Review: Ethics in Mental Health and Deafness

Editor: Virginia Gutman. Review by Sally Austen, Consultant Clinical Psychologist, Deaf Mental Health Services, Denmark House, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2QZ. Tel 0121 678 2178.

'Ethics in Mental Health and Deafness' is an extremely readable and thought-provoking textbook for the clinician experienced in this field. The ten authors raise, and informally discuss, issues in such a way that one feels that many of one's own clinical difficulties are, in fact, relatively commonplace: issues of negotiating boundaries with clients whom we may also socially, negotiating our caseload, perfecting the use of interpreters in therapy or designing a research project involving Deaf participants.

Rather than ethics being a complex and somewhat esoteric subject only considered by learned individuals on research ethics committees, this book points up the blurred boundaries between ethics and 'good practice' to address immediately recognizable issues. The reader is challenged to consider their competency to treat or assess Deaf clients whose types of difficulties we would not normally accept if they were hearing. We may be the only clinicians with sufficient linguistic and cultural knowledge and may feel magnanimous in taking clients with an increasing variety of difficulties. Yet, we are challenged here to question whether we are being altruistic or unethical.

The chapter on 'Law and Ethics' extends this point to consider when or where one might risk litigation because of caseload management. Although the UK is long way from the USA's litigious culture, this makes fascinating reading and serves to caution us to get our own house in order before we are forced to do so by legal precedent. Somewhat ironically, I note that we are probably still safe from such litigation all the while that our courts are still not implementing the Disability Discrimination Act in their own practice.

Clinicians with interests in cross-cultural mental health practices and working within small or rural communities will find the discussion of the overlap with mental health and deafness useful. Likewise, the call to consider the place of paternalism within rehabilitation will strike chords with clinicians working with many different client groups.

I thoroughly enjoyed reading this book and would have no hesitation in recommending it to my colleagues. However, I did think the editor had missed an opportunity to make the book even better. The editor's decision to allow each author to write on the subject of their choice resulted in a lot of repetition and an overly narrative style. Many of the authors had some superb ideas and recommendations, which were somewhat lost in their loquaciousness. As a result, the chapters that I am likely to come back to time and again will be the chapters that stood out as having a clear focus: 'Law and Ethics in Mental Health and Deafness' by William P. McCrone, 'Defining the shadow: Recognizing the Imprint of the Interpreter in the Mental Health Setting' by Lynnette Taylor, 'Ethical Issues in Genetic Counselling and Testing for Deafness' by Kathleen S. Arnos and 'Ethical Conduct in Research Involving Deaf People' by Robert Q. Pollard.

British Society for Mental Health and Deafness, Registered Charity Number 1057135

Your use of this site is in accordance with our Privacy Statement

© British Society for Mental Health and Deafness, 2004-10