ethics

In the post on anorexia and coercive psychiatry, one side-topic that’s been raised in the comments thread is the use of psychopathology as a way of dismissing complaints.

Remember this case? The emo kid who came to CAMHS and found himself being hectored by a consultant psychiatrist, accused of being in a cult and having his depression and self-harm dismissed as a fashion trend. Funnily enough, his mother made a complaint against the psychiatrist.

The case was discussed with another psychiatrist in CAMHS, who had not met the patient or his family. Nor had he read the notes. His response to the complaint?
Read the rest of this entry »

This post is specifically directed at Ted, our occasional representative of Thomas Szasz-esque libertarianism and opponent of all forms of coercive psychiatry.

So, Ted, this is from me, a jackbooted representative of evil psychiatric totalitarian bastardry, to you, brave standard-bearer of freedom and liberty.

And the subject of this post is: eating disorders.
Read the rest of this entry »

Behaviour. Is it choice or is it pre-determined?

Read the rest of this entry »

Everyone employs moral reasoning in various situations, almost daily. To pay taxes, to not speed, to honour promises - all require a sense of moral reasoning. Some things we know intrinsically as being good simple choices - to kill is bad - to give to charity is good.

But when it comes to making more complex moral decisions, such as enforced medication, declining leave or involuntary treatment - how trained are nurses in the process of moral reasoning?

Read the rest of this entry »

As I’ve mentioned previously, the drug companies heavily target my CAMHS service with drug lunches, sponsored conferences and freebie handouts, usually for ADHD medications.

Just browsing through the NMC Code of Conduct, I notice one of the obligations of a nurse is that:

You must refuse any gifts, favours or hospitality that might be interpreted as an attempt to gain preferential treatment

Well, I’d say that whenever a drug company provides us with lunch, gives us some free pens or post-it notes, or sponsors a conference, they’re certainly hoping to gain preferential treatment for their medication. They’re certainly not doing it because they think we look hungry or could do with a pen.

Therefore, surely that means that all this big pharma schmoozing and gifting is causing nurses to breach our own code of conduct regularly, and on a massive scale?

(For more on this sort of thing, please visit the No Free Lunch website)

The quickest and most effective way to totally invalidate somebody’s viewpoint - as I’m sure Ted will be happy to tell you - is to state that they’re mentally ill. The psychoanalytic movement in particular used to be notorious for dressing up their feuds in the language of psychopathology. At its most horrific extreme, the Soviet Union used psychiatric hospitals to incarcerate and drug political dissidents on the grounds that “no sane person would declaim against Soviet government and Communism”.

The example I’m going to use isn’t anywhere near on that scale, but it does demonstrate the ways in which psychiatric labels can be abused as a means of attacking a political opponent. It involves none other than my old mate Dr Crippen.
Read the rest of this entry »

The National Health and Social Life Survey supervised by Dr. Edward Laumann of the University of Chicago, was the largest and most reliable of its kind in North America. Laumann and his team reveal that straight women report having had five sex partners since they turned eighteen. Straight men report having had seventeen. As William James’s doggerel puts it

Hogamous, higamous; Men are polygamous.
Higamous, Hogamous; Women monogamous.

But is this true? Logically it takes two to tango so you might expect women and men to have almost the same number of sexual partners. In most countries the number of women exceeds the number of men by a few percentage points but this could only account for a tiny share of the discrepancy. Also adult men have sex with teenage girls more often than adult women have sex with teenage boys, but the survey only asked how many partners the respondents had had since the age of 18. The number of sexual relationships between adult males and minor females are a tiny fraction of all sexual encounters so this is unlikely to explain the discrepancy either.
Read the rest of this entry »

I read this here the other day. In it the author, Unity, takes Edward Leigh MP to task for his views on abortion and his links to a pro-life lobby in the House of Commons seeking to advance the case for increased restrictions on abortion. The piece is an intelligent one and well written and I would recommend the site, “Ministry of Truth” to anyone.

Read the rest of this entry »

A recent scenario gives me cause to vent. But also to raise for discussion the ethically debatable issue of ‘where to draw the line?’ when it comes to detained mental health treatment. The Shrink raises similar issues in his blog on issues of capacity and Advanced Directives.

My scenario revolves around Pt X who has a long standing diagnosis of schizophrenia. Now this in itself is a load of crap. He does however have some educational deficits, a limited ability to cope with stress and possibly an alcohol induced dementia. Mostly these are environmentally and culturally within the norm for his social group as such presentations are widespread amongst the communities from which this man hails.

Read the rest of this entry »

Many areas of MH nursing require the use of evil. Probably many areas of all nursing but I will write about what I know.

Some of the following is planned to be aggravating & provocative.

First of all a definition of evil from the Compact Oxford English Dictionary:

adjective 1 deeply immoral and malevolent 2 … 3 extremely unpleasant

Number 2 involves the devil, I may return to Nursing and Satan in a later post

Read the rest of this entry »