Psychiatry/Psychology Archives - Page 2 of 3 - Protection of Conscience Project Library

Of Pills and Needles: Involuntary Medicating the Psychotic Inmate When Execution Looms

Julie Cantor

Extract
The coalescence of involuntarily administered antipsychotic medications and competency for execution created a novel and controversial issue that became the basis of Singleton’s final appeal. The Arkansas Supreme Court stated the question succinctly: May the State ”mandatorily medicate [Singleton] with antipsychotic drugs in order to keep him from being a danger to himself and others when a collateral effect of that medication is to render him competent to understand the nature and reason for his execution[?]” Or, as Singleton put it, “Am I too sane to live, or too insane to die?” The cynical view of that question is that Singleton was clever and manipulative. Like most people, he would do just about anything to forestall his death. The more charitable view is that Singleton found an Achilles heel in the execution process and physicians’ involvement with it, one that created what some physicians consider to be an intolerable dilemma.

Cantor J. Of Pills and Needles: Involuntary Medicating the Psychotic Inmate When Execution Looms. Indiana Health L Rev. 2005;2(1):119-172.

(Correspondence) Abortion perils debated

Linda Capperauld

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
Not only is the article by David Reardon and associates1 flawed . . . but the authors, particularly the lead author, have a specific and known political bias against abortion rights. . . By publishing an article that does not adhere to high standards, we feel that CMAJ has done a disservice to our field, not to mention women and their families across the nation.

Capperauld L. (Correspondence) Abortion perils debated. Can Med Assoc J. 2003 Jul 22;169(2):101.

The Killing of Psychiatric Patients in Nazi-Germany between 1939-1945

Michael Von Cranach

Israeli Journal of Psychiatry and Related Sciences

Abstract
Between 1939 and 1945, 180,000 psychiatric patients were killed in Nazi Germany. This paper opens with a brief discussion of the reasons for addressing this issue today; it is followed by the details of the so-called euthanasia program that entailed killing of patients by gas in special hospitals in the years 1939-1941, and in psychiatric hospitals in the years 1942-1945. In this latter period, patients were killed with lethal injections and through the introduction of a starvation diet. The fate of the Jewish patients and forced laborers, as well as the experiments conducted on the patients, are mentioned. Finally, some thoughts are presented to answer the question of why this could have happened. To me, the giving up of individual responsibility in an authoritarian system leads to the loss of the individual conscience and soul, including those of a psychiatrist.

Cranach MV. The Killing of Psychiatric Patients in Nazi-Germany between 1939-1945. Israeli J Psych & Related Sciences. 2003;40(1):8-18

A presentation by the same title with a similar abstract was presented at a meeting of the Israel Psychiatric Association, Jerusalem, 6th of December 2001.

(Correspondence) The tragedy of abortion

Luis Huaypaya

Extract
Cook and Howe (Can Med Assoc J 1984; 131: 539) state that “a possible tragedy was avoided” by recommending an abortion to a pregnant woman with schizophrenia. What constitutes a tragedy may be considered from different perspectives, and I would like to suggest an alternative view. It can be considered a tragedy that many well-intentioned health professionals believe that suppressing a life is an appropriate way of preventing human suffering. . . that many childless couples have to wait years to adopt while thousands of potentially adoptable children . . . are prevented from being born . . .

Huaypaya L. (Correspondence) The tragedy of abortion. Can Med Assoc J. 1985 Jan 15;132(2):93-96.

(Correspondence) Abortion denied – outcome of mothers and babies

Wendell W Watters

Extract
Apparently Dr. Carlos Del Campo (Can Med Assoc J 1984; 130: 361, 362, 366) consulted only a small portion of the literature in concluding that it shows “no evidence that a continued unwanted pregnancy will endanger the mother’s mental health”. He ignored the Aberdeen study, . . .Dr. Del Campo was very selective in examining the work done in Czechoslovakia. . . the conclusion to be drawn from these studies is that termination of an unwanted pregnancy is likely to be beneficial to a woman’s mental health if it is her choice to exercise this option, whereas mandatory motherhood is likely to be harmful to her mental health. This conclusion is consistent with my clinical experience of 20 years in working with couples and families, as it is with that of many other family psychiatrists.

