Ethics and old age psychiatry

Abstract

This chapter is about ethics, i.e. about right or wrong decisions and good or bad judgments in clinical practice. It starts by reflecting on the extent to which all clinical decisions are, at one and the same time, ethical decisions. This is reflected in the idea of values-based practice. It outlines the major moral theories and a range of approaches to ethical issues. These theories and approaches have to be put into practice and it is not always clear how this should be done. The notion of patterns of practice, which will be described, may be helpful. There is a great variety of ethical issues that emerge in old age psychiatry, in particular in connection with dementia. The notion of patterns of practice is used, with the help of fictional vignettes, to discuss and understand such issues.