Posted on 12/18/2005 3:05:55 PM PST by sionnsar
We need a writ of Habeas Corpus in Medicine. Somebody Sue us PLEASE!
Now I am going to do my level best to get these diagnoses expunged from your record, but I cannot do this without your assistance. That means that you have to stop saying stupid things for the fun of yanking everybodys chain. You cant afford it! Is that clear?
By the time I had finished, my face was flushed, my 14 year old patient was in tears, and my office manager had stuck her head into the examination room to find out why I had raised my voice.
We Americans enjoy more rights than any other nation on earth. Not only do we have our Bill of Rights, which are the rights guaranteed in the first 10 amendments to the Constitution, but some rights are so fundamental that they are enshrined in the Constitution herself. The right of Habeas Corpus (Latin for produce the body) is so basic a freedom that it is guaranteed specifically in the Constitution (Article One, Section Nine, Paragraph Two). This gem of Anglo-Saxon common law, preceded the Norman invasion, and was written into the Magna Carta in 1215. Since then the right of Habeas Corpus has found her way into the English Bill of Rights, and from there to our own Constitution. Nothing could be more basic than the right of Habeas Corpus which states that no individual may be taken up on charges and imprisoned indefinitely. Such individuals, must, MUST under law, be brought to court, judged by a jury of his peers, be given the opportunity to defend himself, and be found guilty before he can be (in the language of the Magna Carta) imprisoned or sisseised or exiled or in any way destroyed .
Indeed, the whole point of the carefully crafted balancing of powers, by our nations founders, was to arrange it such that no branch of the federal government could ever become so powerful, that it could abridge these our basic freedoms. The power of the Presidency is checked by Congress and the Judiciary. The power of Congress is checked by the President and the Judiciary. Judges are appointed by the president and confirmed (and impeached) by Congress. No branch of the federal or state government could ever grow so strong as to overthrow so basic a freedom as the one that states that no man may be imprisoned without charge.
Only doctors are allowed to do that.
Which is what my patient had run into. She was a fairly unexceptional teenager until her biological mother moved to a different state with her new boyfriend and she failed to fit comfortably into the new family unit. She continued to get reasonably good grades in regular classes, was not sexually active, and never had any trouble with the law. However, she failed to get along with her mothers boyfriend and openly campaigned to be allowed to live with her dad (who was also in a new relationship). When the usual teenage sulking and defiance failed to be helpful, she took a page from one of the teen magazines she was reading. This told the touching tale of a teenager who was misunderstood and began cutting herself. This self mutilation made the storybook parents realize how truly unhappy the storybook teenager was, and what fools they, the storybook parents, were. This in turn gave birth to a new and wonderful relationship between the fictional teenager and her parents, in which they all learned to understand and appreciate one another. Now my patient was not quite brave or stupid enough to actually cut herself, however with some difficulty she did manage to make a couple of painful, if not precisely blood-drawing, scratches on her skin with a safety pin. Then she called 911, sobbed to the police radio operator that she was miserable, that nobody understood her, and that she was going to slash her wrists and waited, her wounded wrists quite unnecessarily bound with toilet paper (there being no blood), for everybody to start being nice to her.
Unfortunately she was well insured.
This is why three months later, after she had been released from an inpatient psychiatry unit with diagnoses of Major Depression and Oppositional Defiant Disorder with possible Bipolar illness, she was seeing me. I am not a psychiatrist, nor do I wish to be. However since there are no child psychiatrists in my part of the country, and since I happen to be the only neurologist who sees poor kids in a three hundred mile radius, I tend to get folks with psychiatric diagnoses sent to me from their family physician with a referal diagnosis of behavioral disturbance, rule out seizure. By the time my patient saw me, she had run out of insurance, and her grandmother was now her guardian. (The mothers boy friend had refused to keep her, and the fathers girl friend also did not want a teenager who was mentally handicapped). By this time also, her psychiatric diagnoses had resulted in her missing most of a semester in school, which meant that she was in danger of being dropped from the college bound track into the track reserved for children with learning disabilities and mental illnesses, that lacked the core courses needed for college work. The patients grandmother was unable to make her take her medications and the teen pointed out that she felt much better off of medications than on them and that she didnt need them anyway. Review of her extensive hospital chart corroborated the teenagers clinical judgment. Every time she insisted that she felt fine and wanted to leave, her anti-psychotic medications would be increased in order to treat her denial and delusions of being in control. These made her sleepy but more docile and easier to manage. It doesnt surprise me that she felt much better off of them, and Im quite sure she didnt need them. Im also quite sure that she had never needed them.
