A Review of Indian Psychiatry Research and Ethics

Article excerpt

Byline: A. Agarwal

Ethics does not seem to be a favorite topic of Indian authors. Electronic search of the IJP web site could only identify six articles which were directly related to ethics. One article discussed the relationship of ethics religion and psychiatry. Another editorial discussed the concept of responsibility in psychiatrists. Other editorial discussed the truth about 'truth serum' in legal investigations. One article discussed the ethical aspects of published research. There were two articles that specifically discussed ethical aspects. This write-up provides some details about the ethical aspects of psychiatric practice, specific to India, and emphasizes the need to rediscover ethics in India.

Introduction

Ethics do not appear to be a favorite subject for Indian authors. Repeated search by electronics means at the IPS Journal website could only select six articles which are basically related to ethics in psychiatry. Many other articles were also picked up, which had hardly any connection with ethics. A brief review of these articles is essential before we can proceed further.

First article [sup][1] selected is entitled Psychiatry , Religion and Ethics from IJP 1965. This is a very interesting article. I am fortunate to know the author who was doing course in Clinical psychology at the same time when I was studying psychiatry at the All India Institute of Mental Health, Bangalore. He was a very considerate individual very helpful and respectful for all. He could stand against authority if he felt he was on the right side. These are the qualities of an ethical person who can risk personal gains to preserve ethical values. This article is basically a reflection of his personality as well as psychiatric teaching of that time. Any mental illness was considered a consequence of psychosocial forces; the biological factors were acknowledged but not emphasized. The hypothesis put forward by Singh in this paper are as follows:

All religions are basically same and all of them emphasize on ethical behavior. Mental illnesses are caused by psychosocial stressors and if one could follow ethical path or the path of righteousness, one would not have any stress and ultimately no mental illness. The mentally ill could also gain health following a similar path. The emphasis is on ethical behavior; even today, if one follows the path of righteousness one would at least be more comfortable, if not fully healthy.

The other two articles are editorials by N. G. Desai [sup][2] and AK Kala, [sup][3] both very important and worth discussion in some detail.

Responsibility of psychiatrists : Need for pragmatic idealism is the title of Desai's editorial. The author quotes Chodoff to enumerate the responsibilities of psychiatrists.

The responsibilities cited are:

*Competence or the need to master their task; *Ethical behavior or to police their ranks; *Accountability or to be accountable to public; *Advocacy or to be advocate for mentally ill persons. These responsibilities are generally not emphasized. Most clinicians feel comfortable following the traditional clinical role of one-to-one relationship. The emphasis on advocacy and accountability are new concepts which are important in today's scenario. Desai emphasizes that the responsibility of being a competent psychiatrist with adequate skills seems to be undermined by varying standards of education and indifferent monitoring mechanisms. The training of psychiatrists in this country varies widely from center to center. Poor competence is also ascribed to the perception that psychiatry is not a very exact science and many people feel that exacting skill training is not required. The author further emphasizes that a psychiatrist should be well aware of the different laws that effect mentally ill persons and should respect those laws. Ethical responsibility is often ignored as the ethical guidelines are not clear and effective. …

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