Posted by Racer on October 16, 2005, at 13:58:06
In reply to Treatment or control?, posted by med_empowered on October 16, 2005, at 6:02:17
> I think the poster raises an important point--historically, medications have often been used to control "symptoms" (and people) instead of empowering them. Look at Thorazine and the other early neuroleptics. Not only were they used on those with schizophrenia, they were also used: in "hostile" elderly people (very popular in old folk's homes...minimized staff costs), in prisons (both on the mentally ill and the generally aggressive), in juvenile facilities, and in foster homes.
That was pretty much what they had at the time, though. It may not be pretty, but sometimes ya gotta do the best you can with whatcha got, ya know? (I just gotta play The Apologist. Dunno why. Just my mood today.)
>>In fact, some states in the US have recently been found to have over 50% of their foster children on at least 1 psychotropic drug. Think about it. 50% of the kids are mentally ill? Even when you take into account the "disturbed" pasts some of these kids might have, when you have over 1/2 of them on some sort of psychotropic, and many of them on several, there are serious problems.
Yep. That is a problem, and I find it sickening, too. It's unfortunate that the most vulnerable members of our communities are also the least likely to be defended by others. And I'll shut up on that subject before I become uncivil.
>>Sooooo, the point is, I guess, that medication is really like any other drug--they're not really inherently good or bad; the usefulness of their effects really depends on context.
Absolutely, and well stated.
This is where there are a few problems, though, in my experience and opinion. I'm gonna break it into pieces, and hope it ain't too confusing:>> My "tweaks" would include: the end of forced hospitalization,
There really isn't much in the way of forced hospitalization in the US anymore. Mostly, now, there's the short term involuntary hospitalization, for stabilization, and only in cases where there's a pretty clear and immediate danger. This is good and bad, but mostly a good thing.
>the end of forced medication,
I guess I don't know much about forced medication. I have no idea how much of that goes on, because I've never come across it.
> increased penalties for shrinks who over-prescribe and/or expose their patients to unnecessary risk,
Amen to that. I don't remember if you were here when I was going through my nightmare with the psychiatrist whom I reported to the licensing board? Let's just say you'll find no disagreement on this point.
>> increased emphasis on truly **informed consent** for all drugs--in my ideal vision, docs would have to have forms signed for most drugs given to patients, and these forms would have to include data regarding side effects and alternative medications and/or non-drug treatments.
Aha! This is what I really wanted to respond to. During my Nightmare, the doctor had informed consent forms for every drug he prescribed. All the forms included side effect profiles, and a bunch of other stuff. I signed each and every one.
Now ask me if the doctor discussed any of the information on the forms? Ask me if he gave me time to read the forms before signing? Ask me if my consent was truly informed in any way that you and I would recognize?
Having the forms, having the information available, is a wonderful idea, but it's not going to fix the underlying problem for most of the country. For anyone who doesn't have insurance -- had I had insurance, I would have been spared the misery I experienced -- or anyone who doesn't have access to adequate mental health care, the problem will continue as doctors shove forms under our noses and hurry us along into signing. Until there are some fairly extensive and fundamental changes made to our health care system in general, there is very little chance that most patients will be able to give informed consent, no matter what the rules governing it may be.
(Not, you understand, that I have any opinions on this subject...)
I really hope you don't mind that I jumped in on this. Mostly, I agree with you, just had a few experiences that proved to me that informed consent rules aren't nearly enough to protect patients, and felt the need to jump in.
Thanks for your thought-provoking post, by the way. I find your perspective very interesting, always.
poster:Racer
thread:567099
URL: http://www.dr-bob.org/babble/20051010/msgs/567646.html