ABSTRACT
This chapter discusses some of the ethical challenges that occur while working as a psychiatrist or therapist in the emergency department (ED) of a hospital. It covers such topics as capacity and consent, autonomy, beneficence, non-maleficence, free will, paternalism, when to initiate a Tarasoff or refrain from initiating a Tarasoff, confidentiality, legal detainment against one's will, and physical and chemical restraints. The chapter provides a framework where ethical principles can be called upon to help deliver the best possible care for patients that are commonly seen by psychiatrists in the emergency room setting, an environment where it can be especially challenging to deliver ethical care to difficult patients. Another common scenario the psychiatrist faces in the emergency department is to determine whether or not a patient has the capacity to consent to a medical procedure or treatment, or to leave the hospital against medical advice.
