Diagnosing Dangers


As I wrote in my first blog, A Three Pronged Approach to Mental Health System Change, after I read Mad in America in 2002, the Law Project for Psychiatric Rights (PsychRightsÂź) was formed to mount a strategic litigation campaign against forced psychiatric drugging and electroshock.  Since then, PsychRights has won four Alaska Supreme Court decisions holding various aspects of Alaska’s adult involuntary commitment and forced drugging regime unconstitutional or otherwise illegal.

In defending such involuntary commitment and forced drugging cases, PsychRights has not challenged the diagnosis per se, or the invalidity of the diagnosing process as a whole, because the person seems clearly crazy and I have felt that challenging a diagnosis of “mental illness” in such circumstances would only serve to destroy my credibility in arguing that the person should not be locked up and forced to take the drug(s) against their will.

This tactical decision does not mean I don’t recognize that diagnosing, itself, can be very harmful.  One obvious harm is the stigma that attaches once one is diagnosed, especially, a diagnosis of serious mental illness, such as schizophrenia.  People with such labels can immediately lose their jobs and essentially become unemployable.  They often become social outcasts, that has been described as “social death.”

In fact, the legal system often recognizes that having such a psychiatric diagnosis can be harmful.  For example, in Alaska, where I practice, psychiatric respondents (those on the wrong side of the locked door and at the the sharp end of the needle) have the right to have commitment hearings closed from the public in order to protect their reputations.  As an aside, they also have a right to have them open to the public, a right which is ignored except in the cases I take because I ask my clients their preference after discussing the pros and cons.

There are other harms from diagnosing.  Just consider a diagnosis of “personality disorder.”  To me, any profession that tells people they have a personality disorder has mainly served to expose itself as not a healing profession.

I do know that some people find getting a diagnosis comforting to have a name put on the trouble they are having, but I would suggest this is a false comfort.  Accepting that one has a brain disease, must give up any hope of a full life, and must take debilitating drugs for the rest of their lives that will only allow one, at best, to spend one’s time in a day treatment room watching television and smoking cigarettes is not truly helpful.  One thing that it does is remove responsibility for gaining control of one’s life, which is harmful in itself.

Of course, the extreme harm caused by the drugs for many is the obvious result and, indeed, I would say is ultimately the purpose of most diagnoses.  That and to allow the diagnoser to get paid for their effort.

Let’s take a particular look at diagnosing mental disorders in foster children and youth.  These children are in foster care because they have been found to be the subject of abuse or neglect.  While many times these removals are not really warranted and it would be far better in any event to give the parent(s) help in being better parents, assuming the child or youth has been the subject of abuse or neglect, it is natural for the child or youth to “act out” in ways that disturbs the adults in their lives.  Then, no matter how bad the home situation might be, for most, removing them from their home is upsetting, which is also a reason for acting out.  The foster placements can be pretty horrific, which is another reason for a child or youth to be upset and act out.  Finally, many foster children and youth experience multiple rejections with many different foster placements.  It is not unusual for a youth who has been in foster care for many years to have been placed in 20 different foster homes without being adopted, which is the holy grail for most foster children.  The rejection and lack of permanency is also inherently upsetting.

Instead of giving them diagnoses and drugs, we should be giving them help in dealing with the natural emotions they are experiencing and most importantly, we should be giving them help to become successful.  At the end of a meeting I once had with the Alaska Commissioner of Health and Social Services when we were suing the State of Alaska over drugging children and youth in PsychRights v. Alaska, he said, “so what you are telling me is we should do a better job of diagnosing.”  After I pulled out my hair I said, “No, we should do a better job of not diagnosing.”

Whether it is adults or children, or seniors, for that matter, is it moral to give people dubious, harmful psychiatric diagnoses in order to get paid?

With respect to the dubious nature of psychiatric diagnoses, there are two books I heartily recommend.  The first, Schizophrenia: A Scientific Delusion, by Mary Boyle, Ph.D, analyzes the definition of schizophrenia and demonstrates that it is invalid as a classification, just considering that it does not distinguish schizophrenia from not schizophrenia.  They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal, by Paula Caplan, PhD, is an insider’s account of the unscientific process in promulgating DSM IV.  Now the American Psychiatric Association is preparing to adopt its Fifth Edition of the Diagnostic and Statistics Manual of Mental Disorders, commonly called “DSM5.”

