Current Ideas: A Blog by Jeffrey A. Schaler

2007-09-06T23:59:00.000-04:00

The Washington Post
Health Section
Letters

Addiction
Tuesday, September 4, 2007; HE02
. . .

Let me offer two clarifications on the question "Is addiction a disease or a defect?"
First, as psychologist Jeffrey Schaler's book title suggests, "addiction is a choice."
Second, stigmatization is a marvelous negative reinforcer for undesired behavior.
Ending untoward habitual behavior is all about encouraging and persuading people to exercise choice and willpower.

Richard E. Vatz, PhD
Professor
Towson University
Towson

MENTAL ILLNESS: PHILOSOPHY MASQUERADING AS MEDICINE

2007-09-06T23:51:00.000-04:00

Electronic Letters to:

Book reviews:
Derek Bolton
The Metaphor of Mental Illness
Br J Psychiatry 2007; 191: 271 [Full text] [PDF] eLetters: Submit a response to this article

Electronic letters published:

MENTAL ILLNESS: PHILOSOPHY MASQUERADING AS MEDICINE
Jeffrey A. Schaler (6 September 2007)

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MENTAL ILLNESS: PHILOSOPHY MASQUERADING AS MEDICINE 6 September 2007

Jeffrey A. Schaler,
Professor
Dept. of Justice, Law & Society, School of Public Affairs, American University, Washington, D.C.
Send letter to journal:
Re: MENTAL ILLNESS: PHILOSOPHY MASQUERADING AS MEDICINE
Jeffrey A. Schaler

In his review of Neil Pickering’s book, The Metaphor of Mental Illness, Derek Bolton correctly suggests that the analysis of mental illness has more to do with philosophy than science or medicine (Bolton, 2007). Mental illness refers to the moral and ethical judgment of behavior, not biology, neurology or pathology. This distinction – discovered, not “invented” by professor of psychiatry emeritus Thomas Szasz over forty-five years ago – does not go out of style. Consequently, any policy – legal, clinical, social, public – based on the idea that mind is physical, and that mental illness is identifiable in a cadaver at autopsy, can only fail. The premise on which the policy is based is false.

Part of Szasz’s genius has always been his articulation of the obvious (Schaler, 2004). If mental illness refers to a brain disease, then it would be listed in a standard textbook on pathology as such. It is not listed as a brain disease precisely because mental illness refers to behavior, not a cellular lesion.

In an interview with Michael Rybalka, the great existential philosopher Jean-Paul Sartre remarked: “There is philosophy, but there is no psychology. Psychology [Psychiatry] does not exist; either it is idle talk or it is an effort to establish what man is, starting from philosophical notions” (Rybalka, 2002, p. 245).

Bolton, R. (2007) The metaphor of mental illness. British Journal of Psychiatry, 191: 271.

Rybalka, M. (2002) Interview with Jean-Paul Sartre. In Genius In Their Own Words: The Intellectual Journeys of Seven Great 20th-Century Thinkers, (ed D.R. Steele), pp. 241-253. Open Court.

Schaler, J.A. (ed) (2004) Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics. Open Court.

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Drugs, Alcohol and Society with Schaler at American University, May 21 to June 28, 2007

2007-05-04T17:29:00.000-04:00

Drugs, Alcohol and Society, Summer 2007
JLS-303-B01
American University
Instructor: Jeffrey Schaler
May 21, 2007 to June 28, 2007
Tuesdays and Thursdays, from 5:30pm to 8:40pm.

This is an intense, high-power course focused on everything you thought was true about addiction (but were afraid to ask). Study the synthetic and analytic truth about addiction. You'll learn all kinds of intellectual tools to win arguments with adversaries and "wow" your friends. Your life will change as a result of taking this course.

This is also an opportunity to study the ideas of Thomas Szasz, Jeff Schaler, and others (inaccurately labeled as "anti-psychiatrists") concerning the myth and meaning of addiction; the various explanations offered for addiction including theological, biological, psychological, and sociocultural explanations; and the various consequences of those explanations in diverse policy arenas including legal policy (First Amendment rights and court-ordered attendance in Alcoholics Anonymous and other forms of "treatment") as well as general consequences for liberty and responsibility; clinical policy (including the meaning of psychotherapy, different types of psychotherapy, similarities between psychotherapy and religion; why treatment doesn't work, etcetera); public policy (including various forms of formal social control, paternalism, how the state attempts to protect people from themselves in the name of public health and medicine; the consequences of drug prohibition, problems facing doctors in terms of prescribing opiates for pain control, etcetera); and various elements of social policy (the difference between formal and informal social control; conformity, compliance, and obedience to authority, etcetera.

For more information about summer courses with Professor Schaler, click HERE.

See past syllabi and evaluations by students of Schaler's teaching by clicking HERE.

Note: The Distance Education (DE) course with Schaler entitled "Psychiatry, Psychology, and Law" (JLS-596.N0XL) beginning May 14, 2007, is now full. If you registered for that course, you'll be sent the syllabus by email shortly. Blackboard will be enabled in the next couple of days.

Drugs, Alcohol and Society is the only other opportunity to take a course with Schaler this summer.

The Search for Meaning in a Killer's Hieroglyphics

2007-04-21T14:20:00.000-04:00

The Search for Meaning in a Killer's Hieroglyphics
By Libby Copeland
Washington Post Staff Writer
Saturday, April 21, 2007; C01

"We cannot predict who is going to do this type of thing and who is not with any more accuracy than guessing and that's just a fact," says Jeffrey Schaler, a psychologist at American University. There are people who "write much more disturbing literary messages than this guy did and never commit acts like this."

Tragedy abhors a vacuum.

"Ismael Ax" said the words on Seung Hui Cho's arm. Or maybe "Ismale Ax" or "Ismail Ax," depending on the news report.

In the absence of much understanding, we study these words, like cryptographers trying to crack enemy code.

After he killed 32 people at Virginia Tech on Monday, Cho died with some variety of this phrase penned to his arm. (It wasn't a tattoo, it turns out, despite earlier reports.) Then Wednesday, NBC News received the package Cho mailed between murders, and here was another clue. The sender is listed on the envelope as "A. Ishmael."

What could these words mean? Are they invoking the biblical Ishmael, born to a lowly servant, cast out by his father, Abraham? Are they an English major's reference to James Fenimore Cooper's "The Prairie," in which the outlaw settler Ishmael Bush sets west across the country with his axe? What about the loner who narrates "Moby-Dick"?

"It begins with 'Call me Ishmael,' " the crime writer Patricia Cornwell says. "The whole story is about an obsession that eventually drags you into the vortex of the sea."

Cho's pseudonym is our "Rosebud," the mysterious word that begins the movie "Citizen Kane," when it is uttered by the dying publishing tycoon Charles Foster Kane. It is the phrase we hope to understand, to help a 23-year-old mass murderer make sense.

Everybody's got a theory. The suggestions come in by e-mail, they are posted to online comments boards, they are posed by colleagues and bloggers, with Talmudic attention to detail. One person ruminates that "Ismale Ax" might be derived from a song Bob Marley performed, "Small Axe." Another person says the phrase might come from computer coding language. Another person mentions an alien named "Ax" from the children's science fiction series, "Animorphs."

Someone else: Could "Ismale Ax" be an anagram for "Islam Axe," suggesting some sort of religious vengeance? Could another spelling, "Ismail Ax," be an anagram for "Salami XI," derived from the Italian word for -- oh, never mind.

A guy named Bill McClelland, who lives on the west side of Cleveland, calls The Washington Post to offer some tips. He directs a reporter to the Web site for a "Gothic Male Model" who goes by the name of "Ax." Could the Web site somehow be connected to Cho's murderous rampage? McClelland wants to know.

"I've followed this story for three days now and it's intriguing," McClelland says. "What drove him? I think everybody would like to know that."

We would, we would. In mystery novels, the plot often turns on a single clue. Find the gun, find the killer. Motives are one-dimensional. (The wife did it for the life insurance!) Here we don't have such luck. Instead, what we have is wild speculation, with occasional input from a wacko. (Wackos always rise from their slumbers to send the media e-mail at times like this. As in: "Why is the media helping Bush hide the fact that this wasn't 'senseless random violence' at all, and in fact was clearly a suicide attack staged in protest of US Support for Israel?")

There's something very human in all this, something akin to our tendency to see faces in knots of wood. We look for reason in the nonsense. We look for ourselves. (Let's see, how would I justify the murders if I were Cho? . . . No, no, no.)

Cornwell has made several trips to England to study the letters allegedly written by Jack the Ripper, which were sent to police and newspapers during his lifetime. These letters are filled with hieroglyphs, she says; she studies them for clues as to who he was and why he was.

"Why did he choose this type of handwriting? Why did he draw this doodle?" she asks. "Is he simply making fun of us and it doesn't mean anything?" Each one might be a clue to the bigger why, the why that scares us, the why we'd like to answer and thereby emasculate. In the case of Jack the Ripper, Cornwell says: "Why do you cut someone open and dump their intestines to the pavement? Why do you flay somebody to the bone?"

What's scariest is that we can't see ourselves in Cho. The hieroglyphs are meaningless. If he was invoking the Bible or "Moby-Dick" with those words on his arm, it doesn't make any more sense than if he wasn't. Try parsing the sweeping rage in those writings he sent to NBC News, or in his violent plays. No way to reason with the anger. No one to blame but him. That's what's scariest.

"We cannot predict who is going to do this type of thing and who is not with any more accuracy than guessing and that's just a fact," says Jeffrey Schaler, a psychologist at American University. There are people who "write much more disturbing literary messages than this guy did and never commit acts like this."

...

Full

Psychiatry, Psychology, and the Law with Professor Jeffrey Schaler Summer 2007 at American University

2007-04-07T23:13:00.000-04:00

On-line course this summer 2007

American University, Washington, D.C.
5/14/07-6/25/07

Psychiatry, Psychology, and the Law JLS-596 N01L
Instructor: Jeffrey Schaler

This on-line course deconstructs concepts of mental illness, explanations for disease and behavior, and legal policies based on diverse explanations for both. It also investigates the insanity defense as legal fiction. In addition, it studies due process and involuntary commitment procedures and why and how society creates and welcomes the union of medicine and state, pharmacracy, and paternalistic practices based in psychiatric and psychological theories and practices.

Click here to register for this Distance Education/on-line course

Buprenorphine Program Aimed at Reducing Heroin Addiction, Drug-Related Violence

2007-02-28T09:29:00.000-05:00

[Originally broacast from WYPR, 88.1 FM, Baltimore, the story is carried around the country. Where it says TAPE in all caps is when the voices from the interviews are broadcast.]

Buprenorphine Program Aimed at Reducing Heroin Addiction, Drug-Related Violence

By Sarah Richards

http://www.publicbroadcasting.net/wypr/news.newsmain?action=article&ARTICLE_ID=1046231

BALTIMORE (2007-02-28)
BODY:TAPE: (4 SECONDS), MINIDISC 1, TRACK 6, 5:34 - 6:10 IC:

Let me see that? For the people that just came in, this is what happens to a person that come off heroine, get on buprenorphine and stop and change their life. "The Community College of Baltimore County, this award of recognition is presented to this young lady for successful completion of human services training" Applause Eight men and women are sitting around a table at the Park West Medical Center in Reisterstown. They're celebrating a former drug addict's academic comeback. That comeback is due in part to a drug called buprenorphine.

TAPE: (4 SECONDS), CD 1 , TRACK 1IC:

It works, it works. You just put them on your tongue and let them dissolve That's Mike. He's 48 years old, and he's agreed to be interviewed on condition that his last name not be used. He attends a different counseling group, but, like Park West's, the idea is the same: to get off heroine. After several attempts, Mike finally did in 2004, thanks in part to buprenorphine, or "bupe" for short. Bupe is different from methadone. It's not as addictive, so Mike can get it off a general practitioner. And unlike methadone, it won't add to your high if you use heroine at the same time.

TAPE: (7 SECONDS), CD 1, TRACK 1IC:

If you're taking bupe it's a waste of money if you try to get high because it's going to block it. I even experimented to see and it works.Bupe is one of the newer tools in Baltimore's never-ending shot at redemption. The city is pinning big hopes on bupe. Joshua Sharfstein is the city health commissioner.

TAPE: (19 SECONDS), CD 1 , TRACK 1IC:

Our interest in this comes from the expert opinions of countless federal agencies and substance abuse experts who have looked at this and looked at the experience of places like France, where the number of drug overdose deaths dropped from 500 to over 150 in a few years after bupe became widely available. But Baltimore's bupe program aims to do more than get people off drugs. Addicts who have gone through at least three months of detox will be set up with a primary care doctor. Doctors will not only prescribe them bupe, but also treat other health problems they may have. Adam Brickner is the president of Baltimore Substance Abuse Systems.

TAPE: (12 SECONDS), CD 1 , TRACK 1IC:

It's going to be a huge cost savings to the community. Because most of these guys are uninsured, most are male, the only time they access the healthcare system is through the emergency department, which is the most expensive way for them to access care. It's a great idea. But let's go back to that part about being uninsured. Many doctors don't want to deal with drug users because of that. Plus, they often have serious health problems, like HIV. It's for these reasons that the city is now paying doctors to be trained on how to prescribe buprenorphine. But drug treatment programs are always controversial, and this one is no different.

TAPE: (9 SECONDS), CD 1 , TRACK 1IC:

Treating opiate addiction with bupe is like treating scotch addiction with bourbon. You're substituting one drug for another. Jeff Schaler is a professor at the American University School of Public Affairs. He believes people take drugs because of their behavior and environment. He says even if a government could solve all the problems that lead people to use drugs-- things like racism and money issues that wouldn't stop some people from using. He believes the best solution is to legalize drugs, which he says would end most drug-related crime.

