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Ethics in Psychiatry

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228 papers 100 to 500 followers Articles highlighting ethical issues (and other interesting stuff). Worth reflecting on, discussing...
https://read.qxmd.com/read/30870153/do-you-see-what-i-see-reflections-on-the-relationship-between-transparency-and-trust
#1
Bridget C O'Brien
The prospect of a more transparent society sounds promising. Advocates of transparency envision a future in which public trust in institutions and peoples' trust in one another run high because all information worth viewing is readily available and open to scrutiny. As health professionals, administrators, and educators work to enact this vision, careful consideration must be given to complex processes through which transparency occurs. Using examples from the 2019 Academic Medicine trainee-authored letters to the editor, this Invited Commentary describes two ways of framing transparency...
March 12, 2019: Academic Medicine: Journal of the Association of American Medical Colleges
https://read.qxmd.com/read/30870154/compassion-and-health-care-a-discussion-with-the-dalai-lama
#2
Ralph Snyderman, Tenzin Gyatso The Th Dalai Lama
The calling to be a physician has historically been driven by compassion-that is, the desire to relieve the suffering of others. However, the current health care delivery system in the United States has increasingly limited the ability of physicians to express compassion as they are afforded little time for meaningful interaction with their patients. One of the authors (R.S.) draws on his current focus on developing personalized, proactive, and patient-driven models of care to argue that patient engagement plays a critical role in achieving favorable outcomes...
March 12, 2019: Academic Medicine: Journal of the Association of American Medical Colleges
https://read.qxmd.com/read/30280415/reflections-on-the-mental-health-parity-and-addiction-equity-act-after-10-years
#3
Richard G Frank
No abstract text is available yet for this article.
October 2, 2018: Milbank Quarterly
https://read.qxmd.com/read/30332924/china-s-reward-policy-for-family-care-of-persons-with-serious-mental-illness
#4
Yu Yu, Wei Zhou, Shuiyuan Xiao
In 2016, the Chinese government instituted a policy that provides a financial subsidy to encourage family involvement in the care of family members with serious mental illness. The policy is designed to prevent violent behaviors of persons with serious mental illness and to promote community safety. The reward, mainly a living allowance for the family, is delivered monthly on the condition of zero crimes or legal offenses committed by the person with mental illness. If executed properly, the policy has the potential to substantially improve the well-being of persons with serious mental illness and their family caregivers...
October 18, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://read.qxmd.com/read/30322984/watching-canada-s-experiment-with-legal-cannabis
#5
EDITORIAL
Diane Kelsall
No abstract text is available yet for this article.
October 15, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://read.qxmd.com/read/29877136/a-review-of-mental-health-and-mental-health-care-disparities-research-2011-2014
#6
Benjamin LĂȘ Cook, Sherry Shu-Yeu Hou, Su Yeon Lee-Tauler, Ana Maria Progovac, Frank Samson, Maria Jose Sanchez
Racial/ethnic minorities in the United States are more likely than Whites to have severe and persistent mental disorders and less likely to access mental health care. This comprehensive review evaluates studies of mental health and mental health care disparities funded by the National Institute of Mental Health (NIMH) to provide a benchmark for the 2015 NIMH revised strategic plan. A total of 615 articles were categorized into five pathways underlying mental health care and three pathways underlying mental health disparities...
June 1, 2018: Medical Care Research and Review: MCRR
https://read.qxmd.com/read/30134270/narrative-intersectionality-in-caring-for-marginalized-or-disadvantaged-patients-thinking-beyond-categories-in-medical-education-and-care
#7
Michael Blackie, Delese Wear, Joseph Zarconi
Categories are essential to doctors' thinking and reasoning about their patients. Much of the clinical categorization learned in medical school serves useful purposes, but an extensive literature exists on students' reliance on broad systems of social categorization. In this article, the authors challenge some of the orthodoxies of categorization by combining narrative approaches to medical practice with the theoretical term "intersectionality" to draw students' attention to the important intersecting, but often overlooked, identities of their patients...
January 2019: Academic Medicine: Journal of the Association of American Medical Colleges
https://read.qxmd.com/read/30150248/cancellation-of-basic-income-project-a-blow-to-health-research
#8
Roger Collier
No abstract text is available yet for this article.
August 27, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://read.qxmd.com/read/29970375/medical-school-admission-requirements-lock-out-many-indigenous-students
#9
Lauren Vogel
No abstract text is available yet for this article.
July 3, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://read.qxmd.com/read/30012807/health-professionals-decry-detention-of-migrant-children-in-canada
#10
Lauren Vogel
No abstract text is available yet for this article.
July 16, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://read.qxmd.com/read/30061324/the-association-between-suicide-deaths-and-putatively-harmful-and-protective-factors-in-media-reports
#11
Mark Sinyor, Ayal Schaffer, Yasunori Nishikawa, Donald A Redelmeier, Thomas Niederkrotenthaler, Jitender Sareen, Anthony J Levitt, Alex Kiss, Jane Pirkis
BACKGROUND: Exposure to media reporting on suicide can lead to suicide contagion and, in some circumstances, may also lead to help-seeking behaviour. There is limited evidence for which specific characteristics of media reports mediate these phenomena. METHODS: This observational study examined associations between putatively harmful and protective elements of media reports about suicide in 13 major publications in the Toronto media market and subsequent suicide deaths in Toronto (2011-2014)...
