Tuesday, January 25, 2005

America's Socialized Health Care

Throws cold water on pharmacracy. I particularly like this:

"The new model stresses participation and presumes the patient is responsible for his health. Changes in diet and lifestyle can only be recommended. Self-discipline and a desire to be well are required. An adult-adult or client-consultant relationship with the doctor replaces the parent-child relationship that currently exists between doctors and adults. Patients need to ask a lot of questions. Taking responsibility is healing in itself."

Friday, January 21, 2005

Thief uses "Doorknob" Defense

Jan. 19, 2005
Port Washington - A Racine man with a self-described obsession for doorknobs has been charged with stealing tools, materials and other items from several Mequon construction sites.

According to a criminal complaint filed Wednesday in Ozaukee County Circuit Court, Thor Jeffrey Steven Laufer, 42, told police that he stole the items from the construction sites to disguise his obsession and "so that it would look like a typical burglary rather than someone just stealing doorknobs."
...

On Dec. 29, Laufer waived his right to a preliminary hearing and entered a plea of not guilty.

In a preliminary hearing waiver form signed by Laufer, he stated that he had been committed to mental institutions or declared mentally ill or incompetent "numerous times."

Laufer is in custody at the Milwaukee County Jail in lieu of $10,000 bail.

Full Story

Thursday, January 20, 2005

Oregon Supreme Court weighs criminal insanity issue for substance pleas

Corvallis Gazette-Times
Thursday, January 20, 2005

Oregon Supreme Court weighs criminal insanity issue for substance pleas
Offenders shouldn't be in state hospital, Portland attorney says

By CHARLES E. BEGGS

Associated Press writer

SALEM — Accused criminals shouldn't be able to raise insanity defenses when their disorders are only drug or alcohol dependence, the Oregon Supreme Court was told Wednesday.

Under state law, criminals found guilty "except for insanity" are sent to the State Hospital instead of jail or prison.

A key issue in two appeals to the court is whether substance addiction alone is a mental illness that justifies sending offenders to the hospital or keeping them there when another disorder, such as paranoia, has been treated.

A ruling that addiction alone doesn't justify hospital confinement could free a handful of the 480 patients who are in the Salem hospital for crimes, said Harris Matarazzo, a Portland lawyer handling one of the cases before the state's top court.

Most criminally insane offenders with alcohol or drug problems also suffer from mental illness, he said in an interview.

Matarazzo said offenders with only substance-abuse problems shouldn't be in the state hospital because it has no treatment programs for them. He also said such addicts shouldn't be able to make an insanity defense in the first place.

For the rest of the story

Germany about to make advance directives binding by law!

Rene Talbot writes:

Where Germany was once at the forefront regarding crimes against humanity, it now seems to lead with the social dismantling of medical coercion: Soon all medical advanced directives (proposed by Thomas Szasz in 1982 as a “Psychiatric Will”) will be legally binding, even if the person can no longer express him/herself, is unable to consent, has no illness insight or is considered incompetent, as long as active killing is not requested. Custodians or persons authorized by a representation agreement will by law have to execute the individual's previously formulated will. Each coerced diagnosis against such a directive would become a violation of the fundamental rights of informal self-determination, psychiatric incarceration becomes a sanctioned deprivation of liberty, any coercive treatment would be a bodily injury, indeed torture. In my opinion, the further development of such legislation throughout the European Union can hardly be stopped. The new law was proposed in November 2004 by the minister of justice of the Federal Government, Brigitte Zypries. It initiated an immediate controversy. The new law is being discussed, especially on the issue of a dignified form of dying but nevertheless logically and explicitly it will be valid also for non terminal illnesses. Here is the key argument: Suicide assistance is punishable by law in Germany, so the opponents of the new law tried to insinuate that the new legislation would be a kind of physician assisted suicide… (The full article can be read here: http://www.iaapa.ch/doctors_abandon_psychiatrists.htm)

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.

Sunday, January 16, 2005

We Didn't Start the Stigma

I've submitted this letter to the Arkansas Democrat-Gazette:
Psychologist Daniel Holland peddles the mental-health lobby’s vintage whine that “mental illness . . . continues to be stigmatized” (“Remove the Stigma of Mental Illness,” January 15). Who is responsible for that? Is it the general public that locks up the so-called mentally ill and calls it hospitalization? Is it the general public that compels the so-called mentally ill to take toxic drugs against their will and calls it treatment? Is it the general public that attributes violence to mental illness? Is it the general public that testifies in court that people who commit heinous crimes can’t help it and should be acquitted by reason of insanity? Is it the general public that arbitrarily defines misbehavior as brain disorders? No. It is the psychiatric and allied professions that do those things. Then they blame the public for being uncomfortable with the people these professions have branded sick in mind or brain. Could the good doctor of psychology be engaging in projection?

