Posts Tagged ‘Informed consent’

Use of chemical restraints in nursing homes called an epidemic

Friday, March 25th, 2011

Ventura County Star, March 24, 2011
by Tom Kisken

Antipsychotics are given in nursing homes or other facilities without the informed consent of residents or surrogates and are used as chemical restraints

Nearly 25 percent of the residents in California’s nursing homes are placed on antipsychotic drugs, often used as sort of a chemical leash to control behavior in a trend a watchdog called an epidemic Thursday at a symposium.

The drugs can double the risk of death for seniors with dementia and cause side effects ranging from stroke to delirium, according to speakers at an Oxnard conference called “Toxic Medicine.” Often the drugs are given in nursing homes or other facilities for dementia without the informed consent of residents or surrogates and are used as a restraint rather than to treat psychiatric conditions.

Over the past decade the use of the drugs has evolved from a sniffle to a flu to something much worse, said Sylvia Taylor Stein, of the Long Term Care Services of Ventura County ombudsman program.

“By 2010 we had an epidemic,” she said in a symposium organized by her group and the California Advocates for Nursing Home Reform. It was attended by a packed house of nursing home leaders, assisted-living administrators, elder abuse lawyers and state licensing agencies.

Some at the conference linked the use of antipsychotics to staff shortages that make it impossible for employees to properly care for patients, state cuts in mental health programs that have brought more patients with psychiatric problems to long-term care facilities and doctors who have a drug-first mentality when it comes to long-term care residents.

Read the rest of the article here:  http://www.vcstar.com/news/2011/mar/24/use-of-chemical-restraints-in-nursing-homes-an/#ixzz1Hd9VUKAg

For More on Antipsychotic Drug Side Effects :

To read summaries of international studies and warnings on antipsychotic drugs, simply type in Antipsychotic in the Search box or use the drop down menus here: http://www.cchrint.org/psychdrugdangers/drug_warnings.php

To read side effects reported to the US FDA on antipsychotics,  visit CCHR’s FDA Medwatch reports and choose Antipsychotics at the very bottom of the Drug Name/Drug Class drop down menu and choose age  65 to 99 in the Age Range menu here http://www.cchrint.org/psychdrugdangers/medwatch_psych_drug_adverse_reactions.php

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In Ireland: No Consent for 12% of those getting electroshocked

Wednesday, March 16th, 2011

Note from CCHR:  Electroshock is the “treatment” psychiatrists employ when their first line of “treatment”— drugs—fail to work.  And the drugs inevitably fail to work,  simply because they are no more effective than placebo, yet have side effects rivaling the most hardcore street drugs.    In the U.S. alone, more than 100,000 people are electroshocked every year, and the majority of them are elderly.   But psychiatrists also electroshock two of the other most vulnerable subjects; pregnant women and children.  Hard to believe, but true.   And what’s more,  psychiatrists are pushing harder than ever for increases in electroshock treatment, recently lobbying the U.S. FDA to downgrade electroshock machines from the most high risk category of device (Class III) to Class II.   They failed.  And the reason they failed is because the facts were made known by CCHR and other experts who testified before the FDA.  You can read about this FDA hearing here: http://www.cchrint.org/2011/01/31/fda-advisory-panel-recommends-electroshock-device-too-risky-for-reclassification/

The article below talks about the administration of electroshock without the consent of the patient.  But even in cases where the patient does give consent, do we really believe they or their family members are getting enough information to make an informed choice?  Are they told psychiatrists still have no idea how electroshock “works?”  That if they imagine sticking their finger in a light socket, then multiply that current by about 3-4 times, they will have an idea of the amount of electricity that will be sent searing through the brain?  Are they told they could lose their memories, often permanently? Not remember their own wedding or where they were born, or their own children?  That side effects also include death? Or how about the fact that electroshock treatment was born in Italy, 1938,  when psychiatrist Ugo Cerletti saw pigs being made more docile before slaughter so decided to give it a shot on humans?   Are those facts in the consent form?

To get the facts about Electroshock, watch this video:
Electroshock: It’s Not Treatment, It’s Torture
http://www.youtube.com/cchrint#p/c/5/QDR3cD8_kck



The Irish Independent, March 16, 2011

By Eilish O’Regan

Almost one in eight patients who were given electric shock treatment over the course of a year were either unable or unwilling to give consent to the controversial procedure.

A higher number of women (62.5pc) than men were given the electroconsvulsive treatment (ECT) without consent, the 2009 monitoring report from the Mental Health Commission watchdog revealed.

The majority of the 373 treatments were given to patients who gave their agreement — but the law does allow for it to be given in cases where a person is “unwilling or unable to do so”.

However, where ECT is given without the permission of the patient, the treating doctor has to ensure he or she gets a second opinion from another psychiatrist who must agree it is the best course. They do not need to get the consent of family members.

The report, which looked at 66 mental health centres, found that there were 34 fewer programmes of ECT administered in 2009 compared to 2008.

St Patrick’s Hospital in Dublin, the largest of the centres, had the highest number of ECT treatments (126) and accounted for one third of all cases.

St Brigid’s Hospital in Ballinasloe had the second highest number followed by the Department of Psychiatry in Waterford Regional Hospital.

The patients were mostly suffering from depression while others had schizophrenia and mania.

The main reason for resorting to electric shock treatment was the patient’s lack of response to medication.

Other reasons included risk of suicide and physical deterioration and where a “rapid response” was deemed necessary in a significant number of the patients.

An improvement was seen in the vast majority of patients but no improvement was seen in 5.4pc of those treated. It was stopped in a small number of cases due to complications.

Irish psychiatrists have differing views on the merits of the treatment with some saying it should be stopped because of complications such as risk of memory loss.

