Hi Andrea,
I'm not a medical ethicist (I do medical humanities, that is I use
literature, film & literary theory and criticism to teach med and nursing
students about the socio-cultural aspects of illness & disability, although
I have some training in bioethics & teach in bioethics courses). Anyway,
your email is an excellent call. Not only because of cases like Ashley, I
think that feminist bioethicists could learn more about & from disability
studies and disability rights, and, in particular, about the social model of
disability. In fact, I think that that model extends to all conditions
treated in medicine.
Below I've copied a few links to mad movement/psychiatric survivor groups
you're likely familiar with (but perhaps others on the list aren't). They
both have links to articles. You might also want to look at Brad Lewis's
Moving Beyond Prozac, DSM, and the New Psychiatry: The Birth of
Postpsychiatry.
http://theicarusproject.net/
http://www.mindfreedom.org/
For those not familiar with disability studies, on the broader topic of
disability & feminist bioethics, I recommend Rosemarie Garland-Thomson, for
example "Integrating Disability, Transforming Feminist Theory" from Lennard
Davis's Disability Studies Reader or Susan Wendell's The Rejected Body:
Feminist Philosophical Reflections on Disability.
Good luck with your work!
Rebecca Garden
Upstate Medical University
>>> <[log in to unmask]> 07/03/09 3:09 AM >>>
I think this list is in a summer slumber but hopefully there are still
some reading:
This past month I taught a graduate course in health ethics for a
master's of health administration program. One of my own areas of
specialization is mental health ethics, which includes the ethics of
psychiatric diagnosis and treatment. I have worked in community
organizations for people with severe problems in living (e.g.
"schizophrenia", and victims of religious and political persecution)
and have presented papers at conferences on human rights and mental
health. When I went to look for materials to use in the course I was
surprised by the assumption in many health ethics articles, some
included in health ethics/bioethics textbooks, of the inherent validity
or "healthiness" of psychiatric diagnosis and delineation, with
examples of people in a "europhic or morbid phase" of "bipolar" or
having values warped or compromised by "a severe psychiatric illness."
Deleterious images of people who are addicted to heavy drugs also
abound. These kinds of perspectives, in my opinion, are harmful to the
health interests of those who have been unfortunate enough to fall into
continual psychiatric attention and stigmatization, such as people with
very poor or noxious networks of support and sufferers of chronic
trauma or victimization.
I do worry about harms falling on psychiatric users with the teaching
of articles to health care professionals and administrators that
present uncritically "the findings" of psychiatry. There are pervasive
destructive assumptions that 1) severe problems in living are primarily
psychological, biological, and genetic-- thoroughly personal-- in nature,
rather than primarily informed by relational/social/cultural factors,
and 2) that mental illness and mental competence are diametrically
opposed to each other (usually people don't see something like chronic
backache, arthritis, diabetes, or itchy skin as necessarily or as a
matter of course posing a threat to mental competence and proficiency).
Health care ethicists have embraced the notion that physical
disability is socially constructed, though the notion that mental
health disability is socially constructed has been less accepted it
seems, though there has been some helpful work on mild- moderate
depression and an excellent anthology by Fulford, Dickenson and
Murray-- "Healthcare Ethics and Human Values." Sometimes this can be
because of a conflict of interest, where health care ethicists are
friends and colleagues of psychiatrists; I have known a few health care
ethicists in this conflict. But I hope feminist health care ethicists
can help more with this problem. I am hoping to write more on this
topic this summer. In the meantime, if people are wanting to be
sensitive to this issue in their own writing or anthology editing, I
would be happy to give input from my grass roots experience.
Thanks for reading, Andrea Nicki
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