Abstract
Can ethical theory inform the choice of intervention in circumstances under which there is more than one effective treatment available? We argue that the philosophical and ethical perspective of existentialism (which emphasizes the autonomy, responsibility, and free choice of the individual) can help answer this question. In our analysis, we selected depression- and anxiety-related problems as examples because they are associated with two alternative intervention approaches of demonstrated efficacy. These alternatives are cognitive behavior therapy and pharmacotherapy. Although both treatments would be considered to be reasonably ethical from a teleological ethical perspective, existential philosophy would suggest that the former has an additional ethical advantage.
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References
Sartre, J. P. (1957) Existentialism and human emotions, The Winston Library, New York.
Jacobson, N. S. and Hollon, S. D. (1996) Cognitive-behavior therapy versus pharmacotherapy: Now that the jury returned its verdict, it’s time to present the rest of the evidence. J. Consult. Clin. Psychol. 64, 74–80.
Rush, A. J., Beck, A. T., Kovacs, M., and Hollon, S. D. (1982) Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cogn. Ther. and Res. 1, 17–39.
Ballenger, J. C., Burrows, G. D., Dupond, R. L., Lesser, I. M., Noyes, R., and Pecknold, J. C. (1988) Alprazolam in panic disorder and agoraphobia: results from a multi center trial: I. Efficacy in short-term treatment. Arch. Gen. Psychiatry 45, 413–422.
Barlow, D. H. and Lehman, C. L. (1996) Advances in the psychosocial treatment of anxiety disorders: implications for national health care. Arch. Gen. Psychiatry 53, 727–735.
Craske, M. G., Brown, T. A., and Barlow, D. H. (1991) Behavioral treatment of panic disorder: A two year follow up. Behay. Ther. 22, 289–304.
Zohar, J., Judge, R. and the OCD paroxetine study investigators. (1996). Paroxetine vs. clomipremine in the treatment of obsessive compulsive disorder. Brit. J. Psychiatry 169, 468–474.
Flentge, F., van den Berg, M. D., Bouhuys, A. L., and The, H. T. (2000) Increase in NK-T cells in aged depressed patients not treated with antidepressant drugs. Biol. Psychiatry 48, 1024–1027.
Okasha, A., Lotaief, F., Ashour, A. M., el Mahalawy, N., Seif el Dwala, A., and el-Kholy, G. (2000) The prevalence of obsessive compulsive symptoms in a sample of Egyptian psychiatric patients. Encephale 26, 1–10.
Ononye, F., Sijuola, O. A., Chukwuani, C. M., Mume, O. C. and Makanjuola, R. O. (2000) Open comparative randomised study of Moclobemide versus Amitryptiline in major depressive illness (DSM-IIIR) in Nigeria. West Afr. J. Med. 19, 148–153.
Hornstra, R. (1962) The psychiatric hospital and the community. Paper presented at the Annual Workshop in Community Mental Health, Pisgah View Ranch, Candler, NC.
Child, N. (2000) The limits of the medical model in child psychiatry. Clin. Child Psychol. and Psychiatry 5, 1359–1045.
Milton, O. and Wahler, R. G. (1969). Perspectives and trends, in Behavior Disorders: Perspectives and Trends, 2nd ed., Milton, O. and Wahler, R. G., eds., JB. Lippincott, Philadelphia, pp. 3–16.
Kessler, R. C. (1997) The effects of stressful life events on depression. Annu. Rev. Psychol. 48, 191–214.
Brown, G. W. and Harris, T. O. (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women, Tavistock, London.
Durand, V. M. and Barlow, D. H. (2000) Abnormal Psychology, Wadsworth/Thompson Learning, Belmont, CA.
Guze, B. M. (1992) Why Psychiatry Is a Branch of Medicine, Oxford University Press, New York.
Widiger, T. and Costa, P. T. (1994) Personality and personality disorders. J. Abnormal Psychol. 103, 78–91.
Barlow, D. H. (1988) Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic, Guilford, New York.
Blume, S. (1987) Compulsive gambling and the medical model. J. Gambling Behay. 3, 237–247.