Dr. Caplan is a leader of what is called the PLAN T Alliance (PLAN T stands for Psychiatric Labeling Action Network for Truth), which recently launched a petition against the DSM5.  As the PLAN T petition states:

It is increasingly clear that the editors of the major psychiatric manual, which reaps huge profits for the American Psychiatric Association that publishes it, are ignoring the massive evidence of harm done by the labels of previous editions of the manual and of likely harm from what they plan to put in the edition they are now preparing. Previous editors ignored the need for both reform of their work and concern for those it harmed, despite letters and petitions representing more than six million people. . . . The pledge we request here is one of the major kinds of action we recommend. It is a boycott. If you, like us, are deeply concerned about the lack of science behind the Diagnostic and Statistical Manual of Mental Disorders, the absence of evidence that it helps in identifying effective treatments, the absence of evidence that helps with outcome, and the abundance of evidence of people being seriously harmed by receiving a psychiatric label, as well as because the editors of the previous, current, and in-preparation editions of the DSM have been largely unresponsive to concerns expressed about these problems, please sign this petition as a statement that you take the pledge here below [to boycott the DSM].

In addition, a petition by the Humanistic Division of the American Psychological Association (Div. 32) protesting various aspects of the proposed DSM5 has garnered quite a few signatures.

Both petitions are worthy of support in my opinion.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Jim Gottstein, JD
Law, Alternatives and Change: Law, Alternatives and Change: A Harvard-educated lawyer and long time activist for change in the mental health system writes about law as it relates to psychiatric rights and fostering truly helpful, non-coercive alternatives to the current system. Jim's book, The Zyprexa Papers, chronicles the dramatic events surrounding his subpoenaing and releasing secret, damning Eli Lilly documents and surviving the resulting legal onslaught by Lilly, as well as his battles fighting the forced drugging of Bill Bigley for whose case the documents were subpoenaed.


  1. Thank you for your work, Jim! You are an inspiration to many.

    I think you are dead on about the negative and dehumanizing aspects of diagnosing. Instead of addressing this, the DSM-V Task Force is hell bent on making it worse, adding many new diagnoses, vain attempts to make the “science” of psychiatry more “legitimate” … as its credibility continues to crumble.

    You will likely not be surprised to know that at least 68% of the DSM-V task force openly admits significant financial ties to the pharmaceutical industry. In many cases, members of specific task forces (say… Psychotic Disorders, for example) are funded by the makers of drugs that treat those very disorders (anti-psychotics, in our example). It is shameful. More info on this issue here.

    Thanks again for your insights. I look forward to more!

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  2. I agree wholeheartedly and am thankful Jim’s remains a strong voice for freedom.

    But at this point, I have given up on my own account. I am not fighting the drugging anymore, nor the diagnosis of schizoaffective. I see my life ripped away from me, and nowhere to turn.

    I am told to be – and I am – grateful to have a separate roof over my head and food to eat. But without the DSM I might also have a relevant life, as I once did before diagnosis became an abnormal normal.

    God bless and keep up the great work!

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  3. Thank you for this article Jim. As an educator, I would totally agree with,

    “Instead of giving them diagnoses and drugs, we should be giving them help in dealing with the natural emotions they are experiencing and most importantly, we should be giving them help to become successful.”

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  4. I have also written a book challenging psychiatric diagnoses. THis is because psychiatry is atheistic, and has been falsely calling christiand and others with spiritual beliefs and experiences schizo for 50 years. 1 court psychologist said to me “if you believe in the bible you’re mntally ill”
    Freud the atheist father of psychiatry said “i consider myself to be the greatest danger to religion” he was speaking the truth.
    The nazis killed mental patients with psych meds n the t4 euthenasia program. This genocide has continued worlwide using mental health as a cover.
    This was a stealth genocide of christians, who they falsely called schizo; this has continued since.
    see my article
    The mental health system is front for nazi genocide”http://www.1prophetspeaks.blogspot.com/2011/08/mental-health-system-is-continuation-of.html

    My free book Manual for Transformational Healing-God’s Answer to psychiatry is at http://www.1prophetspeaks.com
    It exposes atheistic psychiatry & their genocide by toxic drugs, and tells how to heal mental & physical illness thru prayer.

