Post Reply
Page 1 of 32  •  1 2 3 4 5 6 ... 32 Next
Switch to Forum Live View The hornswoggle problem
7 years ago  ::  Dec 12, 2007 - 4:34PM #1
mindis1
Posts: 7,910
Is it moral or ethical for a physician to diagnose and prescribe treatment to people for having the hornswoggle disease when:

(1) there is no evidence that there is a hornswoggle disease; despite massive amounts of research, there has never been found any physiological lesion or abnormality that causes the collection of phenomena knows as the symptoms; and

(2) the treatments prescribed have never been shown to treat or correct any physiological lesion or abnormality (one obviously cannot "treat" a disease that doesn't exist), and have been shown to be quite dangerous, causing a myriad of adverse effects, including death.

Psychiatry diagnoses and prescribes treatments for hornswoggle diseases:  In the words of Fred A. Baughman Jr., MD, Fellow, American Academy of Neurology, expressing a common critique of psychiatry:

Not only have they never validated a single psychiatric entity as a real disease, they never will, for all of them are wholly-subjective contrivances of the DSM Committee of the APA where they are voted--show of hands-- into existence.

It is on the basis of this absence of scientific method in psychiatry in making the physician's primary determination of "disease/no disease" that Dr. Thomas Szasz, Emeritus Professor, Psychiatry, State University of New York, argues that psychiatry is "an institution of social control".  Indeed, due to psychiatry’s inextricable relationship with and sanctioning by the state, psychiatry is a governmental power for social control.

And while the prescribed psychiatric treatments have never been shown to treat or correct any disease state, all prescribed psychiatric treatments have been shown to result in adverse effects, oftentimes quite serious and permanent effects including death, and to result in poorer outcomes than non-"treatment".  For instance, long-term studies, including large replicated studies sponsored by the WHO, have shown that compared to people diagnosed with schizophrenia in Europe and the US, people diagnosed with schizophrenia developing countries, where there is significantly less use of neuroleptic drug "treatments" for this diagnosis, have "considerably better outcomes":  The International Pilot Study of Schizophrenia:  five-year follow-up findings[, Leff, J. Psychological Medicine, 22 (1992), 131-145.

In Schizophrenia: manifestations, incidence and course in different cultures, A World Health Organization ten-country study., Jablensky, A. Psychological Medicine, suppl. 20 (1992), 1-95:

only 15.9% of patients were continuously maintained on neuroleptics compared to 61% of patients in the U.S. and other developed countries.

Outcome of schizophrenia: some transcultural observations with particular reference to developing countries., Kulhara, P.  Eur. Arch. Psychiatry Clin. Neurosci. 1994;244(5):227-35.

Analysis of the published and unpublished data on SSRI drugs clearly establish their adverse physiological effects, teratogenic effects, increased aggression or violence, increased suicidality, withdrawal syndromes, and, at the same time, lack of antidepressant efficacy over placebo--contrary to the claims by the manufacturers and the researchers remunerated by the manufacturers.  Stunningly these are the findings despite the variety of methodological and statistical manipulations commonly used in pharmaceutical-company-funded trials to ensure a favorable finding for their drugs, some of which are noted in the two British Medical Journal papers below.  (In a meta-regression analysis of 105 trails with11,537 subjects, Freemantle, et al., found that the strongest predictor of a favorable outcome for SSRIs in trails compared to other drugs was whether the trial was sponsored by the manufacturer.Predictive value of the pharmacological activity for the relative efficacy of antidepressant drugs.  Freemantle et al.The British Journal of Psychiatry (2000) 177: 292-302.)

Efficacy and safety of antidepressants in children and adolescents. Jureidini JN, Doecke CJ, Mansfield PR, Haby MM, Menkes DB, Tonkin AL.  BMJ 2004;328:879–83.

Efficacy of antidepressants in adults. Moncrieff J, Kirsch I. BMJ 2005;331;155-157.

