Fwd: NEWS: Szasz in Medical Journal, How You May Reply!

[Guest guest]

" www.MindFreedom.org " <office wrote:Tue, 6 Jan 2004

13:31:00 -0800

" Mind Your Freedom "

" www.MindFreedom.org "

NEWS: Szasz in Medical Journal, How You May Reply!

 

 

NEWS: Mind Your Freedom! - 6 Jan. 2004

http://www.MindFreedom.org - please forward

 

Breakthrough in Prestigious

_British Medical Journal_!

 

Text of New Tom Szasz Article is Below:

He Condemns Forced Psychiatry and

Endorses Use of " Psychiatric Wills. "

 

How You May Post a " Rapid Response "

on _British Medical Journal_ Web Site.

 

Thomas Szasz, MD has a new article highly critical

of forced psychiatry. He promotes the use of

" psychiatric wills " to defend against

coercion in the mental health system. The

text is BELOW.

 

Tom's article is published in the Dec. 2003

issue of the UK publication, _British

Medical Journal_, BMJ, which is widely read

in the medical community. As well as a

world-famous author and professor, Tom is

also a member of MindFreedom.

 

GET ON THE RECORD - AND ON THE WEB:

 

ACTION ALERT!!!!! The web site for BMJ has a

" Rapid Response " section where editors say

they will try to publish *all* responses to this

article within 24 hours! As you may imagine,

many of the initial " Rapid Responses " are

from individuals defending the medical

establishment.

 

AFTER READING THE BELOW Szasz article, you

may post a response to the Szasz article (or

reply to other respondents) at BMJ's web page here:

 

http://bmj.bmjjournals.com/cgi/eletter-submit/327/7429/1449

 

Please forward this news alert to all

appropriate places on and off the Internet!

 

Tom's article below along with graphics, footnotes and

the current " Rapid Responses " appear on the BMJ web

site here -- check out the ongoing debate on this article:

 

http://bmj.bmjjournals.com/cgi/content/full/327/7429/1449

 

[At BOTTOM of below article is text of MindFreedom's

letter submitted to _BMJ_'s web site.]

