Moral treatment

Moral treatment appeals to the remaining free will, or moral powers, of the individual ... 

Moral treatment grew out of the converging Enlightenment trends, rational philosophy, and Christian charity. In keeping with this combination, Tuke the Quaker (1996) concluded his work with a quote from Montesquieu about the need for even the most virtuous to be restrained in their power because experience continually demonstrates, that men who possess power, are prone to abuse it they are apt to go to the utmost limits (p. 187). 

I have taken time to quote the lessons of moral treatment because these ethically based approaches remain alien to modern psychiatry. Yet these principles were proven effective nearly 200 years ago, when institutions treated people without the so-called advantage of mind-numbing drugs, electroshock, and lobotomy. 

Bockoven, S. (1963). Moral treatment in psychiatry. New York Springer Publishing. 

Shulman NS, Bosch RJ, MeUors JW, Albrecht MA, Katzenstein DA (2004) Genetic correlates of efavirenz hypersusceptibility. AIDS 13 1781-1785 Staszewski S, Morales-Ramirez J, Tashima KT, Rachlis A, Skiest D, Stanford J, Stryker R, Johnson P, Labriola DE, Earina D et al (1999) Efavirenz plus zidovudine and lamivudine, efavirenz plus indinavir, and indinavir plus zidovudine and lamivudine in the treatment of HIV-1 infection in adults. Study 006 Team. N Engl J Med 341 1865-1873 SteUbrink HJ (2007) Antiviral drugs in the treatment of AIDS what is in the pipeline Eur J Med Res 12 483 95... 

I confirm that I want to perform the treatment of my own free will without any physical or moral conditioning and I confirm that I have the right to interrupt the therapy such as I want without the necessity of justifying my decision. 

Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, Lefkowitz L, Plasse TF and Shepard KV (1995). Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of Pain and Symptom Management, 10, 89-97. 

The consumer does not usually have to pay the whole of the price of the drag prescribed by the doctor. Even in the case of a perfect agency relationship between prescriber and patient, drag consumption may not be optimal because of the existence of moral hazard. This means that the insured patient has no incentive to induce the doctor to make the effort to seek information on lower-cost treatments. Even if the doctor had complete information, because of moral hazard the patient would tend not to demand the socially optimal quantity of prescribed drags. Consequently, the patient may receive an excess of prescriptions and/or the drags prescribed may be too expensive in relation to the social optimum.17... 

Kertel LM, Murphy AA, Morales AJ, Yen SS (1994) Clinical efficacy of antiprogesterone RU 486 in the treatment of endometriosis and uterine fibroids. Hum Reprod 9 116-120... 

Moral and Ethical Issues Related to Treatment, Therapy, and Continuing Care... 

Gomez-Villacieros, R. Hernan, L. Morales, J. Tirado, J.L. (1984) Textural evolution of synthetic y-FeOOH during thermal treatment by differential scanning calorimetry. J. Colloid Interface Sci. 101 392-400... 

The principle of beneficence entails helping people to further their interests. As the primary moral principle quoted in medical codes and oaths, the principle of beneficence is fundamental to the practice of medicine and clinical research. For example, concerns about beneficence motivate physicians, pharmacologists, pharmacists, and clinical investigators, all of whom share the goal of conducting studies that will ultimately benefit society by producing or refining effective treatments. 

Reprinted with permission from Heaton JP, Adams MA, and Morales A. A therapeutic taxonomy of treatment for erectile dysfunction An evolutional imperative. Int J Impot Res 1997 9 115-121. Dept of Urology, Queen s University, Kingston, Ontario. 

That s sick, Sally says. It would be morally indefensible. There are parallels in the cases of deaf children who can be fitted with artificial hearing organs, but such things are opposed by many in the deaf community. The beings will pull the children upsilon into their world and eventually teach the children how they can best use their new eyes. It would be unethical not to give children the new retinas. The president pauses. If a child were born with eyes that saw no colors, wouldn t it be cruel to withhold treatment that allowed them to see color ... 

Simple, straightforward explanations of a patient s condition and the rationale for a specific course of action are generally well received. For those unable to benefit because of cognitive disruption, reassurance and expressions of empathy and concern are often therapeutic. A thorough, brief review of what is known about the patient s disorder should be communicated while dispelling common myths about his or her condition (e.g., the problem is related to a lack of moral strength). A patient s prognosis should be realistically and, to the extent possible, optimistically explained. Various treatment options should also be discussed, as noted in the section Informed C of Chapter 2. 

Bilsen, H.P.J.G. van (1987) Heroin addiction morals revisitedJournal of substance abuse treatment, 4 127-34. 

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