Global mental health, autonomy and medical paternalism: reconstructing the ‘French ethical tradition’ in psychiatry

Abstract

In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the 'French ethical tradition in psychiatry' and its relationship with establishing institutional spaces for ethical decision-making. The 'ethical tradition' thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.

Ethical Implications of Mental Health Stigma: Primary Health Care Providers’ Perspectives

“…Researchers should follow rules concerning use of consent forms and how it might vary according to the target population being studied, the setting or cultural context where the study taking place (Alahmad et al, 2012;Carrier et al, 2017;Chowdhury, 2016;Corcoran, 2016;Mittal, Dean, Mittal, & Saks, 2015;Pires Marques, 2017;Sharma et al, 2013;Shen et al, 2017;Vaz & Srinivasan, 2014). Literature noted different components for consent forms, however they all point to the one important piece of "providing enough and detailed information in order to get the consent".…”

“…Further, efforts are to be made toward initiating specialized training program to provide care providers with needed knowledge and skills required to identify mental health problems, and thus identify those cases require specialized mental health care (Ayalon et al, 2015;Campbell et al, 2015;Chowdhury, 2016;Lally, O' Conghaile, Quigley, Bainbridge, & McDonald, 2013;Pires Marques, 2017;Shen et al, 2017). Empowering primary health care providers will enable them to diagnose mental health problems at early stages, provide the required treatment and thus breack the barriers of stigma associated with mental illness.…”

Illness and the Politics of Social Suffering: Towards a Critical Research Agenda in Health and Science Studies*

“…Along these lines, some authors have argued that the models developed under the labels of "health democracy", "health governance", and "care" are neither ethically nor politically neutral (Castel, 2011;Paperman and Laugier, 2011;Marques, 2017aMarques, , 2017b. For example, the hegemonic discourse of governance, in some cases implemented in public hospitals in the form of clinical committees, implies the delegation of competences hitherto allocated to political entities (Orfali, 2003;Marques 2017a). Their legitimacy is based on the technical and institutional complexification of health services and responds to the "health democracy" ethos.…”