Special issue

G. Meynen, M. Destoop, J.J.M. van Delden, A. Vellinga, H.L. Van, J. Vandenberghe, K.R. Goethals

Review article

Ethics of (big) data applications in psychiatric practice

F.E. Scheepers, M. Mostert, M.M. Milota, G.J.M. van Thiel

Background Due to rapid digitalization, an increasing amount of data is available in healthcare settings; big data and artificial intelligence (AI) have also made their appearance.
Aim To provide insight into various ethical dilemmas that nee...

Early detection of risk for antisocial behaviour: towards moral bio enhancement?

J. Specker, M.H.N. Schermer

Background New technological possibilities for early identification of (risk) of later antisocial behavior.
Aim To raise the question whether, or under what conditions, early identification is in the best interest of the (young) child.
Me...

The moral courage of psychiatrists

E. Karssing

Background Moral courage is the courage to do what you morally believe to be right, despite the presence of danger. Courage is certainly important in critical situations where moral values are at stake. Reflection is not enough, you have to act w...

Waiting for death: an analysis of the waiting list of the expertise centre for euthanasia

S.M.P. van Veen, G.A.M. Widdershoven

Background The waiting list of the expertise center euthanasia (EE) in the Netherlands for patients requesting euthanasia on the basis of psychiatric suffering has increased to two years in a short space of time.
Aim Clarity about the causes ...

The role of patient competence in the new Dutch statute concerning involuntary treatment in psychiatry

A. Vellinga, I.M. Hein, C. Blankman, A.J.K. Hondius, S.P.K. Welie

Background In the new Compulsory Mental Health Care Act (Wvggz), patient competence has a more central position.
Aim To describe the new position of patient competence in the Wvggz and to reflect on related moral questions.
Method Discuss...

Values under fire; ethics in forensic psychiatry

S. Kremer, K. Goethals

Background Professionals in forensic psychiatry regularly face moral issues. For example, they have to make trade-offs between the treatment of a patient and society’s security.
Aim To provide insight into some difficult, specifically forensi...

The patient voice in psychiatry: not heard, co-creation, co-optation or parallel organisation?

J. van Os, J.J.M. van Delden, W. Boevink

Background A key ethical issue in psychiatry concerns the relationship with patients. A central dilemma is that experiential knowledge (regarding existential recovery) and professional knowledge (the framework of specific-medication-for-specific-...

The underrepresentation of complex patient groups in scientific research: ethical considerations

M.B. de Koning, T.J. Burger, R. van Eck, M.J. Kikkert, L. de Haan, A. Vellinga

Background Subgroups of patients with severe mental illness are underrepresented in scientific research. One of the possible causes is the fact that in these patient groups barriers may exist to the giving of competent informed consent.
Aim D...

‘Is this the best I can do?’ Ethical reflections on good care in a context of scarcity and limitations

Y. Denier

Background Scarcity and limitations determine the context of care and have an impact on our general experience of good care. This appears in a continuous experience of deficit in, for example, lack of time, shortage of people, long waiting lists,...

Ethical issues for the further development of psychiatric deep brain stimulation

A.F.G. Leentjens, K. Schruers, P.C.M. Ackermans, D. Horstkötter

Background Except in the case of obsessive-compulsive disorder, deep brain stimulation (DBS) for psychiatric indications is an experimental treatment, reserved for the most severe and treatment resistant cases.
Aim To discuss ethical aspects ...

Coercion and urge from a care ethics perspective

Y. Voskes, G.A.M. Widdershoven, A.L. van Melle

Background Coercion is much discussed topic in psychiatry.
Aim Presentation of an ethics of care perspective on coercion, focusing on the moral aspects of the relationship between care recipient and caregiver, and the prevention and reduction...

Moral case deliberation: dialogical inquiry as a vehicle for continuous learning and good care

A.C. Molewijk

Background Professionals committed to good mental health care may experience different types of moral questions.
Aim To describe a specific conversation method for jointly discussing these moral questions: moral case deliberation.
Method ...

Ethics of assertive outreach: a case study