My patients case is not an isolated one. One individual, a close friend of mine from my residency days, whom I know well, had something similar happen to her. She was a physician, had had no previous history of mental or physical illness, had excellent family supports, and in the setting of an acute family crisis went to a psychiatrist saying that she was depressed and felt that life was over for her. She was walked to the evaluation room of a nearby psychiatric hospital, and there she was urged to consent to be admitted voluntarily for her safety. She refused. She was then told that if she did not admit herself voluntarily, she would be admitted involuntarily and that she would probably be in the hospital at least six weeks if she was committed. By contrast, she was told, if she admitted herself voluntarily she could leave voluntarily as soon as staff could ensure that she was safe. My friend therefore admitted herself voluntarily, and tried to leave the next day in the company of her family who testified that they would ensure her safety. She was then told that her treating psychiatrist didnt think she would be safe to leave for two weeks (oddly enough the maximum period for a voluntary admission that her insurance paid for). Nor was she allowed to leave against medical advice since this was a matter of patient safety. Eventually she was there five days refusing all medications thrust on her, and threats of false imprisonment had to be made by her family before the psychiatrists in charge agreed to let her have a second opinion. The consultant rendering the second opinion agreed that she was in no danger of suicide, that she had excellent family support, and the patient in question has never required psychiatric attention in the twenty years that have passed since that day.
Physicians answer to nobody when they declare that their patients have delusions or hallucinations or are mentally ill. Such mentally ill patients can be confined against their will indefinitely, until such time as a physician pronounces them to no longer be a danger to themselves or others. Indeed, the very refusal of medical care is a billable psychiatric illness according to the Diagnostic and Statistical Manuel (DSM-IV) being known noncompliance with treatment disorder (DSM: V15.81). There is no writ of habeas corpus in medicine. There is no balance of power in medicine. Patients just trust us to do the right thing.
Which is why I was alarmed, but not really surprised to learn that the American Psychiatric Association is considering making homophobia or extreme bias a psychiatric illness treatable by counseling and medications.
We treat racism and homophobia as delusional disorders, said Shama Chaiken, who later became a divisional chief psychologist for the California Department of Corrections, at a meeting of the American Psychiatric Association. Treatment with antipsychotics does work to reduce these prejudices.
Dr. Chaiken did not mention that the usual mechanism by which treatment with antipsychotic drugs reduces such prejudices in otherwise healthy individuals, is by causing mild sedation. This is why antipsychotic drugs were freely used in the Soviet Union in order to discredit advocates of human rights and religious believers by pronouncing them mentally ill, as well as to intimidate and confuse them into altering their political postions by both pharmacological agents and the fear of indefinate incarceration. Labelling dissidents as being mentally ill and treating them with antipsychotic drugs is also a favorite technique of the Cuban regime. It requires no scientific justification.
We like to believe that such things cant happen in the United States. However, even in the United States, pathologizing behavior does not require any scientific justification. Indeed, as one prominant US psychiatrist (who is in favor of making homophobia a mental illness) points out: Psychiatrists who are uneasy with including something like this in the Diagnostic and Statistical Manual need to get used to the fact that the whole manual reflects social context. That is true of depression on down. Pathological bias is no more or less scientific than major depression.
Exactly. Inclusion as a disease entity in the DSM-IV has never required a scientific justification. Psychiatric diseases are voted in and out of the DSM manuel by a committee of academic psychiatrists based on their best clinical judgment. This is how homosexuality stopped being a disease. It was voted out of the DSM manual in 1974 by a thin margin of politically active advocates. Feminist groups helped vote out self-defeating personality disorder when it was proposed due to the political implications. There is no reason why, if homosexuality can be voted out of the DSM manuel, homophobia cannot be voted in. And once it is recognized that homophobia, or Biblical literalism, or for that matter Christianity itself is a pathological condition, then psychiatrists will have a right and duty to incarcerate such individuals to prevent harm to themselves or others. There is no due process under the Constitution for the mentally ill. The Constitution, and the United States leaves such people to the mercy and justice of physicians.
