Tuesday, November 10, 2009

Significant Moments: Psychoanalytic Character Assassination

     I ask you:
Lucretius, De Rerum Natura.
     What crime of doubt could be greater than that which would rob you of credence?
Richard Wagner, Lohengrin.
      His reputation had . . .
William Faulkner, Light in August (Chapter 11).
        . . . been shattered by . . .
Henry Miller, Man In The Zoo: George Grosz’ Ecce Homo.
                   .
. . psychoanalytic character assassination.
E. James Lieberman, Acts of Will. 
     He was . . .
William Faulkner, Light in August (Chapter 11).
               . . .demeaned in public and private, in plain words and in jargon, in professional and lay circles. . .
E. James Lieberman, Acts of Will.
                       . . . and his opinions were . . .
William Faulkner, Light in August (Chapter 11).
         . . . received with . . .
Jack London, The Sea Wolf.
                    . . . contempt, ridicule or obloquy.
U.S. Supreme Court, Masson v. New Yorker Magazine, Inc., et al. (1991). 
     What did I have to say to that?
J. Moussaieff Masson, Final Analysis. 
     "I'll tell you this. . . ."
Merle Miller, Plain Speaking: An Oral Biography of Harry S. Truman. 
     Put bluntly, . . .
Douglas R. Hofstadter and Daniel C. Dennett, The Mind's I: Fantasies and Reflections on Self and Soul. 
     "They can all go to Hell."
J. Moussaieff Masson, Freud and the Seduction Theory quoting Sigmund Freud, Letter to Wilhelm Fliess.
     Period. End quote.
U.S. House of Representatives, Hearings of the Committee on Veterans' Affairs.
_________________________

February 22, 1999

Mr. James R. Granger, Jr.
Executive Director
Government of the District of Columbia
Board of Medicine
Dept. of Consumer and Regulatory Affairs
Occupational and Professional Licensing Administration
614 H Street N.W., Room #108
Washington, D.C. 20001

Re: Mr. Gary Freedman: your letter of January 6, 1999

Dear Mr. Granger:

This is not an issue of quality of care. Appropriate medication has been offered to Mr. Freedman who refuses to take the medicine (an antipsychotic). He is insisting that I absolve him of any mental illness in 1988 when he was in a struggle with his law firm. The letter is not possible since I only have been meeting with him since August of 1998 and can make no statement about his mental status in 1988.

My first direct contact with Mr. Gary Freedman occurred last summer [Friday August 7, 1998] when I became his psychiatrist for the purpose of prescribing medication. Ms. Lisa Osborne, a psychology intern at that time, started to see him in weekly psychotherapy.

In view of Mr. Freedman's long record of mental illness (paranoid schizophrenia) I recommended antipsychotic medication which he refused. At first I saw him weekly and subsequently I have been seeing him monthly. He has always refused medication. One week he tentatively agreed to try medication, but changed his mind. At the time he said he might try medication, if I were to sign the letter of August 17, 1998 (revised 8/22/98) vindicating him in his legal struggles with his former law firm which took place approximately ten years ago.

I didn't sign his manifesto since I could make no judgments about events that occurred ten years ago. He didn't seem surprised at my refusal to sign and I don't believe he really expected me to sign. However, it did give him a face saving reason to refuse medication. He has never agreed to take medication that I suggested. Ms. Osborne, the rest of the clinical staff, and I did not feel he was at that time imminently homicidal or suicidal.

Subsequently, he has settled down into his usual lifestyle which includes prolific letter writing. Please let me know if I can be of further assistance to you.

Sincerely,

Albert H. Taub, M.D.
Faculty Member
Department of Psychiatry
Residency Training Program
St. Elizabeths/CMHS

[Docket no. 99-198]

2 comments:

My Daily Struggles said...

The proposed informed consent statement is at the following site:







http://dailstrug.blogspot.com/2010/04/informed-consent-statement-albert-h.html

To some extent Dr. Taub's letter is simply tap dancing around the following issues.

Fact: The AMA recommends that a doctor obtain informed consent from a patient before the practitioner embarks on any treatment.

Fact: I requested from Dr. Taub a written statement of benefits/risks. I wanted to know the precise reasons why the medication was being recommended. The medication was an antipsychotic. Delusions are a psychotic symptom. Exactly what ideas of mine did Dr. Taub consider delusional? If he could not state what ideas he considered delusions, how could he assess whether the treatment was effective? He never explained that.

Fact: Dr. Taub not only refused to sign the statement I wrote (which, of course, he had a right to do) -- he refused to provide any written statement.

Dr. Taub's letter does not address the issue of informed consent, in fact, never even uses the term.

My Daily Struggles said...

AMA Statement Regarding Physician's Ethical Duty to Obtain Some Type of Informed Consent:



http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/informed-consent.page