Seizure

If ECT is recommended, the patient is given a general anaesthetic and medication to relax their muscles. Electrodes are then placed on the person’s head and a pulse of electricity passed through the brain which will set off a fit or seizure.

The patient normally has around six to 12 sessions with two administered a week. Electricity changes the chemical composition of the patient’s brain and lifts them out of their low mood.

‘Coronation Street’ actress Beverly Callard credits ECT with rescuing her from severe depression after she was unresponsive to medication.

The College of Psychiatry in Ireland has proposed changes in selecting a doctor asked for a second opinion. The doctor should be part of a panel set up by the Mental Health Commission and would also have to consult with others treating the patient.

http://www.independent.ie/health/latest-news/no-consent-for-12pc-of-electric-shock-care-2581131.html

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Americas Mental Illness Epidemic

Thursday, August 26th, 2010

Rense.com
By Gary G. Kohls, MD
August 25, 2010

Tens of millions of innocent, unsuspecting Americans, who are mired deeply in the mental “health” system, have actually been made crazy by the use of or the withdrawal from commonly-prescribed, brain-altering, brain-disabling, indeed brain-damaging psychiatric drugs that have been, for many decades, cavalierly handed out like candy ­ often in untested and therefore unapproved combinations of drugs – to trusting and unaware patients by equally unaware but well-intentioned physicians who have been under the mesmerizing influence of slick and obscenely profitable psychopharmaceutical drug companies aka, BigPharma.

That is the conclusion of two books by investigative journalist and health science writer Robert Whitaker. His first book, entitled Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill noted that there has been a 600% increase (since Thorazine was introduced in the US in the mid-1950s) in the total and permanent disabilities of millions of psychiatric drug-takers. This uniquely First World mental ill health epidemic has resulted in the life-long taxpayer-supported disabilities of rapidly increasing numbers of psychiatric patients who are now unable to be happy, productive, taxpaying members of society. Whitaker has done a powerful, albeit unwelcome job of presenting previously hidden, but very convincing evidence to support his thesis, that it is the drugs and not the diagnosis that is causing the epidemic of mental illness disability. Many open-minded physicians and many aware psychiatric patients are now motivated to be wary of any and all synthetic chemicals that can cross the blood/brain barrier because all of them are capable of altering the brain in ways totally unknown to medical science, especially when the patients are taking the drugs long-term..

In Whitaker’s second book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, he goes much further in advancing this sobering reality. He documents the history of the powerful forces behind the relatively new field of psychopharmacology and its major shaper and beneficiary, BigPharma. Psychiatric drugs, whose developers, marketers and salespersons are all in the employ of the giant drug companies, are far more dangerous than the drug and psychiatric industries are willing to admit: These drugs, it turns our, are fully capable of disabling ­ often permanently – body, brain and spirit.

More evidence to support Whitaker’s well-documented claims are laid out in two important new books written by psychiatrist and scholar Grace Jackson. Jackson did a beautiful job of researching and documenting, from the voluminous basic neuroscience research (which is uniformly ignored by the clinical sciences) the unintended and often disastrous consequences of the chronic ingestion of any of the five major classes of psychiatric drugs. Her second and most powerful book: Drug-Induced Dementia: A Perfect Crime, proves beyond a shadow of a doubt, that any of the five classes of drugs that are commonly used in psychiatric patients (antidepressants, antipsychotics, psychostimulants, tranquilizers and anti-seizure/”mood-stabilizer” drugs) have shown microscopic, macroscopic, biochemical, clinical and/or radiological evidence of brain shrinkage and other signs of brain damage, which can result in clinically-diagnosable, permanent dementia, premature death and a variety of other related brain disorders that can mimic mental illnesses. Jackson’s first book, Rethinking Psychiatric Drugs: A Guide for Informed Consent was an equally sobering book warning about the many hidden dangers of psychiatric drugs.

This sad truth is that the seemingly knee-jerk prescribing (without very much information being given to patients about the long list of serious long-term adverse effects) of potent and often addicting/dependency-inducing psychiatric drugs has become the standard of care in American psychiatry since the introduction of the so-called anti-schizophrenic “miracle” drug Thorazine in the mid-1950s. (Thorazine was the offending drug that all of Jack Nicholson’s fellow patients were coerced into taking at “medication time” in the Academy Award-winning movie “One Flew Over the Cuckoo’s Nest”.) Thorazine and all the other “me-too” early antipsychotic drugs are now universally known to have been an iatrogenic (= doctor or other treatment-caused) disaster because of their serious long-term, initially unsuspected, brain-damaging effects that resulted in a number of incurable neurological disorders such as tardive dyskinesia and Parkinson’s disease.

Thorazine and all the other knock-off drugs like Prolixin, Mellaril, Navane. etc, are synthetic “tricyclic” chemical compounds similar in molecular structure to the tricyclic “antidepressants” like imipramine and the similarly toxic, obesity-inducing, diabetogenic, “atypical” anti-schizophrenic drugs like Clozaril, Zyprexa and Seroquel.

Thorazine, incidentally, was originally developed in Europe as an industrial dye. That doesn’t sound so good although it may not be so unusual in the closely related fields of psychopharmcology and the chemical industry, especially when one considers that Depakote, a popular drug marketed initially as an anti-epilepsy drug but now is being heavily used as a so-called “mood stabilizer”. Depakote, known to be a hepatotoxin and renal toxin, was originally developed as an industrial solvent capable of dissolving fat – including, presumably, the fatty tissue in human livers and brains.

Some sympathy and understanding needs to be generated for the various victims of BigPharma’s compulsive drive to expand market share and “shareholder value” (share price, dividends and the next quarter’s financial report) by whatever means necessary. Both the prescribers and the swallowers of BigPharma’s drugs have succumbed to BigPharma’s cunning marketing campaigns, the prescribers having been seduced by attractive drug company representatives and their “pens, pizzas and post-it note” freebies in the office, and the patients being brain-washed by the inane and unbelievable (if one has intact critical thinking skills) commercials on TV that quickly gloss over the lethal adverse effects in the fine print while urging the watcher to “ask your doctor” about the latest unaffordable wannabe blockbuster drug..

