Update on Karina.

[Cheshire]

Well, it seems they've re-diagnosed her with some psych condition and decided she does not have capacity to make decisions. That strips her of the right to have free will and make bad choices, in Europe at least. If "bad" decisions like "choosing" to stay in bed all day, not engage in self care/grooming/feeding etc. are deemed to be the result of mental incapacity, then the mental health legislation over here gives them the right to make her what in Ireland we call a ward of court. Seems Denmark is much the same in that the state has appointed her a "guardian".

I just read the legal texts for France, and I think you could be sent to a psychiatric ward similarly, but you've got the right to consult any lawyer or any physician you wish, this second opinion choice has been refused to Karina. Does that right exist in Denmark? It seems a basic human right.

 

[Sidereal]

I just read the legal texts for France, and I think you could be sent to a psychiatric ward similarly, but you've got the right to consult any lawyer or any physician you wish, this second opinion choice has been refused to Karina. Does that right exist in Denmark? It seems a basic human right.

Same here in Ireland, you are entitled to a lawyer and a tribunal. But the second psychiatric opinion will just go along with the first. You know how doctors are, they close ranks.

 

[MeSci]

It's alarming to read on the page linked by @Art Vandelay that:

She sits in a wheelchair, makes facial grimaces and mumbles to herself. She is thin and pale.

It worries me that she may now be seriously mentally ill as a result of her treatment.

I have been in isolation (for infection control) in hospitals and well know the feeling of going 'stir crazy'. The second time was worst. There were multiple bleeps going off almost constantly, starting and stopping unpredictably, all different, in time with each other, out of time with each other...many were just on TVs and furniture so completely unnecessary. I had no phone contact, no radio, no TV, and not even somewhere I could sit comfortably to read and write.

I felt my sanity slipping very quickly and was close to discharging myself the first night due to the crazy cacophony of bleeps. Others (in the ward opposite - I opened my door to try to get help and heard the discussions - I wasn't supposed to open my door) were complaining about them too, and some bleeps were finally silenced.

To be stuck for as long as Karina has been with no contact with friends or family and no prospect of escape - how long can anyone stay sane?

OTOH, she is said to be in a wheelchair, so moving her would be much easier than if she were in a bed.

 

[CantThink]

I think it would be better to try to make a case that regardless of one's beliefs about the aetiology of her symptoms, the treatment has objectively made her worse and is clearly not working so it would be in her best interests to be discharged from the institution she is currently in.

My heart goes out to the family. This is the stuff of nightmares. I must say when I was severely ill, I stopped interacting with the medical profession completely and did not go to my GP ever, not even for an unrelated problem, because I know how the system works and was afraid of falling into the state's clutches like this. I think it's preferable to stay under the radar and risk dying of a preventable cause in one's own bed/home instead of being tortured by nurses and physiotherapists in some hospital ward.

Regarding the first paragraph - I agree... Perhaps we can launch a mass approach towards the state guardian to push for her to be moved to another facility and removed from the 'care' of these two doctors. If she can be moved to another facility where presumably her family (or at least some of them) can visit her and, just as importantly, she can get a second opinion from an M.E. specialist that might help.

Regarding the second paragraph - I have had exactly the same approach. I stay away. I mention M.E. as little as possible of I do have to see a doctor (if I can get away without mentioning it. I choose that path). I'd rather die naturally than because I'd been locked up and forcibly deteriorated.

 

[CantThink]

To be stuck for as long as Karina has with no contact with friends or family and no prospect of escape - how long can anyone stay sane?

OTOH, she is said to be in a wheelchair, so moving her would be much easier than if she were in a bed.

I agree. It's heartbreaking to read this. When I'm stuck bed or housebound, it drives me crazy sometimes. The first opportunity my mum has to move me if I get a bit of improvement, she gets me in the car and just drives me around so I get a different view than my 4 walls. I literally feel like a hermit coming out of its cave.

So with that being said, I just cannot imagine not only being locked inside but never seeing my family (even prisoners have more rights!), and on top of that being disbelieved... To fight for oneself when one is so ill in those circumstances I feel is almost impossible. Eventually they beat the spirit down (like deconstructing the person).

I believe that these doctors have been purposefully trying to harm her with the social isolation... to literally cause a psychiatric illness. In the Western world we recognise how damaging isolation is... Animals that are isolated quickly display repetitive and anxious behaviours that reflect their distress.

The wheelchair thing is interesting - perhaps forced? It doesn't sound as if she had improved in any way to merit being moved from a bed to a wheelchair.

I wonder if Karina was ever tested for Lyme disease. It certainly sounds as if her neurological symptoms at the beginning of her sectioning would have warranted testing.

