DSM 5 AND CLASSIFICATION OF MENTAL ILLNESS

DSM 5 AND CLASSIFICATION

OF MENTAL ILLNESS  

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On 18 May 2013, the fifth edition of the updated ‘Bible’ of the American Psychiatric Association’ Diagnostic and Statistical Manual of Mental Disorders (DSM) became available to practicing psychiatrists, clinical psychologists, neuro-psychologists, and others involved in psychiatry.  DSM 5 replaced DSM 4 which was issued in 2000.  Normally a select task force is entrusted with the required research and contribution involved in producing such a reference Manual.  In this case the Task Force was formed in 2007 and the Manual is some 947 pages.

Significance of DSM 5 on everyone

You may well ask why bother writing such a blog when it really is an intrusion on the domain of the medical profession and specifically, the specialty of psychiatry.  The reason is simply the effect DSM 5 will have either directly or indirectly on all, yes all of us!  Unless a patient who is not feeling well and his General Practitioner cannot find anything organically to explain that feeling he or she is often referred to psychiatrist or clinical psychologist.  The chances are that patient is often privately health insured.  Unless that psychiatrist or psychologist provides diagnosis based on DSM 5 classification that patient is denied medication and denied private health insurance coverage.  If not covered by the Public Health such as the Australian Medicare System that can be costly exercise for anyone undergoing treatment.

In DSM 4 excessive bereavement, homosexuality, gender identity disorders, post traumatic stress disorders, autism, certain types of schizophrenia and Asperger syndrome were included and classified as mental conditions for which medication were prescribed and all private health insurance covered.  DSM 5 sets the bars higher for diagnosis of these conditions by either adding further criteria or complete deletion of the condition.

In recent weeks there had been major discussion and criticism of DSM 5 by members of various psychiatric associations especially in USA, UK, Canada, and Australia.  The thrust of these criticisms relate to undue influence by psychiatric drug industry, lack of independent empirical support and corroborative evidence for the addition, revision, and deletions.  Perhaps the more telling criticism relates to the quality of the information in support of changes, confusion and contradictions.  The bulk of those telling criticism comes from practicing psychiatrists and clinical psychologists!   

Personally, I'm outraged. What are your thoughts?

        

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QLD Bikie Laws - A Mockery of Justice

Sun-Stroked Perception of Justice

or Sheer Insanity?

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The National Liberal Party won unprecedented majority in the last election in the State of Queensland.  A majority that can justifiably ignore, let alone take any heed of the Labor opposition and its contribution to debate matters of concern to the residents of the State of Queensland and to Australia as a whole.  The Premier Campbell Newman is first time Premier and politician for that matter having been inducted months before the election. Likewise numerous member of the Newman government are first time politicians that are  at best novices compared with seasoned politicians.  The novice aspect, the size of the majority, and lack of opposition pose unprecedented danger to the required and expected standard of parliamentary debate and speeches for passage or defeat of legislations.  This is more so when the legislations impacts on lives of every individual in Queensland.  The added danger to this mix of first time Premier, and lack of experience is the tendency of the Labor opposition to side with the Newman government.  Sadly this siding with Newman Government cannot be more ill conceived and pronounced then the latest maverick, ignorant, ill thought, unconscionable, and illegal legislations purportedly specifically geared to control Bikie gangs.  Legislations that not only demeaned the integrity of the office of the highest legal officer in the State of Queensland, that of the Attorney General, Jarrod Bleijie, but makes mockery of that office in the eyes of the legal profession in Queensland, the judiciary, and the civilized world.

