Ethics in Labeling and Diagnoses PDF

Ethics in Labeling and Diagnoses Sydney B. Miller PSYC 340  Outline 1. Arguments 2. Arguments in against Diagnosis favor of Diagnosis ◼ Lack of clear definition ◼ Mental illness as real ◼ Validity issues...

Ethics in Labeling and Diagnoses Sydney B. Miller PSYC 340  Outline 1. Arguments 2. Arguments in against Diagnosis favor of Diagnosis ◼ Lack of clear definition ◼ Mental illness as real ◼ Validity issues ◼ Practical importance ◼ Reliability ◼ Labelling theory revisited ◼ Labelling ◼ The system will improve  Problems in diagnosis: Lack of clear definition o DSM definition of mental illness provides insufficient and hard to operationalize conceptualization of mental disorder o “Clinically significant behavioral or psychological syndrome…associated with distress or impairment in one or more areas….behavioral, psychological, biological dysfunction…disturbance is not only in the relationship between the individual and society”.  Problems in diagnosis: Validity ◼ Are types of mental disorders natural kinds? Objectivity and fundamental theoretical importance (such as chemical elements?) Homogeneity within categories? ◼ patients with the same diagnosis can have differing symptoms Categories mutually exclusive? ◼ many categories of illness overlap (having similar symptoms)  Problems in diagnosis: Validity ◼ Diagnosis requires social judgment Assessing distress, impairment… Perceptions altered by expectations / beliefs ◼ Socio-political factors: ex: Gender Identity Disorder  Problems in diagnosis: Reliability Inter-rater reliability ◼ Poor reliability for more ambiguous disorders Ex: Schizophrenia vs. alcoholism  Problems in diagnosis: Labelling ◼ Stigma and discrimination: Angermeyer et al., 2003 study on schizophrenics: ◼ Positive correlation with the belief that the individual is dangerous, increased fear, greater desire for social distance Rosenhan (1973) – experience of pseudopatients Many patients cope with stigma by keeping mental illness a secret, or by isolation  Reasons for diagnosis ◼ Mental illness exists, though it may not come in a perfectly packaged form Evidence for genetic causes Heritability as a pre-disposition Even physical symptoms are partly based on relativity and subjectivity ◼ Pain as a criterion of illness Ethics in medicine is just as important as in psychology  Reasons for Diagnosis: Labelling theory revisited ◼ Positive effects to labels Labeling replaces uncertainty and false beliefs by better understanding the nature of the problem Sociological role theory: ◼ Illness removes responsibility; more accepting attitudes towards the suffering ex. Insanity defense  Reasons for Diagnosis Practical importance ◼ Communication ◼ Aid to scientific investigations Understanding disorders, etiology, effective treatment ◼ Treatment possibilities An accurate diagnosis suggests a small number of treatments ◼ Enabling third-party payments  Reasons for Diagnosis: Things can only get better! ◼ Scientific research will help us understand psychological problems better; DSM V bound to be more accurate ◼ Diagnostic techniques will improve ◼ Anti-stigma awareness can help those who suffer due to societal  Conclusions ◼ Many pros and cons to the classification system ◼ The debate is hardly over Should we abandon the medical model? Try to improve it with the hopes that it will one day reflect natural mental disorders? ◼ Perhaps by recognizing its limitations, the DSM can be properly used?