A Seat at the Table

[摘要] Organized medicine and psychiatry have a long tradition of governmental advocacy and public engagement. The American Academy of Psychiatry and the Law (AAPL), since its founding 50 years ago, has made some forays into these fields. However, its involvement has been less substantial than other similarly situated professional organizations. With its increasing membership and expertise, AAPL now possesses the capacity to dedicate some of its organizational attention, energy, and resources to educating policymakers and the public on current and future topics related to forensic mental health. In addition, an increasing number and type of professional activities related to this discipline are affected by governmental regulation and public opinion. Therefore, the need to become involved in shaping policy is more urgent, particularly in light of the fact that other forensic mental health organizations have been actively involved in governmental advocacy for decades. Finally, as a field and in the near future, we likely will deal with life-changing technological innovations related to the practice of forensic psychiatry. AAPL and its members are perhaps uniquely qualified and have a responsibility to help ensure that these innovations are developed, implemented, and utilized appropriately. This can only be accomplished by having a proverbial seat at the table in the process. Organized medicine in general and organized psychiatry in particular have an extensive and rich tradition of governmental advocacy and public engagement. Organizations such as the American Medical Association (AMA) and the American Psychiatric Association (APA) have long encouraged these pursuits, both for their individual members and their organizations as a whole. For example, the AMA Advocacy Office is more than 70 years old, and the AMA fields two Councils related to this office. Similarly, the APA has been involved in public relations, governmental advocacy, and judicial action for decades. The APA's Office of Government Relations has operated for approximately 70 years, and the Council on Psychiatry and the Law has been active for more than 50 years. The AMA's and APA's commitment to advocacy are codified in the organizations' ethics directives. For example, and as other members of the American Academy of Psychiatry and the Law (AAPL) have noted (e.g., Jennifer Piel, JD, MD, in a recent Journal of the American Academy of Psychiatry and the Law ( JAAPL ) article ¹ ), the AMA encourages physicians to “advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human well-being” (Ref. 2 , p 147). Similarly, the APA's Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry states, “Psychiatrists are encouraged to serve society by advising and consulting with the executive, legislative, and judiciary branches of the government …” (Ref. 3 , p 9). The Annotation does not directly address the topic of organizational advising and consulting. However, it stands to reason that the collective wisdom and expertise of an organization, tempered by consultation among its members, might be even more valuable to members of the executive, legislative, and judicial branches and the general public than individual consultation. Advocacy is admittedly a term that can be interpreted quite broadly. In its most extreme contexts, it may involve specifically endorsing political candidates, parties, or controversial topics or positions. Similarly, advocates can be individuals, organizations, professions, or other entities. As this pursuit relates to organized medicine and psychiatry, however, this endeavor generally has involved the education of legislatures, administrative agencies, regulators, and the judiciary, hereafter referred to collectively as policymakers (members of the judiciary functionally make policy by their rulings), as well as the media, the general public, and others, hereafter referred to as the public, to apprise them of current scientific principles, new developments, and pragmatic concerns related to the practice of medicine and psychiatry. This assists them in making informed decisions about topics related to their interface with these disciplines. The rationale for psychiatric governmental advocacy and public engagement is perhaps self-evident and may be both ethical and altruistic (i.e., better understanding by policymakers and the public of topics related to psychiatry, to the betterment of patients and society) and professionally pragmatic. Regardless of the motivation for advocacy, the benefits potentially extend to patients, evaluees, the public at large, and the profession itself.

[学科分类] 儿科学