By Peter C. Gøtzsche at Brownstone dot org.
When people under psychiatric care commit suicide or homicide, or are killed or seriously harmed, because of medical malpractice, it is extremely rare that it has any consequences for the doctors. Psychiatry seems to be the only area in society where the law is being systematically violated all over the world. Even Ombudsman and Supreme Court decisions are being ignored.
In 2003, using scientific arguments, lawyer Jim Gottstein convinced the Supreme Court in Alaska to decide that the government cannot drug patients against their will without first proving by clear and convincing evidence that it is in their best interests and that there is no less intrusive alternative available.2 Unfortunately, this victory for human rights has not created a precedent in Alaska, where the authorities continue to force people into being treated with antipsychotics. Just like everywhere else, including in Norway.
I have collaborated with Norwegian former Supreme Court Attorney Ketil Lund on these issues, and we explained in a law journal why forced medication cannot be justified. The efficacy of antipsychotics is poor, and the risk of serious harms is so great that forced medication seems to do far more harm than good. Two years later, the Ombudsman concluded in a concrete case, with reference to the Psychiatry Act, that it violated the law to use forced treatment with an antipsychotic.
I studied consecutive cases where patients had appealed forced treatment orders, which had never been done before. It was difficult to get access to the records, but it was worthwhile as it turned out that the legal protection of patients was a sham.
We found that the law had been violated in every single case. The 30 patients were forced to take antipsychotics, even though less dangerous alternatives could have been used, e.g., benzodiazepines.6 The psychiatrists had no respect for the patients' experiences and views. In all 21 cases where there was information about the effect of previous pills, the psychiatrists claimed a good effect, whereas none of the patients shared this view.
The harms of prior medication played no role in the psychiatrist's decision-making, not even when they were serious. We suspected or found akathisia or tardive dyskinesia in seven patients, and five expressed fears of dying because of the forced treatment.
The power imbalance was extreme. We doubted the psychiatrists' diagnoses of delusions in nine cases, and there is an element of Catch-22 when a psychiatrist and a patient disagree. According to the psychiatrist, it shows the patient has a lack of insight into the disease, which is a symptom of mental illness.
The abuse involved psychiatrists using diagnoses or derogatory terms for things they didn't like or didn't understand; the patients felt misunderstood and overlooked; and the harm done was immense.
The patients or their diseases were blamed for virtually everything untoward that happened. The psychiatrists were not interested in traumas, neither previous ones nor those caused by themselves or their staff. Withdrawal reactions after stopping drugs were not taken seriously - we didn't even see this term being used although many patients suffered from them.
When Jim Gottstein and I wanted to do a similar study of 30 consecutive petitions from Anchorage, we were met with so many obstacles that it took over four years of litigation before Jim was granted access to redacted records. US psychiatrist Gail Tasch and I found that the legal procedures were a sham where the patients were defenceless.
In violation of previous Supreme Court rulings, the patients' experiences, fears, and wishes were ignored in 26 cases, even when the patients were afraid that the pills might kill them or when they had experienced serious harms such as tardive dyskinesia. Several psychiatrists obtained court orders for administering drugs and dosages that were dangerous. The ethical and legal imperatives of offe...