Ethics, Experience and Evidence

Ethics, Experience and Evidence: Integration of Perspectives in Psychiatry

14th International Conference for Philosophy and Psychiatry

14th International Conference for Philosophy and Psychiatry


Last update: 2011-08-25

Detailed course program 


Thursday, September 1, 14.15–18.00

What is phenomenology?
Jan Almäng, University of Gothenburg, Sweden; Helge Malmgren, University of Gothenburg, Sweden


1.    What is phenomenology? (JA)

2.    Phenomenology of time consciousness (JA)

3.    Group discussion of time consciousness in schizophrenia

4.    Phenomenology of the body (HM)


Reading

Almäng, J.: Phenomenology. Handout material.

Fuchs, T., The Temporal Structure of Intentionality and Its Disturbance in Schizophrenia. Psychopathology 2007;40:229–235, also available as pdf.

Smith, D.W. "Phenomenology". The Stanford Encyclopedia of Philosophy.
http://plato.stanford.edu/entries/phenomenology/

de Vignemont, F., "Bodily Awareness", The Stanford Encyclopedia of Philosophy. http://plato.stanford.edu/entries/bodily-awareness/



Meaning, Understanding, Explanation
Tim Thornton, University of Central Lancashire, UK

Please refer to the following site:
https://sites.google.com/site/drtimthornton/courses/meaning-understanding-and-explanation



Essential Psychiatric Ethics
Ingemar Engström, Örebro University, Sweden; Göran Hermerén, Lund University, Sweden

14.15    Special features and challenges in psychiatric ethics (IE)

14.45    Commentary (GH)

14.50    General discussion

15.00    Models for ethical analysis (GH)

15.30     Commentary (IE)

15.35    General discussion

15.45    Coffee break

16.15    Ethics of coercive care (GH)

16.45    Commentary (IE)

16.50    General discussion

17.00    Justification for coercion – an empirical study (IE)

17.15    General discussion

18.00    End of session



Evidence Based Psychiatry
Derek Bolton, Kings College, London

Selected topics to be addressed in the workshop:
*    What is evidence-based medicine? (see e.g. Sackett)
*    Hierarchies of evidence (see e.g. OCEBM table and background documents)
*    RCTs: logic, virtues and limitations (see e.g. Cartwright, Bolton, Worrall, La Caze et al.)
*    Applications in mental health: medications (e.g. Gaudiano and Herbert)
*    Applications in mental health: psychotherapies (e.g. Chambless, Marzillier & Hall, Clark et al, Hellerstein)
*    Summary of problems of generalizability
*    Summary of problems of implementation
*    Concluding: is evidence based psychiatry a good idea?

Preparations by workshop participants before the workshop: Prepare to speak for 3 minutes on any, some or all of the follow topics:
1.    What is evidence-based medicine? What are the reasons for it?
2.    What is evidence-based medicine? What are the reasons against it?
3.    Are there special features relevant to psychiatry/mental health practice different from other areas of healthcare?
4.    Is there a good epistemological basis for the view that RCTs are best for determining the causal efficacy of treatments?
5.    What are the problems of generalising from RCTs to everyday practice?

Reading

Sackett et al. Evidence based medicine: what it is and what it isn't. BMJ 1996.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2349778/pdf/bmj00524-0009.pdf

Anthony F. Lehman, Howard H. Goldman, Lisa B. Dixon, and Rachel Churchill (2004). Evidence-Based Mental Health Treatments and Services: Examples to Inform Public Policy.
http://www.milbank.org/reports/2004lehman/2004lehman.html

David J. Hellerstein, Practice-Based Evidence Rather Than Evidence-Based Practice in Psychiatry. Medscape J Med. 2008; 10(6): 141. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491680/

Adam La Caze, Benjamin Djulbegovic, Stephen Senn (2011). What does randomisation achieve? Evidence-Based Medicine Online First, 10.1136/ebm.2011.100061

Bolton, D. (2008). The epistemology of RCTs and application in psychiatry. Philosophy, Psychology and Psychiatry 15 (2), 159-165.  (*pdf attached)

OCEBM Levels of Evidence Working Group. The Oxford 2011 Levels of Evidence. 2011. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653

Worrall J. Why there's no cause to randomize. Br J Philos Sci 2007;58:451-88.

Cartwright N. What are randomised controlled trials good for? Philos Stud 2010;147:59-70.
http://www.springerlink.com/content/93p577p2n8594l48/fulltext.pdf

Chambless DL (2007) Psychotherapy Research and Practice: Friends or Foes? (Review)
http://psychologymatters.org/pubs/books/4318033c.pdf

Brandon A. Gaudiano and James D. Herbert (2003) Antidepressant-Placebo Debate in the Media. Balanced Coverage or Placebo Hype? The Scientific Review of Mental Health Practice
http://www.srmhp.org/0201/media-watch.html

Debate about implementation (UK IAPT): Opinion by Marzillier & Hall; reply by Clark et al.