For a quick overview of these issues, I recommend that everybody with an open mind read a long essay written by Whitaker that persuasively identifies the source of America’s epidemic of mental illness disability (a phenomenon that doesn’t exist in Third World nations because costly psych drugs are not prescribed so cavalierly as in the US).

Whitaker and Jackson (among a number of other ground-breaking and whistle-blowing authors who have been essentially black-listed by the mainstream media and mainstream medical journals) have proven to most critically-thinking scientists, alternative practitioners and assorted “psychiatric survivors” that it is the drugs – and not the so-called “disorders” – that are causing our nation’s epidemic of mental illness disability. The Whitaker essay, plus other pertinent information about his books can be accessed at www.madinamerica.com A recent interview on Wisconsin Public Radio can be accessed at www.wpr.org (at their radio archives link) and a long interview with Dr.Joseph Mercola can be heard at: http://articles.mercola.com/sites/articles/archive/2010/05/08/robert-whitaker-interview.aspx

After reading and studying all these inconvenient truths, mental health practitioners must consider the medicolegal implications for them, especially if the information is ignored or if the information is dismissed out of hand by practitioners who might be tempted to not take the time to study this new information. Those people who are hearing about this for the first time need to pass the word on to others, especially their prescribing healthcare practitioners who should be equally concerned. This is important because the opinion leaders in the highly influential (for good or ill) psychiatric and medical industries have been marketed into submission without hearing the all the facts (which may have been intentionally hidden from them. If that is the case, they cannot be automatically blamed for proceeding in a practice that some day might represent malpractice. It shouldn’t have to be pointed out that is the solemn duty of ethical practitioners who are in positions of authority to fully examine potential malpractice issues and then warn others, especially their patients, of the dangers.

Sadly, it must be admitted that most of the over-worked, double-booked care-givers in medical clinics have not yet heard the news that most if not all of the brain-altering synthetic chemicals known as psychotropic drugs (which are treated as hazardous waste unless they are packaged in a swallowable capsule!) have been marketed as safe and effective – but only for short-term use. The captains of the drug industry know that the psychotropic drugs that they present for the FDA-approval have only been tested in animal trials for days and in clinical trials for 6 weeks. They also know ­ indeed they hope – that patients will be taking their drugs for years (despite no long-term trials proving safety and efficacy) as the only “treatment” for mental ill health. They know that their brain-altering drugs are also dependency-inducing (aka addicting, causing withdrawal symptoms when stopped), neurotoxic and increasingly ineffective (a la “Prozac Poop-out”) as time goes by.

The truth is that the people diagnosed as “mentally ill” for life are often simply those unfortunates who find themselves in acute or chronic states of crisis or “overwhelm” due to any number of preventable, curable and treatable (without the use of drugs) bad luck accidents such as poverty, abuse, violence, torture, homelessness, discrimination, underemployment, brain malnutrition, addictions/withdrawal, brain damage from electroshock “therapy” and/or exposure to neurotoxic chemicals in their food, air, water or prescription bottles.

Those labeled as the “mentally ill” are just like us “normals” who have not yet decompensated because of some yet-to-happen, crisis-inducing, overwhelming (however temporary) life situation. And thus we have not yet been given a billable code number (accompanied by the seemingly obligatory – and unaffordable – drug prescription or two signifying we are now chronically mentally ill. Unlabeled, we are likely to remain off prescription drugs but with a label and in “the system”, it is hard to “just say no to drugs.”

The victims of hopelessness-generating situations like simple bad luck, bad circumstances, bad company, bad choices, bad government, big business, and a competitive society that generates a few winners but mostly losers. America tolerates, indeed celebrates, punitive and thus fear-inducing social systems resembling in many ways the infamous police state realities of 20th century European totalitarianism, where people who were different or just dissidents were thought to be abnormal and therefore “disappeared” into insane asylums, jails or concentration camps without just cause or competent legal defense. And many of them were and are drugged with disabling psychoactive chemicals against their will.

The truth is that most, if not all, of BigPharma’s psychotropic drugs are lethal at some dosage level (the LD50, the lethal dose that kills 50% of lab animals, is calculated before efficacy testing is done), and therefore the drugs must be regarded as dangerous. The chronic use of these drugs is a major cause of cognitive disorders, brain damage, loss of creativity, loss of spirituality, loss of empathy, loss of energy, loss of strength, fatigue and tiredness, permanent disability and a multitude of metabolic adverse effects that can readily sicken the body, brain and soul by causing insomnia or somnolence, increased depression or anxiety, delusions, psychoses, paranoia, mania, etc. So before filling the prescription, it is advisable to read the product insert labeling under WARNINGS, PRECAUTIONS, ADVERSE EFFECTS, CONTRAINDICATIONS, TOXICOLOGY, OVERDOSAGE and the ever-present BLACK BOX WARNINGS ABOUT SUICIDALITY.

Long-term, high dosage or combination psychotropic drug usage could be regarded as a chemically traumatic brain injury (TBI) or, as drugs like Thorazine were known in the 1950s and 60s, a “chemical lobotomy”. That is a useful way to conceptualize this serious issue, because such chemically brain-altered patients are often indistinguishable from those who have suffered a physically traumatic brain injuries or been subjected to ice-pick lobotomies which were popular in the 1940s and 50s – before the drugs came on the market.

