Introduction

People have always been fascinated by the human mind and its functions and dysfunctions. Over the centuries, philosophers and scientists have suggested a variety of explanatory models for the nature of the mind and its relationship to the body; the causes of mental dysfunction have been examined and treatments for it prescribed. Today we may marvel at the explanations offered in times past for mental illness and shudder at the barbarity of the treatments inflicted upon the mentally ill. We consider ourselves to be more enlightened, both in our explanations of, and treatments for, mental illness. In the contemporary world, with ever-increasing amounts of knowledge, specialisation has entered the arena, and mental illness is now the province of a variety of 'experts'; doctors, nurses, psychologists, psychotherapists and social workers all have their part to play in the care and treatment of the mentally ill. These experts, whose assumptions in the main often appear unchallenged and even unacknowledged within in their own fields of expertise, and in some cases, outside them, all have their corners to fight in the professional hierarchy and power stakes. All these different experts have their own models of mental illness; these may overlap and share significant characteristics, or they may diverge sharply from each other, often causing hostility and friction between their protagonists; and there may be little real understanding of these different models by professionals from the different fields whose jobs involve them in treating the mentally ill. All too often opinions polarise, the result of simplistic stances on both sides, and meaningful debate is stifled before it even begins. Thus the ethical issues involved in mental illness may be reduced to antagonistic posturing by tlle most vociferous members of the opposing sides in the debate; those who stand to lose most from this unseemly wrangle are the mentally ill.