A historical perspective

Studying the history of ethics in psychiatry through the chronological development of ethical codes does not do justice to the manner in which ethical themes and issues vanish and recur in that history. This chapter considers some aspects of the history of these codes, though its primary aim is to explore major ethical themes and issues in the history of psychiatry. The humanity of the ‘mad’ and the increasing manner in which persons with mental disorders are thought to be autonomous individuals are two themes that will occupy us. Increasing recognition and acceptance of the autonomy and self-determination of persons with mental disorders is the crowning ethical achievement of the history of psychiatry recounted here. However, there are also reasons to be concerned about possible excesses that may be emerging in this regard in some sectors of psychiatric treatment and research—new historical developments that merit careful ethical scrutiny.