America has a mental ill health epidemic on its hands that is grossly misunderstood because it is worsening, not by the supposed disease progression, but because of the neurotoxic, non-curative drugs that are somehow regarded as first-line “treatment.”
Read the rest of this article here: http://www.rense.com/general91/edi.htm

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LewRockwell.com—No Excuses:The Reality Cure of Thomas Szasz—Szasz has been, for over 50 years, the gadfly of psychiatry

Wednesday, August 4th, 2010

LewRockwell.com
By Phil Barker and Poppy Buchanan-Barker
August 4, 2010

And you thought Tom Szasz was yesterday’s hero? This paper brings us up to date.

Future historians may well cast Thomas Szasz as an intrepid campaigner for the blindingly obvious: people do not have “mental illnesses” but experience a wide range of moral, interpersonal, social and political “problems in living.” All such problems concern, or have an impact on, our sense of who and what we are and could just as easily be called spiritual crises. However, despite his prodigious scholarly output, Szasz might well be written out of history, as punishment for his single-handed and persistent exposure of the greatest hoax of the modern age – the construction of the “myth of mental illness” and psychiatry’s ludicrous attempts to “treat” it.

In the best Socratic tradition Szasz has been, for over 50 years, the gadfly of psychiatry. In his classic book, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Szasz, 1961), he contended that, contrary to the professional and public opinion of the time (the late 1950s) the mind – an abstract concept – could only be considered “sick” in the same sense that a joke or a building might similarly be described. This mind metaphor functions as a powerful myth, like many fictions, offering comfort to all who embrace the idea as a way of explaining the “inexplicable.”

At the end of the 20th century religion, especially Christianity, was furiously debunked by radical secularists like Richard Dawkins, Daniel Dennett and Christopher Hitchens. They exposed not just its mythical nature but the harm and injustice associated with its practice down the ages. Ironically, their glaring sin of omission was to ignore psychiatry – by far the most potent and influential religion of the past two hundred years.

Psychiatrists might feign offense at their portrayal as “high priests,” believing that they offer a complex and compassionate form of psychological medicine, worshipping at the same altar as scientists like Dawkins. Historically, the facts tell a very different story, as Szasz’s works have vividly illustrated.

Traditional religions can hold sway over large sections of any population, and may be considered a force for good or evil. However, such “myths” are, at the very least, embraced by the faithful; who gain socially, culturally or spiritually from their allegiance; and are free to rejoin secular society whenever they wish. The same could never be said of “psychiatric patients.” The open secret of the 20th century was that modern psychiatry became a “church” founded on hocus-pocus masquerading as science, and promoted a range of means of detaining and restraining its “patient” flock. Today, as psychiatry rebrands itself as a branch of neuroscience, it seeks to colonize “developing nations,” despite its near-bankrupt status in its Western world of origin. Parallels with the Christian missionaries seem wholly apposite.

Over the past 60 years Thomas Szasz has published over 30 books and around 700 papers and articles, all focused on exposing the logical weaknesses of psychiatric thought, and the moral bankruptcy of its practice. Heidegger proposed that every great thinker thinks but one thought. Szasz’s singular, original thought concerns the moral bankruptcy of expecting (far less forcing) people to see psychiatrists; to be admitted to so-called “mental hospitals”; to take psychiatric drugs; and otherwise to comply with the capricious fashions of psychiatric religion. His diverse and remarkably accessible writings around this single proposition have led many to view him as the foremost, contemporary moral and existential philosopher of psychiatry and psychotherapy: the psychiatric equivalent of the boy obligated to point out the Emperor’s nakedness. In his 90th year, the uncompromising fury of Szasz’s scholarship shows no sign of waning as three of his latest books attest.

Coercion as Cure (Szasz 2007) has a “classic” feel providing, as its subtitle makes clear, a much-needed “critical history of psychiatry.” Szasz acknowledges that, from his first day in medical school in the early 1940s, his understanding of the physician’s role was to try to relieve the suffering of individuals who asked for, and accepted, medical help. He quickly formed the view that psychiatrists were committing a grave moral wrong by imprisoning and coercing people who neither sought nor wanted their “help.” This simple, yet profoundly humanist view became, and remains, his raison d’être.

Read entire article here:  http://www.lewrockwell.com/orig10/szasz5.1.1.html

Dr. Thomas Szasz is also the co-founder of CCHR.  For more on Thomas Szasz, including his CV, quotes, video, accolades and his relationship with CCHR, click here:  http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/

And you thought Tom Szasz was yesterday’s hero? This paper brings us up to date.

Future historians may well cast Thomas Szasz as an intrepid campaigner for the blindingly obvious: people do not have “mental illnesses” but experience a wide range of moral, interpersonal, social and political “problems in living.” All such problems concern, or have an impact on, our sense of who and what we are and could just as easily be called spiritual crises. However, despite his prodigious scholarly output, Szasz might well be written out of history, as punishment for his single-handed and persistent exposure of the greatest hoax of the modern age – the construction of the “myth of mental illness” and psychiatry’s ludicrous attempts to “treat” it.

In the best Socratic tradition Szasz has been, for over 50 years, the gadfly of psychiatry. In his classic book, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Szasz, 1961), he contended that, contrary to the professional and public opinion of the time (the late 1950s) the mind – an abstract concept – could only be considered “sick” in the same sense that a joke or a building might similarly be described. This mind metaphor functions as a powerful myth, like many fictions, offering comfort to all who embrace the idea as a way of explaining the “inexplicable.”

At the end of the 20th century religion, especially Christianity, was furiously debunked by radical secularists like Richard Dawkins, Daniel Dennett and Christopher Hitchens. They exposed not just its mythical nature but the harm and injustice associated with its practice down the ages. Ironically, their glaring sin of omission was to ignore psychiatry – by far the most potent and influential religion of the past two hundred years.