Once a patient or a physician is labelled as being mentally ill there are all sorts of consequences. It is unlikely that my 14 year old patient will ever be able to join the military, even if she remains off medications henceforth. (The military will not accept youngsters who have had psychiatric diagnoses - including the ubiquitous if often mythical attention deficit disorder - that required medication after the age of 12). If I am unsuccessful in having my patients diagnoses expunged, her ability to qualify for either health or disability insurance for many years will also be poor. For that matter, the physician I referred to also failed to qualify for disability insurance for almost 10 years. Her diagnosis, however bogus, also meant that she had her medical licence suspended for six months, as she was considered impaired for health reasons. Had she been an airline pilot instead of a physician, her license would likely have been tabled much longer. Once homophobia is a mental illness, advocates with traditional Christian views will automatically be suspect, and will have their licenses stripped from them, as they will be considered impaired by their medical disability. Nor can such cases be easily reported to the press. Unlike ordinary employment or political speech, a host of privacy laws limits access to information when health care is involved. Thus, the suspicion of mental illness will cling to such individuals, however unfair such a designation might be, and those who label such individuals as being mentally ill, will refuse to provide documentation on the grounds of health care privacy laws. In addition, once homophobia or extreme bias enters the DSM-IV, even fewer physicians will raise their voices in protest, as doing so may result in them also being investigated for mental illness. As it is, there are few enough physicians who are willing to speak in favor of traditional values, even though it is my belief that the overwhelming majority of physicians support traditional values. Most of us learned to keep our mouths shut, and to focus on our immediate duties, sometime during medical school. Even physicians or patients who have been victimized by this sort of process are reluctant to speak up. The very fact that someone has been considered mentally ill is, of itself, damaging. Nobody so victimized wishes to be dragged through the media to prove the justice of their cases, even were it easier to obtain access to the health information that would justify their claims.
Our nation has built her foundation on a Constitution that protects the rights of the weak against the strong, the ignorant against the knowledgeable, and prevents powerful interest groups from muzzling free speech or imprisoning those who disagree with them. However we have left a loophole which powerful entities already use to abuse and imprison those who disagree with them.
It is time to have a writ of Habeas Corpus in Medicine. Somebody sue us PLEASE!
This is very scary. I am greatly concerned that the psychiatric and related industries do all they can to encourage business. My daughter was required to sit through several lectures/movies on cutting, supposedly to warn teenagers not to do it, but in my opinion to give them the idea. Before this lecture, she had never heard of, or considered doing such a thing. The next time she had an argument with me, she threatened to cut herself if she didn't get her own way.
I'm glad that Patriot Act will be out of the way so I can be free and think what I want....DoH!
This astounds me to think that homosexuality is considered "normal" but "homophobia" is classified as a mental illness. 1984 here we come.
The article and the headline went in two differentdirections, so now I'm mainly confused.
But grasping at the frail hope that the headline is more correct, can I count on being freely out of the "homophobia closet"?
Is not a psychiatric disorder an absolute defense for thought crimes?
There. I fixed it.
"Sorry Professor Moonbeam, I didn't finish my giant Bush puppet for the anti-capitalism rally because my dang Homophobia was acting up again last night. The constant Brokeback Mountain hype is really hard to avoid these days don't you know."
You wouldn't want to miss this one.
Phobia: A persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous.
It's not a phobia, it's an opinion. The term was created to insult the people who don't agree with their stance.
Thanks - have been very busy lately, but will be back pinging pretty soon. You can always alert DirtyHarryY2K too!
Not all dislikes, fears or even hatreds are phobias. Many are quite rational. Sometimes it is the refusal to fear or hate something that is irrational or phobic.
If you are ever confronted with such problems...
Don't "refuse care." Instead, express a lack of confidence in the diagnosis and insist on a second and third opinion from doctors of your own choosing. Make no commitments saying you are unfamiliar with procedures and need to discuss with your lawyer.
In Georgia, it is scary how easy it is to be involuntarily;y committed. You just need to people to swear to a judge that you said something that indicated you are a danger to yourself or others.
So if a slaughter some fags, its not a hate crime anymore - I can plead insanity?
Of course, characterizing all that as homophobia is a frightening stretch; it was really a form of obsessive-compulsive behaviour with a sexual component to it.
Mrs VS
Another Soviet idea adopted by the liberals: if you don't accept lib-think you must be crazy.
" And of course, Homosexuality was thought of as a mental illness for years."
It still is, by me...
If "extreme bias" is now deemed a psychiatric illness, doesn't this indicate that all the fanatic Bush haters are sickos??
Um, is this what you meant?
The term `homophobia' is not only silly, but schizoid.
Greek `homos': same. Greek `phobos': fear.
So, if I am `homophobic', I have an irrational fear of those who are the same as me, being other conservative heterosexual Christian gunowning Freepers.
Otherwise, a homophobe hates `homos'. And isn't `homo' a bigoted slang term? And aren't straight people routinely beaten up for using politically incorrect terminology?
Can't have it both ways, Brucie-woosie.
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