Discussion Can psychiatrists determine whether a psychiatric patient is rational?

[ron_g]

Are psychiatrists the most qualified persons for assessing whether a person is rational? The question of a patient's rationality is important for the choice among different treatment options or refusing treatment altogether.

I argue that psychiatrists cannot be expected to reliably assess someone's rationality on the following grounds.

Psychiatrists can be biased for several reasons. They may benefit financially from the treatment. Even if the treatment is to be performed by a colleague (who will get paid), the psychiatrist may consciously or unconsciously overestimate the effectiveness and underestimate the risks because their acceptance in society depends on there being a perception in the public of overall positive outcomes of treatments. If the patient is suicidal, they have a self-interest in preventing suicide which may lead them to err on the side of imprisoning people who wouldn't have suicided otherwise.

As documented by sources like Mad in America, survivor groups, newspaper articles and others, psychiatry has a history of providing biased information about treatments, failing to disclose adverse effects and conflicts of interest and opposing criticism and accountability.

Obviously, this isn't true for all psychiatrists.

 

[Anima]

I highly doubt they can. Some time ago I read an article about a group of scientist pretending to be mentally ill in order to see what diagnosis they will get

https://en.wikipedia.org/wiki/Rosenhan_experiment

Psychiatry is a fairly young discipline and there are tons of things science has no explanation for. Lobotomy is something that always pops up in my mind ... creepy. Go to five different psychiatrists and you usually get 5 different opinions on what is wrong with you.....

 

[TiredHorse]

"Never ask your barber if you need a haircut."

 

[ron_g]

Psychiatry is a fairly young discipline

One problem is that being brutally honest about themselves is apparently a threat to their interests.

 

[Anima]

One problem is that being brutally honest about themselves is apparently a threat to their interests.

Unfortunately, that seems to be the case far too often .....

 

[Anima]

The thing about medical "professionals" is they are human too...and a lot of humans aren't very good ones. I knew a child psychologist once who was one of the most messed up people I have ever known. Really selfish and cruel and behaved wildly and irresponsibly...yet every day she was responsible for the mental health of kids. After my own very negative experiences with surgeons and healthcare as a patient it's become very clear that like most people....healthcare folks are ego driven and unable to admit not knowing something, fault, or appear weak or incapable. There is a lot of bullshitting, rationalizing, and flat out lying going on to patients. I'd not trust any psychiatrist or anyone else if I didn't trust them as a person. Genuine and caring people give off an aura, and their words are honest. Fakers and egoists are easy to spot but sadly there are tons of them in every field and place.

I have made similar experiences and can relate to that. Not everyone who went to med school should be a doctor deciding over what is good or bad for people and ultimatively about peoples lives. Eirher they care or they dont and then there are those who just dont know any better ...

 

[Circles]

I always believed rationality is subjective only to an individual. No one can make up your mind but you.

 

[sif]

Basically it should be up to the patient to decide whether a psychiatrist is able to assess them for being rational maybe there are extenuating circumstances but in many cases where a patient is lucid and not delusional, they should not be forced treatment if they do not want it. Only if they do want it then they give the psych the right to give their opinion of course.

 

[Hopeless_soul]

The thing about medical "professionals" is they are human too...and a lot of humans aren't very good ones. I knew a child psychologist once who was one of the most messed up people I have ever known. Really selfish and cruel and behaved wildly and irresponsibly...yet every day she was responsible for the mental health of kids. After my own very negative experiences with surgeons and healthcare as a patient it's become very clear that like most people....healthcare folks are ego driven and unable to admit not knowing something, fault, or appear weak or incapable. There is a lot of bullshitting, rationalizing, and flat out lying going on to patients. I'd not trust any psychiatrist or anyone else if I didn't trust them as a person. Genuine and caring people give off an aura, and their words are honest. Fakers and egoists are easy to spot but sadly there are tons of them in every field and place.[/QUOTE

Yup. I just had an appointment with a new psychiatrist, and he seemed very unscrupulous, condescending, and just weird... Said something like I would be damaged forever. But hey, at least I got a prescription for alprazolam.

 

[ReadyasEver]

I was nudged to go see a psychiatrist on my physical diagnosis. Apparently, people get very depressed with news that they will not survive for more than a couple years at best. I listened to him, told how I felt physically and mentally. He prescribed a couple of drugs for me, an anti-depressant and for some reason an anti-psychotic. That one baffled me, as he said people can get delusional in my condition. Called my oncologist with what prescribed, he nearly stroked over the phone. I did not fill them. The psychiatrist's office called back to set a series of appointments. I laughed, told to actually call and consult with my oncologist and hung up the phone. I really believe this guy never even really read my file and to see what I've been through and the drug treatments I had already done. I was always skeptical of psychiatrists, now I really know.