Reaseach on antidepressants.  Very informative.

Moreover, it is well established that psychiatry in Western countries is a practice of systematic racism in its diagnoses and its prescribed "treatments".  For instance, in the paper, Paved With Good Intentions: Do Public Health and Human Service Providers Contribute to Racial/Ethnic Disparities in Health?, (Michelle van Ryn, PhD, MPH and Steven S. Fu, MD, MSCE.  Am J Public Health. 2003 February; 93(2): 248–255), the authors provide 21 separate peer-reviewed sources to substantiate this statement:

It has been shown that, independent of clinical factors, both US and UK psychiatrists are more likely to prescribe antipsychotic medications to non-Whites than to their White counterparts; also, these individuals are more likely to be involuntarily hospitalized and to be placed in seclusion once hospitalized. In addition, African Americans and Latinos have been found to be less likely than Whites to receive guideline-adherent treatment and follow-up.

Racism is, of course, not the only prejudice that psychiatry practices.  One of the clearer examples is the fact that from 1952, when the APA first published its Diagnostic and Statistical Manual of Mental Disorders, to 1973, "homosexuality" was a mental disorder.  In 1974, "homosexuality" was no longer a mental disorder, as of result of a show of hands by the DSM nosology committee--however, it was essentially only reformulated as the mental disorder classification "Sexual Orientation Disturbance."  This disorder was in turn reformulated in 1980 as the mental disorder, "Ego-dystonic Homosexuality."  Dr. Robert Spitzer, Professor of Psychiatry, Columbia University, argues that what is at issue in these mental disorder classifications is "a value judgment about heterosexuality, rather than a factual dispute about homosexuality":   The diagnostic status of homosexuality in DSM-III: a reformulation of the issues.Spitzer, RL, Am J Psychiatry 1981; 138:210-215.  Today, the same value judgments by psychiatrists concerning gender is the basis of the DSM formulation of "Gender Identity Disorder" and many other "mental disorders".

Thus, given that psychiatric diagnoses are not medical diseases in any sense but are value judgments expressing social disapproval, the prescribed "treatments" are both harmful and inefficacious and are dispensed on the basis of social prejudices, is psychiatry moral or ethical in its theory and practice?  If yes, explain.
Quick Reply
Cancel
7 years ago  ::  Dec 12, 2007 - 5:45PM #2
Marcyy
Posts: 723
Thank you Mindis, for a very thought provoking post. I will follow up on the leads you have provided.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 12:38PM #3
LittleBuddha73
Posts: 1,399
OK, there was so much information there. I printed a lot of it and read it on my long train ride over the weekend.
What I conclude are two major points:
1. A lot of focus is being placed on the word "disease." Still, it's false to claim that psychiatric diagnoses are not diseases. Among other things, physical and physiological changes in brain activity show that psychiatric diagnoses are very real and very treatable.
2. I find this guy and this theory prepostorous and dangerous. There is no evidence that the government is controlling people via psychiatric diagnoses. Furthermore, it is dangerous to tell people that what they feel doesn't really exist.
I hope there are very few people who take this "conspiracy theory" seriously.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 2:35PM #4
mindis1
Posts: 7,910
[QUOTE=LittleBuddha73;145490]Still, it's false to claim that psychiatric diagnoses are not diseases. Among other things, physical and physiological changes in brain activity show that psychiatric diagnoses are very real . . .[/QUOTE]

Present your evidence that any psychiatric entity is a medical disease (is caused by a physiological lesion).  No psychiatric entity is diagnosed by any objective test.

If psychiatric entities are medical diseases, then how can these so-called diseases completely be eradicated by a vote?

[QUOTE]. . . and very treatable.[/QUOTE]

Present the evidence that any "treatment" used by psychiatry treats or corrects any physiological lesion.  I already presented a good deal of evidence, but only a fraction that exists, that neuroleptics result in poorer outcomes for people diagnosed with schizophrenia, and that SSRIs are inefficacious and are detrimental. 

