Why is nonconsensual, compulsory treatment widely accepted in mental healthcare? Why are many in the medical and bioethics community so certain that the “insane” are undoubtedly unfit to choose for themselves? Who is to say? Who is to decide what is the most whole/beautiful/meaningful/ “right” existence of another?
* Thinking specifically about nonconsensual electroconvulsive therapy (ECT) in schizophrenic patients, some who deny their diagnosis and treatment. See the case PBU & NJE v Mental Health Tribunal from 2018 in Victoria. Essentially, the patients won and were freed from forced treatment. For those on the side of patient advocacy and autonomy, this was good news. However, this ruling upset some psychiatrists and bioethicists.
Can the mentally ill, as certain medical systems see them, make rational, autonomous decisions for themselves? Do certain emotions halt capability to reason? Can anyone make autonomous decisions for themselves? Or are we all embedded in and influenced by altered/unaltered choice/default design?
Future-mindedness is as much the distinctive mental habit, and intellectual corruption, of this century as the history-mindedness that, as Nietzsche pointed out, transformed thinking in the nineteenth century. Being able to estimate how matters will evolve into the future is an inevitable byproduct of a more sophisticated (quantifiable, testable) understanding of process, social as well as scientific. The ability to project events with some accuracy into the future enlarged what power consisted of, because it was a vast new source of instructions about how to deal with the present. But in fact the look into the future, which was once tied to a vision of linear progress, has, with more knowledge at our disposal than anyone could have dreamed, turned into a vision of disaster… Anything in history or nature that can be described as changing steadily can be seen as heading towards catastrophe. (Either the too little and becoming less: waning, decline, entropy. Or the too much, ever more than we can handle or absorb: uncontrollable growth.) Most of what experts pronounce about the future contributes to this new double sense of reality—beyond the doubleness to which we are already accustomed by the comprehensive duplication of everything in images. There is what is happening now. And there is what it portends: the imminent, but not yet actual, and not really graspable, disaster.”
Fifteen micrograms of acid, on a sliver of paper, washed down with a glass of water. This is my medicine of choice.
I microdosed 1P-LSD from April to December 2017 following a regimen: one day on, threeish days off. It’s been over a year since I stopped that routine and tapered my dosing to as-needed for mood support.
Eight months is a bit longer than most ~microdosing experts~ recommend. Online sources typically suggest six weeks or three months, but that’s mostly speculative. Any recommendations for continued psychedelic use (and all psychiatric medicine?) are relatively inexpert given our still premature understanding of the brain. When it comes to intimate psychological issues, there is no single cure for what has complex—and largely unknown—causes. No one knows which precise treatment or prescription will work for anyone. Especially in people with discreet or hard-to-diagnose issues, who experience difficulty communicating, or who are especially young or old. It’s all an experiment. That’s what the medical community has been doing, as well as a few rogue individuals.
Psychedelic researchers, advocates, and skeptics alike met on February 13th, 2019 in Melbourne for the Mind Medicine Australia launch. Fresh from San Francisco and eager to meet people in this city also interested in psychedelic medicine, I bought an early-bird ticket.
February 13th, 2019, 5:30 PM. At this point in life getting ready to go out involves more time bopping around with acid under my tongue than looking in the mirror. Microdosing quells my zapping nerves and oftentimes overactive mind, especially before larger gatherings.
So I took a small dose before biking to the University of Melbourne for the Mind Medicine launch. The bats weren’t out yet, but they would be soon, and the air was a perfect 23°C. I locked my bike, tried to tame my helmet hair, and entered the Sidney Myer Asia Centre. Immediately greeted, thick lashes ushered me to the left. More smiling eyes appeared around the corner, showing the way upstairs. I entered the full, bustling theater.
There were only a few seats left. Everyone was finding their space, finding their friends. I sat down in the back and observed the crowd. No matter if it’s in Melbourne, London, Berlin, or San Francisco, the general attitude and sense of psychedelic conferences remains the same: compassionate, curious, positive, and present. There’s this shared understanding, communicated with kind and sometimes cheeky glances that say: “We’ve seen a glimpse of the possible. That’s why we’re all here.” It’s usually a clash of characters, buttoned-up scientists, artists. The kind of people you might bond with at a music festival and never see again are there, anticipating a lineup of lectures.
Sound cultish? It really shouldn’t. People from all edges of the earth have been interested in psychedelic medicine and its potential for millennia. Many aboriginal people wonder what took us so long to make the connection. This goes beyond a Reddit thread.
“Hi neighbor,” the man next to me introduced himself. He was wearing a sheen suit and said he wanted a job.
Migration as a bioethics issue — not allowing people to migrate physically (from asylum seeking to relocation for better opportunity and simply travel) and mentally (with psychoactive substance or mind-altering experiences) is a bioethics issue. Regulations on migration, travel, and drug use serve some and harm many.
The ethics of psychiatric diagnosis/prescription vs. self-medication — the current psychiatric system also serves some, but hurts many, and moving from the doctor-patient power imbalance to patient empowerment could be a solution. This research would seek information about people who do not receive psychiatric treatment (for reasons from ability to financial), who do not benefit from current pharmaceuticals, and who already know which drugs they want to try — whether from their psychiatrist or from the street. Do you know people who go to the doctor knowing what they’ll be asking for? Isn’t this doctor-approved self-medication? Do you know people given drugs by doctors that they wouldn’t take on their own, that might even make them seem worse? (Thinking strictly re: psychiatric medicine, not for example, cancer treatment.) Is self-medication really the problem authorities should fight or should they provide wider education and harm reduction instead? Reference: Portugal. Will the information age cut out doctors as the middle men between patients and their preferred medicine? This would reference Our Right to Drugs by Thomas Szasz, among others.