(OT?) "Psychiatry during the Nazi era: ethical lessons for the modern professional"

[Dolphin]

Somebody posted this on another forum I'm on.

I don't think it is really that important but might be of interest to the odd person.

As well as being somewhat interesting on the role of psychiatry in society, it clarified medical ethics a bit (I didn't know a lot about it but can see why strict rules in research are important).

Review

Psychiatry during the Nazi era: ethical lessons for the modern professional

Rael D Strous

Department of Psychiatry, Beer Yaakov Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Annals of General Psychiatry 2007, 6:8doi:10.1186/1744-859X-6-8


Received: 2 December 2006
Accepted: 27 February 2007
Published: 27 February 2007

2007 Strous; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
For the first time in history, psychiatrists during the Nazi era sought to systematically exterminate their patients. However, little has been published from this dark period analyzing what may be learned for clinical and research psychiatry. At each stage in the murderous process lay a series of unethical and heinous practices, with many psychiatrists demonstrating a profound commitment to the atrocities, playing central, pivotal roles critical to the success of Nazi policy. Several misconceptions led to this misconduct, including allowing philosophical constructs to define clinical practice, focusing exclusively on preventative medicine, allowing political pressures to influence practice, blurring the roles of clinicians and researchers, and falsely believing that good science and good ethics always co-exist. Psychiatry during this period provides a most horrifying example of how science may be perverted by external forces. It thus becomes crucial to include the Nazi era psychiatry experience in ethics training as an example of proper practice gone awry.

Full free text at: http://www.annals-general-psychiatry.com/content/6/1/8

I see there is one commenter who thinks the author was too soft on the psychiatrists and complains about those in schools of clinical psychiatry and psychology!

 

[Dolphin]

Although an extreme view, I have found reading some of what Thomas Szasz says about psychiatry interesting:
http://www.szasz.com/manifesto.html
e.g.

Separation of Psychiatry and the State. If we recognize that "mental illness" is a metaphor for disapproved thoughts, feelings, and behaviors, we are compelled to recognize as well that the primary function of Psychiatry is to control thought, mood, and behavior. Hence, like Church and State, Psychiatry and the State ought to be separated by a "wall." At the same time, the State ought not to interfere with mental health practices between consenting adults. The role of psychiatrists and mental health experts with regard to law, the school system, and other organizations ought to be similar to the role of clergymen in those situations.

It is interesting how with ME/CFS, psychiatry has got intermingled with the State particularly in some countries e.g. the UK. For example, psychiatrists promote the view that GET and CBT based on GET can give patients back the ability to work, and one can see from boards they have been involved in, they promote the view that State benefits shouldn't really be given long-term and/or can impair recovery. Proponents of other therapies such as (non-psychiatric) drug therapies seem less inclined to get involved in such areas.

 

[Lucie]

Current practices regarding ME in the UK, and the use of psychiatry in the Nazi era, remind me of the punitive psychiatry in the Gulag Archipelago. If memory serves me correctly, it was the intellectuals who were branded mentally ill in that scenario. Governments calling somebody crazy to discredit their truth seems to be a trick that has been around for a long time.

 

[Countrygirl]

I have a quote from an ex-psychiatrist, which caught my eye (I don't recall his name).

"I am no longer a psychiatrist. I renounce it because I believe cruelty is at the core of the profession. I believe that there is something inherent in the profession that tends to bring out any cruelty lurking within."

C.G.

 

[flybro]

I have a quote from an ex-psychiatrist, which caught my eye (I din't recall his name).

"I am no longer a psychiatrist. I renounce it because I believe cruelty is at the core of the profession. I believe that there is something inherent in the profession that tends to bring out any cruelty lurking within."

C.G.

I'm not sure but I think it was richardson

 

[Dr. Yes]

Hey guys,

That quote is by John Diamond, a former psychiatrist, from his book "Facets of a Diamond".

 

[Countrygirl]

Hi Dr. Yes.

Hey guys,

That quote is by John Diamond, a former psychiatrist, from his book "Facets of a Diamond".

Absolutely right, Dr. Yes! Just testing. :Retro smile:

 

[muffin]

Always exceptions but...

