Seattle University Collaborative Projects - International Academy of ...

Notions of Psychiatric Disorder versus Disease in Psychiatric Classification andResearch: A Contribution to Historical/Philosophical Debate on the Very Natureof Psychiatry and its Future or Lack ThereofDenis Morrison, University of Calgary (denis.morrison@hotmail.ca)With the coming of DSM-V, still focused on disorders and more so on the dimensional criterion,Psychiatry could finally crumble under its own weight of “culturally derived abnormalbehaviours or harmful dysfunctions" (Jerome Wakefield). Research studies on disease entitiesare very few or non-existent (Shorter and Fink). Should Psychiatry become again a clinicalneuroscience like the old "Neuro-Psychiatry" of pre-Freudian days or something along the linesof Shatzberg and Kupfer's proposal? Should it continue to be a mix of the "psychological art ofhealing and understanding" adhering to both obligations of social contract and social control andstill be part of a physician's domain (medication prescription and diagnosis)? There is indeed areality not too far down the road of Psychiatry becoming simply irrelevant, not being a clinicalneuroscience, for Neurology will have taken over on one side of the fence and Psychology willhave taken over on the other. This paper discusses the implications of such and the more likelymajor changes ahead.Brain Interventions and the LawBjoern Schmitz-Luhn, University of Cologne (b.schmitz-luhn@uni-koeln.de)Deep Brain Stimulation has become an example of a most promising, reversible and versatilenew method of treatment for a variety of psychiatric conditions – only it involves entering thepatient’s brain. In clinical practice, the law is one of the major challenges to interventions in themost vital, personality-controlling, and sensitive organs of the human body. A whole frameworkof rules needs to be obeyed by physicians. While these legal norms differ internationally, theirfunction always includes safeguarding both the patient’s autonomy to decide whether to undergotreatment and to weigh risks and potential benefits of intervention, as well as adherence to thestandard of quality for medical treatment. But what are the rules that doctors have to almostuniversally obey? This presentation will give an overview of internationally fundamental aspectsof the law, categorizing requirements for good clinical practice regardless of the specificjurisdiction by their function, role and historical background, including the protection of patients’rights, the most difficult question of how to deal with impaired patient autonomy, enrolment inclinical trials vs. individual treatment attempts, ethical rules of conduct, the impact ofconstitutional law, and the avoidance of liability.278