Apathy or a lack of ethical integrity?

photo: Sky Blue Sight blog

I am a MadMother  and I advocate for the removal of fraudulent research data from the 'Evidence Base,' i.e. Study 329.  I advocate for the raw data from the TEOSS drug trials to be made available to the American people, we paid for it--a couple kids paid with their lives, I hear...I advocate for psychiatry to demonstrate ethical integrity by demanding it from research psychiatrists, peer reviewers, and members of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry who are 'Key Opinion Leaders.'  I also advocate  for all psychiatrists, AKA 'psychopharmacologists'  to stop medically neglecting their patients with iatrogenic diseases, and  neurological and cognitive impairments.  I am a MadMother advocating for psychiatrists to  stop pretending  that iatrogenic drug-induced deaths are 'natural' deaths---let's be real, they are in effect and in reality, iatrogenic homicides.   

My son had serious behavioral problems as a child and adolescent---he really struggled and was aggressive and violent when he was a kid---I never gave up on him and he tried harder than anyone I have ever known to be different.  I am now and I was then, real clear on this point: There is no way in hell I wanted him to believe that his emotional and behavioral problems, his psychiatric diagnosis, or his victimization were an excuse or a reason that he was not responsible for his own conduct.  It was the hardest thing that I have done as a mother---to hold him accountable, for his own actions regardless.  I did it because I love him.  In the real world, it is important that one be accountable for oneself; and responsible for one's actions.  I have no doubt whatsoever that blaming psychiatric diagnoses cripples people with self-stigma; it grants people permission to abdicate having any personal accountability relieving them of any real sense of responsibility for their own conduct. 

I avoid speculating about events and crimes without any actual facts upon which to base my speculations.  I do not assume when heinous criminal acts are committed, the person who is the perpetrator must be "mentally ill."  Speculating without any factual information, is basically gossiping and spreading rumors; both of  which feed biases, bigotry and fears.  Biases, bigotry and fear are fueled by bio-psychiatry and 'advocates for the seriously mentally ill' and the unethical journalists who use tragedies as a marketing tool to sell more ads in their news forums, and/or for furthering a personal agenda. Misinformation and misdirection of precious resources reinforce biases, feed ignorance, heighten fear and seemingly justify bigotry; ultimately further stigmatizing people who are labeled with psychiatric diagnoses.  Advocates claim we are not depriving enough people of their Constitutional Rights to Substantive Procedural Due Process of Law. In reality the US legally compels "medical treatment" which is neither safe nor effective for far too many. So-called patient advocates are demanding increased "access" to community treatment orders, and Involuntary Inpatient Treatment as if it is perfectly acceptable to act as if SOME people (the "seriously mentally ill")  just don't have any Human Rights, i.e. individual rights under the US Constitution that are worthy of preserving or defending.  When biased  and outright false 'information,' gossip, and innuendo can be used as "evidence" admissable in Courts of Law, when Court Orders to deprive people with psychiatric labels of their Liberty, their human dignity, and potentially their lives, preserving their Human Rights is not possible without Due Process of Law, which means adhering to the Rules of Evidence required in every other Court proceeding.

The proponents of increased access to 'medical treatment' under Court Order for those who are diagnosed with mental illness fail to acknowledge that psychiatric drugs can and do cause sudden death and disability. Not counting the bodies of those who die or the number of people disabled, or mentioning that the drugs also increase the risk of suicidal and homicidal behavior, does not make the drugs more effective or safe; it only demonstrates a lack of concern for those who are maimed and killed by the drugs.  Direct  'adverse effects' are caused by a drug's mechanism of action, calling these adverse effects, "side-effects" is inaccurate and misleading, i.e. dishonest and unethical. The failure to provide appropriate information in order to ethically obtain Informed Consent for treatment is pervasive and appears to be intentional. There are mighty serious risks for people who take psychotropic drugs so why are the drugs commonly prescribed off label at all? The fact the drugs are prescribed without appropriate information and are legally forced by Court Order seems to be criminal mis-treatment of the mentally ill, not ethical medical treatment of a condition, much less medical care provided FOR the person who is the recipient of it.

  

Never trust a man's opinion without knowing his vested interest.

photo and quote credit

My 'vested interest' is doing everything in my power to prevent another child or adult from being mis-treated, misled and maligned by unethical 'professionals' like my precious son has been. Psychiatrists have repeatedly traumatized him instead of helping him deal with the reality of being a crime victim who was beat up and locked in a closet. Instead of treating his PTSD, as their own guidelines recommended--being 'psycho' pharmacologists, they drugged him with teratogens instead. Being doctors, they could legally, if not ethically, prescribe any drug with impunity; so long as there is agreement among psychiatrists doing so is acceptable...

