Thursday, June 30, 2005

BMA drops euthanasia opposition

Doctors have voted to drop their opposition to changes to the law which would allow terminally ill patients to be helped to die.

The British Medical Association conference said it should end its current stance against euthanasia and physician-assisted suicide.

When the BMA discussed the issue earlier this week, doctors spoke powerfully for and against change.

But delegates backed a neutral position at Thursday's vote.

They agreed that the question of the criminal law in relation to assisted dying was "primarily a matter for society and for Parliament".

Doctors backed a motion stating: "The BMA should not oppose legislation which alters the criminal law but should press for robust safeguards both for patients and for doctors who not wish to be involved in such procedures."

The BMA now neither opposes or backs campaigns for assisted dying.


Different models have been established in countries where some form of right to die has been allowed.

In Holland, assisted suicide and voluntary euthanasia are responsible for one in 40 deaths.

Whereas, one in 700 deaths in the US state of Oregon are from assisted suicide - voluntary euthanasia is not allowed.

Click header for full story.

BBC News

Tuesday, June 28, 2005

Psychiatrists hit back at Cruise

Actor Tom Cruise has been criticised by the American Psychiatric Association (APA), following remarks he made on US TV attacking psychiatric medicine.
"It was irresponsible for Mr Cruise to use his movie publicity tour to promote his own ideological views," it said.

Cruise called psychiatry a "pseudo science", after NBC host Matt Lauer questioned the 42-year-old's stance against anti-depressant drugs.

Click header for full article.

BBC News

Saturday, June 25, 2005

Scientologists vs. Psychiatrists: Why they don't get along

A contributor's explanation for the conflict.

Friday, June 24, 2005

Officials Say Drug Raids Found Clubs Were a Front

Officials Say Drug Raids Found Clubs Were a Front
New York Times, June 24, 2005

SAN FRANCISCO, June 23 - Federal authorities said Thursday that they had cracked the biggest case ever involving the use of medical marijuana dispensaries in California as a cover for international drug dealing and money laundering, which they said extended to Canada and countries in Asia.

"This organization had been operating for over four years," Javier F. Peña, the special agent in charge of the Drug Enforcement Administration in San Francisco, said at a news conference. "It is now dismantled."

In court documents unsealed here, the federal authorities accused a 33-year-old San Francisco man, Vince Ming Wan, of leading a multimillion-dollar operation in the trafficking of marijuana and Ecstasy that used three medical marijuana clubs in the city as a front.

United States Attorney Kevin V. Ryan said that an arrest warrant had been issued for Mr. Wan on charges of conspiracy to distribute more than 1,000 marijuana plants, but that he remained at large. Twenty other people, all from San Francisco and its suburbs, were charged with a variety of crimes, including conspiracy to grow and traffic in marijuana plants, conspiracy to distribute Ecstasy and conspiracy to engage in money laundering.

Mr. Ryan said the two-year investigation was continuing and could result in more arrests and charges. In addition to Mr. Wan, seven other suspects remained at large on Thursday.
"We're not talking about ill people who may be using marijuana," Mr. Ryan said. "We're talking about a criminal enterprise engaged in the widespread distribution of large amounts - millions of dollars, if you base it on historical evidence - of marijuana and other drugs, and money laundering their proceeds from these activities."

Agents from the D.E.A., the Internal Revenue Service and other federal agencies executed search warrants on Wednesday at the three medical marijuana clubs. Twenty-three residences, businesses and other growing locations in San Francisco were also searched.

Agents hauled away more than 9,000 marijuana plants. In all, a drug agency official said, the investigation yielded 18,000 marijuana plants over the two years with a wholesale value of $17 million. The official, Special Agent Jose Martinez, said it was the largest drug investigation ever by federal authorities that involved medical marijuana dispensaries. In addition, the court documents said, some of the marijuana was grown in Canada.

Kenneth J. Hines, assistant special agent in charge of the I.R.S. in Oakland, said the authorities were still tracking financial transactions in Asia that Mr. Hines said had been funneled through 40 bank accounts at 12 financial institutions by two of the suspects, Phat Van Vuong, 30, and Richard Wong, 28, both of San Francisco.

Mr. Hines, who declined to name the country or countries that were involved, said the suspects had also bought automobiles, real estate and "other high-end items" with the money in an attempt "to disguise illegal proceeds derived from their activities."

California has allowed the distribution of medical marijuana since voters approved a statewide ballot measure in 1996, but the state law is in conflict with federal narcotics laws. Mr. Ryan said the timing of the investigation, called Operation Urban Harvest, had nothing to do with a ruling by the United States Supreme Court two weeks ago that upheld the authority of federal officials over marijuana, even in the states where it is permitted for medical purposes.

An affidavit unsealed Thursday said that one of the suspects, Enrique Chan, 26, described in detail how the clubs were used as "a backbone" for illegal sales. The affidavit said Mr. Chan estimated that only half of the people who bought medical marijuana were really sick.

"You'll get busted, but you remember, you got to beat the prosecution in court," Mr. Chan told an undercover agent, according to the affidavit. "So if it comes down to a battle in court, what are you gonna do? You're going to bring patients in court, like really sick patients with cancer, have them sit on the stand for you. And no jury is gonna try, is gonna convict you."