TAPE: (27 SECONDS), CD 1 , TRACK 1IC:

The arguments used for repeal of drug prohibition are the same used for methadone and bupe. You reduce the crime associated with illegal drug use, it's cost effective to just give them the drugs they want than to just talk to them and listen to them and they can become productive members of society. But you're still causing harm when you're jailing people for illegal drug use when you have a bupe substitution type program. For now, that an opinion many disagree with. At roughly $2.50 for a 2 milligram pill compared to roughly 50 cents for a dose of methadone-- Baltimore's buprenorphine program is anything but cheap. But it's definitely cheaper than fixing the deeply entrenched social problems that so many people using drugs struggle to conquer.

I'm Sarah Richards, reporting in downtown Baltimore, for 88-1 WYPR.

© Copyright 2007, WYPR

Renaming Schizophrenia

2007-02-02T07:58:00.000-05:00

BMJ 2007;334:108 (20 January), doi:10.1136/bmj.39057.662373.80
Editorials
Renaming schizophrenia
Diagnosis and treatment are more important than semantics

===============================================

Rapid Responses

Stigma and psychiatry
22 January 2007

sobia haqqi, Resident department of psychiatry,Aga Khan University Hospital, Karachi,
Send response to journal: Re: Stigma and psychiatry
The authors have done a good job in highlighting a rather controversial issue that has been a center of century long debates globally. Stigma and psychiatry go hand in hand. In my opinion,the tendency to stigmatize seems to be deeply rooted in human nature as a way of responding to people who appear or behave differently. Stigmatization is based on the fear that those who seem different may behave in threatening or unpredictable ways, and it is reduced when it becomes clear that the stigmatized person is unlikely to behave in ways that were expected. Having said that, one must also remember that all Psychiatric diagnosis are based on reliable diagnostic tools (whether DSM-diagnostic and statistical manual or ICD-international classification od disease) with established reliability and validity, and the treatment would also be planned according to the established guidelines. However, one does wonder, would changing the name of schizophrenia to some other entity would have any benefits in removing the stigma attached to it ? or would changing the name be beneficial in modifying the treatment modalities ? some questions that still remain unanswered.
Competing interests: None declared

What’s wrong with the term “Schizophrenia”?
23 January 2007

Niraj Ahuja, Consultant Psychiatrist/Honorary Clinical Lecturer Northumberland, Tyne and Wear NHS Trust, NE28 7PD, Andrew J Cole, Consultant Psychiatrist/Honorary Clinical Lecturer and Associate Medical Director, Northumberland, Tyne and Wear NHS Trust
Send response to journal: Re: What’s wrong with the term “Schizophrenia”?

The recent report in the Guardian(1), citing Prof. Bentall’s comments, argues that the term schizophrenia should be abolished. The arguments used in the report include poorer outcomes in the developed world, stigma attached to the “label” of schizophrenia, and the fact that it does not define a specific illness.

The attempt to rename schizophrenia is reminiscent of the letter by Kellner and Ramsey(2) calling for abolishment of the term ECT. We agree with the arguments put forward by Lieberman and First(3) and we respond in the similar vein as the previous response to renaming ECT(4).
To our minds, there appear to be three main options.

The first option is to change the name as soon as possible and “hide” behind the new label, avoiding any hint of the terms mind or brain. However, it is really foolish to expect the newfangled term to be devoid of any stigma.

The fact the term “epilepsy” consists of a collection of multiple disorders and is often perceived to be stigmatizing, has not led to its premature demise. The new name is very likely to be as unpopular as were Koch’s and Hansen’s for tuberculosis and leprosy, respectively(4). The media and general public are still likely to call it schizophrenia and the public will wonder what we are defensive about.

The second option is to keep the present name till there is hard scientific evidence that the present name is best replaced by another name(s). Even while renaming dementia praecox as Schizophrenia, Eugene Bleuler(5) had indicated that it is a group of conditions. It is widely acknowledged that it is unlikely that schizophrenia represents a single disease entity. However there has been a considerable amount of work done in clarifying its core symptoms and improving the specificity and sensitivity of its diagnosis.

The term schizophrenia serves to communicate a meaningful set of signs and symptoms, outcome, prognosis, and treatment options to most clinicians and researchers through the world. This represents one of the core purposes of diagnosis and classification in psychiatry.

Whilst keeping the term schizophrenia, it is of paramount importance to educate the public, patients and carers about the current understanding of the condition and work proactively towards de-stigmatizing not only schizophrenia but also all psychiatric disorders.

The third option is of course to change the name of the condition and work towards public education and de-stigmatization.

For example, the Japanese classification has renamed schizophrenia as “integration disorder” in 2004(6). The change appears understandable in the light of translation of the word “schizophrenia” in to Japanese, as “Seishin Bunretsu Byo” means “mind-split-disease”(7). It is not difficult to see as to how the term would seem pejorative to the patients and their families. The new term “Togo Shitcho Sho”, with the meaning of “integration disorder”, seems therefore more positive to the patients and their families.

One of the dangers of such an exercise is that “nicer sounding names” would replace the pre-existing term without adequate scientific data. To argue against another term suggested for replacing schizophrenia, “dopamine dysregulation disorder”, there is a substantial body of evidence to suggest that there is more than dopamine that is dysregulated in schizophrenia. There is therefore a peril of plethora of names emerging for the same condition, as none of these would have an evidence base supporting the change in name. It would certainly be a retrograde step to rename schizophrenia without the backing of valid scientific data.

We suggest that we need to focus on psycho-education, which is crucial to remove the stigma of having a serious mental disorder. For this purpose, we do not need to hide behind novel labels.

References
1. Boseley S. Call to wipe out schizophrenia as catch-all tag. Guardian, 10 October 2006.
2. Kellner CH, Ramsey D. Please, no more “ECT”. Am J Psychiatry 1990; 147: 1092-1093.
3. Lieberman JA, First MB. Renaming schizophrenia. BMJ 2007; 334: 108.
4. Ahuja N. What’s wrong with “ECT”? Am J Psychiatry 1991; 148; 693- 694.
5. Bleuler E. Dementia praecox, oder die Gruppe der Schizophrenien (Dementia praecox or the group of the schizophrenias) Leipzig, Germany: Franz Deuticke, 1911.
6. Sugiura T, Sakamoto S, Tanaka E, Tomoda A, Kitamura T. Labelling effect of Selshin-bunretsu-byou, the Japanese translation for schizophrenia: an argument for re-labelling. Int J Soc Psychiatry 2001; 47: 43-51.
7. Sato M. Renaming schizophrenia: Japanese perspective. World Psychiatry 2006; 5: 53–55.
Competing interests: None declared

Schizophrenia can and should be renamed
23 January 2007

David G Kingdon, Professor University of Southampton, Royal South Hants Hospital, Southampton SO14 0YG, Lars Hansen, Yoshihiro Kinoshita, Farooq Naeem, Shanaya Rathod, Maged Swelam, Selveraj Vincent

Send response to journal: Re: Schizophrenia can and should be renamed

Lieberman and First1 make the case against renaming schizophrenia on the grounds that changing the term would not change the stigma attached to the underlying condition. Yet renaming is a key strategy used by marketing and public relations industries to improve image, alongside attitude change and education, as happened successfully when the National Schizophrenia Fellowship became RETHINK. Similarly many stigmatised terms have been replaced to good effect, e.g. idiot, retard, spastic and, recently, manic depressive with bipolar disorder.
But what should it be replaced with? Over the century since ‘the group of schizophrenias’ were first described by Bleuler, there has been much discovered about the conditions involved. Evidence of genetic influences and abnormalities in brain structure does indeed exist but these are not specific to schizophrenia such that one of the conclusions emerging from the ‘Deconstructing psychosis’ conference, part of the DSMV Prelude project was for ‘replacing the current categories with a general psychosis syndrome’2. However this would increase still further the heterogeneity that currently bedevils biological and psychosocial research, clinical practice and resource management when differentiation is really needed.
Trauma has recently been recognised as relevant to a significant group of patients with this diagnosis3 probably because disclosure has now become much more acceptable. Since the 1950’s, a new group has also been included to broaden the diagnosis further; those in whom there is an association with hallucinogenic drugs4. They probably have a lower incidence of negative symptoms, poor adherence to medication and higher risk of harm to others. Renaming and differentiation of these two groups (‘traumatic’ and ‘drug-precipitated psychosis’) is clinically possible from those patients who develop systematised delusions and those who seem to be particularly vulnerable to stress (‘sensitivity psychosis’). In a study of the use of these terms with medical students (n=241), we found that they were associated with reduced perception of dangerousness and much increased expectation of recovery than ‘schizophrenia’.

Most importantly, patients and carers themselves, when asked, find the term unacceptable5, demoralising6 or unusable7. (It was their views that led to the adoption of ‘Integration disorder’ in Japan.) The development of DSMV and ICD11, due for publication in 2011, provides an opportunity now to develop more accurate, specific and acceptable terminology as part of broader efforts to reduce stigmatisation.

(1) Lieberman JA, First MB. Renaming schizophrenia. BMJ 2007; 334(7585):108.
(2) First MB. Deconstructing psychosis. http://dsm5.org/conference5.cfm (Accessed 20/1/2007).
(3) Read J, Agar K, Argyle N, Aderhold V. Sexual and physical abuse during childhood and adulthood as predictors of hallucinations, delusions and thought disorder. Psychology and Psychotherapy: Theory, Research and Practice 2003; 76(1):-22.
(4) Hall W. Is cannabis use psychotogenic? The Lancet 367(9506):193- 195.
(5) Kingdon D, Gibson A, Turkington D, Rathod S, Morrison A. (in press) Acceptable Terminology and Subgroups in Schizophrenia: an Exploratory Study. Social Psychiatry and Psychiatric Epidemiology 2006.
(6) Rathod S, Kingdon D, Smith P, Turkington D. Insight into schizophrenia: the effects of cognitive behavioural therapy on the components of insight and association with sociodemographics - data on a previously published randomised controlled trial. Schizophrenia Research 74(2-3):211-9, 2005.
(7) Beveridge A. Psychiatry in Pictures. Br J Psychiatry 2006; 189:A10.
Competing interests: None declared

De-stigmatising Schizophrenia
23 January 2007

James Paul Pandarakalam, consultant psychiatrist, 5 Borough Partnership NHS Trust St Helens North CMHT, Peasley Cross Resource Centre, St Helens, Merseyside WA 9 3DA
Send response to journal: Re: De-stigmatising Schizophrenia

The editorial of Lieberman and First have raised interesting points 1. Psychiatric classification is essentially based on the clinical features of individual disorders. There has been attempts to make etiological diagnosis on a few limited conditions involving organic causes but they were unrewarding. Psychiatric diagnosis is meant for communication purposes among the professionals but laypersons are using psychiatric diagnosis and symptoms with different meanings. These illnesses are poorly understood by lay persons in terms of their level of recognition and understanding of the symptoms and nature of mental illness, a situation that has contributed to the stigma of schizophrenia. The general public still thinks that the term schizophrenia means “split personality” without realising the professional meaning that it refers to dissociation between thinking and emotions. When it was initially introduced, the term schizophrenia gave a “medical refuge” to the afflicted patients who were once thought to be possessed by evil spirits; a labelling that carried its own stigma before the medical era. Yet the new nomenclature began to incorporate a stigma as the illness was considered incurable and debilitating like a cancer of the mind. In spite of the vast cybernetic literature available on the subject, the stigma is still very much alive both among the lay public and within the medical profession.
Depression has social acceptance now; bipolar disorder is also getting some social acceptance because of the recent media claim that it is associated with creative achievement and many a media celebrities have publicly claimed to be sufferers of the condition. People have started using terms like “paranoid, manic etc” in colloquial language, a sign of liberation from the fear of psychiatric symptoms. The film “Beautiful mind” does not appear to have much impact on reducing the stigma associated with schizophrenia.

Stigma is not without some usefulness in preventing manipulation. Imagine the hypothetical situation that psychiatric illness has no stigma at all. As most of the psychiatric symptoms except formal thought disorder can be feigned, but for the stigma attached to psychiatric disorders, many normal people would have faked mental illness for personal gains, and the number of psychiatric patients would have been apparently far higher now. Stigma is unfortunately unhelpful for the genuine patients but advantageous for the gatekeepers of psychiatric services.

The dopamine blockade hypothesis is 40 years old and still underpins much contemporary theorising. From an etiological perspective, probably the renaming of schizophrenia as a “Dopamine dysregulation disorder” might have been reasonable but cannot guarantee that the new name would de- stigmatise the illness. The best way of overcoming the stigma of this illness is finding the true aetiology and a new treatment method that would promise a permanent cure. Historically, Pellagra psychosis was also grouped under schizophrenia but disappeared from the scene once the cause and cure was found out. It is hoped that in a later stage of research with stem cells, radically therapeutic and preventive interventions are likely to happen in complex brain conditions like schizophrenia promising light at the end of the tunnel 2. We may be able to rename the illness more accurately at that period of scientific advancement and remove the stigma altogether.
1.Lieberman A Jeffrey (2007) Renaming schizophrenia. BMJ, 334:108. 2. Thomson JA, et al (1998) Embryonic Stem cell lines derived from human blastocysts. Science, 282:1145-1147
Competing interests: None declared
Renaming Schizophrenia; stigma and semantics
23 January 2007

Daniel V Riordan, Consultant Psychiatrist New Craigs Hospital,, Leachkin Road, Inverness, IV3 8NP
Send response to journal: Re: Renaming Schizophrenia; stigma and semantics

One of the arguments in favour of renaming schizophrenia, not mentioned by Lieberman and First 1, is that the word is a confusing misnomer 2. Derived from the Greek for “split mind”, it was coined as a descriptive term in the early twentieth century, when our understanding of the phenomenon was very different to what it is today.
The semantics would be irrelevant were it not that the word is often understood by the public as referring to split or dual personality, suggestive of Jekyll and Hyde characters who are dangerously unpredictable. We health professionals may be well aware that this is not a valid description of the relatively common psychotic disorder, but this is an insight not shared by all.

