>Often these kind of "reports" are written by professionals who have
>conflicts of interest and push their preferred methods for career
>reasons.
Wouldn't your argument end up making all knowledges of interested parties -- doctors, scientists, patients, patients' families, patients' advocates who take donations, etc. -- inadmissible? Sufferers of all illnesses have a subjective interest in avoiding treatments that are painful in themselves and/or have painful side effects (whether or not such treatments are effective), which in part explains the difficulty of adhering to the drug-taking regimen -- the difficulty that is compounded by mental illnesses. In any case, having social interests -- including an interest in profit-making -- is not necessarily contradictory to effective knowledge production. Evaluation of the quality of knowledge cannot be reduced to the identification of knowledge producers' non-cognitive social interests.
>I don't know about Richard Glass but this statement is wrong:
>
>> As currently practiced, ECT
>> involves the use of informed consent, ultra-brief general anesthesia
>> and muscle relaxants ......
>
>Electroshock is going on without informed consent.
>
>There is a case going on right now in New York -- Paul Henri Thomas is
>being forcefully shocked against his will at PILGRIM PSYCHIATRIC
>CENTER . His lawyers have been trying to stop it in the courts.
>
>http://mindfreedom.org/mindfreedom/paul.shtml
To repeat myself, whether electroconvulsive therapy is effective in treating depression & other mental illnesses is not at all the same question as whether involuntary admission & treatment are ever justified. One may very well join a civil rights campaign on behalf of Paul Henry Thomas & others, without campaigning to ban ECT, for instance.
I've looked into the case of Paul Henry Thomas:
***** Newsday (New York, NY) March 3, 2001 Saturday NASSAU AND SUFFOLK EDITION SECTION: NEWS, Pg. A07 HEADLINE: His New Battle; Patient takes fight against electric shock treatment to court BYLINE: By Andrew Smith; STAFF WRITER
Paul Henri Thomas, a former Haitian human rights activist, is now an American citizen championing a different cause:the right of psychiatric patients to refuse forced electric shock therapy.
As in Haiti, he counts himself among the oppressed here. Thomas, 49, has been a patient at Pilgrim Psychiatric Center in Central Islip for the past 22 months, where he has received shock therapy between 30 and 50 times.
Pilgrim psychiatrists say he needs to be shocked because he has schizophrenic affective disorder, a form of psychosis that in Thomas' case shows itself through manic, delusional behavior.
Thomas says he's fine. He's not mentally ill, so he doesn't need shock treatment, he says. If anything, Thomas says, shock treatment makes his life worse.
"After the treatment, it is just as if I came back from nowhere," Thomas said during a court hearing Friday. "I am surprised I am myself...It is not a pleasant experience."
The hearing was held to determine whether Thomas is psychologically competent to refuse shock therapy. If state Supreme Court Justice W. Bromley Hall determines he is competent, the focus of the hearing will turn to whether shock treatment is appropriate for Thomas. If Hall decides Thomas is not competent, the hospital may proceed with therapy, despite Thomas' wishes.
Thomas and his plight have become an international cause. Anti-shock therapy Web sites urge viewers to rally behind him.
Friday's hearing took place in a cramped courtroom in Building 69 on the Pilgrim campus. About 30 activists, some from as far away as Syracuse, gathered outside. Although Thomas waived his privacy rights and Hall assured the public it could attend, state Office of Mental Health officials made the activists unwelcome.
Pilgrim police officers made them stand outside in the snow for hours until court was in session and then allowed only five to sit in the courtroom. Pilgrim police also threatened news photographers with arrest if they took pictures on campus. Police followed a group of activists to make sure they were photographed beyond Pilgrim's property line.
Dr. Robert Kalani, Pilgrim's associate medical director and the director of electroconvulsive therapy there, testified that Thomas came to Pilgrim in May 1999 when he became unmanageable at South Nassau Community Hospital in Oceanside.
Thomas' psychiatric problems date to 1977, when he had a breakdown while living in Haiti.
Kalani said shock treatment is appropriate for Thomas because years of taking psychotropic drugs have damaged his liver. Thomas still takes 3,000 milligrams of Depakote and 1,200 milligrams of lithium a day. Depakote and lithium are mood stabilizers.
During questioning by Assistant Attorney General Laurie Gatto, Kalani said Thomas is not competent to decline shock treatment. Evidence of that is Thomas' belief that he's not even mentally ill, Kalani said.
"He does not appreciate the consequences of refusing treatment," Kalani said.
Kalani also said Thomas' illness is apparent in how he communicates. He has "pressured speech"-he speaks rapidly-and needs to be frequently redirected or else his answers to questions quickly ramble off the topic. For example, Thomas responded to one question during an interview about how he was functioning by listing his educational background, Kalani said.
But Thomas' attorney, Kim Darrow of the state Mental Hygiene Legal Services, suggested that Thomas gave his education as an example of how well he was functioning.
But Thomas' own sister, Mary Ann Pierre-Louis of Elmont, testified that he cannot function in society. Before his transfer to Pilgrim, Pierre-Louis said, Thomas was out of control.
"He was playing with his feces," she said. "He said he was doing an experiment."
Later during the hearing, Thomas said he didn't recall that, adding that if he had been experimenting with feces he would have known enough to have worn latex gloves.
"My brother is sick," she said. "We know it. My brother is very ill."
Thomas' answers on the witness stand were frequently elliptical, often unrelated to the question and sometimes completely incoherent. At times Darrow struggled to follow his client's answers.
"What are we talking about now?" Darrow said in confusion at one point.
Thomas' speech was slurred and his hands trembled, a result of the psychotropic medicine he took when he was younger, according to his doctors.
But Dr. Ron Leifer, a Syracuse psychiatrist hired by Darrow, testified that he agreed Thomas had no major mental illness.
"If he's suffering from delusions, so am I," Leifer said. "His speech is not disorganized, if you have the patience to listen to him. He always comes back to the point."
Thomas' refusal of shock therapy is well reasoned, Leifer said.
"Shock treatment is very unpleasant, and because he believes he's not mentally ill, it doesn't make any sense," Leifer said.
During cross-examination by Gatto, Leifer stood by his diagnosis and added that everyone suffers from some kind of personality disorder.
The hearing will continue next week. *****
Since Thomas doesn't want ECT, it shouldn't be forced upon him. That's the civil libertarian position, and a necessary one. Where does that leave him, though? Back to the psychotropic drug regimen only? Or liberation from psychiatry, since "he believes he's not mentally ill"? Who is to take care of him? His sister who says he was "out of control," "playing with his feces," before his transfer to Pilgrim & ETC?
Yoshie