Post by Admin on Apr 17, 2024 18:48:52 GMT
Humility
www.cambridge.org/core/blog/2024/04/16/humility/
The Royal College of Psychiatrists’ values and behaviours, Courage, Innovation, Respect, Collaboration, Learning and Excellence combine into the CIRCLE acronym. In the list under Excellence, a link takes you to core values for psychiatrists. One of those is humility.
‘Our values and our historical understanding of psychiatrists‘ notes the lack of humility displayed by two psychiatrists a century ago, Henry Cotton and Ernst Rüdin. Without humility they ceased to listen to colleagues who critiqued their work and they failed to reflect on the ethics of their own clinical and research practices. Their actions resulted in huge injustices for people suffering from mental disorders of many sorts. Fortunately, such extreme examples are rare. Cotton and Rüdin were chosen intentionally for this article, to provoke thought about how we practice medicine. Understanding the flaws and strengths of our forebears may prompt us to reflect on our own work, in ways which may help us improve in our professional duties.
It is disturbing to read a recent BMJ editorial citing Rob Behrens, Parliamentary and Health Service Ombudsman. He has noticed an arrogance from some doctors which stops communication between them and their patients. If he is right, where is their humility and what harm might come from its absence?
Another recent editorial, Severe mental illness in the UK: a crisis of compassion, in the Lancet, paints a gloomy picture of NHS psychiatry, especially provision for the most seriously mentally unwell people. The editorial supports the Royal College of Psychiatrists “in their call for all parties to prioritise mental health in their manifestos. We need an evidence-led mental health service that we can trust to ensure that no one is left uncared for.”
What else should we do? Are we humble or arrogant, or where, on a continuum between the two do we sit? We are, of course, only part of a bigger whole, but might we risk being another generation in which bad psychiatry or inhumanities perpetuate associated with our actions or inactions? What will future generations of psychiatrists learn from us when they try to interpret our values in their historical understanding of their forebears?
Thank you to Claire Hilton for this excellent and thoughtful article. It reminds us that while progress is important, and necessitates looking forward, we must also look back, lest we forget, then repeat some of the mistakes of yesterday. But how might we do that best? How do we consider the events of the past – in this case, the events of psychiatry’s past – while simultaneously acknowledging that our forebears were invariably operating under different societal terms and conditions, yet not shy away from difficult conclusions when they must be reached. Hilton examines two examples in some depth – the theory of focal sepsis as a causative agent in mental disorder, and the rise of eugenics in the early 20th Century. She tackles both head on, as a good historian must, and later concludes: “just because practices become established does not mean that they are fit for purpose clinically, scientifically, or ethically”. Her point is well made. In order to do more moving forward, we must also do more looking back.
Andrew Forrester
Editor-in-Chief, BJPsych Bulletin
www.cambridge.org/core/blog/2024/04/16/humility/
The Royal College of Psychiatrists’ values and behaviours, Courage, Innovation, Respect, Collaboration, Learning and Excellence combine into the CIRCLE acronym. In the list under Excellence, a link takes you to core values for psychiatrists. One of those is humility.
‘Our values and our historical understanding of psychiatrists‘ notes the lack of humility displayed by two psychiatrists a century ago, Henry Cotton and Ernst Rüdin. Without humility they ceased to listen to colleagues who critiqued their work and they failed to reflect on the ethics of their own clinical and research practices. Their actions resulted in huge injustices for people suffering from mental disorders of many sorts. Fortunately, such extreme examples are rare. Cotton and Rüdin were chosen intentionally for this article, to provoke thought about how we practice medicine. Understanding the flaws and strengths of our forebears may prompt us to reflect on our own work, in ways which may help us improve in our professional duties.
It is disturbing to read a recent BMJ editorial citing Rob Behrens, Parliamentary and Health Service Ombudsman. He has noticed an arrogance from some doctors which stops communication between them and their patients. If he is right, where is their humility and what harm might come from its absence?
Another recent editorial, Severe mental illness in the UK: a crisis of compassion, in the Lancet, paints a gloomy picture of NHS psychiatry, especially provision for the most seriously mentally unwell people. The editorial supports the Royal College of Psychiatrists “in their call for all parties to prioritise mental health in their manifestos. We need an evidence-led mental health service that we can trust to ensure that no one is left uncared for.”
What else should we do? Are we humble or arrogant, or where, on a continuum between the two do we sit? We are, of course, only part of a bigger whole, but might we risk being another generation in which bad psychiatry or inhumanities perpetuate associated with our actions or inactions? What will future generations of psychiatrists learn from us when they try to interpret our values in their historical understanding of their forebears?
Thank you to Claire Hilton for this excellent and thoughtful article. It reminds us that while progress is important, and necessitates looking forward, we must also look back, lest we forget, then repeat some of the mistakes of yesterday. But how might we do that best? How do we consider the events of the past – in this case, the events of psychiatry’s past – while simultaneously acknowledging that our forebears were invariably operating under different societal terms and conditions, yet not shy away from difficult conclusions when they must be reached. Hilton examines two examples in some depth – the theory of focal sepsis as a causative agent in mental disorder, and the rise of eugenics in the early 20th Century. She tackles both head on, as a good historian must, and later concludes: “just because practices become established does not mean that they are fit for purpose clinically, scientifically, or ethically”. Her point is well made. In order to do more moving forward, we must also do more looking back.
Andrew Forrester
Editor-in-Chief, BJPsych Bulletin