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El. knyga: Is evidence-based psychiatry ethical?

(Psychiatrist and researcher in bioethics, University of Montreal, Canada)

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Rated as one of the top 15 breakthroughs in medicine over the last 150 years, evidence-based medicine (EBM) has become highly influential in medicine. Put simply, EBM promotes a seemingly irrefutable, principle: that decision-making in medical practice should be based, as much as possible, on the most up-to-date research findings. EBM has been particularly popular within psychiatry, a field that is haunted by a legacy of controversial interventions. For advocates, anchoring psychiatric practice in research data makes psychiatry more scientific valid and ethically legitimate. Few, however, have questioned whether EBM, a concept pioneered by those working in other areas of medicine, can be applied to psychiatric disorders.

In this groundbreaking book, the Canadian psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of EBM, and critically examines their applicability to psychiatry. By highlighting the basic ethical tensions between psychiatry and EBM, the author addresses the fundamental and controversial question - should psychiatrists practice evidence-based medicine at all?

Recenzijos

For those who wish not to "get swept along in this latest chapter in the history of medical ideas" (p 186), Is Evidence-Based Psychiatry Ethical? is a 1-stop primer on EBM (albeit a biased one) and a stimulus for thinking critically about its central tenets and implications. * Nicholas Kontos, Harvard Medical School, Journal of Clinical Psychiatry Book Review * Read this brilliant book by Mona Gupta, Is Evidence-Based Psychiatry Ethical... The lesson is that psychiatry is not just another branch of medicine. The essential issue in psychiatry is not what we all share, but what makes us unique. This book on Evidence-Based Medicine in psychiatry has layers of riches. First, and particularly for practitioners and trainees, the book explains EBM in a detailed, fair-minded, and critical way that allows readers to understand the utility as well as the limits of EBM in everyday practice. Second, it describes the ethical context of psychiatric practice and its relationship to "knowledge production" that will be of substantial interest to those training directors in psychiatry who wish to avoid a naive scientism and train effective, moral clinicians with equal portions of knowledge, skills, and attitudes. Third, the ingenious research methodology behind the book combines qualitative social science research, philosophical analysis, and iterative peer discussion that could provide a fruitful model for any number of social/conceptual issues in mental health. In her excellent book, Mona Gupta fruitfully organizes and interprets this uneasiness. She shows that, because the care of the mentally disordered always occur in an intersubjective space, it is by definition a social and ethical enterprise. Many of the variables involved in this process are beyond the reach of quantification. Hence, the question of whether by ignoring them āevidence-based psychiatryā effectively infringes and distorts essential aspects of treatment needs an answer. After a thorough analysis, Mona Guptaās conclusion is that it does. This is an illuminating and interesting book on the applicability of evidence-based medicine (EBM) to psychiatry... an excellent and scholarly book that addresses an important issue for the future of psychiatry. I highly recommend it to any practicing psychiatrist. * Doody's Notes *

Daugiau informacijos

Highly commended at the BMA Medical Book Awards 2015
1 What does evidence have to do with ethics?
1(12)
2 What is evidence-based medicine?
13(32)
3 Values and evidence-based medicine: the debate
45(24)
4 Psychiatry and evidence-based psychiatry
69(22)
5 The critique of evidence-based psychiatry
91(26)
6 The ethics of evidence-based medicine
117(32)
7 Experts talk about ethics, evidence-based medicine, and psychiatry
149(18)
8 Is evidence-based psychiatric practice ethical?
167(14)
9 Conclusions
181(6)
Appendix 1 187(10)
Index 197
Mona Gupta is a psychiatrist and researcher in bioethics at the Université de Montréal in Montréal, Canada. She received her medical degree from McGill University and then completed her postgraduate training in psychiatry at the University of Toronto where she also received her PhD in bioethics. Dr Gupta has published and presented widely on the subject of ethics and evidence-based medicine in psychiatry.