Ethical issues for the consultant in the general hospital

Abstract

Medical practice has changed dramatically in the past 50 years since psychiatry first made inroads into the general hospital setting. The image of the wise, gentleman-psychiatrist in a tweed jacket, spreading pearls of wisdom to a train of eager students and house-officers has been gradually replaced by that of a harried consultant being summoned for triage and tranquilization. In her quest to be all things to all people, the consultation-liaison psychiatrist has to confront many an ethical dilemma. This article highlights some familiar conflicts and attempts to achieve resolution.

Many Faces of the Dual-Role Dilemma in Psychiatric Ethics

“…A frequent pretext of the involvement of a C-L psychiatrist is to provide an intervention at the level of system, such as where there is a problematic relationship between a difficult patient and a medical team. In such circumstances, the C-L psychiatrist is expected to be ‘all things to all people’ [76]. Indeed, it has been argued elsewhere that by virtue of its broad perspective, C-L psychiatry has a credible role providing ethical guidance in difficult clinical situations [77], [78].…”