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Everyday Ethics Voices from the Front Line of Community Psychiatry

ISBN-10: 0520274792
ISBN-13: 9780520274792
Edition: 2013
Authors: Paul Brodwin
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Description: This book explores the moral lives of mental health clinicians serving the most marginalized individuals in the US healthcare system. Drawing on years of fieldwork in a community psychiatry outreach team, Brodwin traces the ethical dilemmas and  More...

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Book details

Copyright year: 2013
Publisher: University of California Press
Publication date: 1/1/2013
Binding: Paperback
Pages: 248
Size: 6.00" wide x 8.75" long x 0.75" tall
Weight: 0.748
Language: English

This book explores the moral lives of mental health clinicians serving the most marginalized individuals in the US healthcare system. Drawing on years of fieldwork in a community psychiatry outreach team, Brodwin traces the ethical dilemmas and everyday struggles of front line providers. On the street, in staff room debates, or in private confessions, these psychiatrists and social workers confront ongoing challenges to their self-image as competent and compassionate advocates. At times they openly question the coercion and forced-dependency built into the current system of care. At other times they justify their use of extreme power in the face of loud opposition from clients. This in-depth study exposes the fault lines in today's community psychiatry. It shows how people working deep inside the system struggle to maintain their ideals and manage a chronic sense of futility. Their commentaries about the obligatory and the forbidden also suggest ways to bridge formal bioethics and the realities of mental health practice. The experiences of these clinicians pose a single overarching question: how should we bear responsibility for the most vulnerable among us?

Acknowledgments
Introduction: The Terrain of Everyday Ethics
Background to Practice
Genealogy of the Treatment Model
Expert knowledge and Encounters with Futility
Tools of the Trade
Treatment Plans
Mandatory Narratives of Progress
Representative Payeeships
The Deep Logic of Dependency
Commitment Orders
The Practice of Consent and Constraint
From Everyday to Formal Ethics
Coercion, Confidentiality, and the Moral Contours of Work
Bibliography
Index

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