Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, (...) they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real. (shrink)

Physicians often appear more troubled by moral dilemmas than would seem justified given the present social and professional consensus on many of the questions involved. Their discomfort arises not only at ethical, technical, and behavioral levels (the most commonly identified sources of difficulty), but also at an existential level, that is, as the manifestation of conflicts rooted in the processes and conditions of our coming-to-be as persons. Analysis of this level of physicians' moral difficulties requires renewed attention to the physician (...) as a person, and suggests new perspectives on the interpersonal environment of medical practice. Keywords: medical ethics, existential themes, religion and psychology, physician as person CiteULike Connotea Del.icio.us What's this? (shrink)

The purpose of this paper is to evaluate the significance of the existential notion of authenticity for medical ethics. This is done by analyzing authenticity and examining its implications for the patient-professional relationship and for ethical decision-making in medical situations. It is argued that while authenticity implies important demand for individual responsibility, which has therapeutic significance, it perpetuates ideas which are antithetical both to authentic interaction between patients and professionals and to fruitful deliberation of moral dilemmas. In order to counteract (...) these consequences, an alternative idea of authenticity is introduced. According to this idea, authenticity is not regarded primarily as individual sovereignty, but as an ability to participate in a dialogue in which the subjectivity of both partners is respected. Such practice, based on mutual trust and responsibility, would enhance common decision-making and overcome the alienation between patients and professionals. (shrink)

A contrast is often drawn between standard adult capacities for autonomy, which allow informed consent to be given or withheld, and patients' reduced capacities, which demand paternalistic treatment. But patients may not be radically different from the rest of us, in that all human capacities for autonomous action are limited. An adequate account of paternalism and the role that consent and respect for persons can play in medical and other practice has to be developed within an ethical theory that does (...) not impose an idealised picture of unlimited autonomy but allows for the variable and partial character of actual human autonomy. (shrink)