Attorney General Jarrod Bleijie, did not grimace when he pronounced the proposed legislations entitled: Vicious Lawless Associations Disestablishment Bill, The Tattoo Parlours Bill, Criminal (Gang Disruption) Amendment Bill.  Each of these three Bills banishes and removes all judicial and legal discretion by imposing lengthy mandatory sentences that makes judicial officer rubber stamps.  Sentences, that are further enhanced and given weight by the imposition of additional (non concurrent) sentence by refusal to answer questions or divulge information to law enforcement officers.  The President of Australian Council of Civil Liberties, Terry O’Gorman was not wrong when he said these laws highlights the inexperience of the holders of the highest governmental offices in the State of Queensland and makes these laws a laughing stock.   Despite the size of its minority by not standing up and screaming loudly against these misconceived draconian laws, in my opinion the Queensland Labor opposition became part and parcel of that laughing stock.

Australia is a signatory to number of international treaties that guarantees human dignity, human rights including minimum standard for treatment of prisoners.  These obligations are clearly foreign to Premier Campbell Newman or is Queensland succeeding from Australia? Does Premier Campbell Newman seriously think he can build Bikie only prison and incarcerate Bikies in cell for 23 hours a day dressed in pink?  If he does I seriously feel sorry for the residents in the State of Queensland.

Before concluding this blog I would like to remind all Ministers in the State of Queensland that in a speech to the House of Lords, 9 January 1770 William Pitt, Earl of Chatham (1708 – 1778) and Prime Minister 1766-8 said: ‘unlimited power is apt to corrupt the minds of those who possess it. Likewise the famous British historian, Lord Acton (1834-1902) said: ‘power tends to corrupt and absolute power corrupts absolutely’.  

Finally I consider it to be the duty of the legal profession of Queensland either the Bar Association or the Law Society or combined to forthwith commence legal challenge in the High Court of Australia to strike out the three Bills.  If any doubt exists about the illegality of the three Bills section 29 of the Australian Constitution giving Parliament power to legislate for the purpose of ensuring Australia complies with its foreign obligation in international treaties and covenants  is a good start.      

         

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The Wasp

UNIQUE PRIESTLY HOMILY

Part 1

(The Wasp)

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I cannot say that I have firsthand knowledge of this homily but I can say that I did hear it from Abo Kamil who was the president and caretaker of St Elias Church in my beloved village of Aramoun.

Due to its size being some 40 homes the Christian Community of Aramoun could not afford to have permanent resident priest at all times.  The arrangement that existed was that the Orthodox Patriarchy of Mount Lebanon adopted rostering system in allocated priests to various villages in Mount Lebanon for Sunday mass.  The procedure was a priest will come late Saturday and leaves late Sunday.  This particular homily that left indelible tale in the village was delivered by a newly rostered priest, Father Francis, and that was his first mass in St Elias Aramoun.  Father Francis was in his mid thirties and arrived in the village midday Saturday.  He was met by Abo Kamil who showed him the church and took him as a guest to his house.  Father Francis was from the Akkar Region of Lebanon and Aramoun was the second village in his six week roster.  Besides the normal handbag containing the priest’ regalia Father Francis had a round brown bag that was strapped to his left shoulder.

As most serious church parishioners know before the main mass there are matins and and at night there are vesper masses in which chants are performed in one of eight tones in accordance with Byzantium traditions.  On this particular occasion with Father Francis Abo Kamil told me that the Epistle reading was from Saint Paul’s letter to the Hebrew and the Gospel reading was according to Saint Mark.  Girgi Abdallah was icon of Aramoun.  He had heavenly voice and was well trained in all Byzantium tones and church traditions.  After Girgi read/chanted the Epistle Father Francis read the Gospel and it was time for Father Francis to give his homily.  Not wanting to follow church tradition and give standard homily applicable to the Gospel Father Francis fetched the bag he carried strapped to his shoulder from behind the altar opened it and to the amazement of the Aramouni congregation he took out a human skull!  From behind the pulpit Father Francis lifted the skull so everyone could see it.  For a few seconds Father Francis appeared to be thinking how he was going to commence his homily.  He started:

‘From dust to dust, human life, one minute you are here the next you gone’ said Father Francis to his captive Aramouni parishioners looking at the skull.  He continued:  