Psychiatric Standard Practice: A consensus-based treatment recommendation. 

There isn't even definitive empirical support for using the drugs in standard clinical practice for any purpose in children; that I've found---but then I'm no doctor...But, if there were evidence of a neuroleptic drug's safety and efficacy, why is psychiatry permeated with ethically questionable "standard" practices which are based on consensus instead of data?  It is fairly easy to trace the development of many unethical standards, and then reasonably conclude that the standards serve to facilitate cooperation in illegally marketing of the drugs for use in children. Psychiatry fails to discredit unethical researchers; fails to retract fraudulent, biased, "peer reviewed" journal articles; and uses Continuing Medical Education as a means to further propagate pharmaceutical companies marketing agendas.

Psychiatrists, psychopharmacologists, the "professionals" who have redefined and repurposed the privilege of writing "off label prescriptions;" prescriptions no longer require empirical support. Somehow, the powers that be determined after the latest Senate Investigation, into the the Medicaid fraud due to the off label drugs being prescribed to kids on medicaid, that it's a good idea to trust the same "professionals" to fix the mess they've made, the plan is to continue monitoring the situation... No plan to STOP the ongoing fraud. No plan to stop the unethical "medical treatment" that is being billed to Medicaid fraudulently. No plan to act proactively to protect children at risk of being inappropriately prescribed teratogenic drugs. The plan is to have the same psychiatrists responsible for this medical malfeasance to "monitor" the ongoing criminal provision of "necessary medical care," and of course, to continue to (mis)educate others... 

Here in Washington State, the State has imported the use of TMAP and continues to act as if doing so is a public good that is helping patients... It is not ethically, scientifically, medically, or morally justifiable to have imported this social engineering program which was supposedly a 'health plan.' AS IF the health of the patients was even considered in it's development! TMAP was sold as a treatment algorithm, but is in fact a marketing agenda developed to make money for the pharmaceutical industry by robbing we the people through Federal Medical programs claiming that it would save money and ensure appropriate treatment is provided for the unfortunate mentally ill...Most of the money has been 'made' by committing Medicaid and Medicare fraud-- The Medical Institutions and federally funded psychiatric researchers apparently have some kind of hypnotic power over the membership of the America Psychiatric Association and the American Academy on Child and Adolescent Psychiatry.  Psychiatry is complicit in an ongoing criminal enterprise, psychiatrists continue to willfully commit Medicaid fraud by using consensus as a means to standardize unethical treatment methods. These treatment algorithms developed by consensus form the foundation of psychiatry's currently used 'Standard of Care.'

This whole scheme rests on selling the belief that it is being done to treat 'diseases;' no disease has ever been found, mind you---they're doctors we are to trust blindly; and everyone else is a patient, or potential patient.

Don't question! Respect psychiatric authoritah!!! 

Reminds me of Cartman...

THAT'S THE PLAN.

CAN YOU SAY RICO STATUTE?

There is no honor in being a doctor who lies to a child, and lies to the parents. In all reality, it is criminal to medically treat a person and/or conduct research in a manner that ignores altogether the Hippocratic Oath. Any reasonable person who has even a modicum of critical thinking skills would wonder, "Does psychiatry conform to ANY ethical, scientific, medical or legal standards?" Honorable people who are medical professionals would have no reason to treat fellow human beings as if they are less than worthy of respect; and undeserving of the truth. Honorable medical professionals would not purposely use fraud to ensure treatment compliance, or spread misinformation about what is and is not known about the nature of the psychiatric diagnoses themselves, and the drugs theoretically medically treating the underlying "diseases" that psychiatric professionals theorize are causing the diagnoses psychiatrists develop by consensus...

Medical professionals don't seem to know what children are taught in Grade School:

Human Rights are not "earned" and can be neither diminished nor deprived.
Human Rights cannot be stripped from anyone due to having any "medical diagnosis" under color of law.

Psychiatric diagnoses are not "medical diagnoses" in any case. Psychiatric diagnoses are derived from a political process and are adjudicated to become a legal determination, i.e. a legal judgement and sentence.
None of these legal machinations are a substitute for ethical medical diagnostic and treatment procedures...  

updated 4-21-2014 

previously titled:  Is it apathy or ignorance caused by a lack of ethical integrity? 

originally much longer, and titled, "Is it apathy or ignorance caused by a lack of ethical integrity?"

