Alan I. Leshner, psychiatrist and former head of the National Institute of Drug Abuse once stated: “My belief is that today...you [the physician] should be put in jail if you refuse to prescribe S.S.R.I.s [the new types of antidepressants] for depression. I also believe that five years from now, you should be put in jail if you don’t give crack addicts the medications we’re working on now.”
In the many years of working on mental health reform, I have spoken to hundreds of physicians and thousands of patients, while helping to expose numerous psychiatric violations of human rights. However, until recently, the thought had never occurred to me that physicians’ rights might also be under assault. Why should a physician be jailed for refusing to prescribe an antidepressant for depression?
Many primary care physicians have acknowledged there are numerous physical conditions that can cause emotional and behavioral problems, and the vital need to check for them first. It follows then that relying on an antidepressant to suppress emotional symptoms, without first looking for and correcting a possible underlying physical illness, could simply be giving patients a chemical fix, while leaving them with an illness that could worsen.
What if a primary care physician or family practitioner correctly diagnosed and cured such a physical illness and the depression ended without psychoactive drugs? Could that physician then be accused of being unethical, or even be charged and jailed for the “criminal medical negligence” of not prescribing an antidepressant?
Crazy, you say? Couldn’t happen? Well, perhaps. But it seems the day has come when a good physician can be accused of being unethical for practicing ethical medicine. Today, a physician, specialist or otherwise, can be criticized, bullied and treated like a “fringe” dweller for practicing workable, diagnostic medicine.
This information has been gathered with physicians in mind, particularly those who would just like to practice nonpsychiatric medicine, who are driven by a high and caring purpose in the best Hippocratic tradition, and who want to be left to get on with the job of caring for people’s health to the best of their ability. It is for physicians who are concerned about the fact that millions of children are taking prescribed addictive, speed-like stimulants for a supposed mental disorder, Attention Deficit Hyperactivity Disorder (ADHD).
There is a pervasive mental health thinking that appears in primary care medicine today. It is largely due to the “success” of psychiatry’s diagnostic system, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). This system and the mental diseases section of the International Classification of Diseases (ICD-10) have been heavily promoted as vitally necessary, mental disorder standards for nonpsychiatric physicians.
But there is something else here. Psychiatry’s diagnostic system did not arrive in a spirit of professional respect for the traditions and knowledge of primary care medicine and other medical specialties. There was no letter of introduction saying, “We respect the sanctity and seniority of your relationship with your patients, and your wish to provide the best for them. Here is our diagnostic system, please look it over and first satisfy yourself from your own experience that we are on the right track. This is valid science. We would appreciate your feedback and constructive criticism. By all means holler for help if you need us. Yours in the quest for better health.”
Instead, it arrived in effect saying, “Here is a young child with severe mental problems. Our expert diagnosis is already made, in which case you have to do no more than follow our strict drug prescription instructions and be subject to our expert supervision.” Or put otherwise, it says, “Your patients seem to trust you more than us, so here is how you have to diagnose their mental illness, from which they undoubtedly suffer.”
This is the coercive undercurrent that has indelibly characterized psychiatry since it first assumed custodial duties within asylums 200 years ago. It is manifest in many different ways, and wherever it meddles, it is extremely destructive of certainty, pride, honor, industry, initiative, integrity, peace of mind, well-being and sanity. These are qualities that we must fight to preserve for all patients. And for all physicians.
Sincerely,
Jan Eastgate
President
Citizens Commission
on Human Rights International
