Should Clinicians Medicate against Structural Violence? Potential Iatrogenic Risks and the Need for Social Interventions

AMA J Ethics. 2017 Aug 1;19(8):753-761. doi: 10.1001/journalofethics.2017.19.8.ecas2-1708.


This paper examines how a child psychiatrist might approach treatment of aggression in foster care youth. We argue that a multimodal approach is best. Physicians should weigh not only the iatrogenic risks of off-label antipsychotic medications but also the possible consequences of failing to treat complicating social factors at hand. Advocates must address structural violence and failures of imagination in their efforts to improve mental health equity among vulnerable youth.

MeSH terms

  • Aggression / drug effects*
  • Aggression / psychology*
  • Antipsychotic Agents / therapeutic use*
  • Foster Home Care / organization & administration*
  • Humans
  • Iatrogenic Disease
  • Risk
  • Social Adjustment
  • Social Behavior*
  • Violence


  • Antipsychotic Agents