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News of the Day ... In Perspective

10/02/2006

Psychiatry used as a tool against dissent

In March, a former nuclear scientist and vocal public defender was forcibly taken from her home after police broke down her door and injected her with haloperidol. Marina Trutko was then subjected to daily injections for six weeks at Psychiatric Hospital No. 14 in Dubna, Russia, to treat her for a “paranoid personality disorder.”

An independent psychiatric evaluation found her to be “very gifted and creative,” and without symptoms of a psychiatric disorder. She is able to quote the minutiae of Russian law from memory.

Although she was released, Trutko said her career had been ruined. “I will always have this medical record now. That means I cannot go to court because judges say I’m a psycho and call for an ambulance.”

Despite reforms in the 1990s, forced psychiatry has reemerged in Russia as a weapon to intimidate or discredit citizens who tangle with the authorities, according to the Independent Psychiatric Association of Russia. Also, in business or family disputes a wrongful hospitalization creates an opportunity to seize someone’s property.

Last year, Nikolai Skachkov, who protested police brutality and official corruption in the Omsk region of Siberia, was ordered to undergo a psychiatric evaluation because investigators said they suspected he was suffering from an “acute sense of justice.” He spent 6 months in a closed psychiatric facility, with a diagnosis of paranoia. An independent evaluation concluded that he was healthy.

Current abuse is “not on a mass scale like in Soviet times, but it’s worrying,” said Lyubov Vinogradova, executive director of the Independent Psychiatric Association of Russia.

In the Soviet years, tens of thousands of dissidents were imprisoned, sometimes for years, in psychiatric “hospitals,” based on trumped-up diagnoses of schizophrenia. Opposition to Communism was considered to be evidence of insanity (Peter Finn, Washington Post 9/30/06)

In the United States, the Federation of State Medical Boards has seemingly embraced the concept that the “disruptive physician” has a “mental illness” that needs to be treated. AMA CME credits are granted for courses about the diagnosis and treatment of this illness.

The Committee for Physician Health (CPH) of the Medical Society of the State of New York offers help to disruptive physicians. It has a toll-free line to report such physicians, with all calls being “strictly confidential.” MSSNY does acknowledge that the “accused still merits due process” (MSSNY’s News of New York, September 2006).

Some advertisements of self-styled centers of excellence for treating the “disruptive physician” talk about “therapeutic punishment.” Being forced to pay the cost of an inpatient stay plus the financial loss from being away from the practice are supposed to be therapeutic, notes Lawrence Huntoon, M.D., Ph.D., Chairman of the AAPS Sham Peer Review Committee. Moreover, calling an “offense” an “illness,” and substituting “treatment” for “punishment” can allow hospitals, managed-care plans, or medical boards to circumvent due process.

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