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Ethics before technology: Is ‘treatment’ the best way to think about mental health work? 

Ethics before technology: Is ‘treatment’ the best way to think about mental health work?
Chapter:
Ethics before technology: Is ‘treatment’ the best way to think about mental health work?
Source:
Postpsychiatry: Mental health in a postmodern world
Author(s):

Patrick Bracken

and Philip Thomas

DOI:
10.1093/med/9780198526094.003.0012

Chapter 6 marks the end of the central section and also starts the process of opening up some of the implications of our analysis for the world of mental health practice. If postpsychiatry is to be remembered by an aphorism, then that aphorism would be ‘ethics before technology’. In Chapter 6, we dwell in detail on this. Our most important proposition here is that, despite claims to objectivity and neutrality, the technology and evidence on which current mental health practice are based are laden with assumptions and particular interests. Our position is that there is no such thing as a truly objective human knowledge or understanding, and that the sooner we recognize this and start attending to issues of transparency and accountability, the better for all concerned. We start by challenging the way that the profession conventionally interprets the evidence (from randomized controlled trials) for the effectiveness of psychotropic medication. Related to this, we consider the cultural significance of the ‘Prozac phenomenon’ and the highly problematic links between academic psychiatry and the pharmacological industry. We propose that, to a large extent, the effectiveness of drugs used in psychiatry is to be understood in terms of their cultural significance. This is an important issue that we return to in the final section of the book. At the end of Chapter 6, we argue the case for the priority of ethics in mental health practice and examine a key event in the history of psychiatry: the opening of the York Retreat at the end of the 18th century.

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