"stigma" of psychiatric treatment, again 
Author Message
 "stigma" of psychiatric treatment, again

I just heard a news story about a man in Quincy, Illinois.
Apparently he showed up in an ER complaining of chest pains
shortly after a robber had held a gun to his head.  They
checked him out, found nothing wrong with his heart, and
suggested he was probably suffering from "post-traumatic
stress syndrome" and that he should stay overnight.

They also reported his stay to the state, which pulled
his gun license.  Apparently, Illinois law will not allow
anyone to own a gun who has ever been treated in a hospital
for any mental disorder.

At no time during any of this was there any suggestion that
he might be a danger to himself or others.  He has filed an
appeal of the revocation; I'll post the results if I hear
about them.
--
                                --Andrew Koenig



Mon, 05 Jun 1995 23:21:05 GMT
 "stigma" of psychiatric treatment, again

|> I just heard a news story about a man in Quincy, Illinois.
|> Apparently he showed up in an ER complaining of chest pains
|> shortly after a robber had held a gun to his head.  They
|> checked him out, found nothing wrong with his heart, and
|> suggested he was probably suffering from "post-traumatic
|> stress syndrome" and that he should stay overnight.

This must have resulted, of course, from the application of
the objective criteria used in diagnosis that we have seen
referred to recently.
--
Gary H. Merrill  [Principal Systems Developer, C Compiler Development]
SAS Institute Inc. / SAS Campus Dr. / Cary, NC  27513 / (919) 677-8000



Tue, 06 Jun 1995 05:04:28 GMT
 "stigma" of psychiatric treatment, again

|>
|> Please note, however, that the person in the PTSD example was not held
|> against his will, and other than psychiatrists made the "diagnosis."

There is more scary here than who makes the diagnosis, of course.  A question
I raised in an earlier posting (and was unanswered either because it is
so very difficult to answer or because it was simply skipped over as
relatively insignificant) is, I think, quite germane.  That is, what
counts as malpractice in areas of this sort?  If we are really talking
about diseases and criteria for diagnosing and classifying diseases, then
there should be pretty clear criteria for malpractice, as there are in
other areas of medicine (please don't take this to imply that malpractice
is always straightforward to establish -- I'm concentrating on the
conceptual issues here).

The case described briefly by Andrew Koenig appears to me to be a real
candidate for a malpractice claim.  It seems that an analogous case in
internal medicine or surgery (one in which I had suffered physically
or financially or by having my rights affected in some manner) would
be actionable *unless* it could be demonstrated that something like
"reasonable and customary practices" had been followed.  But in *this*
case if the claim is made that "reasonable and customary practices"
were followed, then something is dangerously wrong.  And it doesn't
*matter* whether the doctor in question is a resident or a board
certified psychiatrist.

What I am saying is that there is a cluster of concepts in medical
practice and medical science (involving disease, treatment, methodology,
responsibility, and others) that are closely related.  But it is not
obvious how closely related these are in psychiatry or how analogous
their employment and meanings in psychiatry are to their roles in other
areas of medicine.  Frequently, however, I have seen psychiatry made
an exception on the grounds that it is not as much a "hard science"
as are other areas of medicine.  But this smacks of seeking respectability
without responsibility, of milking an analogy while it works *for*
you, but choosing to abandon it when you will be stuck with unpleasant
consequences.  The issue of what counts as malpractice in the types
of cases in question cuts to the heart of how good a fit the "medical
model" is for psychiatry.  I don't claim to have a final answer to this,
but I do have some fundamental concerns about this fit.  And the goodness
of fit has rather sweeping consequences for the justification of practice.

Beyond this, the case described by Koenig illustrates a transfer and
abuse of power that is independent of whether psychiatry fits well into
the medical model.  When "due process" becomes some resident (or an
experienced board certified psychiatrist) calling a bureaucrat and
having my rights restricted, a travesty has occurred.

--
Gary H. Merrill  [Principal Systems Developer, C Compiler Development]
SAS Institute Inc. / SAS Campus Dr. / Cary, NC  27513 / (919) 677-8000



Wed, 07 Jun 1995 02:51:57 GMT
 "stigma" of psychiatric treatment, again



|>

|>    |> I just heard a news story about a man in Quincy, Illinois.
|>    |> Apparently he showed up in an ER complaining of chest pains
|>    |> shortly after a robber had held a gun to his head.  They
|>    |> checked him out, found nothing wrong with his heart, and
|>    |> suggested he was probably suffering from "post-traumatic
|>    |> stress syndrome" and that he should stay overnight.
|>
|>    This must have resulted, of course, from the application of
|>    the objective criteria used in diagnosis that we have seen
|>    referred to recently.
|>
|> Do you,  by any chance,  draw distinctions between medicine
|> and politics?  It would seem that this is an application of
|> the later and not the former,  hardly a good support for your
|> statement.

Between *medicine* and politics, yes.  Between *psychiatry* and politics,
... see my posting in response to Jim Kent.  (See also the long history
of psychiatry in the Soviet Union.)
--
Gary H. Merrill  [Principal Systems Developer, C Compiler Development]
SAS Institute Inc. / SAS Campus Dr. / Cary, NC  27513 / (919) 677-8000



Wed, 07 Jun 1995 03:27:24 GMT
 "stigma" of psychiatric treatment, again

Quote:
> resulted , of course, from the application of the objective criteria....

Gary, I'm 100% with you on this one.  I'm certain that over 90% of the
people carrying that diagnosis do _not_ meet the objective criteria.  I do
wish that you would arrange to meet someone with an acute exacerbation (long
medical word for flare-up) of schizophrenia.  They are entirely different
from the people you meet who "carry the diagnosis.

I looked at Toxic Psychiatry in a bookstore last night.  Other than talking
about {*filter*} that weren't on the market in 1968, it looked like a rehash of
Szaz's work.

Please note, however, that the person in the PTSD example was not held
against his will, and other than psychiatrists made the "diagnosis."

Jim



Tue, 06 Jun 1995 23:44:56 GMT
 "stigma" of psychiatric treatment, again


   |> I just heard a news story about a man in Quincy, Illinois.
   |> Apparently he showed up in an ER complaining of chest pains
   |> shortly after a robber had held a gun to his head.  They
   |> checked him out, found nothing wrong with his heart, and
   |> suggested he was probably suffering from "post-traumatic
   |> stress syndrome" and that he should stay overnight.

   This must have resulted, of course, from the application of
   the objective criteria used in diagnosis that we have seen
   referred to recently.

Do you,  by any chance,  draw distinctions between medicine
and politics?  It would seem that this is an application of
the later and not the former,  hardly a good support for your
statement.

--

Snail:         11 Cambridge Center,  Cambridge,  MA  02142
Disclaimer:    I don't know if OSF agrees with me... let's vote on it.
Amateur Radio: KC1KJ



Tue, 06 Jun 1995 19:18:41 GMT
 
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