Saturday, April 4, 2020

Comments by Vicki Martin, MD

Showing 4 of 4 comments.

  • Hi Peter. Thanks so much for your thoughtful comment. It is quite clear that you “get it”. As for your disappointment with the social work profession, I think many feel uncomfortable questioning a doctor. At a child welfare agency where I consult, we have tried to attack this by education/training social workers about psych medications and ways they can better advocate for the best interests of their clients ie: question the doctor. It has been a heavy lift and am not certain how successful we are.

    I have pretty much given up trying to influence my colleagues (child psychiatrists) which I will expand upon in future blogs.

    At this point, I am wondering if the best way to affect change is through the legal system. The work of Jim Gottstein (an author on this site) pursuing the Medicaid fraud angle is a good example. My paper, (link above) recommends several new regulations. Though this may be unrealistic, I keep wondering if a class-action law suit with foster kids as the class would help. I have run this idea by a few attorneys but so far….. no luck. Thanks again for your input here.

  • Hi Ted. Thanks for your courage in sharing your story. I agree with your view that child psychiatrists are often willing participants in the violation of the human rights of children. As I noted in the paper, children have few rights and legal protections in the U.S. They are generally medicated with psychiatric drugs because their legal guardian has provided consent. Psychiatrists who prescribe these medications to children are expected to complete a robust informed consent process such that the risks and benefits are clearly outlined. There is currently no law that requires a physician to inform a patient or guardian that a medication is being prescribed off-label or outside practice guidelines.

    Many foster children are prescribed medication cocktails of 3+ psychotropic medications. It is important to ask WHO is providing legal consent for this and how is this dangerous practice funded? What I have seen is that an uninformed social worker consents because “the doctor said it was necessary”. As for those kids in foster care, whose parents retain parental rights, the parents often feel pressured to agree to the medications or risk being viewed as “non-compliant” by child welfare officials. As for the funding of these medications, we (taxpayers) are paying for these medications through Medicaid.