Philosophy and psychiatry: problems of clinicians and problems of life.

Abstract

Psychiatry raises key philosophical questions. Psychiatric classification systems raise ontological questions about diagnostic thresholds (have we have optimally divided conditions from health, and from one another?) and validity (do our particular diagnostic criteria optimally reflect the phenomenology of psychopathology, and its underlying causal mechanisms?). Psychiatric case formulations raise epistemological questions about the strength of studies of causal mechanisms in psychiatric disorders, and about how best to integrate work on biological, psychological, and societal mechanisms. Psychiatric treatments raise ethical questions about when such interventions should be provided, and about whether some treatment modalities are more appropriate; while such decisions rely on the evidence base, they also require engagement with patients’ values.