Anosognosia

[ysabetwordsmith]

Here's a spectacular example of assault on body and mind autonomy of the "for your own good" type.


>> Anosognosia means that the person with the condition denies/is unable to understand that they have a mental illness. <<

It also means that if you don't have a mental problem, but someone else wants to make believe that you do, now they have this weapon to use against you. Let's take a look at some historical examples, shall we?

Drapetomania

Gender differences

Homosexuality

Hysteria

This diagnosis undermines people's ability to say, "I like myself the way I am and I reject your attempts to change me," and make that stick.


>> As you can imagine, this makes treatment difficult.<<

In other words, they want to use this diagnosis to force treatment on people who have refused it.  The obvious result will drive people away from seeking help they do want, because it's too risky that someone will take advantage of them.


>> Applicable to adult patients aged 15-124 years inclusive.<<

Just in case you thought it only applied to violating the boundaries of legal minors, this is a direct assault on legal adults to deny them control of their own mind and body.


>>• R41.85 in Loved-One’s (LO’s) medical chart = medical evidence even if / when Loved One (LO) claims “I Am Not Sick, I Do Not Need Help”.

HIPAA: WE ALL HAVE RIGHTS<<

These two statements directly contradict each other.


>>Where a patient is not present or is incapacitated, a healthcare provider MAY SHARE the patient’s information with family and friends, or others involved in the patient’s care or payment of care, as long as the health care provider determines based on professional judgement, that doing so is in the best interests of the Patient.<<

So one thing they want is the ability to conspire against people and talk behind their back. This will have a ruinous effect on family relationships and client-provider relationships. It makes it more dangerous to talk about one's problems and seek help that one actually wants, because that creates a vulnerability for others to step in and do things without consent. America is a post-boundary, post-privacy society and this particular example is just brutal.


>> 2. R41.85 –contradicts “I Am Not Sick. I Do Not Need Help” claims <<

This explicitly ranks a medic's opinion over a client's lived experience, agency, and freedom. Therefore it violates "First, do no harm."  Forced therapy is harmful and can go as far as torture.  Consider that a key factor in traumatic disorders is not the severity of the experience but feeling helpless to do anything about it.  So anything that makes people feel helpless and undermines their agency will run up that risk.


>>1. Make sure R41.85 is in LO’s medical records (Make hospitals, clinics, docs aware of code in medical record).<<

So if you see it in yours, some prudent options include:

* Escape the area while you still can.

* If your alleged friends or family are in on the violation, leave them too and seek others who will not violate your body/mind.

* If your friends or family react with horror when you tell them about the violation, then they may help you fight it.

* Seek healthcare elsewhere and don't transfer your old records.  You need someone who will genuinely help you get your body/mind in the shape you want, and will take no for an answer.  On the mental side, Rogerian therapy (aka client-centered or person-centered therapy) is worth exploring.

* If you want or need to stay in the same locale, talk to a lawyer about your legal options.


>> •Patients often refuse all treatment, because they are genuinely puzzled why family and caregivers want them to take medication and participate in other treatments.<<

People have a right to their own mind, even if others don't like the kind of mind they have. It is morally permissible to stop someone from hurting others, but not to violate the integrity of a human mind.

And let's not forget "Why don't you just settle down and marry someone nice?" "Because I'm gay."  Many claims of mental illness start with someone just not being or doing what someone else wants.  That is a conflict of interest, not a disease.


>> • CIT teams, hospitals, docs begin to think that caregivers are the problem <<

Which is true in cases such as described above.


>> • LOs resent caregivers and trust us even less

• Things just get WORSE at home <<

Well you've just drastically increased that.


>> • Incomplete picture of LO’s: history, diagnoses, cognitive impairment <<

Have fun with the increased rate of people not telling you things so you can't hurt them with the information and share it with others who want to manipulate them.  Doctors already bitch about that, but they themselves have created and continue to exacerbate the conditions which encourage it.


Finally, I'd like to remind folks that privacy was one of the things humans had to invent in order to have a society beyond the immediate family. Humans are damned irritating creatures. If they can't ignore that, they will eat each other. Society requires the skill of minding your own business. A sense of safety requires security in your own body and mind. Without those, mayhem ensues.

You have a right to your own body and mind, your own beliefs and experiences, your feelings and identity, your way of existing, even if other people don't believe in you and try to hurt you because they want you to be something else. Fuck 'em. You do you. But watch your caboose out there, this society is breaking down.