The word is stigmatising in an unusual way, in that much of the negative public associations are not a result of the medical usage, but of the (semantically legitimate) usage in another context altogether. It is often used by those who wish to criticise perceived inconsistencies in the behaviour of others. It is difficult to think of the name for any other medical condition which, as a result of an alternative meaning, is used in common speech in such a derogatory manner.

The concept of schizophrenia is indeed useful and almost certainly valid. Unfortunately, in this case, semantics are a problem which should not be ignored.

1. Lieberman J.A and First M.B. BMJ 2007; 334:108
2. Riordan D.V. “Split personality” and the stigma of schizophrenia. Irish Journal of psychological medicine 2005; 22(4): 156.
Competing interests: None declared
Change is required; but name or attitude?
23 January 2007

Arnob Chakraborti, Addiction Psychiatry SHO St. George's Hospital, Stafford ST16 3AG, Luay Kafienah, CAMHS Senior House Officer
Send response to journal: Re: Change is required; but name or attitude?

Dear Editor
Mental illness attracts attention from lay people or professionals alike, and rather fortunately or unfortunately, from the media. The general public always had a concept of madness – and the ICD 10 F20s diagnosis of Schizophrenia fits well into the same. Whilst the biological concept appears more prevalent in developed societies compared to the lesser developed and supernatural believing ones, the general attitude towards mental symptoms is a negative one. Be it the enduring, unresponsive nature of the illness or the un-understandable, implausible symptoms or behaviour. Also, the much highlighted incidents of violence and attacks by people with mental illness have generated, but very sadly, a stereotype. Stigma is highly prevalent among people labelled with mental illness in the community (1).

We agree with the authors Lieberman and First that establishing a correct diagnosis and then initiating appropriate treatment is much more important than the name of the illness. The stigma is attached to the unexplainable presentations of schizophrenia that deviate from the ‘normal’. The stigmatised one at some point does realise this different status. And this further constitutes a detriment towards return to ‘normalcy’, restriction of social networking (2), social rejection and self-deprecation (3), impaired functioning and recurrent stress. There is ample evidence to suggest higher relapse of schizophrenia living in a hostile and critical environment compared to an accepting one (4).
We also believe that the answer lies in a change of attitude. Public attitude, corrected through imparting correct information, dispelling beliefs, stereotypes and fears. The media should as well take on an active role upon itself, imparting knowledge, preventing stigmatisation and undoing the incorrect. Even elaborate and definitive steps similar to the suicide prevention WHO resource for the media professionals may be necessary (5), which may hopefully establish some guidelines on how to and how not to report incidents involving the mentally unwell.
And to talk of wrong names and medical incorrectness, malaria still stands for ‘foul air’.

References:
(1) On stigma and its consequences: evidence from a longitudinal study of men with dual diagnosis with mental illness and substance abuse. Link BG, Struening EL, Rahav M et al, 1997. Journal of Health and Social Behaviour 38:177 – 190
(2) Making it crazy: an ethnography of psychiatric clients in an American community. Estroff S 1981. University of California Press, Berkeley.
(3) From the mental patient to the person. Barham P, Haywood R 1991. Routledge, London.
(4) Influence of family life on the course of schizophrenic disorders: a replication. Brown GW, Birley JL, Wing JK 1972. British Journal of Psychiatry 121: 241 – 258
(5) Preventing suicide: A report for media professionals - Mental and Behavioural Disorders, Department of Mental Health, World Health Organization, Geneva 2000
Competing interests: None declared
This is related to stigma
25 January 2007

Vivek Furtado, Senior House Officer Leeds Mental Health Trust
Send response to journal: Re: This is related to stigma

The media article cited goes on to prove that the way we perceive Psychiatry has not changed. Labels or diagnosis in Psychiatry is inherently stigmatizing and people would prefer to shy away from such a diagnosis.
Considering the current controversies regarding the biological basis of the illness, it would be unwise to change the label to something which we are even more unsure of.
We must always bear in mind that most psychiatry illness are diagnosed on the basis of symptom clusters rather than a fundamental biological change. With this view do we still want to change the name of an illness?
Competing interests: None declared

Renaming schizophrenia: open up the debate
28 January 2007

Robert H Chaplin, Consultant Psychiatrist Warneford Hospital, warneford Lane, Oxford OX3 7JX
Send response to journal: Re: Renaming schizophrenia: open up the debate

Lieberman & First1 argue that schizophrenia should not be renamed as it is a valid diagnostic category, it has many treatment options with a sound evidence base and there are valid and reliable diagnostic criteria. These assertions would not be disputed by the vast majority of those working in mental health services. These are reasons, though, to keep the diagnostic category rather than the name of it unchanged. They are quite correct that the name is less important than its diagnosis or treatment. However, many patients and carers are unhappy with the name.2

The main problem with the name, schizophrenia, is not that it is ‘politically incorrect’ but just incorrect. The concept of a ‘split mind’ is not supported by scientific advances and it is therefore unhelpful to apply this concept to people with the disorder any more. The argument that the name of a diagnosis has stood the test of time is no reason not to modernise it. For example, in the ICD-10 the diagnosis of hysteria has been replaced by categories of dissociative or conversion disorders.3 In the UK the term mental handicap has been changed to learning disability by the Royal College of Psychiatrists and the new term is now in popular usage. Schizophrenia should not be exempt from the same processes.
Other interesting evidence that informs the debate about a possible name change for schizophrenia comes from psychiatrists. According to Clafferty et al4, psychiatrists don’t tell their patients the diagnosis frequently enough. In a postal questionnaire they found only 59% of psychiatrists informed their patients of a diagnosis of schizophrenia after a first episode, and 15% said they would not use the term schizophrenia. Moreover, 43% stated they felt uncomfortable about it and 10% felt it may harm the therapeutic alliance. In my own research, I found further evidence that psychiatrists are cautious about telling a patient their diagnosis of schizophrenia. In this qualitative study of psychiatrists’ views about their practices, some stated that they opted to preserve the therapeutic alliance by finding common ground or circumventing the diagnosis, tried to minimise the impact of symptoms, and exercised considerable judgement about the exact language and timing of a discussion of diagnosis.5

It should be acknowledged that the stigma associated with schizophrenia would not be abolished by a name change. This is supported by a Chinese study.6 Students did not display any less stigmatising attitudes to a vignette of a person with schizophrenia whether give a diagnosis of schizophrenia, an alternative diagnosis or no diagnosis. Conversely a label of schizophrenia generated more positive attitudes amongst students with religious beliefs.

The issue of stigma is further complicated by patient’ own internal working models. There can be a perception of stigma by people with mental illness in addition to the actual attitudes expressed by other people. This can lead to psychiatrists avoiding the term so as not to stigmatise their patients. The avoidance of the term schizophrenia can lead to alternative terms being adopted by patients and psychiatrists. Examples are ‘Neuro Biochemical Disorder’ adopted by a patient2 and psychosis commonly used by clinicians. It is therefore necessary to review all the evidence for and against a name change rather than altogether rejecting the idea or adopting an over zealous attitude to change.

The final difficulty is that schizophrenia describes a characteristic, although very diverse, pattern of symptoms. This is in contrast to the diagnoses of anxiety states, mood disorders, eating disorders and learning disability where a central theme is generally present with people who have the conditions. There is no obvious new name, as illustrated by the many different names suggested by clinicians and service users: the survey of names suggested by service users described2 identified over 120 different ones. The participation of people with schizophrenia is central to the debate about a possible name change.
References
1. Lieberman JA, First MB. Renaming schizophrenia: Diagnosis and treatment are more important than semantics. BMJ 2007;334:108
2. Berg SZ. Changing the S word: is there a better name? Schizophrenia Digest 2006;Fall:30-34
3. World Health Organization ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1992
4. Clafferty RA, McCabe E, Brown K. Telling patients with schizophrenia their diagnosis. Psychiatric Bulletin 2001;25:336-339
5. Chaplin R, Lelliott P, Quirk A, Seale C. Negotiating styles adopted by consultant psychiatrists when prescribing antipsychotics. Advances in Psychiatric Treatment 2007;13:43-50.
6. Chung KF & Chan JH. Can a less pejorative Chinese translation for schizophrenia reduce stigma? A study of adolescents’ attitudes toward people with schizophrenia. Psychiatry and Clinical Neurosciences 2004;58:507-515
Competing interests: None declared

Schizophrenia cannot be justified as brain pathology
29 January 2007

D B Double, Consultant Psychiatrist Norfolk & Waveney Mental Health Partnership NHS Trust, Peddars Centre, Norwich NR6 5BE
Send response to journal: Re: Schizophrenia cannot be justified as brain pathology
Lieberman & First justify the concept of schizophrenia as brain pathology.1 However, they admit that the cause of the disorder and the precise pathophysiology are unknown.
Operational diagnostic criteria were introduced in an attempt to improve the reliability of psychiatric categories, such as schizophrenia.2 Despite what Lieberman & First say, the genetic basis of schizophrenia can be challenged.3 It is not clear why they dismiss disturbed psychological development and parenting as factors in aetiology. Nor what abnormalities in brain structure and function they think have been demonstrated on neuroimaging and electrophysiological tests.
The question is whether schizophrenia is an improvement over the mere description of psychotic symptoms. Eugene Bleuler introduced the term in 1911 as an advance over Emil Kraepelin's notion of dementia praecox, as not all schizophrenic patients are "victims of deterioration early in life".4 Bleuler regarded schizophrenia as a functional disorder, although he could not exclude the possibility of "certain mild organic disturbances". He believed it was a disease, which did "not permit a full restitutio ad integrum", and that it was demarcated by the presence of fundamental symptoms which occur only and always in schizophrenia representing "a more or less clear-cut splitting of the psychic functions". Few would now accept this Bleulerian understanding of schizophrenia. And yet the term survives. This is more in the Kraepelinian rather than Bleulerian sense. What is needed is a biopsychological understanding of schizophrenia.5 The danger of focusing on schizophrenia as a biomedical diagnosis is that it may avoid understanding of the person by reducing mental health problems to brain pathology. The justification for retaining the concept of schizophrenia is that it seems to provide some organisation to the classification of psychosis, not because it points to an underlying brain abnormality.

Lieberman JA, First MB. Renaming schizophrenia. BMJ 2007; 334:108. (20 January 2007) [Full text]
Blashfield, R.K. The classification of psychopathology. Neo-Kraepelinian and quantitative approaches. New York: Plenum, 1984
Joseph J. The gene illusion. Genetic research in psychiatry and psychology under the microscope. Ross-on-Wye: PCCS books, 2003.
Bleuler E. Dementia praecox: or the group of schizophrenias. (trans. by J. Zinkin). New York: International Universities Press, 1950
Double DB. The biopsychological approach in psychiatry: The Meyerian legacy. In DB Double (ed) Critical psychiatry: The limits of madness, pp 165-87. Basingstoke: Palgrave Macmillan, 2006.
Competing interests: None declared

Renaming schizophrenia:the need for evidence
2 February 2007

Graham Thornicroft, Professor of Community Psychiatry Institute of Psychiatry, King's College London, Norman Sartorius, Diana Rose and Elaine Brohan
Send response to journal: Re: Renaming schizophrenia:the need for evidence
Dear Dr. Godlee,
Re: Renaming schizophrenia: the need for evidence
We share the caution of Lieberman and First 1 in their leader about renaming schizophrenia. The stigma and discrimination of people given the diagnosis of schizophrenia are grave and influence the quality of their life as well as the course and outcome of the disease 2 3. In other domains of medicine there are numerous examples of name changes which were intended to make a condition more speakable, for example, Hansen’s disease (leprosy), or Down’s syndrome (‘mongolism’), which has changed name repeatedly over the last century without clear data on whether this has been beneficial 4. These debates are rarely illuminated by evidence.
We have recently co-ordinated the INDIGO (International Study of Discrimination and Stigma Outcomes) Study. In 28 countries across the world (full details are available from GT) face to face interviews were completed with 736 people with a clinical diagnosis of schizophrenia. The main purpose of the study was to assess anticipated and experienced discrimination. Several questions related to the name of the condition. In reply to the question ‘Do you know what diagnosis your doctor has made?’ 83% answered yes. To the question ‘Do you agree with the diagnosis?’; 72% agreed, 17% disagreed and 10% were unsure. For the question ‘How much has it been an advantage or disadvantage for you to have the specific diagnosis of schizophrenia?’ 54% reported disadvantage, 26% advantage (eg in directing them information on the condition, or to a self-help group), and 18% reported no difference.
It is also notable that after the renaming of schizophrenia in Japan the proportion of such people who were told the name of their condition increased from 8% to 60% 5. Nevertheless a change of name should not happen alone: it would be of central importance to introduce a number of changes into the legislation, services and education of professionals and of the public if we wish to improve the way in which people with schizophrenia have to live. Changing the name of schizophrenia would in that instance probably be beneficial because it would be an indicator of change rather than the change. In particular, before initiating far- reaching changes in psychiatric terminology it is vital to have clear evidence of any benefit, particular from the perspective of people with schizophrenia.

Graham Thornicroft, Norman Sartorius, Diana Rose and Elaine Brohan.
References
(1) Lieberman JA, First MB. Renaming schizophrenia. BMJ 2007; 334(7585):108.
(2) Sartorius N, Schulze H. Reducing the Stigma of Mental Illness. A Report from a Global Programme of the World Psychiatric Association. Cambridge: Cambridge University Press; 2005.
(3) Thornicroft G. Shunned: Discrimination against People with Mental Illness. Oxford: Oxford University Press; 2006.
(4) Jain R, Thomasma DC, Ragas R. Down syndrome: still a social stigma. Am J Perinatol 2002; 19(2):99-108.
(5) Kim Y, Berrios GE. Impact of the term schizophrenia on the culture of ideograph: the Japanese experience. Schizophr Bull 2001; 27(2):181-185.
Competing interests: None declared

Today is the birthday of Thomas Paine

2007-01-29T08:37:00.000-05:00

"Literary and Historical Notes:

It's the birthday of writer and politician Thomas Paine, (books by this author) born in Thetford, England (1737). With his anonymously published pamphlet "Common Sense," in 1776, he helped start the American Revolution, even though he'd only been living in America for a little more than a year.

