Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
The philosophy of psychiatry has grown explosively over this period. The Royal College of Psychiatrists' Philosophy Group has over 1200 members; there is a similar thriving organisation in the USA, the Association for the Advancement of Philosophy and Psychiatry, and there are over 20 new groups in other parts of the world. The UK now has no less than three Masters and PhD programmes (at the universities of Sheffield, Warwick and London). Equally important for the future, many philosophy of mind undergraduate courses in the UK offer options in psychopathology (including the universities of Durham, Oxford and Southampton). There have been local, national and international meetings (the next major international meeting is in Florence, Italy, in the late summer of 2000). On the research front, the Nuffield Foundation has funded a pilot project based on combined philosophical and empirical methods at Warwick University, UK, and the Wellcome Foundation has recently launched a major initiative in this area. The hot news is that Philosopher's Index, the premier citation index for philosophical research, has recently adopted 'philosophy of psychiatry' as a distinct subdiscipline of philosophy.
Five-years-old is not a majority, perhaps, but the articles in this year's issue demonstrate a growing maturity, in methods, in the agendas of the three main areas of philosophy of psychiatry (ethics, philosophy of science and philosophy of mind), and in the relationship between the philosophy and the history of psychiatry.
In regard to methods, German Berrios remains an exemplar of the value of rigorous technique. His two recent books, drawing together the now encyclopaedic research on the histories respectively of psychopathological symptoms [1] and syndromes [2] have transformed our understanding of the intellectual origins of modern psychiatry. In this year's review, Bynum (pp 545-548), whose publications on the history of psychiatry have been an important counterbalance to earlier polemics [3], shows that Berrios and others continue their work with undiminished energy. The past year's publications have included not only a number of new studies of the history of our basic psychopathological concepts, but also new work on the histories of psychiatric treatments (Moniz's psychosurgery, it seems, was not as original as his Nobel prize implied!) and on the origins of our major institutions.
The methodological lessons for philosophy from the history of psychiatry are clear: modest objectives, well defined problems, carefully validated techniques, interdisciplinary methods and a thorough grounding in the realities of day-to-day clinical work and research in psychiatry, are the keys to success. Modern psychiatric ethics shows all these qualities. In this year's issue, Szmukler and Holloway (pp 549-553) cover the ethical problems emerging in community psychiatry and Adshead (pp 555-558) looks at new work on consent.
The articles reviewed by Szmukler and Holloway cover a range of critically important developments; the care programme approach, supervision registers, the UK's new 'involuntary outpatient commitment' orders. As the authors note, the ethical problems raised by these developments are old problems but in new guises. The buzz phrase is assertive community treatment. This is driven by the best of clinical motives; the need to reach those with severe mental disorders who would otherwise fall through the net.
