy; drug treatment; surgery; sex therapy; involuntary commitment for treatment; child psychiatry; psychogeriatric care; forensic issues; and an examination of some of the abuses of psychiatry in various social and political settings. This latter area is clearly informed by the extensive experience of the editors in their own work relating to abuse within Soviet psychiatry and elsewhere and investigations into the underlying causes of the abuse. At first sight this very comprehensive work can look daunting. However, the editors have managed to achieve a very readable and uniform style throughout, which should make the material very accessible to the initiated and uninitiated alike. It should certainly be recommended reading for those studying for professional examinations as well as for those already well established in the profession and related professions. In the final chapter of the book Sidney Bloch concludes by saying ‘What we as a profession can, and should, strive for are two interrelated goals: to commit ourselves to the task of facing the ethical dimensions of our work, and to try to clarify as clearly as possible the nature of these ethical dimensions’ (p. 513). This book will continue to be an asset to those seeking to reach that joint goal.
Royal
Personality
and Disease.
Edited by H S FRIEDMAN. New York:
PETER W. SPECK MA BSc Chaplain and Hon. Senior Lecturer Free Hospital and School of Medicine London, NW3
Wiley,
1990, pp. 315. Price f28.30.
ONE OF the gulfs separating North American academics and their British counterparts is the unrestrained use of hyperbole on the other side of the Atlantic. In the preface of this collection of essays on the possibility that personality increases the risk of disease, the editor, Howard Friedman, described his contributors and contributions as follows. ‘Although I held high expectations for these renowned scientists, my expectations were repeatedly exceeded as I received a series of brilliant chapters.’ There follows a rather indigestible 93 pages on ‘General Conceptual Issues’ which omitted to discuss two important areas. The first is the nature of personality. Only passing reference was made to the extensive literature on