Psychiatric terms need clarification

I WAS interested to read the letter by Fiona Crowley, of Amnesty International Ireland (Irish Examiner letters, January 3), in which she outlined the organisation’s position on the use of forced psychiatric interventions involving electroconvulsive ‘therapy’ (ECT).

She states that “it should only be administered after obtaining informed consent — whether from the person or, if they lack capacity, their personal representative — and where the decision has also been confirmed by an independent authority”.

I object to the use of psychiatric terminology such as “capacity” and “informed consent” which has often been used to argue that a person lacks “insight” into their “illness” and which is then used to justify psychiatric force against those who resist the medicalisation of their mental and emotional distress.

Indeed, such people are simply told that they lack insight or capacity, despite the fact that there are no objective medical tests which can prove the existence of even one of the so-called mental illnesses.

If Amnesty is saying that a “patient” who in advance has chosen an advocate or representative to object to ECT or any other psychiatric intervention on their behalf when they are judged to lack capacity — and that this should overrule the views of the psychiatric profession or any other independent authority — then this is to be greatly welcomed.

If, on the other hand, the organisation is saying that the profession and independent authority or tribunal should be the final arbiters in these matters, then I oppose them on civil libertarian grounds.

In my view, a person has the right to be “mentally ill” and suffer no infringement of their civil liberties provided they do not commit a crime or infringe upon anyone else’s human rights.

We should remember that people with objectively diagnosed and real medical illnesses have the right to refuse treatment and are not subjected to the use of force.

It is also my view — and that of the psychiatric survivor movement — that ECT and interventions involving neuroleptic drugs cannot be considered genuine medical treatments given that their only real effects are irreversible memory loss, brain damage and neurological illnesses such as tardive dyskinesia.

Sean Fleming

Bishop O’Donnell Rd

Rahoon

Galway