Eugenics & the 2014 Murphy Bill

Bonnie Schell
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Sterilization of the “unfit” and proposals to help families with a mental health crisis may seem to be disparate topics, certainly one historically more repugnant than the other. Yet, the two “solutions” have several things in common:

  • The absence of choice by the individual affected
  • The paternalistic assumption that those with power know what is needed
  • Both serve the interests of families, caretakers, guardians, and conservators
  • Both proceed out of good intentions.

Both the Murphy Bill (H.R. 3117 of 2014) and the eugenics movement were unfortunate solutions to real problems. What are the problems of the family with a diagnosed mentally ill “loved one”?  Relatives of a family member in emotional and/or cognitive distress can’t get a crisis response for a relative who is currently or likely to be violent toward self or others or likely to deteriorate until the family member can no longer care for himself. They can’t get the family member to admit she is ill or to take recommended psychiatric medications. They are unable to find out the whereabouts of the family member in the “system;” they don’t know if their family member has been mugged on the street or is “safe” in a hospital bed. They can’t get civil and human rights organizations to acknowledge the rights of the family. They can’t get timely professional services (due to personnel shortages and Utilization Management Departments of Managed Care Organizations) and instead are offered peer services by persons they believe to be under educated and once “crazy” themselves who mislead their family member to hope for recovery.

The intent of the Murphy Bill is to offer solutions to these problems.  To do this confidentiality and choice have to be compromised. “This bill has great intentions,” writes Morgan Shields. “However, it seems to be driven by fear, and is constructed to persuade the public that this bill will protect them from violence…this bill would impose treatments that are not reliably effective and are possibly harmful.” (The Murphy Bill: Ethical Considerations for the State of Mental Health Care and its Consumers,” Harvard Public Health Review, February, 2015)  Likewise, Ian R. Dowbiggin in Keeping America Sane, (Cornell Studies in the History of Psychiatry), tells the story of eugenics in North America as one of human fallibility, of good people advocating abuses of basic human rights for the very best reasons.

A sterilization  bill around 1920 might have been called Helping Families and the State with a Reproduction Crisis, precipitated by a fear of immigrants and crime. This bill would have addressed the problem of getting women, not men, to do family planning. It would have addressed the difficulty of getting jobs, housing or personal care for needy people (before SSI, SSDI and The Great Society). Disabled people included those with mental illness, mental retardation (idiocy), epilepsy, those with vision, hearing and mobility impairments, and those who masturbated. The offspring of these “unfortunates” were often exposed to neglect, trauma or domestic violence. Disabled women did not stay in marriage relationships. Some took to their beds after childbirth and did not care for their babies. Families worried that there would be no one around to care for the offspring. All of these conditions were believed to be hereditary and to cause degeneracy. By far most sterilization in the U.S. was performed in psychiatric hospitals and homes for the intellectually challenged (Philip Reilly, The Surgical Solution, John Hopkins Press, 1991). Sterilization was not banned from correctional facilities in CA until September 2014.

From the few records that still exist, 62,000 people were sterilized between 1920 and 1979. “Mentally ill patients were sterilized without their consent, and sometimes without their knowledge, while they were contained in hospitals so as to prevent them from interacting or mating with ‘normal’ people” (Robert Whitaker, “Deinstitutionalization and Neuroleptics” (2009) in Y. O. Alanen, A. S. Silver, et al, Eds. Psychotherapeutic Approaches to Schizophrenia Psychoses: Past, Present, and Future, p. 346-356). As late as 1995, I knew a lovely woman named Clara who was diagnosed with schizophrenia and loving another teenager. She became pregnant. Upon delivery the baby was placed up for adoption because Clara couldn’t hold a baby bottle properly and the young woman was given a hysterectomy for “female problems”—a common diagnosis of many homeless and mentally ill women in the Bay Area of CA. Clara went to work as receptionist in a drop-in center, played the cello in the University orchestra and gave up smoking. Clara never married or was hospitalized after age 22. She “divorced” her parents for ignoring her hard work on her own recovery and testifying behind her back at NAMI meetings that thank goodness she couldn’t have children and was a Clozaril success story—until she had bone marrow failure.