Thomas Paine said, "He that would make his own liberty secure, must guard even his enemy from oppression; for if he violates this duty, he establishes a precedent that will reach to himself."

More

Expert Ties Ex-Player’s Suicide to Brain Damage

2007-01-18T08:00:00.000-05:00

New York Times
By ALAN SCHWARZ
Published: January 18, 2007

Since the former National Football League player Andre Waters killed himself in November, an explanation for his suicide has remained a mystery. But after examining remains of Mr. Waters’s brain, a neuropathologist in Pittsburgh is claiming that Mr. Waters had sustained brain damage from playing football and he says that led to his depression and ultimate death.

The neuropathologist, Dr. Bennet Omalu of the University of Pittsburgh, a leading expert in forensic pathology, determined that Mr. Waters’s brain tissue had degenerated into that of an 85-year-old man with similar characteristics as those of early-stage Alzheimer’s victims. Dr. Omalu said he believed that the damage was either caused or drastically expedited by successive concussions Mr. Waters, 44, had sustained playing football.

In a telephone interview, Dr. Omalu said that brain trauma “is the significant contributory factor” to Mr. Waters’s brain damage, “no matter how you look at it, distort it, bend it. It’s the significant forensic factor given the global scenario.”

He added that although he planned further investigation, the depression that family members recalled Mr. Waters exhibiting in his final years was almost certainly exacerbated, if not caused, by the state of his brain — and that if he had lived, within 10 or 15 years “Andre Waters would have been fully incapacitated.”

Dr. Omalu’s claims of Mr. Waters’s brain deterioration — which have not been corroborated or reviewed — add to the mounting scientific debate over whether victims of multiple concussions, and specifically longtime N.F.L. players who may or may not know their full history of brain trauma, are at heightened risk of depression, dementia and suicide as early as midlife.

The N.F.L. declined to comment on Mr. Waters’s case specifically. A member . . .

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Aux Etats-Unis, le tabac hors-la-loi dans les bars, au travail, en voiture et même chez soi

2006-12-10T13:36:00.000-05:00

vendredi 8 décembre 2006, 11h49

Aux Etats-Unis, le tabac hors-la-loi dans les bars, au travail, en voiture et même chez soi

Par Virginie MONTET

agrandir la photo

WASHINGTON (AFP) - La cigarette, que l'Amérique a popularisé à travers le monde, devient de plus en plus hors-la-loi aux Etats-Unis, où comme ailleurs on l'interdit dans les bars-restaurants et au travail mais aussi parfois chez soi et en voiture.Dix-neuf Etats et 2.300 villes, dont New York, Los Angeles, Chicago et au 1er janvier Washington, ont passé des lois contre la cigarette au nom de la protection contre le tabagisme passif. 21% d'Américains fument encore contre 26,5% il y a vingt ans.
En Ohio (nord), le dernier Etat en lice qui a interdit jeudi la cigarette au travail et dans les lieux publics, on encourt une amende de 100 dollars si l'on fume dehors juste devant l'entrée de son lieu de travail, une habitude qu'avaient depuis longtemps pris les fumeurs.

Les autorités recommandent de ne pas fumer à moins de six mètres d'une entrée afin d'éviter que la fumée ne pénètre dans un bâtiment.
Des interdictions de fumer à l'air libre sont en vigueur également devant les porches des entreprises dans l'Etat de Washington (nord-ouest), dans certains parcs de San Francisco, sur des plages et dans de nombreux parcs zoologiques. Des chaînes d'hôtels, telles Marriott et Westin, sont devenues totalement non-fumeurs cette année.

Dans plusieurs Etats depuis quelques mois, comme la Louisiane, l'Arkansas et le Texas, il est aussi défendu de fumer en voiture si l'on transporte des enfants de moins de six ans. La Californie, Etat le plus peuplé du pays, y songe aussi.

La vague d'interdiction n'épargne pas les bastions des manufacturiers de tabac. A Louisville dans le Kentucky (centre-est), où on fabriquait un temps une cigarette sur six vendues dans le monde, la fumée va être bannie de tous les lieux publics d'ici juillet.

"Les recherches montrent que 126 millions d'Américains sont exposés au tabagisme passif qui provoque plus de 3.000 morts par cancer du poumon chaque année chez les non-fumeurs. Le débat sur les effets du tabagisme passif n'est plus en question", affirme à l'AFP Colleen Wilber, porte-parole de l'Association américaine contre le cancer qui a beaucoup poussé à l'adoption de lois contre la fumée dans les lieux publics. "Il y a un soutien sans faille de l'opinion publique pour ces lois", ajoute-t-elle.
La puissante organisation ne se mêle pas en revanche d'obtenir des interdictions de fumer chez soi, un nouveau type d'initiatives qui suscite davantage de polémiques. "Ce n'est pas notre politique", indique l'American Cancer Society.

Pour Jeffrey Schaler, professeur de droit à la faculté d'administration publique d'American University et auteur du livre "Addiction is a choice" ("L'accoutumance est un choix"), ces interdictions relèvent du syndrome de "l'Etat thérapeutique". "Le gouvernement ne devrait pas s'occuper de nous protéger de nous-mêmes", affirme-t-il pour l'AFP.
De plus en plus de complexes résidentiels toutefois demandent à leurs locataires de signer un contrat affirmant qu'ils ne sont pas fumeurs et qu'ils ne recevront pas de fumeurs chez eux.

Dans les tours "The Blairs" de Silver Spring près de Washington, les locataires des 1.400 appartements viennent de recevoir une lettre les informant qu'à partir du 1er janvier le complexe entier devient non-fumeur.

Des résidents depuis dix ans ne pourront pas renouveler leur bail s'ils fument et la presse locale a dénoncé cette nouvelle "tyrannie du sans-tabac".

De telles politiques sont suscitées par la crainte de procès de résidents non-fumeurs qui se plaignent d'asthme et de sinusites.

"Fumer n'est pas un droit constitutionnel", argumente sur son site le groupe "Smokefreeapartments" qui milite pour un environnement privé sans cigarette et justifie, armes juridiques à l'appui, les procès que peuvent encourir les promoteurs qui laissent leurs locataires fumer.

Smoking Laws

2006-12-10T11:05:00.000-05:00

----- Original Message -----
From: Kenneth Sandale
sandale111@bellsouth.net
To: schaler@american.edu
Sent: Sunday, December 10, 2006 10:40 AM
Subject: Smoking Laws

In an AP story on smoking today you are quoted as saying "The government shouldn't protect me from myself,"

Bizarrely you miss the whole point. Laws restricting smoking protect NON-smokers from smokers. As far as I am concerned, I wiuld strongly encourage people like yourself to kill yourselves, but not in a way that exposes other people to poison. (I do not say that with malice, but rather for protection of the gene pool.)

Do you also think drunk driving laws are there to protect drunk drivers from themselves?

Smoking becoming taboo in US workplace, homes and even in public

2006-12-10T10:52:00.000-05:00

Smoking becoming taboo in US workplace, homes and even in public

Published at www.physorg.com
Dec. 10, 2006

The property manager at The Blairs, an apartment complex near Washington, recently sent tenants a letter that has many up in arms: Stop smoking at home come January or move out, the note essentially said.

The letter came as a rude awakening to residents of the 1,400-unit complex, some of whom have been living there for more than 10 years and who would not be allowed to renew their lease if they do not comply with the new rule. But the measure is by no means an isolated incident in a country where smoking is increasingly becoming taboo in restaurants, in the workplace, outdoors and even in one's own car and home.

So far, 19 US states and 2,300 cities, including New York, Los Angeles and Chicago, have adopted legislation against cigarette smoking, citing health concerns. The US capital joins the list beginning in January.

In the midwestern state of Ohio, which this week became the latest state to ban smoking in the workplace and in public areas, violators face 100 dollars if caught puffing on a cigarette on the doorstep of their workplace, as has become the custom in many cities.

The law calls for smokers to stand at least six meters (20 feet) away from a building's entrance so as not to allow smoke to enter.

Outdoor smoking bans are also in effect on the balconies and porches of companies in the northwestern state of Washington, in some San Francisco parks and on beaches and various zoos across the country. Several hotel chains, including the Marriott and Westin, have also implemented smoking bans this year.

Even cities that came to symbolize the cigarette industry are not spared. In Louisville, located in the central-eastern state of Kentucky, where much of the world's cigarettes were once produced, smoking will be banned in public places come July.

"Research shows that more than 126 million Americans are exposed to second-hand smoke and there are more than 3,000 deaths a year due to lung cancer of non-smokers," said Colleen Wilber, spokeswoman for the American Cancer Society, which has lobbied to pass anti-smoking laws in the country.

"So the debate on that is pretty much over, ... and there is overwhelming support for these laws in the United States," Wilber told AFP.

She added, however, that the powerful organization is not involved in lobbying to ban smoking in private residences.

According to statistics, some 21 percent of Americans are smokers, compared with 26.5 percent 20 years ago.

Jeffrey Schaler, a law professor at American University in Washington and author of "Addiction is a Choice", said the anti-smoking laws being adopted nationwide are "characteristics of the therapeutic state".

"The government shouldn't protect me from myself," Schaler argued.

© 2006 AFP
This news is brought to you by PhysOrg.com

Reply/Comment at http://www.physorg.com/news84949716.html

America Continues Crackdown on Smoking

2006-12-09T22:17:00.000-05:00

INTERNATIONAL12.10.2006 Sunday - ISTANBUL 05:09

America Continues Crackdown on Smoking
By Anadolu News Agency (aa),
Washington Saturday, December 09, 2006
www.zaman.com

"First Turkish Paper on the Internet"

"Certainly there are people who are unhappy with the regulations. Jeffrey Schaler, a law professor and author of “Addiction is a Choice,” describes these types of bans as the syndrome of the ‘treating state’."

While tobacco was introduced to the world by America in 1492, some states in the U.S are now considering a ban on smoking in cars and even homes. Nineteen states and the administrators of nearly 2,300 cities are passing a law to protect people from being affected by second-hand smoke in as many places as possible.

When in 1950 Dr. Evart Graham discovered that tobacco caused cancer, the number of addicts gradually declined, owing to the campaigns launched and legal regulations in developed countries.

During the two decades between 1950 and 1970, 50 million Americans quit smoking and the amount of tobacco consumed by the population dropped to 25 percent from 40 percent.

Nowadays, 21 percent of the American population smokes.
Losing an important part of their markets in developed countries, multinational tobacco producers have gravitated toward markets in underdeveloped countries, including Turkey.

For instance, while America is doing its utmost to protect its own citizens from the lethal effects of tobacco, it backs the policy of selling tobacco to third-world countries.

It has launched a fierce battle against tobacco through legal regulations.
The state of Ohio recently passed a law banning smoking in workplaces and public places.

Even those smoking outside their workplaces will be fined $100.
According to a legal regulation made to prevent smoke from entering business buildings, smokers will not be allowed to smoke within the proximity of six meters from the company building.

For example, it is forbidden to smoke under the company building porches in Washington and on some beaches and parks in San Francisco, California. Moreover, in states such as Louisiana, Arkansas and Texas, people are not allowed to smoke in cars with children under 6 years old.
Certainly there are people who are unhappy with the regulations. Jeffrey Schaler, a law professor and author of “Addiction is a Choice,” describes these types of bans as the syndrome of the ‘treating state’.

The professor noted that the state had to give up protecting its citizens from themselves. Despite criticisms, the number of landowners who rent property to non-smokers is growing by the day.

09.12.2006Anadolu News Agency (aa)Washington
http://www.zaman.com/?bl=international&alt=&hn=39076

Medicaid Plan Prods Patients Toward Health

2006-12-03T14:13:00.000-05:00

Medicaid Plan Prods Patients Toward Health
NY Times
December 1, 2006

By ERIK ECKHOLM

HAMLIN, W.Va. — No question, John Johnson is a doctor’s nightmare.
Speaking from the easy chair where he spends his days in a small wooden house near this small Appalachian town, his left trouser leg folded by a safety pin where a limb was lost to diabetes, he lighted another cigarette.
Mr. Johnson, 61 and a former garbage collector, takes insulin and goes to a clinic once a month for diabetes checkups. Taxpayers foot the bill through Medicaid, the federal-state health coverage program for the poor.

But when doctors urged him to mind his diet, “I told them I eat what I want to eat and the hell with them.”

“I’ve been smoking for 50 years — why should I stop now?” he added for good measure. “This is supposed to be a free world.”

Ignoring doctors’ orders may now start exacting a new price among West Virginia’s Medicaid recipients. Under a reorganized schedule of aid, the state, hoping for savings over time, plans to reward “responsible” patients with significant extra benefits or — as critics describe it — punish those who do not join weight-loss or antismoking programs, or who miss too many appointments, by denying important services.
The incentive effort, the first of its kind, received quick approval last summer from the Bush administration, which is encouraging states to experiment with “personal responsibility” as a chief principle of their Medicaid programs. Idaho and Kentucky are also planning reward programs, though more modest ones, for healthful behavior.
In a pilot phase starting in three rural counties over the next few months, many West Virginia Medicaid patients will be asked to sign a pledge “to do my best to stay healthy,” to attend “health improvement programs as directed,” to have routine checkups and screenings, to keep appointments, to take medicine as prescribed and to go to emergency rooms only for real emergencies.