Psychiatry: focused on defending unethical research and clinical care standards instead of real world outcomes

"Currently, there are no pharmacological or psychosocial therapies with enough evidence in youth samples to meet the standards for empirically-supported treatments as defined by Chambless & Hollon (1998; Brown et al., 2008; McClellan & Werry, 2001)." here

via NYTimes:
Use of Antipsychotics in Children Is Criticized
By GARDINER HARRIS

Published: November 18, 2008

a few excerpts:

"From 1993 through the first three months of 2008, 1,207 children given Risperdal suffered serious problems, including 31 who died. Among the deaths was a 9-year-old with attention deficit problems who suffered a fatal stroke 12 days after starting therapy with Risperdal."

"At least 11 of the deaths were children whose treatment with Risperdal was unapproved by the F.D.A. Once the agency approves a medicine for a particular condition, doctors are free to prescribe it for other problems."

"Panel members said they had for years been concerned about the effects of Risperdal and similar medicines, but F.D.A. officials said no studies had been done to test the drugs’ long-term safety."

"Dr. Dure said he was concerned that doctors often failed to recognize the movement disorders, including tardive dyskinesia and dystonia, that can result from using these medicines."

“I have a bias that extra-pyramidal side effects are being under-recognized with these agents,” Dr. Dure said.

"Dr. Laughren of the F.D.A. said the agency could do little to fix the problem. Instead, he said, medical specialty societies must do a better job educating doctors about the drugs’ side effects." here

via Archives of General Psychiatry:

Original Article | June 2006

National Trends in the Outpatient Treatment of Children and Adolescents With Antipsychotic Drugs

Mark Olfson, MD, MPH; Carlos Blanco, MD, PhD; Linxu Liu, PhD; Carmen Moreno, MD; Gonzalo Laje, MD

an excerpt:

Child and adolescent mental health visits that include antipsychotic treatment occur disproportionately among publicly rather than privately insured patients. After adjusting for patient diagnosis and other background characteristics, mental health visits by publicly insured children and adolescents were significantly more likely to include prescription of an antipsychotic medication. This finding is in line with higher youth antipsychotic prescription utilization among populations covered by Medicaid^2 - 3 compared with commercially insured populations.⁴ The basis of this is unknown but may relate to differences in public and private payer reimbursement schedules for pharmacologic or psychological interventions, insurance-related variations in parent or child acceptance of antipsychotic treatment, or selection of patients in different insurance plans by physicians for treatment. Because Medicaid covers children and adolescents with Social Security Income and young people who are medically needy or in foster care, illness severity may account for differences in antipsychotic medication use across insurance groups.²⁹ Additional study is needed to understand the factors that contribute to insurance-related differences in child and adolescent antipsychotic treatment.

Approximately one third of the child and adolescent visits with prescription of antipsychotic medications were by young people with mood disorders. In addition, approximately one third of antipsychotic visits included coprescription of an antidepressant medication and one third included coprescription of a mood stabilizer. At present, there is a dearth of empirical evidence to support these prescribing patterns. 

In office-based practice, almost all of the antipsychotic treatment among children and adolescents is provided by psychiatrists. Although the NAMCS data suggest that primary care physicians and other nonpsychiatrist physicians provide care in approximately half of the youth mental health visits, they seldom prescribe antipsychotic medications. (emphasis mine) here

via American Journal of Psychiatry:

November 01, 2008 

Double-Blind Comparison of First- and Second-Generation Antipsychotics in Early-Onset Schizophrenia and Schizo-affective Disorder: Findings From the Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) Study

Linmarie Sikich; Jean A. Frazier; Jon McClellan; Robert L. Findling; Benedetto Vitiello; Louise Ritz; Denisse Ambler; Madeline Puglia; Ann E. Maloney; Emily Michael; Sandra De Jong; Karen Slifka; Nancy Noyes; Stefanie Hlastala; Leslie Pierson; Nora K. McNamara; Denise Delporto-Bedoya; Robert Anderson; Robert M. Hamer; Jeffrey A. Lieberman