 

[adreno]

Regarding the second paragraph - I have had exactly the same approach. I stay away. I mention M.E. as little as possible of I do have to see a doctor (if I can get away without mentioning it. I choose that path). I'd rather die naturally than because I'd been locked up and forcibly deteriorated.

Me too. I never mention ME when I (rarely) see doctors, only very specific symptoms. And at the first mention of psych issues from the doctor I'm out the door immediately.

 

[CantThink]

There is a petition here:
https://secure.avaaz.org/en/petition/Justice_for_Karina/share/
https://secure.avaaz.org/en/petition/Justice_for_Karina/share/

 

[chipmunk1]

I just read the legal texts for France, and I think you could be sent to a psychiatric ward similarly, but you've got the right to consult any lawyer or any physician you wish, this second opinion choice has been refused to Karina. Does that right exist in Denmark? It seems a basic human right.

I am sure it does in theory but in practice it doesn't always work like that. I think Denmark is not the problem. Psychiatrists need little evidence or no evidence to declare someone insane if they want to.

Such cases are not unusual in psychiatry and i have read about such stories occuring in other parts of the world. It is not limited to ME. There was case in germany where a man who was perfecly sane was declared insane and commited to a psychiatric hospital where he stayed for for 7 years.

http://www.theguardian.com/world/2012/nov/28/gustl-mollath-hsv-claims-fraud
http://en.wikipedia.org/wiki/Gustl_Mollath

Keep in mind that:

• Karina had been seen by 3 psychiatrists that did find her mental state to be normal.
• 
  
• Hammel Neurocenter stated that she was not psychotic.
• 
  
• Karina's parents were accused of holding her against her will and damaging her. They have never been taken to court indicating that these accusations were baseless.
• 
  
• This reminds one of Munchhausen per proxy where one or both parents intentionally harm their child(a minor) in order to get attention from healthcare providers. Karina is 24 years old.
• 
  
• If this had been the case it would have been up to Karina to decide if she had been held against her will and if she had been damaged. Since her position was deemed irrelevant by per Fink one has to conclude that he views her to be a minor.
• 
  
• Karina has been diagnosed with pervasive refusal syndrome a controversial child psychiatric disorder that is not even included in standard psychiatric classification schemes. According to medical literature there are no reports indicating that this syndrome occurs in adults.

 

[Cheshire]

I don't know what a second opinion would bring on, but she has not even had that oportunity! She would have more rights if she were in jail.

 

[MeSci]

I wonder if Karina was ever tested for Lyme disease. It certainly sounds as if her neurological symptoms at the beginning of her sectioning would have warranted testing.

Has she had any biological tests? Maybe just initially - the ones used to 'rule out' other illnesses, which lead ignorant docs and psychs to assume that negative results mean that there cannot be anything organically wrong?

 

[MeSci]

There is a petition here:
https://secure.avaaz.org/en/petition/Justice_for_Karina/share/

Unfortunately, although it is in the Avaaz system, which usually indicates quality, it's not a properly-worded petition. What's needed is one that addresses specific targets and demands specific action of them.

E.g. To/Dear Prime Minister

We the undersigned request that you....

plus some background info for the target and the signatories.

 

[Sidereal]

I agree. It's heartbreaking to read this. When I'm stuck bed or housebound, it drives me crazy sometimes. The first opportunity my mum has to move me if I get a bit of improvement, she gets me in the car and just drives me around so I get a different view than my 4 walls. I literally feel like a hermit coming out of its cave.

So with that being said, I just cannot imagine not only being locked inside but never seeing my family (even prisoners have more rights!), and on top of that being disbelieved... To fight for oneself when one is so ill in those circumstances I feel is almost impossible. Eventually they beat the spirit down (like deconstructing the person).

I believe that these doctors have been purposefully trying to harm her with the social isolation... to literally cause a psychiatric illness. In the Western world we recognise how damaging isolation is... Animals that are isolated quickly display repetitive and anxious behaviours that reflect their distress.

The wheelchair thing is interesting - perhaps forced? It doesn't sound as if she had improved in any way to merit being moved from a bed to a wheelchair.

I wonder if Karina was ever tested for Lyme disease. It certainly sounds as if her neurological symptoms at the beginning of her sectioning would have warranted testing.

Maybe she looks so sick and doped up because they are forcing her to sit in a wheelchair instead of lying down. They obviously don't know that postural abnormalities/changes are extremely important in this disease. We all know when you have severe or very severe ME sitting up is impossible for more than a few seconds or minutes as it results in low BP and brain hypoperfusion. When I was in a similar state (though nowhere near as severe as Karina), if I sat up for more than a few minutes I'd get altered mental status from lack of blood/oxygen in the brain.

