INTRODUCTION The Manipulation of Medicine

In 1998 Alan I. Leshner, psychiatrist and former head of the National Institute of Drug Abuse 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 more than 25 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 traditional, workable, diagnostic medicine.

This publication has been written 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).

It is also written for anyone who thinks that government employees threatening parents with charges of criminal neglect for refusing to drug their child with stimulants or antidepressants, as is happening now, is more than just a little strange.

How did this state of affairs come about? We trust that this booklet helps to answer that question.

There is a pervasiveness about the 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 (DSMIV) . This system and the mental diseases section of the International Classification of Diseases (ICD10) have been heavily promoted as vitally necessary, mental disorder standards for non-psychiatric physicians.

But there is something else here. Among the many pressures facing physicians today, there is one that is unique, in that it is accompanied by a subtle quality of malignant enforcement. 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. 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, wellbeing and sanity. These are qualities that we must
fight to pre serve for all patients. And for all physicians.

Sincerely,

Jan Eastgate
President,
Citizens Commission on Human Rights International

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