Am J Psychiatry 2008;165:1420-1431. doi: 10.1176/appi.ajp.2008.08050756

a couple of excerpts:
Finally, different choices could have been made with regard to the specific medications studied. At the time the trial was initiated, olanzapine was widely used in the pediatric population, whereas quetiapine had a small market share. Ziprasidone and aripiprazole, both of which may have fewer metabolic side effects, were introduced subsequent to the initiation of the study. Efforts to introduce them partway through the study were not supported by the FDA or NIMH. We also considered utilizing a placebo for comparison, as opposed to a first-generation antipsychotic. We expected that this would increase the demonstrated efficacy of the second-generation antipsychotics, but it would not address the fundamental comparative questions. Distributing the sample among four treatment conditions rather than three would also have reduced statistical power. We also considered requiring a drug-free baseline to minimize the likelihood of finding no apparent benefit of substituting one partially effective treatment for another. However, concerns about the long-term consequences of delaying effective treatment and associated recruitment difficulties argued against including a placebo treatment group or a drug-free baseline. At the time the study was initiated, there were significant ethical concerns about utilizing any first-generation antipsychotic in comparison with second-generation antipsychotics, because second-generation antipsychotic treatment was the standard of care for early-onset schizophrenia and schizoaffective disorder. We felt any traditional medication selected as a comparator would have to provide a strong potential advantage to maintain therapeutic equipoise. Molindone was chosen as the best option among first-generation antipsychotics based on its low propensity for both weight gain and extrapyramidal side effects. Despite this advantage, molindone is not commonly used in clinical practice. A more frequently used medication, such as perphenazine or haloperidol, might have facilitated comparison with adult studies and acceptance in the community. Failure to require a drug-free baseline may have reduced response rates and led to earlier treatment discontinuation.

Another potential limitation of the study is the 8-week duration of treatment. Different patterns of response or risk of side effects might have emerged over a longer trial. Some young people may require more extended therapy to adequately respond, and it is likely that some aspects of the illness, such as negative symptoms, neurocognitive function, and associated anxiety, may require longer periods to recover (44, 45). However, published standards of care for early-onset schizophrenia and schizoaffective disorder recommend the use of 6- to 8-week trials (1). A longer acute phase trial would have increased the risk of exposing subjects to prolonged ineffective treatment. Furthermore, antipsychotic medication trials in adults with schizophrenia suggest that nonresponse as early as 2–4 weeks after initiating treatment predicts nonresponse up to 12 weeks later (46–49).

The results question the nearly exclusive use of second-generation antipsychotics to treat early-onset schizophrenia and schizoaffective disorder. The safety findings related to weight gain and metabolic problems raise important public health concerns, given the widespread use of second-generation antipsychotics in youth for nonpsychotic disorders. here

Let's be real, using neuroleptic drugs for any psychiatric diagnosis is not supported by any definitive evidence; calling the drugs "effective treatment" is more than stretching the truth---Indeed, the evidence clearly demonstrates neuroleptic drugs are minimally effective for a small minority of children and adults experiencing symptoms of psychosis; and have significant disabling and fatal risks particularly for  children and the elderly.  The standards used in clinical practice are not supported by or derived from empirical data from clinical trials, or data collected from the decades long use of neuroleptic drugs off label in clinical practice---begging the question, how did prescribing these drugs to children "off label" become a "standard practice?"  This experimental use is a standard of care only because it was discussed, and adopted as a "standard" by psychiatrists. It is not because the prescription of neuroleptics is supported by, or derived from any empirical data of the safety or efficacy for the symtoms the drugs are being prescribed to children and youth to treat. In psychiatry, there are standards of care that are without support from any ethical scientific psychiatric research.  Since they are not derived from or supported by the evidence base, these so-called "standard practices" are not ethical medical standards. The drugs are used off label as a "standard" treatment due to the hubris of psychiatric professionals who have determined that consensus will suffice in place of the objective evidence that theoretically is required for a particular practice to become a clinical care "standard." 

I have been reading 'peer-reviewed' psychiatric journal articles for over ten years and I am still amazed at the lack of critical thinking exhibited by the psychiatrists who do the research and write the articles.  The utter lack of of ethical integrity of "RESEARCH PSYCHIATRISTS" is truly stunning.  The commonality is that all of them continue to repetitively state more evidence is needed to support psychiatric standards of care that are the standards psychiatrists disseminate to other professionals for clinical use; and teach to students and other medical professionals! When reporting trial results that don't support the standards used, which are the recommended 'first line treatments' that comprise the Standard of Care---does it not occur to any of these geniuses that the standards are not ethical medical standards!?  Apparently, psychiatric research and clinical practice requires no critical thought...

For example, in the TEOSS drug trials, 12% of patients enrolled were "effectively treated."  97 out of the either 116 or 119 enrolled experienced a serious adverse event; the Olanzapine arm was stopped due to the number of adverse events---At the time, Olanzpine was the most widely prescribed neuroleptic drug in the pediatrics population!  BUT there were no warnings for professionals to stop prescribing the drug to children...Exactly how many more children need to be subjected to what are harmful teratogenic neurotoxic drugs which may in fact disable and kill them, before "external forces" put a stop to these dorktors conducting research in their attempt to validate unethical standards of care? 

As a society we need to recognize that Human Experimentation on people given a psychiatric diagnosis is not an ethical standard of care; nor is it a benificent act. 