While the solution of the Eugenics Boards across the country was forced sterilization, since deinstitutionalization the solution for insufficient community programming has become forced inpatient or outpatient treatment and compulsory disclosure to families of the diagnosis and treatment details of their family member. This is only true for mental illness and sexually transmitted diseases. (Partners must be notified). No one would bat an eye if a white male with late stage cancer or heart disease asked his doctor not to disclose his diagnosis or prognosis to his children or even his wife. Long before HIPPA, this confidence was part of the doctor-patient relationship in which the family does not have access to information about the patient unless he consents.

People with high cholesterol, blood pressure and/or out of control blood sugar levels, obesity or chronic alcoholism cannot be forced to take medication or change their lifestyle even though they may die prematurely. In the case of mental illness, treatment in the public system  leads to death 10-35 (depending on source of data) years before the general population.  Dr. Peter Weiden, professor of psychiatry at the University of Illinois College of Medicine, maintains that “Society would not tolerate 20 years of lost life expectancy for other groups, even those that suffer discrimination like Latino or blacks or gays…. We are complacent because the lives of those with severe mental illness do not matter to us.” (As quoted in “Having a Severe Mental Illness Means Dying Young,” Huffington Post by Allen Frances, professor emeritus at Duke University and chairman of DSM-IV committee)

The projection  that 1 out of every 5 Americans needs mental health treatment is a boon for the pharmaceutical industry. At the same time fewer medical students choose psychiatry as a specialty because it has become the practice of prescription writing. Most psychiatric medications are now prescribed for people without a diagnosis, particularly those in nursing homes and foster care (Deborah Brauser, Medscape Medical News, September 12, 2013). The more Americans get treatment, the more money Big Pharma makes.

It is instructive sometimes to follow the money. Even the birth control pill development was motivated by a desire to prevent mental illness from being passed down in families. Margaret Sanger introduced Katherine McCormick to Gregory Pincus and his research on fertilization and hormones and development of a contraception pill. McCormick funded Pincus’s work because her husband Stanley had schizophrenia. When he died in 1947, his vast fortune for the invention of the McCormick Reaper went to Katherine who never wanted his malady to be passed on. The birth control pill was licensed in 1960. Not only did the Pill allow women, for the first time, to plan the course of their lives, but the pill, patch and implants have been used as a condition of welfare, food stamps, public housing, treatment programs, and parole.

Pharmaceutical companies, some of the largest corporations in the US, heavily fund the National Alliance for Mental Illness, which began as a family-focused organization and is now a major lobbyist for the Murphy bill. Big Pharma has contributed to Tim Murphy’s campaign and that of other congressmen who signed on as sponsors. Why do these corporations, several convicted of personal injury and illegal marketing, care about the Murphy Bill or helping families in mental health crisis? The U.S. mental health system, unlike most of Europe, operates under the Medical Model which says that mental illness is the result of chemical imbalances that a lab can’t measure as yet and can only be treated by psychiatric medications. No one is sentenced by a court to forced talk and listening therapy or forced psychosocial rehabilitation programs or forced trauma counseling.  One side effect of anti-psychotic medications besides weight gain, elevated triglycerides and cholesterol, extremely dry mouth, gum disease and tooth loss (a doughnut is easier to eat than raw carrots or apples) is hyperprolactinsemia or sexual dysfunction. Even psychiatric medications have the same effect as forced sterilization.

It is a weakness of an entire society that we prioritize medical solutions over social reconstruction. Patients with medication and talk therapy fare far better than those with medication alone. From my personal observations, patients placed in safe “Housing First” environments have faster positive outcomes than those on medication alone. Patients with an apparent need for repeated Electro Convulsive Therapy do less well over time than those afforded trauma therapy. The Consumer Movement and some renegade psychiatrists propose that the medical profession ask “What has happened to you?” instead of “What’s wrong with you?”

The public discourse in the wake of acts of violence by individuals both with and without mental health treatment weighs the cost of mental health treatments and hospitalization against other human needs. Indeed, it was probably the costs of implementing the Murphy Bill and not its detractors that kept it from coming to the floor of Congress for a vote. School mathematics books in Nazi Germany posed such questions as: “The construction of a lunatic asylum costs 6 million marks. How many houses at 15,000 marks could have been built for that amount?” (Brochure, United States Holocaust Memorial Museum). State legislatures try to prioritize the needs of disabled people against housing and education costs, unemployment benefits, raising the minimum wage, and cleaning up coal ash spills.

