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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Rzip on November 23, 2000, at 23:21:44
Feel free to share your experiences from medical settings: How has your autonomy been violated because of your diagnosis?
Posted by dj on November 23, 2000, at 23:43:27
In reply to Autonomy and Mental illness , posted by Rzip on November 23, 2000, at 23:21:44
> Feel free to share your experiences from medical settings: How has your autonomy been >violated because of your diagnosis?
Medical diagnosis or not, it's one's beliefs that limit as much as not...it seems, which just adds to the negative spirals (or positive ones if one is cycling in the differet direction - nocebo vs placebo effects)... which is why cognitive therapies can work and help if one is willing to engage them consistently. Seems to me faith has a lot to do with it in one's own abilities and judgements...which through a depressive lens can be depressing...and negatively re-enforcing.
Came across an interesting book which I scanned which seems to make a few good points on all this. : "Half Empty, Half Full: Understanding the Psychological Roots of Optimism" by Susan C. Vaughan, M.D., who is an assistant professor of psychiatry at the Columbia University College of Physicians and Surgeons. A graduate of Harvard and Columbia University, she is the recipient of numerous research awards and the author of "The Talking Cure".
As one Amazon.com reviewer noted: “Half Empty, Half Full is good news for pessimists, and even good science, a timely summary of the state of neuroscience, as it bolsters many theories of what Vaughan describes as the "positive psychology movement." The antidepressant Paxil, early cortico-limbic development, desperation in milk-treading lab rats, even Cocoa Crispies ("which are apparently like ambrosia to rats")--they're all here and, thanks to Vaughan, good reading and a compelling argument for not simply chalking up pessimism to factors beyond our control. --Paul Hughes “
Nuff said... I'm outta here...
Sante!
dj
Posted by Rzip on November 24, 2000, at 0:04:40
In reply to Autonomy and Mental illness , posted by Rzip on November 23, 2000, at 23:21:44
RE-TITLE:
Feel free to share your experiences from medical settings: How has your self-determination been violated because of your diagnosis?
Posted by stjames on November 24, 2000, at 15:50:02
In reply to Re: Self-determination and Mental illness, posted by Rzip on November 24, 2000, at 0:04:40
> RE-TITLE:
> Feel free to share your experiences from medical settings: How has your self-determination been violated because of your diagnosis?James here.....
Perhaps if you flesh this out a little more it would help.
james
Posted by dj on November 24, 2000, at 16:59:55
In reply to Re: Self-determination and Mental illness, posted by stjames on November 24, 2000, at 15:50:02
> > RE-TITLE:
> > Feel free to share your experiences from medical settings: How has your self-determination been violated because of your diagnosis?
>
> James here.....
>
> Perhaps if you flesh this out a little more it would help.
>An example of what exactly you mean, perhaps from your own experience, would help...
> james
Posted by coral on November 24, 2000, at 18:04:11
In reply to Re: Self-determination and Mental illness, posted by dj on November 24, 2000, at 16:59:55
I encountered incompetent members of the medical community (physicians and psychiatrists) during an anguishing severe clinical depression, and stayed "under their care" far, far too long. Had I not been depressed, I feel certain that I would've realized the incompetence sooner. The experience was very hard on my own belief in myself. However, concerning self-determination, if anything, it was increased. I kept fighting until I found the right combination of docs and meds.
So, while their incompetence was a violation to my dignity, (and they were an embarrassment to their own profession), I never lost my autonomy or self-determination.Coral
Posted by Rzip on November 24, 2000, at 18:28:21
In reply to Re: Self-determination and Mental illness, posted by dj on November 24, 2000, at 16:59:55
In my education, we are taught that patient's autonomy triumphs all else. As long as the patient is a competent individual, his medical decisions (matters of life and death) are supposed to be respected above all else. Throughout the courses, I continue to struggle with the term competency. In literature, it seems to be so clear cut...you know, if you as a clinician is in doubt, get a psych consult. It's like if the psychiatrist say the patient is competent...volia, autonomy of the patient triumphs; and if the psychiatrist's diagnosis is incompetency...volia, the responsibilities shift to the proxy.
The truth of the matter is that clinicians always hold back in their respect for the patient's own self-determination, especially when that patient has a psychiatric history. Despite the advances in mental health education, the stigma toward the patient(s) is still acted out by the very people who are supposed to be most educated.
So, the question that I put to you guys is the following:
Do you feel that your decisions about your health (physical and mental) is being disrespected by your clinicians? Even more importantly, how competent do you feel about your medical decisions?Personally, I fear that I will always be looked down upon by my clinicians. My insurance company helps to pay for my therapy sessions. Is it unethical to treat me in a more hesitant and cautious way?
The real dilemmas for me: How competent am I to make my own decisions? Is my mentalility compromised by my roller-coaster health? How much respect do I deserve? Am I a nuiance or a contributor to society? Am I a good person overall? Will I learn from my past mistakes and grow up to be a significant contributor to society? And finally, will my earnest dream to be a healthcare provider ever bear fruit? Am I still fooling myself? WHAT AM I GOING TO DO WHEN I GROW UP?
Now, your turn to share your thoughts from your experiences...
- Rzip
Posted by stjames on November 24, 2000, at 18:54:08
In reply to Re: Self-determination and Mental illness, posted by dj on November 24, 2000, at 16:59:55
> > James here.....
> >
> > Perhaps if you flesh this out a little more it would help.
> >
>
> An example of what exactly you mean, perhaps from your own experience, would help...
> > jamesJames here...
Never mind !
Posted by dj on November 24, 2000, at 19:43:00
In reply to Re: How competent am I?, posted by Rzip on November 24, 2000, at 18:28:21
> So, the question that I put to you guys is the following:
> Do you feel that your decisions about your health (physical and mental) is being disrespected by your clinicians? Even more importantly, how competent do you feel about your >medical decisions?I'm not going to go into much detail here other than to say that the quality and speed of treatment depends on how curious you are and the better off you are info. and resource-wise, mentally and financially the better the system works for you...generally...
>Will I learn from my past mistakes and grow up to be a significant contributor to society? And finally, will my earnest dream to be a healthcare provider ever bear fruit? Am I still fooling myself? WHAT AM I GOING TO DO WHEN I GROW UP?
>Depends on you, who you deal with, luck and determination and articulation and willingness to hardily pursue what you desire. If you haven't already read it check out: "An Unquiet Mind" by Kay Redfield-Jamison who suffers from bi-polar and is one of the leading and respected authorities on the same...
Sante!
dj
Posted by Rzip on November 25, 2000, at 10:16:01
In reply to Re: How competent am I?, posted by dj on November 24, 2000, at 19:43:00
np
This is the end of the thread.
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