When Medical Marijuana is Misused

When Medical Marijuana Is Misused
New York Times
June 24, 2005

Those who believe, as we do, that marijuana should be legally available for medical treatments have to be concerned about reports of abuses in California's pioneering medical marijuana program. If the abuses cannot be curbed, a political backlash could undermine the ability of thousands of patients to get marijuana to treat the nausea of chemotherapy, the loss of appetite that accompanies AIDS and other medical problems.

The future of medical marijuana in California and 10 other states that allow its use is already precarious given a recent Supreme Court decision that the federal government may prohibit and prosecute the possession and use of marijuana for medical purposes. Nobody yet knows what impact that decision will have on the states but raids by federal agents on medical marijuana dispensaries in San Francisco this week could be harbingers of a broader crackdown. Public officials would be wise to clean up their programs lest flagrant abuses by a few bad actors bring about destruction of a program that benefits many.

In this environment, it was worrisome to read a first-person report in The Times on June 12, that the writer, a 31-year-old marathon runner, found it "shockingly easy" to obtain marijuana in San Francisco. Although she was in peak health, she sought medical marijuana on the grounds that she suffered a migraine headache every month or so. After her own health plan turned her down, she got a recommendation from a clinic doctor who never asked to see her medical records. His say-so was enough to get her an identification card from the city's health department, along with cards for two friends she had designated as "primary caregivers" so that they could pick up her marijuana if she felt too ill to fetch it herself. That laissez-faire transaction sounds like an easy target for anyone seeking to denigrate the whole program.

Californians who support medical uses of marijuana see the danger and are already moving to tighten regulations. Public officials and even medical marijuana advocates in California have been looking for ways to rein in abuses and oversee the dispensaries. Stronger regulation, some say, would help defuse opposition and send a message that, whatever federal drug officials may have in mind, the state stands behind its medical marijuana law.

Bill would force mentally ill to take their meds

Bill would force mentally ill to take their meds
Tuesday, June 21, 2005
- Bangor Daily News

AUGUSTA - The mental health community is divided over a proposed new law that would require some people with mental illness to take prescribed psychiatric medications or face involuntary admission to a state hospital.

The initiative, known as "community commitment," had all-but-unanimous bipartisan support in both the House and Senate during the recently adjourned legislative session, but has been held over for reconsideration because it would draw about $600,000 over the next two years from the state's bare-bones General Fund.

Lawmakers on the budget committee may approve the fiscal note when they reconvene in special session at the end of this month. If not, the bill will be reintroduced in the regular fall session.

The Maine chapter of the National Alliance for the Mentally Ill, a leading organization that advocates for patients' rights, has refused to take a position on the community commitment bill for fear of splintering its membership. A NAMI spokeswoman said last week that while some providers and family members see the measure as a way to keep people healthy and productive, others find it coercive and an infringement of personal rights.

In its final amended form, L.D. 151, An Act to Improve the Delivery of Maine's Mental Health Services, would set up a one-year, Augusta-based pilot project to treat a maximum of 50 people. It would trigger a court review of patients with multiple psychiatric hospitalizations and repeated outpatient noncompliance with their medication orders. When those patients are discharged from Riverview Psychiatric Center in Augusta - one of Maine's two public psychiatric hospitals - they could be ordered by a court to participate in an "assertive community treatment" process, or ACT.

ACT provides intensive outpatient support and monitoring with a team of mental health professionals. While there are already a number of ACT teams working with recently discharged patients in Maine communities, they don't have the authority to require medication compliance and often simply stop seeing patients who drop off their radar or become noncompliant, hostile or uncontrolled.

The pending law would create a new ACT team dedicated to serving community commitment clients. If team members determined that a client has stopped taking medications as ordered and is showing even mild symptoms, the team would be empowered to have the client readmitted to the hospital against his will. Once restabilized, the client could once again be discharged to community commitment and the ACT program. The law would limit the initial commitment period to four months and subsequent discharges to more than one year.

The measure also would fund temporary housing for those assigned to the program.

The bill's sponsor, Sen. John Nutting, D-Leeds, said Monday that family members, frantic to protect the well-being of their loved ones, have been a primary driver of the proposal. Other pressures include the societal costs of having people with poorly controlled mental illness living in Maine communities, as well as the cost of repeated hospitalization or incarceration of those who become dangerous. The measure has the support of a broad coalition of health care groups and law enforcement officials.

According to Nutting, 42 other states have community commitment provisions. In New York, he said, the average length of stay in psychiatric hospitals has decreased from 50 days to 15 days, and there has been a 78 percent decrease in the number of inmates in the state's prisons and jails who have a diagnosed mental illness.

In New Hampshire, Nutting said, the average length of time a psychiatric patient stays compliant with medications after discharge has risen from 31/2 months to 11 months since the state enacted an outpatient commitment process.

Nutting's bill has engendered strong opposition from Maine's Disability Rights Center. Public Policy Director Helen Bailey said last week that people with mental illness have the same rights as those with other illnesses.

There are good reasons why people may choose not to take their medications, she said, and the right to do so should be protected. Some drugs cause intolerable side effects, and some should not be taken, for example, if a woman is pregnant. Some people have no transportation or other complicating factors and are unable to get their medications, she added.

