Psychiatrists' attitudes and practices regarding the moral worries of their patients: A postcard survey

The 2004 presidential election process highlighted the relevance to the American public of the moral character of each candidate. Recent works in psychology and philosophy have enlarged our understanding of the moral emotions, especially guilt, shame, regret, and remorse, and the centrality of a sense of moral concern in defining personal identity. A previous study demonstrated that patients report a moderate degree of worry about moral issues in their daily lives, along with worries about finances, work, health, and relationships. A postcard survey of Minnesota psychiatrists examined their attitudes and practices in regard to their patients' moral concerns. There were 182 respondents (response rate 45.4%). Eighty-nine percent of psychiatrists indicated willingness to discuss moral issues when brought up by patients, but only 25% said they would raise such issues if not indicated or specifically raised by a patient. Younger psychiatrists tended to rate the importance of moral concerns as less than do older psychiatrists. There were no gender differences in rating the importance of patients' moral concerns, but female psychiatrists were less likely than male psychiatrists to bring up moral concerns that were not raised by patients. The authors raise the issue of whether moral concerns might be considered part of a psychiatric interview, along with inquiries about child abuse, job stress, and personal relationships.