 

~~~~~~~

 

_British Medical Journal_

 

BMJ 2003;327:1449-1451 (20 December)

 

Ward round

 

The psychiatric protection order

for the " battered mental patient "

 

by Thomas Szasz, emeritus professor of

psychiatry

 

Department of Psychiatry, Upstate Medical

University, State University of New York,

Syracuse, NY 13210, USA

 

Correspondence to: 4739 Limberlost Lane,

Manlius, New York, NY 13104, USA

tszasz

 

Psychiatric patients are routinely treated

against their will. Legally enforceable

psychiatric protection orders would protect

patients from coercive psychiatric

interventions

 

The avowed desires of patients and doctors

conflict more often in psychiatry than in

any other branch of medicine. People known

as " mental patients " are routinely subjected

to " diagnostic " and " therapeutic "

interventions against their will. Many such

people see being committed (sectioned) and

treated against their will as a personal

violation -- a " psychiatric abuse " -- and

want to protect themselves from future

involuntary psychiatric hospitalisation and

treatment. At present former psychiatric

patients, even when legally competent, have

no means to defend themselves from such a

contingency.

 

Mental health laws -- reflecting the point of

view of psychiatrists and society -- protect

(or are said to protect) mentally ill

patients from the dangers they pose, because

of their illness, to themselves and others.

Many mental patients view -- and have always

viewed -- psychiatrists as posing a danger to

them. Respect for the self defined interests

of such patients requires that the law

protect them from further unwanted

psychiatric interventions.

 

The psychiatric protection order

 

Courts recognise the validity of

" psychiatric wills " (psychiatric advance

directives) only when they prospectively

authorise treatment; courts do not recognise

them when the " psychiatric testator " rejects

psychiatric " help. " 1 To remedy this defect,

especially when patients are released into

the community after a period of involuntary

treatment for mental illness, I propose a

new legal safeguard: the psychiatric

protection order. Such an order, similar to

the protection order used in domestic

conflicts, would make it a criminal offence

to impose involuntary psychiatric

interventions on people protected by the

order.

 

In free societies only psychiatric patients

are routinely treated against their will.

(Public health laws explicitly serve the

interests of the public, not the therapeutic

needs of particular persons.) Competent

patients with uraemia are not treated

against their will and can use a " medical

will " to protect themselves from undergoing

dialysis. If psychiatry were like any other

medical specialty competent patients with

schizophrenia would not be treated against

their will and could protect themselves with

a psychiatric will from being treated.2 But

they cannot: neither psychiatrists nor the

courts recognise the validity of the

psychiatric will. Mental health laws trump

psychiatric advance directives.

 

Not by coincidence the history of

psychiatric interventions forcibly imposed

on patients is long and depressing. In a

letter he wrote to me in 1988 Karl Menninger

summarised the history of psychiatry with

these sad words: " Added to the beatings and

chainings and baths and massages came

treatments that were even more ferocious:

gouging out parts of the brain, producing

convulsions with electric shocks, starving,

surgical removal of teeth, tonsils, uteri,

etc. " 3 To this list Menninger might have

added the use of straitjackets,

tranquillising chairs, confining chairs,

cold baths, emetics, purgatives, Metrazol

shock, inhalations of carbon dioxide, and

neuroleptic drugs.

 

Freedom from enforced psychiatry

 

From the beginnings of the specialty,

psychiatric patients have had no opportunity

to free themselves from their

protective-oppressive relationship with

psychiatrists. In this brief paper I focus

on a single issue: the desire of some

psychiatric patients to free themselves,

once and for all, from what they regard as

an abusive relationship with the psychiatric

profession. The Anglo-American legal system

has always denied this option to these

patients. This denial resembles the denial

of slaves' opportunity, in a slave society,

to leave their master; of the wife's

opportunity, in traditional marriage, to

leave her husband; and of citizens'

opportunity, in the modern totalitarian

state, to leave their country and its

rulers. These people may enjoy all manner of

benefits and privileges, but they cannot,

without the permission of the repressive

authority, leave the system for good.

 

The English and American legal systems

maintain the fiction that the relationship

between a family member responsible for

committing a " loved one " and the

incarcerated individual -- as well as that

between psychiatrists and involuntarily

detained patients -- is always one of " care "

and " treatment. " It can be otherwise only in

" unfree, " " totalitarian " countries; such was

the case in the Soviet Union and is now the

case in China. That self serving

rationalisation is at the core of the

problem facing us.

 

Anglo-American law assumes, as a matter of

fact, that the relationship between a person

and a legal agent of the state is

adversarial. Justice Potter Stewart of the

US Supreme Court famously remarked: " To

force a lawyer on a defendant can only lead

him to believe that the law contrives

against him. " 4 The law student is taught the

duties and roles of both prosecuting attorney

and defence attorney. Both jobs are

legitimate and proper.

 

In contrast Anglo-American psychiatry

assumes, as a matter of law and psychiatry,

that the relationship between a person and a

psychiatric agent of the state is

therapeutic. Forcing psychiatrists on mental

patients is routine practice, and the patient

who protests is likely to be given a

