Abstract
Objective: To describe the procedure adopted by the Ethics Committee of the Royal Australian and New Zealand College of Psychiatrists in revising its 1992 foundational code of ethics and to outline the substantial changes agreed upon and subsequently ratified by the College's General Council.
Method: The members of the Ethics Committee reviewed their experience of revising the code by monitoring the process as we went along, examining all relevant documents that emerged over the 18 months it took, and discussing both procedure and outcome with the benefit of hindsight.
Results and Conclusion: The revision process comprised two consultative stages, three face to face meetings of the committee and a presentation to General Council for its consideration. The second consultation, in which an advanced draft was circulated to various arms of the College and to pertinent community organisations, yielded a highly satisfactory response compared to the first consultation's desultory results. The most notable change is the introduction of an entirely new principle which addresses directly the power differential in the psychiatrist–patient relationship and its potential for exploitation of the patient. Sexual exploitation is explicitly and emphatically cited, in that sexual relations between psychiatrist and patient, including a former patient, are always unethical. Other forms of exploitation, such as on the grounds of age, gender, race, ethnicity, sexual orientation, creed, disability, religion and political affiliation, are carefully spelled out. One specific form of exploitation, sexual harassment, is entirely new; its scope is outlined and examples provided. The new code pays more attention than its predecessor to the role of the family and other carers in a patient's life, as well as to the fact that many features of the family are culturally specific. The final principle, covering responsibilities psychiatrists have to society overall, has been modified in several ways. All the principles and their respective annotations have been brought up to date. The new code pertains to affiliates and trainees as well as to Fellows.