[QUOTE]There is no evidence that the government is controlling people via psychiatric diagnoses. [/QUOTE]

Psychiatrists make psychiatric diagnoses that are based on no objective tests.  On the basis of such non-medical diagnoses, courts order involuntary confinement and mandatory "treatment" that have never been shown to be efficacious in treating any disease and have been shown to be highly brain damaging.

If you think that there is anything scientific about psychiatric diagnoses or that courts should order involuntary confinement or mandatory “treatments” on the basis of psychiatric diagnoses, then explain why, in 1969, if you had been around at that time, should you not have been ordered to undergo mandatory “treatment” and drugging for being a lesbian?

[QUOTE]I find this guy and this theory prepostorous and dangerous. [/QUOTE]

What guy?  Me?  Fred Baughman?  Thomas Szasz?  Robert Spitzer? 

You're not very familiar with the anti-psychiatry literature, are you?  Dr. Szasz has had a very significant effect on psychiatry.

[QUOTE]Furthermore, it is dangerous to tell people that what they feel doesn't really exist.[/QUOTE]

You won't find the claim that "what [people] feel doesn't really exist" made by any of the psychiatrists or psychologists I quoted, nor by any of the many other anti-psychiatrists.  Knocking down straw men doesn't help anything.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 4:09PM #5
LittleBuddha73
Posts: 1,399
How do you explain the early stages of dementia? What about catatonic schizophrenia?
[QUOTE=mindis1;145822]Present your evidence that any psychiatric entity is a medical disease (is caused by a physiological lesion).  No psychiatric entity is diagnosed by any objective test.[/QUOTE]
First, I already noted that I have a problem with your definition of “medical disease.” There are plenty of things that wouldn’t be considered medical diseases if a lesion was necessary to diagnose. However, there are plenty of studies that show changes in memory, fear, and fear response after brain lesions. How do you account for emotional or mental responses actually resulting from lesions?

[QUOTE]Present the evidence that any "treatment" used by psychiatry treats or corrects any physiological lesion.[/QUOTE]
Not a lesion, but the illness itself.
[QUOTE]If you think that there is anything scientific about psychiatric diagnoses or that courts should order involuntary confinement or mandatory “treatments” on the basis of psychiatric diagnoses, then explain why, in 1969, if you had been around at that time, should you not have been ordered to undergo mandatory “treatment” and drugging for being a lesbian?[/QUOTE]
Courts reserve such extremes for those who have the (imminent) potential to or history of hurting themselves or others. 1969 had its own problems, with homosexuality being considered a “disorder” at that time, but was never truly considered imminently dangerous in the same sense as an attempted suicide or schizophrenia. It was generally something people were just jailed for. But this leads to an interesting point. In all honestly, I could “pretend” not to be a lesbian – the same is not true of schizophrenia.

[QUOTE]You won't find the claim that "what [people] feel doesn't really exist" made by any of the psychiatrists or psychologists I quoted, nor by any of the many other anti-psychiatrists.  Knocking down straw men doesn't help anything.[/QUOTE]
Perhaps not, but it’s the same thing – stating that because evidence “A” doesn’t exist, the condition doesn’t exist, regardless of the fact that evidences “B,” “C,” “D,” etc. exist.
In any case, most psychologists and psychiatrists agree that mental disorders are a result of multiple factors, most often a biological predisposition (genes, etc.) compounded by one or more social/emotional/mental experiences.

