Should We Just Prescribe? Ethical Considerations When Using Antidepressants and Benzodiazepines For Emotional Distress

Sep 30, 2026

Prescribing antidepressants and benzodiazepines for patients with emotional distress is a common primary-care practice that raises ethical questions. The paper sets out three aims: to describe general practitioners’ motivations for such prescribing, to analyze the ethical implications using Beauchamp and Childress’s four biomedical principles (autonomy, nonmaleficence, beneficence, and justice), and to offer recommendations to reduce the medicalization of emotional distress. It highlights clinical uncertainties and systemic pressures shaping decisions, including dependence risks and limited long-term benefit.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Abstract

Introduction

Prevalence of prescriptions in primary care

Medicalization of daily life and emotional distress

Bioethical Inquiry (2025) 22:899–915 [https://doi.org/10.1007/s11673-025-10437-4](https://doi.org/10.1007/s11673-025-10437-4) Should We Just Prescribe? Ethical Considerations When Using Antidepressants and Benzodiazepines For Emotional Distress G. García‑Calderó · S. Peregalli Politi Received: 25 June 2024 / Accepted: 13 February 2025 / Published online: 15 September 2025 © The Author(s) 2025 Abstract Prescribing antidepressants and benzodiazepines for patients with emotional distress is a common practice in primary healthcare that raises certain ethical questions. This paper has three aims. First, to describe the motivations that lead general practitioners to prescribe antidepressants and benzodiazepines in these cases. Second, to reflect on the ethical implications of such prescriptions based on the four principles of biomedical ethics defined by Beauchamp and Childress (autonomy, nonmaleficence, beneficence, and justice) . Finally, to propose some recommendations for the mitigation of the medicalization of emotional distress in primary healthcare. Results show that general practitioners seek to alleviate patients’suffering but their prescribing decisions are influenced by some uncertainties in clinical judgement as well as by systemic factors (patients’ pressures, time constraints, and unawareness of resources) . Ethical issues arise in relation to the potential for dependence, the questionable long-term benefit of prescriptions, the uncritical fulfillment of patients’ G. García-Calderó (*) Institute for Biomedical Ethics (IBMB), University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland e-mail: [gemma.garcia@unibas.ch](gemma.garcia@unibas.ch) S. P. Politi Child and Adolescent Psychiatry Clinical Services, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland e-mail: [santiago.peregalli@hug.ch](santiago.peregalli@hug.ch) expectations, and the impediment to address underlying social issues or to develop patients’ capabilities. Clinical consultation should be founded on effective communication between doctors and patients and a holistic care approach that acknowledges the psychological, social, and existential dimensions should replace a merely symptomatic approach. Some strategies to mitigate medicalization are proposed: the promotion of regular monitoring visits with patients and multidisciplinary collaboration, the enhancement of physicians’ knowledge about non-pharmacological interventions, as well as the establishment of an evidence-base for the effectiveness of these drugs in the primary healthcare setting. Keywords Antidepressants · Benzodiazepines · Emotional distress · Medicalization · Primary Healthcare · Bioethics Introduction In many Western culture countries, General Practitioners (GPs) are accountable for a vast percentage of antidepressant and benzodiazepine prescriptions, which are the most common drugs prescribed by GPs (Siriwardena 2010). In Norway, for instance, they prescribe the 73 per cent of antidepressants consumed by the general population (Svensson et al. 2019) . A study conducted in the region of Catalonia, reported that between 2 and 42 per cent of primary care patients are treated with psychotropic drugs (antidepressants, anxiolytics, antipsychotics, and hypnotic–sedatives)(Rubio-Valera et al. 2012) . Intuitively, one would expect such prescriptions to result from the diagnosis of some disease for which such drugs are indicated. However, research attests that a significant proportion of patients have been prescribed with antidepressants without having a mental disorder: according to Demyttenaere et al. (2008) almost 55 per cent of patients seeking help for emotional problems in six European countries were prescribed with antidepressants. Antidepressants are commonly prescribed for variable combinations of physical symptoms and psychological distress (Mercier et al. 2011) . The fact that this type of prescribing occurs mainly in p

FAQs

What motivations lead general practitioners to prescribe antidepressants and benzodiazepines for emotional distress?

The paper describes how GPs aim to alleviate patients’ suffering, while prescribing decisions are shaped by clinical uncertainties and systemic factors such as patient pressures, time constraints, and lack of awareness of resources.

Which ethical principles are used to assess these prescriptions?

The ethical analysis is based on four biomedical ethics principles by Beauchamp and Childress: autonomy, nonmaleficence, beneficence, and justice.

What recommendations are proposed to mitigate the medicalization of emotional distress?

The paper proposes strategies including regular monitoring visits, multidisciplinary collaboration, improving physicians’ knowledge of non-pharmacological interventions, and establishing an evidence base for effectiveness in primary healthcare. It also emphasizes effective doctor–patient communication and a holistic care approach beyond symptom-focused treatment.

Sep 30, 2026

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