Yeah but we’re not allowed to talk about how that 85% has been prescribed stuff that doesn’t help them, very often has negative, deleterious, harmful mental and physical sideeffects, oh and also often cause dependency/addiction.
Because then when you look at it that way, that would mean basically all currently active, prescribing pscyhiatrists would be open to malpractice lawsuits, and/or drugmakers would be open to gigantic class action lawsuits.
You know, like with opioid pain killers?
But uh nope, nope, that can’t be allowed to be considered, so … just don’t talk about it.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
Knowing that antidepressants don’t work for most people presents a difficult problem though. There is no test to determine whether they will work other than trying them for months. Never trying them would be unethical because they can be life saving and life changing for those who respond. Using them indiscriminately is also unethical because they have side effects and withdrawal symptoms.
I would at least appreciate it if doctors were permitted to jump ahead to the actually effective stuff (i.e. ketamine, psilocybin therapy) without having to force the patient through the gauntlet of ineffective drugs first. I believe it’s insurance companies to blame for that one. They would rather not pay out for quarterly/yearly/one time ketamine treatments that actually work, because that means their money isn’t flowing in the preferred direction. I guess they prefer us to die buying tainted drugs off the street.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
We electroshocked and then lobotomized the patient, they’re basically a 4 year old now mentally, but thats all fine because the science at the time said so.
We smoked in our office consults with pregnant women, but thats all fine because science said so at the time.
… Uh, nah, no, at least from a morality perspective.
So, so much tangible quantifiable financial damage done to so many people by sideffects and then meds for those sideffects…
Legally, yeah, maybe not malpractice if … thats the actual legal standard, maybe it falls on the drug mfgrs legally, but uh what ever happened to harm reduction, is it now maybe time to have some kind of actual reckoning with this as a field/industry?
To me, at this point, in the US, psychiatrists are basically very snobby and arrogant drug salesmen, who will confidently tell you they know what they’re doing and then oops turns out they don’t.
Your second paragraph illustrates this perfectly.
Don’t even have a method of assessing how any of this should work.
Just no clue, none, might as well be popping random pills at a rave, nearly the same epistemic level of ‘will this do what the person i got it from said it will’, difference being stuff from a psych is very unlikely to be cut.
This is is mad scientist level shit.
15% chance it works, 85% chance it doesn’t, you’re all experimental test subjects actually who were not informed of that.
I dunno about you but I don’t tend to trust people who tell me to do something and tell me its all very well understood, and then oh haha, no it isn’t.
I had MDD for a while and my psychs ran me through an ever increasing gauntlet of drugs for it that justade everything worse and worse, to the point I now have them all listed as things I am allergic to, turns out I just needed less stress and pressurr in my life and to get away from my abusive family.
Roughly 1 in 10 people in the US are on anti-depressants, … and for 85% of them, that can basically only be neutral to harmful.
Maybe revoke all these things as approved treatments and move them back to the experimental trials phase, stop using about 30 million people as test subjects, and also lying about that?
None of those things are “fine”. They just shouldn’t result in penalties for individual doctors who were following established best practices.
The problem should be addressed at institutional and structural levels. Drug companies shouldn’t be allowed to throw away 30 studies with inconclusive results and get approved based only on the two with positive results. Drugs that work by inducing a structural change like SSRIs shouldn’t be approved for indefinite use, and if that evidence is found after their initial approval, the approval should be amended. Drug companies should never have been allowed to advertise that depression is a “chemical imbalance in the brain” which is corrected by their drugs when there was never evidence for that beyond the drugs having an effect.
Sure, ok, yeah, we need systemic change at a fundamental level, yep, totally agreed.
Anyway, do any psychiatrists have any morals?
Why do we even have medical ethicists when basically the entire system is fundamentally broken, the extent and details of this are well known to experts, but they just content themselves with ‘doing their best’, and require layman to investigate how full of shit all of this is?
How can you work in this field and sleep soundly at night at the same time?
Sorry, right, like, I’m an anarchist, the ‘point’ of a system is what it actually does, not what it claims to do or aspires to do.
Road to hell, good intentions, all that.
This is all provably ludicrous, and imo, the field should be on fire, revolting in droves at how fucked up this situation is and how they won’t participate in a massively harmful and morally dubious system.
Otherwise, I guess the Hippocratic Oath isn’t a thing for psychiatrists, this is just their day job.
