Justina Pelletier: The Debate Continues

Philip Hickey, PhD
29
125

On April 1, 2014, Slate published an online article titled Mitochondrial Disease or Medical Child Abuse?  The author is Brian Palmer.  Slate is a daily, general interest web magazine, founded in 1996, that provides “analysis and commentary about politics, news, business, technology and culture,” and is a subsidiary of the Washington Post.  Brian Palmer is Slate’s “chief explainer.”

As the title suggests, the article tries to explore the central question in Justina’s case:  does she have mitochondrial disease or is she a victim of medical child abuse?  The author does a good job of defining the various terms, unraveling the issues, and presenting both sides of the argument, though on balance he comes down in favor of Boston Children’s Hospital.  Here are some quotes:

“It’s easy to get angry about this scenario — and there are some troubling things about the way the conflict has been managed — but the doctors at Boston Children’s deserve a defense.”

“…the science is complicated. Mitochondrial disease (Justina Pelletier’s original diagnosis) and medical child abuse (the Boston Children’s diagnosis) can look extremely similar. Both can be deadly if not treated properly.”

“‘Mito,’ however, is incredibly difficult to diagnose definitively.”

“Just as Justina Pelletier exhibited some symptoms consistent with mitochondrial disease, her case also has some of the hallmarks of medical child abuse. One of her chief complaints was digestive trouble, the most common symptom among medically abused children. She had gone through extreme surgical procedures, including the placement of a permanent port in her belly to flush her digestive tract. Her parents had engaged in physician shopping, and experts at Boston Children’s felt that Justina’s emotional state improved when her mother left the room.”

“The doctors at Boston Children’s had few options if they really believed in their diagnosis. Just as the treatment for strep throat is antibiotics, the treatment for medical child abuse is separating a child from her parents. Sending Justina Pelletier home would have represented the height of irresponsibility if their diagnosis was correct. One in 10 children who suffers medical abuse eventually dies at the hands of his or her parent.”

Obviously all of these issues have been debated at great length, not only in the courtrooms, but also in the mainstream media and in the blogosphere.  It is likely that these debates will continue, and will be wide-ranging.

But in this post I would like to focus on just one issue.  If the “extreme surgical procedures” that Justina had undergone were an integral part of the alleged “medical child abuse,” why is the surgeon who performed these procedures not being censured or charged?  Are we to believe that this surgeon performed these extreme procedures without valid cause or justification?  Is it plausible that he/she performed these procedures more in response to parental pressure than genuine medical need?

If, as is claimed, Justina was the victim of “medical child abuse,” isn’t it reasonable to consider the surgeon one of the primary perpetrators?  And if not, why not?  In other forms of child abuse, aiders and abettors are routinely taken to task.  Why is medical child abuse different?

It has been widely reported that an abnormal “congenital band” of cartilage, 20 inches long, was removed from Justina’s abdomen in 2010.  This indeed would constitute an “extreme surgical procedure,” but the critical question is:  was it justified?  Is there a pathologist’s report that casts doubt on the need for the surgery?  If not, then what is the relevance of the assertion that she had gone through “extreme surgical procedures.”  It is possible that a surgeon might excise tissue needlessly either to boost his income or even from over-enthusiasm.  But there exists, in the form of the pathology lab, a time-tested safeguard against this sort of excess.

The validity of the concept of medical child abuse in this case hinges, at least to some extent, on a history of surgical procedures which, apparently, in the opinion of psychiatrists were unnecessary and potentially injurious.  But, on the other side of the scale, we have a surgeon excising real tissue and subjecting this tissue, and incidentally his/her own medical judgment, to critical objective scrutiny.  A surgeon who routinely excises benign tissue, or who performs other unnecessary surgeries, will quickly incur some challenges from the hospital’s Q.A. committee, the medical licensing authorities, and ultimately from malpractice trial lawyers.

By contrast, the psychiatrist’s opinion as to the necessity or appropriateness of the surgery is subjected to no objective check whatsoever.  And perhaps therein lies the answer to my earlier question.  If those psychiatrists who allege medical child abuse had to challenge the surgeons who aided and abetted the alleged abuse, it is likely that in most cases, the surgeon’s judgment would prevail, and another nail would be put in psychiatry’s coffin.  It’s easier by far to lay the blame on the “persistent and deceptive” parents and to absolve the surgeons and other medical specialties by the blanket contention that they were duped.

* * * * *

This article first appeared on Philip Hickey’s website,
Behaviorism and Mental Health

 

29 COMMENTS

  1. Dr. Alice Newton sees Korson and Flores as “innocent victims” of the manipulative parents. She has no option but to present it that way or go head to head with the Tuft’s medical team. Lou is correct that there is an “agenda” and it’s somatoform. Korson’s medical diagnosis was a roadblock to a successful, Newton led “parent-ectomy”. I don’t believe Palmer deals with the 5 other cases in the last 18 mos. as reported by the Globe.

