Chemical restraint or “medicine”

An interesting editorial has appeared in the Las Vegas Sun Times about an investigation of hospital staff neglecting to report incidents of using psychiatric drugs to subdue patients that were considered ‘out of control’. The hospital being investigated is Rawson-Neal Psychiatric Hospital in Las Vegas. The editorial is titled Protect Patient Rights.

My concern is that the fact that those patient rights are also human rights might be skipped over in a cursory scanning of this editorial by a reader. The editor of the Sun Times apparently had no problem indentifying them as patients, but whether he had any inkling that those patients were also human beings is another thing again.

Alright, Patient 3267, you didn’t receive your Miranda Rights because you have less rights than a prisoner does in the criminal justice system. It’s easy to forget here that you are also a human being, a citizen, and a member of the public.

As Marshall Allen reported in Saturday’s Las Vegas Sun, investigators looked at 10 randomly selected cases and found that the hospital failed to disclose the use of medicine as a “chemical restraint” in all of them. Investigators said that in two of those cases the hospital staff failed to give any reason for using the drugs.

10 randomly selected cases? That is disturbing!

However, the state official who oversees the Las Vegas hospital said it did nothing wrong and plans to appeal the finding to a hearing officer. Howard Cook, head of the state’s Mental Health and Developmental Services Division, said the hospital does not use chemical restraints. Instead, he said, the drugs in those cases were used as part of the treatment for psychological issues that caused behavior problems.

I get it. Define chemical restraints. Treatment of “psychological issues” leading to “behavior problems”. He hasn’t used the word that relates most directly to the pathologizing of behavior, and that word is psychiatry. If we’re only talking psychology here then that pathology is still not beyond question.

Although this appears to be a matter of semantics, it is an important distinction. There is a significant difference between using a drug in a crisis to calm someone and using medication therapeutically to treat a mental illness. The investigation paints a picture of the use of medications as a chemical restraint. It says that drugs were given to patients, without their authorization, in response to specific behaviors or situations, including aggression, threats or agitation. Three of the patients were not only given medication, but they were also physically restrained.

Diagnosis is determined by a doctor. Argue with the doctor’s diagnosis, resist the chemical restraints, and you will be both physically restrained and chemically restrained. That some people will only be chemically restrained by physical assault is an issue that is not being dealt with here. Under most circumstances assault is treated as a criminal offense. Unfortunately this is not the case when the people doing the assaulting are the staff in a psychiatric facility. The issue here regards the little matter of the reporting of these incidents in which patients (human beings, citizens, and members of the public) were physically assaulted and forcibly drugged.

The documenting and reporting of these incidents isn’t to create more paperwork, it’s for safety. Documenting why patients are given medication gives patients and their doctors a record of what happened. Because they are being given the medications without patient consent, there has to be a solid reason for it, otherwise the hospital is violating patient rights.

This investigation follows the death of a patient last month from some indeterminate cause, a patient who was supposed to have been under observation by staff, and a fine lodged against the hospital for an attack last year made on a woman patient by a male patient who was known to be violent.

Let’s hope that the fact that these patients are human beings, citizens, and members of the public finally begins to dawn on people in general. In this instance, and in many others like it, that mistreatment which goes about mascerading as acceptable medical practice needs to come to an abrupt end.