Is the solution to the problems addressed by the Murphy Bill a moral one? Most citizens are familiar with the Golden Rule. It is shared by many religious traditions. The traditional Golden Rule in its negative form says “Do not impose on others what you do not wish for yourself.” Neither sterilization nor forced psychiatric treatment has ever been applied across all gender, race and class lines. Proponents of sterilization or the “abnormal” and forced treatment can cite some cases where the solution was the perfect “fix”, instead of outreach, compassion, and information.

The Principles for the protection of persons with mental illness and the improvement of mental health care adopted by the United Nations General Assembly of December 17, 1990 addressed diagnosis and confidentiality and autonomy. Principle 4 says “Family or professional conflict, or mere conformity with moral, social, cultural or political values or religious beliefs prevailing in a person’s community, shall never be a determining factor in diagnosing mental illness.” Principle 6 states that “The right of confidentiality of information concerning all persons to whom these Principles apply shall be respected.” “The treatment of every patient shall be directed towards preserving and enhancing personal autonomy” maintains Principle 9.

It was Adolf Hitler and German nationalism that willed all disabled people be exterminated  to make sure disability would be wiped out of the Aryan race and to rid society of the burden of caring for the “less fortunate.” Poverty was characteristic of genetic inferiority.  His Eugenics methods and theories came from a manual put out in California (Edwin Black “Eugenics and the Nazis – the California connection” San Francisco Chronicle, November 9, 2003). Few human beings are not horrified by the extent of the Holocaust. We see this in retrospect. Yet it is possible that we look with narrow angle vision in the present at forced treatment for emotional and cognitive disturbances. It would have been a great loss if Winston Churchill, Virginia Woolf, John Nash, Lionel Aldridge, Meera Popkin, Nijinsky, Alan Turing, or Emily Dickinson and so many others had been subjected to forced treatment.

“A person with a mental illness can be committed in most of the 37 states that have Involuntary Outpatient Commitment laws without any finding of imminent dangerousness to self or others. Even without any dangerousness requirement, a number of states explicitly allow police forcibly to pick up and detain people for mental evaluations if they have failed to comply with any provision in an IOC order, “particularly black males” (“Forced Treatment Policy Documents,” 2014, Bazelon Center for Mental Health Law). It is believed and frequently said in print that depriving people of their liberty surely has been shown to be effective and in the individual’s  best interest. Sponsors of the Murphy Bill and leading advocate groups funded by pharmaceutical companies seem to believe that this is true, despite evidence to the contrary.

The mental health system as a whole is a poor judge of its performance. Outcome studies on individuals involuntarily committed do not look at the individual’s well-being a year or two after the commitment is over. In a mid-1990’s study at Bellevue Hospital in New York City, before Kendra’s law, “on all major outcome measures, no statistically significant differences were found between the two groups — IOC and control groups” (Steadman, H. et al, Assessing the NRC Involuntary Outpatient Commitment Pilot Program, Psychiatric Services. 52(3): 330-336). Outcome measures included re-hospitalization, arrest, quality of life, symptomatology and treatment compliance. The RAND Corporation in 2001, studying IOC in eight states found that “There is no evidence that a court order is necessary to achieve compliance and good outcomes” (The Lancet, Early Online Publication, 26 March 2013). The literature when reviewed showed that “alternative community-based mental health treatments can produce good outcomes for people with severe mental illness.” Comprehensive services are effective, not IOC. A field study in North Carolina by Jeffrey Swanson and colleagues found that IOC was effective only if combined with other intensive treatment, but the study is cited as proof that IOC is effective by itself. The 32 million budget for New York’s Kendra’s Law in 2005-06 included an additional $125 million for expanded case management services and other supports. IOC and AOT (Assisted Outpatient Treatment) are proposed in the Murphy Bill as a desperate means of preventing violence by mental health patients even though research shows they are more likely to be the targets of violence. The leading expert on Kendra’s law, Dr. Swanson of Duke University told Behavioral Healthcare that people who understand what outpatient commitment is would never say this is a violence prevention strategy (“AOT cost effectiveness study stirs national debate,” August 22, 2013 Behavioral Healthcare).  Failing to pay attention to these studies is an example of motivated reasoning (wanting to believe that the things we do make a difference) which was true of the solutions by psychiatry and institutionalization in the past: bleeding, sweating, vomiting, electro therapy, focal infection, the spinning chair, ice baths, insulin and malarial comas, lobotomies.

