Ethical Issues Arising in Revising Classifications of Mental Disorders

Abstract

The classification of mental disorders in the International Classification of Diseases (ICD) will be revised in the course of the next three years and its publication (as the 11^th Revision of the ICD) will be published, after the approval of the World Health Assembly in 2014. In parallel, the American Psychiatric Association created a Task Force which has begun work on the proposals for the revision of its Diagnostic and Statistical Manual which is to be published as the DSM 5^th Revision, in 2012. The World Health Organization has established a special advisory group that should assist it in developing proposals for the classification of mental disorders for the 11^th Revision of the ICD and this group collaborates closely with the APA Task Force creating the DSM5 proposals.

Numerous ethical issues arise in this process and need to be discussed now so as to inform the process of agreeing on the proposals for the new classifications. They include the importance of an internationally accepted classification as a protection against abuses of psychiatric patients; the need to set the threshold for the diagnosis of a mental disorder at a level ensuring that people with such disorders receive help, the need to avoid imposition of diagnostic systems or categories without sufficient evidence and others. The presentation will briefly discuss the process of constructing the proposals for the new classifications and ways in which the groups established by the WHO and the APA handle these ethical questions.