Friday, January 14, 2005

The Danger of Science

My article "The Danger of Science," first published in Freedom Daily, is now online.

Wednesday, January 12, 2005

Opposing Bush: A Form of Mental Illness?

Humor:

http://kurtnimmo.com/blog/index.php?p=485

JAMA review of Szasz Under Fire

A remarkable review of Szasz Under Fire appears in the current issue of the Journal of the American Medical Association. Below is an extract from the JAMA site. The article is pay-per-view. It is worth the purchase.

Books, Journals, New Media

Psychiatry Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics
edited by Jeffrey A. Schaler (Under Fire Series), 450 pp, paper, $36.95, ISBN 0-8126-9568-2, Chicago, Ill, Open Court, 2004.
JAMA. 2005;293:240-241.

http://jama.ama-assn.org/cgi/content/extract/293/2/240
http://jama.ama-assn.org/current.dtl
http://jama.ama-assn.org/cgi/reprint/293/2/240

Thomas Szasz is a psychiatrist and psychoanalyst well known for his condemnation of what he sees as the coercive nature of psychiatry and state control. He has achieved both notoriety and admiration for his testimonies against the insanity defense, his support of freedom to commit suicide, and his fiercely libertarian views on such issues as illegal drugs and the provision of medical service—a nutshell synopsis that does not do justice to the vehemence with which Szasz opposes "psychiatric misdeeds" (p 50) and government control over our bodies. He has long condemned the "fraudulent character of psychiatric nosology" (pp 294-295) and disputes conventional understanding of mental illness. For example, he views "hallucinations as disowned self-conversations and delusions as stubborn errors or lies. Both are created by ‘patients’ and could be stopped by them" (p 324).

--From the review by Schuyler W. Henderson

Tuesday, January 11, 2005

Italy bans smoking in public places

Italy has a new law banning smoking in public places, but restaurants aren't willing to enforce it:

http://www.gulf-news.com/Articles/print2.asp?ArticleID=147284

It should be up to private individuals and businesses to set their own smoking policies. I previously wrote about it here:

http://slashdot.org/comments.pl?sid=52169&cid=5184694

Monday, January 10, 2005

Malpractice vs. "Malresult"

Malpractice vs. "Malresult"
A new form of insurance for an eternal problem
January 10, 2005
by Thomas Szasz
http://www.reason.com/hod/ts011005.shtml

Saturday, January 08, 2005

For the Record

Rosemary Kennedy died yesterday. She was 86. This daughter of Joseph P. and Rose Kennedy, sister of the late President John F. Kennedy and Senator Edward M. Kennedy, was lobotomized without her consent in 1941—at the age of 23—by authorization of her father and without the knowledge of her mother. Joseph Kennedy made this decision because he feared that his mildly mentally retarded daughter might embarrass the family and jeopardize the political ambitions he had for his oldest son, Joseph P. Kennedy Jr., who died later in World War II. According to a biography of the family, Rosemary's father was told by doctors that the lobotomy would eliminate her erratic behavior. It reduced her to a passive incoherent being who was unable to care for herself. She spent the rest of her life in institutions.

In 1949, eight years after Rosemary's operation, neurologist Egas Moniz of Portugal won the Nobel Prize in Medicine for inventing lobotomy.

Update
According to Reuters, "Rosemary was the inspiration for sister Eunice Kennedy Shriver, who founded the Special Olympics for mentally disabled athletes."

A statement issued by the Kennedy family said in part: "From her earliest years, her mental retardation was a continuing inspiration to each of us, and a powerful source of our family's commitment to do all we can to help all persons with disabilities live full and productive lives. Millions of people of all ages have greater hope today because of Rosemary."

Friday, January 07, 2005

A Little Compassion, Please

By now everyone knows that the convictions of Andrea Yates for the drowning of her children have been thrown out because the prosecution's psychiatric witness, Park Dietz, said falsely that just before the drownings the television program "Law and Order" featured an episode in which a woman drowned her children and was acquitted by reason of insanity. The import of the testimony, presumably, was that Yates got the idea from the program, which she used to watch. It turned out that "Law and Order," which employed Dietz as a consultant, never had such an episode.

Dietz of course is now the object of scorn. But why isn't the mental-health establishment rushing to his defense? Obviously, he was having delusions about that nonexistent television show. Someone would have to be sick to make up a story on the witness stand while under oath. Where's the compassion for those with mental disorders?

