Comments on ECT

Foucalt Tribunal Indicts Psychiatry

This statement was drafted and approved by the Tribunal Jury, 11 psychiatric survivor-activists from four different countries (Germany, Israel, Canada and the United States), at the "Foucault Tribunal on the State of Psychiatry" held in Berlin on May 1-3,1998. Kate Millett, a juror, internationally-respected feminist author and antipsychiatry activist, read the charges aloud at the Volksbuhne Theatre (People's Theatre) on May 1; they were immediately translated into German. The Tribunal program, indictment ("The Case Against Coercive Psychiatry" by Dr.Thomas Szasz) and verdict are available at this website:
www.fu-berlin.de/foucault-tribunal

A STATEMENT OF CHARGES

We, the Jury, would like to give notice that we do not see this occasion as a forum or debate on the state (lage) of psychiatry but instead as a Tribunal whereas psychiatry is brought to justice for crimes against humanity. Crimes we have ourselves witnessed and even been subjected to. We frame the charges upon the following grounds.
This is the fiftieth anniversary of the Universal Declaration of Human Rights, the most basic of which is freedom from fear, including fear of arbitrary incarceration, torture and arbitrary killing. We charge psychiatry based upon coercion and forced treatment with arbitrary incarceration and various tortures including electroshock, lobotomy or psychosurgery, the bondage of four point restraint, forced drugging, the divestment of human dignity and status through labeling and stigma and frequent lifetime incapacity and disability.
Coercive psychiatry habitually and continuously violates civil and human rights through its denial of due process in depriving persons of liberty of person through arrest and imprisonment and further violating bodily integrity through forced injection, restraint, and electrical tortures, its victims even denied access to the records of their experience. Under the pretense of medicine, psychiatry has legally instituted a subhuman category of "mental patient", a group demoted beneath human recognition to whom they have historically and consistently denied every human right in both democratic and totalitarian societies; under the Nazi eugenic policy even deliberately and systematically subjecting them to mass murder through gassing in this very city of Berlin.
Functioning as an arm of the state and with state powers, psychiatry has created a category of subhuman from whom every protection and right is withdrawn. We assert the full humanity of those so stigmatized and bring the charge of inhumanity against psychiatry both for its acts and for its demeaning ideology. Crimes against the category of persons nominated "mental patients" and heretofore dismissed as irrational and without judgement or intellect will henceforth be considered crimes against humanity for which both the individual psychiatrist and the institution of psychiatry itself, abrogating state sanction and police powers, will be held responsible.
To this end non-governmental organizations will be formed to present these claims to the United Nations and to charge psychiatry and psychiatrists with criminal instances and evidence of torture, false imprisonment and forced drugging both to individuals and to the class of persons so stigmatized, the actions of psychiatry and its system of social control consisting in themselves of crimes against humanity.
http://www.fu-berlin.de/foucault-tribunal

Medical Power

Medical power, unrestrained, allows physicians to use any method which is the professional fad, no matter how irrational. Even when a sizable number, approaching 50%, of patients actually report they have been harmed, not helped. This is the way it is with Psychiatry's Electroconvulsive Shock Treatment.
How has this professional group acquired the authority to judge others as less than human, invalid and unworthy of the protection of ordinary human rights? They commonly do not even warn patients of the serious brain damage and memory loss that is a consequence of the 'treatment' of ECT. This is actually what is happening daily when, disguised as a practitioner of the healing arts, an agent for the control of those viewed as irrational, or 'mentally ill', does his work as he is sanctioned by our society to do.
Blaming the individual for aberrations which result mostly from a skewed civilization that places the privilege of a few above the well-being of the bulk of humanity, they look for something to fix in that person as if he is only a broken machine. Tampering with the brain by means of electricity, drugs, and whatever other perverse ideas come to fruition in their 'clinics' funded by drug company and government largesse, they truly care nothing for the souls, minds, bodies or rights of the individuals entrusted to their 'care'.
The very name of Psychiatry is a lie, for it means "mental healing". Allowed unlimited discretion to create the realities in the area of 'mental health care', they even claim the very brain disease they are producing by their drugs and shock has been 'discovered' to be the cause and proof of the biological basis of 'mental illness' they've been looking for for the better part of 200 years!
It is quite certain to those of us who have tried for years to get those in psychiatry to hear and see past the 'mental illness', that heeding the grievances of the thousands upon thousands harmed by their carelessness is nowhere on their priority list...

