Central to the identity of modern medical specialities, including psychiatry, is the notion of hypostatic abstraction: doctors treat conditions or disorders, which are conceived of as “things” that people “have.” Mad activism rejects this notion and hence challenges psychiatry’s identity as a medical specialty. This article elaborates the challenge of Mad activism and develops the hypostatic abstraction as applied to medicine. For psychiatry to maintain its identity as a medical speciality while accommodating the challenge of Mad activism, it must develop (...) an additional conception of the clinical encounter. Toward elaborating this conception, this article raises two basic framing questions: For what kind of understanding of the situation should the clinical encounter aim? What is the therapeutic aim of the encounter as a whole? It proposes that the concepts of “secondary insight” and of “identity-making” can allow the clinical encounter to proceed in a way that accommodates the challenge of Mad activism. (shrink)

Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.

In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work?

This article develops a eudaimonistic account of professional virtue. Using the case of teaching, the article argues that professional virtue requires that role holders care about the ends of their work. Care is understood in terms of an investment of the self. Virtuous role holders are invested in their practice in a way that makes professional excellence part of their own good. Failure to care about the ends of professional practice reveals a lack of appreciation of the value of professional (...) work. This ‘investment view’ is contrasted with the currently popular ‘key goods view’, which claims that professional virtues require a profession-specific teleological structure. Unlike ordinary virtues, which are governed by eudaimonia or human flourishing, professional virtues are allegedly derived from professional ends, like health or education. The article argues that this delivers an unconvincing criterion for determining the merits of character traits. (shrink)