    God sent me into the psych system to be a witness against it and write this book.

    Someone had prophesied to me at a christian prayer meeting, before this happened, “Im

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  5. I was warm, anxious, and loveable, a regular human being and kid, until I was 9. At 10 my Mom remarried, after a whole deacde of not once going out with a single guy, except for an office friend, and we had the whole wide world. The three months before I was 18, dad did an intervention. He got sober as a result. At 28, my whole family died, my Grandmother and Dad. The first year I got sober, my ex-fiancee with a double-PhD died. She was my mentor. I have been clean and sober, off pot, liquor, and tripweed, since 1998. I am lucky that I never did ANY hard drugs. Life has been…. horrible…. since 1998. I had to keep sober, but my only endgoal is NO mental illness, like before 1997. On the bright side: I downloaded some of the DSMV, just bought a desk, have my mother and step-mother, aunt, and her children still alive. Since turning bipolar 3 in 1998. I have been absolutely lost and shut off. I have not seen my step-family in 15 years, and my aunt and her children, in 35 years. I wrote a book with a working tittle, The Marriage of True Minds, for 34 years. I Thank YOU for adding me to your blog. This is my second time in any kind of print, so please excuse me, for writing such a long narrative therapy.

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  6. Thank you for this terrific article, Jim. I just want to add that the PLAN T Alliance (Psychiatric Labeling Action Network for Truth) has posted two action petitions: (1) the one petition you mentioned about boycotting the DSM and (2) the petition that absolutely anyone can sign, calling for Congressional hearings about psychiatric diagnosis. That one is at http://www.change.org/petitions/everyone-who-cares-about-the-harm-done-by-psychiatric-diagnosis-endorse-the-call-for-congressional-hearings-about-psychiatric-diagnosis

    We hope that people will sign either petition or both, help spread the word about both, and consider — if they are not connected with the CCHR or any other part of Scientology — joining the PLAN T Alliance, which they soon will be able to do by posting on our upcoming Facebook page with their name and bio or, if an organization, their name and mission statement.

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    • If the method of naming illnesses in the DSM are not scientific why are they treated as if they are real? What is the pathology for mental illness? Psychiatrists declare speech and behavior that they do not like or do not understand as mental illness. What psychiatrists say and do is offensive to others. So, what psychiatrists say and do can be mental illness under their own system.

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  7. Jim: As you know I am have full guardianship of an individual in prison who may end up facing civil commitment when he is let out of prison. During the past two years I have learned to be increasingly more distrustful of those who purport to be “mental health professionals” because I see virtually no evidence of their being professionals in the field of mental health. What I do see disgusts me to no end. I am deeply ashamed about what we, as a collective society, knowoingly and willingly allow to happen to people with mental illness.

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  8. Gottstein says he does not question the diagnoses. My question is why not question the illness? If as Paula Caplan states the DSM illnesses are not defined scientifically what makes them real? If only psychiatrists can see mental illnesses what does that say about the viewers or the objects they view? What role does advertisements (public relations, propaganda), campaign contributions to politicians play in creating the market for taxpayer funded psychiatry? David Rosenhan revealed that psychiatry cannot distinguish between sane and insane (see YouTube videos). What makes psychiatry anything more than personal opinion masquerading as science? When an “expert” makes a diagnosis in court why not challenge the “illness” then. Make them provide scientific evidence. They cannot do that.

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  9. I should have been clearer that PsychRights’ strategy of not challenging diagnoses is in the defending against involuntary commitments and forced drugging context. In other contexts, I think it would be very worthwhile to challenge diagnoses and the invalidity of the whole diagnosing system.

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    • Why not challenge the unscientific nature of the illness, in the settings of forced drugging and involuntary commitment? Is the reason that it will be a lengthy maneuver, while the client gets drugged and is held? No psychiatrist can show evidence of an illness in the body. They use color pictures of brains but how is that evidence of illness? What is the causal connection between color pictures and speech and behavior?