 

[Sidereal]

Has she had any biological tests? Maybe just initially - the ones used to 'rule out' other illnesses, which lead ignorant docs and psychs to assume that negative results mean that there cannot be anything organically wrong?

It sounds like she was hospitalised some years ago in what they're calling an "arthritis hospital" which presumably means a rheumatology ward or hospital so they probably did some testing then?

 

[CantThink]

Has she had any biological tests? Maybe just initially - the ones used to 'rule out' other illnesses, which lead ignorant docs and psychs to assume that negative results mean that there cannot be anything organically wrong?

I have a suspicion that they haven't tested her for anything useful... Imagine if she got tested by KDM and someone like Klimas - I bet something would show up.

 

[chipmunk1]

more about pervasive refusal syndrome.

here in this article this seems to be viewed as a psychiatric illness of the mother based on psychoanalytic ideas.

http://ccp.sagepub.com/content/10/3/337.abstract

Abstract
Five children from asylum-seeking families required hospital care due to serious loss of function arising in the ‘limbo’ conditions in which they were living as refugees. Hopelessness, helplessness and an uncertain time perspective dominated family life; they had not worked through the traumas of the intolerable life from which they had fled. The massive loss of functions in the children resembles that of pervasive refusal syndrome (PRS), but the purposive aspect of the refusal seemed less pronounced. Treatment applying the principles for managing PRS was rapidly successful. The fixed behaviour of the mothers - staging a delusion/fantasy that the child was dying - was interpreted as a desperate coping strategy. It made the situation ‘understandable’ and bestowed on them a role and a meaningful function. Improvements in the children were not noticed until the mothers gave up this ‘lethal’ mothering. The interplay between parents and their children seemed of greater importance to the child than the information provided by the actual circumstances of their lives. The hypothesis about ‘lethal mothering’ presented here adds a psychodynamic perspective to the theory of ‘learned hopelessness and helplessness’; both are seen as relevant in understanding the devitalization reported here, and for understanding and treating PRS more generally

http://www.ncbi.nlm.nih.gov/pubmed/19458987

Abstract
Pervasive refusal syndrome (PRS) is a rare child psychiatric disorder characterized by pervasive refusal, active/angry resistance to help and social withdrawal leading to an endangered state. Little has been written about PRS. A literature search yielded only 15 relevant articles, all published between 1991 and 2006. This article presents a critical review of the published literature, illustrated by a case report of an 11-year-old girl. PRS most often affects girls (75%). The mean age of the known population is 10.5 years. A premorbid high-achieving, perfectionist, conscientious personality seems to play an important role in the aetiology of PRS, as can a psychiatric history of parents or child and environmental stressors. PRS shows a symptom overlap with many other psychiatric disorders. However, none of the current DSM diagnoses can account for the full range of symptoms seen in PRS, and the active/angry resistance can be considered as the main distinguishing feature. Treatment should be multidisciplinary and characterized by patience, gentle encouragement and tender loving care. Hospitalization, ideally in a child and adolescent psychiatric unit, is almost always required. Although the recovery process is painfully slow (average duration of therapy 12.8 months), most children recover fully (complete recovery in 67% of known cases). In our opinion, it is important to increase knowledge of PRS, not only because of its disabling, potential life-threatening character, but also because there is hope for recovery through suitable treatment. We therefore propose an incorporation of PRS into the DSM and ICD classifications. However, an adaptation of the current diagnostic criteria is needed. We also consider PRS closely related to regression, which is why we introduce a new concept: "the refusal-withdrawal-regression spectrum".

they can't seem to agree how it should be treated and what causes it. some advocate replacing the parents and giving the child the love it did not get and others recommend eliminating the mother, i meant eliminating the mother's delusions.

i wonder how they know what a suitable treatment is as there have been no controlled studies to date it seems.

 

[CantThink]

So we have a name of someone involved in the legal side -

Jakob Skjoldan, a Danish lawyer, believes that many laws have been broken in this case and has written to the Danish Minister of Health listing some of these violations and asking him to look into the case. The letter will be posted in English when a translation is available.

(from the FB update posted earlier)

I don't know when the new Danish Minister of Health was appointed, but it seems that until he has responded that door is still open (so to speak).

I found a website (others than the FB page) which gives details about ways one can help: Justice for Karina

Particularly of note is:

Write Letters
Please consider writing to danish officials, your embassies, journalists and everyone else you think might be able to get involved and make a difference.

You can find a template letter here, and a list of adresses here.

