Protect the Mentally Ill — St. Louis Post-Dispatch — Editorial

May 30, 1998. St. Louis Post-Dispatch. Editorial.

“Protect the mentally ill.” p. 38

What sort of physician would take schizophrenics off their medications and give them drugs known to cause paranoia just to see how the patients react?

What sort of unscrupulous researchers would give psychotic patients amphetamines to worsen their symptoms so the changes in their brain chemistry could be tracked with the latest technology?

These are just tow examples of the kinds of abuses federal officials found in a nationwide investigation of nearly 300 research projects involving the mentally ill. Investigators for the National Bioethics Advisory Commission found that mentally ill patients were commonly taken off their medicines so doctors could observe psychotic behavior. In some cases, researchers replaced beneficial medicines with harmful substances so doctors could observe their effects. And many patients, despite signing consent forms, apparently did not understand their role in research projects.

Such unethical and inhumane treatment of vulnerable people must stop immediately. Stronger protections to safeguard the mentally ill must be put in place and strictly followed.

Federal rules governing psychiatric research do not now require special protections or competency requirements for mentally ill subjects. But in light of the new findings, the National Institutes of Mental Health – which funds many of the mental health experiments – is reviewing its guidelines.

New guidelines should include rigorous requiremnents that scientists justify high-risk experiments to local reviw boards. Researchers should provide legal and medical monitors, to whom patients can appeal during experiments. The review boards should have to include at least one patient advocate.

In addition, researchers should have to do more than just get a signature on a consent form. Researchers who recruit mentally ill patients should be reuired to test patients to see if they are really capable of giving consent. Studies have shouwn that fewer than half of the psychiatric patients understand the standard consent forms they signed. Doctors need to take more time to talk in depthe with their patients.

Given the chilling history of some psychiatric research, and the profession’s continued resistance to more stringent standards to protect patients’ rights, it’s unlikely that any change will be voluntary.

Consider the comments of Dr. William Carpenter of the Maryland Psychiatric Research Center, in defense of studies where patients were taken off medication for observation.

“If they hear voices 15 times, instead they might hear them 20 times a day,” Dr. Carpenter said. “It may not necessarily cause them distress.”

The fact that the nation’s leading research agency on mental health issues has approved, funded and in some cases even conducted tests that violate the most basic elements of humane treatment is irresponsible and shameful.

Mental patiens must no longer be subjected to unethical scientific experiments. The National Institute of Mental Health, and the entire psychiatric profession, must move quickly to protect the rights of these vulnerable patients.

© Copyright 1998. St. Louis Post-Dispatch, Inc.

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