"Medical responsibility" in institutional settings

The economics of institutional delivery of mental health care sometimes makes it impossible for psychiatrists to meet the demands of medical ethics. At times the psychiatrist's signature is used to imply a degree of medical responsibility that is not justified or a degree of supervision of less highly trained personnel that has not been given. The continuing variance between psychiatry's ethical precepts and its practice in some institutions creates an undesirable situation. The author examines several options and concludes that the ethics should be rewritten. Dr. Frederick J. Stoddard comments on the author's presentation.