Tag: Dominic Sisti

Why do psychiatrists choose not to disclose borderline personality disorder diagnoses with patients?

bbag-blog-image-logoTherapeutic Privilege in Psychiatry? The Case of Borderline Personality Disorder

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Borderline personality disorder (BPD) is a serious mental illness that effects 2-3% of the population, is highly stigmatized, and is often comorbid with other mental disorders. Although no pharmaceutical interventions exist, long-term psychotherapy has been shown to alleviate the symptoms of BPD. Nonetheless, behavioral health care professionals often hesitate to discuss BPD with their patients even when it is clear they have this disorder. Why do psychiatrists, in particular, fall silent? In this talk, Dr. Sisti will sketch the history of BPD and describe ethical arguments for and against of therapeutic nondisclosure. Dr. Sisti will summarize empirical data regarding psychiatrist nondisclosure of BPD, including recent research conducted by his team at Penn. Dr. Sisti will argue that diagnostic nondisclosure, while well-intentioned, can have long-term negative consequences for patients, caregivers, and the health system more generally. As a form of therapeutic privilege, nondisclosure of BPD is ethically inappropriate.

sept19-bbagJoin us for Dr. Sisti’s lecture on Wednesday, September 19, 2018 from noon until 1 pm in person or online.

Dominic Sisti, PhD is director of the Scattergood Program for the Applied Ethics of Behavioral Health Care and assistant professor in the Department of Medical Ethics & Health Policy at the University of Pennsylvania. He holds secondary appointments in the Department of Psychiatry, where he directs the ethics curriculum in the residency program, and in the Department of Philosophy. Dominic’s research examines the ethics of mental health care services and policies, including long-term psychiatric care for individuals with serious mental illness and ethical challenges in correctional mental health care. He also studies how mental disorders are defined, categorized, and diagnosed with a focus on personality disorders. Dr. Sisti’s writings have appeared in peer-reviewed journals such as JAMA, JAMA Psychiatry, Psychiatric Services, and the Journal of Medical Ethics. His work has been featured in popular media outlets such as the New York Times, NPR, Slate, and The Atlantic. Dr. Sisti received his PhD in Philosophy at Michigan State University, working under the supervision of Professor Tom Tomlinson. A native of Philadelphia, Dominic received his Master’s degree in bioethics from the University of Pennsylvania and his bachelor’s degree from Villanova University.

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Can’t make it? All webinars are recorded! Visit our archive of recorded lectures. To receive reminders before each webinar, please subscribe to our mailing list.

Should psychiatric hospitals be reestablished to provide long term care?

bbag-icon-decGiving Asylum? The Ethics of Long-Term, Structured Care for People with Severe, Refractory Mental Illness

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There are hundreds of thousands of individuals in the US who have serious mental illness. Most of these individuals thrive in the community, but there remains a population who do not. Because the number of long-term psychiatric hospital beds has largely evaporated over the past 50 years, they often cycle between homelessness, acute care, and prison. Of the 2.5 million individuals incarcerated in the US, close to 20% are diagnosed with a serious mental illness. How did we get to this point? How can we correct what has become a moral stain on our society? In this talk, Dr. Sisti will argue that we need to seriously consider the reestablishment of psychiatric hospitals to provide long term care. Dr. Sisti refers not the kinds of institutions that shocked our moral sensibilities in the 1960s and 1970s, but to ones that may serve to help individuals overcome crisis or manage chronic conditions and begin or continue a life in recovery. In the parlance of the early reformers of mental health care, “asylums” were originally established to serve this purpose—they were meant to be a place of sanctuary, safety, and healing. Today we may refer to them as recovery centers or structured care settings. They offer an ethically preferable option to the current and rather disturbing state of affairs, and we need more of them.

mar-23-bbagJoin us for Dominic Sisti’s lecture on Wednesday, March 23, 2016 from noon till 1 pm in person or online.

Dominic A. Sisti, PhD is director of the Scattergood Program for the Applied Ethics of Behavioral Healthcare and assistant professor in the Department of Medical Ethics & Health Policy at the University of Pennsylvania. He holds a secondary appointment in the Department of Psychiatry. Sisti’s current research examines the ethical and philosophical dimensions of the concept of mental disorder, with a particular focus on personality disorders. He has written, taught, and presented papers on issues related to the philosophy and ethics of behavioral healthcare, clinical bioethics, and research ethics. Sisti’s writings on healthcare ethics have appeared in JAMA, Nature Immunology, the Journal of Medical Ethics, and elsewhere. He is an editor of three books, most recently Applied Ethics in Mental Healthcare (with Caplan & Rimon-Greenspan, The MIT Press, 2013). In 2008, Sisti was an Edmund D. Pellegrino Fellow at Georgetown University. Dr. Sisti earned his PhD in Philosophy at Michigan State University in 2010.

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Can’t make it? All webinars are recorded! View our archive of recorded lectures.