Comments

[siliconshaman]

Just when I think we've hit rock bottom, society finds new more horrible ways to demonstrate how fucked up it is.

And my opinion of the psyche industry was partly formed by the treatment of Sarah Conner in Terminator 2.

Yes ...

[ysabetwordsmith]

>> Just when I think we've hit rock bottom, society finds new more horrible ways to demonstrate how fucked up it is. <<

"Drill, baby, drill!" >_<

>> And my opinion of the psyche industry was partly formed by the treatment of Sarah Conner in Terminator 2.<<

Only the angry robots were fictional.

You know what I'd love to see? Fanfic of those whitecoats on Judgement Day. It would be awesome to read about them going "Oh shit she was right oh shit she was right we didn't believe her and we doomed the world and now we're all gonna DIEEEEEE!!!!" I would read the hell out of that.

Re: Yes ...

[siliconshaman]

It would be a very short fan-fic... but yes, very satisfying. There was an appearance of the lead doctor in T-3 and yeah, he'd done a 180... and yeah, it was vindicating to see him being treated as the crazy.

Re: Yes ...

[ysabetwordsmith]

That was awesome. :D

[wispfox]

I can't see the original link. I'm not sure if that's a bad thing.

Also, yikes.

Well ...

[ysabetwordsmith]

It's been locked. I can't see it now either. Sadly, all we have left are the fragments I quoted.

I venture a guess that the audience response may have been something other than the poster expected.

Re: Well ...

[wispfox]

Ah, no wonder clicking didn't work then!

[crunchysteve]

Wikipedia isn't so coy as the poster of the original article linked.

https://en.m.wikipedia.org/wiki/Anosognosia

What a nightmare! There may be the odd, VERY rare psychotic case where this might apply but it's so fraught with abuse potential and boundary violations I can't imagine it ever being anything but a fools errand.

Thoughts

[ysabetwordsmith]

I acknowledge that there may be cases where someone is mentally ill or injured and unable to recognize it. However, I don't believe that justifies violating their mind and body. Think how hard treatments are when you know what is happening and choose to undergo it because you believe it will help. Now imagine how tortuous it must be for others to force such things on you when you have no way to escape and they don't listen to anything you say, no matter how bad it feels to you.

Re: Thoughts

[crunchysteve]

Totally agree

[see_also_friend]

1) There are cases where people do not consider themselves to have a mental illness when others would disagree. Examples :
- From what I understand, it happens with dementia, since the memory formation and higher cognitive thinking are among the first things to go.
- Also, psychopathy and narcissism. A psychopath doesn't usually have a problem being what they are and (as I understand it) wont usually seek treatment. Narcissists will only seek treatment if they think it will get people to adore them.

Now, psychopaths and narcissists are generally coherent and self-functional enough that if I did anything, I'd be trying to address the problematic behavior, rather than strongarm them into therapy.

Dementia...well, legal guardianship.

2) This doesn't say /how/ it will determine family who can be told about the charts, and if they don't have strong standards they will run into other /actionable/ problems, such as doxxing someone to an abusive non-marital ex who claims to be a spouse, or doxxing someone to a parent they have been legally separated from...or giving an underage person access to medical information because 'family.'

3) Some forms of mental illness are either caused by or exacerbated by abuse, and abusers are commonly in close proximity to the victim. So then we have someone who develops mental issues from abuse, and then their abuser has more ammunition to attack them with. This /will/ drive people to suicide.

4) It has not addressed people who know they have a problem but are resistant to treatment for various legitimate reasons. If you have an eating disorder because you can't afford food, you can't fix that without better access to food - and mandatory medical appointments will decrease the amount of money you have. Similarly, people do not always have the luxury to get more sleep, leave bad situations, get a therapy animal, etc.

5) There are going to be people who are resistant to treatment because it is dangerous. What if someone is allergic to the cheap generic drug, but the insurance won't pay for anything else? What about someone who want to try other, non-drug treatments first because they are afraid of addictions/can't fit monthly prescriptions into their budget?

6) A lot of the things one can do to escape being attacked in this way are more accessible with money.
:/

7) I'm sure people had a concept of privacy/boundaries in small family groups too, even if only as "Get your feet out of my face!"

[(Anonymous)]

Well this is awful. Add it to the pile why don't you, it'll get lost in the flood of SOS memos on that merrily crackling bonfire....