“We always talk about Medicaid members’ rights, but rarely about their responsibilities,” said Nancy Atkins, state commissioner of medical services.

“We’re in an Appalachian culture where there’s a fatalism, and many people don’t go in for checkups or preventive services,” Ms. Atkins said, noting that West Virginia had some of the country’s highest rates of obesity, smoking, heart disease and diabetes. “We want to reach people before they get chronic and debilitating diseases that will keep them on Medicaid for the rest of their lives.”

Those signing and abiding by the agreement (or their children, who account for a majority of Medicaid patients here) will receive “enhanced benefits” including mental health counseling, long-term diabetes management and cardiac rehabilitation, and prescription drugs and home health visits as needed, as well as antismoking and antiobesity classes. Those who do not sign will get federally required basic services but be limited to four prescriptions a month, for example, and will not receive the other enhanced benefits.

In future years, those who comply fully will get further benefits (“like a Marriott rewards plan,” Ms. Atkins said), their nature to be determined but perhaps including orthodontics or other dental services.

No one questions that West Virginia, more than most other states, needs more healthful lifestyles and better primary and preventive care. But the new plan has stirred national debate about its fairness and medical ethics. A stinging editorial in The New England Journal of Medicine on Aug. 24 said it could punish patients for factors beyond their control, like lack of transportation; would penalize children for errors of their parents; would hold Medicaid patients to standards of compliance that are often not met by middle-class people; and would put doctors in untenable positions as enforcers.

“What if everyone at a major corporation were told they would lose benefits if they didn’t lose weight or drink less?” said a co-author of the editorial, Dr. Gene Bishop, a physician at Pennsylvania Hospital in Philadelphia.

Denying mental health aid to those who do not sign seems especially counterproductive, Dr. Bishop said in an interview.

“If you think about the people least able to do simple things like keep appointments and take all their medications,” she said, “people with mental health and substance abuse problems are right up there.”
Judith Solomon of the private Center on Budget and Policy Priorities, in Washington, said that the plan was unlikely to save West Virginia money or improve patient health and that it carried “the risk that some very vulnerable people may be denied health care they need.”

But Ms. Atkins, the state health official, said critics had misunderstood the plan, which, she said, simply “gives people rewards and incentives to improve their health.”

Here in Lincoln County, as in the two other counties in the pilot phase, there is a federally subsidized primary-care center that is a leader in developing “care management” programs, nudging people into preventive services and lifestyle changes voluntarily.

The Lincoln Primary Care Center in Hamlin, a town of 1,500 an hour’s winding drive west of Charleston, is a showcase for preventive medicine, with its own fitness center, an exercise physiologist, a dietary adviser and a mental health counselor — resources that are lacking in many rural clinics. The center stays open until 9 most nights, making it easier for sick people to come in for urgent care rather than driving to distant emergency rooms.

A former tobacco-growing area, Lincoln is one of the state’s poorest counties, with a population of 22,000 scattered through the hills. About 9,000 use this care center, a majority of them uninsured or on Medicaid, said Brian Crist, the chief executive.

Some doctors here and throughout the state were initially alarmed by the new rules, which were delayed six months for discussions and fine-tuning. But state officials appear to have allayed some fears, and many doctors are now taking a wait-and-see attitude.

Officials have offered assurances, for example — and Ms. Atkins emphasized in an interview — that doctors will be able to provide medically necessary drugs and care to children even if their parents have not followed the agreement. This was not clear in the written plan and may be needed in any case, critics said, to comply with federal law.
Dr. Syem B. Stoll, a physician at Lincoln, said the clinic’s three-year-old effort to promote lifestyle changes for patients with hypertension, obesity, diabetes and other problems had already made a difference for many.

“We’re doing a lot more than just giving people pills and sending them home,” Dr. Stoll said.

Of the new Medicaid rules, he said: “My interactions with patients won’t change — I am who I am. But giving people responsibility and initiative is the way to go.”

In interviews with several residents of the Hamlin area, including Medicaid recipients, none said they had heard about the new rules.
When they were outlined for Mr. Johnson, the cantankerous diabetic, he said he had no intention of participating. “Hell, no,” he said. “I wouldn’t sign an agreement like that.” Somewhat incongruously, he appears to be off the hook: as a disabled person he will be exempt under the rules.

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Girl, 4, who is so sad she may need anti-depressants

2006-11-14T14:27:00.000-05:00

Girl, 4, who is so sad she may need anti-depressants
By PAUL SIMS

The Daily Mail
London
November 9, 2006

A girl of four is being treated for stress and depression after she was refused a place at her local school.

Mollie Murphy became so distraught at being separated from her best friends that she had to see a doctor.

Also seeHave toxins damaged millions of children?

Last night, the youngster's mother spoke of her shock after the GP said he would consider a course of anti-depressants and counselling if Mollie's condition does not improve.

"When he said she had stress and depression at first I thought he must be joking," said 26-year-old hairdresser Victoria Anderson.

"I thought, how can a little girl suffer from that? It's an adult's problem and Mollie's only four. But he told me it does happen."

Although the number of children suffering from depression remains relatively low, experts claim the rate has dramatically increased in recent years.

According to research by the National Institute for Health and Clinical Excellence, as many as 40,000 children and adolescents were prescribed anti-depressants in 2003.

Miss Anderson said her daughter started experiencing problems in September.

Full

Foley's folly

2006-11-08T22:20:00.000-05:00

Foley's folly
Liberty, Vol. 20, 15, December
http://www.schaler.net/foleysfolly.pdf

In the Libby Case, A Grilling to Remember

2006-10-28T12:35:00.000-04:00

In the Libby Case, A Grilling to Remember
By Carol D. Leonnig
The Washington Post
Friday, October 27, 2006; A21

With withering and methodical dispatch, White House nemesis and prosecutor Patrick J. Fitzgerald yesterday sliced up the first person called to the stand on behalf of the vice president's former chief of staff.

If I. Lewis "Scooter" Libby was not afraid of the special counsel before,the former Cheney aide, who will face Fitzgerald in a trial beginning Jan.11, had ample reason to start quaking after yesterday's Ginsu-like legal performance.

Fitzgerald's target in the witness box was Elizabeth F. Loftus, a professor of criminology and psychology at the University of California at Irvine. For more than an hour of the pretrial hearing, Loftus calmly explained to Judge Reggie B. Walton her three decades of expertise in human memory and witness testimony. Loftus asserted that, after copious scientific research, she has found that many potential jurors do not understand the limits of memory and that Libby should be allowed to call an expert to make that clear to them.

But when Fitzgerald got his chance to cross-examine Loftus about her findings, he had her stuttering to explain her own writings and backpedaling from her earlier assertions. Citing several of her publications, footnotes and the work of her peers, Fitzgerald got Loftus to acknowledge that the methodology she had used at times in her long academic career was not that scientific, that her conclusions about memory were conflicting, and that she had exaggerated a figure and a statement from her survey of D.C. jurors that favored the defense.

Her defense-paid visit to the federal court was crucial because Libby is relying on the "memory defense" against Fitzgerald's charges that he obstructed justice and lied to investigators about his role in the leaking of a CIA operative's identity to the media. Libby's attorneys argue that he did not lie -- that he was just really busy with national security matters and forgot some of his conversations.

When Fitzgerald found a line in one of her books that raised doubts about research she had cited on the stand as proof that Libby needs an expert to educate jurors, Loftus said, "I don't know how I let that line slip by."

"I'd need to see that again," Loftus said when Fitzgerald cited a line in her book that overstated her research by saying that "most jurors"consider memory to be equivalent to playing a videotape. Her research, however, found that to be true for traumatic events, and even then, only 46 percent of potential jurors thought memory could be similar to a videotape.

There were several moments when Loftus was completely caught off guard by Fitzgerald, creating some very awkward silences in the courtroom.

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Dr. Kay Redfield Jamison this Friday October 27, 2006

2006-10-26T21:25:00.000-04:00

Only National Conference for Young Adult Mental Health Advocates to Convene at American University

Dr. Kay Redfield Jamison to Keynote Active Minds
4th Annual Conference
WASHINGTON, D.C. (October 20, 2006)

—More than one hundred college student mental health advocates,experts and authors will assemble for the only national conference geared towards young adult mental health activists at the fourth annual Active Minds Mental Health on Campus Conferenceto be held at American University on Friday, Oct. 27 and Saturday, Oct. 28.Hosted by Active Minds at AU and supported by Potomac Ridge Behavioral Health Center, this year's national gathering aims to engage and educate a new generation of mental health advocates while raising mental health awareness as students transition from adolescence to adulthood.

Dr. Kay Redfield Jamison, an internationally-recognized expert on mood disorders and author of the New York Times best-seller, An Unquiet Mind, will be the featured speaker at 8 p.m.in Kay Spiritual Life Center on Friday, October 27, 2006. “Since suicide is the second leading cause of death for college students, the Active Mindschapters are ensuring the well-being of their universities’ student bodies,” said AlisonMalmon, founder and executive director of Active Minds, Inc. “This assembly of students representsa new generation of mental health advocates dedicated to eradicating the stigma of mental illness.”

Additional sessions will be held in the Butler Pavilion’s Butler Boardroom including guest speakers: Jerilyn Ross, M.A., L.I.C.S.W., president and CEO, Anxiety Disorders Association of America (Oct 27, 3:45 p.m.) Ross Szabo, director of youth outreach, National Mental Health Awareness Campaign (Oct 27,5 p.m.) Karen Bower, senior staff attorney, Bazelon Center for Mental Health Law (Oct 28, 3 p.m.) Lizzie Simon, author of Detour: My Bipolar Road Trip in 4-D. (Oct 28, 4:15 p.m.) Representatives from the National Mental Health Association, Suicide Prevention Action Network (SPAN-USA), and Jed Foundation Student leaders from Colorado State University, Niagara University, Regis University, and the University of Pennsylvania will be presenting as well.

For a full conference agenda go to: http://www.activemindsoncampus.org/. Active Minds is the nation’s only grassroots organization dedicated to raising mental healthawareness among young adults as they transition from adolescence to adulthood—when studentsmay find themselves without a familiar support system. Since its founding in 2003, Active Minds has become the definitive young adult voice in mental health advocacy and the organizational catalyst for student-based mental health awareness on college and university campuses. Thereare more than 50 student-run Active Minds chapters on college campuses across the United States and Canada.

Located in Washington, DC, American University (www.american.edu ) is a leader in global education,enrolling a diverse student body from throughout the U.S. and nearly 150 countries and providing opportunities for academic excellence, public service, and internships in the nation's capital and around the world. American University is located at 4400 Massachusetts Ave., NW, Washington, D.C., 20016. For map and directions visit: http://www.american.edu/maps . Media are welcome to attend all or a portion of the conference, but must pre-register withMaralee Csellar, acting director of AU’s Media Relations Office, at (202) 885-5952, or AlisonMalmon, executive director of Active Minds Inc, at (202) 719-1177.

# # # --------------------------------------------------------------------------------Contact: Maralee Csellar Date: 10/20/2006 Phone: (202) 885-5952 Release Category: Campus Life E-mail the Contact Person: csellar@american.edu

The Superpower Myth

2006-10-18T14:27:00.000-04:00

The Superpower Myth
by Sheldon Richman

http://www.fff.org/comment/com0610g.asp

". . . Moreover, any government efforts to protect us will likely make things worse through corruption and ineptitude. If there are technological ways to shield us from a nuclear attack, the government should step aside and let private enterprise discover them. . . . "

Naivete squared . . . So, the private sector should protect us from a foreign enemy???

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Methicillin-Resistant Staphylococcus aureus Skin Infections Among Tattoo Recipients --- Ohio, Kentucky, and Vermont, 2004--2005

2006-10-17T18:50:00.000-04:00

Morbidity and Mortality Weekly Report
Centers for Disease Control and
June 23, 2006 / 55(24);677-679

Methicillin-Resistant Staphylococcus aureus Skin Infections Among Tattoo Recipients --- Ohio, Kentucky, and Vermont, 2004--2005 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5524a3.htm

Disney bans all junk food

2006-10-17T18:22:00.000-04:00

Disney bans all junk food
Daily Mail
London
October 17, 2006

17/10/06 - News section

Disney announced today it is severing all connections with junk food.
Burger and chips will soon be off the menu at its theme parks worldwide. Film and cartoon characters will no longer be used to promote salty snacks and sugary drinks.

The move by such a powerful and influential company is being hailed as a major breakthrough in the battle against obesity among children.

Out will go products such as The Incredibles Pop Tarts and Winnie The Pooh biscuits. In could be Nemo mineral water and porridge courtesy of Goldilocks. Disneyland, Disney World in Florida and Disneyland Paris will serve up vegetables and fruit juice.

The firm is also ending its 10-year $1 billion deal with McDonald's to advertise on its happy meals.

Walt Disney Corporation has come under pressure-for years in Britain to follow the lead of the BBC in banning its children's programme characters from tie-ins with junk food.

Critics say Disney characters have driven the worst forms of pester power.

The company says that its change of policy means it will only lend its name to products that meet standards for healthy eating.

In its licensing deals from 2009 Disney will in most cases refuse to link its brand to foods that get more than 30 per cent of their calories from fat, over 10 per cent from saturated fat and in excess of 10 per cent from added sugar. "Sugar things like Lucky Charms and Sugar Frosted Flakes wouldn't make it. Cheerios and Rice Krispies would said James Hill, a child nutrition expert who worked with Disney in recent months as it planned the change in policy.

But Disney's TV channels are still likely to come under fire as they will continue taking junk food ads.

The company's chief finance officer, Thomas Staggs, said more storylines would include a healthy diet and exercise, adding that Disney's new "nutrition programme", which has been worked on for 18 months, would be phased in as current contracts expired.

"Parents try to make intelligent choices, he said. "The right thing to do for our company is to provide them with those choices. Last year, Disney's largest shareholder, Steve Jobs, the head of the Pixar Animation Studio, spoke of his doubts about tie-ins with fast food products.

