Objectives:
Summary The authors express an opinion that discussion on psychotherapy should be based upon its ethical dimension. In their opinion, the source of that are the expectations of the patient and the obligations of the therapist that emerge in a therapeutic relation. In that relation, the ethics of psychotherapy appears and develops, influenced by the ethical principles of both participants of the therapy. The authors suggest referring to the medical paradigm and medical ethics when dealing with ethical decisions in psychotherapy. The article also presents ethical implications of actual or nominal handling of mental illnesses and disorders, also in connection to psychotherapy. The influence of the specific position of the therapeutic relation’s participants on the importance of ethics in this relation is pointed out (the patient’s status as both the healed and the healer, and the therapist’s characteristic experience of carrying the therapy’s burden). The authors also refer to the issue of the patient’s autonomy in psychotherapy and investigate a related problem of the patient’s conscious consent to psychotherapy and the question of medical paternalism in psychotherapy. The article points out the issue of the therapist’s loyalty towards the patient, as well as possible limitations to the therapeutic dialogue determined by the psychotherapist’s and patient’s worldviews and ethical principles. The authors reckon that because of relational nature of ethics, the ethical problems of a psychotherapist are different in relation with every patient and in every moment of therapy.

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