Dan Stein, South Africa

Prof. Stein has contributed a range of articles on the philosophy of psychiatry in general and psychopharmacology in particular. His recently published volume, "Philosophy of Psychopharmacology”, is perhaps the first extended text to focus on the intersection between philosophy and psychopharmacology. This volume not only reviews the questions that lie at this intersection but also develops a theoretically sophisticated and clinically useful framework for providing novel answers to these questions. This framework attempts to synthesize opposing conceptual arguments in the field in order to provide an integrative and unifying approach. Importantly, the framework is also a naturalistic one; it draws upon neuroscientific findings in order to support the conceptual position that it argues for. This volume therefore provides an important foundation for the growing field of the ethics of psychopharmacology.

Prof. Stein has contributed to the philosophy of medicine and psychiatry more generally as founding editor of one of the first open access journals in the field, "Philosophy, Ethics, and Humanities in Medicine" (PEHM). He drew together an expert editorial board which included pioneers in the field from around the world. The journal has published a broad range of articles addressing issues in the philosophy and ethics of psychiatry and psychopharmacology and mental health and is a useful resource for those interested in medical ethics. Prof. Stein showed foresight in establishing this journal which allows readers from around the world free and easy access to articles on ethics of medicine and psychiatry.

Prof. Stein has contributed to the field of psychiatric ethics in his home of South Africa by playing a role in investigating various aspects of the country's "Truth and Reconciliation Commission" (TRC). This Commission was established to help the country successfully address the transition from apartheid to democracy and it therefore required an examination of many moral issues, including the role of medical doctors during apartheid. Prof.  Stein and his colleagues collected some of the only empirical data available on psychiatric disorders on those who testified before the TRC; addressing issues such as the prediction of morbidity and the role of forgiveness in helping survivors come to terms with the past. This work argues that although the TRC provided dignity and acknowledgement to those who had suffered during apartheid, and that although forgiveness was associated with a lower risk of psychiatric disorder, many individuals who were survivors of gross human rights violations during apartheid required ongoing clinical care. He has continued to explore related issues in subsequent research, most recently publishing findings from a national survey of attitudes towards the TRC.

As the Chair of the Dept. of Psychiatry and Mental Health at the University of Cape Town, Prof. Stein has argued for equal access of patients to mental health services. At hearings before South Africa's "Human Rights’ Commission" on health and medicine in the country, for example, he emphasized that mental health services are under-resourced and psychiatric patients are stigmatized.  He and his colleagues’ publications from the South African Stress and Health Study, the first nationally representative psychiatric epidemiology study in South Africa, demonstrate clearly that those with mental illness are far less likely to receive treatment than those with physical disorders, despite the fact that the disability associated with mental illness is experienced by respondents as greater than that associate with physical disorders.

The ethics prize was established this year by the CINP as an indication of the increasing importance of ethical issues in psychopharmacology in particular and medicine in general. Prof. Stein will be awarded his prize at the opening session of the CINP in Hong Kong.