Accepting that ACT teams should sometimes be more aggressive in maintaining therapeutic relationships with difficult clients, Bailey said it's appropriate to beef up their accountability without "putting the onus on the people with mental illness."

The debate over LD 151 has focused on a few "anecdotal situations," Bailey said, but the real problem is the overall quality of care being provided in the community mental health system.

At the Bangor Area Homeless Shelter, Executive Director Dennis Marble said he supports the idea of community commitment, while acknowledging that its coercive aspect is a problem. Many of his clients regularly cycle through the mental health system, Marble noted - they get hospitalized to get their medications straightened out, are discharged for follow-up services in the community, function well for a time and then gradually get worse. When they reach the point where they are a danger to themselves or others, they get recommitted to the hospital, or are imprisoned.

With each cycle, Marble said, people with mental illness take longer to restabilize. They also suffer "cumulative consequences to their overall health," he said, including worsening chronic conditions such as heart disease or diabetes, loss of nutritional health and injuries due to loss of judgment.

Marble said he "gets comfortable" with the idea of community commitment when he focuses on the notion of community - both as a source of caring intervention and as a system with limited financial resources. Unmanaged mental illness costs the state a lot of money, he noted - dollars that could be better spent providing health care to a broad range of Mainers.

Bangor Publishing

Wednesday, June 22, 2005

Massachusetts Considering Mandatory Health Insurance

Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Governor Mitt Romney unveiled yesterday.

Full Story

Tuesday, June 21, 2005

Ron Paul Continues His Fight against Psychiatric Screening of Children

This was issued today by the Liberty Committee, chaired by U.S. Rep. Ron Paul of Texas:
The American tradition of parents deciding what is best for their children is under attack. The pharmaceutical industry wants universal mental screening for every child in America, including preschool children. But universal screening alone is not what the pharmaceutical industry wants. The real payoff for the drug companies is the drugging of children that will result -- as we learned tragically with Ritalin -- even when parents refuse!

The drug companies want your children to be "screened." The psychiatric establishment wants to do the "screening." And even a recent presidential commission (New Freedom Commission on Mental Health) supports it all. These powerful groups want your children "screened" -- whether or not you, as parents, give permission.

Congressman Ron Paul, an OB/GYN physician for over 30 years, is desperately trying to keep the drug companies, politicians and federal bureaucrats from becoming parents to your children. Dr. Paul will introduce this week an amendment to the Labor, HHS, and Education Appropriations Act for FY 2006 that will withhold funds from being used to implement or support any federal, mental screening program.

In a letter to his congressional colleagues, Dr. Paul states: "As you know, psychotropic drugs are increasingly prescribed for children who show nothing more than children’s typical rambunctious behavior. Many children have suffered harmful effects from these drugs. Yet some parents have even been charged with child abuse for refusing to drug their children. The federal government should not promote national mental health screening programs that will force the use of these psychotropic drugs such as Ritalin."

If you think this action alert is about something that "can't happen here," think again. In 1995, the state of Texas launched the Texas Medication Algorithm Project. (, June 21, 2004)

The state of Illinois has also approved a mental health screening program. The Illinois legislature passed the Children’s Mental Health Act of 2003 which will provide screening for "all children ages 0-18" and "ensure appropriate and culturally relevant assessment of your children's social and emotional development with the use of standardized tools." In addition, all pregnant women in Illinois are to be screened for depression.

Dr. Karen R. Effrem, a pediatrician and leading opponent of universal screening with EdAction states: "Universal mental health screening and the drugging of children, as recommended by the New Freedom Commission [presidential commission], needs to be stopped so that many thousands if not millions of children will be saved from receiving stigmatizing diagnoses that would follow them for the rest of their lives. America’s school children should not be medicated by expensive, ineffective, and dangerous medications based on vague and dubious diagnoses."

Dr. Effrem warns:

1. Parental rights are unclear or non-existent under these screening programs.
2. Parents are already being coerced to put their children on psychiatric medications and some children are dying because of it.
3. Mental health screening does not prevent suicide.
4. Mental health diagnoses are "subjective" and "social constructions" as admitted by the authors of the diagnostic manuals themselves.
5. Most psychiatric medications do not work in children.
6. The side effects of these medications in children are severe.
7. The untoward influence by the pharmaceutical industry, or at least the impropriety, is abundantly clear in two important aspects of this issue.
8. Merging screening with the academic standards required by No Child Left Behind, as is happening in Illinois, will lead to diagnosis for political reasons. School mental health and violence prevention programs funded by NCLB and government counterterrorism operations are already using such criteria as "homophobia" and "defenders of the US Constitution against federal government and the UN" to label school children and US citizens as mentally unstable and violent. (

Urge your U.S. representative to vote "yes" on the Paul amendment to stop universal mental screening of children. If your U.S. representative does not vote "yes" on the Paul amendment, he or she supports screening your children without your permission -- just as the drug companies want.

The U.S. House will vote on the Paul amendment Thursday or Friday. Send your e-mail message today and call your U.S. representative too. Also, please spread the word.

Monday, June 20, 2005

Medical Marijuana

My take on the Raich medical-marijuana case is posted here at The Future of Freedom Foundation website.