We've already got too many problems with patient/provider relationships as it is...

And too many actual sadists going in to medicine and not getting reprimanded or weeded out....

And not enough time for the good providers to actually treat patients appropriately....

And way way way way way too much interference from non-medical entities like insurance companies telling health care providers what we can and cannot do for our patients.....

And BigPharma upcharging the cost of life saving medication by 7000 percent from its production cost....

And healthcare workers drowning in unsafe patient ratios being told to suck it up "you knew what you were getting into when you said you were going into medicine"....

I had a provider look me in the face today and say "I'm tired of trying to fix anything, when I try to implement even small changes I get told No, over and over and over. I'm done."

The healthcare system is basically on the verge of collapse and actively on fire, but healthcare workers in the thick of it get threatened coming and going, the administration will wave around things like abandonment of care and duty lawsuits....they'll be left holding the ashes when there are no more healthcare workers or doctors or anyone to help- we're changing fields, shifting to specialty, retiring, or literally dying from the stress and all any of the suits do is shrug their shoulders scratch their heads, mutter "weird, these selfish people just don't want to work anymore"

[arlie]

There's a long tradition of things like forced commitment to mental hospitals. It's been subject to all kinds of abuses - but what else do you do with someone who is a danger to others?

(The usual phrasing is "a danger to themselves or others," but I'm not sure that it's ethical, in general, to interfere with someone's suicide, except possibly to delay it long enough they can be more certain that it's not just a passing mood. And not even that, if they are in enough pain.)

I think there's a need to do something about people who are actually dangerous, not merely in violation of other people's idea of how they should behave. No matter how good the safeguards are, there will be abuses, because there are humans involved. But IMO the tradeoffs favor some amount of interference regardless.

Note that this is different from forced treatment, though in practice they've often gone hand in hand.

Thoughts

[ysabetwordsmith]

>> There's a long tradition of things like forced commitment to mental hospitals.<<

Yes, and it does a bang-up job of discouraging people from interaction with mental care for fear of being imprisoned without a trial.

>> It's been subject to all kinds of abuses - but what else do you do with someone who is a danger to others? <<

You put them somewhere they can't hurt others, but you don't abuse them like prisons do and you don't try to mindrape them. Because abusing them certainly will not make them healthier or kinder to others. Since isolating humans tends to drive them insane, that's not okay. But if you really don't feel safe in the same room with them, then use technology for such purposes as delivering meals and interaction. They should have access to a counselor any time they wish, along with entertainment and educational materials.

>> (The usual phrasing is "a danger to themselves or others," but I'm not sure that it's ethical, in general, to interfere with someone's suicide, <<

The most fundamental right of a soul is when to enter and exit an incarnation. Because that is their freedom of travel, and usually nobody else can know what they came to do or when it is done. Some people with spiritual gifts can read another person's life list, but it's not a common ability.

>> except possibly to delay it long enough they can be more certain that it's not just a passing mood. <<

The type of suicide that it is ethical to delay is a mistake. Sometimes people feel or believe things that are not true, such as thinking that nobody loves them when people do. Sometimes they think there is a problem that cannot be solved, when it could. Sometimes they are overwrought and need help. Society is terrible at helping in these situations, but it would be possible to do so if people thought it through and were willing to provide resources and assistance rather than demanding that an upset person bootstrap their way out.

>> And not even that, if they are in enough pain.) <<

Preventing someone from dying to escape severe pain is torture, which is unethical. But there are worse things that than, such as trapping someone in a rotting body while their mind slowly decays, for months or years. That's downright evil.

Very often, suicide prevention isn't about helping the person who is suffering. It's about ensuring that other people don't feel bad because someone died. I don't see them saying, "Here's a prescription for a maid to do all your housework for a month. Let's see if lightening your burdens will help you feel better." or "We've wiped out your student debt. Let's talk about how you feel about your future now." Society mostly wants people to be of use and won't give that up even if it's literally killing them.

>> Note that this is different from forced treatment, though in practice they've often gone hand in hand. <<

Yeah, see, it's not necessary to violate someone's mind and body to keep them away from others. You can imprison them if they are credible threat, but put them in a humane place with things to do. Of course there will be abuses because humans often like to hurt each other or just want what they want and don't care who gets hurt. But the damage can be minimized as much as possible. Thing is, most medics are like a dog that wants to hump your leg. The dog is far more concerned with its own gratification, and isn't considering how you feel at all.