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Psychiatric consent debacle (oh, great)

Hooo. Okay. So there's some brouhaha at the moment over a proposed mental healthcare bill here that would give youths input on their psychiatric treatment.

This is definitely a gray area, and as always, it's nigh-impossible to find anyone willing to examine both sides of the arguments or even try to understand why someone (psychiatric professionals and other people in command of specific knowledge and experience in this area) would support the idea. As always, people aren't interested in doing more than making a snap judgement about something they're completely clueless about.

The bill does deserve to be controversial, I just get the feeling not enough people are taking the time to understand what the ramifications of the bill would be within a practical context. Or why it should be controversial.
Given I vociferously support the rights and respect for children and teenagers, sometimes people get the impression that I don't distinguish, whereas that's actually what my point is, that people don't distinguish.

So, let's clarify.
I've never said that all 9-year-olds were precisely as capable as adults; just that they're more capable (and could be even better if we changed our approaches towards them and education) than we give them credit for or the chance to prove.
I've never said that all 9-year-olds were precisely as capable as 16-year-olds. They aren't, and because this "hormones" nonsense is utterly bunk, a smart 9-year-old is only going to get smarter as he progresses through adolescence. People who lump 6-year-olds in the same category as 16-year-olds deserve a kick in the face.
I've never said that all 16-year-olds were precisely as capable as adults; just that they're more capable (and could be even better if we changed our approaches towards them and education) than we give them credit for or the chance to prove. However, yes, a teenager at this age absolutely can be as accomplished as an adult in many ways.

In short, no I'm not a whackjob and I understand why people are reacting emotionally to the idea that 12-year-olds could consent to sterilization surgery. It is true that they might not understand the import of what they're doing and the effect it will have on them for the rest of their lives - some of them absolutely could. Well, this example is a little poor, I doubt any of them wouldn't understand what this means.

Go ask a 13-year-old if s/he wants to be sterilized. Find me just one that agrees to it. "Man, I haven't even had sex yet, what's the freakin' point in doing this to myself?" Oh, also, don't do this if you don't want to spend the night in jail.

The problem is that people aren't understanding why this bill was brought into play, what the 'reverse' of the controversy is, and why it's so important that we at least consider the possibility of youths being able to have input in their psychiatric treatment.

Firstly, let's play the reverse card. Why is this bill being considered? A teenager is dragged by their ear into a clinic. Their parents insist she has problems, and want treatment carried out. Under the current laws, the "child" isn't given much input at all in the matter. The psychiatrist and the parents are the only ones who decide, and frankly, their decision, their absolute power, is going to be affected by things like religion, greed, politics and in some cases a flat out disregard for the dignity of the child (not all parents are nice, and many of them would like their "unruly child" to be controllable and "respectful" - see the abuse of the ADD/ADHD diagnosis over the past decades).

This person, this individual, is given no sovereignty at all over their most private, defining aspect: their mind. Their personality. Instead, others with personal beliefs influencing their opinion that may not reflect the beliefs of the person actually being affected by these decisions, are the ones with the say.

Flip side, the parents are religious and deny their child treatment that the child wants. Or, the child accepts their parents' beliefs and opts against/for undertaking surgery with permanent effects because of them.

Secondly: people, the point of this bill is to allow trained professionals to determine if a teenager (12+) is capable of making decisions about his or her mental health treatment. It's to give a youth the chance- if they are capable - to get the surgery they think they need, after being fully informed about it and its consequences, even if parents try to stop them, or the reverse - to refuse treatment, if they are deemed by a trained professional to be capable of making an informed decision, that might harm them or their dignity.

It doesn't mean that a child can walk into a clinic and ask for psychosurgery as if they were getting free breast implants, which is precisely how it's being portrayed here. The psychiatrists will not just allow a youth to get unnecessary treatment; what responsible psychiatrist would allow it, and what kid would demand it, if it wasn't warranted?

It also doesn't mean that parents won't be able to exert their extremely considerable influence to control what their offspring chooses anyway. Let's face it, how much distaste for this bill comes from the fact that it strips a little power from the parents? Ignoring the fact that parents can dominate children without redress but irresponsible psychiatrists are transparently judged by Boards and courts?
There are some children out there capable of making informed consent and there are some parents out there that do not make the correct choice for their offspring. (See: every fucker that sent their kids to a "ranch" for "their own good" - there's tens of thousands of them in the US alone).

Psychiatrists can be bastards too, but the big, gaping hole through which they can harm patients by inflicting unnecessary drugs and restrictions on them is the disregard society has for younger people and their right to their own body.

One should never be forced to take psychiatric medication or therapy that causes distress or harm - but we do this to children (terrifying and dominating attachment therapy, aka 'torture', is one example; forced drugging is another) on a regular basis, regardless of distress, regardless of consent.
Imagine being an intelligent youth with a disorder that can be cured easily, but your parents refuse treatment because they are Scientologists or don't think you're as bad off as you think you are - and when you object, they tell you that you are too stupid to know what's good for you. Even though they can't even spell the name of your disorder.