Tim Konza
Director,
Distributive Information Services-
Alliance for the Reform of Medicine
DISARM

Difficulties in Protecting 'Clients'

Hi!,
I'm Matthew Davis ( tassy@faroc.com.au ), a 'client' or whatever down here in Australia. I wish to comment on the ECT debate. In my opinion there is little use becoming philosophical about it, what we need is also to amend international law to reflect somehow the rights of people in psychiatric care. Here is an article I garnered off the internet on the debate in this country about the rights of people in psychiatric care, most of it comes from the much read Burdekin report of 1993 I think it was, or '94. Here he alludes to some of the practical problems.
Mr Burdekin has a great reputation as a human rights advocate. His report was well-reported in the press and managed to spark off a good deal of criticism of perceptions about, and treatment of, people in psychiatric care. I would recommend it to anyone interested in an independent assessment of the care of people diagnosed with a mental illness. I found it an interesting read, perhaps someone who is more widely read could recommend some further reading to me on international law and how it supposedly 'protects' or otherwise, the rights of sick people? Here goes:
UN Principles on Mental Illness
The Soviet use of psychiatry for political purposes was the catalyst for a more general investigation into international psychiatric practices by the UN Commission on Human Rights. In 1977 the Commission appointed a "Sub-Commission to study, with a view to formulating guidelines, if possible, the question of the protection of those detained on the grounds of mental ill-health against treatment that might adversely affect the human personality and its physical and intellectual integrity."[13] The primary task given to the two Special Rapporteurs the Sub-Commission subsequently appointed was to "determine whether adequate grounds existed for detaining persons on the grounds of mental ill-health."[14]
The UN Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care[15] did not emerge until more than a decade later. Unfortunately, despite the brave start, the final document has been so repeatedly rewritten and massaged by numerous committees that the original focus -- on the problems of involuntary detention and the risks of treatment -- has been lost. The primary tasks of attending to involuntary detention and the risks of treatment have been largely buried by cross-referencing and other priorities.
The final version of the `Principles' adopted by the United Nations General Assembly in 1991 is primarily designed to protect the rights of voluntary patients, not involuntary patients. Principle 1 begins with an assertion of the 'right to treatment.' This right thereafter becomes the basis for most of the other voluntary patients' concerns, like confidentiality and protection against discrimination, addressed by the document.
Where the problems of involuntary patients are addressed, the `Principles' tend to undermine their rights rather than protect them. Principle 11, for instance, deals with "Consent to Treatment" and specifies that "No treatment shall be given to a patient without his or her informed consent, except as provided for in paragraphs 6, 7, 8, 13, and 15." Paragraph 6, however, denies the right of informed consent to involuntary patients: ".... treatment may be given to a patient without a patient's informed consent if the following conditions are satisfied: (a) The patient is, at the relevant time, held as an involuntary patient...."[16]
Involuntary admission is not only permitted under the `Principles,' but the civil liberties protections concerning this issue are considerably weaker than those already found in some existing mental health legislation. In the state of New South Wales (Australia), for instance, the Mental Health Act (MHA) requires that a person be dangerous to themselves or other people, as well as mentally ill, before involuntary committment is permitted.[17]. The `Principles', however, allow the requirement of `dangerousness' to be bypassed and the effect of this discrepancy has been to provide grounds for an argument that the NSW legislation should be weakened to bring it into line with UN standards.[18]
The weakness of the UN Principles in relation to involuntary patients invites a speculation: had the Principles been in existence in the 1970s and 1980s would they have deterred the Soviets from using psychiatry for political purposes? The answer to this question is by no means certain. Although Principle 4 requires that diagnosis "shall be made in accordance with internationally accepted standards" and "A determination of mental illness shall never be made on the basis of political, economic or social status,"[19] these requirements might merely have served to guide Soviet psychiatrists to be more circumspect in their definitions.