The BEST INTERESTS of the patient must come first---even if the patient is unpleasant, and even if we have been taught that the some psychiatric diagnoses mean that a patient's Human Rights can be ignored or revoked--in the interests of society... It is immoral, and it is unconstitutional.  It is also the same ignorant reasoning used to implement Eugenics laws in this country that brutalized tens of thousands, and unlike the Germans in WWII, we didn't keep track of those we killed.  America's program wasn't as 'successful' as Germany's, but it has left a stain.  Worse than that, the fundamental social control strategies and bigotry that propelled eugenics as public policy remain embedded in our publicly funded social service and mental health programs.  Sadly, the lessons learned have not remained in the general public's collective conscience...  

I believe the fact that medical care is supposed to be in the best interests of the patient, has been lost in the debate about how to help 'the seriously mentally ill' altogether.  Patients are being used as research fodder and Human Experimentation is standard psychiatric clinical practice.  In Medicine, a "standard practice" is theoretically supposed be derived from and well-supported by empirical evidence that is ethically gathered and reported in an unbiased manner.  In psychiatry, standards are discussed in committees and "validated" by a vote; these are not scientific methods, so the "standards" are unethical.  Without empirical evidence to support a particular "standard practice" or treatment protocol it is not a "standard of care," it is nothing more than an affirmative defense for psychiatric fraud and medical malpractice.  

The academic elite, Key Opinion Leaders who are members of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry are unethical psychiatrists who are desperately defending what are obviously gross departures from ethical scientific methods and ethical medical practice, inexcusable errors in judgement, and blatant abuse of power and authority.  Ironically, these medical professionals are doing this while claiming it is not their ethical medical duty to treat the iatrogenic neurological impairments brain damage and physical diseases psychiatrists inflict upon their patients.  It is medical neglect; it is criminal.  Psychiatrists are doctors, doctors should treat the illnesses they cause instead of spending so much time defending their so-called "professional integrity."  Perhaps treating the iatrogenic illnesses and injuries they are causing will remove the scales of prejudice from their eyes...

It is certain that continuing to deny the iatrogenic harm psychiatrists are causing patients while simultaneously medically neglecting the victims and frantically tryiing to validate unethical clinical care standards with federally funded seeding trials, are desperate, dishonest acts that serve only to further undermine the integrity of psychiatry as a profession.  It's sheer hubris to vehemently defend unethical "standards of care" and "professional integrity," (which is sorely lacking) while maligning psychiatric survivors; adding insult to iatrogenic injury.  It's not possible to regain trust  with the same dishonest, unethical behavior that destroyed it. 

via Vitals NBCNews.com:
Docs: Antipsychotics often prescribed for 'problems of living'
by Sandra G. Boodman Kaiser Health News  March 18, 2012

"Adriane Fugh-Berman was stunned by the question: Two graduate students who had no symptoms of mental illness wondered if she thought they should take a powerful schizophrenia drug each had been prescribed to treat insomnia."

"In 2010 antipsychotic drugs racked up more than $16 billion in sales, according to IMS Health, a firm that tracks drug trends for the health-care industry. For the past three years they have ranked near or at the top of the best-selling classes of drugs, outstripping antidepressants and sometimes cholesterol medicines. A study published last year found that off-label antipsychotic prescriptions doubled between 1995 and 2008, from 4.4 million to 9 million. And a recent report by pharmacy benefits manager Medco estimated that the prevalence of the drugs' use among adults ballooned more than 169 percent between 2001 and 2010."

"Wayne Blackmon, a psychiatrist and lawyer who teaches at George Washington University Law School, said he commonly sees patients taking more than one antipsychotic, which raises the risk of side effects. Blackmon regards them as the "drugs du jour," too often prescribed for "problems of living. Somehow doctors have gotten it into their heads that this is an acceptable use." Physicians, he said, have a financial incentive to prescribe drugs, widely regarded as a much quicker fix than a time-intensive evaluation and nondrug treatments such as behavior therapy, which might not be covered by insurance."

"Medco is asking doctors to document that they have performed diabetes tests in patients taking the drugs. "Our intention here is to get doctors to reexamine prescriptions," Muzina said."

"In the short term, I don't see a change in this trend unless external forces intervene." here

Silence It's Not Dark Yet

Mother and Child  Picasso

Silence
the sound of silence

reverberates

pounding in my still heart

 as my breath

fills my gasping

lungs then

slowly

pushes out

that which life

held until

spent

It is a universal truth that pain is individual; unavoidable.  

One must be aware to avoid one pain, means experiencing another.

I now know why my son pities those who have harmed him.