Ulysses' crew or Circe? – the implications of advance directives in mental health for psychiatrists

Abstract

Advance directives in mental health care are currently attracting interest, although there is some anxiety that they can restrict clinical freedom. The so-called ‘Ulysses contract’ is a form of opt-in to services that has been suggested in the USA. Psychiatrists might thus consider themselves to be the equivalent of Ulysses' crew in being bound by the contract. This paper suggests, in some cases, that they might function more as Circe, who suggested the directions to Ulysses, and considers this in the light of contemporary relationships between psychiatrists and patients.