The Burdekin Inquiry

The UN Commission on Human Rights was not the only official human rights body to be galvanised into action by the Soviet example -- only to end up burying psychiatry's darker side beneath a restatement of the `right to treatment.' In Australia the Human Rights and Equal Opportunity Commission undertook a national inquiry (The Burdekin Inquiry) into mental health practice only a few years ago. The Australian Human Rights Commissioner, Brian Burdekin, in his opening address to the Sydney hearings in 1991, referred to Soviet psychiatry and said that Soviet human rights abuses in this area had been the catalyst for his own Inquiry.[20]
Burdekin explained that human rights circles in the Western democracies had formed the view that the mental health systems of democratic countries should be reviewed, to ensure that they were beyond reproach, before a full human rights assault was launched on the Soviet psychiatric system. He said that his own Inquiry had been conceived as part of this project, but while preparations had been under way to commence his Inquiry, the issue had gone off the boil because the Soviet Union had collapsed.[21] This change of affairs probably explains the confusion that subsequently developed in the Commission's priorities over mental health.
The Commission's confusion of priorities is apparent in a number of respects. A good example is the lack of significance given by the Inquiry to the rights of involuntary patients when they conflict with the needs of their frustrated relatives. Under the heading of "Involuntary Detention," the Burdekin Report observed:
Involuntary detention--for any reason and under any circumstances--is an extremely serious matter involving curtailment of several fundamental rights the most important of which is the right to liberty. The Inquiry received extensive evidence on this subject, particularly from consumers.[22]
Even so, after only one more brief sentence on the subject, the report moves on to a lengthy discussion in support of denying the very same "fundamental rights" the Inquiry had just recognised:
Difficulty in Gaining Involuntary Admission--Families and other carers are faced with a dilemma when the person for whom they are responsible has lost touch with reality and has insufficient insight[23] into his or her condition to accept the need for treatment.[24]
The Commission's confused priorities become further evident when the Terms of Reference are carefully analysed in the light of the subsequent course of the Inquiry. The first Term of Reference clearly listed the classes of people the Inquiry had initially intended to deal with: "To inquire into the human rights and fundamental freedoms afforded to persons who are or have been or are alleged to be affected by mental illness, having due regard for the rights of their families and members of the general community."[25] [my emphasis]
What is meant by alleged to be affected by mental illness is not immediately apparent. An early usage of the term `alleged mental illness' can be found in a published dialogue between US patient rights activist Leonard Roy Frank and American Civil Liberties Union attorney and mental patient advocate, Bruce Ennis. Ennis explains in the interview that he uses `alleged mental illness' because "I personally have seen no evidence at all that there is such a thing as mental illness."[26]
The Terms of Reference made no attempt to define what it meant by alleged , but it is unlikely that it was used to question the existence of all mental illnesses in the way that Ennis used the term. What is more likely is that in the planning stage of the Inquiry it was thought necessary to distinguish between certainty in the accuracy of diagnoses of mental illness when applied to some people and uncertainty when the diagnoses are applied to others.
There are at least two ways the Inquiry might have originally intended to utilise this distinction. The first possibility may have been an intention to examine the problem of false positive diagnosis. This is a perennial problem for psychiatry and arises from the subjective nature of psychiatric diagnostic techniques. The second possibility may have been an intention to determine whether any patients had been diagnosed with certain varieties of mental illness which some psychiatrists may allege to exist although they are not generally recognised by international standards. Sluggish schizophrenia would fit into this category as would Fanatic Personality Disorder, which is indicated by traits like strict vegetarianism. Perhaps the Inquiry had originally planned to investigate both problems. There are well-established concerns about Western psychiatric practice regarding both the problem of false positive diagnosis[27] and the proliferation of new varieties of mental disease.[28] Regardless of what the Inquiry's original interpretation of alleged mental illness might have been, it certainly seems appropriate that an Inquiry into Human Rights and Mental Illness should give hearing to any person who might have suffered the discomfort and humiliation of a psychiatric diagnosis and, more seriously, incarceration and imposed treatment on the basis of a mere allegation. But despite the nomination of this category in the Terms of Reference, as it transpired, the Inquiry completely ignored these people. Outside of the Terms of Reference, those with an alleged mental illness were not mentioned at all in the Inquiry's Report.

In fact, the definitions that were eventually adopted by the Inquiry made it impossible to recognise people who are alleged to be mentally ill. The Inquiry chose to use the term "consumer"[29] to describe all of the people who are deemed to have a mental illness thereby implying that they are all willing participants in a mental health service industry. This does not necessarily pose a problem for the recognition of people who are or have been mentally ill, but the description of "consumer" was totally inappropriate for those who are alleged to be mentally ill. Neither false positives nor people diagnosed with non-existent diseases are satisfactorily described as consumers.
It seems apparent therefore that somewhere between the time when the Terms of Reference were drafted and the time when the hearings of witnesses began a mechanism was deliberately or inadvertently put into place which blocked the people who are alleged to be mentally ill from influencing the outcome of the Inquiry. This diversion of purpose is similar to the UN Commission on Human Rights' diversion from its original investigation of the human rights risks involved in coercive psychiatry and its subsequent drafting of `Principles' that endorse coercion. Perhaps it is time that a definitive human rights test was applied to try to determine whether or not coercive psychiatry actually violates human rights.

ECT

From: Lynne Moss-Sharman, lsharman@mail.microage-tb.com

The use of ECT increased 1000% from 1991 to 1994 in Northwestern Ontario, then 3000% from 1995 to 1997.

Foucalt Tribunal/electric shock

From: Sylvia Caras sylviac@netcom.com

ECT use is increasing. It is now recommended for mania and schizophrenia as well as drug-resistant depression. A study from Wisconsin showed that the largest group receiving electro-shock without consent is women over 65.
The business of making and administering shock is profitable.

Electroshock - What the professional literature says:

From: Red Buffalo cgrandy@kendaco.telebyte.com

http://www.epix.net/~pmhca/alternatives/ect-popular.html

ECT Lit Search

From: DAbrahart DAbrahart@aol.com

It is mandatory for several US states (including California) to keep figures on the use of ECT, and also to record side effects. A simple search on an Internet search engine quickly finds these.
In England, such figures are not officially kept. A recent private members bill concerning the training, use and reporting of the use of ECT ran out of time in Parliament and hence was dropped. A good case can be argued that the Bill actually was pulled by the government, as it is trying to be 'nice' to the health sector workers rather than to impose added regulations on them. A copy of this can be found on the Institute of Mental Health Law's web site:
http://www.imhl.com.
ECT is frequently used for depression in older people (65+), individuals from ethnic monorities and women. The scale with which it is used is not clear but does depend on area and the Consultant's treatment preferences.
Under the Mental Health Act 1983, in certain circumstances and with a second opinion from an independent psychiatrist, ECT can and is given to individual's without their consent. This is a frequent occurence in Bath, where I work.
Dave Abrahart