APA Daily Bulletin - Day 1, 2008 - (Page 4) saturday / sunday The Daily Bulletin may 3-4, 2008 m a n F r e d s . g u t t m a c h e r a w a r d Lecture re-examines implications of the Tarasoff decision Douglas Mossman, M.D., takes a Kantian perspective regarding obligations to patients and the public. For more than 30 years, mental health professionals have debated the implications of the Tarasoff decision and what it says about their obligations to protect the public. In this landmark decision, the California Supreme Court ruled that therapists bear a duty of reasonable care to warn threatened persons of foreseeable danger arising from the patient’s mental state. To help therapists understand and make peace with their obligations to patients and to third parties who could potentially be harmed by those patients, Douglas Mossman, M.D., will present, Critique of Pure Risk Assessment or Kant meets Tarasoff. This Manfred S. Guttmacher Award Lecture will take place Sunday, May 4, from 2:30 to 4:00 p.m. in Room 143 A/B/C, Level One of the convention center. During his talk, Dr. Mossman will re-examine the Tarasoff decision, applying perspectives from his dual roles as professor of psychiatry at Wright State University’s Boonshoft School of Medicine and as administrative director of the Glenn M. Weaver Institute of Law and Psychiatry at the University of Cincinnati College of Law. “Tarasoff tells psychotherapists that they must act to protect foreseeable victims of their patients,” Dr. Mossman said. “But this assumes two things. First, Tarasoff assumes that there’s something special about people with mental illness that makes them dangerous or that they are uniquely violent in some way. Second, Tarasoff presupposes that mental health professionals actually can detect and intervene to prevent future violence.” Dr. Mossman said that when Tarasoff was issued in 1976, mental health professionals didn’t believe they could reliably detect which patients would become dangerous. “Violence wasn’t something we felt we could predict very well,” he said. But evidence has accumulated since the decision suggesting that having a mental disorder is a risk factor for acting violently, Dr. Mossman said. In addition, mental health professionals do appear to have some ability to sort out people who will become violent from those who will not. “However, that does not really help us,” he said. “It does not help us because we can’t do it perfectly, and there’s no social agreement on what level of risk justifies taking action.” This, of course, raises the question, “what does one do instead?” Dr. Mossman will use his talk to answer that question. “I titled my presentation ‘Critique of Pure Risk Assessment’ because I take a Kantian perspective on what therapists’ obligations really ought to be,” he said. “Rather than predict violence, I suggest that therapists have obligations that are consistent with the Kantian perspective on what ethical obligations are generally, as they apply to all people… We have to think about how we would want a therapist to respond to us. Kant suggests that the proper basis for taking action can’t simply be utilitarian considerations of what might happen in the future. “If you or I were in therapy and we told our therapist that we had plans to harm someone, we would want the therapist to respond. But notice something, our therapist would not be making a prediction, but responding to our threat — something we actually did.” Dr. Mossman said that while American legal tradition has not required persons to protect third parties, most people believe a moral obligation does exist. “I suggest that this obligation applies to everyone — therapist or not,” he said. “I think all of us can accept a moral obligation to respond to what people do. When patients utter threats that they intend to act on, they’ve done something that legitimizes our taking action.” Dr. Mossman said he believes mental health professionals “do have a duty to take steps to respond to threats.” Such steps, he said, can include revising treatment plans, hospitalization, and warning the police. The Manfred S. Guttmacher Award honors outstanding contributions to the literature on forensic psychiatry. The award is co-sponsored by the APA and the American Academy of Psychiatry and the Law. 2008 APA Annual Meeting Sunday MAY 4, 2008 7:30 AM – 11:00 AM RECENT ADVANCES OF FIBROMYALGIA AGENDA 7:30 8:00 AM AM IN THE DIAGNOSIS AND TREATMENT – 8:00 – 8:05 AM AM Breakfast Opening Remarks Lesley M. Arnold, MD Associate Professor of Psychiatry Director, Women’s Health Research Program University of Cincinnati Cincinnati, Ohio Lesley M. Arnold, MD Grand Hyatt Washington Independence Ballroom Washington, DC TARGET AUDIENCE This activity is intended for psychiatrists and other mental health care professionals attending the 2008 Annual Meeting of the American Psychiatric Association. EDUCATIONAL OBJECTIVES After attending this symposium, participants should be better able to: • Describe the epidemiology and shared underlying mechanisms of fibromyalgia and other central pain syndromes • Review the theoretical and clinical implications of genetic factors in fibromyalgia • Examine the role of CNS pain sensitization and inadequate pain inhibition in management strategies • Evaluate nonpharmacologic and pharmacologic strategies in the treatment of fibromyalgia ACCREDITATION STATEMENT The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. DESIGNATION STATEMENT The APA designates this educational activity for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. DISCLAIMER STATEMENT The opinions or views expressed in this CME activity are those of the presenters and do not necessarily reflect the opinions or recommendation of the APA or the commercial supporter. The attendee should appraise the information presented critically and is encouraged to consult appropriate resources for any product or device mentioned in this program. ACTIVITY CHAIRPERSON 8:05 AM – 8:30 AM Overview of Fibromyalgia and Related Conditions Daniel J. Clauw, MD Professor of Medicine Division of Rheumatology Associate Dean for Clinical and Translational Research Director, Chronic Pain and Fatigue Research Center Michigan Institute for Clinical and Health Research University of Michigan Ann Arbor, Michigan 8:30 8:55 AM – 8:55 – 9:20 AM Genetics of Fibromyalgia Lesley M. Arnold, MD AM AM Nonpharmacologic Treatment of Fibromyalgia Dina Dadabhoy, MD Rheumatologist Northwest Rheumatology Specialists Fox River Grove, Illinois 9:20 AM – 9:45 AM The Role of Antidepressants as Analgesics David A. Fishbain, MD, FAPA (dist.) Professor of Psychiatry and Behavioral Sciences Adjunct Professor of Neurological Surgery and Anesthesiology Miller School of Medicine at the University of Miami Miami, Florida 9:45 AM – 10:10 AM Pharmacologic Treatment of Fibromyalgia Don L. Goldenberg, MD Professor of Medicine Tufts University School of Medicine Boston, Massachusetts Chief of Rheumatology Newton-Wellesley Hospital Newton, Massachusetts 10:10 AM – 10:55 AM Panel Discussion Lesley M. Arnold, MD Moderator 10:55 AM – 11:00 AM Closing Remarks Lesley M. Arnold, MD Attendees must be registered for the APA Annual Meeting to attend this symposium. Seating is limited and will be based on first-come, first-served. For more information about the meeting, please visit the APA web site at www.psych.org or contact the APA toll free at 1-888-357-7924 (within the U.S. or Canada) or 703-907-7300. Lecture Details Manfred Guttmacher Award Lecture “Critique of Pure Risk Assessment or, Kant Meets Tarasoff.” Douglas Mossman, M.D. Sunday, May 4, at 2:30 p.m. Room 143 A/B/C, Level One Washington Convention Center Sponsored by Supported by an educational grant from http://www.psych.org
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