Neuroethics and Psychiatry: New Collaborations for Emerging Challenges

By Emily R. Murphy, PhD; Judy Illes, PhD

“Better sick than lazy,” wrote one respondent on a survey assessing receptivity to diagnostic brain scans for depression. Mental illness, long the domain of psychiatry, may prove to be the first major medical or scientific area to intrude on the average sense of “intuitive dualism” — the conviction that the mind, which can be judged to be lazy, is treated as distinct from the brain, which may be broken when sick. Widespread information about brain scans and promise of targeted new neurotreatments may bring more untreated mental illness into the clinic and increase treatment compliance, if the allure of anything neuro-based helps biologize mental illness and treatments become more tolerable with fewer side effects. Basic and clinical neuroscience research resulting in new technologies and drugs to manipulate the brain and relieve or cure mental illness will compel this merger of psychiatry, neurology, and neurosurgery. These developments herald an era of great hope for patients who may return to a normal life and for practitioners who will have access to more tools for effective diagnosis and treatment.

ABOUT THE AUTHORS

Emily R. Murphy, PhD, is a Fellow, Center for Law and the Biosciences, Stanford Law School. Judy Illes, PhD, is Professor of Neurology and Canada Research Chair in Neuroethics, National Core for Neuroethics, University of British Columbia, Vancouver, British Columbia.

Address correspondence to: Emily R. Murphy, PhD, Center for Law and the Biosciences, 559 Nathan Abbott Way, Stanford, CA 94305-8610; or e-mail ermurphy@ stanford.edu.

Dr. Murphy and Dr. Illes have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

1. Describe the scope of the field of neuroethics.
2. Discuss the ethical implications of newer technologies applied to psychiatry.
3. Review potential ethical issues raised by the prospect of neurochemical manipulation of memory and cognition.

This CME activity is primarily targeted to patient-caring physicians specializing in psychiatry. Physicians can receive AMA PRA Category 1 Credits™ by reading the CME articles in Psychiatric Annals and successfully completing the quiz at the end of the articles. Complete instructions are given subsequently. Educational objectives are found at the beginning of each CME article.

CME ACCREDITATION

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and Psychiatric Annals. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Vindico Medical Education designates this educational activity for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

FULL DISCLOSURE POLICY

In accordance with the Accreditation Council for Continuing Medical Education's Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.

UNLABELED AND INVESTIGATIONAL USAGE

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

INSTRUCTIONS

1. Review the stated learning objectives of the CME articles and determine if these objectives match your individual learning needs. You must read each of the CME articles in this issue carefully in order to take the quiz. Do not neglect the tables and other illustrative materials as they have been selected to enhance your knowledge and understanding.
2. The cost of taking the CME quiz is $25; you must pay this fee prior to completing the quiz online.
3. The quiz questions have been designed to provide a useful link between the CME articles in the issue and your everyday practice. Read each question and choose the correct answer by checking the box next to your desired answer.
4. After you answer all questions, your quiz is graded. A score of at least 80% is required to pass
5. If you passed the quiz, you will receive by mail a CME certificate of within 4 to 6 weeks. If you failed the quiz, you may retake the quiz at another time by returning to the CME articles and then registering again for the quiz.

| | |

Ethics and Design Flaws of Humanity
Jan Fawcett, MD

Psychiatric Ethics — A Complicated Challenge
Michael Robertson, MB, BS, FRANZCP; Garry Walter, MB, BS, PhD, FRANZCP

Psychiatry in the News

 Care Ethics: What Psychiatrists have been Waiting for to Make Sound Ethical Decisions
Sidney Bloch, MD, PhD

 The Ethics of Psychiatric Diagnosis
Michael Robertson, MB, BS, FRANZCP; Garry Walter, MB, BS, PhD, FRANZCP

Narrative Ethics in Psychiatry and the Literature of Youth
Karen Fisher, MB, BS; Garry Walter, MB, BS, PhD, FRANZCP; Michael Robertson, MB, BS, FRANZCP