In `Mental Health Ethics: The Human Context' Barker presents a critical often raw critique of the psychiatric context profoundly influencing routine clinical decision making. Both he and the additional authors masterfully stitch a rich ethical tapestry drawn from clinical practice, research, academic and wider literature, personal experience and service user perspectives. The reader is provoked at every level to more fully engage with familiar moral and ethical issues and in revisiting these, prompted to act on a deeper appreciation of the relevance of ethics to everyday psychiatric/mental health care.
As a lecturer in mental health nursing, I found that the text touched all of the obvious bases required of either novice or seasoned ethical thinkers. Readers are implored to put common ethical tensions back under the psychological microscope. The chapters related to therapeutic relationships and ECT should be essential reading for all people either considering or involved in delivering mental health care. Further, I found the text to be a timely addition to the bookshelf, particularly for psychiatric/mental health nurses. As nursing takes its first tentative steps towards becoming a degree based occupation and the changing professional scene set to further reduce skill mix, it is essential that nurses equip themselves with the aptitude to think through and act upon ethically risky or problematic situations, demonstrating an ability to act righteously but more importantly humanly if not with heart.
Whilst some chapters focus more generally upon where respective professions might best position themselves ethically and morally in relation to psychiatry, the wider, re-occurring and more intense theme within the book is to locate responsibility for ethical decision making at the level of the individual. For the most part, I found that the book maintained a close focus on the human perspective. In so doing, it ensures that the reader is in no doubt of the Editors view that in moral and ethical terms the enemy is more often located within than without. As such, the book often resonates uncomfortably and powerfully. In a closing summary chapter entitled 'The Elephant in the Room' Phil Barker summarises his audacious thesis which is as vivid and engaging as the Banksy image of the same name. In so doing, Barker made me mindful yet again that `Acting responsibly is not a matter of strengthening our reason, but of deepening our feelings for the welfare of others' (Jostein Gaarder).