Roles and Responsibilities: Theoretical Issues in the Definition of Consultation Liaison Psychiatry

Abstract

Using consultant liaison psychiatry as an example, Agich explores the social role of the physician as it relates to medical ethics. His initial discussion of some of the features of the theoretical concept of a social role is followed by an outline of the main components of the consultant psychiatrist role. He then considers three alternative models of consultation and consultative relationships--the contractual, the authoritarian or paternalistic, and the traditional medical--and their normative rules, and discusses their applications to consultation liaison psychiatry. Agich argues that, by focusing on the relationship between primary physician and consultant physician (the authoritarian and the traditional medical models), or on patient autonomy (the contractual model), all three models ignore the ethical implications of the consultant's role as one who works within an institutional setting or with nonphysician health professionals. (KIE abstract)