A medical diagnosis or impairment as such should never be a legitimate ground for forced intervention, treatment or detention. The Committee of the Disability Rights Convention (CRDP) encompasses such a norm in Article 14 where it says "that the existence of a disability shall in no case justify a deprivation of liberty." This is a very important normative standard to be implemented in psychiatric and other facilities. A human rights model of disability demands that forced intervention should not be made merely on a medical diagnosis but instead on the behavior of the individual patient. Nondisabled persons by law usually have recourse to the courts and thus judicial review of their case if subjected to detention or any form of forced intervention.The normative standard in Article 15 (2) of CRPD demands that prevention of persons with disabilities from being subject to torture or cruel, inhuman or degrading treatment or punishment shall be "on an equal basis with others." Thus to provide disabled persons with full and equal human rights protection there needs to be checks and balances in the control of the executive branch as well as full investigation of any violation of human rights law.
Mind-control techniques, including the use of chemical substances,[v] have been used increasingly by those who do torture. Some of these mind control substances have permanent debilitating consequences on the prisoner/patient. Neuroleptic drugs can have an effect of perception that causes loss or separation from self, causing terror and panic that may lead to desperate acts such as homicide and suicide. [vi] Neuroleptic drugs have the signature effects EPS (extra-pyramidal symptoms)[vii] such as psychic apathy or numbing and movement disorders such as akathisia [viii] (extreme restlessness and agitation) with a psychological as well as physical manifestation. Akathisia [ix] can be described as a severe overwhelming sense of gloom and anxiety, an inability to sit still, an intense sense of restlessness and even an almost indescribable sense of terror. When this problem is visible it can manifest itself as a shifting of weight from foot to foot, walking around in the same spot or inability to keep the legs still. This can and is in clinical settings often mistaken for psychotic agitation which then may result in an increase in the dosage of neuroleptic medication thus leading to suicide and homicide. In addition the neuroleptic medications can cause a dysphoric mental state which causes a paralysis of will. So it is no surprise that governments have used these drugs to subject political prisoners to their will and through the effects of mind altering chemicals forced captives to obey them. These drugs can be used make captives sign fabricated statements and to force compliance in video interviews of false confessions. Neuroleptics can also cause a variety of "tardive"[x] or late-appearing syndromes, particularly movement disorders that are frequently irreversible. [xi] Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs, characterized by repetitive, involuntary, purposeless movements. Symptoms of tardive dyskinesia may remain long after discontinuation of neuroleptic drugs. Overcoming of resistance by intimidation or physical force in order to administer such substances against a person's will, can only be seen as a hostile act, within the meaning of intentional infliction of severe mental or physical pain or suffering. [xii]
Within the context of nonconsensual psychiatric interventions, there is loss of liberty and the length of detention is indeterminate and may depend on one's apparent compliance with arbitrary standards. Persons may be taken in their late teens or early twenties, before they have had a chance to experience their full adult powers and competencies, and thus be able to exert their constitutional rights and advocate for their human rights. Sometimes they were involuntarily detained while they were in the midst of intense psychological experiences, and thus the additional suffering caused by psychological mistreatment and torture can be unbearable. The destruction of a person's identity, self-concept, personal relationship to the world, and their inner subjective experience, may be a process of growth when embarked on by choice. But personality change forced by powerful mind altering drugs imposed by another person, is a violent and extreme human rights violation irrespective of the rationale of the perpetrator. This can lead to patient suicide.
For users and survivors of psychiatry, the disclosure of nonconsensual interventions may itself lead to greater discrimination, including the risk of additional periods of incarceration and forced interventions. So silence blankets this routine abusive treatment and leads to continuation of the practice. In addition the elderly, physically disabled and those with cognitive impairments are often captive to their care givers and are thus particularly vulnerable to violations of their human rights especially when these violations are presented as "medical treatment". The involuntary use of psychotropic medications for restraint and control is common. These drugs have been used to allow nursing homes to decrease night time staffing levels by administering drugs to all the patients to keep them in their beds and to prevent evening demands on the nursing staff. This use of drugs for the convenience of nursing staff, or to increase the profit margin of a nursing facility, constitutes a violation of the human rights of the patients. Many individuals have strong feelings and beliefs against the use of psychotropic medication and thus their use constitutes a violation of their constitutional right to religious practice and belief.
There
needs to be two forms of legal protection against torture or ill
treatment:
1. Review and control of medical action
Where the medical doctors sufficiently independent and unbiased in their prognosis and diagnosis?
Is the medical diagnosis correct?
Based on the behavior of the patient is the detention and coercion truly necessary?
Has the coercion and detention been reviewed by an outside human rights expert to have been necessary?
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