Friday, May 25, 2012

Who Speaks for the Disabled?

Today's Chicago Tribune (page 25) includes the ostensibly pro-family perspective of attorney William Choslovsky. I'm mainly in favor of respecting the choices of families over those of self-proclaimed advocates, and certainly over those of state bureaucrats.

However, it is absolutely critical to presume, first of all, that the disabled may speak for themselves. It's only when an individual disabled person clearly does not speak for him or her self, that we may ethically consider anybody else's choice.

This is more complicated than it looks because disabled people do not really speak for themselves when they cannot pay, in addition to when they are actually incapable of speech. For that matter, to the degree that any of us cannot pay for or independently create what we want, we are all "disabled".

Many Americans may sincerely wish to live in the White House, but they must respect highly ritualized choices of around a hundred million fellow citizens on that, and they only have one chance every four years. This is not an entirely different kind of conflict from one where a profoundly retarded person sincerely wishes to live in their own home, but cannot work to pay the mortgage. Who speaks for another is not an entirely different kind of question from who depends on whom.

Hopefully we each depend, first of all, on ourselves. After that we have families, friends, community groups, organizations and governments, more or less in that order. Who speaks for us is closely tied to whom we depend on. It just has to be.

It's not a question of who, in all cases, ought to speak for the disabled. It's a separate question in each case, which is inextricably bound up with the particular relationships and dependencies of the individual disabled person.

If Johnny murdered his girlfriend and was found not guilty by reason of insanity, and mom and dad have the idea that Johnny was adopted after all, so it's probably a genetic mental illness and they can't help him, then maybe Johnny is not represented any better by mom and dad than he is by the state, when they say he needs to take anti-psychotic medication for the rest of his life. And in fact, if Johnny can't pay for his own private attorney, he'll sure have to deal with other agendas.

NAMI has served the interests of medical psychiatry and pharma for thirty years with a heavy pretense of being all for families who know what's best for their own mentally ill. Obviously it's not always true. Sometimes people just want a magic pill, and they can be fooled. Calling a person disabled can be a power play, too.

I worked for a client who was at Choate Mental Health Center in Anna, IL. That's the facility offered by William Choslovsky as an example of a campus with real community life, where Rita and Kevin Burke's son Brian lives happily. My client would certainly argue that Choate was a prison for him, and the state should close it and every institution like it.

He speaks for himself, and I agree with him.

Monday, May 14, 2012

Another proposed resolution...


WHEREAS, Systematic review has been undertaken over the past decade at national, state and local governmental levels, and in collaboration with private and not-for-profit research, regarding strategies to address potential incidents that could have large-scale health consequences including disease outbreaks, natural disasters and terrorist attacks; and

WHEREAS, The U. S. Department of Health and Human Services, after conducting its own review of these issues, published a National Health Security Strategy of the United States of America in December, 2009; and

WHEREAS, The 2009 HHS Strategy is replete with statements recognizing an overarching necessity to convince the people to trust and independently cooperate, at the individual, family and community levels, with organized efforts by authorities in the amelioration of any significant health incident; and

WHEREAS, Contrary to these overarching security needs for broad trust and cooperation, notable social trends now exist toward increasing public doubt and cynicism, especially with regard to medical science and health care; and

WHEREAS, An example of such doubt and cynicism was a New York Times book review in 2009, which characterized Americans' recent love affair with modern psychiatry as a sub-prime crisis waiting to happen; and

WHEREAS, Over the last several years, the American Psychiatric Association and the world community of mental health professionals have been in an uproar regarding the general validity of psychiatric diagnosis, as evidenced by incessant protests over the new paradigm of "dimensional" definitions of mental disorder to be established in 2013 by the publication of the fifth revision of the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5); and

WHEREAS, Endemic, spectacular and increasingly frequent media stories of health care fraud and falsified medical studies are not conducive to pubic confidence in and cooperation with authority on issues of health; and

WHEREAS, An ultimate security threat might entail a catastrophic failure of confidence in authority and cohesion in the face of disaster; therefore

BE IT RESOLVED BY THE LEGISLATURE, That a fundamental distinction shall be recognized: between practical and empirically-proven medical science and clinical health care practices, as opposed to popular or academic scientism embodying mere theories or wishful thinking about easy solutions to human behavior and magic pills for all unpleasant life experiences; and be it further

RESOLVED, That our government shall refrain whenever possible from forcing, coercing or deceiving families or individuals into health care solutions which they do not choose themselves by fully informed consent; and be it further

RESOLVED, That human emotions and complex behavior are not realistically a subject for, and may never be amenable to, medical management, especially such management as should ever be attempted by any state medical or mental health bureaucracy; and be it further

RESOLVED, That fundamental and vital principles of any health security strategy shall be free and honest information, open dialogue, and collaboration with the people.

Friday, May 11, 2012

Suggested Resolution to be Introduced in State Legislatures and/or the U.S. Congress


WHEREAS, Love and loss are two sides to the same coin of human connection; and

WHEREAS, Bereavement, especially traumatic bereavement such as comes with the sudden death of a spouse or a child, may bring existential grief and the darkest hours of human experience; and

WHEREAS, We cheapen and demean our own humanity and disqualify ourselves from loving, if we merely label the grief of mourning as a "mental illness" on a par with biological dysfunctions like diabetes or cancer, to be "cured" with a pill; and

WHEREAS, A psychiatric diagnosis of depression can be misapplied to a person who is grieving; and

WHEREAS, The several editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) published since 1980 have defined depression, or Major Depressive Disorder, in terms of a checklist which has included sadness as a symptom tending to indicate a diagnosis; and

WHEREAS, An exclusion of sadness due to bereavement, as a symptom of mental illness needing medical treatment, was reduced from one year in the American Psychiatric Association's DSM-III (published in 1980) to two months in DSM-IV (published in 1994); and

WHEREAS, The proposed bereavement exclusion in DSM-5 (to be published in May, 2013) is only two weeks, meaning for example that the bereaved parent of a child lost to murder or suicide, or the spouse of a dead husband or wife of 50 years, would be labelled mentally ill for grieving longer than two weeks and encouraged to take powerful, expensive and potentially dangerous psychotropic medications; and

WHEREAS, Many experts in diverse mental health fields believe this DSM-5 scheme will be patently unscientific, arbitrary and potentially harmful to patients and clinical practice; therefore

BE IT RESOLVED BY THE LEGISLATURE, That all people have a natural human right to grieve for life's losses, and especially for losses of loved ones; and be it further

RESOLVED, That no one should be judged as having a medical or mental disorder because of normal sadness over significant loss; and be it further

RESOLVED, That the right to grieve without being labelled as ill may not be limited to any short time of a few weeks or months, because each individual must face bereavement in his or her own way and in his or her own time, and for many genuine grief over the loss of a loved one lasts for life; and be it further

RESOLVED, That our Government shall always recognize human grief and human love alike as precious to life itself, existential, and ultimately beyond the scope of mere scientific medicine.