Saturday, June 18, 2005

Study Shows Big-Brained People are Smarter

Virginia Commonwealth University, "ranked nationally by the Carnegie Foundation as a top research institution," is once again at the leading edge of scientific research, according to a press release

In a study that "could settle a long-standing scientific debate about the relationship between brain size and intelligence," Michael A. McDaniel, professor in management in VCU’s School of Business has found, in a meta-analysis of studies that used "MRI-based brain assessments," that big-brained people are smarter. This has long been suspected, but in the darker ages the tools were too crude to provide conclusive proof.
"Before MRIs, scientists often used external skull measurements or waited until a person died to estimate brain size. The external skull measurements were only approximate estimates of brain volume."
Not only should this discovery put a handsome new furrow in Charles Murray's brow as he laments the hopelessness of the puny-brained lower classes, but it is apparently a giant leap forward for personnel managers.
As an industrial and organizational psychologist, McDaniel works with employers to screen job applicants and measure their performance. He said employers will appreciate his findings because intelligence tests are the single best predictor of job performance.
Will they show their appreciation by requiring applicants to have MRI-based brain assessments?

Dr. McDaniel must keep his students spellbound with the following sort of insight:
“On average, smarter people learn quicker, make fewer errors, and are more productive.”
It is therefore disheartening that the professor is unable to properly spell either the first or last name of the famous German researcher, Friedrich Tiedemann
"Ever since German anatomist and physiologist Frederick Tiedmann (sic) wrote in 1836 that there exists 'an indisputable connection between the size of the brain and the mental energy displayed by the individual man,' scientists have been searching for biological evidence to prove his claim."
Shouldn't Dr. McDaniel, the article's reviewers, and the editors of the journal Intelligence, be big-brained enough to know who Tiedemann was and how to spell his name? Tiedemann's fame is so enduring that, for a brain-sizer, mispelling this name is equal to a geneticist not knowing how to spell "Crick" or "Watson."

The press release is accessed by clicking the title of this post. A pdf of the full article is here. An abstract of the article, "Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence," is here.

Friday, June 17, 2005

You'd have to be crazy: Mental illness is the new normal

Jacob Sullum has a new column in which he ridicules the aforementioned survey revealing the ubiquity of "mental illness."

As the psychiatric iconoclast Thomas Szasz has been arguing for many years, mental illness is a literalized metaphor that conceals more than it reveals.

Tuesday, June 14, 2005

"Snake Phobias, Moodiness and a Battle in Psychiatry"

This exercise in question-begging is in today's New York Times.

Monday, June 13, 2005

The Legality of the Use of Psychiatric Neuroimaging in Intelligence Interrogation

Cornell University - School of Law


This Note seeks to analyze the legality of the use of fMRI during the interrogation of foreign detainees in U.S. custody. It assesses the legality of using fMRI in the interrogation of POWs and civilians detained during an armed conflict, arguing that the use of fMRI to detect deception in the voluntary statements of these detainees would be permissible, but that the use of fMRI to extract cognitive information from a nonconsenting detainee would not. The Note also examines the legaity of using fMRI in the interrogation of unlawful combatants, whether they are held in U.S. territory or abroad. The Note argues that the use of fMRI to extract cognitive information from a nonconsenting unlawful combatant held in U.S. territory may "shock the conscience" and, therefore, violate U.S. obligations under International Humanitarian Law. The analysis will vary on a case-by-case basis, depending on the level of force used to effect the scan and the government interest involved. Because, under current U.S. policy, unlawful combatants held outside U.S. territory are only protected by the U.S. Federal Anti-Torture Statute, fMRI in any form would be permissible in the interrogation of these detainees.

Full Report

Joan Kennedy stripped of rights by judge, family

What a sadly fitting event this is in the year of Rosemary Kennedy's death. "Losing your sharp edge" around the Kennedys is a spiritual, if not literal, death sentence. How dare they call this a "settlement."

Joan Kennedy Settles Guardianship Case
The Associated Press
Sunday, June 12, 2005

BOSTON -- Joan Kennedy has reached a settlement with her children that calls for two trustees to manage her estate, while a guardian supervises her personal affairs, a source close to the case said Sunday.

The settlement also calls for the former wife of U.S. Sen. Edward Kennedy to enter a program to treat her alcoholism, the source said on condition of anonymity.

Kennedy's three children, including U.S. Rep. Patrick Kennedy, D-R.I., had been scheduled to appear in court Monday to ask a judge to appoint a permanent legal guardian to manage their mother's finances and to make decisions about her health.

The hearing was canceled following the agreement on the settlement, said Patrick Kennedy's spokeswoman, Robin Costello. She declined to provide any further details.

Joan Kennedy's attorney also declined to comment on the settlement, but said his client will not have a permanent legal guardian managing her estate.

The anonymous source said the guardian ad litem will monitor Joan Kennedy's finances and health and report to a judge, but will not have the power to make decisions for her. The source also said her estate _ including a $6.4 million oceanfront home on Cape Cod _ will be held in a trust and managed by two trustees.

Joan Kennedy, 68, has been arrested several times for drunken driving and gone through rehab repeatedly. In March, she was hospitalized with a concussion and a broken shoulder after a passer-by found her sprawled on a Boston sidewalk.

