Are there many ethical issues specific to forced psychiatric treatment of the schizophrenic?
I'm guessing there's a few, if the failure of psychoanalysis to treat the schizophrenic represents a failure of the universality of its claims.
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2Is there something missing?– gnasher729Apr 19, 2016 at 7:58
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Please expand on what you would like to consider coercion, treatment, and the degree of the illness. Or are you asking... Is it ever ethical to force treatment onto someone who is ill? Sorry, my level is too low to comment– Eliot G YorkApr 19, 2016 at 20:38
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2Freud actually thought that schizophrenia should not be treated by psychoanalysis, and even that it could not be treated by his primary methods. The 'talking cure' in his opinion needed defenses and compromizes to deconstruct, and the problem with schizophrenia was a complete failure of defensive structure. So there is no such claim for its universality, at least at its source.– user9166Apr 19, 2016 at 21:33
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@jobermark that was pretty much my point.– user6917Apr 20, 2016 at 2:58
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3the failure of psychoanalysis to treat the schizophrenic is like the failure of screwdrivers to drive nails. It isn't designed to treat schizophrenics, it cannot treat schizophrenics, and its handbook says that is adequate to treat neurotic symptoms, not psychoses, schizophrenia included.– Luís HenriqueAug 18, 2016 at 14:48
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4 Answers
Are there many ethical issues specific to forced psychiatric treatment of the schizophrenic?
I'm guessing there's a few, if the failure of psychoanalysis to treat the schizophrenic represents a failure of the universality of its claims.
It's a bit unclear whether you realise that there is a distinction between psychiatry and psychoanalysis. Some people who called themselves psychoanalysts refused to coerce their patients, see e.g. - 'The Ethics of Psychoanalysis' by Thomas Szasz.
There are ethical issues in the treatment of schizophrenia. One issue is that lots of psychiatrists say it is an illness like diabetes, but they are wrong and are giving bad advice. There is no way to detect schizophrenia by finding a chemical structural abnormality in the body. A pathologist could never look at a corpse and conclude the person had schizophrenia. Schizophrenia is always diagnosed by looking at person's behaviour and complaints made about him by himself or by others. Schizophrenia is a label to legitimise coercing a person in the light of such complaints. Claiming schizophrenia is an illness is similar to counterfeiting:
http://www.independent.org/publications/tir/article.asp?a=557.
This obscures moral and personal problems and so makes it more difficult to solve such problems.
Another ethical problem with coercive treatment is that it amounts to imprisonment or forced drugging without trial. As such, coerced treatment is a grave threat to the rule of law. See "Law, Liberty and Psychiatry" by Thomas Szasz.
Could you be more specific about the psychoanalytic part of your question? Also, If you could provide some context it would be easier to look for article or book that will be best for you.
As for the rest of the question, there is a lot of ethical/moral issues concerning treatment of mental illness especially schizophrenia. For a starter in schizophrenia treatment, you could read one of these:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719554/ and especially
you can look also in textbooks of psychiatry for the ethical issues concerning coercive treatment of mental illness in general.
The Hippocratic Oath is considered as a moral yardstick of the medical profession. Hence a discussion on that point would have to take it into consideration. Though it would have to be taken in its entirety, I excerpt the following parts (in its classical form):
"I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."
"Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief [...]."
What are the ethical issues specific to the coercive treatment of schizophrenia? Are there many ethical issues specific to forced psychiatric treatment of the schizophrenic?
Yes, coercive or otherwise, psychiatric treatment is ethically problematic, but not without pragmatic resolution. If a person is causing harm to their self or others, then, as with any psychiatric emergency room prognosis, critical triage and long term management of the condition have their relative considerations including probabilistic merits and liabilities. "Coercive" however, seems somewhat dismissive of extenuating circumstance and any ethical issues would consider these pertinent, no?
I'm guessing there's a few, if the failure of psychoanalysis to treat the schizophrenic represents a failure of the universality of its claims.
If -analysis is used to mean the resolution of something complex into simpler constituents and psycho- (from the Greek psyche) likewise used to mean "self" or "breath" (as opposed to the imponderable use of psycho- to mean "spirit" or "soul") then it is arguable that psychoanalysis is not so much the point of failure as its misapplication to physiogenic malady. Unlike psychoses (e.g., schizophrenia, etc.) neuroses are not physical conditions; they are not brain disorders; they do not have physical causes; they are purposive behavior (e.g., phobias), something you undertake, not something you undergo. Neuroses may benefit from psychoanalysis, but psychoses not so much.
Also, I think the ethical problems are more specific to the forced aspect, as well the efficacy of even relevant psychiatry. In the case of emergency, tho, there are uppers, downers and stabilizers and the physiological considerations of appropriate diagnosis and application are a matter for the practitioner, not the philosopher.
As for the philosophical relevance, if you have not read Frank Cioffi's work on Freud, I think you might appreciate his work, e.g. "Was Freud A Liar?" & an extract from “Are Freud’s Critics Scurrilous?" - otherwise if you are registered w/Jstor a bunch of Cioffi's writing is available there.
Also, consider that the reason why, for example, Freudian explanations are not hypotheses is not just that they cannot be verified or falsified; it is that anything given in their support are themselves incapable of being verified or falsified. Example: How do we know that a man's unconscious desires to (1) have sexual intercourse with his mother, (2) bear his father a child and (3) be reborn manifest themselves and find fulfillment in the act of defecation? Such claim cannot be verified because the desires Freud claims are unconscious, to which the patient cannot attest because he is wholly unaware of them; and such claim similarly cannot be falsified because any grounds given to falsify the claim that taking a shit is to the patient fulfillment of an unconscious wish to have sexual intercourse with his mother would itself be imponderable. Plato's idea of Forms and indeed all of metaphysics are exactly like Freudian explanations: In all cases there are claims to knowledge for which no one or no thing can be given to verify or falsify either the claim or the evidence given in its support. To say that there is an idea of a thing to which all like things aspire and partake may give pause for contemplation, but it is not demonstrable by any rational means. Ask yourself: Why is no more known about Forms now than was known upon first utterance, and this despite tedious frequentation over two millennia? Answer: For same reason that no more is known about the unconscious, id and superego than was known upon first utterance 100+ years ago.