Consultation-liaison psychiatrists on bioethics committees: Opportunities for academic leadership
ABSTRACT This article briefly reviews the history of the relationship between psychiatry and the leadership of ethics committees as a background for examining appropriate educational initiatives to adequately prepare residents and early career psychiatrists to serve as leaders of ethics committees.
A Medline review of literature on psychiatry and ethics committees and consultation as well as recent survey data from the Academy of Psychosomatic Medicine indicate that psychosomatic medicine psychiatrists are particularly qualified and interested in serving as chairs of ethics committees. The authors compare knowledge and skills obtained in psychiatric training with the Society for Heath and Human Values and the Society for Bioethics Consultation Task Force on standards for ethics consultation proposed as core competencies for ethics committee leadership.
Psychiatric residency and fellowship training in psychosomatic medicine can provide the knowledge and skill sets to meet the standards for ethics consultation. Further professional development through pursuit of formal ethics training, advance degrees in bioethics, mentoring, and residency and felloships focus on ethics and enhance competency, confidence, and the skills required for ethics committee leadership.
Academic psychiatrists, particularly those in psychosomatic medicine, have historically made a significant contribution as chairs of ethics committees. Continuation and expansion of this leadership may require interested psychiatrists to obtain additional training in bioethics.
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ABSTRACT: Over the past 30 years, institutional ethics committees have become the standard vehicle for addressing ethical issues in health care institutions. Early in this development, general psychiatrists became integrally involved; however, child and adolescent psychiatry roles on institutional ethics committees have been delineated less clearly. This article provides an overview of the functioning of institutional ethics committees, including composition and a definition of the roles across education, policy development, and case consultation. Within the context of the various roles of the institutional ethics committee, the potential contributions of a child and adolescent psychiatrist are defined and specific areas of expertise are delineated. Case examples are cited to demonstrate the unique contributions in the areas of developmental understanding, enhanced understanding of communication styles and failures, as well as an understanding of specific psychiatric factors and cultural issues that a child and adolescent psychiatrist may bring to the institutional ethics committee.Child and Adolescent Psychiatric Clinics of North America 02/2008; 17(1):209-24, xi. DOI:10.1016/j.chc.2007.07.006 · 2.60 Impact Factor
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ABSTRACT: A good physician must be both clinically and ethically competent. High ethical standards are especially important in psychiatry in which several unique challenges present due to a vulnerable patient population, intimate physician-patient relationships, diagnoses made on signs and symptoms rather than irrefutable laboratory investigations, and therapeutic options directed at altering thinking and behaviour. It is critical that psychiatric training equip practitioners with the ability to identify ethical dilemmas in clinical practice and research and respond appropriately. Despite a call to action and the development of guidelines for ethical practice by several regulatory bodies, formal ethics teaching in psychiatry training programmes is still in embryonic stages in the developed world and virtually non-existent in the developing world. Here we highlight the current status of bioethics teaching in psychiatry residency programmes in Pakistan, an example of a developing country where such training is vital, as unethical practices abound in resource-poor settings where clinical and research practices are non-transparent and there are no effective regulatory, legal and accountability bodies. It is critical and urgent that needs-responsive bioethics curricula are developed, institutionalized and implemented in medical schools and post-graduate training programs across the developing world. [Box: see text] [Box: see text].International Review of Psychiatry 06/2010; 22(3):294-300. DOI:10.3109/09540261.2010.482096 · 1.80 Impact Factor