Ethics of psychiatry practice: consent, compulsion, and confidentiality

The belief of the universality of implementing similar ethical codes in all cultures and societies is a mirage. Informed consent, involuntary admission and confidentiality are not so empowering in some traditional and eastern societies, representing two-thirds of the World's population. Autonomy versus family-centered decision is one of the main connectors of differences between western and eastern societies. The influence of managed care and the third party in mental health services has changed not only the doctor-patient relationship, but also the disclosure of information, informed consent in therapeutic alliances and research became a basic human right and has been emphasized in the World Psychiatric Association Declaration of Madrid and its specific guidelines. Curr Opin Psychiatry 13:693-698. (C) 2000 Lippincott Williams & Wilkins.