Abstract
Part of the complexity of determining a given instance of betrayal lies in determining whether its occurrence results from an individual or a social moral failure. It may also be represented by a contradictory set of behaviors, depending upon the moral framework within which it is defined. Two competing indictments of psychiatric practice, those of Thomas Szasz and Peter Sedgwick, agree that psychiatry is guilty of patient betrayal. They also agree that the nature of that betrayal is psychiatry's violation of the personhood of its patients. But their definitions of personhood-Szasz's based on autonomy and Sedgwick's based on community membership-lead to radically different recommendations for psychiatric reform. The work of Carol Gilligan and her description of two competing moral "voices," each based on one part of the paradox of human experience, provides a moral framework within which Szasz's and Sedwick's critiques emerge as exemplars of each "voice." Their apparent irreconcilability, points to both the paradoxical nature of psychiatric practice and its necessary reliance upon moral reasoning.