Question

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.

Sigh, it’s benign

Notebook entry on October 2, 2018

9:10 am, waiting room. People rushing, apologizing for minutes. The parking lot was full. “I’d like to make an appointment.” “How about next month?” Holding time to cram us in. This mole is new and dark in the middle of my chest. From a pale pore to an odd shape. An island, collecting the sun of my life. Forming near my heart. Doctor, please see me. 

Bioethics topics to explore

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.