Comparison of philosophical concerns between professionals and the public regarding two psychiatric treatments

Abstract

Background: Psychiatric interventions are a contested area in medicine, not only because of their history of abuses, but also because their therapeutic goal is to affect emotions, thoughts, beliefs, and behaviors that are regarded as pathological. Because psychiatric interventions affect characteristics that seem central to who we are, they raise issues regarding identity, autonomy, and personal responsibility for one’s own well-being. Our study addresses two questions: (1) Do the public and academic researchers understand the philosophical stakes of these technologies in the same way? Following from this, (2) to what extent does the specific type of psychiatric technology affect the issues these two groups raise? This study compares how ethical issues regarding neurosurgical and pharmaceutical psychiatric interventions are discussed among the public and in the professional community of academic medicine and bioethics. Methods: We analyzed (1) online public comments and (2) the medical and bioethics literature, comparing the discussions of pharmacological and neurosurgical interventions in psychiatry in each source. Results: Overall, the public discussed philosophical issues less frequently than academics. For the two types of psychiatric interventions, we found differences between the academic literature and public comments among all themes, except for personal responsibility. Conclusions: These findings reveal some of the similarities and discrepancies in how philosophical issues associated with psychiatric treatments are discussed in professional circles and among the public. Further research into what causes these discrepancies is crucial.

Keywords:

• authenticity
• autonomy
• enhancement
• identity
• pharmaceuticals
• neurosurgery

Acknowledgments

None.

Conflicts of interest

None disclosed.

Ethical approval

This study used publicly available data; as such, IRB approval was not sought.

Notes

1 Obesity was used as a proxy term to identified articles discussing other patterns of eating behavior that result in weight gain rather than weight loss (e.g., binge eating disorder). While binge eating disorder is not limited to obese individuals, it is common in this group (Zwaan 2001). Moreover, people who seek help do so for treatment of overweight rather than for binge eating, and clinical trials very often focus primarily on obese samples (Devlin 2007).

2 Gilbert and colleagues (2017), however, provide a more complex model of causality between self-change and psychiatric intervention, recognizing the complexity of the relationships among illness, surgery, stimulation, other concurrent treatments, and individual characteristics of the patients themselves.

Additional information

Funding

This study was supported by a Science and Society at State (S3) internal Michigan State University (MSU) grant.

Notes on contributors

Laura Yenisa Cabrera

Conception and design: Cabrera. Acquisition of data: Cabrera, McKenzie. Analysis and interpretation of data: Cabrera, McKenzie, Bluhm, Brandt. Drafting the article: Cabrera. Critically revising the article: all authors. Reviewed submitted version of article: Cabrera, Brandt, Bluhm. Approved the final version of the article: all authors.

Marisa Brandt

Conception and design: Cabrera. Acquisition of data: Cabrera, McKenzie. Analysis and interpretation of data: Cabrera, McKenzie, Bluhm, Brandt. Drafting the article: Cabrera. Critically revising the article: all authors. Reviewed submitted version of article: Cabrera, Brandt, Bluhm. Approved the final version of the article: all authors.

Rachel McKenzie

Conception and design: Cabrera. Acquisition of data: Cabrera, McKenzie. Analysis and interpretation of data: Cabrera, McKenzie, Bluhm, Brandt. Drafting the article: Cabrera. Critically revising the article: all authors. Reviewed submitted version of article: Cabrera, Brandt, Bluhm. Approved the final version of the article: all authors.

Robyn Bluhm

Conception and design: Cabrera. Acquisition of data: Cabrera, McKenzie. Analysis and interpretation of data: Cabrera, McKenzie, Bluhm, Brandt. Drafting the article: Cabrera. Critically revising the article: all authors. Reviewed submitted version of article: Cabrera, Brandt, Bluhm. Approved the final version of the article: all authors.