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  10. In the year 2000, my Mom was misdiagnosed in an Ontario hospital. She had a side-effect from Imovane. The emergency doctor diagnosed her with anxiety and gave her chloral hydrate and Zoloft. While drugged to the gills, she was given a 15 page mental assessment by Dufferin County Mental Health. On her way out of the hospital one week later (a shuffling wreck), she was given an appointment time to see the county psychiatrist. He involuntarily committed her to a huge facility in another town after a 20 minute interview. His professional evalutation consisted of pointing in her face and asking her if she wished she was dead. She was 78 and blind and looking after my sick father. Then he told her if she did not arrive at Homewood Psychiatric Hospital by 9 pm, he would call the Ontario Provincial Police and embarrass her in front of her neighbours. At the psychiatric facility, she was put in “Lock-Up” with the drug addicts where the light was left on 24 hours. Her extended health care plan was charged for “preferred accommodation”. I helped her get out of this awful situation.She was out within 72 hours after I threatened to sue them. It took a year for her to recover. She is 90 now and takes no drugs. I filed a complaint which was labelled “vexatious” by the Ontario College of Physicians and Surgeons. We appealed it to the Ontario Review Board. My Mom, my brother and I went up against the psychiatrist’s lawyer there. One year later we received a fed-exed reply saying the whole thing was correct. The diagnoses she received were fraudulent, cost a mint in Ontario Health Insurance Premiums and were endorsed by authorities at several levels of medical authority. What do you think of that…..?

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    • Katherine, you are brilliant – persistent and dogged in the face of psychiatric and bureaucratic oppression. Good on you, I want to hear more stories like this.

      A slogan I have recently heard goes, “Recovery starts with non-compliance.” It’s good, but I also think, “Recovery starts with fighting back”.

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      • I have read the medical journals for my husband for 25 years. I began culling certain articles which I found suspect and reporting them to the College of Physicians and Surgeons, Ontario. I always got a reply that I was “vexatious”. I appealed it a few times in front of a tribunal at the Health Review Board. I always lost. In 2010, I was sued for $5 million dollars and roped into a bogus “conspiracy” against a psychiatric centre. They sued me the day certain individuals went in front of the “Select Committee on Mental Health” to get more power. They dropped it when the Committee disbanded and put out its report. What people must realize is that psychiatry is allied with the LAW!! They use the courts. They have a mind-boggling infrastructure and they are DANGEROUS! These individuals filed a 500 page affidavit in which they lied. I couldn’t do anything about their lies….it would have cost me at least $150,000 to do that! Unfortunately for this place, a Toronto newspaper put out an expose on their abuses right in the middle of their action against me. That expose still comes up when you google their name. The public must learn that psychiatry is a dangerous fraud and they must learn how to fight back!

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  11. Dear friends
    I support the view, that tackling the diagnosis is addressing the main problem. The reason is obvious: without the psychiatric slander of such an alleged illness none of the mental health acts could be applied.
    So as our new law on advance medical directives (AMD) in Germany explicitly names medical investigations as a medical act, which can be prohibited by a AMD, we have now a special Psychiatric Advance Directive exactly prohibiting any psychiatric diagnosis, see all details here: http://www.patverfue.de/patverfue_english.html
    Using our PAD successfully demonstrates: the diagnosis is the true danger which results very often in incarceration and bodily harm by forced drugging.
    I hope soon your are also able in America to sign such a valid PAD and excluding by that all the horror measures of coercive psychiatry. Than you can tell everybody: “Insane? Your own choice!”

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  12. Jim,
    It does my heart good to see you “keep on truckin” because that “long strange trip” so many of us have been on needs to be utilized to make it better for those who come after us. I deeply admire your perseverance in speaking truth to power despite its cost.

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  13. We believe and present arguments to support the belief that the schizophrenic label is being used to discriminate against people with natural psychic talents such as clairvoyance [seeing things others can’t] and clairaudience [hearing things others can’t]. These natural skills are in the religious spectrum and therefore exempt from government interference under freedom of religion constitutional protections. However, this is completely ignored by psychiatrists and others who believe in scientific athiesm because they do not believe that Spirituality exists and so feel that Spiritual people must be crazy. They are free to believe this but they are NOT free to attack Spiritual people because it is unconstitutional to do so.