Failing to pay attention to studies that show IOC and AOT do not achieve the results sought or are not the only means of doing so is a confirmation bias (the tendency to look for evidence that supports what we think we already know and to ignore the rest.) There are alternative solutions to family problems in a Mental Health crisis. For instance, families could be told if a “loved one” is safe and off the streets. It is much easier for the provider to simply refuse to communicate with families at all and not even ask the patient if they have permission to communicate with family members.  Hospitals need to find beds for those patients trying to take care of themselves by seeking voluntary treatment or safety, the original meaning of “asylum.” Better gun control laws could be enacted. Each problem family members face needs to be unpacked rather than seeking one sweeping solution that has the potential like Eugenics to snowball into future tragedy.

If the American public moves with fear and hysteria into supporting the new Murphy Bill, including its budget cuts to rights organizations, grants for recovery programs, and its medical model treatment bias, we may someday look back in shame on the means of forced treatment we use to justify public safety. While those with physical disabilities struggle with barriers of architecture, those diagnosed with mental illness face barriers of attitude. Sterilization, mental hygiene, and forced treatment (including restraints and seclusion) and exclusion from mainstream society speak to our narrow concept of human diversity. The widest range of human variations in race, genders, ability, socio-economic status and interdependence is part of democracy’s promise of social justice for all.

25 COMMENTS

  1. “I knew a lovely woman named Clara who was diagnosed with schizophrenia and loving another teenager. She became pregnant. Upon delivery the baby was placed up for adoption because Clara couldn’t hold a baby bottle properly ”

    Let me guess, tardive dykinesia? Cant think of a simple other reason that a “schizophrenic” person wouldn’t be able to properly hold a baby bottle… probably should be some mention that there really isn’t any other reason. It either had to be iatrogenic, drug induced brain damage, or the statement makes no sense.

  2. I wonder how many “NAMI mommies” would support psychiatric treatment if they were aware of its roots? …

    In this video, psychiatrist Peter Breggin discusses the euthanasia that took place in Nazi Germany against the “mentally ill.” These programs served as a training ground for the later mass extermination camps for Jews:

    http://breggin.com/index.php?option=com_content&task=view&id=288

    I also wonder how many “pro-choice” people who support Planned Parenthood if they were aware of the history of the organization. I would suspect that not many supporters are knowledgeable of its roots; full of racism and eugenics:

    https://www.madinamerica.com/forums/topic/psychiatry-and-planned-parenthood-common-history-of-racism-and-eugenics/

    (Chose the Forum section, so as not to derail from the blog author’s article).

    Duane

    • Duane: I was just listening to a Pacifica Radio broadcast about the implications of the Hyde Ammendment on public policy- This seems to be on the one hand and on the other hand issue. Senator Henry Hyde was a philanderer who made hay out of Clinton’s picadelos (sic) what ever one thinks about abortion or Bill Clinton, both figures helped two ingrain a Dickensian double standard in our society. The Hyde Ammendment does little to impede well-off women from getting abortions, but it does render poorer women with fewer choices and greater financial burdens for carrying them out.
      On the other hand, NOW oriented feminists who priviledge reproductive rights over other social issues, likely don’t take into consideration the Eugenics slant when it comes to socially engineering Downs people out of society, the forced sterilization of black and white mountain women, or how Russia women feel about abortion being the defacto only form of birth control available. I find the Comstockery Right-wing in this country to be a nuisance, but Third World people treated to Sangerism family planning may well be put more upon.

      • “Socially engineering Downs people out of society?”

        I cannot imagine such a world.

        Regarding the topic of abortion at large, I can only say that my views on the subject are “biased” on my religion, a large part of who I am.

        I simply believe that an individual’s worth is not contingent upon anybody’s assessment, but on something much higher. And that worth is beyond imagination.

        Best,
        Duane

          • The federal government has programs for children; the states as well. The welfare spending per year by feds/state is approximately a trillion dollars per year. Yet the long-term success these programs is not good.

            Since LBJ’s ‘Great Society’, we continue to see poverty, dependence; breakdown of families, especially in minority communities.

            I think we need safety nets, both public and private. I also think we need to create incentives to help people wean off these programs, so they can move away from dependence and poverty.

            In short, it’s more complex than continuing to call on the federal government to do more. We need to do more – in communities, private non-profit, religious organizations. We need to believe in people. Not scream at them to get a job, but encourage them to begin to believe they can become more independent (actively inter-dependent).

