The Ethical Treatment of Depression: Autonomy Through Psychotherapy (Philosophical Psychopathology: Disorders of the Mind)

A philosopher argues there is an ethical imperative to provide psychotherapy to depressed patients because the insights gained from it promote autonomy. One in six people worldwide will experience depression over the course of a lifetime. Many who seek relief through the healthcare system are treated with antidepressant medication; in the United States, nearly 170 million prescriptions for antidepressants were written in 2005, resulting in more than $12 billion in sales. And yet despite the dominance of antidepressants in the marketplace and the consulting room, another treatment for depression has proven equally effective: psychotherapy-in particular, cognitive behavior therapy (CBT). Antidepressants can lift mood independent of a person's understanding of symptoms or stressors. By contrast, CBT teaches patients skills for dealing with distressing feelings, negative thoughts, and causal stressors. In The Ethical Treatment of Depression, Paul Biegler argues that the insights patients gain from the therapeutic process promote autonomy. He shows that depression is a disorder in which autonomy is routinely and extensively undermined and that physicians have a moral obligation to promote the autonomy of depressed patients. He concludes that medical practitioners have an ethical imperative to prescribe psychotherapy-CBT in particular-for depression. To make his case, Biegler draws on a wide philosophical literature relevant to autonomy and the emotions and makes a comprehensive survey of the latest research findings from the psychological sciences. Forcefully argued, densely researched, and engagingly written, the book issues a challenge to physicians who believe their duty of care to depressed patients is discharged by merely writing prescriptions for antidepressants One in six people worldwide will experience depression over the course of a lifetime. Many who seek relief through the healthcare system are treated with antidepressant medication; in the United States, nearly 170 million prescriptions for antidepressants were written in 2005, resulting in more than $12 billion in sales. And yet despite the dominance of antidepressants in the marketplace and the consulting room, another treatment for depression has proven equally effective: psychotherapy—in particular, cognitive behavior therapy (CBT). Antidepressants can lift mood independent of a person’s understanding of symptoms or stressors. By contrast, CBT teaches patients skills for dealing with distressing feelings, negative thoughts, and causal stressors. This book argues that the insights patients gain from the therapeutic process promote autonomy. It shows that depression is a disorder in which autonomy is routinely and extensively undermined and that physicians have a moral obligation to promote the autonomy of depressed patients. The book concludes that medical practitioners have an ethical imperative to prescribe psychotherapy—CBT in particular—for depression. To make this case, the book draws on a wide philosophical literature relevant to autonomy and the emotions, and makes a comprehensive survey of the latest research findings from the psychological sciences. The book issues a challenge to physicians who believe their duty of care to depressed patients is discharged by merely writing prescriptions for antidepressants In This Book, Paul Biegler Argues That The Insights Patients Gain From The Therapeutic Process Promote Autonomy. He Shows That Depression Is A Disorder In Which Autonomy Is Routinely And Extensively Undermined And That Physicians Have A Moral Obligation To Promote The Autonomy Of Depressed Patients. He Concludes That Medical Practitioners Have An Ethical Imperative To Prescribe Psychotherapy- Cognitive Behavior Therapy In Particular- For Depression.--[book Jacket]. Autonomy : The Importance Of Justified Beliefs About Material Facts -- Autonomy : The Importance Of Justified Beliefs About Affect -- Depression : Disorder Of Affect, Disorder Of Autonomy -- Understanding Negative Biases Promotes Autonomy In Depression -- Understanding Causal Stressors Promotes Autonomy In Depression -- A Special Duty To Promote Autonomy In Depression : The Moral Case For Psychotherapy. Paul Biegler. Includes Bibliographical References (p. [175]-206) And Index. "This book is long overdue. Biegler gives a compelling analysis of the impact depression has on autonomous decision making -- a factor which, he argues, has important implications for its treatment. Given how many people suffer from this debilitating disease worldwide, his insight has the potential to transform the medical, moral, and social well-being of a substantial portion of the world's population. The Ethical Treatment of Depression is essential for clinicians, bioethicists, lawyers, and policy practitioners." -- Patricia Illingworth , Department of Philosophy and Religion, College of Business Adminstration, and School of Law, Northeastern University Cover ......Page 1 Contents......Page 8 Series Foreword......Page 10 Acknowledgments......Page 12 1 Introduction......Page 14 2 Autonomy: The Importance of Justified Beliefs about Material Facts......Page 22 3 Autonomy: The Importance of Justified Beliefs about Affect......Page 52 4 Depression: Disorder of Affect, Disorder of Autonomy......Page 78 5 Understanding Negative Biases Promotes Autonomy in Depression......Page 110 6 Understanding Causal Stressors Promotes Autonomy in Depression......Page 132 7 A Special Duty to Promote Autonomy in Depression: The Moral Case for Psychotherapy......Page 156 Appendix: The Hamilton Rating Scale for Depression......Page 182 Notes......Page 188 Index......Page 220 Is there is a moral imperative on physicians to refer patients with mental depression for psychotherapy rather that treating the ailment with drugs? Psychotherapy, in particular cognitive behavior therapy, promotes autonomy & it is the loss of autonomy, argues Paul Biegler, that is at the heart of depression