- By Leigh DuPuy

Though a person suffering from the flu may turn to the same managed health care system as does a person suffering from depression, their needs are radically different. Psychiatrists and mental health clinicians provide different types of treatments and lead different types of doctor-patient relationships than those of their biomedical colleagues. These differences, unfortunately, are not always accounted for in current definitions of medical ethics. "There is a set of moral and ethical problems distinctive to, or at least magnified by, mental health settings," explains UMass Boston's Jennifer Radden, who seeks to create a new ethical framework for psychiatry.

Radden, professor of philosophy, received a collaborative grant of $49,392 from the National Library of Medicine at the National Institute of Health to conduct a study of character and gender in psychiatric ethics. Working with clinician John Sadler, MD, of the Psychiatry Department at the University of Texas's Southwestern Medical Center in Dallas, she is developing a handbook of professional ethics for residents training to become psychiatrists.
"Psychiatry tends to see itself as a medical subspecialty," she says. "But it is a particularly unique social and medical practice."

Radden and Sadler have begun by looking at ways to emphasize the importance of character in psychiatry using virtue theory. "Virtue ethics centers around the character of the individual," says Radden. "Instead of focusing on the duties and rights of the clinician, we look at what a virtuous person would do as a measure of right or wrong." For example, a mental health clinician's actions can be defined as ethical if they maintain trust, respect confidentiality, and do not exploit the vulnerability of a patient.

For the other part of the study, she wants to examine how gender affects psychiatric diagnosis and treatment. "I believe psychiatry is tangled up with gender. Throughout history, women's reproductive characteristics have been linked to madness," Radden says. "Do women really suffer more from mental disorders than men? I believe there has been a double standard on what mental health means for women and what it means for men." For example, she points out, many times assertive and rational behavior is interpreted as a sign of good psychiatric health for men, but not always for women.

Over the next three years, Radden and Sadler will combine theory and case materials to create a manuscript that examines the uniqueness of the mental health context and provides an ethics sensitive to gender and character in psychiatric practice. Radden sees the work as also providing philosophers with a new way to think about virtue ethics in relation to professional, psychiatric ethics.

Radden describes her specialty as the philosophy of psychiatry and teaches undergraduate classes in "Sanity and Madness" and "Mental Health Law and Public Policy." For the last year, she has worked on a task force for the American Psychiatric Association rewriting its ethics guidelines for psychiatrists.

Image: Professor Jennifer Radden specializes in the philosophy of psychiatry and currently works on a task force for the American Psychiatric Association to rewrite its ethics guidelines for psychiatrists. (Photo by Harry Brett)

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