Ethics and psychiatry.
Madrid Declaration On Ethical Standards For Psychiatric Practice.


The psychiatric practices implies ethical considerations. Psychiatrists have the duty to be aware of the specific ethical needs of psychiatry.
The Declaration of Madrid includes seven guidelines that focus on the aims of psychiatry to treat mentally ill patients, prevent mental illness, promote mental health and provide care and reinsertion for patients
The World Psychiatric Association (WPA) approved the following ethical standards that should govern the conduct of psychiatrists worldwide.
Each patient has the right to know it and check if his/her physician respects this code
Meme page en Francais / Same page in french
Madrid Declaration On Ethical Standards For Psychiatric Practice (august 2OO2)
  1. Psychiatry is a medical discipline concerned with the provision of the best treatment for mental disorders, with the rehabilitation of individuals suffering from mental illness and with the promotion of mental health. Psychiatrists serve patients by providing the best therapy available consistent with accepted scientific knowledge and ethical principles. Psychiatrists should devise therapeutic interventions that are least restrictive to the freedom of the patient and seek advice in areas of their work about which they do not have primary expertise. While doing so, psychiatrists should be aware of and concerned with the equitable allocation of health resources.
  2. It is the duty of psychiatrists to keep abreast scientific developments of the specialty and to convey updated knowledge to others. Psychiatrists trained in research should seek to advance the scientific frontiers of psychiatry.
  3. The patient should be accepted as a partner by right in the therapeutic process. The psychiatrist-patient relationship must be based on mutual trust and respect to allow the patient to make free and informed decisions. It is the duty of psychiatrists to provide the patient with relevant information so as to empower the patient to come to a rational decision according to personal values and preferences.
  4. When the patient is incapacitated and/or unable to exercise proper judgment because of a mental disorder, or gravely disabled or incompetent, the psychiatrists should consult with the family and, if appropriate, seek legal counsel, to safeguard the human dignity and the legal rights of the patient. No treatment should be provided against the patientís will, unless withholding treatment would endanger the life of the patient and/or those who surround him or her. Treatment must always be in the best interest of the patient.
  5. When psychiatrists are requested to assess a person, it is their duty first to inform and advise the person being assessed about the purpose of the intervention, the use of the findings, and the possible repercussions of the assessment. This is particularly important when the psychiatrists are involved in third party situations.
  6. Information obtained in the therapeutic relationship should be kept in confidence and used, only and exclusively, for the purpose of improving the mental health of the patient. Psychiatrists are prohibited from making use of such information for personal reasons, or financial or academic benefits. Breach of confidentiality may only be appropriate when serious physical or mental harm to the patient or to a third person would ensue if confidentiality were maintained; as in case of child abuse in these circumstances, psychiatrists, should whenever possible, first advise the patient about the action to be taken.
  7. Research that is not conducted in accordance with the canons of science is unethical. Research activities should be approved by an appropriately constituted ethical committee. Psychiatrists should follow national and international rules for the conduct of research. Only individuals properly trained for research should undertake or direct it. Because psychiatric patients are particularly vulnerable research subjects, extra caution should be taken to safeguard their autonomy as well as their mental and physical integrity. Ethical standards should also be applied in the selection of population groups, in all types of research including epidemiological and sociological studies and in collaborative research involving other disciplines or several investigating centers
    (All rights reserved - World Psychiatric Association approved at the General Assembly on August 25th, 1996 - http://www.wpanet.org )
See also the pages
Is the DSM useful, not to say essential or "dangerous" ?,(DSM and ethics)
The right to be sick and dignity,(in french)
Do we have the right to ask the question of the training and competence of "shrinks" ?,(in french)
French medical code of ethics, right to information and diagnosis
AAPEL's code of ethics

AAPEL - Back to BPD summary page

All the information in this site is aimed at helping people understand a "rather particular" and puzzling kind of disease
But more especially, to support everyone affected by it, sick or not.  In any case, it is ESSENTIAL to see a therapist who specialises in this field they can confirm or give an alternative diagnosis
The name of what youíve got doesnít matter so much, getting the right treatment for the right patient does
last update  2019
Copyright AAPELTM - All rights reserved
Author, Alain Tortosa, founder of the Aapel