‘Not one of you, neither I, know who this man was or how he lived his life.  Rich, poor, good, bad, dignified, undignified, saintly, wicked’ … then Father Francis screamed:

‘Hhhhhhhhhhhhh fuck, fuck’ as a wasp that was trying to get out from the orbital fissure (eye socket) stung Father Francis middle finger and another wasp followed as the stunned  Aramouni congregation ducked to avoid the two wasps now buzzing in the church.  Regaining his composure Father Francis said: ‘He could not have been a good man he was obviously ‘ibn sharmouta’ - wicked son of bitch.

Abo Kamil who is known as a man of wisdom in village opened the door so the two wasps left asked Father Francis either to retract the ibn sharmouta comments of a deceased person or give credible evidence that the skull is identified and it is that of a wicked man.  A parishioner lady named Salma sitting at the back shouted: ‘How do you know that the skull is not that of a woman?’ Now irate Father Francis nursing his swollen middle finger said: ‘If it is that of a woman then that woman is bint sharmouta - wicked daughter of a bitch.   Another parishioner asked Father Francis who he got hold of this skull.  Now clearly angry Father Francis with clearly swollen and red throbbing middle finger said: ‘if a deceased is able to harm a man of the church in death and years after death he or she is not only son or daughter of a bitch he or she is manuik or manuiki you interpreted whichever way you like’. Father Francis walked off the pulpit in disgust and refused to continue with the mass.

Needless to say Abo Kamil made formal complaint against Father Francis to the Patriarchy.  The following week Father Ephram fronted up to give the mass at Saint Elias.

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Conception, Life and Criminal Law

Conception/Life and Criminal Law

When does life begin? This is a question that occupied the minds of humanity greatest thinkers and philosophers throughout mankind recorded civilizations.  Different religions offer different answers.  Embryology tells us the full systems that makes the human body functional and that sustain life after birth, ie, the nervous system, the circulatory system, the kidneys etc are complete after 13 weeks gestation in utro.   But what legal right does that 13 weeks systemically fully functional foetus has before the common and criminal law?  This is a question that modern day societies have to come to term with.  The one thing that is certain the final version of that law whether it be amendment to the existing Crimes Act, or new precedent set by the Highest Court in the land it will reflect on each one of us as citizen.  How and why? Think for one moment about motor traffic and transport, illicit drug use, and the practice of obstetric and gynaecology.   

Imagine for one moment serious motor accident in which pregnant female was either the driver or passenger.   The concern of the medical staff and those involved in treating the injured mother is the status and injuries to the foetus.  If as a result of the injuries the mother passes away and the foetus cannot be saved is it one life or two lives that are lost?  If the mother passes away and the foetus is saved but sustains injuries what legal rights did that foetus have under the law? More importantly is the question when did that legal right become operative? Is it in utro or when the surgeon performed Caesarean operation and brought premature and deformed baby to life?

Let us take another example imagine for one moment a pregnant young lady is illicit drug user, heavy smoker, and alcoholic gives birth to a baby that is grossly under weight, malnourished, and has serious health problem including deformities.  Could this mother be charged under the Criminal Law with supply of drugs to her foetus/baby whilst in utro?   Theoretically yes depending on the answer to the question when life begins.

The question when does life begins? And that life is bestowed with legal rights is a question that often arises in medical malpractice against the medical profession and the specialty of obstetric and gynaecology. Questions and legal issues to do with life and legal rights more often than not arise in cases involving undetected foetal deformities, genetical or otherwise,  miscarriages, breeched deliveries,  and stillbirths.  The answer to these questions determines legal liability and award of damages.  At present all that lawyers go by in advising clients or counsel proffering advice are precedents set by the Highest Court in the land.

In the next blog I will attempt to address the question: when life begins and the legal rights that ensue from ethical, philosophical, and religious points of view.