            We need to encourage and support strong families – ones with two parents, whenever possible, while providing resources for single parents. But this is not the stuff that the federal government has a strong track record in promoting. The government is large, bureaucratic, removed… and 18 trillion dollars in debt.

            We can make a “great society,” by using *many* creative ideas, and implementing them.

            We. Not solely the federal government.

            Duane

      • Also on a related topic on Pacifica’s project censored, the host and the guest discussed mass incarceration, and included psychiatric incarceration in the same breath. Most of the broadcast was devoted to the private corrections system as it intertwined with minimum sentencing guidelines, private prison control of immigration prisons, and the requisite lobbying and scare mongering that takes place in the electoral arena. The broadcast mentioned, but I did not catch the name of the prison located next door to the “psych hospital for pedophiles.” of the same name. Apparently there is another one of these afoot in California in the Stockton area. (Film maker Louis Proyect featured the “hospital” in one of his documentaries). The broadcast did not go into detail about the role of psychiatry in this project, but it did take a couple of much needed side swipes at the unholy alliance of mass incarceration, moral panic, and the pseudoscience of psychiatry. The broadcast took pains to note the massive cash cow generated by this, noting the high salaries of the psychiatrists and the profit motive of the private prison industry.

        • IMO, there is a huge difference between someone who is violent, and who has been convicted of rape, murder, armed robbery and someone whose greatest “crime” is emotional distress.
          It saddens me that we are somehow in a place where we are in the position to be having this conversation. What happened to the Constitution?
          There are criminals who need to be locked up, but I think it’s time we looked at decriminalizing street drugs (not legalizing then, but decriminalizing them). Our prisons are not good places to help people get off of them, so they can be active members of society. We need more places where they can get help. This is a huge problem, and needs to be addressed. Of course, this applies to people on psychiatric drgs as well. We are simply going in the wrong direction.
          Duane

  3. If it looks defective it is defective. Spartans killed the visibly defective http://www.history.com/news/history-lists/8-reasons-it-wasnt-easy-being-spartan

    If a tree did not produce fruit they would cut it down. Bible “A healthy tree cannot bear bad fruit, nor can a diseased tree bear good fruit. Every tree that does not bear good fruit is cut down and thrown into the fire.”

    Modern psychiatry predicts a bad outcome , then makes it come true with the meds/drugs/chemicals.

    Circular reasoning.

      • Stephen: My uncle is buying the Hawkings book for my son’s graduation. Nice to see Hawking stand up for Palestinian rights. Woody Gutherie had Huntington’s Disease. Current gene therapy to detect this disease now exists. Had this been used at the turn of the century, there would have been no This Land Is my Land This Land Is Your Land, nor Arlo’s Alice’s Restaurant.

  4. Bonnie,

    Thank you for this comparison, I agree it’s appropriate. Especially since it seems that our country has been taken over by the exact same central bankers our founding fathers warned us about, and the same “warrior elite” families and corporations who financed both sides of WWII (research the Bush family, for one). Thomas Jefferson quote:

    “If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around them will deprive the people of all property until their children wake up homeless on the continent their Fathers conquered…I believe that banking institutions are more dangerous to our liberties than standing armies… The issuing power should be taken from the banks and restored to the people, to whom it properly belongs.”

    The scientifically invalid “mental illnesses” allow those in charge to divided people within a nation. And, of course, divide and conquer has long been known to be a tactic to destroy nations.

    • Someone else: Our mainstream media constantly harps on the evils of various potentates, strongmen, evil dictators like the Kim Dynasty in Korea, or the Assad family in Syria. The great labor leader, presidential candidate, and war resister Eugene V. Debs once remarked, when asked, what he thought about the threat of the Prussian Junkers:Debs remarked, that he was more worried about the American Junkers-today’s Cintons and Bushes.

      • I think some American leaders are good and some are evil, and the evil goes all the way to the top. I come from a die hard Republican family, I’m personally registered as an independent, however. I’m not certain, personally, who is good and evil. And I have no desire to know in my waking hours. I personally pray for those who believe “In God We Trust” to win.

        But as a woman of English and German decent, I do have concern of the evils our founding fathers warned us.

