Geminus Corporation
8400 Louisiana St.
Merrillville, Indiana
46410-6353
Phone 219.757.1800
Fax 219.757.1950
www.geminus.org  info@geminus.org

Head Start all locations Lake and Porter Counties                  1-888-893-6891


powered by centersite dot net
Depression: Major Depression & Unipolar Varieties
Resources
Basic Information
Introduction and Types of DepressionRelated Disorders / ConditionsHistorical and Current UnderstandingsBiology, Psychology and SociologyTreatment - Medication and PsychotherapyAlternative Medicine and Self-Help ResourcesSpecial IssuesReferences
More InformationTestsLatest NewsQuestions and AnswersLinksBook Reviews
A Heart of StoneA Mood ApartA Philosophical DiseaseActive Treatment of DepressionAdolescent DepressionAgainst DepressionAn Unquiet MindBeating the BluesBefore ProzacBeyond BlueBlaming the BrainCalm EnergyConquering Postpartum DepressionConquering the Beast WithinCry Depression, Celebrate RecoveryDamageDepressionDepression 101Depression FalloutDepression in ContextDepression Is a ChoiceDepression, the Mood DiseaseDepression-Free for LifeDoctors of DeceptionDown Came the RainDysthymia and the Spectrum of Chronic DepressionsEmotional ClaustrophobiaEssential Psychopharmacology of Depression and Bipolar DisorderEverything Is FineExperiences of DepressionHandbook of DepressionHandbook of DepressionHistory of SuicideHow I Stayed Alive When My Brain Was Trying to Kill MeIn Pursuit of HappinessJourneys with the Black DogKilling the Black DogLifeForce Yoga to Beat the Blues--Level 1LifeForce Yoga to Beat the Blues: Level 2Lifting DepressionLincoln's MelancholyLucy Sullivan Is Getting MarriedMalignant SadnessManufacturing DepressionMindfulness-Based Cognitive Therapy for DepressionMood GenesMy DepressionNatural Healing for DepressionNew Hope for People with DepressionOn DepressionOn the Edge of DarknessOutsmarting DepressionOvercoming DepressionPotatoes Not ProzacProzac and the New AntidepressantsProzac BacklashProzac DiaryProzac NationPuppy Chow Is Better Than ProzacQuiet Your Mind & Get to SleepRaising a Moody ChildSelf-CoachingSongs from the Black ChairSpeaking of SadnessSpontaneous HappinessStudent DepressionSubordination and DefeatSunbathing in the RainSwing LowTalking Back to ProzacThe American Psychiatric Publishing Textbook of Mood DisordersThe Anatomy of MelancholyThe Anti-Depressant Fact BookThe Antidepressant EraThe BeastThe Bell JarThe Breakthrough Depression SolutionThe CorrectionsThe Cruelty of DepressionThe Depressed ChildThe Depression CureThe Devil WithinThe Emotional RevolutionThe Family SilverThe Feeling Good HandbookThe Mood CureThe Nature of MelancholyThe Noonday DemonThe Postpartum EffectThe Secret Strength of DepressionThe Van Gogh BluesThe Van Gogh BluesUndercurrentsUnderstanding DepressionUndoing DepressionUnholy GhostUnstuckViniyoga Therapy for DepressionWhat the Birds SeeWhen a Parent is DepressedWhen Nothing Matters AnymoreWhen Words Are Not EnoughWhy Are You So Sad?Writing Through the Darkness
Related Topics

Anxiety Disorders
Bipolar Disorder
Suicide
Addictions: Alcohol and Substance Abuse
Pain Management

by Linda Andre
Rutgers University Press, 2009
Review by Leo Uzych, J.D., M.P.H. on May 18th 2010

Doctors of Deception

Doctors of Deception is a book about "shock" treatment, in the form of electroconvulsive therapy ("ECT").  The author, Linda Andre, experienced ECT personally, and is the director of an entity called the Committee for Truth in Psychiatry.  The writing of Andre, focusing sharply on ECT, is bluntly critical and discerningly opinionated.  Following the historic path of ECT, Andre examines its scientific, legal, and regulatory evolution instructively; the perceived "politicizing" of ECT, historically, also draws Andre's rapt attention.  As observed by the critically discerning eye of Andre, ECT historically has been twisted and shaped, in a scientifically disfiguring way, by the arms of politics and public relations.  The insinuation of myriad, financial related conflicts of interest into many crevices of ECT, as sighted by Andre, likewise elicits harshly critical comment.