He said: "There is value, but there also some concerns as our society becomes more conscious of some of the implications of fast food. Earlier this year in Britain, a row erupted over proposed measures unveiled by TV watchdog Ofcom to curb ads for junk food aimed at children, including banning them before 9pm.

Amber Alert issued for baby boy; social worker dead

2006-10-17T13:45:00.000-04:00

"It's a dangerous job anytime you're taking someone's child away from their parents," Duncan said. "You know how protective parents can be."

CNN.COM
Amber Alert issued for baby boy; social worker dead
POSTED: 12:40 p.m. EDT, October 17, 2006

HENDERSON, Kentucky (AP) -- Police found a social worker slain in a western Kentucky home and issued an Amber Alert for the 10-month-old boy the woman had taken to the house for a visit with his mother, authorities said Tuesday.

The child's mother, Renee Terrell, 33, of Henderson, did not have custody of her developmentally disabled son, police said. She and her boyfriend, Christopher Wayne Luttrell, 23, were both missing Tuesday and were believed to have the child.

Police were called Monday afternoon when the social worker didn't return to work after taking the baby, Saige Terrell, to visit his mother, said Henderson Police Sgt. Dwight Duncan.

"It's a dangerous job anytime you're taking someone's child away from their parents," Duncan said. "You know how protective parents can be."
The social worker was identified as Boni Frederick, 67, of Morganfield, who worked for the Kentucky Cabinet for Health and Family Services. Her station wagon, a 2000 white Daewoo Nubia, also was missing, police said.

Duncan said police believe Frederick was killed, but he would not comment on her cause of death pending an autopsy under way Tuesday.
The white-paneled house where she was found was roped off by police tape Tuesday, and a police car was parked out front.

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Va. Parents Trying to Unadopt Troubled Boy--Mother Says Caseworkers Failed to Disclose Child's Stormy History

2006-10-09T12:43:00.000-04:00

Va. Parents Trying to Unadopt Troubled Boy
Mother Says Caseworkers Failed to Disclose Child's Stormy History
By Brigid Schulte
Washington Post Staff Writer
Monday, October 9, 2006; Page A01

A talkative 9-year-old boy came to Helen Briggs on Valentine's Day 2000. She was a foster mother with years of tough love and scores of troubled kids behind her. But she grew to love this boy. Within the year, she'd talked her husband into adopting him.

Now, six years later, Briggs and her husband, James, a maintenance worker for the city of Alexandria, are taking the highly unusual step of trying to unadopt him.

In 2003, when the boy was 12, he sexually molested a 6-year-old boy and a 2-year-old girl still in diapers. She said it was only then, as she waited outside the courtroom for his sexual battery hearing and caseworkers handed her his psychological profile, that she found out just how damaged the boy had been when he came into her life.

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Foley Checks Into Clinic for Alcoholism

2006-10-02T13:30:00.000-04:00

Foley Checks Into Clinic for Alcoholism
October 2, 2006
By THE ASSOCIATED PRESS
Filed at 12:30 p.m. ET
The New York Times

WASHINGTON (AP) -- Former Rep. Mark Foley, under FBI investigation for e-mail exchanges with teenage congressional pages, has checked himself into rehabilitation facility for alcoholism treatment and accepts responsibility for his actions, his attorney acknowledged Monday.
The attorney, David Roth, would not identify the facility, but told the Associated Press in West Palm Beach, Fla., that Foley had checked in over the weekend.

''I strongly believe that I am an alcoholic and have accepted the need for immediate treatment for alcoholism and other behavioral problems,'' Foley said in a statement, Roth told the AP.

Foley, a Republican, abruptly quit Congress on Friday after reports surfaced that he'd sent sexually charged electronic messages to boys working as pages. In the statement, Foley said the ''events that led to my resignation have crystalized recognition of my long-standing and significant alcoholism and emotional difficulties.''

''I deeply regret and accept full responsibility for the harm I have caused,'' Foley said. He also expressed ''gratitude for the prayers and words of encouragement that have been conveyed to me.''

The FBI, meanwhile, ''is conducting an assessment to see if there's been a violation of federal law,'' according to FBI spokesman Richard Kolko.

The Florida Department of Law Enforcement said Monday it was also investigating whether the e-mail communications violated state law.

Spokesman Tom Berlinger called the state probe ''a precursor to a possible criminal investigation.''

The developments sent House Republicans into damage control mode amid charges by Democrats that some House leaders may have known for months about Foley's inappropriate overtures toward the young pages.
Democrats have questioned whether the GOP leadership, including House Speaker Dennis Hastert, R-Ill., tried to protect a House seat in an election year at the expense of the well-being of teenage pages.

Hastert issued his strongest statement yet on Monday, saying he was ''outraged and disgusted with Congressman Mark Foley's actions.''
The speaker was in Washington meeting with his staff, the House clerk and Rep. John Shimkus, R-Ill., the congressman who oversees the page program, to review the procedures on protecting the teenage pages while they are working at the Capitol and after they finish their assignments, said Ron Bonjean, Hastert's spokesman.

White House press secretary Tony Snow, asked about that Monday on ABC's ''Good Morning America,'' urged greater efforts to ''figure out what happened here.'' He called it ''a terrible story'' and said he considered it unfortunate that ''people are thinking, 'OK, can I get political advantage out of this'.''

Hastert in a letter sent Sunday to Attorney General Alberto Gonzales, asked the Justice Department to ''conduct an investigation of Mr. Foley's conduct with current and former House pages,'' including ''any sexually explicit communications between Mr. Foley and any former or current House pages and what actions such individuals took, if any, to provide them to law enforcement.''

Democrats demanded that investigators determine whether Republican leaders tried to cover up Foley's actions for political reasons.

''The attorney general should open a full-scale investigation immediately,'' Senate Democratic leader Harry Reid of Nevada said in a statement, including whether GOP leaders ''knew there was a problem and ignored it to preserve a congressional seat this election year.''

Foley's West Palm Beach district is largely Republican, but now may be won by a Democrat. Republicans are struggling to maintain their House majority in the upcoming election. Florida Republican leaders were meeting Monday to try to choose a candidate to replace Foley in the November election.

FBI cyber sleuths are looking into the text of some of the Foley messages, checking to see how many e-mails and instant electronic messages were sent and how many computers were used, according to a law enforcement official, who spoke on condition of anonymity because of the ongoing investigation.

The FBI also was trying to determine if any of the teenagers who received messages are willing to cooperate with the investigation, the official said.
Ironically, Foley, who is 52 and single, could be found to have violated a law that he helped to write as co-chairman of the Congressional Missing and Exploited Children's Caucus.

Rep. Thomas Reynolds of New York, head of the House Republican election effort, said he told Hastert months ago about the allegations involving a 16-year-old boy from Louisiana.

Full article

Foley's folly

2006-10-02T10:23:00.000-04:00

Foley's folly
Liberty, Vol. 20, 15, December

http://www.schaler.net/foleysfolly.pdf

Shopping bug bites men, too

2006-10-01T14:46:00.000-04:00

Shopping bug bites men, too
By Julie Sevrens Lyons
Mercury News
October 1, 2006

In the battle of the sexes one more stereotype has fallen: A new Stanford University study suggests men are just as likely as women to be serious shopaholics.

But they're much less likely to get help for their problem, according to the most comprehensive survey to date of out-of-control spending among Americans.

The random telephone survey of 2,514 adults found that 5.5 percent of men and 6 percent of women are addicted to shopping -- so obsessed that they may go deep into debt, wind up divorced or even consider suicide.
These aren't your average folks who enjoy an occasional day at the mall. The problem must be so severe that the sufferer is in financial or personal turmoil and has problems functioning.

``What's shocking and unexpected is how common this problem is,'' said Eric Hollander, professor and chairman of psychiatry at Mount Sinai School of Medicine in New York, who was not involved in the study.
Previous studies indicated that perhaps 2 percent of the American public had such severe shopping compulsions that they could be labeled as having an ``impulse control disorder.''

Yet the Stanford researchers found the prevalence is about three times greater, with about 1 in 20 Americans afflicted.

They didn't come out and ask people whether they were shopaholics. Instead, they asked a series of questions designed to reveal the urges within. Compulsive buyers were more likely to say they need to spend money, buy things to improve their moods, lose control when shopping, see their spending as aberrant and have financial problems as a result.
Shopaholics, the researchers found, tend to be young and live in homes with annual incomes less than $50,000. They're also about four times less likely than the average consumer to pay off their credit card balances in full.

``The behavior creates stress in the form of guilt or remorse, or dysfunction in the form of family conflict or unapproved time away from work to shop,'' said Lorrin Koran, lead author of the study and an emeritus professor of psychiatry at Stanford. The research appears in October's American Journal of Psychiatry.

. . .

But some experts don't buy the notion that the tendency to shop 'til you drop is a problem requiring medication.``Calling irresponsible buying a disease or a disorder is a way for removing responsibility for the behavior,'' said Jeffrey A. Schaler, a psychologist and professor at American University's School of Public Affairs in Washington, D.C.

``We're going down a slippery slope where any socially undesirable behavior can be excused.''Schaler, author of ``Addiction Is a Choice,'' argues that ``impulse control disorders'' such as compulsive buying are ``fabricated'' to serve the financial interests of doctors and researchers. Medical conditions such as cancer, diabetes and AIDS are true diseases, he said. Behaviors, such as gambling, smoking and shopping, are not.

. . .

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Scared of Letting Go?Balancing Safety and Independence

2006-09-30T20:49:00.000-04:00

Washington Parent Magazine
October 2006

Scared of Letting Go?Balancing Safety and Independence
by Erin Mantz

For many parents, Halloween conjures up fond memories of the ultimate childhood fun — running carefree through the neighborhood, knocking on doors of known neighbors, full of excitement and a familiar sense of adventure. But that was then. Today, as our kids climb into their costumes, letting them step outside the house seems a little bit trickier. Even trick-or-treating on the block makes many moms and dads more anxious, concerned and cautious than ever before. Does this level of protection and caution impact our kids? We talked with experts and parents to gauge their experiences and impressions, and we found some helpful solutions along the way.

Nurturing Independence & Creativity In a Scary but Brave New World
We live in a world where terrorism and kidnapping stories are a frequent part of the nightly news. We lived through the horrible sniper attacks in our area. Some of us don't know our neighbors well — or at all. Given these factors, we should be careful when we let our kids outside! Understandably, many parents do limit — or even prohibit — their kids from playing alone outside. But what consequences does this caution have on our children?
As running around outside with the neighborhood kids becomes harder to do, children can be affected. "Playing outside is a big part of imagination and interactivity," states Heidi S. Emmer, LCSW, who works with children in her Bethesda practice. Emmer has seen how television and video games — often alternative activities to what parents remember as playing outside — can make some kids less sociable, less expressive and less interactive. But even in today's troubled times, Emmer believes parents have the power to do a lot of positive things inside the home. Proposing creative activities, doing art projects, giving kids age-appropriate responsibilities around the house, encouraging them to make choices when possible — all these actions contribute to a child's growing independence and confidence around his decision-making abilities.

McLean native Caroline Hacker, mom of 2- and 4-year-old boys, tries hard to walk that fine line of encouraging their sense of adventure while keeping a watchful eye. She marvels at how she played freely outside as a child, less than a mile away from her current home, and how her sons' experience is already so different. "Even though our area has a very small-town feel — young families even arrange for dinner delivery when someone in the neighborhood has a new baby — I wouldn't dream of letting my oldest son walk next door unsupervised or run through the sprinkler alone for five minutes in the front yard. It's hard. I don't want my sons to know that I feel the world is unsafe, but I've been face-to-face with indications that bad things do happen here." To give her sons the sense of independence they may be missing from unstructured, outdoor neighborhood play, Hacker purposely limits both television and electronic toy time to encourage more creativity and imaginary play. She sees how day care settings and preschool camps can play important roles in making kids more independent and building social skills away from mom and dad.

The Psychological Impact
Can today's kids be impacted for growing up without simply "going out to play"? Absolutely, according to Dr. Jeffrey Schaler, a professor in the Department of Justice, Law and Society at the American University School of Public Affairs. As we keep our kids closer, they may miss out on key benefits of unstructured, outdoor play with neighborhood peers: spontaneous interactions to build social skills and practice decision-making, chances to go exploring, time to create new games. "As they hear the world is a dangerous place and that they have to be careful, some kids can develop catastrophic expectations or come to view the world in black-and-white terms. In addition, kids are naturally egocentric. As they hear about bad things going on, they may feel responsible for them," says Schaler.

Schaler offers many other examples of how kids can be negatively impacted. Some may become more dependent on their parents or experience separation anxiety. Some may become depressed or have problems interacting with the world. Others may view their parents as somewhat helpless and take on the role of protector. Sensitive children may learn to be paranoid. Overall, it may affect kids' abilities to do what they want to do, because they view the world as more powerful than they are. The good news is, parents can do a lot of positive things to avoid negative outcomes (see "Tips" sidebar). Learn how we can protect our children, teach them to be careful and instill some independence — without portraying the world as an extraordinarily scary place.

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Final Analysis

2006-09-30T20:33:00.000-04:00

The New Republic
Correspondence Post date 09.28.06 Issue date 10.09.06
p.4

FINAL ANALYSIS
Elisabeth Lasch-Quinn lists me as one of the persons who has followed a "new tradition of social criticism" inaugurated by Philip Rieff ("The Mind of the Moralist," August 28). I began my criticism of the medicalization of (mis)behaviors--and their de facto criminal control defined as psychiatric treatment--in the mid-'50s and introduced the term "myth of mental illness" in 1960 and the concept of "the therapeutic state" in 1963. Rieff's book, The Triumph of the Therapeutic, was published in 1966. Who was following whom?