From the SurgeonGeneral.gov site:
Overview of Etiology
The precise causes (etiology) of most mental disorders are not known. But the key word in this statement is precise. The precise causes of most mental disorders—or, indeed, of mental health—may not be known, but the broad forces that shape them are known: these are biological, psychological, and social/cultural factors.
What is most important to reiterate is that the causes of health and disease are generally viewed as a product of the interplay or interaction between biological, psychological, and sociocultural factors. This is true for all health and illness, including mental health and mental illness. For instance, diabetes and schizophrenia alike are viewed as the result of interactions between biological, psychological, and sociocultural influences. With these disorders, a biological predisposition is necessary but not sufficient to explain their occurrence (Barondes, 1993). For other disorders, a psychological or sociocultural cause may be necessary, but again not sufficient.
As described in the section on modern neuroscience, the brain and behavior are inextricably linked by the plasticity of the nervous system. The brain is the organ of mental function; psychological phenomena have their origin in that complex organ. Psychological and sociocultural phenomena are represented in the brain through memories and learning, which involve structural changes in the neurons and neuronal circuits.

Infectious Influences
It has been known since the early part of the 20th century that infectious agents can penetrate into the brain where they can cause mental disorders. A highly common mental disorder of unknown etiology at the turn of the century, termed “general paresis,” turned out to be a late manifestation of syphilis. The sexually transmitted infectious agent—Treponema pallidum—first caused symptoms in reproductive organs and then, sometimes years later, migrated to the brain where it led to neurosyphilis. Neurosyphilis was manifest by neurological deterioration (including psychosis), paralysis, and later death. With the wide availability of penicillin after World War II, neurosyphilis was virtually eliminated (Barondes, 1993).

Neurosyphilis may be thought of as a disease of the past (at least in the developed world), but dementia associated with infection by the human immunodeficiency virus (HIV) is certainly not. HIV-associated dementia continues to encumber HIV-infected individuals worldwide. HIV infection penetrates into the brain, producing a range of progressive cognitive and behavioral impairments. Early symptoms include impaired memory and concentration, psychomotor slowing, and apathy. Later symptoms, usually appearing years after infection, include global impairments marked by mutism, incontinence, and paraplegia (Navia et al., 1986). The prevalence of HIV-associated dementia varies, with estimates ranging from 15 percent to 44 percent of patients with HIV infection (Grant et al., 1987; McArthur et al., 1993). The high end of this estimate includes patients with subtle neuropsychological abnormalities. What is remarkable about HIV-associated dementia is that it appears to be caused not by direct infection of neurons, but by infection of immune cells known as macrophages that enter the brain from the blood. The macrophages indirectly cause dysfunction and death in nearby neurons by releasing soluble toxins (Epstein & Gendelman, 1993).
Besides HIV-associated dementia and neurosyphilis, other mental disorders are caused by infectious agents. They include herpes simplex encephalitis, measles encephalomyelitis, rabies encephalitis, chronic meningitis, and subacute sclerosing panencephalitis (Kaplan & Sadock, 1998).
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 6:16PM #6
mindis1
Posts: 7,910
[QUOTE=LittleBuddha73;146018][QUOTE]Originally Posted by mindis1 
Present your evidence that any psychiatric entity is a medical disease (is caused by a physiological lesion). No psychiatric entity is diagnosed by any objective test.[/QUOTE]

First, I already noted that I have a problem with your definition of “medical disease.” There are plenty of things that wouldn’t be considered medical diseases if a lesion was necessary to diagnose. [/QUOTE]

A medical disease means that there is a physiological lesion (abnormality).  If you know of any medical disease that doesn't require a physiological lesion, then name it.

[QUOTE]However, there are plenty of studies that show changes in memory, fear, and fear response after brain lesions. How do you account for emotional or mental responses actually resulting from lesions?[/QUOTE]

The changes you noted result from the lesion, not a “mental disorder” that is diagnosed by interview.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 6:20PM #7
mindis1
Posts: 7,910
[QUOTE=LittleBuddha73;146018][QUOTE]Present the evidence that any "treatment" used by psychiatry treats or corrects any physiological lesion. [/QUOTE]

Not a lesion, but the illness itself.[/QUOTE]

What distinction are you making?

