Abstract
This is the introductory paper to the special issue on ethics in psychiatry. We introduce the other papers that follow and set them in a context. Inevitably, they represent only a thin slice of the work going on in psychiatric ethics. But they serve to show two unique features of this discipline. First, it has a tendency to dig deep and to make connections with other philosophical concepts. So, for example, in a number of ways the papers that follow touch on the nature of personhood. We examine this notion. Second, psychiatric ethics, because of its content and its embededness in the real world, tends to hit upon diverse and sometimes conflicting values. We introduce the idea of values-based medicine, which provides both a theoretical framework and a practical approach to the common dilemmas of psychiatric practice. The need to think deeply, but also clearly and coherently, combined with the need to engage with the hurly-burly of the world of patients, users and carers, suggests the reasons why psychiatric ethics offers a paradigm for practical ethics generally.
Notes
1The idea of the social construction of selves is presupposed by both Baldwin Citation[5] and Sabat Citation[6]. This is the idea that our selfhood is created in a social way. The idea is also apparent in works elsewhere contributed to by Gillett Citation[9], who writes in this issue too Citation[4]. Clearly, the idea of the social construction of selves raises important issues in psychological and social theory, as well as in philosophy. It is an idea that has had both significant support and influence Citation[10]. But it also has its critics. Thornton, for instance, while acknowledging its practical, heuristic value, suggests doubts about the possibility that it is coherent to speak of meaning being constructed by a social process such as discourse Citation[11]; by implication, it would be hard to construct a whole self by similar social means.
2The debate about personhood in dementia is taken forward by a number of the contributions to the forthcoming volume edited by Hughes et al. Citation[16].