July 30, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://read.qxmd.com/read/30071756/two-challenges-affecting-access-to-care-for-inmates-with-serious-mental-illness-detecting-illness-and-acceptable-services
#12
Alexander I F Simpson, Roland M Jones
No abstract text is available yet for this article.
October 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://read.qxmd.com/read/29987089/on-blindness-and-blind-spots
#13
Ruth Kannai, Aya Alon
This story is a reflection on the evolving relationship of a family physician with a patient suffering from a severe conversion disorder, expressed inter alia through "blindness." The narrative follows our journey as I attempt to unravel the meaning of the symptoms as a metaphoric expression of her agony. Eventually, I conclude that clinicians at times also may have a "blind spot" that prevents us from entirely grasping patients' complex inner struggles.
July 2018: Annals of Family Medicine
https://read.qxmd.com/read/29909778/unwell-in-hospital-but-not-incapable-cross-sectional-study-on-the-dissociation-of-decision-making-capacity-for-treatment-and-research-in-in-patients-with-schizophrenia-and-related-psychoses
#14
Benjamin Walter Jack Spencer, Tania Gergel, Matthew Hotopf, Gareth S Owen
BACKGROUND: Consent to research with decision-making capacity for research (DMC-R) is normally a requirement for study participation. Although the symptoms of schizophrenia and related psychoses are known to affect decision-making capacity for treatment (DMC-T), we know little about their effect on DMC-R.AimsWe aimed to determine if DMC-R differs from DMC-T in proportion and associated symptoms in an in-patient sample of people with schizophrenia and related psychoses. METHOD: Cross-sectional study of psychiatric in-patients admitted for assessment and/or treatment of schizophrenia and related psychoses...
August 2018: British Journal of Psychiatry: the Journal of Mental Science
https://read.qxmd.com/read/29871682/the-significance-of-ethics-reflection-groups-in-mental-health-care-a-focus-group-study-among-health-care-professionals
#15
Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen, Reidar Pedersen
BACKGROUND: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. METHODS: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive...
June 5, 2018: BMC Medical Ethics
https://read.qxmd.com/read/29760032/white-privilege-in-a-white-coat-how-racism-shaped-my-medical-education
#16
Max J Romano
In this essay, I reflect on some of the ways racial privilege influenced my experience as a white physician in training. While white Americans often think of "racism" as a social construct primarily affecting people of color, "racism" is a system of both racial disadvantage as well as reciprocal racial advantage. Medical professionals are increasingly aware of how social determinants of health lead to important health disparities, however white physicians seldom ask how their own racial privilege reinforces a white supremacist culture and what effects this may have on our patients' health...
May 2018: Annals of Family Medicine
https://read.qxmd.com/read/29745363/application-of-n-of-1-treatment-trials-in-schizophrenia-systematic-review
#17
Katie F M Marwick, Anna J Stevenson, Caitlin Davies, Stephen M Lawrie
BACKGROUND: Single patient or 'n-of-1' trials are a pragmatic method to achieve optimal, evidence-based treatments for individual patients. Such trials could be particularly valuable in chronic, heterogeneous, difficult to treat illnesses such as schizophrenia.AimsTo identify how often, and in what way, n-of-1 trials have been used in schizophrenia. METHOD: We performed a systematic search in the major electronic databases for studies adopting n-of-1 methodology in schizophrenia, published in English from the start of records until the end of January 2017...
July 2018: British Journal of Psychiatry: the Journal of Mental Science
https://read.qxmd.com/read/29614866/coercion-in-outpatients-under-community-treatment-orders-a-matched-comparison-study
#18
Arash Nakhost, Frank Sirotich, Katherine M Francombe Pridham, Vicky Stergiopoulos, Alexander I F Simpson
OBJECTIVE: Since the deinstitutionalization of psychiatric services around the world, the scope of outpatient psychiatric care has also increased to better support treatment access and adherence. For those with serious mental illness who may lack insight into their own illness, available interventions include coercive community practices such as mandated community treatment orders (CTOs). This paper examines the perceptions of coercion among service users treated with a CTO. METHOD: We used a cross-sectional comparative design where service users treated under a CTO were matched to a comparison group of voluntary psychiatric outpatients...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://read.qxmd.com/read/29635929/-for-their-own-good-a-response-to-popular-arguments-against-permitting-medical-assistance-in-dying-maid-where-mental-illness-is-the-sole-underlying-condition
#19
Justine Dembo, Udo Schuklenk, Jonathan Reggler
Canada is approaching its federal government's review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when "natural death" is not "reasonably foreseeable". For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent...
July 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://read.qxmd.com/read/29528031/how-do-doctors-deliver-a-diagnosis-of-dementia-in-memory-clinics
#20
Jemima Dooley, Nick Bass, Rose McCabe
BACKGROUND: Dementia diagnosis rates are increasing. Guidelines recommend that people with dementia should be told their diagnosis clearly and honestly to facilitate future planning. Aims To analyse how doctors deliver a dementia diagnosis in practice. METHOD: Conversation analysis was conducted on 81 video-recorded diagnosis feedback meetings with 20 doctors from nine UK memory clinics. RESULTS: All doctors named dementia; 59% (n = 48) approached the diagnosis indirectly but delicately ('this is dementia') and 41% (n = 33) approached this directly but bluntly ('you have Alzheimer's disease')...
April 2018: British Journal of Psychiatry: the Journal of Mental Science
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