Drugs and Schizophrenics
I am a graduate of Harvard Medical School who is currently a second-year resident in psychiatry at UCLA’s Neuropsychiatric Institute, and I was frustrated and angered to read Joy Horowitz’s article, “For the Sake of Science” (Sept. 11). I have worked closely with Dr. Michael Gitlin for the past six months, caring for adult inpatients at the institute.
Horowitz’s portrayal of Gitlin is at odds with my perceptions and those of nearly everyone who has worked with him. Far from being imperious, as Horowitz described him, he is a warm and caring physician and teacher and a most knowledgeable and competent psychiatrist. I have seen his superior ethical standards in practice on the inpatients wards daily.
I find it ironic that the rules that he upholds in order to protect patient confidentiality condemn him to keep silent about the case in question, rather than air important and relevant truths. I wonder if these rules are always in the best interests of patients. They certainly make objective discussion of the Enrique Lamadrid case impossible.
Dr. Jeffrey L. Calcagno
Los Angeles
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As a sociologist and psychotherapist, and based on what I saw while a human-subjects protection committee reviewed some of the most advanced medical research in the United States, I feel safe in saying that issues of morality were not and could not be adequately dealt with by such a group.
First mandated by law in 1974, such committees were instituted primarily because issues of morality were being neglected in medical research. For that reason, the committees were to contain non-medical public representation. However, my research indicates that patient-protection groups have evolved various strategies to ensure group stability that have resulted in physician members dominating the committees.
Since moral issues tend to be raised by public representatives, who are in the minority, such matters get little attention. What results is the medical profession policing itself.
Regarding informed consent, I have seen schizophrenics being given informed consent and know, from the inappropriateness of their responses, that they had no idea what was being said.
Barbara Lampert
Brentwood
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As a graduate of the UCLA School of Nursing in the late ‘60s, I am not surprised by Horowitz’s article. Part of my assignment had been to help doctors conduct their research. I saw many things that disturbed me greatly:
The oxygen tent of a dying child, lifted up time and time again so that groups of interns and medical and nursing students could get a better look.
The gaping wound of an elderly woman probed by an endless stream of “observers,” even though it obviously was causing her pain.
Make no mistake. The primary interest of a teaching and research institution like UCLA is teaching and research, not the welfare of the individual patient.
Jeanne Elmore
Fountain Valley
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First, psychiatry is attacked for putting horrible, brain-damaging drugs into people. Then, when researchers try to find out what characteristics might identify patients who can discontinue these drugs, or which warning signs might indicate that they need to resume taking them, psychiatry is attacked for that, too.
And how about Dr. Richard Wyatt’s idea that regression in schizophrenia, induced by medical noncompliance, results in irreversible loss of function? If he’s correct, the patients’-rights movement is directly involved in getting thousands of patients out of hospitals and helping them to refuse medication. They eat out of trash cans, get covered with lice and drink Thunderbird instead. Kind of makes you proud to be an American, doesn’t it, watching them die with their rights on?
Dr. Stephen G. Hayes
Department of Psychiatry, USC School of Medicine
Los Angeles
the private sector. It is time for the medical and legal professions to be held up to the same close scrutiny as the insurance industry.
Karen Young
Huntington Beach