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  14. Jim, While doing research for my case here in Michigan I ran across something that you or others may be able to use. A State may, it is believed, lawfully seize and confine an individual thought to need treatment and justify that deprivation of liberty solely by providing some treatment. But recognition that diagnostic validity might raise substantive due process implications was evident in the following colloquy between Justice Souter and the Kansas Attorney General in the oral argument in Kansas v. Hendricks (1996, Oral Argument, pp. 20,22), in which the Kansas Attorney General was defending Kansas’s use of a civil commitment criterion that allowed commitment of a person alleged to have a “mental abnormality or personality disorder”:

    SOUTER: What is the function of this medical recognition as you understand it under Foucha? Why do we have this element? Why do we–why would you say–why do you say that in order to satisfy the mental illness element under Foucha there has got to be a medically recognized category within which the particular individual falls?

    GENERAL STOVALL: I think so that the Court doesn’t worry that we confine merely for dangerousness or merely for a class of people that we don’t want to be around. We need to–to be able to civilly commit and provide treatment for them it has to be a medically recognized condition, I

    U.S. Supreme Court Justice Kennedy, in his concurring opinion supporting his tie breaking vote in Kansas v. Hendricks (1997), warned;

    “…[I]f it were shown that mental abnormality is too imprecise a category to offer a solid basis for concluding that civil detention is justified, our precedents would not suffice to validate it” (p. 373).

    Here, in the Supreme Courts own words, Justice Kennedy and Justice Souter both agreed that the “dangerousness” had to be coupled with a recognized serious mental illness, or “our precedents would not suffice to validate it”. Note however that for a Mental Illness to be “recognized” does it not have to be “diagnosable” as well? If not diagnosable then we are simply dependent on psychiatrist “opinions” of such diagnosis. In my research I also found that there is no such “biological” way to diagnose Mental Illness. So it would stand to reason that in fact the “mental abnormality” does not offer a solid basis for any conclusion that a civil detention is justified!

    Keep up the GREAT work Jim
. I’ll do the same!!

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  15. I really wish to address people’s abilities to invade a person’s home when there is NO crisis and on their say-so, being able to succeed in getting police to haul people away to a restrictive environment. In my case, I had been my husband’s caregiver through 2001 and took care of very complex medical issues. I cared for him and others all my life. I was taking care of myself ! I hurt no one ! A year later, family should have thrown me a party or something, not judged me ! I was functioning and formulating new plans… I cannot believe that one who self-advocates is NOT listened to at all and others succeed in ruining that person’s life !! Careers go out the window and financial downward spirals occur, oppressiveness is felt, and as I have said for years now, “more pain is added by others to someone’s existing pain” in life for whatever reason. I still cannot believe that psychiatrists encourage home invasions, forced so-called treatment and get away with it. Patients are not soothed but treated like criminals instead ! They never care if a body gets their thyroid medication. And thyroid problems and other hormonal problems and overall medical needs are not looked at fully ! Besides, treatment to me would be good food, supplements, music, massage and a swimming pool~~~especially in menopause !! THAT is what is beneficial AND pills are NOT treatment !! Also, family mediation is not had and that is absolutely needed but ignored !! In the field of developmental disabilities, what I worked in for years, I worked very hard in person-centered planning meetings, really listening to a person and their family members and anyone else they wanted at meetings. The next step was putting THEIR desires on paper in the form of goals, that THEY wanted to meet ! It has NOT been like that in the mental UNhealth system at all ! Civil rights abuse to get many in the system, doctors seeing people they do NOT know, for a couple of minutes and diagnosing them with some diagnosis that doesn’t even make sense just so they can prescribe toxic meds ! THEN, they have the audacity to call it “treatment” ! $$$$, just still can’t believe it !!