If a treatment does not correct the physiological abnormality that constitutes the disease, then it is not treating the disease.  You can take aspirin and alleviate the headache caused by a brain tumor, but you have not treated the disease.  Right? 

So present the evidence that any "treatment" used by psychiatry treats or corrects any physiological abnormality.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 6:29PM #8
mindis1
Posts: 7,910
[QUOTE=LittleBuddha73;146018][QUOTE]Quote:
If you think that there is anything scientific about psychiatric diagnoses or that courts should order involuntary confinement or mandatory “treatments” on the basis of psychiatric diagnoses, then explain why, in 1969, if you had been around at that time, should you not have been ordered to undergo mandatory “treatment” and drugging for being a lesbian?  [/QUOTE]

Courts reserve such extremes for those who have the (imminent) potential to or history of hurting themselves or others. [/QUOTE]

In 1969, you would have been committing a crime by having sex with a person of the same sex, an act caused by the "mental disorder" homosexuality.  Courts order involuntary confinement and mandatory drugging all the time for such "mental disorders"--even when there is no evidence that a "mental disorder" has ever caused anyone to break the law.  So why shouldn't you have been likewise treated in 1969 for being a lesbian?


[QUOTE]1969 had its own problems, with homosexuality being considered a “disorder” at that time[/QUOTE]

The list of conditions considered "mental disorders" by the APA today is much more extensive than it was in 1969. 

[QUOTE]but was never truly considered imminently dangerous in the same sense as an attempted suicide or schizophrenia. [/QUOTE]

There is no objective assessment of risk of committing a crime when ordering involuntary confinement or mandatory drugging for a "mental disorder".  In fact, the risk of people diagnosed with "mental disorders" committing a crime is extremely low.  I'm fairly sure studies have shown that people diagnosed with schizophrenia are no more likely to commit a crime than those not so diagnosed.


[QUOTE]But this leads to an interesting point. In all honestly, I could “pretend” not to be a lesbian [/QUOTE]

Not if someone is informing on you, or a witness is testifying against you.  If a psychiatrist testified to the court in 1969 that you have the "mental disorder" homosexuality and are in need of conversion therapy, then that is the expert testimony.  Is there some reason the court shouldn’t accept this expert testimony?

Your denial of what a psychiatrist has diagnosed and ordered treatment for would only be considered an instance of your "lack of insight: (into your mental disorder).

[QUOTE]– the same is not true of schizophrenia.[/QUOTE]

In fact, with schizophrenia your best bet for getting a different diagnosis and avoiding drugging with neuroleptics is to change your race from an ethnic minority to someone of European descent.
Quick Reply
Cancel
7 years ago  ::  Dec 17, 2007 - 6:38PM #9
mindis1
Posts: 7,910
[QUOTE=LittleBuddha73;146018][QUOTE]You won't find the claim that "what [people] feel doesn't really exist" made by any of the psychiatrists or psychologists I quoted, nor by any of the many other anti-psychiatrists. Knocking down straw men doesn't help anything. [/QUOTE]

Perhaps not, but it’s the same thing – stating that because evidence “A” doesn’t exist, the condition doesn’t exist, regardless of the fact that evidences “B,” “C,” “D,” etc. exist.[/QUOTE]

I have no idea what that is supposed to mean.  None of psychiatrists or psychologists I quoted or referred to have made any claim such as "what people feel doesn’t really exist."  The problem is the arbitrary and subjectively-assessed diagnosis that certain feelings are diseases, and prescribing "treatments" that have shown to result in poorer outcomes compared to non-treatment and, other than that, are inefficacious.

[QUOTE]In any case, most psychologists and psychiatrists agree that mental disorders are a result of multiple factors, most often a biological predisposition (genes, etc.) compounded by one or more social/emotional/mental experiences.[/QUOTE]

I notice you haven't presented any data showing that any psychiatric entity is a medical disease.  Nor did anything you quoted present any evidence that "mental disorders" are medical diseases. 

