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Rev. Colomb. Psiquiat., vol. 37
No. 4 / 2008
e d i t o r i a l
Colombian Psychiatry: Moments and Challenges
I would like to begin with an acknowledgement to the serious and wise
management of my predecessor, Doctor Carlos López.
To assume the presidency of the Colombian Association of Psychiatry
has this strange connotation of multiple, sometimes contradictory, feelings
that important moments of life have; in practice, things seem simple: to
continue the mature and successful lines of work that the organization
established some time ago, and to manage new or old situations. The joint
importance of these components forces an immediate approach, for which
the principles and objectives of the Association always constitute a guide.
Regarding emotions, life makes the chosen one face challenges, res-
ponsibilities, introspective looks, questions, doubts.
.. and joys of course,
which—because of their innovative character—are resolved and renewed
day by day.
To be president of the Association is an honor for me, phrase that—even
though it is used so frequently—does not stop being true; an honor, fruit
of the generosity of many friends and colleagues. I want to make clear that
the annual management is the result of the work of a committee of twel-
ve people, among whom the president is just another member. I have to
express my satisfaction and gratitude to Beatriz, Marcela, Sonia, Alfredo,
Carlos, Christian, Juan David, Mario, Ramón, Roberto, and Rodrigo, for
their company in this process that begins.
The political moment of the Association
We face a moment when complex situations are intensifying in the
world, in the country, and in the profession. What happens in a global con-
text is not alien to us, neither in a good sense—for example, the availability
of immediate information as well as of the events—, nor in a bad sense,
such as the present moment of the economy that some have described as
the end of wild Capitalism. This ending week, the spokesman of the Inter-
national Monetary Fund af±rmed that the world is in recession and it is in
the worst economic situation in eighty years; a Colombian economist, an
expert invited to our Congress, told us that one of the clear effects of this
situation for the country will be the loss of jobs; an additional damage for
a country that has the highest rate of unemployment in the region.
Colombian Psychiatry: Moments and Challenges
Rev. Colomb. Psiquiat., vol. 37
No. 4 / 2008
We know that this type of contexts increases the incidence of disea-
ses that are strongly modifed by social surroundings, and it makes the
attention oF more serious pathologies diFfcult; in terms oF public health,
it means more patients, more serious complications in order to take care
oF them, and less resources due to the crisis; surely, sacrifces have to be
made by all of us in general, but especially by professional service pro-
viders, a trade that has more and more inequality in its labor situation,
as the testimonies presented to the general assembly of the Association
It is a moment then, when all the actors related to mental health are
vulnerable; and there is an ethical duty to act like a trade, with the clearest
expression our resources allow. As an Association, this moment does not
come to us without preparation: the Committee of Policies wrote the poli-
cy oF the feld oF mental health, document that establishes the diagnosis,
the context and the road toward actions; the Ministry has the word. But
it does not mean that our responsibility has fnished; the Association has
sought to maintain its presence in order to contribute to the application
of this proposition.
In addition, we are lucky to have achieved important relationships
with control institutions, the ombudsman oFfce, and the oFfce oF general
attorney; these entities oF vigilance have promised to monitor the Fulfll
ment of the policies and have requested that the Association become a
consultant. In accordance with the statement of Doctor Edgardo Maya
on the day of the inauguration of the Congress, this consultancy will be
oFfcial with the oFfce oF general attorney, through signing an agreement
for such effect.
Equally, the Board of Directors of the Association and the trade Com-
mittee have begun to make declarations in order to try to modify particular
situations in the national geography where the rights and the remuneratio-
ns of mental health workers are violated. As I mentioned at the beginning,
the lines of work already undertaken will be followed by the new Board,
with the same seriousness and discipline of our predecessors.
At this moment, there is an ample legislative agenda that is directly
incumbent to us: the Law of Human Talent, which has found obstacles
in the control of the Court and which is to be regulated, or the prices,
principal question for the survival of the system, just to mention the most
well-known cases. We will work hard so that the voice of the group is lis-
tened to and participate in the decisions.
