Ethical Self-Evidence and the Principle of Proportionality: Two Fundamental Ethical Principles Applied to a Psychiatric Case Report

Andrade, Barbara; Ugalde, Oscar
March 2011
Ethical Human Psychology & Psychiatry;2011, Vol. 13 Issue 1, p29
Academic Journal
Case Study
When confronting ethical problems, clinicians generally feel both unprepared as well as in need of orientation. Ethical norms issued by medical associations are necessary and helpful but insufficient: by definition, codes and norms are preethical; that is, they establish guidelines before the truly ethical question even arises. To arrive at a clear ethical formulation and to bridge the gap between a set of rules and their application in particular cases are essential. This article discusses some problems with ethical systems and then demonstrates that it is possible to formulate two fundamental ethical principles--ethical self-evidence and the principle of proportionality--applicable to treatment situations in a process of effective practical reasoning. Such a process forms an integral part of the doctor-patient relationship and can be practiced individually, and in staff and treatment sessions. The principles and the reasoning process are valid in all medical and mental health fields. The example shown here is their application in psychiatry, specifically, in a case of Huntington's disease.


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