Miéville C
Schweiz Arch Neurol Neurochir Psychiatr. 1978;122(1):21-8.
The author attempts an analysis of some of the socio-cultural elements which have marked the birth of (modern?) psychiatry and which have consequently influenced the education, identity and ethical values of the practitioner who choses to become a psychiatrist. The author draws attention to the problem of the psychiatrist's autonomy by stressing the important relationship between autonomy (or lack of autonomy) and the dominant political ideologies. Such relationship appears more clearly when the psychiatrist uncritically accepts to become "the psychiatric expert" in criminal and civil law, suicide, sex, death, etc., in other words, whenever accepting the role of "managerial technician". It is evident that the psychiatrist cannot renounce the social responsibilities which fall upon him because of his understanding and analysis of human behaviour, but it is also evident that a redefinition of the psychiatrist's role in society is called for. Such a re-definition will be possible only by the permanent exercise of self-criticism, honesty towards oneself, moral integrity and the capacity to differentiate between true autonomy and the illusion of autonomy when operating in the name of an official psychiatry which is often also a vehicle for the enforcement of a political ideology.
作者试图分析一些标志着（现代？）精神病学诞生的社会文化因素，这些因素进而影响了选择成为精神科医生的从业者的教育、身份认同和伦理价值观。作者通过强调自主性（或缺乏自主性）与占主导地位的政治意识形态之间的重要关系，提请人们关注精神科医生的自主性问题。当精神科医生不加批判地接受成为刑法和民法、自杀、性、死亡等方面的“精神病学专家”时，换句话说，每当接受“管理技术人员”的角色时，这种关系就会更加明显。显然，精神科医生不能因为对人类行为的理解和分析而放弃落在他身上的社会责任，但同样明显的是，需要重新界定精神科医生在社会中的角色。只有通过不断进行自我批评、对自己诚实、道德正直以及在以官方精神病学的名义行事时能够区分真正的自主性和自主性的幻觉（官方精神病学往往也是推行政治意识形态的工具），才有可能进行这样的重新界定。