Kennedy didn't contest her children's bid for guardianship last July, when a judge ruled she was "incapable of taking care of herself by reason of mental illness."

More details from a prior article:

Bruce D. Bixby, a Boston lawyer who specializes in probate law, said awarding permanent guardianship would forever change Joan Bennett Kennedy's life. He said the guardianship would remain in effect unless she convinces a judge that she can live on her own again.

''If you commit a crime, you go to jail," Bixby said. ''In a guardian situation, if you start losing your sharp edge, you can wind up having all your freedoms taken away indefinitely -- without ever having harmed a soul. . . . You can't be in charge of your own money, you can't be in charge of healthcare decisions."

Saturday, June 11, 2005

Hamilton Naki, 78, Self-Taught Surgeon, Dies

Hamilton Naki, 78, Self-Taught Surgeon, Dies

NY Times
June 11, 2005


Hamilton Naki, a laborer who became a self-taught surgeon of such skill that Dr. Christiaan N. Barnard chose him to assist in the world's first human heart transplant in 1967, but whose contribution was kept secret for three decades because he was a black man in apartheid-era South Africa, died on May 29 at his home in Langa, near Cape Town. He was believed to have been 78.

The cause apparently was heart trouble, according to African and British newspapers, which reported the death.

The transplant, which took place on Dec. 3, 1967, at Groote Schuur Hospital in Cape Town, made medical history. It also made Dr. Barnard, who was young, handsome and white, world famous.

Dr. Barnard began to acknowledge Mr. Naki's work only after the end of apartheid in 1991. In an interview shortly before his death in 2001, he called Mr. Naki "one of the great researchers of all time in the field of heart transplants."

Mr. Naki, who left school at 14 and had no formal medical training, spent five decades working at the University of Cape Town. Originally hired as a gardener there in about 1940, he acquired his formidable surgical skills through years of silent observation and covert practice at the university's medical school. He retired in 1991.

In 2003, the university awarded Mr. Naki an honorary master of science degree in medicine.
Although South Africa's apartheid laws forbade blacks from performing surgery on whites, Mr. Naki's skills were so esteemed that the university quietly looked the other way. He worked alongside Dr. Barnard for decades as a lab technician, perfecting his craft and assisting in many operations on people. Operating on animals, Mr. Naki also taught surgical techniques to generations of medical students.

"If Hamilton had had the opportunity to perform, he would have probably become a brilliant surgeon," Dr. Barnard told The Associated Press in 1993.

Hamilton Naki was born, most likely in 1926, in a poor, rural village in Transkei, a largely black former British protectorate in what is now South Africa's Eastern Cape Province. At 14, lacking the money to continue his education, he hitchhiked to Cape Town to find work. The university hired him to tend its grounds and tennis courts.

In the late 1950's, Mr. Naki took a job at the medical school, where he cleaned lab animals' cages. He was quickly recognized for his intelligence, keen powers of observation and steady hands, and was gradually allowed to become involved in more serious work.

Mr. Naki learned to anesthetize animals, and eventually to do surgery on them, operating on rabbits, pigs, dogs and even a giraffe. Many of the animal surgeries he performed, including coronary bypasses and heart and liver transplants, helped to perfect techniques that were later used on humans.

"Hamilton Naki had better technical skills than I did," Dr. Barnard said in an interview quoted in The Daily Telegraph of London this week. "He was a better craftsman than me, especially when it came to stitching, and had very good hands."

But because of his race, Mr. Naki's role in the world's first heart transplant remained unknown for years.

On Dec. 2, 1967, Denise Darvall, a young white South African woman, was hit by a car as she was crossing a Cape Town street. Taken to Groote Schuur Hospital, she was declared brain-dead. Her family gave permission for her heart to be transplanted into the chest of Louis Washkansky, a 55-year-old grocer whose own heart was failing.

As a black man, Mr. Naki could not operate on Ms. Darvall even after she was dead. But Dr. Barnard so prized his ability that he drafted him as a member of the team that would lift out her heart.

In a painstaking operation lasting many hours, Mr. Naki's team removed Ms. Darvall's heart, washing it repeatedly to cleanse it of her blood before introducing some of Mr. Washkansky's. On Dec. 3, Dr. Barnard transplanted the heart into Mr. Washkansky, who lived for 18 days before dying of pneumonia.

During his years at the university, Mr. Naki lived on the outskirts of Cape Town in a one-room shack without electricity or running water. When he retired, he was paid a gardener's pension, far less than a lab technician's.

Mr. Naki is survived by several children, and many grandchildren and great-grandchildren, according to the reports in overseas news media.

In 2002, Mr. Naki was awarded the Order of Mapungubwe, one of South Africa's highest honors, for outstanding contribution to medical science.

In an interview with The Guardian of London in 2003, Mr. Naki expressed little bitterness about a lifetime spent working in the shadows. "I was called one of the backroom boys," he said. "They put the white people out front. If people published pictures of me, they would have gone to jail."

Friday, June 10, 2005

Lilly to settle Zyprexa claims for up to $690M

The Indianapolis Star
June 10, 2005

Lilly to settle for up to $690M: Deal may resolve 8,000 Zyprexa claims

Eli Lilly and Co. said Thursday it will pay up to $690 million to settle legal claims by about 8,000 patients alleging they were harmed by the antipsychotic Zyprexa, Lilly's top-selling drug.

