From the Editor

People who live in ethical ‘glass houses’

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What about our own ethical conduct?

Finally, perhaps psychiatrists should think twice before throwing stones because we, too, may live in ethical “glass houses.” Although we try to adhere to our ethical standards, some of us occasionally may commit ethical peccadilloes, such as:

  • continuing to use haloperidol, a 45-year-old drug that has been shown to be neurotoxic in >20 studies over the past decade13
  • ignoring tier I evidence-based treatments and using unproven modalities that may delay illness resolution
  • not regularly monitoring patients for metabolic complications of antipsychotics14
  • not using depot antipsychotics for patients who exhibit violent behavior each time they relapse due to nonadherence
  • requiring a drug company representative to bring lunch to the entire clinic staff in return for access to the prescriber.

The quandary with ethics is that they can be too nuanced, enabling almost anyone who breaches an ethical boundary to find a justification. The most unambiguous ethical standards have long been moved from a moral philosophy to codified and legally enforced laws (robbery, assault, rape, homicide, etc.). Psychiatry deals with many groups that have their own version of an “ethics compass.” We psychiatrists have our own ethics standards, which we always aspire to uphold. However, are we so ethically infallible that we can smugly throw stones at people who live in ethical “glass houses?” Doesn’t our ethical “brick house” have glass windows?

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