For a more poignant example, imagine being a child dying of a curable disease in hospital but your wishes are overwritten by your religious parents. What you want doesn't matter. You don't want to die but you're not considered a "full-human" so you don't get to choose such things. (Thankfully, this is not always allowed by governments.)

Children absolutely should have the right to their own bodies and minds.  Parents and professionals should only be able to step in if it is guaranteed that serious permanent harm will come from the choice the child makes; and we must all be mindful of the fact that adults do not always make perfect choices or act with respect towards a child's person.*

Remember, folks, the entire point of this bill is to avoid the horrific human rights abuses that typify attachment therapy, drugging, and other dangerous psychological/psychiatric practices being forced on unwilling victims by misguided (or evil) parents and professionals, regardless of consent - and, on the flip side, to give children a say in their own treatment when those same forces try to prevent them accessing treatment.

It's not much different from allowing young girls access to abortions regardless of whether their parents whip themselves up into a religious, O'Reilly-inspired frenzy over the idea. Or, you know, forcing them to have them for other reasons.
It's not much different than giving Kirk Andrew Murphy the chance to say no to the therapy that destroyed him; the chance to ask for a second opinion; the chance to defend who he really was in the face of the religious and cultural ignorance that stripped him of his dignity and sentenced him to a short life of misery.

That was the choice made by his parents, not him. By a religious psychiatrist desperate to prove that you can "de-gay" a boy... not him. Was he ever asked? Would he have said "no" anyway, faced with beatings and scorn from his normal-for-the-day parents? Was he at any point given the dignity and respect of a human being, let alone an adult, during these proceedings?

I understand this is a controversial issue and I know very much why - after all, it still keeps power in the hands of the psychiatrists (who may receive 'kickbacks'; may prioritize this over a teen's well-being) rather than the kids, but for understandable reasons. The bill needs work. We need to work on this bill.

But more than that, our society needs some serious work. We need to come to understand that youths have the right to their own bodies and minds, and they deserve some latitude and input into things that concern them, regardless of their lack of experience. A binary "under 16/18, no say" system that ignores when a youth is capable or when the adults are making selfish, poor choices that distress the youth, is just not good enough.

When it comes to our bodies and our minds: consent, and the right to revoke it, should be an implicit right of the human condition, regardless of age.
The rule. Not the exception. Make the exceptions as necessary, and only as necessary.

So think about it before you castigate this bill for letting "12 year olds consent to psychosurgery." It's more complex than you think, and there is a reason why professionals with years of education and experience with many, many youths and parents are pushing for these changes.

But getting people in this country to think about things is impossible. They have V8 Holdens to watch going in circles and shit beer to drink, like we're America Lite.

* - Funnily enough, because that makes people think of sexual abuse, they get inflamed, but they fail to understand how it applies to beatings and forcing them to take antidepressants. Overriding someone's wishes when it comes to their person should never be sanctioned just because of their young age. It should come down to capabilities and respect for them as a human.
Oh, and also note how we find this troubling, but it's fine to mutilate a boy's genitals, reducing sexual sensation, nearly always for religious reasons, regardless of his consent or objection. In some countries, this is performed when they are older - so, uncircumcised friends, tell me: how would you like it if your mother announced you were getting your dick maimed and you had no right to stop it? Does it really make much sense to say that your objection is any different from that of a eight, ten or twelve year old here? Do you have special knowledge you gained on your 18th birthday, or is it just bullshit to inflict things on someone against their will?
Viewed: 53 times
Added: 6 years, 5 months ago
6 years, 5 months ago
I haven't heard of this bill. Link to any info on it?
6 years, 5 months ago
I feel like I should be getting involved in this but you know my feelings.
6 years, 5 months ago
Firstly, I'd like to say that there are a lot of Americans intensely jealous of your Holden V8s.

As for the topic at hand, in defense of ADHD/ADD diagnoses, had I been diagnosed with ADHD earlier I'm fairly sure I would've had a shot at an Ivy League school. Instead, because my parents dragged their feet on getting me help, my grades slipped, my emotional stability followed, and they nearly buried me 13 years ago. I think kids should have a lot more say in what treatment they get, but I acknowledge that kids (and adults), even smart/rational ones, are prone to making stupid mistakes. The difference, though, is that adults basically have their lives set up already. Got a job, family, living arrangements, or some combination of those things. Kids, meanwhile, have basically the world in front of them*, and so there's the argument that allowing them to make such important decisions could hinder their options for the future, which I can understand. But it doesn't always seem to work out that way.