Please note that all letters must be polite and non-threathening. We all feel very passionately about Karina's situation, but impolite or threathening letters can do irreversible damage to those directly involved in Karina's legal case.

 

[MeSci]

some advocate replacing the parents and giving the child the love it did not get and others recommend eliminating the mother, i meant eliminating the mother's delusions.

i wonder how they know what a suitable treatment is as there have been no controlled studies to date it seems.

I didn't get love from my parents but still did the usual things - going to school, etc. I was very lacking in confidence, so poor at socialising. I bunked off school sometimes, pretending to be ill (not very often) and didn't always do as I was told. Is that an illness too? If so, there is probably a major epidemic of it...

 

[CantThink]

From: http://www.diagnosticrights.org/1491-2/karina-hansens-painful-fight-for-justice/

Matters of Human Rights

The CDR is a medical organization focused on ethics, so our concerns always center on patient’s rights – especially the right of an ill patient to medical care from her doctor. While patients’ rights are a indeed a special kind of human rights, there are also central human rights issues that arise in a case like this, and it’s important to acknowledge those directly at the outset.

In any democratic society there are provisions in place to ensure multiple voices are heard when decisions must be made for those who cannot make decisions for themselves. These include:

1. Prior determinations of wishes on record.
2. Legal power of attorney, that is, someone specified by a patient who will make sure her medical wishes are known and respected in the event that she is unable to speak for herself.
3. Choice of attorney. Patients with Karina’s foresight and intelligence secure an attorney when there seems to be a threat of forcible treatment looming. The attorney, along with the legal power of attorney, ensure that doctors can never tyrannically dictate the course of a patient’s life when she becomes incapacitated.

In Karina’s case, however,

1. Medical wishes on record were overridden when compliance was forced through the physical strength of five police officers. At this time there still has been no date set for a hearing on the legality of Karina’s forcible detainment and treatment. After fourteen months of detainment without medications for excruciating pain, clearly this violates Karina’s right to due process.
2. The authority of Karina’s legal power of attorney, her parents, to make decisions on her behalf has been ignored by Hammel, and that egregious violation of rights has been supported by the Court. The appointment of a guardian who accepts her forcible detainment and withdrawal of medications in no way mitigates the seriousness of this act on the part of the Court. It is a clear violation of rights for a dissenting legal power of attorney to be silenced in favor of a new appointment who does not express dissent against the Court’s opinions.
3. Karina’s choice of attorney has been ignored by the court. Her inability to organize and express her desire to see her attorney, or her desire to fight for her rights, has been caused by Hemmel’s own actions and cannot justly be construed as assent.

The details of Karina’s world – the roles of her doctors, her parents, and her lawyers – have been dictated by her psychiatrist to an extent that is truly staggering, in a way that very clearly violates fundamental human rights. Moreover, her psychiatrist has taken the extra step of barring visitation and phone conversation with all those who disagree with forcible detainment and withdrawal of medications. Yet again, the court has granted him this indefensible level of authority. While in cases of involuntary treatment for psychiatric illness psychiatrists do have the power to determine visitation, Hammel’s claim to a medical approach makes it impossible to defend this intrusion into the personal relationships of a patient.

It is the view of the Coalition that human rights violations in the case of Karina Hansen urgently require, and clearly deserve, immediate remedy on the part of the Danish government. Moreover, these violations warrant action on the part of human rights watchdogs because, while such organizations generally prefer not to interfere in individual medical or mental health cases, it cannot be reasonable for injustice to stand merely because it is perpetrated upon a patient. Every case where human rights are violated to this extent, and with this degree of clarity, cries out for action on the part of the human rights community.

N.B. my bolding and underlining.

According to this excellent letter from the CDR - http://www.diagnosticrights.org/the...-minister-of-health-on-karina-hansens-behalf/ (which lists 10 violations of human rights - very interesting for those following this case/situation), Amnesty International Denmark and Human Rights Watch Brussels along with other organisations were copied into the letter... So they are well aware. Thus partly answers my earlier question, but also begs a further question... What are they doing about it and if nothing, then why not?

 

[chipmunk1]

The details of Karina’s world – the roles of her doctors, her parents, and her lawyers – have been dictated by her psychiatrist to an extent that is truly staggering, in a way that very clearly violates fundamental human rights.

he is not "her" psychiatrist. He is a doctor who believes only he has the right to treat her and got rid off her doctors and caretakers with the help of courts.

 

[A.B.]

Fink behaves like the guru of a sect: "If only you let me control all your life, everything will be fine". When Karina Hansen refused to, he took control by force. The man should be locked up and probably needs antipsychotics to counter his delusions.