Thomas Szasz, MD
Emeritus Professor of Psychiatry
State University of New York
Syracuse, New York

Elisabeth lasch-quinn responds:
The point I made in my essay was that Rieff's work, together with that of several others, was part of a larger mid-to-late twentieth-century critique of the therapeutic culture that is tremendously important and worthy of further attention. Although coming at the question from a very different angle from Rieff's, Szasz's work contributed in an unforgettable fashion to our understanding of the dangers of the seemingly benign imperatives of the therapeutic age. I wrote in my essay that Rieff "helped to inaugurate" this line of inquiry--with earlier work that culminated in Freud: The Mind of a Moralist (1959) as well as The Triumph of the Therapeutic--not that he inaugurated it. His critique emerged, of course, within an intellectual milieu in which many had come to question--in manifold ways--the orthodoxies of politics and culture regnant at the time.

Suicide Rates Decline In Antidepressant Era

2006-09-30T19:08:00.000-04:00

Suicide Rates Decline In Antidepressant Era

Friday, September 29, 2006; Page A09
Washington Post

Suicide rates among young people and senior citizens have fallen by at least 25 percent since the introduction of antidepressants such as Prozac but have declined much less in other age groups, a study found.

Suicides among people ages 15 to 24 have fallen 25 percent since 1988, and the rate among people over 65 fell 26 percent, according to a study published yesterday in the American Journal of Public Health. Suicides by people ages 25 to 64 fell less than 10 percent.

The study, which examined census data from 1970 to 2002 and mortality reports from the National Center for Health Statistics, found no clear overall trend before 1988.

Improved trauma care, mental health treatment and medical care for senior citizens may be factors, experts said. Seniors are more likely to kill themselves than people in any other age group.

"You look at people between 25 and 64, and you don't see the same kind of decline," said Robert E. McKeown, author of the study and a professor of epidemiology at the Arnold School of Public Health at the University of South Carolina. "If these drugs really were the driving force, you would expect to see a decline there, too."

In Russia, Psychiatry Is Again a Tool Against Dissent

2006-09-30T19:02:00.000-04:00

In Russia, Psychiatry Is Again a Tool Against Dissent

By Peter Finn
Washington Post Foreign Service
Saturday, September 30, 2006; A01

DUBNA, Russia -- On March 23, police and emergency medical personnel stormed Marina Trutko's home, breaking down her apartment door and quickly subduing her with an injection of haloperidol, a powerful tranquilizer. One policeman put her 78-year-old mother, Valentina, in a storage closet while Trutko, 42, was carried out to a waiting ambulance. It took her to the nearby Psychiatric Hospital No. 14.

The former nuclear scientist, a vocal activist and public defender for several years in this city 70 miles north of Moscow, spent the next six weeks undergoing a daily regimen of injections and drugs to treat what was diagnosed as a "paranoid personality disorder."

"She is also very rude," psychiatrists noted in her case file.

In person, Trutko presents a different profile, reserved and formal as she recounts her legal and psychiatric ordeal and invokes the minutiae of Russian law without having to refer to texts. An independent evaluation found that although she did not have an "ordinary personality," she was "very gifted and creative" and displayed no psychiatric symptoms.

Trutko is new evidence that Soviet-style forced psychiatry has reemerged in Russia as a weapon to intimidate or discredit citizens who tangle with the authorities, according to human rights activists and some mental health professionals. Despite major reforms in the early 1990s, some officials are again employing this form of repression.

"Abuse has begun to creep back in, and we're seeing more cases," said Lyubov Vinogradova, executive director of the Independent Psychiatric Association of Russia, an advocacy group. "It's not on a mass scale like in Soviet times, but it's worrying."

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The new anti-Semitism

2006-09-29T10:06:00.000-04:00

From the Baltimore Sun

By Victor Davis Hanson
September 29, 2006

Hating Jews, on racial as well as religious grounds, is as old as the Roman destruction of the Second Temple in Jerusalem. Later in Europe, pogroms and the Holocaust were the natural devolution of that elemental venom.

Anti-Semitism after World War II often avoided the burning crosses and Nazi ranting. It often appeared as a more subtle animosity, fueled by envy of successful Jews in the West. "The good people, the nice people" often were the culprits, according to a character in the 1947 film Gentleman's Agreement, which dealt with the American aristocracy's social shunning of Jews.
A recent third type of anti-Jewish odium is something different. It is a strange mixture of violent hatred by radical Islamists and what amounts to more or less indifference to it by Westerners.
. . .

We're accustomed to associating hatred of Jews with the ridiculed Neanderthal right of those in sheets and jackboots. But this new venom, at least in its Western form, is mostly a left-wing, and often an academic, enterprise. It's also far more insidious, given the left's moral pretensions and its influence in the prestigious media and universities. We see the unfortunate results in frequent anti-Israeli demonstrations on campuses that conflate Israel with Nazis, while the media have published fraudulent pictures and slanted events in southern Lebanon.

The renewed hatred of Jews in the Middle East - and the indifference to it in the West - is a sort of "post-anti-Semitism." Islamic zealots supply the old venomous hatred, while affluent and timid Westerners provide the new necessary indifference - if punctuated by the occasional off-the-cuff "amen" in the manner of a Louis Farrakhan or Mel Gibson outburst.

The danger of this post-anti-Semitism is not just that Jews are shot in Europe and the United States - or that a drunken celebrity or demagogue mouths off. Instead, ever so insidiously, radical Islam's hatred of Jews is becoming normalized.

. . .

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Plumbing the depths of depression

2006-09-26T18:09:00.000-04:00

Plumbing the Depths Of DepressionScientists Hope A New Tool Will Tap Into the Source Of the Blues

http://www.washingtonpost.com/wp-dyn/content/article/2006/09/25/AR2006092501387.html

By Neely Tucker

Washington Post Staff Writer

Tuesday, September 26, 2006;

C01Ketamine, sweet ketamine, answer to our glutamatergic dreams. In the long November night of the soul, in the ever-dark downpour of depression, it turns out that there might be a better umbrella than Prozac and Zoloft and Paxil and their serotonin-loving ilk.

Of course, when it comes to antidepressants, nobody really knows anything, anyway, so why not go with ketamine, a mild hallucinogen known to club freaks as Special K?

Yes, yes, break out the male Wistar rats and the injection needles -- researchers at the National Institute of Mental Health announced a study recently in which 18 chronically depressed patients infused with low dosages of ketamine improved within two hours. Seventy-one percent improved within a day, and nearly 30 percent were depression-free by that time. In 24 hours! These were people who had been dealing with depression from three to 47 years. They had failed to respond to just about every drug on the market.

Most of them stayed depression-free for up to a week.

Chronic depression, one of the most common, debilitating diseases known to mankind, blown away like a flower petal on a passing breeze.

Is it not the modern nirvana, the utopia of a neurotic generation, the idea that the demons lurking in the nether regions of the cerebral cortex could just . . . evaporate? Reigning there in the wet muck of the Freudian dark, the gargoyles of the mind took ketamine like a hit of kryptonite.

Doesn't it make Prozac and friends look like punks? The subsequent news stories focused on the speed -- antidepressants generally take two weeks or longer to work -- but the true breakthrough, scientists say, is that ketamine seems to do something entirely new. It focuses on glutamate, a chemical neurotransmitter that is involved in electrical flow among brain cells. It has not been targeted by any other antidepressant medication.

Think of depression as a leaky water faucet in the kitchen of the mind. Prozac and friends start working on the problem back at the water plant and, in about half of the cases, eventually find the problem.

In this trial, glutamate (and the "glutamatergic system") was shown to be a wrench-toting plumber who makes house calls. It got right to the problem.

"It's not quite the director of the orchestra, but it's involved with many other systems in the brain than other antidepressants," said Carlos A. Zarate Jr., chief of the mood disorders research unit at NIMH, and lead author of the study.

"It's early, but this is exciting because this gives us a new target, and it's a heck of a first move on it," said J. Raymond DePaulo Jr., chief of the Department of Psychiatry at Johns Hopkins School of Medicine and one of the nation's preeminent researchers on depression. He was not involved in the ketamine trials. "This is working on . . . a different set of chemicals. It says the malfunction may be in several different parts of the brain. Ketamine has problems with potential negative effects, but we could create 100 drugs to hit this target of glutamate."

If, you know, that is where the demon actually resides.

* * *

Depression: the Jersey dump fire of the mind, being stuck in the urinal of a Charles Bukowski

The Institute for the Study of Global Antisemitism and Policy

2006-09-20T11:00:00.000-04:00

The Institute for the Study of Global Antisemitism and Policy

The Institute for the Study of Global Antisemitism and Policy is a non-profit organization dedicated to the scholarly research of processes and manifestations associated with antisemitism globally, as well as other forms of racisms, and policy related issues, in the age of globalization. ISGAP examines antisemitism, racisms and policy, (and any related matter) and disseminates analytical and scholarly material to help combat hatred and to further understanding.

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Cf.

Yale Creates Center on Anti-Semitism
The Associated PressTuesday, September 19, 2006; 2:54 PM
NEW HAVEN, Conn. -- Yale announced the creation Tuesday of the first university-based center in North America dedicated to the study of anti-Semitism.
"Increasingly, Jewish communities around the world feel under threat," said Charles Small, director of the new Yale Initiative for Interdisciplinary Study of Anti-Semitism. "I think we need to understand the current manifestation of this disease."
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and

STRIKING THE “RIGHTS” BALANCE: Respecting Parents While Protecting Children

2006-09-19T22:27:00.000-04:00

National Center for Adoption Law & Policy
SYMPOSIUM 2006
Co-sponsored by the Ohio Department of Job & Family Services
Mark your calendars for October 5 & 6, 2006
2006 Multidisciplinary Symposium
Greater Columbus Convention Center
Columbus, Ohio

STRIKING THE “RIGHTS” BALANCE: Respecting Parents While Protecting Children

Day Two Agenda
1:45 pm – 3:00 pm

Tobacco Use as a Factor in Case Decision-Making

Dr. Jeffrey A. Schaler, Assistant Professor, School of Public Affairs, American University, Washington D.C.

Patriotism, Nationhood, and the American Indian

2006-09-19T18:38:00.000-04:00

Dr. David Yeagley Interviews Ilana Mercer

Dr. David Yeagley is a Comanche Indian from Oklahoma, educated at Oberlin, Yale, Emory, Hartt, and the University of Arizona. (He was a special student at Harvard in 1982). He has invited several nationally known conservative and independent writers to offer their perspective on American Indians. The following interview with Free-Market News Network columnist Ilana Mercer is the first in the planned series. Dr. Yeagley thinks the American Indian is conservative by nature, and should assume a leading role in “love of country” and patriotism, a cause to which he is devoted. Yeagley is the only conservative American Indian in national media. He is president of the Bad Eagle Foundation, named after his great, great grandfather.

Ilana Mercer’s work has appeared in the Journal of Social, Political and Economic Studies, Free Life: a Journal of Classical Liberal and Libertarian Thought, FrontPageMagazine, The American Spectator, The New Individualist, The Colorado Gazette, The Orange County Register, The American Conservative, Insight On the News, Ideas on Liberty, The Financial Post, The Globe and Mail, The Ottawa Citizen, The Calgary Herald, London’s Jewish Chronicle, and others. She is the author of Broad Sides: One Woman’s Clash With a Corrupt Culture, and the proprietor of www.ilanamercer.com.

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What's a "cult?"

2006-09-18T09:55:00.000-04:00

http://www.youtube.com/watch?v=vT2KckG0aHo

Why I Can't Save My Brother

2006-09-09T14:16:00.000-04:00

Why I Can't Save My Brother

By Joan Mitric
The Washington Post
Sunday, September 10, 2006; B03

My brother BJ has not killed anyone. Not yet. And I hope he never will. But in various disturbed, hyper-vigilant and paranoid states over the past 30 years, he has slashed screen doors, severed phone wires at the family home, tossed scalding coffee at our now-deceased mother, left bizarre or menacing messages on his siblings' phones and otherwise exhibited behavior that screams: "I am a danger to myself and others."

BJ also drinks or drugs himself into a stupor countless times a year and has spent the greater part of the past two decades in jail for drunken, disorderly or disruptive conduct. Two years ago, he created an hours-long hostage situation in the Southern California beach town where we grew up after threatening someone in a motel with a pellet gun. For this, he was thrown into Wasco State Prison near Bakersfield and charged with the felony of "threatening a crime with intent to terrorize," as well as several misdemeanors.

BJ is clearly ill. Yet the exact nature of his illness remains undiagnosed because in the decades that he has waged war against his demons, he has never had a full psychiatric workup.

DEA Revises Rule on Prescribing Painkillers

2006-09-07T13:49:00.000-04:00

DEA Revises Rule on Prescribing Painkillers
Doctors Freed to Write Multiple Prescriptions

By Marc Kaufman

Washington Post Staff Writer

Thursday, September 7, 2006; Page A04

The Drug Enforcement Administration yesterday overturned a two-year-old policy that many pain specialists said was limiting their ability to properly treat chronically ill patients in need of powerful, morphine-based painkillers.

While defending its efforts to aggressively investigate doctors who officials conclude are writing painkiller prescriptions for no "legitimate medical purpose," the agency agreed with the protesting experts that it had gone too far in limiting how doctors prescribe the widely used medications.