Psychiatrists might feign offense at their portrayal as “high priests,” believing that they offer a complex and compassionate form of psychological medicine, worshipping at the same altar as scientists like Dawkins. Historically, the facts tell a very different story, as Szasz’s works have vividly illustrated.

Traditional religions can hold sway over large sections of any population, and may be considered a force for good or evil. However, such “myths” are, at the very least, embraced by the faithful; who gain socially, culturally or spiritually from their allegiance; and are free to rejoin secular society whenever they wish. The same could never be said of “psychiatric patients.” The open secret of the 20th century was that modern psychiatry became a “church” founded on hocus-pocus masquerading as science, and promoted a range of means of detaining and restraining its “patient” flock. Today, as psychiatry rebrands itself as a branch of neuroscience, it seeks to colonize “developing nations,” despite its near-bankrupt status in its Western world of origin. Parallels with the Christian missionaries seem wholly apposite.

Over the past 60 years Thomas Szasz has published over 30 books and around 700 papers and articles, all focused on exposing the logical weaknesses of psychiatric thought, and the moral bankruptcy of its practice. Heidegger proposed that every great thinker thinks but one thought. Szasz’s singular, original thought concerns the moral bankruptcy of expecting (far less forcing) people to see psychiatrists; to be admitted to so-called “mental hospitals”; to take psychiatric drugs; and otherwise to comply with the capricious fashions of psychiatric religion. His diverse and remarkably accessible writings around this single proposition have led many to view him as the foremost, contemporary moral and existential philosopher of psychiatry and psychotherapy: the psychiatric equivalent of the boy obligated to point out the Emperor’s nakedness. In his 90th year, the uncompromising fury of Szasz’s scholarship shows no sign of waning as three of his latest books attest.

Coercion as Cure (Szasz 2007) has a “classic” feel providing, as its subtitle makes clear, a much-needed “critical history of psychiatry.” Szasz acknowledges that, from his first day in medical school in the early 1940s, his understanding of the physician’s role was to try to relieve the suffering of individuals who asked for, and accepted, medical help. He quickly formed the view that psychiatrists were committing a grave moral wrong by imprisoning and coercing people who neither sought nor wanted their “help.” This simple, yet profoundly humanist view became, and remains, his raison d’être.

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The Psychologist, UK: Madness, Myth and Medicine—the continuing relevance of Thomas Szasz, now in his 91st year

Monday, August 2nd, 2010

The Psychologist

by Ron Roberts

Only after we abandon the pretense that mind is brain and that mental disease is brain disease can we begin the honest study of human behaviour and the means people use to help themselves and others cope with the demands of living (Szasz, 2007a, p.149).

Fifty years ago American Psychologist published a seminal article by the Hungarian-born psychoanalyst and psychiatrist Thomas Szasz, “The myth of mental illness” (Szasz, 1960). The thesis was elaborated at length in a book of the same name a year later (Szasz, 1961).

As the decade got into full swing, Szasz’s critique of psychiatric theory and practice was herded into the same conceptual basket as the musings of Scottish psychiatrist R.D. Laing, and his erstwhile friend and collaborator David Cooper. The quite different ideas of these men came to be bracketed inappropriately under the rubric of “anti-psychiatry”—an expression coined by Cooper though disclaimed by Laing and rejected outright by Szasz.

Since then biological psychiatry has developed a stranglehold on research, teaching and practice in the field of “mental health,” and Szasz’s opposition to psychiatry and the basis for it has been mislocated in the art and culture of the day, its relevance for today denied. Szasz’s view has become viewed by many as a supposed child of its time—a component in the social manufacture of the so-called anti-establishment Swinging Sixties. To let such misapprehension pass unchallenged into the history of the behavioural sciences would be a serious error, and Szasz for his part has constantly endeavoured to set the record straight.

First it must be said that Szasz’s insights into the shortcomings of conventional psychiatry pre-date the 1960s by some considerable margin. In a brief autobiographical sketch Szasz makes clear that the absurdity of psychiatric fictions had dawned on him long before Fellini’s masterpiece was highlighting the shallowness of La Dolce Vita: “Everything I had learned and thought about mental illness, psychiatry, and psychoanalysis—from my teenage years, through medical school, and my psychiatric and psychoanalytic training—confirmed my view that mental illness is a fiction; that psychiatry, resting on force and fraud is social control, and that psychoanalysis—properly conceived—has nothing to do with illness or medicine or treatment.” (2004, p.22)

Szasz graduated in medicine in 1944, having migrated to the US from his native Hungary in 1938, a fugitive from the looming menace of Nazism. He undertook a psychiatric residency and trained in psychoanalysis. The appeal of psychoanalysis, besides its intellectual and interpersonal attractions, lay in its ostensibly consensual and contractual nature. Less well known than his other works, his dissection of power in psychoanalytic relationships—published as The Ethics of Psychoanalysis (Szasz, 1965)—is central to his thinking and stands complementary to the assertions that mental illness is a myth. In this Szasz effectively provides a practical guide on how to ensure a level playing field in psychotherapeutic relationships, to the benefit of both parties. He is honest and open enough to explicitly explore the role that money may play in distorting therapeutic means and ends. As such, it not only stands the test of time but stands squarely against the numerous vested interests, both pharmaceutical-financial and professional, which dominate the mental health industry past and present

Anti-psychiatry or pro-consent?
Szasz is not “anti”-psychiatry. He advocates the right to agree consensual contractual relations of any kind, including consensual psychiatry if that is what suitably informed people want. He has proposed, for example, the use of advanced psychiatric directives whereby people could agree to accept or refuse specific interventions to be made “on their behalf” in the event of their becoming extremely distressed and “irrational” in future. Such ideas have unfortunately been rejected outright by leading figures in both psychiatry and medical ethics, and accordingly Szasz sees little possibility of any kind of consensual psychiatry until the use of coercion, whether explicit or tacit, is relinquished.

