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Ethics in Psychiatry

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223 papers 100 to 500 followers Articles highlighting ethical issues (and other interesting stuff). Worth reflecting on, discussing...
Benjamin Lê 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
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" in order to draw students' attention to the important intersecting, but often overlooked, identities of their patients...
August 21, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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
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
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
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
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
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
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
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
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
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
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
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
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
Mark Sinyor, Ayal Schaffer, Marnin J Heisel, André Picard, Gavin Adamson, Christian P Cheung, Laurence Y Katz, Rakesh Jetly, Jitender Sareen
This paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on May 3, 2017. The original policy paper1 was developed by the Scientific and Research Affairs Standing Committee and approved by the Board of Directors on November 10, 2008.
March 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Dearbhail Bracken-Roche, Emily Bell, Eric Racine
No abstract text is available yet for this article.
June 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Katherine Baicker, Heidi L Allen, Bill J Wright, Sarah L Taubman, Amy N Finkelstein
Policy Points: We take advantage of Oregon's Medicaid lottery to gauge the causal effects of Medicaid coverage on mental health care, how effectively it addresses unmet needs, and how those effects differ for those with and without a history of depression. Medicaid coverage reduced the prevalence of undiagnosed depression by almost 50% and untreated depression by more than 60%. It increased use of medications and reduced the share of respondents reporting unmet mental health care needs by almost 40%. There are likely to be substantial mental health consequences of policy decisions about Medicaid coverage for vulnerable populations...
March 2018: Milbank Quarterly
Joshua D Wallach, Joseph S Ross
No abstract text is available yet for this article.
February 27, 2018: JAMA: the Journal of the American Medical Association
Yesenia Merino, Leslie Adams, William J Hall
This Open Forum explores the role of implicit bias along the mental health care continuum, which may contribute to mental health disparities among vulnerable populations. Emerging research shows that implicit bias is prevalent among service providers. These negative or stigmatizing attitudes toward population groups are held at a subconscious level and are automatically activated during practitioner-client encounters. The authors provide examples of how implicit bias may impede access to care, clinical screening and diagnosis, treatment processes, and crisis response...
June 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
2018-03-03 23:10:39
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