Pianalto review of Fatal Freedom

A review of
Fatal Freedom
The Ethics and Politics of Suicide
by Thomas Szasz
Syracuse University Press, 1999
Review by Matthew Pianalto on Jan 4th 2005
http://mentalhelp.net/books/books.php?type=li&cat=new_reviews

Dutch Euthanasia Law

The electronic version of the British Medical Journal yesterday published an article about the recent controversy on "euthanasia" in the Netherlands. The article, as well as my response below, will remain accessible to the general public for a week at:
http://bmj.bmjjournals.com/cgi/content/full/330/7482/61

Dutch euthanasia law should apply to patients "suffering through living," report says
This article accurately reflects the reports which have appeared in the Dutch media, and likewise overlooks the same points:

  1. Euthanasia is a term which in the Netherlands is used spuriously to indicate a doctor's killing his patient at the patient's request or providing the patient with the means to kill himself. The not uncommon practice of deliberately causing the patient to die from dehydration without his or his family’s consent is not called euthanasia but rather natural death. This confusion of terms muddles the debate.
  2. It is true that a person’s suffering cannot always be "unambiguously measured according to his illness." However, by claiming that the medical domain of doctors is far broader, and includes the reduction of suffering unrelated to classifiable and measurable somatic illness, physicians are proposing to redefine medicine, and vastly expand its already inflated territory.
  3. The very fact that the cited report was commissioned by the Royal Dutch Medical Association, the physician’s own organization, implies, wrongly, that physicians are faced with the moral dilemma of deciding whose lives they may terminate. There is no moral dilemma. Terminating another person’s life is murder.
  4. The association claims for physicians the right to terminate the lives of patients according to standards set by the medical profession. At the same time, it continues to support, or at least not deny, the right of “medical” personnel to confine and punish competent people who express the wish or attempt to terminate their own lives. When the doctor disapproves, he calls it suicide, and obtains court permission to forcibly restrain the person. When he approves, he takes control of the act, and calls it euthanasia, not homicide.
  5. The physicians' association also continues to support laws that prohibit free trade in drugs, including drugs which can be effectively employed to terminate one’s own life. Thereby physicians seek to compel people to be dependent on them for accessing such drugs, and thus require physicians' permission for a decision which is not the physicians' to make.
Non-physician supporters of the Dutch “euthanasia law” mistakenly believe that it grants them the right to die. It does no such thing. It only grants immunity to physicians. Unsurprisingly, the committee commissioned by the physicians recommends expanding that immunity.

Wednesday, January 05, 2005

Vested Interest in the War on Drug Consumers

Here's another letter to the editor that I had published a few months ago in the Arkansas Democrat-Gazette. Larry Counts runs a drug-rehabilitation center that exists by virtue of the taxpayers:

Re Larry Counts’s Voices article “Aid for substance abuse is at hand”: It is hard to see what Counts means when he says drug addiction is a disease. People become addicted by willfully taking drugs repeatedly, and countless people become unaddicted by willfully stopping the taking of drugs, often without any outside help. This does not sound like disease.

Also puzzling is Counts’s attitude toward state-exercised violence. Clearly, he believes that the state is justified in banning certain drugs, even though people routinely consume them peacefully and in moderation. Moreover, his silence on whether drug consumers should be forced into what he calls treatment implies that he believes this is an appropriate use of coercion. But some people don’t want treatment. They submit to it only because a judge has threatened them with prison if they don’t. Finally, Counts advocates forcing taxpayers to finance drug treatment. Why should non-drug-consuming citizens have to pay the bills of drug-consuming citizens? That's a poor way to teach self-responsibility.

A civil society would forbid all the coercion that Counts champions and profits from. The proper rule is simple: Ingest what you want and pay for it, along with any unpleasant consequences that may ensue.

Monday, January 03, 2005

Medical Marijuana

Jeff Schaler raises the issue of medical marijuana. I agree with him that this “reform” is not a step in the direction of freedom. I published an op-ed on the subject here. While medical-marijuana laws are bad—they empower doctors not individuals and thus reinforce the Therapeutic State—the federal government should leave the states alone. Unfortunately, the court is not likely to agree.

Todschweigen ("death by silence")

It is distressing to read Norman Fost’s review (1) of Fred Boyce’s America’s Gulag Archipelago in the December 2, 2004 issue of The New England Journal of Medicine (NEJM) for two reasons: There are no references to the work of Thomas Szasz on the topic. The editors of NEJM did not see fit to check the manuscript for appropriate literature review. Editors have a social and professional responsibility to make sure that other authors who have written on a topic addressed by a contributor are appropriately credited.

For over 50 years professor of psychiatry emeritus Thomas Szasz has exposed the fact that mental hospitals are the American equivalent of Abu Ghraib. One need only visit the Thomas Szasz website—which averages over 1,500 hits a day—and view his publications list there to see the truth about this.