As psychiatry continues to function for the most part as an extension of the criminal justice system, Szasz asserts that psychiatry in its current form must be abolished. This would require a concerted challenge to its support structures, premised as they are on the notions of behaviour as disease, the fear of dangerousness and the necessity for medical treatment under the guise of protecting the individual from his or herself. The championing of the latter notion in particular owes much to an ignorance of its origins. A careful reading of Szasz’s historical analysis of the origins of the insanity defence in 17th-century England goes some way to clarifying where behavioural scientists got the idea from that people of “unsound mind” were not responsible for their actions and could not be held accountable for them. In Coercion as Cure, he writes

With suicide defined as a species of murder, the persons sitting in judgment of self killers had the duty to punish them. Since punishing suicide required doing injustice to innocent parties… the wives and minor children of the deceased—eventually the task proved to be an intolerable burden. In the seventeenth century, men sitting on coroners’ juries began to recoil against desecrating the corpse and dispossessing the suicide’s dependants of their means of support. However, their religious beliefs precluded repeal of the laws punishing the crime. Their only recourse was to evade the laws; The doctrine that the self-slayer is non compos mentis and hence not responsible for his act accomplished this task (Szasz, 2007a, p.99)

And so a social practice became reified into an imaginary biological disease process ravaging through the brains of its unfortunate victims, necessitating psychiatric intervention!

The label of “anti-psychiatry” that continues to be attached to Szasz is one which he has been at pains to condemn (Szasz, 2009), used as it is to stultify and nullify any criticism of contemporary psychiatry. While Laing saw himself as “essentially on the same side” as Szasz (Mullan, 1995, p.202), Szasz sees considerable distance between them, for a number of reasons. Perhaps at the forefront of these Laing was known to have forcibly drugged one of his patients (Szasz, 2008) and for all his eloquence and insight into human misery his writings do not in principle condemn the forced treatment or incarceration of people against their will on psychiatric grounds. Finally whilst The Divided Self (Laing, 1960) and Sanity Madness and the Family (Laing & Esterson, 1964) amongst other outpourings proclaimed the intelligibility of going mad within a human rather than biological framework, Laing did not reject outright the notion of mental illness, which in Szasz’s view remains at best a metaphor.

Szasz has throughout his career stood firmly to his principles and steadfastly eschewed psychiatric practice in an environment where people have been deprived of their liberty. He has on occasion appeared in court both to represent individuals deprived of their liberty and to uphold the principle of criminal responsibility in murder cases where those accused have sought to evade it through the insanity defence (see Szasz, 2007b, chapter 13 in particular). Such consistent challenges to institutional psychiatry have been made at some professional cost. Szasz has not simply been the recipient of fierce criticism from the psychiatric fraternity, who feel betrayed by his actions, but has also endured attempts to limit his academic freedom. In the aftermath of the publication of The Myth of Mental Illness, for example, attempts were made to ban him from teaching at the state hospital medical school—citing his beliefs as “proof” of his “incompetence as a psychiatrist” (Schaler, 2004, p.xix).

Some confusion about Szasz’s work has arisen through the quite different political cultures within which it is interpreted, even by those who oppose institutional psychiatry in its current incarnation. His work has been claimed and repudiated by those on both the “left” and “right”—deemed a liberal in some quarters and a fascist in others—with the claims and counterclaims rooted in the predilections of the critics for different configurations of state power. European intellectual tradition on the left, for example, clings to a belief and a desire that state power can be harnessed for the good. This means that while Szasz’s attacks on psychiatric authority are applauded, his admonitions against the “therapeutic state” (Szasz, 2001, 2002), with its merging of psychiatric and state power on the one hand and private and public health on the other, are glossed over. In truth, if such a thing can be said, Szasz’s ideas belong to neither the right nor the left. His work challenges and questions all operations of organised power from the state downwards, as long as they are used to crush and oppress human freedom. His work implies unanswered questions concerning theforms of community and social organisation which people can harness for the individual and common good in order to enable them to deal elegantly with the insatiable demands of living.

Addendum
While preparing this article I encountered Philippe Petit’s (2002) wondrous account of his high-wire walk across the twin towers of the World Trade Center in 1974. Immediately after performing his “artistic crime of the century” Petit was arrested and subject to psychiatric examination. Petit was judged to be sane, but the outcome of the psychiatric interview is less revealing than the fact that psychiatrists were willing to play their part in a pseudo-medical intervention provoked by nothing more than social rule breaking of the highest imaginative order. It struck me that Petit—an imaginative, unusual and beguiling figure—exemplifies much that modern psychiatry stands in antipathy to. Petit cares not for the rules and regulations that structure and govern the lives of citizens and lives, in his terms, only to dream “projects that ripen in the clouds”(Petit, 2002, p.6). There can be little doubt that psychiatry is an enterprise that is engineered to destroy these—that it cannot tolerate idiosyncrasies of thought, whether grandiose or mundane. Petit succeeded in his outlandish and highly improbable quest—but why should one have to achieve outlandish success to be embraced by society and enjoy the right to pop one’s head in the clouds or spend the “afternoons in treetops”? Szasz’s efforts over the years can be seen in many lights, but without doubt he has toiled on behalf of the dream of human accountability and responsibility, for the freedom to be different and to take charge of one’s life, free from the machinations of state sponsored psychiatric interference.

