Ethical Issues- Schizophrenia

Many ethical issues can be presented when working in the medical field; a few major issues are presented in the case of Schizophrenia. Schizophrenia is a mental disorder in which people may hear voices in their heads that tell them to do immoral things, which are not there. A Schizophrenic person may also sit for hours without moving or talking, and are not completely sane. This disorder is a result of genetic and environmental factors. One of the issues that are involved with schizophrenia is telling schizophrenics, partial truths or lies.

Studies have shown that when a schizophrenic is directly confronted, they usually do not return for treatment. As a result, some psychiatrists tell their patients “half-truths” or lies such as treating patients but telling them the medication is for anxiety or dysphasia, this way patients receive adequate treatment. Ultimately the psychiatrist is doing what is best for the patient, but is it really okay to lie to a patient? Another issue is presented during the treatment of a schizophrenic patient, occasionally a patient will ask a psychiatrist for heir opinion on whether or not to pursue a lifelong dream they may have.

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When this occurs, the psychiatrist is presented with the decision of whether or not to support the patient on their dream. If the psychiatrist believes the patient is not capable of accomplishing their goal because of their mental disorder, they might discourage the patient form pursuing it because if they were to pursue it and fail, it could possibly worsen the disorder. On the other hand, the psychiatrist might support the patient in their dream, because in the situation where the patient accomplishes their goal, the notation may improve and could result in a better quality of life.

So what should the psychiatrist do in this situation, when is it okay for the psychiatrist to decide what goes on in a patient’s life? A third issue would be the whether or not to ask a patient dealing with this disorder if they would like to write their advance directives. Advance directives are written consent of what would happen to the patient in the occasion that they lose decisional capabilities, what type of treatment they would receive, etc.

Although advance directives maybe taken as a precaution and not because anything is occurring with the patient, upon being asked for these documents a patient may be caused fear which could result in worsening of the illness. So should the psychiatrist ask a patient for the advance directives knowing it may have a negative result on their health? The involvement of family in the life of a schizophrenic could be extremely beneficial, but convincing a schizophrenic to involve their family is yet another issue.

The process of persuading a mental disorder patient at some point becomes coercion, which is never morally correct because it could be considered as taking advantage of a mentally challenged person. Although coercion is never technically correct, in the long run the involvement of the family will have enormous benefits on the patient, so the psychiatrist must make a decision on if they should or shouldn’t coerce the patient to involve their family. I believe that all the ethical issues presented are difficult, but the psychiatrist should always keep the patients well.

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Sarah
Danielle
Wilson
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