Psychiatrische Praxis
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When founded about 1800, psychiatry was liable to both, philosophy and medicine, at least its liability to anthropological philosophy was accepted. After 150 years of increasingly unilateral medicalization with its fatal consequences for many patients the post war generation of psychiatrists were the first to re-establish the primary ambivalence. The ethical consequences of the anthropological renewal are being discussed respective to some practical situations: 1. The doctor - patient - relatives relationship embedding the activity of the interested parties; 2. mental disorders as relationship disorders; 3. ethical orientation towards the normative ambiguity of self-determination and "being meaningful for others"; 4. the consequences for the post-industrial concept of man; 5. the ethics of self-help groups; and 6. the challenge of inclusion for ethics and human rights.
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Deep brain stimulation (DBS) has been shown to be an efficacious treatment for many neurological conditions and has thus been expanded to psychiatric diseases as well. Following an introduction on the history of DBS in psychiatry, this review summarizes commonly raised ethical concerns and questions on clinical trial design, selection of patients, informed consent and concerns about the possible impact of DBS on an individual's personality. Finally, it highlights the fact that critique on DBS in psychiatry is probably not selectively based on scientific concerns about potential risks; instead, the neurobiological origin of specific psychiatric disorders has been questioned.