diagnosis of paranoia. The medical student

is taught only the duties and roles of the

psychiatrist making diagnoses and providing

treatment. The psychiatrist has no other

legitimate duties or roles; only the job of

the coercive psychiatrist is legitimate and

proper. The psychiatrist who tries to help

the coerced " patient " to reject the patient

role is ostracised, or worse.

 

The gatekeepers: the family

 

We are hypocrites if we ignore who the

parties are that support the enactment of

mental health laws and deny patients the

option of rejecting psychiatric services.

Everywhere the supporters of mental health

laws are psychiatrists and the relatives of

so called mental patients. In the United

States the relatives are now also in control

of a powerful lobby, the National Alliance of

the Mentally Ill, that legitimises the abuse

of family members (mainly adult children) as

the care of " loved ones. " Organisations of

former psychiatric patients -- who call

themselves " victims of psychiatric

abuse " -- are not among the parties

clamouring for more psychiatric coercions

or " services. "

 

People subjected to involuntary psychiatric

hospitalisation and treatment often feel

victimised in much the same way as do wives

(less often husbands) who are abused by

their spouses. Until recent times women had

no effective protection from their abusers,

whom the law defined as their protectors. In

many parts of the world women are still in

that situation. Similarly, in the days of

Dickens children were not protected from

abuse by their parents.

 

Specific treatments may have changed since

this 1818 drawing, but psychiatric patients

are still forced to undergo unwanted

interventions

 

We in the West now recognise that the family

is not just the primary locus of affection,

care, and security for its members: it is

all too often also the source of the most

insidious danger to their physical and

spiritual wellbeing. We acknowledge this

unhappy fact and accordingly speak of

" battered " children, spouses, parents, and

grandparents. In the conflicts that often

arise between adults living together as

married couples or lovers, legal separation,

divorce, and the so called protection order

exemplify the legal system's acknowledgment

of the problem and the need for legally

sanctioned and enforceable mechanisms to

remedy it. A protection order mandates

physical separation between the parties and

makes it a criminal offence for the

denominated threatener to impose their mere

presence on the threatened person. I suggest

that we similarly acknowledge the unhappy

fact of " battered mental patients " and the

need to protect them from their batterers.

In the absence of a protection order the

power relations between psychiatrist and

involuntary patient will continue to

generate " psychiatric abuse, " rationalised

as protection and treatment. Indeed, it is

precisely because psychiatrists reject

advance psychiatric directives authorising

abstinence from further treatment (a request

that non-psychiatric doctors accept) that

makes a legal mechanism such as the

psychiatric protection order necessary.

 

Legalise " divorce " between psychiatrists and

patients

 

Psychiatrists object to efforts to treat

patients as responsible moral agents and

cite the prevention of harm as a basic

social mandate of psychiatry. Typically,

they argue that people who would have

committed suicide but for their involuntary

detention would thereby have been deprived

of the option of changing their minds once

they had recovered from depression. A

similar argument could be made against last

wills or, indeed, any decision that

profoundly affects one's future, such as

marriage or having children. The standard

psychiatric justification for " therapeutic "

coercion either ignores the familiar

conflict between liberty and security or,

more often, equates (involuntary)

psychiatric treatment with ( " true " )

freedom.5 Elsewhere I have examined and

discussed this and related problems in great

detail and proposed reconciling psychiatry

with liberty.6 7

 

Human memory is notoriously short and

selective. We have forgotten that until

recently -- even in the United Kingdom and

the United States -- people could not

divorce.

 

In some countries women still cannot divorce

their husbands. For a long time the law,

supported by religion, ranked the sanctity

of marriage more highly than the need to

protect the wife from her abusive husband

and so prohibited divorce. To make matters

worse, the law deprived her of her voice.

 

The history of the " marriage " between mad

people and their doctors shows a similar

pattern. Since the beginning of mad

doctoring in the 18th century, the law,

supported by medicine (psychiatry), has

ranked the " health " of mad people more

highly than the need to protect them from

the abusive psychiatrist and prohibited them

from divorcing their psychiatrist. This is

still the case. (The psychiatrist is free to

leave the patient, typically by forcibly

" marrying " the patient to another

psychiatrist.) And again the law deprived,

and still deprives, the victim of his or her

voice. Only writers were, and are, willing to

face the realities of psychiatry, illustrated

for example by James Thurber's miniature

masterpiece, The Unicorn in the Garden.8

 

Summary points

 

Many psychiatric patients are denied the

right to refuse treatment they don't want

 

" Psychiatric wills " are recognised by courts

only when patients use them to authorise

treatment, not when they use them to reject

the possibility of treatment

 

Like protection orders that protect wives

from abusive husbands, " psychiatric

protection orders " would protect patients

from coercive psychiatric interventions

 

Doctors, politicians, and journalists assert

that mental illnesses are real diseases and

that psychiatrists are regular doctors. If

that were true there would be no need for

psychiatric protective orders.

 

- end -

 

