Marta Russell wrote:
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> In Jeffrey's case it was a misdiagnosis. He never was ADD, he is
> bipolar and the speed drug was the wrong thing to put him on.
I think a distinction needs to be made here. Misdiagnoses can have various sources, only some of which are institutional, some of which are merely human error, and some of which are a matter of the current scope of medical knowledge. I think from the perspective of a half a century or so _all_ current diagnoses of unipolar depression will be seen as misdiagnosis. Unipolar depression _probably_ doesn't exist, it is merely a "placeholder" as it were for a number of different diagnoses which further advance in neuropsychiatry will reveal. Some institutional arrangements (reflecting the balance of political power) encourage a greater incidence of human error, but under all conditions such error will occur. (In the past, many suffering from bipolar were diagnosed as schizophrenic -- but that was due to the current stage of knowledge, not to either human error or capitalism.)
A recent series in the Chicago Tribune focused on the spread of infections in hospitals by bad practice. Some of its revelations were startling: over half of physicians and nurses do _not_ wash their hands after contact with one patient before contact with a second patient. One physician wore the same scrubs to and from work for many days at a time without laundering them. But again this has to be divided between more or less unavoidable error and forced error, from understaffing, etc. Political action could change the latter.
It is perhaps somewhat easier in psychiatry than in many medical specialties to be a lazy incompetent prick and still make a lot of money.
And an absolute precondition for real progress in psychopharmacology is to put the drug companies out of business and pay for research with public funds. That won't be easy!
Carrol