Wedgeworth, R. L. (1998) The reification of the “pathological gambler”: an analysis of gambling treatment and the application of the medical model to problem gambling. Perspect. Psychiatr. Care 34 (2), 5–9.
Sarbin, T. R. and Mancuso, J. C. (1980) Schizophrenia: Medical Diagnosis or Moral Verdict, Pergamon, Elmsford, NY.
Wyatt, R. C. and Livson, N. (1994) The not so great divide? Psychologists and psychiatrists take stands on the medical and psychosocial model of mental illness. Profess. Psychol.: Res. Pract. 25, 120–131.
Sharma, S. L., ed. (1975) The Medical Model of Mental Illness, Majestic, Woodland CA.
Burnsten, B. (1981) Rallying around the medical model. Hosp. Community Psychiatry 32, 371.
Siegler, M. and Osmond, H. (1974) Models of Madness, Models of Medicine, Harper Collins, New York.
Greenberg, A. S. and Bailey, J. M. (1994) The irrelevance of the medical model of law and illness to law and ethics. Int. J. Law Psychiatry 17, 153–173.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders. 4th ed., American Psychiatric Association. Washington, DC
Hunsley, J., Dobson, K. S., Johnston, C., and Mikail, S. F. (1999) Empirically supported treatments in psychology: implications for Canadian Professional Psychology. Can. Psychol. 40, 289–302.
Beck, A. T., Rush, A. J., Shaw, B. F., and Emery, G. (1979) Cognitive Therapy of Depression, Guilford, New York.
Rachman, S. (1998) Anxiety Psychology Press, East Sussex, UK.
Metalsky, G. I., Joiner, T. E., Hardin, T. S., and Abramson, L. Y. (1993) Depressive reactions to failure in a natural setting: a test of the hopelessness and self-esteem theories of depression. J. Abnormal Psychol. 102, 101–109.
Rachman, S. (1990) Fear and Courage, 2nd ed, Freeman, New York.
Kluge, E. W. (1992) Biomedical Ethics in a Canadian Context, Prentice-Hall Canada, Scarborough, Ontario.
Munson, R. (1999) Intervention and Reflection: Basic Issues in Medical Ethics. Nelson/Thomson Learning, Scarborough, Ontario.
LaFollette, H. (2000) Ethical Theory, Basil Blackwell, Oxford.
Macquarrie, J. (1972) Existentialism, Penguin Books, New York.
Ross, S. and Malloy, D. C. (1999) Biomedical Ethics for Health Care Professionals: Concepts and Cases. Thompson Educational, Toronto.
Heidegger, M. (1962) Being and Time Macquarrie, J. and Robinson, E. transl. Harper and Row, New York.
Kierkegaard, S. (1975) The first existentialist, in Existentialism from Dostoevsky to Sartre, Kaufmann, W., ed., Times Mirror, New York, pp. 83–121.
May, R. and Yalom, I. (1984) Existential psychotherapy, in Current psychotherapies, 3rd ed. Corsini, R., ed., F. E. Peacock, Itasca, IL.
Hynde, G. W., Hern, K. L., Novey, E. S., Eliopulos, D., Marshall, R., Gonzalez, J. J., et al. (1993) Attention-deficit hyperactivity disorder and assymetry of the caudate nucleus. J. Child Neurol. 8, 339–347.
Bandura, A. (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol. Rev. 84, 191–215.
Kierkegaard, S. (1962) The Present Age Dru, A. transi. Harper and Row, New York.
Buber, M. (1958) 1 and Thou (transi. R.G. Smith) TandT Clark, Edinburgh.
Heidegger, M. (1966) Discourse on Thinking, Harper Torchbooks, New York.
McMullen, L. M. (1995) Newt, tammy, and the task force: what happened to common sense and moderation? Canadian Clinical Psychologist 6, 5–7.
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Malloy, D.C., Hadjistavropoulos, T. (2002). Cognitive Behavioral and Pharmacological Interventions for Mood- and Anxiety-Related Problems. In: Humber, J.M., Almeder, R.F. (eds) Mental Illness and Public Health Care. Biomedical Ethics Reviews. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-088-9_3
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DOI: https://doi.org/10.1007/978-1-59259-088-9_3
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