Yeah but we’re not allowed to talk about how that 85% has been prescribed stuff that doesn’t help them, very often has negative, deleterious, harmful mental and physical sideeffects, oh and also often cause dependency/addiction.
Because then when you look at it that way, that would mean basically all currently active, prescribing pscyhiatrists would be open to malpractice lawsuits, and/or drugmakers would be open to gigantic class action lawsuits.
You know, like with opioid pain killers?
But uh nope, nope, that can’t be allowed to be considered, so … just don’t talk about it.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
Knowing that antidepressants don’t work for most people presents a difficult problem though. There is no test to determine whether they will work other than trying them for months. Never trying them would be unethical because they can be life saving and life changing for those who respond. Using them indiscriminately is also unethical because they have side effects and withdrawal symptoms.
I would at least appreciate it if doctors were permitted to jump ahead to the actually effective stuff (i.e. ketamine, psilocybin therapy) without having to force the patient through the gauntlet of ineffective drugs first. I believe it’s insurance companies to blame for that one. They would rather not pay out for quarterly/yearly/one time ketamine treatments that actually work, because that means their money isn’t flowing in the preferred direction. I guess they prefer us to die buying tainted drugs off the street.
We electroshocked and then lobotomized the patient, they’re basically a 4 year old now mentally, but thats all fine because the science at the time said so.
We smoked in our office consults with pregnant women, but thats all fine because science said so at the time.
… Uh, nah, no, at least from a morality perspective.
So, so much tangible quantifiable financial damage done to so many people by sideffects and then meds for those sideffects…
Legally, yeah, maybe not malpractice if … thats the actual legal standard, maybe it falls on the drug mfgrs legally, but uh what ever happened to harm reduction, is it now maybe time to have some kind of actual reckoning with this as a field/industry?
To me, at this point, in the US, psychiatrists are basically very snobby and arrogant drug salesmen, who will confidently tell you they know what they’re doing and then oops turns out they don’t.
Your second paragraph illustrates this perfectly.
Don’t even have a method of assessing how any of this should work.
Just no clue, none, might as well be popping random pills at a rave, nearly the same epistemic level of ‘will this do what the person i got it from said it will’, difference being stuff from a psych is very unlikely to be cut.
This is is mad scientist level shit.
15% chance it works, 85% chance it doesn’t, you’re all experimental test subjects actually who were not informed of that.
I dunno about you but I don’t tend to trust people who tell me to do something and tell me its all very well understood, and then oh haha, no it isn’t.
I had MDD for a while and my psychs ran me through an ever increasing gauntlet of drugs for it that justade everything worse and worse, to the point I now have them all listed as things I am allergic to, turns out I just needed less stress and pressurr in my life and to get away from my abusive family.
This should be a nationwide scandal.
https://www.cdc.gov/nchs/products/databriefs/db528.htm
Roughly 1 in 10 people in the US are on anti-depressants, … and for 85% of them, that can basically only be neutral to harmful.
Maybe revoke all these things as approved treatments and move them back to the experimental trials phase, stop using about 30 million people as test subjects, and also lying about that?
None of those things are “fine”. They just shouldn’t result in penalties for individual doctors who were following established best practices.
The problem should be addressed at institutional and structural levels. Drug companies shouldn’t be allowed to throw away 30 studies with inconclusive results and get approved based only on the two with positive results. Drugs that work by inducing a structural change like SSRIs shouldn’t be approved for indefinite use, and if that evidence is found after their initial approval, the approval should be amended. Drug companies should never have been allowed to advertise that depression is a “chemical imbalance in the brain” which is corrected by their drugs when there was never evidence for that beyond the drugs having an effect.
Sure, ok, yeah, we need systemic change at a fundamental level, yep, totally agreed.
Anyway, do any psychiatrists have any morals?
Why do we even have medical ethicists when basically the entire system is fundamentally broken, the extent and details of this are well known to experts, but they just content themselves with ‘doing their best’, and require layman to investigate how full of shit all of this is?
How can you work in this field and sleep soundly at night at the same time?
Sorry, right, like, I’m an anarchist, the ‘point’ of a system is what it actually does, not what it claims to do or aspires to do.
Road to hell, good intentions, all that.
This is all provably ludicrous, and imo, the field should be on fire, revolting in droves at how fucked up this situation is and how they won’t participate in a massively harmful and morally dubious system.
Otherwise, I guess the Hippocratic Oath isn’t a thing for psychiatrists, this is just their day job.