Ethical dilemmas in contemporary psychiatry: Findings from a survey of National Psychiatric Associations in Europe

Abstract

Background The European Psychiatric Association (EPA) is an organization that speaks on behalf of its individual members and members of National Psychiatric Associations (NPAs). The aim of this study to identify and investigate current contents of ethical codes and practices in the countries belonging to EPA. Methods The study is an expert survey sent out to 44 representatives of 30 NPAs covering the following topics: the existence of national bodies dealing with ethical issues in psychiatry, the availability of documents relevant to ethical issues, the types of ethical issues addressed at the national level, and the current and envisaged ethical debates. Results Out of 44 experts invited to participate in the study, 31 NPAs from 30 countries responded (response rate 70.45%). In the majority of countries, the general mission statement serves as the main document covering ethical issues in psychiatry. Most frequently, internal documents were reported to address medical malpractice, workplace bullying, plagiarism, academic fraud, sexual abuse, and discrimination/racism. Furthermore, internal documents cover the ethical assessment of potentially controversial procedures, including psychosurgery, euthanasia, and pregnancy termination. The most important topics for debate at the level of NPAs/EPA were associated with violations of clinical practice standards and human rights. Conclusions NPAs are active in the field of professional ethics, defining ethical standards related to interactions among professionals and services provided by mental health care professionals. Future collaboration of NPAs, under the umbrella of the EPA, could allow to develop a database of local ethical documents that would be translated into English and accessible to all EPA members.

Comparing the World Psychiatric Association and European Psychiatric Association Codes of Ethics: Discrepancies and shared grounds

“…The WPA and the EPA code of ethics share a common characteristic, that is, a supra-national intended purpose of use, that often leads to the recommendation to act and practice according to the local legislation, and overlooks differences in social and cultural contexts, available resources, and the many factors that may vary drastically from one country to another. Unfortunately, to our knowledge, only 15 of the 145 psychiatric societies members of the WPA have developed national codes of ethics, while the remaining member societies invite their members to rely either on the general medical association's codes or on the WPA code [3], and only 8 of the 31 EPA member societies participating in a recent survey had their own national code of ethics, while 12 briefly addressed ethical issues in their general mission statement [29].…”