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 admissio n and confidentiality are not so empowering in some traditional and eastern societies, representing two-thirds of the World's population. Autonomy ver sus family-centered decision is one of the main connectors of differences b etween western and eastern societies. The influence of managed care and the third party in mental health services has changed not only the doctor-pati ent relationship, but also the disclosure of information, informed consent in therapeutic alliances and research became a basic human right and has be en emphasized in the World Psychiatric Association Declaration of Madrid an d its specific guidelines. Curr Opin Psychiatry 13:693-698. (C) 2000 Lippin cott Williams & Wilkins.