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Abstract:
When psychiatrists treat patients with mental disorders--when clinicians of any stripe have a "difficult patient"--they confront and must come to terms with the thought that the patient is morally responsible for his conduct. Taken to its extreme form, this attitude leads to a repudiation of the whole concept of mental illness. In a modest form, and held perpetually in tension with an objective, clinical stance toward mental disorders, it is an ineluctable part of the practice of psychiatry.