The DSM, Big Pharma, and Clinical Practice Guidelines: Protecting Patient Autonomy and Informed Consent

The author of this paper discusses why the issue of financial conflicts of interest (FCOI) in psychiatry has important public health implications for women and why FCOI complicate the informed consent process. For example, when psychiatric diagnostic and treatment guidelines are unduly influenced by industry, informed consent becomes a critical issue, because women may be assigned diagnostic labels that are not valid and may also be receiving imbalanced or even inaccurate information about their mental health treatment options. However, mere disclosure of industry relationships is an insufficient solution. Following Ells (2003), the author offers a more robust account of autonomy, inspired by Foucault, to strengthen informed consent practices. In addition to addressing power relations, this Foucauldian account of autonomy emphasizes the relational and dialogical aspect of the physician–patient relationship.