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Ethics, Culture, and Psychiatry

International Perspectives

Edited by Ahmed Okasha, Julio Arboleda-Florez, and Norman Sartorius, M.D., Ph.D.

  • ISBN 978-0-88048-999-7
  • Item #8999


Ethics, Culture, and Psychiatry: International Perspectives is a textbook that explores the best ways to promote the use of the Declaration of Madrid, which outlines ethical standards for psychiatric practice throughout the world. The book is written with two questions in mind, both easy to pose and difficult to answer:

  • Is it possible to formulate a set of principles that will be valid for all psychiatrists, regardless of the cultures to which they belong or in which they live and practice, or are there as many sets of ethical principles as there are cultures?
  • If there is such a set of principles, what should we do to ensure that psychiatry as a discipline makes a significant contribution to societal good without helping the evil?

To facilitate the exploration of this territory, 15 experts from a variety of cultures examine the most pressing ethical issues prevalent within the current practice of psychiatry.Many of the dilemmas probed in this book are routinely encountered by clinicians who work in increasingly multicultural societies. The text covers issues that are broadly relevant to clinical practice and research, including:

  • An overview of ethics and societies around the world
  • Discussions of ethical practices and dilemmas specific to various cultural regions
  • Transcultural debate on overarching issues, such as incompetent patients, informed consent, and mental health law reform
  • The complete copy of The Declaration of Madrid printed in the appendix

Readers will find that this is a textbook that stimulates and supports, rather than closes, the debate on ethical aspects of professional psychiatric behavior. Ethics, Culture, and Psychiatry: International Perspectives is much more than just a book on ethics – it is a major contribution to understanding the impact of culture and history on the ethical practice of medicine around the world, and a continuous search for a consensus on how to live together and make contributions to the well-being of people with mental illness, their families, and the family of humans on our planet.


  • Section I: Ethics and Psychiatry Around the World
  • Chapter 1. The impact of Arab culture on psychiatric ethics
  • Chapter 2. Conflicts and crises in Latin America
  • Chapter 3. A West Mediterranean perspective
  • Chapter 4. Scandinavian approaches
  • Chapter 5. Managed care in the United States
  • Chapter 6. Ethics in Sub-Saharan Africa
  • Chapter 7. The Indian experience
  • Chapter 8. Ethics and psychiatry in China
  • Chapter 9. Intersubjectivity and its influence on psychiatry in Japan
  • Section II: Overarching Issues
  • Chapter 10. Research involving incompetent patients: a current problem in light of German history
  • Chapter 11. Informed consent: a historical and medical perspective
  • Chapter 12. An international perspective on mental health law reform
  • Appendix: The Declaration of Madrid
  • Index

About the Authors

Ahmed Okasha is Chairman of the Ethics Committee of the World Psychiatric Association and President-Elect of the WPA. He is also Professor of Psychiatry and Director of the World Health Organization Collaborating Center for Training and Research in Mental Health in the Institute of Psychiatry at Ain Shams University in Cairo, Egypt.

Julio Arboleda-Florez is a Member of the Ethics Committee of the World Psychiatric Association and Professor and Head of the Department of Psychiatry at Queen's University in Kingston, Ontario, Canada.

Norman Sartorius is Past President of the World Psychiatric Association and Professor of Psychiatry at the Hospitaux Universitaires de Geneve in Geneva, Switzerland.

Rapid scientific developments can obscure the more important role of ethics. The editors of this volume are to be congratulated for recognizing and fulfilling an obligation to the field.—Robert Cancro, M.D., American Journal of Psychiatry, 8/1/2001

In an increasingly multicultural society, most clinicians in the United States routinely encounter many of the ethical dilemmas probed in this book. They will, no doubt, find the content of this edited work compelling and thought provoking reading that is broadly relevant to clinical practice and research.—New England Journal of Medicine, Vol. 344 No. 18, 8/1/2001

This book is much more than a book on ethics. Using a panel of distinguished experts, the editors have created a major contribution to understanding the impact of culture and history on the ethical practice of medicine around the world. It is an outstanding textbook on transcultural psychiatry. I read every word, and I highly recommend it.—Robert O. Pasnau, M.D., Professor Emeritus, UCLA School of Medicine, Los Angeles, California

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