Original SDMB thread mandatory medicating


Hi, becd. I'm a person who has been diagnosed (at various times) "paranoid schizophrenic" and "manic-depressive" (now known as "bipolar disorder"). I do not take psychiatric medications and I'm part of an international movement of current and former mental patients against forced psychiatric treatment.

a) All initial psychiatric diagnoses are made on the basis of subjective interpretations of behavior. They can't test your blood for elevated levels of "schizophrenerase" or anything. Even when the doctors stick very rigidly to the diagnostic criteria of the DSM-IV it remains subject to a wide range of immediate interpretations, and in practice they don't stick that tightly to them. In short, the things that can get you a major-psychosis psychiatric diagnosis are behaviors (and possible interpretations of them) that could apply to anyone under a wide range of circumstances.

b) Because, again, they can't test your blood, no one ever gets pronounced "cured". Once a schizophrenic, always a schizophrenic. In other words, most subsequent psychiatric diagnoses are made on the basis of having a psychiatric history and then disrupting, annoying, or disturbing someone, or complaining of being upset confused or disturbed themselves.

c) Psychiatric medication is, at absolute best, a mixed-bag experience for those who have been put on it. Some people find that it enables them to function, to get on with their lives. Others state that it feels as if someone scooped out their brains and replaced them with cotton wadding, that they can't think and can't feel anything strongly enough to care. Yet others say that it gives them horrible waking nightmares. With rare exceptions (such as lithium), psychiatric medications cause permanent brain damage if you are on them for long, as well as a very wide range of somatic and cognitive and emotional side effects.

In summary, in order for the psychiatric system to be able to force your granddaughter to take psychiatric medication against her will, it would be the case that a huge number of people who are competent people who aren't hurting anyone, people who would be doing just fine in the absence of psychiatric interference, would be forced to take a mind-altering substance that robs them of their sense of self and makes them feel like a zombie, and in many cases subjected to permanent and debilitating brain damage.

I think that's an incredibly horrid idea.

As it currently stands, if your granddaugher were found to be an immediate danger to herself and/or other people (i.e., is violent right now), she could be subjected to involuntary psychiatric medication in every US state that I know of. If she were incarcerated as an involuntary mental patient, in some states (NY for instance) she would retain the right to refuse unwanted psychiatric medications until and unless a court hearing (separate from commitment) determined that she lacked capacity to make decisions, and if she lost that hearing she could be forced to take psychiatric medications. In some states, there exists such a thing as involuntary outpatient commitment, in which people are released to live in the community but are subject to psychiatric system control over their lives, which usually takes the form of requiring them to take psychiatric meds. In order to be subject to involuntary outpatient commitment, in most venues it would be necessary to demonstrate in a commitment hearing that the individual in question becomes dangerous to self and/or others unless medicated, and that the medication makes it safe for them to be in the community.

Apparently, because you consider many your granddaughter's decisions and priorities and behaviors to be bad ones, you would wish to extend this range of involuntary treatment.

In contrast, we want the officially acknowledged, overtly stated right to choose to embrace our natural mental condition if we do not wish to be "treated" or "cured".

We wish to be subject to the same laws of the land regarding behavior and conduct that apply to other citizens. In general, people are arrested and charged and convicted and punished, within the confines of due process, for things that they did and not for things that some doctor thinks they might do. In the case of people with psychiatric diagnoses, statistics don't seem to support the conventional notion that we are more violent on average than anyone else. Even if we were, we should still only be responsible for what we actually do. (After all, males are statistically more likely to be violent but we don't lock men up to ensure public safety at night).

A psychiatric diagnosis should not have any legal ramifications in and of itself, and should not be admissable evidence in a competence hearing. If someone is incapable of making their own decisions, lacks insight into situations or is incapable of arriving at conclusions based on rational consideration of the relevant information, it should be possible to demonstrate this without reference to psychiatric labels. And no adult for whom incompetence cannot be demonstrated using the same yardstick of competence that would allow you to take away your Dad's checkbook and prevent him from signing a bank loan contract should be forced to take mind-altering medication.

You may believe that you can assess whether or not your granddaughter is a responsible person at any given time, and that therefore you are in a position to state that she is a responsible person when she takes her meds but that when she doesn't, she isn't. Quite aside from the little inconsistency problem with that formulation (one of the responsible things she does when she is on meds is to go off her meds, indicating that in the state of mind that you regard as desirable she chooses the other one; and if you think it appropriate to overrule that decision you are in essence saying that she is never truly responsible in the sense that she should be regarded as an adult capable of making her own decisions), there's a general problem with extending that claim and making it the law of the land. There needs to be a narrow and conservatively tailored legal standard for determining who gets to be regarded as a responsible person. We can't have every grandmother (or granddaughter) who says she is responsible but that her granddaughter (or grandmother) is only responsible when drugged up on something she doesn't want accorded automatic credibility at face value, now can we?

If you think her incompetent to make her own decisions, such as a person with advanced Alzheimer's or a person with dramatically subnormal intelligence would be, you could precipitate a competency hearing and have a guardian appointed. The guardian could elect to order involuntary psychiatric medication in lieu of her own ability to make that kind of decision as an incompetent person.

But outside of that it's just your opinion and has -- and should have -- no more validity than her possible opinion that you should be drugged up and put in a nursing home ought to have.


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