Psychiatry at the cross-roads: The prescription of mood altering drugs and related ethical obligations

Psychiatrists work with potentially harmful mood altering drugs. Wrongful prescription and conflicts of interest remain as problems despite legal and ethical remedies. Psychiatrists also work in a context where risk management, the fiction of the “informed consumer”, and questions regarding safety and effectiveness of pharmaceutical drugs present challenges to the legitimacy and credibility of the profession. The views of seven psychiatrists are explored, using qualitative interview methods, on how prescribing impacts “doing psychiatry” and what ethical obligations are important in prescribing mood drugs. Data analyzed reveal participant views emerging around active patients, skepticism of the pharmaceutical industry, and the merits of drug treatment for mood disorders. Psychiatrists interviewed highlight the importance of an actor’s sense of ethical responsibility and efficacy. However, the willingness and potential to create dialogue within the profession around ethical prescribing, as well as challenging the entrenchment of the biomedical model, is largely uncertain.