Biological psychiatry and ethics.

Abstract

The crucial concept of biological psychiatry - comprising psycho-chemistry, psycho-physiology and psycho-pharmacology and based on a positivistic scientific view - is explanation through the demonstration of causal material connections. Conversely the central concept of the psycho-dynamic schools, based on a hermeneutic-finalistic ideology, is understanding, pertinent to the meaning of psychical symptoms. The two models are not mutually exclusive but represent complementary concepts whose mutual scientific value can only be measured through their mutual utility as basis for etiological research and for the choice of treatment. Since the age of Enlightment in the 18th century the concept of reason in the shape of an unambigous scientific attitude extensively has rendered the ethics redundant. However, our time is characterized by a reaction against this rationalistic concept about science as a substitute for morality. First of all biological psychiatry, based on the methods of the natural sciences, has been the subject of denunciation and underevaluation with deep emotional undertones. The anti-psychiatric movement, the "critical psychiatry", talks about the psychotic patient as the scapegoat, carrying the burden of the relatives conflicts on his shoulders - thus reintroducing the concept of guilt in the debate. The author claims that the relief for this guilt feeling will be found in the paradigme who regards the endogenous psychoses as biologically determined diseases and not simply as reactions to psychological and social strain. The moral-philosophical counterpart to the antagonism: positivism versus hermeneutics is found in the dualism: determinism versus indeterminism.(ABSTRACT TRUNCATED AT 250 WORDS)