Ethical consideration in non-pharmacological treatments for neuropsychiatric disorders

This chapter explores the ethical landscape of non-pharmacological interventions (NPIs) in elderly adults for neuropsychiatric illnesses. As drug-free alternatives, NPIs ranging from cognitive and behavioral therapies to lifestyle changes, sensory modalities, and AI-based devices, are becoming increasingly popular due to their therapeutic utility and reduced risk of side effects. However, their use raises pertinent ethical concerns of autonomy, informed consent, equity, privacy of information, and the role of artificial intelligence. The chapter addresses the impact of cognitive impairments on decision-making capacity and, therefore, the place of shared decision-making and supported consent. Structural access barriers, including geographic, cultural, and socioeconomic differences, are also addressed. Of particular interest are the ethical use of digital technology, where confidentiality of data, transparency, and impartiality of algorithms are crucial in upholding patient trust and dignity. By threading ethical critique throughout each area of intervention, the chapter invokes inclusive, patient-centered practice respectful of justice, beneficence, and respect for persons. The objective is to support responsible innovation in neuropsychiatric care that is continuous and participative, with stakeholders and ethical oversight at all stages.