On Psychoanalysis, Values, and Ethics

On the present day American scene we are having a tidal wave of inquiry into the ethics of behavior, directed toward officials in their personal lives as well as in their actions and statements of principle, particularly when of national or international scope. The many-faceted Woman's Movement involves an inquiry into the ethical relationship between society in the large and women, and between individual men and women. And in another focus, various professions, notably medicine and law, are being challenged as to their codes of ethics and the ethical quality of their professional acts. These particular challenges arise from the general public and involve the “right to know” and also are a declaration of the rights of those receiving services. A core ethical demand is respect for the physical and psychic boundaries of persons, which has many subtle aspects.

As far as psychiatry and psychoanalytic psychotherapy are concerned, the laws have become specific and clear in establishing guidelines. For instance, those addressed to the confidentiality of patients permit one exception—if it seems likely that a life-threatening act of violence by the patient is imminent. The codes devised by the profession itself involve self-monitoring by the profession, especially to prohibit exploitation of patients, and especially sexually. The temper of both the laws and the codes of the providers of services of psychotherapy openly raises the issue of “policing” and of “self-policing.” But these no-nonense practical procedures are actually the figure in the ground. What is the “ground?” And why do these issues arise now?

And how are these various large questions relevant to us as psychoanalysts? Since ethics deals with behavior and attitude, and is the action aspect of values, it behooves us to press for deeper understanding of its psychologic and societal basis—clearly an interdisciplinary quest. Nor should we overlook the role played by psychoanalysis as a state of knowledge and a conge