~~~~~~~

 

TO REPEAT, you may make a " Rapid

Response " to the above Szasz article (or

reply to other respondents) at this

BMJ web page:

 

http://bmj.bmjjournals.com/cgi/eletter-submit/327/7429/1449

 

The above article along with graphics, footnotes and

the current " Rapid Responses " appears on the BMJ web

site here -- check out the on-going debate on the article:

 

http://bmj.bmjjournals.com/cgi/content/full/327/7429/1449

 

~~~~~~

 

BELOW is a copy of the text submitted

by David Oaks, Director of MindFreedom,

to _BMJ_ about the Szasz article:

 

As director of MindFreedom Support Coalition

International, which unites 100 groups to

take action for human rights in mental

health, I congratulate the _British Medical

Journal_ for publishing Prof. Szasz's

clarion call for a response to the

overwhelming tragedy of human rights

violations involving psychiatric procedures.

 

We are not alone in raising a warning about

the nightmare of human rights violations in

the mental health system.

 

Dr Benedetto Saraceno, director of the World

Health Organization's department of mental

health and substance dependence, was quoted

in _The Independent_ on 14 Dec. 2003 as

declaring, " There is a global emergency in

terms of human rights violations in terms of

all countries. There is not enough attention

paid to the human rights of people suffering

from mental health problems. "

 

We cannot wait for those with a personal

financial stake in the current mental health

industry to lead the way.

 

Truly, democracy must meet the mental health

establishment, the public must take direct

responsibility for the horrendous abuse,

brain damage, addiction and death inherent

in the coerced psychiatric system. This

psychiatric establishment is poised to

globalize to developing nations in the very

near future.

 

We encourage all readers -- wherever they

personally stand on these controversial and

complex issues -- to become familiar with

the social change movement for human rights

in the mental health system. You may start

by going to our own web site at

http://www.MindFreedom.org, the web site for

MindFreedom Support Coalition International.

 

While we are open to the public, the

majority of our members identify themselves

as having personally experienced human

rights violations in the mental health

system. There are literally millions of

individuals who have experienced the forced

drugging, restraint, labeling, solitary

confinement, humiliation, and incarceration

in the mental health system. It is to the

credit of many of these survivors that, like

Gandhi, they have not given up on trying to

reach the perpetrators of human rights

violations, and convince them that real

human suffering is the result.

 

We encourage everyone, everywhere to fill

out a psychiatric will, and to take a stand

against the rise of corporate forced

psychiatry.

 

This is about real human lives.

 

In the last few weeks, I have communicated

with members in three US states where they

are living peaceably in the community, but

are court ordered to take super-powerful

psychiatric drugs against their will, for

years and years and years. Recent medical

studies have shown that the drugs typically

used, neuroleptics, can cause structural

brain damage when used long term at high

dosages. This brain damage can include

actual measurable brain shrinkage of the

frontal lobes so extreme it is visible under

CT scans, and in autopsy. This brain damage

is confirmed in animal studies, and in

countless other studies.

 

The public, clients and family members have

not been informed of the risk of these

powerful neuroleptics. Yes, many of our

members choose to take psychiatric drugs in

any case. But the medical establishment has

failed in informing the public about what

they know from their own studies: That long

term high dosage forced neuroleptics amounts

to the mass chemical lobotomy of countless

people.

 

The combination of brain damaging procedures

with the use of coercion in the psychiatric

system has created an unimaginable

nightmarish catastrophe, a Chernobyl of the

mind, that future generations will be

mourning for a long time.

 

Thank you, Prof. Szasz, for being one of the

few professionals willing to speak out. I

also commend the organization of dissident

professionals, the International Center for

the Study of Psychiatry and Psychology, for

their own independent work in breaking the

silence about these human rights violations.

 

The BMJ is to be deeply thanked for airing

these points of view. May other medical

professionals, their journals and

organizations also inform the public, and

allow democracy to be involved in these

difficult ethical issues.

 

Sincerely,

 

David Oaks, Director, MindFreedom Support

Coalition International

e-mail: oaks

web: http://www.MindFreedom.org

 

~~~~~~~

 

PLEASE FORWARD to all appropriate

places on and off the Internet.

 

~~~~~~

 

Forwarded by

 

MindFreedom Support Coalition International

 

United Action for Human Rights in Mental

Health.

 

http://www.MindFreedom.org

 

To join/donate go directly to:

 

http://www.mindfreedom.org/join.shtml

 

~~~~~~~~~~~~~~

 

 

 

 

 

 

Hotjobs: Enter the " Signing Bonus " Sweepstakes