Dr Phil Barker is an artist,
psychotherapist and Honorary Professor in the School of Medicine, Dentistry and
Nursing, University of Dundee
ethics: the elephant in the room?
For thousands of years, ‘mad’ people were
viewed as possessed by demons or other malicious spirits. We tried to rid
ourselves of such superstitions by renaming such people ‘mentally ill’ – though
the actual causes have yet to be found. Today, we talk about ‘mental health
problems’ – another illustration of our uncertainty over what possesses people
to act in the way they do.
One thing is
clear. The ‘mad’, ‘mentally ill’ or those with a ‘mental health problem’ are
vulnerable. They risk discrimination and rejection along with a host of other
disadvantages. Often they are powerless to control their lives and find
themselves detained and contained by some mental health legislation, which
claims to be in their ‘best interests’.
If we wish to refuse medical treatment for a physical
illness, believing that further treatment would be futile, that is our
prerogative. We may even choose a lingering death if that is our wish. Such a
liberty is frequently denied those who are ‘mentally ill’ on the grounds that
they are unable to make ‘rational’ decisions.
Instead, they may be obliged to submit to highly unpleasant
‘treatments’, which may calm the outward disturbance but may do little to ease
the distress raging within.
We still do not know with any certainty what is ‘mental
illness’, but more people than ever are diagnosed with such ‘disorders’. Ironically, recovery rates were better 60
years ago, before the development of psychiatric drugs, than they are today;
and coming off such drugs is often shown to be the quickest route to long term
recovery. Despite this, forced drug treatment alongside deprivation of liberty
remains the keystone of our ‘mental health’ legislation. This is the ethical
elephant in the room.
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