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  16. Fred A. Baughman, MD responding to the post of Jim Gottstein of Jan. 15, 2012:
    All of psychiatry’s diagnostic entities are said to be diseases (disease = a demonstrable gross, microscopic or chemical abnormality) or the equivalent, i.e., they are said to be an abnormality of the brain, a chemical imbalance when none such have been proved to exist. There is no question their diagnoses stigmatize. As importantly or more so, each disease label is an excuse to drug, even an excuse for psychiatrists or other physicians to ask a court to order drugging or any kind of psychiatric treatment including ECT and incarceration. What’s more, for so long as a label or labels are appended to the citizen they are subject to drugging and the imposition of any treatment and with those labels and prescriptions they are politically neutered, often with this in mind, sometimes with this in mind.
    When victims take comfort in their diagnoses it is the false comfort of people not knowing the downside of biological psychiatry: that there are no diseases, that there is no abnormality to be made normal that there is only harm—invariably so.
    Not only are psychiatrists (an other physicians) paid for the original diagnosis and initial treatment, there becomes a need for follow-up so long as the ‘disease’ persists (for life, as long as the diagnosis is in the record) and so medication checks go on for life and other symptoms arise often the result of drugs leading to other diagnosis and a new drug or drugs for each if not incarceration or court-ordered depot antipsychotics which a patient in Michigan recently told me is on the rise in the Jackson area.
    Correct Jim—we should reject their faux diagnoses, wrench them from their hands, from the DSM, the APA. Exactly! Go back to descriptions of emotions and behaviors and eschew, ban use of all of their diseases and you would put an end to drugging and all of their disease interventions and the chance of normalization would surface in every case in contrast to biological psychiatry and their ‘disease’ diagnoses with never a cure or an end to psychiatric intervention and cure.
    In every case in which a patient is led to believe they have a disease as a basis for informed consent their has been abrogation of that right and no justification for proceeding with that treatment—that drugging, ECT, psychosurgery becomes what it really is—a battery! Said to have a disease when there is no is abrogation of informed consent, drugging with no disease is poisoning, a battery

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  17. Jim, You are right on. There is a triumvirate of oppression of which diagnosis may be the lynchpin:
    1. diagnosis of behavioral problems as individually-based medical conditions
    2. Supposed causality as permanent biological brain disease+
    3. lifetime of Forced medications and control by psychiatric profession, and ruled by psychiatric law rather than the constitution
    I want to see if we can get our National Coalition for Mental Health Recovery to back the PLAN T campaign.

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  18. I recognize the things you write about, it is far too frequently happening that children and youngsters are given individual psyciatric diagnosis as an “answer” to a situation which is indeed not an individual problem, but something which has to do with the context and life situation.

    At my work at Family Care Foundation we use no psychitric diagnosis, either when talking to or about those we call clients. From many years of practice I know how important it is, especially for young people, not to be defined as a psychiatric problem, but instead to be met as a person with all that which goes into being a human.

    I have also many times experienced the importance of responsibility which parents are willing to take if they are invited to take part in a shared work and to see how they have done towards their children and themselves.

    There is also in Sweden this discussion about diagnosis and ofteh it is said that “patients and their families” wish to have a diagnosis, but my experience is the opposite. Most people I meet do not want to be defined, labeled or diagnosed, most people wish to be seen as a human together with other humans and try together with others to find out how to live their life.
    Support is needed, as time and people who care. Just as it is for all of us.

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  19. 1st. I actually stopped being just a diagnosis years ago. Now, I’m the bottom line. With the blood of as many as six million on their hands, the defense at Nuremberg argued their innocence stating, “It is better for all the world. If, instead of waiting to execute degenerate offsprings for crime…or to let them starve for their imbecility,

    society can prevent their propagation…

    by medical means in the first place.

    Three generations of imbeciles

    are enough.” The last sentence echoes the words of Justice Oliver Wendell Holmes is Buck v. Bell. That should have demanded our consideration, but it’s easy to comfort yourself in the security of your own morality and sense of justice when faced with such an unimaginable loss of human life. But is it unimaginable? Over 60,000 patients were sterilized against their will in the US between 1921 and 1980 when it was finally retired from active use though the law remains on the books in some states. An estimated 50,000 underwent forced lobotomies mostly between 1949 and 1952. In 1849, a Dr. Bell published the American Journal of Insanity with death rates for 30 U.S. asylums as an estimated 28% of all admitted. By the 1920’s, it had increased to 33.4% and to 42.4% ten years later. By 1940, you were 15.6 times more likely to die before you reached 24. The records are bizarre and seem to have unusually high cases of third world disease and nonsense like death by manic hysteria. For stark clarity, 44 patients on average were admitted to Byberry Hospital daily. The daily death rate was six though slightly higher when children were being held. What is most striking is that this continued until it’s close… in 2003. There is no way to really factor how many patients died or how many lives were destroyed. And while I won’t say as many died as those in WWII, there is a frightening similarity. The death camps burned night and day towards the end, and no one noticed.

