Medical bioethics is a broad subject. Of all the medical disciplines, perhaps the most enmeshed in medical bioethics is psychiatry. This is particularly true around questions of compulsory treatment, which seem to arise more frequently in the realm of psychiatry. PsychOdyssey has come across a helpful article that puts the ethics of psychiatry into perspective. It is:
Bloch, S. & Green, S. A. (2006). An Ethical Framework for Psychiatry. British Journal of Psychiatry, 188(1), 7-12.
Bloch and Green find a middle ground between Kantian duty-driven, rules-based absolutism and Millsean outcome-based utilitarianism. That middle ground is a combination of a pragmatic Jamesean “principlism” and a Humesean-influenced “ethics of care”. While the subject seems esoteric, families in the maelstrom may find this analysis useful as a philosophical framework for interpreting their own families experiences within The System, especially when faced with the philosophically difficult challenge of compulsory treatment.
From the abstract: Psychiatry has not reached a consensus hitherto concerning an optimal theoretical framework for ethical decision-making and corresponding action. Various theories have been considered, but found wanting. Moreover, classic theories may contradict one another, contribute to confusion and immobilize the clinician. We have examined major theories commonly applied in bioethics, conferred with moral philosophers and psychiatrists and striven to apply more recent insights drawn from moral philosophy. We report that instead of pursuing a single theoretical framework, we should garner the strengths of compatible approaches in a synergistic way. We propose a particular complementarity of principlism – with its pragmatic focus on respect for autonomy, beneficence, non-maleficence and justice – and care ethics, a variant of virtue theory, which highlights character traits pertinent to caring for vulnerable psychiatric patients.