More important, though, is why. Why does Fost act as if Szasz were not alive? Why does Fost cite two obscure references, compared to the plethora of material Szasz has written on the topic?

Reference
1. Fost, N. America’s gulag archipelago. N Engl J Med 2004;351;2369-2370

Addiction: Sacred Symbol of the Therapeutic State

William E. Hurwitz, a physician in Northern Virginia, was indicted by a federal grand jury on September 25, 2003, “on charges that he led a broad conspiracy to illegally distribute prescription narcotics across the nation, resulting in the deaths of at least three patients,” (“N.Va. Doctor Indicted In OxyContin Scheme,” Sept. 26, 2003).
Hurwitz was convicted by a federal jury on December 15, 2004 (“Pain Doctor Convicted of Drug Charges,” Washington Post, December 16, 2004).

Physicians prescribing opioids like Oxycontin to patients in pain are reluctant to do so because they fear they will be harassed or arrested by the Drug Enforcement Agency (DEA). Hurwitz’s prescribing practices were not, in my opinion, the real issue here. Judging Hurwitz’s prescribing practices masks the fact that doctors and patients cannot form their own relationships and do what they want to do. The Hurwitz case obscures the fact that the state has no right to protect people from themselves. Oxycontin is considered a “dangerous” drug because it allegedly causes “addiction.” The state is a dangerous drug.

Drugs are neither good nor bad, safe nor dangerous. Doctors and patients have a right to form and uphold their own contracts. If narcotics were available on the free market, “the drug problem” would cease to exist. A person has just as much a right to put whatever substance he wants into his body, as he does to put whatever idea he wants into his mind.

(People who argue for “medical marijuana” obscure the real issues in a similar way. Medical marijuana pushers (MMP) argue that marijuana is a safe drug, not a dangerous drug: But marijuana is neither safe nor dangerous, good nor bad, just as Oxycontin is neither safe nor dangerous, good nor bad. MMP are lying. They are a problem masquerading as a solution.)

Similarly, the DEA is hurting patients, not doctors, in it’s zeal to persecute and arrest physicians for what it considers inappropriate prescribing practices. Clearly, the Directors of the DEA place a higher value on protecting people from themselves, than on protecting people in pain and in need of the relief that only opioids can bring. In this way, the DEA is no longer a public servant, but a public enemy, working against the public interest and welfare. Congress has a responsibility to remedy the problem.

See also:

Va. Doctor Defends Prescribing Pain Pills,” Dec. 7, 2004.

Specialists Decry DEA Reversal on Pain Drugs,” Washington Post, December 21, 2004,

Pain Doctor 'Cavalier,' Jury Foreman Says ,” Washington Post, December 21, 2004,

New Drug Is Approved To Treat Chronic Pain,” Washington Post, December 29, 2004.

OxyContin Information: FDA Strengthens Warnings for OxyContin.”

Don't Neglect the Newspapers

Letters to the editor can be effective in planting the thought that the mental-health establishment's worldview is, to say the least, flawed. Here's an example that I had published last summer in the Arkansas Democrat-Gazette:
I am puzzled by your June 4 story about moving “criminally acquitted patients” from facilities in Little Rock to facilities in Corning (“Judges get final say in patients’ transfers”). If they have been acquitted, why are they being moved anywhere? Then I learned that the Arkansas Partnership Program “has provided treatment to those acquitted of crimes because of mental disease or defect since…1995.” It goes on: “Most have…years of mental health problems.” Yet I was not reassured. For as Thomas Szasz points out, no one, including psychiatrists, has ever seen a mental disease, mental defect, or mental health problem. When people say they’ve seen those things, all they really mean is that they’ve seen bad behavior. But behavior, however bad, is behavior, not disease, and behavior has reasons, not causes (such as disease), even if the reasons are not readily apparent to observers. (Don’t bring up brain scans: they do not show causes of behavior. Correlation, even if it exists, is not causation.)

So when you report that people acquitted of rape, murder, and aggravated robbery have histories of mental health problems, all you’re saying is that these people have histories of bothering and harming other people. Why not just say that? And if that’s the case, why were they acquitted and why are they locked in a “mental health facility”? They belong in prison. We can't excuse people of responsibility for their crimes, then wonder what happened to self-responsibility.

Saturday, January 01, 2005

A Unique Blog

One of the reasons I am excited about The Szasz Blog is that the issues we'll discuss here are largely ignored by libertarians, as Tom points out in Faith in Freedom. My own discussion of this neglect, "Why Do Libertarians Ignore the Therapeutic State?" can be found here.