Rev. Colomb. Psiquiat., vol. 37
No. 4 / 2008
The disci
plinary and scientifc moment oF psychiatry
While the political moment is critical, the disciplinary and scientifc
moment is promising; we think about psychiatry with different approaches,
tools and resources; the outstanding advances in the scientifc analysis oF
cerebral physiology, of cognition, and of behavior have presented inputs
that help us not only to know more about diseases and their treatments,
but also to invite philosophy of mind, sociology, pedagogy, and critical
historical research to participate in the debate on disease, health and
psychiatry. There is a solid theoretical corpus in construction, to which
those who are practicing our discipline can contribute. The Association
has been participating in the debate, providing settings for different ten-
dencies to be expressed.
This situation—that makes of psychiatry a privileged specialty among
the medical ones—, in terms of presence in generating global knowledge, is
also a risk that must continuously be supervised by academic debate, with
the skepticism that theories deserve in order to be proven; Wittgenstein said:
“concepts are Formed according to what is comFortable For thinking”; For us,
this is a moment of not avoiding incommodity for the good of the discipline.
Our universities have recognized quality and they reach high levels in
the academic development; in this matter, the Association has not been
inferior to the circumstances regarding the quality of its events as well as
for being the only medical association of the country with a journal that
has the highest category in scientifc publications in Colombia; an ack
nowledgement to its director, Doctor Carlos Gómez-Restrepo.
The support to the achievements in this change will be followed by an
unrestricted commitment on behalf of the Board, but it is also the moment
to think about our global projection: our publications are expected to have
international diffusion and we must reach more presence in world-wide
associations and organizations which deal with our subjects. We have the
frm intention to begin a process that obtains positions oF representation For
one or several of our associates in those organizations. The work already
begun under the leadership oF Doctor Rodrigo Córdoba is the frst step.
The ethical moment of the Association
This is also an important ethical moment for us. Under the mentioned
presidency of Doctor Hernán Santacruz, the bioethics committee of our As-
sociation led the drafting of the deontological code which must regulate our
behaviors as psychiatrists. Two points are in the focus at the present: the
Colombian Psychiatry: Moments and Challenges
Rev. Colomb. Psiquiat., vol. 37
No. 4 / 2008
behavior of professionals with patients and the relationship with pharma-
ceutical industry. In the frst case, there is no possibility to be deaF to the
cries of the rights of patients; there is a commitment of vigilance so that the
few people who can infringe the adequate therapeutic behavior receive, as
a minimum, a moral rejection from their pairs. To listen to the patients, to
their associations, will be a commitment of the board; to help them to obtain
spaces for claim and for therapeutic aids is a duty of all of our associates.
The relationship between psychiatrists and pharmaceutical houses is
in the center of the present controversy; a debate that not only requires
our close attention but also our active protagonism. The Association has
been careful about making the rules clear; the search for even greater
transparencies will imply a respectful dialogue with the entities that, in a
historical form, have been our good allies.
The moment of the president
I can say of myself that, as I believe, I have been happy and, without
doubts, very lucky. I am proudly pastuso and intensely caleño, in a duality
that does not want to be solved.
I come from an affectionate, critical and amusing family. From a
practical and dreamer mother who, along with my father, educated seven
children. As for me, with the support of my wife, Indira, we are trying to
construct an oasis in these diFfcult times For our three projects oF good
beings: Valentina, Sebastián, and Santiago, our children. I dedicate to all
four of them the public renovation of my love and commitment, and the
frm belieF that it is also For them that I will entirely Fulfll my duties with
the Association.
Thanks to my colleagues from Valle; they do not know how sensational
are for my life their knowledge, complains, characteristics, and forms of
being. I would like to highlight two of them who, in addition to be colle-
agues, are close friends of mine, Juan Carlos and Eduardo. Thanks for
The affection and knowledge of my family and friends is the best thing
that I have to lead the group which, during a year, will direct the activities
of the Colombian Association of Psychiatry.
Carlos A. Miranda Bastidas
Asociación Colombiana de Psiquiatría