European Psychiatry - Volume 41 - April 2017

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S580 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S521–S582
lish mental health policies for victims and perpetrators in future
reparation.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
e-Poster viewing: ethics and psychiatry
EV0539
Is a psychiatrist-patient
confidentiality relationship
subservient to a greater good?
G.E. Berrios
University of Cambridge, Robinson College, Psychiatry, Cambridge,
United Kingdom
Before embarking in a fruitless exchange the title question must be
unpacked:
– is the ‘psychiatrist-patient confidentiality relationship’ a subset
of the general doctor-patient confidentiality relationship?
– if different, what causes the difference? Is it the nature of men-
tal disorder, for example the fact that some mental disorders may
impair ‘mental capacity’ in ways different from general medicine?
– given that in addition to psychiatrists, psychologists, nurses, and
social workers also enter into ‘confidentiality relationship’ with
patients, should all be considered as tokens of the same type or as
different types? If the latter, should such differences be considered
as intrinsic or extrinsic? Intrinsic differences refer to structural dis-
similarities; extrinsic differences to dissimilarities created by the
respective legal frames imposed by each profession to its practi-
tioners.
– is ‘subservience to a greater good’ an acceptable good way to
describe themetier uponwhich the ethical scrutinywill be applied?
Given that it does describe a ‘consequence’ of the process then it
would seem that it prematurely opts for utilitarianism, an ethical
theory that many may feel is not adequate to the case.
The general question and the pre-formulated debating positions
are setting up a pseudo-debate. A more useful question should
be: “Given the strong political and economic pressures being cur-
rently brought to bear upon all confidentiality relationships (held
by priests, medics, lawyers, bankworkers, etc.), what ethical system
may be more convenient to:
– justify blatant breaches in confidentiality relationships;
– placate our moral conscience?”
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0540
500 years of reformation: The history
of Martin Luther’s pathography and
its ethical implications
B. Braun ∗, J. Demling
Psychiatry and psychotherapy, Friedrich-Alexander University,
Erlangen, Germany
∗ Corresponding author.
Introduction In the context of the 500th anniversary of the Refor-
mation, it is time to take a survey of the history of Martin Luther’s
(1483–1546) pathography.
Method Relevant writings were evaluated.
Results While in a 1035 page work written in German between
1937 and 1941, the Dane Paul Reiter retrospectively diagnosed
Luther as manic-depressive, Kretschmer (1888–1964) in 1955 saw
in Luther “a great polemic and organizer”. In 1956, Grossmann
was unable to prove persistent synchronicity of depressive mood
and reduced motivation in Luther in the key years 1527 and 1528,
which led him to conclude that Luther had a cyclothymic person-
ality with a pyknic constitution. In Roper’s view in 2016, Luther
suffered from “a condition [ . . .], that we would call depression
today”.
Discussion In 1948, Werner concluded that Reiter’s pathogra-
phy was based on an incorrect assumption: Luther’s solution of
the cloister conflict as a dilemma situation between paternal and
clerical authority was not a flight into “the mysticism of despair”.
Hamm adopted this interpretation in 2015 in viewing the escala-
tion of the emotional conflict potential as a logical consequence of
an interiorized and individualized intensified piety. In 2015, Scott
saw a cyclothymic temperament in Luther starting in about 1519,
but emphasized the elasticity of Luther’s emotional reserves: “For
the rest of his life, Luther oscillated between euphoria and dejection
but not to the point of dysfunction”.
Conclusion Luther can be used as an example of the importance
of religiousness as a curative resource for the psyche.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0541
Emotional decision for accepting
patients in the ICU in Greece – where
are the guidelines?
I. Christodoulou ∗, G. Dounias , I. Tsakiridis , N. Peitsidis ,
C. Lahana , D. Gonezou
G. Papanikolaou General Hospital, Thessaloniki, Greece, B’surgical
Department, Thessaloniki, Greece
∗ Corresponding author.
Introduction It is not a rare phenomenon to ask a bed in the ICU in
a basis of emergency. Then, the answer coming fromthe intensivists
may be more than surprising. Objective of our study is to highlight
the fact that emotional reasons and not medical criteria are the
dominant ones for accepting a patient in the ICU.
Methods We present 4 cases of interest.
Results A poor Russian 75-year-oldman with gastric cancer, ane-
mia and haemodynamic instability was not accepted in the ICU
with the oral and not written rejecting answer that he suffers from
advanced cancer. A 35-year-old transplanted patient with bone
marrow, fever, severe lactic acidosis, was not accepted in the ICU
for hours because the intensivist would give her consent only if the
patient would undergo a cholecystectomy first! The intensivist was
a pneumonologist! In the endmultiple liver abscesses were discov-
ered, so an operation would not help. An 80-year-oldman operated
for colon cancer with haemodynamic instability was accepted in
the ICU without delay. A 72-year-old with colon cancer, cachexia,
thrombopenia and severe dementia, coming from the Psychiatric
Hospital where he remained for months, was accepted in the ICU
without delay.
Conclusions If there is not an Ethics Commitee to examine these
unexpectabilitymatters concerning patients needing a place in ICU,
then a psychiatric evaluation of Intensive Unit physicians might
help, for the good of patients. Would a member of the Parliament
or a celebrity receive a “No” from the ICU?
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.