This article deals with the relation between ethics and psychiatry. First we discuss two different views on the nature of ethics: a metonymical and a metaphorical view. Metonymical or practical ethics is the dominant view in the literature about psychiatry and ethics and shares the presuppositions of the medical model. As a consequence, these presuppositions must be taken for granted. In contrary, metaphorical ethics is focused on these presuppositions. In a discussion about the question whether psychiatry must be considered as a metonymical or a metaphorical activity, we develop the thesis that psychiatry in theory as in practice, can provide a good case to criticize metonymical ethics. However, this means that psychiatry as such is a moral enterprise already, because psychiatry is not only one of the instruments of a cultural strategy to deal with otherness, but also fundamental ambiguous in her theory.