Psychiatric Ethics in an Authoritarian State

This lecture examines how psychiatric practice can be shaped and distorted during periods of political instability. Dr. Sisti explores why bearing witness and protecting dignity remain central ethical responsibilities in mental health care today.

Bioethics is entering a period of profound instability. Many of its foundational commitments — autonomy, consent, justice assume a stable liberal order that is rapidly eroding. In this context, psychiatry’s authority, diagnostic tools, and coercive powers become particularly susceptible to misuse.

In this lecture, Dr. Sisti traces both historical and contemporary examples of psychiatric practices being co-opted by political forces from drapetomania and abuses within Soviet psychiatry, to racialized schizophrenia diagnoses, “excited delirium,” and the Trump Administration’s Executive Order on homelessness. Although framed as a response to an urgent social issue, the Trump EO ultimately weaponizes medical language to justify forced removal and heightened coercion. Through these cases, Dr. Sisti argues that psychiatric ethics and clinicians themselves must recommit to bearing witness, upholding human dignity, and resisting institutional cooptation.

This is a timely and essential conversation for clinicians, ethicists, policymakers, trainees, and anyone concerned about the future of mental health care.

Dominic Sisti, PhD
Associate Professor, Department of Medical Ethics & Health Policy
University of Pennsylvania. Dr. Sisti directs the Scattergood Program for the Applied Ethics of Behavioral Health Care and holds secondary appointments in Psychiatry and Philosophy. His scholarship focuses on long-term psychiatric care, ethics in correctional settings, and the emerging ethics of psychedelic research and treatment. His work appears in JAMA, JAMA Psychiatry, Psychiatric Services, Hastings Center Report, and Journal of Medical Ethics, and has been featured in The New York Times, The Economist, NPR, Slate, and The Atlantic.
He teaches graduate courses on clinical ethics, behavioral health ethics, and digital media & bioethics, and his research is supported by the Scattergood Foundation, Greenwall Foundation, Dana Foundation, and more.

Monday, January 19, 2026
4:00–6:00 PM ET

In Person:
Centre for Addiction and Mental Health (CAMH)

McCain Complex Care and Recovery Building

1025 Queen Street West

2nd Floor Arrell Family Auditorium

Online:
Youtube - Link will be send closer to the Event Date

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Host or Publisher University of Toronto Joint Centre for Bioethics