Read the article here:  http://www.centerforindependentthought.org/Psychologist_article.html

Dr. Thomas Szasz is also the co-founder of CCHR.  For more on Thomas Szasz, including his CV, quotes, video, accolades and his relationship with CCHR, click here:

http://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/


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Illinois Department of Public Health: 5 things to know about psychotropics (including the right to informed consent)

Tuesday, October 27th, 2009

Illinois Dept. of Public Health
Chicago Tribune
October 27, 2009

Your rights: Nursing homes cannot give a psychotropic drug without a doctor’s order, informed consent and an adequate diagnosis, according to federal and state regulations. Drugs cannot be administered simply because a resident is disruptive or restless. Rules and guidelines dictate that staff must first try to calm patients; root causes of agitation, such as an infection, must be ruled out. When drugs are given, facilities must check for side effects and reduce dosages when possible.

The consent: Consent forms must be signed by patients or someone with power of attorney. In general, consents must say what drug will be given, how much and how often. If a doctor wants to add a drug, the consent must be re-signed. The patient must be fully informed of risks.

Read entire article: http://www.chicagotribune.com/health/chi-nursing-home-tips-27-oct27,0,7460931.story

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Congressman Ron Paul’s Parental Consent Act

Wednesday, October 14th, 2009

Ron PaulBy John Breeding
Psychologist, Author, The Wildest Colts Make the Best Horses
October 14, 2009

On April 30, 2009, Congressman Ron Paul introduced H.R. 2218, known as The Parental Consent Act of 2009.

The bill forbids federal funding for universal or mandatory mental health screening, and also forbids money for any educational or other government agency that would use a parent’s refusal to consent to their child’s screening as basis for a charge of child neglect or abuse.



A little recent history is relevant. On April 29, 2002, President George Bush created the New Freedom Commission on Mental Health. In 2003, this industry-studded commission presented their recommendations for the reform of the United States mental health system.

“To aid in transforming the system,” the authors of the report wanted to do many things, including:

  • Improve and expand school mental health programs.
  • Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.
  • Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and supports.

This rhetoric serves to hide the truth that New Freedom is better called No Freedom or New Intrusion, and that mental health screening really means mass marketing and target recruitment of a captive population.

By the time of these New Freedom Commission recommendations, there already existed very large numbers of citizens around the country wising up to the extraordinary intrusion of psychiatry into our schools, as demonstrated in the first four years of this millennium by a number of resolutions, education department statements and state laws, all defending a parent’s right to make treatment decisions for a child without coercion, and a child’s right to education without psychiatric labeling and drugs.

Through 2003, there had been at least 46 state bills or resolutions supporting parental choice, in 28 states, that had either passed or were still pending action across the United States.  For example, Connecticut, Minnesota and Texas had passed laws explicitly stating that a parent’s refusal to consent to the administration of a psychotropic drug to a child does not constitute neglect, therefore is not in itself grounds for Child Protective Services (CPS) investigation.  Other states have passed related laws either monitoring or curbing CPS policy in this area.

Many states are pursuing related legislation as the wave of activity in support of parental choice continues to expand.  Texas law now prohibits school personnel from suggesting a diagnosis or recommending a psychotropic drug to a parent for their child.  The public will is clearly for the schools to educate, not medicate, and for the state to allow privacy and autonomy to parents and families.  At a federal level the fight over the Child Medication Safety Act was eventually won so that nowhere in the country is it legal to require a psychiatric controlled substance as a condition of attending school.

Ron Paul has been a key leader in this effort for some time.  On October 6, 2004, he introduced an earlier incarnation of his current Parental Consent Act.  This one, aptly titled the Let Parents Raise Their Kids Act, also attempted to forbid federal funds from being used for any universal or mandatory mental-health screening of students without the express, written, voluntary, informed consent of their parents or legal guardians.

Since that time, the fight has only intensified.  In 2005 in Texas, for example, we fought tooth and nail to the bitter end to defeat a bill that would have initiated mental health screening in schools throughout Texas.  Since we have defeated them consistently, this session they tried to get a pilot program approved for San Antonio and we defeated that as well, but the psychiatric and pharmaceutical lobbies are relentless.  PsychSearch.net provides one of the best websites on mental health screening and the ongoing resistance.

We have been aided by our awareness.  Made possible largely by the work of Pennsylvania whistleblower Allen Jones, we know that many of the New Freedom commissioners are linked directly or indirectly to the Texas Medication Algorithm Project (TMAP), which provides formulas recommending specific psychotropic drugs to treat various “mental illnesses.”  It has been revealed that TMAP pushed an off-label drug marketing scheme that appears to skirt federal law.  We know, therefore, that this commission’s recommendations are intended to encourage an expansion of the fact that “appropriate services” in today’s psychiatric world means psychotropic drugs; there are already millions upon millions of school-age children on psychiatric drugs.

Senator Charles Grassley’s work outing the severe ethical financial conflicts of so many psychiatric industry spokespersons makes it a little easier to challenge these things.  For example, it tends to impress legislators when they hear that three psychiatry department chairs—Charles Nemeroff of Emory University ($1 million from GlaxoSmithKline alone), Martin Keller of Brown University (associated with a severely compromised drug trial) and Alan Shatzberg of Stanford (who was principal investigator on a drug developed by a company in which he owned $6 million of stock) have all recently resigned their positions as a result of Grassley’s investigation.

The very high number of false positives in mental health screening is good data.  In one study at Columbia University, the authors concluded that use of the Columbia Suicide Screen would result in 84 non-suicidal teens being referred for further evaluation for every 16 youths correctly identified.  It also helps to know that these type programs tend not to work anyway.  For example, the United States Preventive Services Task Force (USPSTF) found that screening for suicide risk does not reduce suicide attempts or mortality.

Finally, the facts about the severe dangers and lack of efficacy of the various types of psychiatric drugs gets attention once the truth is made known.

I consider this to represent a tragic situation, and a clear and present danger to our children.  Here is a pledge that thousands specifically signed and that so many more are acting on in the concerted challenges around the country to this scourge:

We promise to actively resist further intrusion of psychiatry into the public schools, and will not cooperate in any way with those who act as agents of this wrong-headed government initiative.  We do not now and will not later consent to the psychiatric or psychological testing of our children by those who act as agents to implement New Freedom recommendations for universal mental health screening of our children.

