Healing Psychiatry: Bridging the Science/Humanism Divide (Basic Bioethics)
In his 1983 treatise, The Reflective Practitioner, philosopher Donald Schon explained that many professionals negotiate a tricky landscape between a high ground of theoretical questions and a swampy lowland of messy, real-life situations. The quandary is that the issues of the high ground, though easy to resolve, are relatively unimportant to most people, whereas the swamp involves matters of deep human concern. Should the practitioner remain safe or descend instead into the soup to help real people in real need? Psychiatrists struggle with such tension daily. Practicing their profession requires theory and diagnostic definition, yet reaching a patient requires an emotional bond between the two individuals. David Brendel, an assistant professor of psychiatry at Harvard Medical School who has academic training in philosophy, explores the complexity of this tension and how it vexes modern mental health care. "The disorder in twenty-first-century psychiatry is all about the search to integrate human values," Brendel writes. "With no objective moral or conceptual compass to orient today’s practitioner, the world of clinical psychiatry remains messy and ill-defined." Despite increasing precision in biological psychiatry, he adds, "inherent limitations" of such approaches often lead to treatment shortfalls when faced with "complex and unpredictable human behavior." Part of the solution, Brendel advises his colleagues, is to invoke a pragmatic approach espoused by the classical American philosophers William James and John Dewey. Together James and Dewey cultivated an eclectic and variegated view of scientific inquiry and discourse that aims for practical consequences for ordinary people. They emphasized the need to remain open-minded when interpreting scientific results, which always arise in a social context that shapes the nature and use of new findings. Along similar lines, Brendel advocates a "clinical pragmatism" that, for example, favors practical results over cumbersome psychological theories, decries moralistic decisions devoid of patient input, and steers clear of attributing greater certainty to clinical interpretations than may actually exist. Fleshing out his pragmatist views, he interweaves case studies with philosophical discourse and vivifies theories with clinical tales. Brendel highlights his message with a New Yorker cartoon captioned "Richard the Pragmatist," in which the king proclaims: "My kingdom for a newer, stabler, more centrally located kingdom!" So, too, for the workaday practitioner, struggling to treat a patient afflicted with recurring depression or anxiety.Richard Lipkin--This text refers to an out of print or unavailable edition of this title.