    • Zoriolus,

      “Roadblock” is a good word for what’s going on here. I suspect that what happens in the great majority of these cases is that the parents roll over and either buy, or pretend to go along with, psychiatry. This case has attracted attention because the Pelletiers wouldn’t play along. Hopefully their example may encourage others who find themselves similarly maligned.

  2. Isn’t Korson supposed to be one of the rare experts on mitochondrial disease? Did these parents shop for experts on mitochondrial disease? Seems that if they wanted to abuse their children with medicine, that they could have just told a psychiatrist that they’re child was problematic. They could have had their child debilitated and collecting social security disability in no time.

  3. Many have asked why BCH would do this. It’s very simple.

    Hannah Poling also has mitochondrial disorder. Her parents (a neurosurgeon and a nurse/lawyer) received a multimillion dollar vaccine injury settlement in 2010, after Hannah had nine vaccines in one day and then immediately developed symptoms of severe autism. Public health officials said at that time that Hannah’s problems were the result not merely of her vaccines, but of a ‘rare underlying mitochondrial disorder’, although it is unclear if she was diagnosed with her mitochondrial disorder prior to receiving the vaccines. Many in the autism community at the time believed that mitochondrial disorders might not be all that rare.

    Evidence over the last decade and a half is clear — autism is iatrogenic (mercury), and so is mitochondrial damage (aluminum).

    What we are seeing is medical terrorism. Doctors and parents are being sent a chilling message, and if no price is paid by the people responsible for what has happened to Justina the message will get through loud and clear to doctors and patients and parents of patients. The message is this – ‘If you know what’s good for you and your children, you’ll shut up when you’re told to shut up.’

  4. “The psychiatrist’s opinion as to the necessity or appropriateness of the surgery is subjected to no objective check whatsoever.” I agree, putting blame on the parents, rather than the prior doctors is a definite sign of likely medical impropriety. Especially given the fact that historically, and today, psychiatrists function as doctors who cover up malpractice for other doctors. I believe actually looking into all Justina’s prior doctors’ possible medical mistakes is appropriate.

  5. Meanwhile in Germany:
    http://www.focus.de/politik/deutschland/kein-anfangsverdacht-gustl-mollaths-aerzte-kommen-ungeschoren-davon_id_3770397.html
    English translation:
    “Despite potential violations, no investigation. Gustl Mollaths doctors get away with it.
    Seven years in the psychiatric ward, referred to as “paranoid” in medical reports : The fate of Gustl Mollath has shaken many people. But doctors and judges who were involved in his case, will probably not have to answer.
    Despite numerous potential violations no investigation against those involved in the case have been initiated in the psychiatric case of Mollath. The Attorney General’s Office in Munich confirmed a decision to the Augsburg public prosecutor, as a spokesman said in Munich on Monday: “No evidence of reasonable suspicion.”
    There is “no evidence of any initial suspicion against any of the parties.” the “Süddeutsche Zeitung” reported earlier. The investigating authorities considered numerous complaints against members of the Mollath case before: judges, prosecutors, experts, doctors, Mollaths ex-wife and manager of HypoVereinsbank.”
    The Nuremberg’s citizen Gustl Mollath was placed against his will in psychiatry for seven years before he came to freedom in the summer of last year and his case was reopened.”

    That’s amazing: the guy was locked up for almost 8yrs and drugged against his will with a non-existent diagnosis because he accused his ex-wife and her colleagues of financial wrongdoings in the banking system (as evidence shows most likely correctly). But somehow nobody’s guilty. Ergo: a psychiatrist can “diagnose” you with anything he likes (possibly to cover up for corruption and wrongdoing of others) and never has to face any responsibility even if his diagnosis was proven bullshit and resulted in years of imprisonment and harm-causing “treatment”.

    • I don’t speak German, but Mollath has a wikipedia page. At first some things in it make me think that his violence was an issue, then I found English versions of his story in German papers, and the violence wasn’t even an issue until 15 months after the time his wife said that he attacked her. There were no corroborating witnesses who could put him at the scene of the tire slashings, either. It’s incredible that his “violence” was considered to be fact in court in the case that charges weren’t pressed at the time. Just. Wow.

      Good grief, what’s most scary about this story is how easily, and how probably often this happens in Western countries where the bio-psychiatry model reigns. It would be as easy now for a predatory husband to have his wife taken hostage and drugged by psychiatrists (or vice versa) than it was when it was a popular plot line in Hitchcock stories. It’s unreal. This could be an effective coup in any case where emotions run high, like a custody battle. Is there any situation an unprincipled psychiatrist can’t make worse?

      • That’s new. Psychiatry was used for political reasons and personal revenge/coverup since it’s dawn. Still is – we keep talking about China, but seems like the West is not immune. On the bright side: it’s cases like that which sensitize the public to psychiatric abuse.

        • My dad was arguably the number one “Management Information Specialist” in the US in the banking industry, prior to retiring early in the early 1990’s, due to “lack of ethics” by the guy who got the job of president of my dad’s employer, instead of him, as EVP of the bank and holding company. And his former bank did eventually deal with a forced government sell-off of his bank. My dad was right.