  5. I’ve been thinking lately that the Nuremberg trials after World War ll were not inclusive enough to bring to trial for crimes against humanity key members of the Rockefeller family and foundation, the same with Carnegie and Harriman and key employees and associates of all 3. I’m sure there were other’s including Prescott Bush but had the 3 big eugenic financial supporters been brought to trial at Nuremberg and the truth brought out about their support for Eugenics and the nazis and time at least served in prison— the same robber baron family’s and foundations and other’s would not have, maybe, had there been proper vigilance, brought to us the poisoness wine of eugenics in ever more inclusive and deadly variations like pseudo science laden health care including the deadly corrosive and coercive pharma-electric psychiatric cartel that is sweeping across the planet like some ancient Biblical plague. Maybe they were just to big to fail.
    I think we need to name names , What are the names of those individuals in the pharmaceutical cartel who profit the most, same for psychiatry .
    Maybe enough interest at some point can be created for an international boycott of their interests , that can crush their bottom line. No one can afford to let them hide any further behind too big to fail. For more root info see Edwin Black’s book ” War Against The Weak” and Robert Young’s book “Sick And Tired”.

    • As a woman whose father was arguably the number one MIS specialist within the US banking industry in the late 1980’s, who did retired early in 1994, because of his disgust at our government’s insane new banking policies. I will say the evil “too big to fail” bankers our founding fathers warned us of did seemingly take over around then. There are no economies of scale that make any bank “too big to fail,” this makes no sense. Our country has been taken over by the evil people our founding fathers’ warned us of.

      • And the mainstream medical and psychiatric industry have been defaming and discrediting all those, including us innocent innocent people who had no idea we might be a potential threat, since 2001.. Perhaps, at some point, the US medical community should get out of the business of defaming, discrediting, tranquilizing, torturing, and trying to murder all those who believe “in God We Trust,” since the Federal Reserve bankers obviously stopped doing so around then?

    • Yes, I picked up this valuable book at an independent book store in Asheville, NC. I haven’t read Black’s book on IBM, but along with Charles Highman, and the authors of books on Operation Paper, and I believe Robert Procter on psychiatry in Nazi Germany, it is apparent that the US Govt. has been soft on fascism. Of course Stalin and his fellow travelers were evil, along with Andre Marty, the commander of the International Brigades in the Spanish Civil War, but our “leaders,” entertainment media, and textbooks whitewash their complicated with the Nazis and other tyrants out of our history. I find it more fruitful to judge revolutionary governments on a case by case discussion, rather than to listen to anti-communist demagogues.

  6. The author says in her first paragraph that both eugenic sterilization and forced drugging legislation “proceed out of good intentions.”

    Really?

    With the sickeningly high numbers of psychiatric patients (variably 50-80%) who report having been sexually abused when they were young, I’d say the Murphy Bill would be more accurately described as the “Child molester protection and assistance act of 2015.”

    • Do you realizing the point you are missing? The oppositions good intentions can lead to results you don’t like, so the first step is to get those intentions understood. That might take rambling or fighting it out. But to divert attention from the author’s carefully considered focus on language and the type of policy it implicates, to some contrived variation on berating Mufphy himself doesn’t bring like minds together right.

      • traviller-vous,
        ” …so the first step is to get those intentions understood.”
        This is precisely what Edwin Black in his astounding book “War Against The Weak ” does all documented in detail and proof laid out like no other. I’ve found used copies at times available at http://www.Abebooks.com for around $17 . Pretty cheap for an essential documented history of what every human should know so they can speak more realistically about our issues here at MIA.
        Sincerely, Fred Abbe