The Parental Consent Act of 2009 is a great idea. Passing this bill in Washington would make a significant difference in protecting children and families against further intrusion of psychiatry into the schools. I know it would also make this Texas activist’s life a little easier!

John Breeding, Ph.D. has been a counseling psychologist in Austin, Texas for 25 years. He is the director of Texans For Safe Education, a citizens group dedicated to challenging the ever-increasing role of psychiatric drugs in schools.  He is the author of numerous articles and four books including: The Wildest Colts Make the Best Horses and True Nature and Great Misunderstandings: On How We Care For Our Children According To Our Understanding.

Click here to read The Parental Consent Act

Contact your member of Congress to support The Parental Consent Act. To find your Representative and get their contact information, go to http://www.congress.org/congressorg/directory/congdir.tt to look them up (you need to enter your zip code).

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INFORMED CONSENT: How to make sure you’re getting quality medical care

Monday, August 3rd, 2009

Informed ConsentBy Moira Dolan, M.D.
August 3, 2009

Quality of health care is a big topic these days; with the majority of news stories covering how we are all going to get our hospital bills paid and our prescriptions filled. But there is a conspicuous absence of any discussion of over-treatment and the over-selling of false diagnoses and dangerous prescription drugs.

It is the responsibility of you, the consumer, to find out about the diagnosis, tests and treatments that are offered. Once you have full information, you can make decisions about accepting it, or not. This is called Informed Consent.

When you are given a diagnosis you need to know the actual physical evidence for it. You don’t want someone’s opinion if you have cancer, do you? You want to know what the biopsy showed under the microscope.

In the case of medications, the minimum your doctor should tell you is based on the information made generally available by the drug manufacturers. However, you should expect that your doctor is aware of any pertinent medical issues beyond what the pharmaceutical companies tend to provide.

This is the minimum your doctor should explain:

What is the evidence for the diagnosis?
How does the treatment affect the body?
How does the treatment affect the mind?
What unwanted effects may occur?
Is it approved by the FDA for your condition?
What is known and not known about how safe it is and how well it works?
What are the alternatives, including the option of no treatment?
Does your doctor or the clinic have a financial interest in pushing the diagnosis or treatment?

You can make your doctor work for you. Demand information and get key questions answered. Doctors are supposed to give every bit of this full information to each patient they diagnose, test, operate on or prescribe for. In fact, they are required to do so by federal guidelines, state statutes and medical society ethics codes.

Your role in the process is to get any questions answered. Then you can carefully consider the information you have been given. You may feel more comfortable taking the information home before making a decision about agreeing to the proposed treatment.

Be a part of the decision-making process when your doctor offers a drug:

Get a thorough understanding of what he or she is prescribing and why.

Ask exactly what the drug is and why it has been chosen for your condition. How does it work?

Find out if it is new on the market. If so, why was it chosen over older drugs?

Find out if the drug is safe to take:

How will this drug interact with your other medications or over-the-counter drugs or natural remedies you are taking?

What does your doctor personally know about the safety of the drug? How long was it tested? How long were patients followed after taking it to determine if they developed bad effects? Has the FDA published any reports of adverse effects?

Why is a new drug being prescribed instead of an older similar drug with a proven safety record?

Ask about how well it works:

Has the proposed drug been proven to be effective for your particular condition?

What is the drug effectiveness in comparison to no treatment; in comparison to older drugs; in comparison to alternate drugs; in comparison to non-drug treatments such as diet, rest, and vitamins; in comparison to herbal or natural remedies?

If your doctor provides any of the following answers, it should give you strong reservations about accepting the diagnosis or taking the drug:

There is only a checklist of symptoms or other peoples’ opinions to make the diagnosis. There is no abnormality of blood, tissue or biochemistry that can be shown to you.

Your doctor is unclear about the mechanism of action of a drug (what it is doing inside the body). Either the mechanism is not known and only guessed at, or your doctor doesn’t understand it.

The drug was approved within the last two years. Thus it lacks an extensive safety record in the general population.

Your doctor doesn’t know of any adverse effects aside from what he reads along with you in the package insert. Since your doctor has not looked at the FDA website of adverse drug events he or she knows of no warnings to give you. This is something you will have to question carefully to see if your doctor is saying, “I know there are no special warnings to give you” or if your doctor is actually expressing, “I don’t know of any special precautions (because I haven’t bothered to look, all my data comes from the manufacturer’s glossy brochures).”

Your doctor is writing with a drug-maker emblazoned pen, jotting on a note pad sporting the logo of the drug manufacturer or carrying a coffee mug advertising the latest. These are indications of a heavily drug salesman-infiltrated office, and may well reflect an inordinate reliance on sales talk in the absence of careful review of the scientific pharmacologic information.

The drug is a look-alike version of an older drug. This is offered to you at much greater expense without obvious medical advantage.

On occasion your doctor may have to honestly say, “I don’t know, I’ll go find out some answers for myself and for you.” However, be alert if your doctor is offended or becomes patronizing. In that case you can expect that you have tread into some areas in which he or she feels challenged or uncomfortable, and may not be ready to be thoroughly frank with you. Then again, sometimes the answer to these questions remains some version of, “I don’t know about the details of safety and effectiveness,” but he or she still feels you should take the drug. In this case you will have to carefully consider the unknowns and make your decision.

You can only really be in charge of the quality of your health care when you have the opportunity for full informed consent.

©Moira Dolan, M.D.

Reproduced by permission of the author.

Moira Dolan, M.D. is an internal medicine physician and executive director of Medical Accountability Network, LLC, dedicated to establishing integrity in medicine.

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