I have long thought that shrinks were nuts and went into psychiatry/psychology to better understand their own issues. THEN, one actually TOLD me that was why he went into psychiatry!

When my husband was first sick five years ago, and not sleeping, I took him to about 8 different shrinks. Only one of them was a decent and normal person and really did want to help him with sleep issues (the start of his CFIDS subset that I gave him). The rest were nuttier than the rest of the general public. Sounds mean, not a big number of shrinks for me to make that assessment, BUT, some of those people were really scary!! One shrink was trying to place my husband's sleep problems on ME!!! The guy had issues with women and his mother in particular, so, off he went to push his theory that my husband was mad at his dead mother and at his "controlling" wife - that would be me, the sick woman who ran him all over the place to every doctor I could get him to - all the while falling asleep in every doctor's office due to my own CFIDS. And I am still mad at some of those "doctors" - my husband was physically sick!

A topic I should NOT be allowed to go near, obviously....

Calling someone crazy, especially when that person is a female, is the easiest way to damn that person and people believe it without question. Using insanity as a means to control a population and put the "troublemakers" away has been used in the Soviet Union, East Germany, and all the other state controlled states. So Reeves and Wessely knew this and picked crazy and psychiatric issues as a way to destroy a patient and keep other doctors from trying to deal with those sick people. And that is what happened with CFIDS. Any doctor who treated the nutty CFIDS people was a quack themselves. And it worked quite well for three decades - but it isn't working anymore, not with the huge amount of valid research out there and the Internet and it's ability to level the knowledge playing field. No longer do we have to believe and trust any expert when we can jump on the Internet, Google for the information and become almost expert in any issue - if we spend enough time and energy learning and reading. Many of you guys are a perfect example of knowing more about CFIDS/ME and the whole virus stuff than most doctors do - and that includes the ones that concentrated in those areas.

Oh my. Rambling again...

 

[Dolphin]

ECT may not be the best example as there are probably pros and cons but it appears from this letter in the Irish Times that Dr. Barry is saying that getting a treatment that is "effective" is a human right and giving treatment without their consent is acceptable.
I get the impression that some UK psychiatrists see that ME/CFS would also qualify and that GET and CBT based on GET should be a bit more than simply voluntary choices.

Comment Letters

The Irish Times - Monday, December 14, 2009

ECT without consent

Madam, – The College of Psychiatry of Ireland has concerns regarding some of the reports that have been recently published concerning ECT and the effect these may have on patients, current and previous, who benefit from this treatment or who may require treatment in the future.

The college has committed to participating in all-party briefing with members of the Dil on ECT which would allow both sides of the debate to be fully aired and to also correct for the public record inaccuracies and misrepresentations that have been expressed.

Some mental illness requires treatment against the person’s wishes, including prescribed ECT, and this human right to be given effective treatment is ethically founded, and bounded by law and regulation. All doctors are properly ethically required to protect and uphold this right to treatment. The college has argued and made constructive proposals as to how this regulation can and should be strengthened, but prohibition of ECT would remove a treatment that research shows as conferring benefit in 80 per cent or more of people who receive it.

We ask for restrained and balanced presentation of the evidence. It should be remembered, because of stigma, many remain silent on its benefits, and it is their right to effective treatment that we seek to protect, a right all campaigners should be mindful of defending while seeking to strengthen the regulation. The alternative is to deny treatment for some of the most severely mentally ill, and we cannot ethically support this. – Yours, etc,

Dr SIOBHAN BARRY,

Consultant Psychiatrist

Director,

External Affairs Policy,

College of Psychiatry of Ireland,

Fenian Street, Dublin 2.

 

[Mithriel]

Cliched as it is I have known some good psychologists and psychiatrists. Mental diseases occur and are dreadful for sufferers.

What is needed is balances and checks to keep the profession and practices from becoming skewed. They should acknowledge the mistakes that have been made - epilepsy as hysteria, autism and refrigerator mothers instead of assuming that it is all in the past and things are great now.

The mental health profession must admit that it is open to abuse and safeguards must be put in place.

Reflective practice is the keynote of modern nursing and it should be used at all levels of medicine. I don't really know the answer but something must be done.

The arrogance and disdain for their patients found in the profession is breathtaking.

Mithriel