'That sort of self-delusion is what it takes to be a real Aussie larrikin'

2006-09-05T21:51:00.000-04:00

'That sort of self-delusion is what it takes to be a real Aussie larrikin'

Germaine Greer
Tuesday September 5, 2006
The Guardian

The world mourns. World-famous wildlife warrior Steve Irwin has died a hero, doing the thing he loved, filming a sequence for a new TV series. He was supposed to have been making a new documentary to have been called Ocean's Deadliest, but, when filming was held up by bad weather, he decided to "go off and shoot a few segments" for his eight-year-old daughter's upcoming TV series, "just stuff on the reef and little animals". His manager John Stainton "just said fine, anything that would keep him moving and keep his adrenaline going". Evidently it's Stainton's job to keep Irwin . . .

more

Outrage over Greer pot shots

2006-09-05T21:43:00.000-04:00

Outrage over Greer pot shots
Danny Buttler and Kate Rose
Herald Sun
Australia
September 06, 2006 12:00am

Mocking Irwin's multi-million-dollar empire and his "Crikey!" catch-cry, Greer accused the world-famous TV star of placing the welfare of animals after his own interests.

"There was not an animal he was not prepared to manhandle," she wrote in The Guardian.

"Every creature he brandished at the camera was in distress.

"Every snake badgered by Irwin was at a huge disadvantage, with only a single possible reaction to its terrifying situation -- which was to strike.

"Easy enough to avoid if you know what's coming."

The author of The Female Eunuch hit below the belt as she accused Irwin of sending the wrong message to kids.

"The animal world has finally taken its revenge on Irwin, but probably not before a whole generation of kids in shorts seven sizes too small has learned to shout in the ears of animals with hearing 10 times more acute than theirs, determined to become millionaire animal-loving zoo-owners in their turn," Greer wrote.

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Eminent Psychiatrist Found Slain In Bethesda

2006-09-04T16:14:00.000-04:00

Eminent Psychiatrist Found Slain In Bethesda
Montgomery Police Question Patient, 19

By Martin Weil and Sandhya Somashekhar
Washington Post Staff Writers
Monday, September 4, 2006; Page A01

A psychiatrist and federal health official who was nationally known for his work in schizophrenia was found slain in his private north Bethesda office yesterday, immediately after seeing a patient.

Police said they were questioning a 19-year-old man who appeared to be the only suspect in the death of Wayne S. Fenton, 53.

Fenton was seeing the patient, who was believed to be "very dangerous," because another psychiatrist was having trouble with him, said Tom Bernard, an entertainment industry executive who was a longtime friend of Fenton's.

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Stop the Drug War by Grant Wilder Smith

2006-09-03T18:19:00.000-04:00

Stop the Drug War
by Grant Wilder Smith

I became drawn to the drug policy reform movement in 2000 while attending a Unitarian Universalist church, and working on local anti-racism projects in the Deep South. Over the years, I have learned much about the societal and public health impacts of the drug war, and have also experienced drug addiction first hand from a close family member. My interest in drug policy brought me to Washington, D.C. where I participated in community outreach services for the city's syringe exchange program, and have worked on several advocacy projects with Unitarian Universalists for Drug Policy Reform and Interfaith Drug Policy Initiative. In addition to studying drug policy, the criminal justice system and congressional behavior at American University (B.A., Political Science; Law and Society, 2005), I interned with Drug Policy Alliance's National Affairs Office and Transform Drug Policy Foundation in the United Kingdom. I've also worked directly with the "offender" population through two internships with a federal law enforcement agency. In addition to supporting and having considerable knowledge of a wide range of drug policy alternatives, I firmly advocate for the harm reduction and legalization models. Now, I'm actively seeking a JOB in the drug policy or criminal justice reform movements. Hiring?

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Opium Harvest at Record Level in Afghanistan

2006-09-03T10:39:00.000-04:00

New York Times

KABUL, Afghanistan, Sept. 2 — Afghanistan’s opium harvest this year has reached the highest levels ever recorded, showing an increase of almost 50 percent from last year, the executive director of the United Nations Office on Drugs and Crime, Antonio Maria Costa, said Saturday in Kabul.

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Meagre success rates of drug treatment programmes are falling

2006-09-01T00:28:00.000-04:00

News extra

Meagre success rates of drug treatment programmes are falling
London Michael Day

British Medical Journal
Table of contents for Saturday 02 September 2006
http://bmj.com/content/vol333/issue7566/

The proportion of drug misusers who leave treatment programmes “drug free” is falling, despite record sums being spent on rehabilitation, new figures from the North West of England indicate.

Since 1999 the amount spent in England and Wales under the Home Office’s drug interventions programme to treat offenders who misuse drugs has risen to £165m (€245m; $312m) a year, in a bid to boost public health and cut drug related street crime.

But figures compiled by researchers at Liverpool John Moores University and published in the online journal BMC Health Services Research on 11 August (www.biomedcentral.com/bmchealthservres, doi: 10.1186/1471-2458-6-205) raise questions about the system’s effectiveness. Their analysis of more than 26 000 drug misusers in Cheshire and Merseyside entering treatment programmes between 1998 and 2002 showed that the percentage who were “discharged drug free” almost halved, falling from 5.8% to just 3.5%.

Mark Bellis, the university’s . . . [Full text of this article]

Related Article

Numbers starting treatment for drug misuse increase by 20% over two years
Lynn Eaton
BMJ 2004 329: 1066. [Extract] [Full Text]

Managing Chronic Pain

2006-08-31T22:23:00.000-04:00

Managing Chronic Pain -- A Project of Common Sense for Drug Policy
http://www.managingpain.org/

Schizophrenia And Other Psychological Maladies Apply On A Global Scale

2006-08-25T13:00:00.000-04:00

Commentary
8/25/06 Schizophrenia And Other Psychological Maladies Apply On A Global Scale
By: ROBERT B. SKLAROFF, Special To The Evening Bulletin
08/25/2006

If humans have been created in God's image, then nations - even those without borders - function as does humanity...with all its strengths and foibles.
That awareness, perhaps, could help America relate with the psychopathology routinely exhibited by the rest of the world.
Schizophrenics are delusional and illogical, but retain intelligence and memory. Recall the "Four A's" articulated a century ago by the Swiss psychiatrist Eugen Bleuler; they have a flat Affect and loose Associations, and are Ambivalent and Autistic.
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The Human and Economic Dimensions of Altruism

2006-08-23T14:17:00.000-04:00

The Human and Economic Dimensions of Altruism
By Richard A. Epstein

http://www.bioethics.gov/background/epstein.html

[This paper was discussed at the Council's April 2006 meeting. The views expressed here do not represent the official views of the Council or of the United States Government.]

The most visible case in my experience is one in which Virginia Postrel recently gave a kidney to Sally Satel.4 Both are libertarians, which should caution against any easy inferences of personal behavior from political philosophy: to recognize the forces of self-interest is not to be selfish.
Yet, for these purposes, it seems clear that one reason why the Satel/Postrel transaction is so notable is that it is so rare.

4. For Virginia Postrel’s blog, see http://www.dynamist.com/weblog/index.html.

Here's Looking at You, Kidney

2006-08-23T11:55:00.000-04:00

Here's Looking at You, Kidney

How and why I became an organ donor -- and how I kept people from talking me out of it.

By Virginia Postrel
Texas Monthly, June 2006

Until last November, I'd never thought about being a kidney donor. I hadn't known anyone with kidney disease, and like most people, I hadn't filled out an organ donation form when I'd gotten my driver's license. I'd never even donated blood. That all changed after I ran into a friend and asked, "How's Sally?" I got an unexpected answer: "She's. . . all right," in a tone that made it clear she was most definitely not all right.

Sally Satel and I have been friends since 1997. . . .

4th Circuit "vacate Hurwitz’s convictions and remand for a new trial." August 22, 2006

2006-08-22T21:38:00.000-04:00

Cf. pdf version of the decision at http://www.schaler.net/usaversushurwitz2006.pdf
http://www.reason.com/hitandrun/2006/08/hurwitz_convict.shtml#015242 http://www.painreliefnetwork.org/

PUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
ü UNITED STATES OF AMERICA,
Plaintiff-Appellee,
v.
WILLIAM ELIOT HURWITZ,
Defendant-Appellant.

...2 UNITED STATES v. HURWITZ

OPINION
TRAXLER, Circuit Judge:
A jury convicted Dr. William E. Hurwitz of multiple counts of
drug trafficking for prescribing narcotic pain medicine in violation of
21 U.S.C.A. §§ 841(a)(1) and 846 (West 1999). Hurwitz appeals,
arguing, inter alia, that the district court improperly admitted evidence
recovered in a search of his office and incorrectly instructed the
jury on the law. Although we affirm the district court’s decision to
admit the evidence seized in the search, we conclude that the district
court did not properly instruct the jury on the controlling law. Accordingly,we vacate Hurwitz’s convictions and remand for a new trial....

Forthcoming: Howard Gardner Under Fire

2006-08-20T13:44:00.000-04:00

Howard Gardner Under Fire:
The Rebel Psychologist Faces His Critics
Edited by Jeffrey A. Schaler

Open Court Publishers (forthcoming: release scheduled Fall 2006)

Amazon

Contents
About the Authors
Acknowledgments

Introduction, by Jeffrey A. Schaler

A Blessing of Influences, Autobiographical Sketch by Howard Gardner

1. What Develops (And How)?
DEANNA KUHN

2. Becoming Responsible for Who We Are:
The Trouble With Traits
DAVID R. OLSON

3. Multiple Invalidities
JOHN WHITE

4. Geocentric Theory:
A Valid Alternative to Gardner’s Theory of Intelligence
NATHAN BRODY

5. Is the Ability to Make a Bacon Sandwich a Mark of Intelligence? and other issues:
Some Reflections on Gardner’s Theory of Multiple Intelligences
SUSAN M. BARNETT, STEPHEN J. CECI, AND WENDY M. WILLIAMS

6. On Spirituality
TANYA M. LUHRMANN

7. Creativity in Creating Minds
DEAN KEITH SIMONTON

8. Creativity is Always Personal and Only Sometimes Social
MARK A. RUNCO

9. Gardner On Leadership
ROBERT SPILLANE

10. The Second Gardner’s Late Shift:
From Psychology to Outer Space?
CARLOS E. VASCO

11. Changing Minds About Goodwork?
ANNA CRAFT

12. Artful Practice: A Reflexive Analysis
GRAEME SULLIVAN

13. Considering the U-Curve
DAVID PARISER

Replies to My Critics
HOWARD GARDNER

Reply to Deanna Kuhn
Reply to David Olson
Reply to John White
Reply to Nathan Brody
Reply to Susan Barnett, Stephen Ceci, and Wendy Williams
Reply to Tanya Luhrmann
Reply to Dean Keith Simonton
Reply to Mark Runco
Reply to Robert Spillane
Reply to Carlos Vasco
Reply to Anna Craft
Reply to Graeme Sullivan
Reply to David Pariser

Howard Gardner Bibliography
Index

[Library of Congress information:
Howard Gardner under fire : the rebel psychologist faces his critics /...

LC Control No.:
2006022995
Type of Material:
Book (Print, Microform, Electronic, etc.)
Main Title:
Howard Gardner under fire : the rebel psychologist faces his critics / edited by Jeffrey A. Schaler.
Published/Created:
Chicago : Open Court, 2006.
Projected Pubication Date:
0609
Related Names:
Schaler, Jeffrey A.

Gardner, Howard.
Description:
p. cm.
ISBN:
9780812696042 (trade paper : alk. paper)

0812696042 (trade paper : alk. paper)
Summary:
"Thirteen essays criticize Howard Gardner’s theories of Multiple Intelligence, ability traits, U-shaped curves in development, and other psychological concepts of spirituality, creativity, and leadership; Gardner responds to each"--Provided by publisher.
Notes:
Includes bibliographical references and index.
Subjects:
Gardner, Howard.

Psychology--Philosophy.
Series:
The under fire series ; v. 2
LC Classification:
BF38 .H67 2006
Dewey Class No.:
150.92 22]

Washington’s interests in Israel’s war

2006-08-17T06:26:00.000-04:00

WATCHING LEBANON
Washington’s interests in Israel’s war.
by SEYMOUR M. HERSH
The New Yorker
Issue of 2006-08-21Posted 2006-08-14

" . . . The Bush Administration, however, was closely involved in the planning of Israel’s retaliatory attacks. . . . "

Is an Armament Sickening U.S. Soldiers?

2006-08-13T12:59:00.000-04:00

Is an Armament Sickening U.S. Soldiers?
By DEBORAH HASTINGS, AP

NEW YORK (Aug. 12) - It takes at least 10 minutes and a large glass of orange juice to wash down all the pills - morphine, methadone, a muscle relaxant, an antidepressant, a stool softener. Viagra for sexual dysfunction. Valium for his nerves.

Four hours later, Herbert Reed will swallow another 15 mg of morphine to cut the pain clenching every part of his body. He will do it twice more before the day is done.

Since he left a bombed-out train depot in Iraq, his gums bleed. There is more blood in his urine, and still more in his stool. Bright light hurts his eyes. A tumor has been removed from his thyroid. Rashes erupt everywhere, itching so badly they seem to live inside his skin. Migraines cleave his skull. His joints ache, grating like door hinges in need of oil.

There is something massively wrong with Herbert Reed, though no one is sure what it is. . . .

Searching for scientific evidence of an afterlife

2006-08-13T10:42:00.000-04:00

Review: Science
Searching for scientific evidence of an afterlife
By Glenn C. Altschuler

Originally published August 13, 2006

Ghost Hunters: William James and the Search For Scientific Proof of Life After Death
Deborah Blum

The Penguin Press / 371 pages / $24.95

"When his father died, William James, the renowned psychologist and philosopher, grew "dizzy" with the possibility of immortality. Although friends warned him that those who sought proof of life after death were often deemed "weak in the head," James joined other researchers in the United States and England in a Society for Psychical Research."

...

2006-08-12T19:10:00.000-04:00

Novelist admits Waffen SS service

Baltimore Sun, August 12, 2006

"BERLIN // German novelist Guenter Grass admitted in an interview that he served in the Waffen SS, the combat arm of Adolf Hitler's dreaded paramilitary forces, during World War II, a German newspaper reported yesterday. The Frankfurter Allgemeine Zeitung ran excerpts of the interview with the Nobel Prize winner . . . "