A thematic current coursing powerfully through the ocean of the text is that the science of ECT should be data driven, rather than being politicized and immersed in a sea of public relations.  And with regard to the law of ECT, a further thematic emphasis of the text is that legal "consent", for ECT, should be truthfully "informed" in nature.

An "Appendix" is joined to the text.  As explained by Andre, the Appendix is comprised of selected letters sent to the FDA by former ECT patients.  These letters, soberingly, describe real life effects of ECT, in the words of persons who have actually experienced it.

The textual matter is referenced considerably.  Citations for referenced research materials are presented in the "Notes" section, following the Appendix.  Some of the references, in the Notes, present pithily annotated comment.

Some "Figures", interspersed in the text, enhance its contents.

The writing of Andre, stylistically, is lay reader friendly.

Over the course of the text, Andre reviews critically an abundance of scientific research materials.  The thought provoking efforts of Andre spawn multitudinous questions.  For example, about how many persons each year receive ECT?  What percentage of these persons actually "benefit" from ECT?  Based on scientific data, what are the known, and suspected, clinical "benefits" of ECT?  What is the mechanism?  Are the benefits, based on scientific evidence, likely to be short term, long term, or permanent in nature?  Are the "benefits" possibly a side effect of brain damage, resulting from ECT?

Questions about risks, associated possibly with ECT,  abound similarly.  For instance, as evidenced by scientific data, what are the known, and suspected, adverse effects of ECT?Is ECT, based on scientific data, associated possibly with:  brain damage?  memory loss?  cognitive impairment?  learning impairment?  loss of creativity? loss of intelligence? Based on scientific evidence, are the risks likely to be short term, long term, or permanent in nature?  What is the relationship between suicide and ECT?  What is the mortality rate, of ECT?  Can ECT harmed persons be rehabilitated?  Are there alternative treatments which may provide the intended clinical benefits of ECT, albeit without deleterious side effects?

Questioning legal strands, as well, are sewed adeptly by Andre into the textual fabric.  Some of the legal strands are tied to the issue of informed consent.  Should ECT ever be allowable, legally, absent "informed consent"?  What scientific data supported information about ECT should providers be obligated, legally, to provide to patients, in order for any "consent" (to ECT) to be "informed" in nature?

Other legal strands are tied to the issue of competence.  In the context particularly of ECT, what is the legal meaning of "competence"?  If a patient, on the advice of the patient's provider, "consents" to ECT, should the law presume the patient's "competence"?  Do "competent" patients have a right, legally, to refuse to consent to ECT?  If a patient, against the advice of the patient's provider, refuses to consent to ECT, should there be a legal presumption of "incompetence"?  What does "incompetence" mean, with respect to ECT?Can an "incompetent" patient give "informed consent", to ECT?  Should the law ever allow ECT with regard to an "incompetent" patient?

Regarding the issue of "involuntary" ECT, what percentage of ECT patients are given ECT involuntarily?  Under what circumstances, if any, should the law allow involuntary ECT?  Is there a compelling state interest in possible support of involuntary ECT?

The ECT tapestry spun by Andre has many interwoven legal issues.  At an overarching level, is there presently adequate legal protection of the rights of patients, concerning ECT?  Should ECT be banned legally?

The many ECT centric questions raised, explicitly or implicitly, by Andre are an intellectually empowering feature of the book, and may help foment constructive debate and study.

From a critical perspective, it may be opined that Andre's strongly vented views regarding ECT are iconoclastic to a degree rendering her writing vulnerable to criticism as being tantamount to a diatribe, far outside the bounds of mainstream thinking.  Other critics may add that Andre has crafted a caricature of ECT, which blinds the reader to its full picture.

In a different vein, because issues across a range of professional disciplines are broached by Andre, the book, alternatively, may have been structured appropriately as an edited collection of papers prepared by experts from different disciplines connected to ECT.

But the pages of this sobering book fuel a fire of concern about ECT, which should sharply spike the interest of lay readers.

The distinctive perspective of Andre should also enthrall the interest of a multitude of professionals, extending to:  psychologists, psychiatrists, psychiatric nurses, neurologists, neuropsychologists, neuroscientists, neurobiologists, neurophysiologists, neurosurgeons, neuroanatomists, neuropathologists, radiologists, healthcare lawyers, law professors, judges, legislators, health policy makers, social workers, medical historians, manufacturers of ECT devices, FDA officials, mental health commissioners, hospital administrators, epidemiologists, and medical journal and lay media editors.

 

© 2010 Leo Uzych

 

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.