The proposed settlement comes six months before the first trial in a rash of Zyprexa lawsuits is scheduled to begin in federal court in New York.

The Indianapolis drug maker said it's not admitting in the agreement that its star drug caused the diabetes-related injuries alleged by claimants, many of whom are schizophrenia patients. The drug also is approved to treat manic depression...Lilly has maintained that its drug is not to blame for diabetes-related problems. Lechleiter said schizophrenia patients are prone to weight gain and also suffer a fourfold greater incidence of diabetes than the general population.

But according to a Pfizer press release, reprinted on a NAMI affiliate site, "antipsychotic" drugs are themselves responsible for weight gain among "schizophrenics":

"The dramatic weight gain often associated with some of the most widely prescribed antipsychotic medicines is the side effect most likely to cause patients to stop taking their medication, according to a nationwide survey of psychiatrists released today at the 155th annual meeting of the American Psychiatric Association."

The press release also says:
"Ninety percent of the psychiatrists surveyed by Roper Starch Worldwide said they believe that weight gain not only affects compliance, but patients' self-esteem as well, and 80 percent said they believe weight gain adversely impacts their patients' overall quality of life."

Schizophrenics have self-esteem? Who knew? And this self-esteem is adversely impacted by weight gain, but not by imprisonment, restraint, electroshock, and the rest of the psychiatric armamentarium? Or perhaps obliterating the self-esteem and quality of life of persons labeled schizophrenic is the point. It sure doesn't seem to harm the quality of life and self-esteem of the psychiatrists.

Tuesday, June 07, 2005

One Quarter of Us Are Mentally Ill?

Oh here we go again. According to a Harvard study, 25 percent of Americans are mentally ill, and 25 percent of those are severely mentally ill. Read about it here. The New York Times story, headlined "Most Will Be Mentally Ill at Some Point, Study Says," is here. Here's a choice quote: "Pretty soon," he [Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University] said, "we'll have a syndrome for short, fat Irish guys with a Boston accent, and I'll be mentally ill."

Thoughts on Raich Decision

Monday's decision in Gonzales v Raich is a mixed bag. While "medical" exceptions to drug laws were rightly rejected, states' rights to regulate intrastate commerce without federal interference were considerably weakened, and the federal war on drugs strengthened. On the whole, the decision is a net loss for liberty.

The majority wrote:

First, the fact that marijuana is used "for personal medical purposes on the advice of a physician" cannot itself serve as a distinguishing factor. 352 F. 3d, at 1229. The CSA designates marijuana as contraband for any purpose; in fact, by characterizing marijuana as a Schedule I drug, Congress expressly found that the drug has no acceptable medical uses. Moreover, the CSA is a comprehensive regulatory regime specifically designed to regulate which controlled substances can be utilized for medicinal purposes, and in what manner. Indeed, most of the substances classified in the CSA "have a useful and legitimate medical purpose."


Accordingly, the mere fact that marijuana--like virtually every other controlled substance regulated by the CSA--is used for medicinal purposes cannot possibly serve to distinguish it from the core activities regulated by the CSA.

Yes, whether the use is "medical", "recreational," or whatever, should have no bearing on the statute's legality. "Medical" marijuana is to commerce laws, what "good" speech is to speech codes.

But why should the utilitarian effects of local laws on interstate markets -- the effects of which can surely not be predicted in advance -- have any bearing on federal power?

The majority continued:

Second, limiting the activity to marijuana possession and cultivation "in accordance with state law" cannot serve to place respondents' activities beyond congressional reach. The Supremacy Clause unambiguously provides that if there is any conflict between federal and state law, federal law shall prevail.

Even when the Constitution does not enumerate those federal powers?

Justice Scalia, having already run over the Ninth Amendment, proceeds to nullify the Tenth:

Finally, neither respondents nor the dissenters suggest any violation of state sovereignty of the sort that would render this regulation "inappropriate," id., at 421--except to argue that the CSA regulates an area typically left to state regulation. See post, at 6-7, 11 (opinion of O'Connor, J.); post, at 8-9 (opinion of Thomas, J.); Brief for Respondents 39-42. That is not enough to render federal regulation an inappropriate means. The Court has repeatedly recognized that, if authorized by the commerce power, Congress may regulate private endeavors "even when [that regulation] may pre-empt express state-law determinations contrary to the result which has commended itself to the collective wisdom of Congress."

The majority decided, in effect, that anything which can be construed to "affect" interstate commerce, even if it doesn't cross state lines, validates federal law, and that it trumps state law. Since growing and using marijuana locally can "affect" interstate markets (by reducing demand for them), the reasoning goes, the feds have every right to step in and regulate local commerce, even if nothing crosses state lines, and even if no money changes hands.

