PERSPECTIVES Character Virtues in Psychiatric Practice Jennifer Radden, PhD, and John Z. Sadler, MD The character-focused approach known as virtue ethics is especially well suited to understanding and promoting ethical psychiatric practice. Virtues are stable dispositions and responses attributed to character, and a virtue-based ethics is one in which people’s selves or characters are at the center of moral assessment. In this discussion by a clinician and a philosopher, clinical scenarios using exchanges and inner monologue illustrate key aspects of virtues. Virtues are acquired through ha- bituation; they are habits of mind as much as behavior; they are as a group heterogeneous, and individually composite; they involve affective responses; they are not impartial; they are compatible with the “role morality” required of professionals; they are responses to particular temptations and weaknesses; and they include, in the capacity for practical judgment known as phronesis, a way of resolving many of the conflicts and dilemmas that arise in practice. The virtue approach to ethics will likely be most useful in the educational setting where practitioners are learning clinical skills and socialized into the broad ethos of professional practice. Aspects of this educational effort are briefly reviewed, including whether it ought to be undertaken at all, whether the effort to teach virtues is possible, and, if so, how it can be achieved. (HARV REV PSYCHIATRY 2008;16:373–380.) Keywords: character, clinical practice, ethics, medical education, psychiatry, virtues The character-focused approach known as virtue ethics is especially well suited, we believe, for understanding and promoting ethical psychiatric practice. Virtues are the per- sonal qualities, such as integrity, honesty, and compassion, that we attribute to character. 1–3 They are traits—stable dispositions and responses rather than more passing and temporary states. For this reason, they are often used in describing people. “She is a courageous person,” we say, or “He is compassionate.” A virtue-based ethics, then, is one in which people’s selves or characters, rather than their ac- From the Departments of Clinical Sciences and Psychiatry, Univer- sity of Texas Southwestern Medical Center (Dr. Sadler); Department of Philosophy, University of Massachusetts Boston (Dr. Radden). Original manuscript received 3 January 2008; revised manuscript received 6 June 2008, accepted for publication 14 July 2008. Correspondence: John Sadler, UT Southwestern—Psychiatry & Clinical Sciences, 5323 Harry Hines Blvd., Dallas, TX 75390-9070. Email: John.Sadler@UTSouthwestern.edu  c 2008 President and Fellows of Harvard College DOI: 10.1080/10673220802564194 tions or the consequences that flow from those actions, are at the center of moral assessment. 4–11 Because virtue ethics emphasizes everyday conduct, behaving virtuously implies that everyday conduct is laden with moral value. Likewise, as we shall indicate later, everyday clinical practices and strategies can be understood as imbued with virtues (and hence with morality, too). A virtue focus can be contrasted with other approaches to ethics, yet pluralistic forms of virtue ethics are also possible—ones in which virtues provide some strong moral reasons, but not the only moral reasons, for acting and living. 7 Moreover, only a misreading, it has been argued, could present either Kantian (emphasizing rights and du- ties) or utilitarian traditions (directed towards maximiz- ing happiness) as indifferent to the importance of character virtues in the moral life. 12 Similarly, an ethical position de- fined by particular values or principles, such as Beauchamp and Childress’s principlism, could be construed as a set of character traits: 13 the principle of beneficence resides in the benevolent character, autonomy in the character that is self-determining and respectful of others, and so on. An ethics of care (where caring and caregiving are central to the moral life) accommodates a focus on the character of the carer. 14 Even a pragmatist approach that emphasizes the need for flexibility and contextualized moral responses can 373