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Biological psychiary and ethics
Author(s) -
Lunn Villars
Publication year - 1988
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1988.tb08561.x
Subject(s) - positivism , epistemology , determinism , volition (linguistics) , reductionism , psychology , subject (documents) , psychosomatic medicine , scientism , meaning (existential) , dualism , psychotherapist , philosophy , linguistics , library science , computer science
The crucial concept of biological psychiatry ‐ comprising psychochemistry, psycho‐physiology and psycho‐pharmacology and based on a positivistic scientific view ‐ is explanation through the demonstration of causal material connections. Conversely the central concept of the psycho‐dynamic schools, based on a hermeneutic‐finalistic ideology, is understanding , pertinent to the meaning of psychical symptoms. The two models are not mutually exclusive but represent complementary concepts whose mutual scientific value can only be measured through their mutual utility as basis for etiological research and for the choice of treatment. Since the age of Enlightment in the 18th century the concept of reason in the shape of an unambigous scientific attitude extensively has rendered the ethics redundant. However, our time is characterized by a reaction against this rationalistic concept about science as a substitute for morality. First of all biological psychiatry, based on the methods of the natural sciences, has been the subject of denunciation and underevaluation with deep emotional undertones. The anti‐psychiatric movement, the “critical psychiatry”, talks about the psychotic patient as the scapegoat, carrying the burden of the relatives conflicts on his shoulders ‐ thus reintroducing the concept of guilt in the debate. The author claims that the relief for this guilt feeling will be found in the paradigme who regards the endogenous psychoses as biologically determined diseases and not simply as reactions to psychological and social strain. The moral‐philosophical counterpart to the antagonism: positivism versus hermeneutics is found in the dualism: determinism versus indeterminism. Realizing the immanent incomprehensibility of the concept of volition the author argues ‐ again from an utilitaristic point of view ‐ that a deterministic outlook will be the decisive support for the psychiatrist in his attempts to comply with the definitive ethical claim: to hold the patient in unlimited respect. So the biological aspect of psychiatry involves ethical prerogatives and values far beyond and contrary to the current prejudices and contortions characterizing the popular‐populistic view of psychiatry ‐ this regarding the attitude of the physician to the mentally ill patient in person as well as regarding the psychiatrists possibilities of supporting the relatives in their relationship to the sick person.