From: sasghm@theseus.unx.sas.com (Gary Merrill)
Subject: Re: Peter Breggin, _Toxic Psychiatry_ (Q)
Originator: sasghm@theseus.unx.sas.com
Date: Tue, 15 Dec 1992 14:22:24 GMT
Organization: SAS Institute Inc.


In article <1992Dec14.175603.530@news.wesleyan.edu>, RGINZBERG@eagle.wesleyan.edu (Ruth Ginzberg) writes:
|> In <Bz9Kr3.H04@unx.sas.com> sasghm@theseus.unx.sas.com writes:

|> Hi, Gary.

|> (Gary Merrill is a frequent contributer to the philosophy newsgroups.)

Well, thanks a lot Ruth.  But I think I can still successfully pose as
an ignorant engineer here (at least I'll get a lot of votes for that
category).

|> I think you are confusing psychiatric *treatment* with psychiatric
|> *committment*.  *MOST* psychiatric treatment is on an outpatient basis and the

Actually, I'm not.  Consider the concept of committment sans treatment.  Think
about that for a while.

|> patients are under no compulsion to receive it (though, true, many have been
|> goaded into going to the doc by their families, but this is true of people with
|> dermatitis & colitis & other more-or-less chronic problems, too).

I am perfectly happy for people to choose to be treated by a psychiatrist.  This
follows from their fundamental rights.

|> A person cannot, to my knowledge, be involuntarily committed to a psychiatric
|> facility in the USA without a court hearing, except on a 72-hour emergency
|> basis.  Even a person who is involuntarily committed to a psychiatric facility
|> *rarely* is *REQUIRED* or *SENTENCED* to involuntary use of medication (there

I'm bothered a bit by the "except" and "rarely".

|> have been some famous medical ethics cases about this, but a person can almost

There has been a lot of other testimony as well that didn't make it into court.

|> never be involuntarily required to take psych meds, even if the person is
|> *sentenced* by a judge to treatment at the psychiatric facility as punishment
|> for a crime).

Oops, Ruth!  You don't get *sentenced* to *treatment* as *punishment* any more
than you get cancer chemotherapy as *punishment*.  You deviate from the disease
model here.  This is almost -- dare I say it? -- a mistake in political correctness.
I expect someone else will point this out as well.

|> For a person to be involuntarily committed (i.e., not allowed to sign himself
|> or herself out and/or discontinue treatment at will), he or she must either
|> have been committed (by a judge) to treatment because he or she was judged to
|> be mentally incompetent to stand trial for a crime in which s/he is a suspect,
|> or been sentenced to psychiatric treatment in lieu of a prison sentence for a
|> crime of which s/he was judged guilty in a court proceeding, or been judged to
|> present an immediate danger to self or others because of mental illness in a
|> court proceeding.  Someone who merely hears interesting voices that nobody else
|> can hear, or who talks to folks that nobody else sees, or who lives in some
|> sort of an "alternate reality" could not be committed by a judge just for being
|> "different."  I.e., you can't be committed for reason of having a mental
|> illness;  you can only be committed for reason of engaging in illegal
|> *behavior*.  You can hear all the voices you want & see all the hallucinations
|> you want & can't be coerced to do anything about it so long as you don't
|> interfere with others' safety, security, privacy, etc.

Sure.  None of this is new to me.  (Among other things, you've got to remember
that my wife taught medical ethics in a medical school for several years.)
But this simply *states* some of the problem involved in issues pertaining
to patients' rights.
-- 
Gary H. Merrill  [Principal Systems Developer, C Compiler Development]
SAS Institute Inc. / SAS Campus Dr. / Cary, NC  27513 / (919) 677-8000
sasghm@theseus.unx.sas.com ... !mcnc!sas!sasghm
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