Both parents and kids tend to end up in situations where they're at war with each other, and not really thinking about what would be best for anyone. For example, I knew a girl in high school who was staunchly conservative in name only. If you talked with her on individual issues, she'd generally side with liberal viewpoints, but because her mother was liberal and she hated her mother, she claimed to be conservative. She'd never admit to that, but that was obviously the reason. That's intensely silly, but that's what seems to happen a lot of times, with kids going against their best interests or their own wishes just because it's the opposite of what their parents want. And that's sometimes difficult to detect.

*: in theory
6 years, 5 months ago
Sheesh, how come you elicit these big-ass responses from me?!

>Firstly, I'd like to say that there are a lot of Americans intensely jealous of your Holden V8s.
Oh god, why?! And don't tell anyone here that, V8 fans are obnoxious enough as it is.

> in defense of ADHD/ADD diagnoses...
I'm not necessarily criticizing all diagnoses of ADHD/ADD. I'm talking about the veritable plague of specious diagnoses; and the fact is that many psychologists know that kids with ADD/ADHD simply need different learning strategies, so virtually all diagnoses that result in drugging should be viewed with that in mind.

> I think kids should have a lot more say in what treatment they get, but I acknowledge that kids (and adults), even smart/rational ones, are prone to making stupid mistakes.

Which is precisely what this bill is about. It is about giving the teenagers the option to have their say; if they're not capable of it and are making a stupid decision, their clinicians/parents can still override them. What this basically comes down to at most is a joint choice between the psychiatrist and the teenager, with the parents obviously being extremely potent influences anyway, rather than absolute power in the hands of the parents.

> so there's the argument that allowing them to make such important decisions could hinder their options for the future,

I see where you're coming from here, but ultimately the parents are not the effected party and are not the best judges of their child's options - the child and the educated psychiatrist, while not infallible, are going to know better than the parents what is appropriate. As a parent, I suspect this might offend you, but it's true: the parents may (or may not) have their kids' best interests at heart, but they don't know precisely what the teenager feels, what they'd prefer, and they're not educated like the psychiatrist. Should parents have a say? Yeah, and they do. I see what you're saying and I agree, but well-intentioned or not a parent should not be able to absolutely trump the preferences of their teens in this area, and not all treatment should require parental consent. Hell, in some cases it shouldn't even warrant telling the parents it's occurring as far as I'm concerned.

From what I've heard, you're an example of this yourself. You're talking about your parents dragging their feet and you not getting the help you needed: this bill is a step in the direction of empowering kids to do that - if necessary and only if a qualified psychiatrist agrees and declares the kid capable of making the informed decision. The next step is getting kids to realize that they can seek help and when they should.

> That's intensely silly, but that's what seems to happen a lot of times, with kids going against their best interests or their own wishes just because it's the opposite of what their parents want.

You're comparing calling yourself "conservative" when you're not to opting for sterilization treatment or psychosurgery - and having a psychiatrist declare you fit and informed enough to make that decision. :P
What's worse, you're presenting an argument for invalidating a teenagers preference because "they might just be doing it to spite their parents." Yes, it can happen, but the decisions and actions a teenager makes are rarely directly related to their parents at all.

They don't wear goth clothes to annoy or spite their parents. They do it because they like the aesthetic/clique; a teenager's every action doesn't revolve around their parents no matter how much some parents (and pandering dicks) tell them it's so. I can't see why a teenager that would be deemed fit and informed enough to make the decision by a qualified psychiatrist would decide on psychosurgery just to irk her mother. It could happen, but it's just not a good argument against this bill. It's a funny idea though.

... And I have to ask: seriously, why are people jealous of V8s? O.o
6 years, 5 months ago
Because they don't sell the Commodore or the Ute in North America, and as power-crazy as you Aussies may be, it pales in comparison to the American craving for muscle cars. Remember that we built the land yachts. And now you have the rear-wheel drive, V8 powered cars that we don't.

Anyway, back on topic. I completely acknowledge that some parents put their own interests ahead of their kids' interests or wishes. I try to not be one of them; trust me, pretty much the only reason my eldest isn't on a fairly strict diet is because I think he's old enough to make his own decisions about that. As for hiding treatment from parents, I'm on the fence on that. Like you said, it depends on the situation. There's doctor-parent privilege, and then there's wanting to know what's up with your kid.

As I've never run into transgender issues and have pretty much no experience with them (not to mention I just don't "get it"), I'm not qualified to discuss things like medical castration or associated pre-sex change stuff. But the point of my mention of political boundaries is that there's a degree of rebellion for the sake of rebellion. They know they're unhappy, but are unsure of how to express exactly how or why they're unhappy. Within that, I think that therapy is a good way to find out exactly what's going on, and help the kid figure out how to make things better himself. But the kid might not agree; a lot of them get more or less dragged to the shrink's office.

And I insist, American Conservatism, if caught early, is a curable disease. :P
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