          “Psychiatry [is] used for political reasons and revenge / coverup since it’s dawn.”

          • Not surprised. I know a dark family story of a girl who tried to commit suicide – her grandfather was a serial child molester, he did it to her mother and then to her and her sister. The girl got locked up and received adequate “therapy”, the guy is free to this day – he’s an esteemed member of society, used to be a member of the city council etc. Received prizes for his good service. You know, good conservative, religious family with great values and that poor girl is just crazy. It’s so disgusting… It happens in families to cover up abuse, it happens in politics and business to destroy whistle blowers. Psychiatry is a useful tool.

      • It wasn’t unusual in the early part of the twentieth century for wives who were too independent and not subservient enough to end up in the mental institution. They were put there by their husbands. Psychiatry seems to have a long history of controlling people. It needs to come to a stop!

      • Well, it comes down basically to the same problem: their diagnosis are subjective labels and are not verifiable in any way. You can’t really prove that you don’t have a mental illness because you can’t really prove you have one either. This way the system is basically down to: the psychiatrist (authority figure) says so, so it must be true. Plus any emotional reaction you have to the situation you were put in by the very “diagnosis” is seen as your symptom and not a normal reaction to the circumstances. It’ exemplified very well in the Pelletiers’ case: although the parents are not technically diagnosed as mental cases as far as I understand, the judge in his decision used the catch 22 straight from the psychiatry’s playbook – he accused the parents of misconduct (shouting and swearing at the people who took Justina away or sth along those lines) which happened AFTER the girl was locked up citing it as a reason why they’re not good parents. We see the parents’ reactions as completely understandable AND linked to the psychiatric abuse of their daughter but in the crazy land of psychiatry it’s all the symptom of underlying pathology.

  6. “That’s amazing: the guy was locked up for almost 8yrs and drugged against his will with a non-existent diagnosis because he accused his ex-wife and her colleagues of financial wrongdoings in the banking system (as evidence shows most likely correctly).”

    He was never drugged against his will. And he did not take them voluntary. He knew the med’s are dangerous.
    Some doctor’s wanted to but they did not get a court order.

    A good coverage of the case can be found here but naturally / sadly in german.
    http://gabrielewolff.wordpress.com/
    The coverage is starting with this post:
    http://gabrielewolff.wordpress.com/2012/12/01/der-fall-gustl-mollath-rosenkrieg-und-versagen-von-justiz-psychiatrie/

    The author is a ex-federal prosecuter herself.
    http://de.wikipedia.org/wiki/Gabriele_Wolff

    • Sorry, I got it wrong. I’ve seen it in some of the reports that he was actually given drugs for his “paranoia”, apparently that was wrong or I misunderstood him being offered drugs for actually taking them. In any case, he spend 7+ years of his life behind bars for nothing and there seems to be no repercussions for anyone involved (this is not definite yet but unless there is massive public outcry it’s likely going to be swept under the rug).
      Honestly, at the very least I’d love to see the people who “diagnosed” him over the years publicly shamed if the system fails to prosecute them and strip them of their right to practice. This case is no less outrageous than the case of Ms Pelletier’s.
      Here are Mollath’s own words on the subject (also German):
      https://www.youtube.com/watch?v=ANzS9odkbTA

  7. I have to agree Philip and its my min argument against people who claim parental abuse.

    I’m sorry, was it the Pelletier parents who diagnosed Mitochondrial Disease? Wp did the parents prescribe the drugs for Justina? Did they perform the surgeries? If Boston’s seriously believed that abuse was occurring then they should have taken their fight against Tufts. They should hold that medical establishment at fault and file criminal changes against their doctors and surgeons.

    To critics who cry “doctor shopping”, we are not talking about how the Pelletiers searched for some Bermuda MD graduate who ran a seedy clinic. We are talking about Tufts, a prestigious medical center. How do the parents lose custody of their child and suffer through public condemnation of abuse while Dr. Korson, the MD who specializes in MItochondrial Disease at Tufts, and other surgeons escape any responsibility?

    This case is so overwhelmingly bogus that it defies comprehension.

    • Jonathan,

      Thanks for coming in.

      Psychiatry is very adept at manipulating language. In our culture the phrase “doctor shopping” has negative connotations, usually associated with people who are seeking controlled substances. But if a person is convinced that he/she or a child is seriously ill, and doctor number 1 doesn’t seem to be finding anything wrong, or doesn’t seem to know what to do, isn’t “doctor shopping” the correct and perfectly understandable response? Shouldn’t it be called “seeking a second opinion,” or third, fourth, fifth opinions if need be? By labeling the Pelletiers’ activity as “doctor shopping” the psychiatrists loaded the dice in their own favor.

      • I don’t even know what that should mean. You have a right not to like your doctor for any reason and want to change her/him. Also as long as the treatment plan you’re following is prescribed and licenced by a medical professional it’s that person’s responsibility, not yours , at least in the legal sense. I get it if the parents are for instance intentionally harming the child, poisoning it or sth – that’s medical abuse but that should be discovered by a smart physician, if not on the first visit then certainly after awhile.