The article “‘It’s a national scandal’: 15 stories which show the state of mental health care in the UK” presented by The Guardian in the year 2014 contains a number of stories about ethics code violations that were committed by English psychologists and psychiatrists.
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For example, Sam from Oldham (diagnosed with depression) described a rather stunning story of ethics guidance violations by his psychiatrists. According to the patient, the psychiatrist that he was meant to see did not meet him and did not explain the reasons for that. Instead, he appointed a “junior” to take care of the patient. This fact did not disappoint Sam as the junior made an impression of a qualified and bright future doctor in need of practice.
However, the junior failed to be supportive. After the talk with the patient he went to discuss the issue with the psychiatrist and came back to announce that Sam had personality disorders, and this was not curable. He did not suggest a line of treatment, and, according to the patient, was tactless and unsupportive. What is important to mention, Sam had had suicidal ideation that was on the record, and the junior was aware of that.
Ethical issues are difficult to measure, describe, and explain. Even though different associations may develop their own moral codes, in either case, they are mostly guided by the universal principles of what is, to put it simple, good and bad. We will use “The Principles of Medical Ethics” as presented by American Psychiatric Association ([APA], 2013).
This ethics code contains general rules, specific advice and includes comments that are concerned with the details of a psychiatrist work. Even though the British psychologists are not expected to follow APA code, they are expected to perform their duties ethically.
The case described by Sam appears to be most unethical. Both the psychiatrist and the junior violated a number of ethics rules, being questionably careless with the information concerning the patient and failing to be compassionate and supportive. All of these requirements are emphasized in the “Principles” (APA, 2013, pp. 3, 6).
However, the most critical lapse of the junior that seems to be a proof of his incompetence, is the fact that he failed to offer support to a vulnerable patient, which may deteriorate his state and possibly even endanger his life. It is true that the idea of supportiveness can be perceived differently by different people. Still, given the specifics of the job, the junior was supposed to be more sensitive to the state of the patient and to take into account the possible consequences of his words and actions.
According to APA (2013) a psychiatrist “shall, while caring for a patient, regard responsibility to the patient as paramount” (p. 10). Yet, no such concern was demonstrated by the junior from the story. He must have heard of various ethics codes, which means that his behavior cannot be explained by ignorance. It appears that the key problem from which all of the above-mentioned violations stem from is the lack of concern.
For fairness’s sake, it should be pointed out that the junior could have learned this kind of neglect from his mentor. The psychiatrist’s behavior also betrays a shocking lack of concern with the state of the patient. Letting an incompetent doctor take care of a vulnerable patient is most unethical. Therefore, to avoid this kind of lapses, the responsibility of a doctor should be emphasized, promoted by the mentors and, most importantly, understood by the medical students.
American Psychiatric Association. (2013). The Principles of Medical Ethics.
‘It’s a national scandal’: 15 stories which show the state of mental health care in the UK. (2014). The Guardian.