Monday, January 17, 2005

Human Rights in Psychiatry

This apparently politically correct term is used by OHCHR, the WHO, Amnesty International, the pharmaceutically funded WFMH, and some groups calling themselves (ex-)users of psychiatry or psychiatric survivors. What is meant by “human rights in psychiatry”?

Most institutions seem to be referring to the right to psychiatric treatment. OHCHR also recognizes a right to refuse treatment, but not in involuntary patients. In other words, everybody has the right to refuse unless he doesn't have the right to refuse. To the WHO, human rights in psychiatry seem to be mostly about eliminating “barriers [that] limit the dissemination of effective interventions for mental and behavioral disorders,” not creating barriers to protect people against unwanted psychiatric interventions. Note the assumption that "effective interventions" exist. Amnesty International endorses guidelines set up by the psychiatric profession itself, which state that no treatment should be provided against the patient's will, unless withholding treatment would endanger somebody. Who would determine such danger AI does not mention. Beyond that, AI is more concerned with obtaining psychiatric services for “victims of human rights violations” than with protecting people against unwanted psychiatric services. WFMH likewise gives lip service to human rights, but specifies only, “improvement of mental health care and elimination of stigma” with no mention of the right to refuse such care. Not even all consumer groups endorse the unequivocal right to refuse psychiatry, although those who call themselves (ex-)users and survivors do.

What emerges, is that the concept of “human rights in psychiatry” like the concept of “mental illness” means different things to different people. Such a nebulous term cannot be useful, and opens the door for creative interpretations satisfying the needs and wishes of the party with the most power.

From the point of view of opposition to psychiatric coercion, the concept of “human rights in psychiatry” is a trap. It suggests that psychiatrized people have different rights than other humans, and that psychiatry is a legitimate social institution. The lack of reference to psychiatry in the “Universal Declaration of Human Rights" should not be lamented but applauded. This declaration determines that people who are suspected of committing a crime have the right to a fair trial, and people who are not so suspected have the right to be left alone. Acknowledging psychiatry only gives psychiatrists the power to obstruct the course of justice by changing the human status.

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