Chapter 5. The New Ethical Context of Psychiatry

  1. Norman Sartorius2,
  2. Wolfgang Gaebel3,
  3. Juan José López-Ibor4 and
  4. Mario Maj5
  1. Ahmed Okasha

Published Online: 29 APR 2002

DOI: 10.1002/0470846488.ch5

Psychiatry in Society

Psychiatry in Society

How to Cite

Okasha, A. (2002) The New Ethical Context of Psychiatry, in Psychiatry in Society (eds N. Sartorius, W. Gaebel, J. J. López-Ibor and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846488.ch5

Editor Information

  1. 2

    University of Geneva, Switzerland

  2. 3

    University of Düsseldorf, Germany

  3. 4

    Complutense University of Madrid, Spain

  4. 5

    University of Naples, Italy

Author Information

  1. WHO Collaborating Center for Research and Training in Mental Health, Institute of Psychiatry, Ain Shams University, 3, Shawarby Street, Kasr El Nil, Cairo, Egypt

Publication History

  1. Published Online: 29 APR 2002
  2. Published Print: 30 APR 2002

ISBN Information

Print ISBN: 9780471496823

Online ISBN: 9780470846483



  • psychiatry;
  • ethics;
  • Madrid Declaration;
  • culture;
  • informed consent;
  • mental competence;
  • research;
  • confidentiality;
  • psychotherapy;
  • involuntary hospitalization;
  • euthanasia;
  • managed care;
  • torture


From the beginning of civilization, the intense human nature of medical acts has caused ethics and medicine to be inextricably linked. Towards the end of the 20th century, doctors have come a long way from a status of demigods to one of service providers whose prime task and objective is to respond to the needs of their patients and to do that to their patients' best interest and appropriateness. The close personal contact required by the psychiatrist-patient relationship is fraught with danger. Boundaries may be transgressed, inadvertently or by design, because of weakness of either the patient or the therapist. Furthermore, the last 40 years have witnessed an advance in medical technology and knowledge that carries with it major hopes for the management of previously incurable ailments. However, it also carries with it several frightening possibilities of abuse. Although there may be cultural, social and national differences, these canons of conduct and ethical debates should remain universal.

This chapter discusses the basic elements of the ethics of psychiatric practice, the increasing and expected challenges that may follow from scientific advancement and knowledge and the main principles that should guide clinical and research practice in psychiatry.