An approach to teaching ethics in child and adolescent psychiatry

Examples of ethical dilemmas, emerging in the context of a resident case-centered seminar, are used to illustrate a proposed approach to instruction in ethics for child and adolescent psychiatry residents. In addition to a rudimentary formal didactic curriculum, a teaching methodology is outlined that intentionally focuses on ethical problems, approaches to analyses, proposed courses of action, and attempts at resolution. Four representative issues are utilized: confidentiality, treatment refusal, treatment termination, and the interface of individual and family therapies. Educational objectives include the increased recognition by child and adolescent psychiatry trainees of potential ethical conflicts, of the utility of ethical analyses to inform choices of clinical interventions, and of the desirability of forestalling premature action before attempts at thoughtful resolution.