[QUOTE]For instance, diabetes and schizophrenia alike are viewed as the result of interactions between biological, psychological, and sociocultural influences. [/QUOTE]

For some reason people love claim that there is an analogy between diabetes and "mental disorders".  There is no analogy whatsoever.  Diabetes is diagnosed by an objective test, and its etiology is well established.  Neither can be claimed about any psychiatric entity. 



Is there some reason you didn’t answer this question:

If psychiatric entities are medical diseases, then how can these so-called diseases completely be eradicated by a vote?

?

You can’t eradicate diabetes by voting it out of existence.
Quick Reply
Cancel
7 years ago  ::  Dec 19, 2007 - 12:09PM #10
LittleBuddha73
Posts: 1,399
[QUOTE=mindis1;146374]In 1969, you would have been committing a crime by having sex with a person of the same sex, an act caused by the "mental disorder" homosexuality.  Courts order involuntary confinement and mandatory drugging all the time for such "mental disorders"--even when there is no evidence that a "mental disorder" has ever caused anyone to break the law.  So why shouldn't you have been likewise treated in 1969 for being a lesbian?
The list of conditions considered "mental disorders" by the APA today is much more extensive than it was in 1969. 
There is no objective assessment of risk of committing a crime when ordering involuntary confinement or mandatory drugging for a "mental disorder".  In fact, the risk of people diagnosed with "mental disorders" committing a crime is extremely low.  I'm fairly sure studies have shown that people diagnosed with schizophrenia are no more likely to commit a crime than those not so diagnosed.[/QUOTE]
I’m not talking about crimes here. I’m talking about disorders that cause people to injure themselves or others, consciously or unconsciously.

[QUOTE]Not if someone is informing on you, or a witness is testifying against you.  If a psychiatrist testified to the court in 1969 that you have the "mental disorder" homosexuality and are in need of conversion therapy, then that is the expert testimony.  Is there some reason the court shouldn’t accept this expert testimony?[/QUOTE]
Why would anyone inform on me if they had no idea I was a lesbian? Are you talking about someone just deciding they hate me and want to get me into trouble? In that case, the example doesn’t apply here at all.

[QUOTE=mindis1;146388]I have no idea what that is supposed to mean.  None of psychiatrists or psychologists I quoted or referred to have made any claim such as "what people feel doesn’t really exist."  [/QUOTE]
You are being black and white again. Your references may not have said this directly, but they are implying it.

[QUOTE]I notice you haven't presented any data showing that any psychiatric entity is a medical disease.  Nor did anything you quoted present any evidence that "mental disorders" are medical diseases.  [/QUOTE]
Definitions, definitions. My point here is not to dispute that mental illnesses are related or not related to physiological lesions. My point is not to dispute that mental illnesses are or are not medical diseases. My point is that your references imply that mental illnesses do not exist at all, or should not be treated, or cannot be cured, etc.

http://www.ocf.berkeley.edu/~ziah/Psych … ethods.pdf  - See page 4 - there are a million more items of research that show changes in brain activity or differences in brain structure between those with mental illnesses and without. But I'm sure you know that.

[QUOTE]Is there some reason you didn’t answer this question:

If psychiatric entities are medical diseases, then how can these so-called diseases completely be eradicated by a vote? [/QUOTE]
No, I guess I just missed it. In any case, I’ve already stated that I’m not arguing whether or not psychiatric entities are medical diseases. And as for the vote method (if it is true), I’m sure there is a far better and more objective way to determine whether or not something is an illness or not, so I agree with you here.

[QUOTE]You can’t eradicate diabetes by voting it out of existence.[/QUOTE]
You can’t truly do so with a mental disease either.
Quick Reply
Cancel
Page 1 of 32  •  1 2 3 4 5 6 ... 32 Next
 
    Viewing this thread :: 0 registered and 1 guest
    No registered users viewing
    Advertisement

    Beliefnet On Facebook