impact of Arab culture on psychiatric ethics

ABSTRACT

The belief of the universality of implementing similar ethical codes in all cultures and societies is a mirage. Informed consent, involuntary admission and confidentiality are not so empowering in some traditional and Eastern societies, representing two thirds of the World population. Autonomy versus family centered decision is one of the main connectors of differences between Western and Eastern Societies. The influence of managed care and the third party in mental health services have changed not only Doctor-patient relationship, but also the disclosure of information. Informed consent in therapeutic alliances and research became a basic human right and has been emphasized in the WPA declaration of Madrid and its specific guidelines.. In what ways does acculturation change the beliefs of patients of various ethnicities? Whether we like it or not, the encounters between psychiatry and law keep bringing us back to our conflicting conceptions of the value of health on the one hand and the value of liberty, integrity and autonomy on the other. In traditional cultures, social integration is emphasized more than autonomy; that is, the family, not the individual, is the unit of society. Dependence is more natural and infirmity is less alien in these cultures. When affiliation is more important than achievement, how one appears to others becomes vital an shame. How can we practice without showing disrespect or disregard for local values? On the other hand, how can we ensure that respect for the local culture does not become a pretext for bypassing ethical guidelines, to the detriment of the patients' rights?