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    • You’ve got to realize that in the bad old days, neurosyphilis was regarded as a mental disease and those ill with this invariably fatal illness were sent to mental institutions, where they died like flies until penicillin went into civilian medical practice in 1950, one of the two great advances in preventative psychiatry during the 20th Century. The other was fortifying white flour with niacinamide and other B vitamins during World War II, which cleansed the old mental institutions of pellagra sufferers, who had previously occupied 10 to 30% of the nation’s mental hospital beds. It was fatal if untreated, the treatment unknown until Goldberger’s time, around World War I and vitamin B3 was isolated around 1930, a more specific (and cheaper) treatment than feeding patients a lot of meat, as was done in Goldberger’s time. Notice that psychiatrists weren’t responsible for either of these advances.

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  20. Reading this was so disturbing to me to continually learn what is happening to patients who endure adverse reactions or toxicity in this case, to prescribed psychiatric drugs. I too, became extremely homicidal while enduring SSRI withdrawals. Mr. Gottstein, is this what we are up against? Too me, this is criminal, for us patients gravely harmed by our prescribed medications, not to mention our families. :

    Jeffs v. West, 275 P.3d 228 (Utah 2012)

    Also under Professional Liability

    Outcome: Very unfavorable


    The issue in this case was whether physicians owe a duty to their patients’ children, which can be breached through inappropriate care to their patients.

    AMA interest

    The AMA strives to avoid the expansion of liability theories against physicians, which can lead to abusive malpractice litigation.

    Case summary

    According to the complaint filed in this lawsuit, a patient was treated for psychiatric problems at a medical clinic. He was seen by an advanced family nurse practitioner, who prescribed a cocktail of seven psychotropic drugs, including stimulants, tranquilizers, antidepressants and steroids. Although Utah law requires that a physician must supervise and consult with a nurse practitioner before prescribing drugs of this nature, the physician in charge of the clinic neither supervised nor consulted with the nurse practitioner, and he failed to monitor the nurse practitioner’s treatment of the patient.

    During his visits to the clinic, the patient displayed “toxic side effects” from the combined medications. Furthermore, he advised the nurse practitioner that he was having marital problems and his wife had had a legal restraining order entered against him. However, the nurse practitioner continued to prescribe the drug cocktail without consulting the supervising physician. Under the circumstances, continuation of the drug cocktail was medically inappropriate.

    Ultimately, the patient shot and killed his wife in a church parking lot, in daylight and in front of several witnesses. Within two hours of the shooting, the patient turned himself in to the police. Blood toxicology reports showed that the patient was within the prescribed ranges of all his medications and he had no illicit substances in his blood stream at the time of the shooting. A causal factor of the shooting was the administration of the drug cocktail and the failure of the nurse practitioner, the supervising physician, and the clinic to provide alternative psychiatric care. The patient subsequently pleaded guilty to and was convicted of murder.

    The patient’s minor children (who were also the victim’s children), through their guardian, sued the nurse practitioner, the supervising physician, and the clinic. The defendants moved to dismiss, asserting that their legal duty was solely to the patient and not the children. The trial court granted the defendants’ motion, and the children have appealed to the Utah Supreme Court. The primary legal question on appeal is whether the defendants owed a common law legal duty to the children to provide proper medical care to their father.

    On February 28, 2012, the Utah Supreme Court found that the medical care providers did owe a duty of care to their patients’ children. The Court emphasized that, under the pleadings, the defendants’ affirmative actions of misprescribing medicine had caused their patient’s psychotic reaction, and the defendants should be responsible for the injury they had caused. The case was reversed and remanded.

    Litigation Center involvement

    The Litigation Center, along with the Utah Medical Association and other health care organizations, filed an amicus curiae brief, arguing that physicians should not owe a duty to their patients’ children on account of the medical care the physicians provide to their patients.

    Utah Supreme Court briefPDF FIle – Jeffs v. West, 275 P.3d 228 (Utah 2012)

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