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[Thoughts on the philosophy of psychiatric practice]
1Psychiatric Department, NIMTS Hospital, Athens, Greece.
Abstract:
Philosophical training within a psychiatric context has been traditionally seen as an out- or metapsychiatric activity, not directly associated with the outcomes of psychiatric therapeutic interventions, whether they belong to the realm of psychoanalysis/psychotherapy or to that of biological psychiatry. Yet, psychiatry's subject matter (personal psychopathology), current status of scientific knowledge and research, as well as marked inefficiency of many psychiatric treatments suggest that we might consider novel ontological, epistemological/epistemic, and ethical parameters that could both enrich psychiatric philosophical thought and enhance psychiatric therapeutic practice by rendering it more efficient. Within a realistic empiricist context, in view of revising currently used diagnostic manuals (DSM-IV and ICD-10), related discourses are proposed to focus upon doctor-patient relationship. This raises ontological (diagnostic, nosographical), epistemological (related to contexts, boundaries, and methods of psychiatric knowledge), and ethical questions (as per moral significance of both quality and fullness of doctor-patient relationship regarding outcomes of treatment administered), which, in their turn till now are either ignored or superficially dealt with by traditional biomedical -psychiatric in particular- philosophy. Within this context, certain suggestions are offered towards a renewal of psychiatric philosophical thought by indicating novel research orientations for scrutiny, with the aim to optimize psychiatric practice.
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