Watters WW. (Correspondence) Abortion denied – outcome of mothers and babies. Can Med Assoc J. 1984 May 15;130(10):1264, 1266.

(Correspondence) Therapeutic abortion

Robert Halliday

Extract
As a psychiatrist I have examined many patients who were referred for emotional or psychological assessment and, where appropriate, I have recommended that the pregnancy be terminated. . . While I am prepared to agree that in this area there may be dispute, nevertheless it is quite different from the so-called “abortion on demand”, which has no ethical medical basis. . . The solution would be to train and legalize abortionists, who would not be physicians, to perform abortion on demand, a procedure that has nothing to do with the ethical practice of medicine..

Halliday R. (Correspondence) Therapeutic abortion. Can Med Assoc J. 1975 August 23;113(4):276-278.

(Correspondence) Unwanted pregnancy and abortion

CW Kok

Extract
. . . A common error made by physicians is that they assume a responsibility that is not theirs. When a healthy woman becomes pregnant it is her responsibility and it is certainly not the duty of the physician to terminate the pregnancy. . . . .

. . . If it is a depression one has to treat the depression, not the pregnancy. We are using the wrong diagnosis to escape from a difficult decision. To justify an abortion one must be sure that health will be permanently damaged, as in a patient with chronic nephritis or one at risk of heart failure. . . .

. . . .The lack of guiding principles has created a very disturbing situation. A most disturbing thought is that those who are unwanted can be disposed of. This happened to the Jews in Nazi Germany and it happens in all totalitarian states. . . .Throughout history, people were first dehumanized, not regarded as people, then used or killed. . .

. . . Physicians’ attention must be focused on preventing the occurrence of those situations in which abortion may be justifiable. . . The Oath of Hippocrates should serve as a means of drawing the members of the medical profession together irrespective of religious or philosophical differences. As it is now, we are the passive onlookers of a debate between fanatically rigid groups.

Kok C. (Correspondence) Unwanted pregnancy and abortion. Can Med Assoc J. 1975 Feb 22;112(4):419-420.

(Correspondence) Wilful exposure to unwanted pregnancy

Carol A Cowell

Extract
. . . the term unwanted pregnancy . . . I use . . . simply to denote a pregnancy in a patient who does not want a baby. . . If he is implying that some of these patients use pregnancy as a club with which to beat their parents over the head, I would certainly agree. . .The “wilful exposure to unwanted pregnancy” syndrome certainly must be one of psychodynamic origin. . . . when are our psychiatric colleagues going to come forward with positive, practical steps to help alleviate it?

Cowell CA. (Correspondence) Wilful exposure to unwanted pregnancy. Can Med Assoc J. 1975 Feb 08;112(3):274.

Attempted abortion by the use of bishyrdoxycoumarin (case report)

NST De Jager, NF Boyd, AD Ginsburg

Extract
The use of an oral anticoagulant in an attempt to induce abortion has not previously been reported. . . Her knowledge of its effects stemmed from two episodes of heavy vaginal bleeding which had been ascribed to the drug. It is felt that in this way she sought to rid herself of a pregnancy which she believed would disrupt her life. In common with almost all patients who knowingly ingest anticoagulants illicitly, she persistently denied self-medication. With adequate psychiatric and social service assistance the underlying problems were resolved and the pregnancy was concluded successfully with the birth of a live infant…

Jager ND, Boyd NF, Ginsburg AD. Attempted abortion by the use of bishydoxycoumarin. Can Med Assoc J. 1972 Jul 8;107(1):50, 53-54.

(Correspondence) Abortion Act in Practice

Myre Sim

British Medical Journal, BMJ — British Medical Journal

Extract
The Act does not give Dr. Hughes the right to castigate those psychiatrists who, acting “in good faith,” are seriously in doubt as to whether an abortion is justified, and for good reasons know that support and treatment would be at least as effective as abortion in dealing with the problem be it-social or medical. They have ample clinical evidence- to support the ” good faith ” of their decisions . . .. It would be of great interest to see- what factual evidence could be produced to support the many decisions to abort under the present Act.

Sim M. (Correspondence) Abortion Act in Practice. Br Med J. 1969 Apr 5;2(5648):50-51.