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February 25 PHL383 notes.docx

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University of Toronto St. George
Thomas Mathien

February 25, 2013 - Virtues for psychiatrists continued  Radden and Sadler, you can never get a completely clear case down on paper  Papers returned today  Next papers need to be submitted by March 11  Phronesis: cognitive capacity  But it’s not just cognitive capacities, but also the whole realm of the emotive that make for a good mental health care provider  Gender vs. sex: the distinction is just a convenience, gender is much more a social categorization, sex has more to do with biological markers that determine gender  But this is nothing that is too hard and fast  Gender self attribution based on a whole set of complex factors  People will fundamentally see themselves as male or female, straight or gay, transgendered  Distinguish between the features that constitute an identity for us, and other features (social roles, symptoms, etc.)  Radden and Sadler make a strong claim about mental health care practitioners, that the moral standards for doing it are very high, in 2 flavours: mental healthcare givers have to present extra virtue, and that they have to also possess/present extra virtues  Interested in trustworthiness (important for all professionals to be trustworthy)  Client expects to depend on the good service of the professional who provides that service  Failure to be trustworthy is important in a profession, but there’s something more in the case of mental health care provision, and it has more to do with the fact that much of mental health in many of the standard approaches to therapy requires that a patient reveals certain important facts about themselves and their behavior and thoughts  In order to do this the client will need to feel that they are able to trust the person they are confiding in  Communication needs trust  Trust is not just framework for the transaction between the therapist and their client, it’s one of the tools by which that transaction takes place, without it you do not get the essential communication need for any therapeutic method  Even if the mode of therapy is primarily pharmacological the trust needs to be there for good diagnoses to be achieved  This is especially true as many maintain that the care recipient think of you as an ally  Trustworthiness is a virtue in many moral situations but especially demanded in the field of mental health care  Propriety is concern about appearances  The person who manifests propriety worries about their actions being perceived as on the up and up  Do well and to be seen to do well  If they only care about appearances we might them of them being a little rigid  The therapist needs to be immune from accusations  A closed door in intimate exchanges looks a little like an opportunity to be exploited, so it’s important for caregivers to respect boundaries and that everyone (patient and observers) recognize that the boundaries are being respected  This is done through the conduct of the professional outside the therapeutic situations and in the everyday community  Both doing well and being seen to do well are both important  Propriety: a heightened concern for how one’s actions are perceived  A failure to engage in propriety can effect how you can conduct therapy in general, and discredit the professional/the whole profession  Concerns for how things are perceived are very important in these cases  Impatience might be the right thing to show at the right time for the right reasons  Patience and perseverance (patience over a long term, sticking with continued treatment of a patient in the face of set backs) are important  Communications difficulties between the therapist and the patient  The patient may be delusional and it will be difficult to figure out what the implications of the strange things they say are  Impact on communication ability  Patience is required  Mental disorders never have a completely clear diagnoses  The problems are much more complex than any physical ailments  No cut and dry guarantee of success therapies  Individuals respond to various chemicals very differently  Decide sometimes whether a potential benefit is worth a considerable risk  Requires fortitude  Gender sensitivity – a good thing for anyone to display gender sensitivity  Particularly important in the case of people giving care to others  People may feel extreme discomfort with their own physiology because of their gender self attribution  In many cases the good psychiatrists is displaying virtues that would be moral virtues elsewhere (professional or general, public or personal)  But there are extra virtues required for mental health care providers that need not be required for others  For example: warmth  An accountant need not be warm, though they may be  Warmth helps build trust, and feeling an emotional connection with their caregiver is another instrument that enables you to use that relationship  Warm caregiver may be a better ally  Empathy certainly seems to be an essential characteristic for a good mental health care provider  Empathy is very central to a good understanding and a good diagnoses  In the case of mental health care you need to be able to imagine what it would be like to be that person in that situation, in order to be able to come to understand what may be going on in that situation  The claim that some psychotic situations are impossible to understand may be a set back  Empathy and warmth cannot be commanded to happen  Role is to be attentive and be helpful, although you are involved in some sense, you are involved primarily as the care provider and so your own personality matters only so that the appropriate responses be mediated by your personality  These virtues will fall depending on the case in category 1 or category 2  Phronesis in category 1, authenticit
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