  7. Bonnie Schell – I notice that you cite the Bazelon Center in your discussion of interpretive context for the benefit of mental health consumers. At least, the mention of the Bazelon Center puts me in mind of that old-fashioned language because their specific influences, ala paternalistic intentions, and their consistent push to over-ride the high civil rights standard approachable under the McNaughton rule years ago, generated the consequences in many aspects that led to the ripest conditions for the very abuses we see in psychiatry today. The problems stemming from lack of accountability and low quality of care given resources available, deliberate inattention to Big Pharma kickbacks, as well as concomitant misleading propaganda about it, are all sociopolitical and socioeconomic effects that depended on the types of extrajudicial authority that Bazelon types of paternalistic liberal ideologues always understood as predictable. Once seeking to enhance the extrajudicial authority of mental health authorities, forever doing it, the self-styled liberal establishment stands. Not only pschiatrist’s ability to detain without explanation, but their state-sanctioned demagoguery under oath as forensic psychopathologists, has never not been part of the Bazelon Center’s and mainstream Treatment Advocacy and Patient Advocacy (pressure) groups’ agenda against psychiatric patients’ and survivors’ empowerment. As for the supposed disvalue to us of persisting to fight the anti-responsiblity partisans favoring the insanity defense, the functional value of such forensic testimony in manipulation of trials and legal enforcement of mandated treatment protocols, this was roundly and patently dismissed as “a public service” for its lacking veracity as expert testimony, or even commitment to it, by none other than Michel Foucault himself. The McNaugthon rule was both more stern about formal protections of due process for defendants and more cordial to actual litigation procedures in many ways in comparison to the insidiously paternalistic values proscribed, and exploited grandly, by psychiatrists, enjoying their developing inroads into government bureaucratic agencies, such as they could enjoy them so conveniently under the intended directions of the Durham rule which came to replace McNaughton. Bazelon lobbied hard for against McNaughton, as I’m sure you can find out. In language and intent, meanwhile, the Durham rule that Bazelon escorted toward official and widely publicized acceptance, and that Bazelon intentionally helped to install, sets the direction by which the Murphy bill now fits into place in our legal adjudicatory framework of laws–laws at work mainly for the self-serving mental health establishment, and hardly a comfort to survivors and patients condemned to indefinite “stays” in involuntary “care” facilities. Certainly mindful of the elitist and entitlement driven atittudes that would be further encouraged in their exploitation of psychiatric patients’ freedoms and individual needs, our Bazelon Center types of “protectors of patients” must have found it just as plain to see is the convenience of their efforts, inlcuding the Durham rule, to those KOL leaders in the behavioral healthcare fields who wished us to become eventually fully socialistic in providing mental health solutions according to medico-therapeutic statism in the full sense of the word. But the liberal establishment itself wouldn’t hypocritically look the other way on such far flung manipulations of government expansionism in order to benefit the more affluent and empowered, not being the same meticulously structured bureaucratically minded regulating network of American institutions fervently “defending” the poor and downtrodden, would they? But, yes, they and their nested mental health insiders obviously would. See Cato Institute’s policy report here:

    http://www.cato.org/sites/cato.org/files/pubs/pdf/pa590.pdf

    Good intentions aside, then, and rights given priority from the first, how should we take it that getting all significant legal changes understood to the nth in terms of good intentions–and notably, all of a sudden, according to the implicit distraction for the apparent Right/Left partisan divide–how and what should we believe about this focus on good intentions in more detailed historical relief? With the implication adumbrated by your discussion setting into question, as it does, the Murphy bill…as well-meant but sadly misguided, what should we seek to learn about the intentions of “our side”? Murphy’s bill really is the historically logical successor to the Durham rule hailed as most compassionate and “realistic” for constraining the voices of the parity we most truly need, and as usual this brave, bold change that wasn’t that got hailed by so-called progressives and leading liberals intending to keep up the drumbeat for making psychiatry great. Does this mean for your discussion of good intentions in your article that there is a silver lining here somehow, on the visible horizon of this step backwards that the Murphy bill represents for survivors–one that will give us means to account for the negative effects of the previous historical move away from McNaughton? Or can a return to that rule’s precepts of legal over psychiatric authority, in the vein of some constructive legal revisions, bring a competing proposal to life for beginning work on legislation to supercede the Murphy bill? Will it just be back to the supercilious policy position of the establishment and Bazelon types of men in black frocks and white lab coats and, in turn, the ladies among them in theirs, and all those followers emulating and adoring their so very thought-out thoughtful ways? But aren’t these the inauthentic attitudes and unwise behaviors that got us the wondrous new scheme to enforce ineffective and disabling treatments that we so dislike? Orwill it some day no more funny stuff based on labels? Will it ever be with the pretense of opposing camps where infighting Left of center displaces meaningful arguments center stage, ad infinitum? Is any peer rights group besides CHRUSP the apt choice for leadership in the legal arena, in this general area? They seem most well informed and motivated for deciding terms and conditions that put good intentions into trustworthy operational form to me.

  8. I am proud to know Bonnie and even prouder to read her work for the first time. She has fleshed out the issues well and deserves thanks from those of us who have been in the trenaches of the battle for digni;ty and respect for those diagnosed and labeled as “defective” by our contemporary US society.