The dissent led by O'Connor let itself get trapped into economic arguments about the effects on interstate markets, while at the same time pretending that they weren't relevant:

Even assuming that economic activity is at issue in this case, the Government has made no showing in fact that the possession and use of homegrown marijuana for medical purposes, in California or elsewhere, has a substantial effect on interstate commerce. Similarly, the Government has not shown that regulating such activity is necessary to an interstate regulatory scheme. Whatever the specific theory of "substantial effects" at issue (i.e., whether the activity substantially affects interstate commerce, whether its regulation is necessary to an interstate regulatory scheme, or both), a concern for dual sovereignty requires that Congress' excursion into the traditional domain of States be justified.


There is simply no evidence that homegrown medicinal marijuana users constitute, in the aggregate, a sizable enough class to have a discernable, let alone substantial, impact on the national illicit drug market--or otherwise to threaten the CSA regime. Explicit evidence is helpful when substantial effect is not "visible to the naked eye." See Lopez, 514 U. S., at 563. And here, in part because common sense suggests that medical marijuana users may be limited in number and that California's Compassionate Use Act and similar state legislation may well isolate activities relating to medicinal marijuana from the illicit market, the effect of those activities on interstate drug traffic is not self-evidently substantial.

And again:

The Government has not overcome empirical doubt that the number of Californians engaged in personal cultivation, possession, and use of medical marijuana, or the amount of marijuana they produce, is enough to threaten the federal regime. Nor has it shown that Compassionate Use Act marijuana users have been or are realistically likely to be responsible for the drug's seeping into the market in a significant way.

The dissent undermined its own arguments, by playing into this utilitarianism.

The dissent also let itself get swayed by personal opinions:

To ascertain whether Congress' encroachment is constitutionally justified in this case, then, I would focus here on the personal cultivation, possession, and use of marijuana for medicinal purposes.

O'Connor seemed apologetic about the effects her decision might have:

Relying on Congress' abstract assertions, the Court has endorsed making it a federal crime to grow small amounts of marijuana in one's own home for one's own medicinal use. This overreaching stifles an express choice by some States, concerned for the lives and liberties of their people, to regulate medical marijuana differently. If I were a California citizen, I would not have voted for the medical marijuana ballot initiative; if I were a California legislator I would not have supported the Compassionate Use Act. But whatever the wisdom of California's experiment with medical marijuana, the federalism principles that have driven our Commerce Clause cases require that room for experiment be protected in this case. For these reasons I dissent.

In his solo dissent, Justice Thomas wrote:

Respondents Diane Monson and Angel Raich use marijuana that has never been bought or sold, that has never crossed state lines, and that has had no demonstrable effect on the national market for marijuana. If Congress can regulate this under the Commerce Clause, then it can regulate virtually anything--and the Federal Government is no longer one of limited and enumerated powers.

The majority holds that Congress may regulate intrastate cultivation and possession of medical marijuana under the Commerce Clause, because such conduct arguably has a substantial effect on interstate commerce. The majority's decision is further proof that the "substantial effects" test is a "rootless and malleable standard" at odds with the constitutional design.

But Thomas relied on the medical model to bolster his arguments:

... The Court of Appeals found that respondents' "limited use is distinct from the broader illicit drug market," because "th[eir] medicinal marijuana ... is not intended for, nor does it enter, the stream of commerce." Raich v. Ashcroft, 352 F. 3d 1222, 1228 (CA9 2003). If that is generally true of individuals who grow and use marijuana for medical purposes under state law, then even assuming Congress has "obvious" and "plain" reasons why regulating intrastate cultivation and possession is necessary to regulating the interstate drug trade, none of those reasons applies to medical marijuana patients like Monson and Raich.

Wow, to hear a Supreme Court Justice say that equal treatment under the law doesn't apply!!!

California's Compassionate Use Act sets respondents' conduct apart from other intrastate producers and users of marijuana. The Act channels marijuana use to "seriously ill Californians," Cal. Health & Safety Code Ann. §11362.5(b)(1)(A) (West Supp. 2005), and prohibits "the diversion of marijuana for nonmedical purposes," §11362.5(b)(2).4 California strictly controls the cultivation and possession of marijuana for medical purposes. To be eligible for its program, California requires that a patient have an illness that cannabis can relieve, such as cancer, AIDS, or arthritis, §11362.5(b)(1)(A), and that he obtain a physician's recommendation or approval, §11362.5(d). Qualified patients must provide personal and medical information to obtain medical identification cards, and there is a statewide registry of cardholders. §§11362.715-.76. Moreover, the Medical Board of California has issued guidelines for physicians' cannabis recommendations, and it sanctions physicians who do not comply with the guidelines. See, e.g., People v. Spark, 121 Cal. App. 4th 259, 263, 16 Cal. Rptr. 3d 840, 843 (2004).

This class of intrastate users is therefore distinguishable from others. We normally presume that States enforce their own laws, Riley v. National Federation of Blind of N. C., Inc., 487 U. S. 781, 795 (1988), and there is no reason to depart from that presumption here: Nothing suggests that California's controls are ineffective.

Oh, really? :-)

No one argues that permitting use of these drugs under medical supervision has undermined the CSA's restrictions.

On the contrary, I'd argue that the use of these drugs under "medical" supervision undermines CSA's restrictions, morally speaking. The majority was right on that one -- there cannot be "medical" or other exceptions. But neither side is willing to go so far as to end the war on drugs.

