Applied Ethics in Mental Health Care

From Basic Bioethics

Applied Ethics in Mental Health Care

An Interdisciplinary Reader

Edited by Dominic A. Sisti, Arthur L. Caplan and Hila Rimon-Greenspan

Foreword by Paul S. Appelbaum

Discussions of key ethical dilemmas in mental health care, including consent, trauma and violence, addiction, confidentiality, and therapeutic boundaries.
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Discussions of key ethical dilemmas in mental health care, including consent, trauma and violence, addiction, confidentiality, and therapeutic boundaries.

This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions. This book meets that need, providing foundational background for undergraduate, graduate, and professional courses.

Topics include central questions such as evolving views of the morality and pathology of deviant behavior; patient competence and the decision to refuse treatment; recognizing and treating people who have suffered trauma; addiction as illness; the therapist's responsibility to report dangerousness despite patient confidentiality; and boundaries for the therapist's interaction with patients outside of therapy, whether in the form of tennis games, gift-giving, or social media contact. For the most part the selections address contemporary issues in contemporary terms, but the book also offers a few historic or classic essays, including Thomas S. Szasz's controversial 1971 article “The Ethics of Addiction.”

ContributorsLaura Weiss Roberts, Frederic G. Reamer, Charles P. O'Brien, and Thomas McLellan


Out of Print ISBN: 9780262019682 422 pp. | 6 in x 9 in 2 charts, 1 graph, 7 tables


$40.00 X ISBN: 9780262525015 422 pp. | 6 in x 9 in 2 charts, 1 graph, 7 tables


Dominic A. Sisti

Dominic A. Sisti is Director of the Scattergood Program for Applied Ethics of Behavioral Healthcare in the Department of Medical Ethics and Health Policy at the University of Pennsylvania's Perelman School of Medicine.

Arthur L. Caplan

Arthur L. Caplan is Director of the Division of Medical Ethics in the Department of Population Health at New York University's Langone Medical Center.

Hila Rimon-Greenspan

Hila Rimon-Greenspan is a researcher at Bizchut, the Israeli Human Rights Center for People with Disabilities.


Paul S. Appelbaum.


  • It has always been puzzling that more attention has not been paid to the profound ethical challenges of mental health care, posing perhaps the most difficult and thorny ethical questions in all of medicine. In this superb volume, Sisti, Caplan, and Rimon-Greenspan have gathered in one place some of the most thoughtful and incisive thinkers about the difficulties of caring for people with mental illness. Most important, the ethical considerations grapple with the lived reality of the mentally ill and those who are caring for them. Applied Ethics in Mental Health Care is an important and timely contribution to this ongoing ethical conversation.

    Paul Root Wolpe

    Asa Griggs Candler Professor of Bioethics and Director of the Center for Ethics, Emory University

  • Mental health is the area of medicine that provides the greatest and most persistent ethical challenges to practitioners. In an era that holds dear 'patient autonomy,' it routinely faces patients who suffer disorders that place the capacity for autonomy in question. In an era that holds dear individuals' rights to pursue the life paths they value, it routinely faces the challenge to distinguish what are merely unwise, or perhaps even immoral, life choices from real pathology. In this book, Sisti, Caplan, and Rimon-Greenspan offer a compendium of thoughtful, reasoned, and down-to-earth discussions of these issues and many others that face the mental health professional on a daily basis. I'm confident that mental health professionals will find themselves consulting this book regularly to help them negotiate the ethics of everyday practice. They may also want to build it into the training they give young professionals who are entering the field.

    Barry Schwartz

    Professor of Psychology, Swarthmore College; coauthor of Practical Wisdom: The Right Way to Do the Right Thing

  • This is a collection of brilliant voices and perspectives that will intrigue and challenge expert and novice alike as it shines light on the complex ethical issues engendered by the messy clinical world that is mental health care.

    John Maher MD

    FRCPC; Senior Editor, Journal of Ethics in Mental Health