Ethics
Individual, Marriage, Group, and Community
Ethics: Individual, Marriage, Group, and Community
The Mental Health Profession is committed to treating the whole psychological person. That commitment requires the consideration of both moral and clinical categories for the effective diagnosis and treatment of the patient. Exclusive reliance on either moral or clinical categories may result in an incomplete diagnosis, ineffective treatment and ultimately a failure of the practitioner's ethical duties to the patient and to the patient's spouse, groups and community.
Ethical Implications of Using Exclusively Clinical Categories or Exclusively Moral Categories for Diagnosis
The Mental Health Profession's ethical responsibility to the individual, marriage, group and community begin, at least theoretically, with diagnosis of the individual. The vital coaction of Moral and Clinical categories has emerged as scholars examine the implications of the DSM-IV. In fact, thoughtful review of DSM-IV categories reveals that personality disorders in Clusters A and C (AllPsych, 2002) are clinical disorders while personality disorders in Cluster B (AllPsych, 2002) are moral disorders (Charland, 2006, p. 117). Cluster A disorders -- paranoid, schizoid and schizotypal disorders, and Cluster C disorders -- Obsessive-Compulsive, Avoidant and Dependent Personality disorders, are set forth in clearly clinical terms (AllPsych, 2002). However, Cluster...
119). Since a patient is quite capable of being simultaneously obsessive-compulsive and antisocial, for example, a thorough diagnosis of the individual must involve a probing inquiry of both clinical and moral categories.
Using strictly moral categories in diagnosis will necessarily limit the mental health professional to Cluster B disorders, curtailing the practitioner's ability to correctly diagnose Cluster A and Cluster C disorders, which the DSM-IV explicitly sets forth in clinical terms. Furthermore, treatment of Cluster A and Cluster C disorders does require "[w]illingness, commitment and effort" but "moral willingness, commitment and effort…is not required" (Charland, 2006, p. 123). In addition, pharmacological treatment may be necessary for the effective treatment of Cluster A and Cluster C disorders but will not be readily used for disorders limited to exclusively moral categories (Charland, 2006, pp. 121-122). Finally, Charland raises the concern that clinically trained therapists might not have sufficient training to treat exclusively moral disorders (Charland, 2006, p. 117). Consequently, reliance on merely moral categories will cause the mental health professional to misdiagnose and mistreat any Cluster…