Even Thomas was swayed by the utilitarianism -- he just qualified it with the medical model:

But even assuming that States' controls allow some seepage of medical marijuana into the illicit drug market, there is a multibillion-dollar interstate market for marijuana. Executive Office of the President, Office of Nat. Drug Control Policy, Marijuana Fact Sheet 5 (Feb. 2004). It is difficult to see how this vast market could be affected by diverted medical cannabis, let alone in a way that makes regulating intrastate medical marijuana obviously essential to controlling the interstate drug market.

Thomas concludes:

In sum, neither in enacting the CSA nor in defending its application to respondents has the Government offered any obvious reason why banning medical marijuana use is necessary to stem the tide of interstate drug trafficking. Congress' goal of curtailing the interstate drug trade would not plainly be thwarted if it could not apply the CSA to patients like Monson and Raich. That is, unless Congress' aim is really to exercise police power of the sort reserved to the States in order to eliminate even the intrastate possession and use of marijuana.

Ah, now you understand!!!

So the side which has historically been more inclined to support states' rights against federal intrusion, used the medical model for its arguments, and supported the federal war on drugs as much as it possibly could, personally if not legally. It was as though they were saying: "We don't like the federal government intruding into states, and we cannot really find a legal reason to support it, but we sincerely support the federal drug war, and will do everything we can to preserve it. As long as you can make it a medical exception, we're fine with leaving it up to the states, no matter how much it undermines the rule of law."

The majority opinion is more consistent, both internally and with past behavior, even though it sanctions federal power that the Tenth Amendment, and common sense, should not allow.

Neither side recognized an individual's right to drug use, or the right of an individual to engage in commerce without state and federal interference. The Justices tried to second-guess the effects of state and federal drug laws on the market, to justify their legal reasoning, and supported preserving the federal war on drugs as much as their sense of the law would allow. Liberty lost.

Other analyses of this ruling can be found Here, Here, Here, and Here.

Sunday, June 05, 2005

Addiction in America: Addiction is a Choice? Christian Network Journal, June 2005

Why Addiction is a Choice

by Jeffrey A. Schaler
Christian Networks Journal
June 5, 2005

Anyone listening to the incessant propaganda for what is called "the disease model" of addiction might suppose that all experts on addiction agree with it. But this is far from the truth. People who have spent a lifetime studying addiction are divided in their opinions. I am one of many psychologists who maintain that addiction is not a disease but a choice.

Some people suppose they can show that addiction is a disease by pointing out that it is a serious problem, that people can destroy or impoverish their lives by excessive consumption
of some chemical substance or by an obsessive preoccupation with some pastime like gambling or sex. I do not dispute that some forms of addiction constitute a serious problem. What I do dispute is the assumption that serious problems are always necessarily medical in nature. Serious problems may be social, or moral, or existential.
People can make unwise choices. People can make self-destructive choices. People can make evil choices, though in our society there is not always agreement about which choices are evil, which are good, and which are morally neutral. It's also true that people can make sensible, constructive, and heroic choices. If we are going to claim that people are not responsible for their bad choices, how can we claim that they are responsible for their good choices? If we are not to blame people for their harmful actions, then how are we to praise them for their fine or noble action?

If someone has made an unfortunate choice, they may be in need of help. My judgment that addiction is a choice is not an excuse to be uncaring. I do not want to be hard on people who are suffering from the difficulties of life. But I believe we do not help people most effectively by classifying their behavior as symptoms of some mysterious and entirely mythical illness. We can help people by offering them advice, or perhaps by enabling them to improve their circumstances so that they are better able to cope, and thus do not feel impelled to take refuge in particular chemical substances.

The full article is accessible by purchase here

Thursday, June 02, 2005

CDC Team Investigates an Outbreak of Obesity

Next assignment: a pandemic of stupidity.

New York Times
Published: June 3, 2005

C.D.C. Team Investigates an Outbreak of Obesity

For the first time, the Centers for Disease Control and Prevention has sent a team of specialists into a state, West Virginia, to study an outbreak of obesity in the same way it studies an outbreak of an infectious disease.

Kerri Kennedy, the program manager at the West Virginia Physical Activity and Nutrition Program, said the state had requested the agency's investigation.

"We were looking at our data," Ms. Kennedy said, and saw that "we are facing a severe health crisis."

The state ranked third in the nation for obesity - 27.6 percent of its adults were obese, compared with 20.4 percent in the country as a whole. And, Ms. Kennedy said, "our rate of obesity appears to be increasing faster than the rest of the nation."


Wednesday, June 01, 2005

Don't say "drug" when you mean "medication"

We can only hope that Lewis H. Richmond has continued his indefatigable effort to clear up this small matter. Inexplicably, we also refer to psychiatrists -- like Richmond himself -- as doctors.

American Medical News
31 Jul 2000
Letters to the Editor

Don't say "drug" when you mean "medication"

For many years I have written and spoken about the need for doctors to differentiate between the terms "medication" and "drug."

It makes little sense for people to "say no to drugs" (illegal substances) and "say yes to drugs" (medications). I would hope our national organizations consider the implications of the confusing message that many physicians give when referring to medications as drugs. Further complicating this issue is the fact that we refer to facilities that dispense medications as "drugstores" rather than "medication stores."

--Lewis H. Richmond, MD San Antonio