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Book Review

Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals

Catherine Chiles, MD

Published: April 15, 2010

Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals

edited by Laura Weiss Roberts, MD, MA, and Jinger G. Hoop, MD, MFA. American Psychiatric Publishing, Inc, Arlington, VA, 2008, 277 pages, $42.95 (softcover).

Crafted as a study guide for mental health professionals, Professionalism and Ethics includes a scholarly overview of a critically important topic straight from the day’s health care headlines and clinical headaches. The majority of the book is dedicated to question-and-answer vignettes with detailed discussions of the rationales behind the answers. However, introductory comments and chapters by the authors challenge the reader to squarely confront the broad conceptual notions of the term ethics and the critical boundaries of "professionalism."

The initial overview, part 1, serves as an essential foundation for practitioners and learners to review not only the scope of these principles, but their wide-ranging application to clinical practice, medical research, and core competencies in medical training and practice standards. It focuses on the centrality of professionalism and ethics in health care, in particular mental health care, with a review of historically established definitions of professionalism and ethical principles. Commonly encountered clinical scenarios are presented in table format along with relevant ethical principles that are in jeopardy, eg, autonomy and justice; the concomitant conflict or tension created for the practitioner during clinical decision-making is outlined. Key ethical challenges in certain clinical circumstances are addressed as well, including the relationship to industry in academic psychiatry and confidentiality in rural psychiatry.

Guidance for problem-solving moves the reader from understanding the meaning of ethics to putting ethical principles into action. The realm of mental health research is reviewed, with special focus on the rights of the mentally ill. The code of conduct for researchers and clinicians is placed in historical context and according to standards set by national mental health organizations. Sample questions to consider in setting up mental health research projects are suggested. The authors discuss prevailing principles of ethical conduct in intimate constructs such as psychotherapeutic relationships, therapeutic boundaries, sexual misconduct, and patient abandonment. They also review the guiding principles for involuntary treatment, decision-making capacity, and the right to refuse treatment. Discussion of social stigma and advocacy for the mentally ill hearkens back to the principle of justice as well as larger social issues. Special attention is given to professional training and the recent evolution of ethics and professionalism within the core curriculum in medical education.

Part 2 is devoted to vignette questions and annotated answers, organized in sections that complement the informational chapters of part 1. These question-and-answer sections include "Core Concepts in Ethics and Professionalism" and "Ethics and Professionalism in Clinical Care." Other question-and-answer sections cover medical research, interactions with colleagues and trainees, and self-assessment. The latter is correlated to its respective chapter location when the reader seeks more than the annotated answer.

In summary, this concise self-study guide offers more than its title professes; it is enhanced by an informative foundational chapter that incorporates myriad viewpoints and goes beyond the typical Q & A in its depth. It is broadly applicable to the ethical dilemmas faced by every practicing clinician, educator, and medical researcher or student, offering guidance and study aid from experts in the field.

Catherine Chiles, MD

Author affiliation: Yale University School of Medicine, New Haven, Connecticut.

Potential conflicts of interest: None.

Volume: 71

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