Psychiatry and ethics: A whirlwind tour

The following is my article originally published in San Francisco Medicine (Vol. 83 No. 10, December 2010), the monthly journal of the San Francisco Medical Society. This issue was devoted to “Psychiatry for the Nonpsychiatric Physician.” Reprinted by permission.

The practice of psychiatry is rife with ethical issues. Some critics, such as author-psychiatrist Thomas Szasz, […]

Diagnostic alphabet soup

Earlier this year a reader asked me:

“I would be very interested to hear your thoughts on patients becoming too focused on diagnoses. […] While I was in an RTC as a teenager, and recently in the hospital as an adult, I have found that people almost treat their diagnoses as a competition. I was […]

Dollars for Docs

I apologize to my loyal readers for not posting in a long while. Fortunately, I was awakened from my torpor by an eye-opening new database that lists some of the money paid to specific doctors by pharmaceutical companies. The Pulitzer Prize winning investigative journalists at ProPublica tapped the public disclosures of seven companies that have […]

Et tu, Seroquel?

What could be worse than Bristol-Myers Squibb marketing its powerful and risky antipsychotic Abilify for simple depression, when there are so many effective and safer alternatives? How about AstraZeneca marketing its equally powerful and risky antipsychotic Seroquel for depression and generalized anxiety? A few days ago the FDA heard arguments from the company to do […]

NY Times roundup

Here are three recent New York Times articles that caught my eye. On March 13th, Tara Parker-Pope’s health blog “Well” reprinted “The 12 Most Annoying Habits of Therapists.” Actually, the list comes from PsychCentral, a blog written by psychologist John M. Grohol, and in my opinion reads better there. I won’t list all 12 habits […]

Abilify for depression?

I’ve written about this before — the expanded use of antipsychotic medication for indications other than psychosis. These run the gamut from acute mania, where a solid rationale exists, all the way to simple insomnia, for which there is no good rationale. Somewhere in between, but closer to the insomnia end of the scale, is […]

No free lunch

The following is my article originally published in Ethical Times (No. 16, Fall 2008), the bulletin of the Program in Medicine and Human Values at California Pacific Medical Center. Since this piece appeared, PhRMA has voluntarily suspended the distribution of branded items and certain food gifts to doctors (see my post). The ethical argument still […]