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Carlos R. Hojaij’s reply to Samuel Gershon’s comment

Carlos R. Hojaij: Ethics for psychiatrists



“The materialism all roughens and petrifies, makes all coarse and false truth.”

“The intuition of the good that does not lead to heroic efforts is a form of cowardice.”

Henri-Fréderic Amiel*                                           


            I do appreciate having my essay on Ethics being read and commented on by Samuel Gershon. His comments remind me of an analysis Henri-Fréderic Ariel made of Western European society in the middle of the 19th century: “Materialism is the auxiliary doctrine of any tyranny, either of one or the masses; it crushes the spiritual, moral, general, specialising let’s say, developing chains of the big social machine and not anymore complete beings, and giving to them a society, not a consciousness; enslaving the soul to things. Depersonalisation of man, that’s the dominant tendency of our time.”*

            I think that more than society, civilisation has changed, unfortunately, for the worse and my opinion cannot be accused of a love for old-fashioned illuminism and romanticism. Pragmatism and consequent materialism quickly destroyed one of the main aspects that had been "making the man" after the French Revolution: merit, inspired by Greco-Roman civilisation.  Abandoning the merit criteria allowing a false equality of rights for all, independent of personal engagement and enthusiasm to achieve whatever one wants to achieve, society has opened the doors to business in all matters and for all, making the value of money superior to anything else. With money and through money it became possible to seduce, influence people, create false images, obtain positions; sin summary, to corrupt and be corrupted. Money’s power replaced merit’s power.

            I completely agree with Samuel: to declare “no conflict of interests” does not mean anything. It does not matter if the declaration mentions one or several pharmaceutical companies. In reality, there is “no conflict of interests” because most of the time there is, indeed, an association of interests. Being cynical, the declaration of "no conflict of interests” regarding one or an extensive list of drug companies, looks like the story of someone who goes to the police station and declares that he had killed someone; but as he made this statement, he considers himself honest and, therefore, not subject to a penalty. The assassin’s victimisation makes him unpunished.

            The power of money has been transforming our values and the way we live. Instead of célèbre people representing a model for many, we have now celebrities. In the psychiatric world, we also have celebrities constructed by extensive marketing through promoted lectures, papers, books, etc., circulating around the world, and not having to report and respond to any recognised institution.

            “How do we develop ethical standards for almost any aspect of human behaviour?” asks Samuel. This magna question has been under examination throughout humanity’s several millennia history. The Greeks found the answer in Education ("Paidea," man’s formation); the Romans in the respect of Law.  In both positions we find human being’s unity and completeness. I understand that the replacement of the Greco-Roman values by the Christians brought about in the person the split body-soul (body is the source of all misery; and soul is the purity) and, further on, in an apparently paradoxical association with materialism, stimulated the ambition to achieve immediate gratification at any cost. Faust sold his soul. To complicate matters more, the technology dominating everyday life removed man’s ability to reflect, imagine and create; is it enough to repeat or follow the instructions. As an example, in our field most guidelines and the DSM became the ticking boxes for the clinicians, creating the illusion of a safe and protected clinical practice.

             It did take about 400 years to have the Renaissance; after that, it did take 300 years to have the French Declaration of the "Rights of Man and Citizen." Hopefully, it will take only 200 years to man’s rebirth.


(*) Henri-Fréderic Amiel in Diário Íntimo. Realizações Editora, Livraria e Distribuidora Ltda., São Paulo, 2013. Free translation by C.R. Hojaij)


October 26, 2017