‘Is Psychiatry A Crime Against Humanity’ by Peter Gøtzsche
A book review
Peter Gøtzsche is a world leader in evidence-based medicine. He is a co-founder of the Cochrane Collaboration (1), an organization that was set up in 1993 to examine healthcare treatments to come to independent analysis of their effectiveness. The Cochrane library is trusted throughout the world for its independent analysis of treatments. If you want to know how effective a drug is, or indeed any other intervention it is the first place to look. Their basic methodology is meta-analysis of trials. Peter Gøtzsche is a world expert in meta-analysis.
In 2013 Peter Gøtzsche published ‘Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare’(2). In this book he alleges that Big Pharma produces drugs that they know cause more harm than good, and may lead to the death of the patient; he alleges that they hide the evidence, exaggerate the benefits and corrupt medical journals which doctors rely on to get evidence for the drugs they prescribe, and write business plans that include any future court costs and fines which may happen once the damage caused by these drugs come to light. The book makes the claim that prescription drugs are the third leading cause of death after heart disease and cancer and it won the British Medical Association’s Annual Book Award. When Peter Gøtzsche speaks he is worth listening to. He has now done a more in-depth analysis and concludes that prescription drugs are the leading cause of death. Psychiatric drugs alone are the third leading cause of death.
His latest book, ‘Is Psychiatry A Crime Against Humanity’(3), makes a similarly shocking claim which he lays out in forensic detail. The basic arguments of the book will be familiar to readers of this website: that the drugs do more harm than good and are massively oversold, that forced treatment is harmful, that diagnoses are not reliable or a sufficient guide to treatment, that psychosocial interventions are superior to drug interventions, that causes of distress are social and mainly ignored by psychiatry. The claim that psychiatry is a crime against humanity is a new and startling one. I will examine this claim and also ask whether it is an appropriate lens in which to view psychiatry.
According to the Rome Statute, there are eleven types of crime that can be charged as a crime against humanity when “committed as part of a widespread or systematic attack directed against any civilian population”: “murder; extermination; enslavement; deportation or forcible transfer of population; imprisonment or other severe deprivation of physical liberty in violation of fundamental rules of international law; torture; rape, sexual slavery, enforced prostitution, forced pregnancy, forced abortion, enforced sterilization, or any other form of sexual violence of comparable gravity; persecution against any identifiable group or collectivity…; enforced disappearance…; the crime of apartheid; other inhumane acts of a similar character intentionally causing great suffering, or serious injury to body or to mental or physical health.”
Forced psychiatric treatment is systemic throughout the world and national laws provide for it. Gøtzsche’s book lays out how these treatments allegedly cause harm to many and he states that some even die as a result. The laws that detain psychiatric patients are much less stringent than other laws. Do these laws constitute “severe deprivation of liberty in violation of international law”? In those rare places where very few people are forced to have treatment, where interventions are mainly voluntary and mainly based on psychosocial approaches, for example Western Lapland (5) and Trieste (6), the outcomes are much better than where psychiatry is forced and drug based. I therefore think Gøtzsche has laid out a good case.
Akathisia is common among those prescribed major tranquilizers, the so-called antipsychotics and it may be described as torture by some patients, yet psychiatric staff are often ignorant of such significant suffering. Even when they identify a patient who is crippled with akathisia, often the response is to continue to prescribe the drug. Does this count as state sanctioned torture on a mass scale? Only a court could decide but Gøtzsche makes a strong case.
Antidepressants, or “Depression pills,” as Gøtzsche calls them, cause sexual numbing for many of the people taking them which ruins their sex lives. This has now been recognized by doctors (7) but no treatment is available. Gøtzsche tells us of several young men who he states have killed themselves due to this condition. Does causing chemical castration on a large scale constitute sexual violence? So far no one has faced prosecution for this, perhaps in the future they will.
Violence and sexual violence are known about in psychiatric hospitals and have been for decades. Recommendations are written and repeatedly ignored. Health Secretary Victoria Atkins recently said that victims should go to the police but surely more should be done; maybe forced treatment should be abolished or at the very least mixed wards ended, something that has been asked for repeatedly over decades but still without result. Should governments that allow this to happen be prosecuted for crimes against humanity? Certainly, there is a case to be answered but who would bring such a case and what chance would there be of a minister being found guilty? Would a guilty verdict change anything?
Gøtzsche tells of how “Depression pills,” are widely prescribed to the elderly and are no more effective than placebo – they increase the risk of fall in the elderly which can in turn, lead to hip fracture and to early death. He lists many other problems with these drugs and also with Electroconvulsive Therapy. He describes how drug companies allegedly fail to tell the truth, knowing about the harms but hiding them, and how some leading psychiatrists receive huge amounts of money – institutional corruption that is systemic to medicine. The book outlines how drug companies are hugely profitable businesses that are central to some governments’ economic plans, and how drugs known to be almost useless become central to drug company profits.
Is psychiatry a crime against humanity? Gøtzsche has laid out his case in an easy-to-read book that uses easy to understand scientific arguments in a way that is well worth reading. The book will be useful for campaigners, doctors, service users and be of interest to the general reader.
But are, “Crimes against humanity,” the best lens in which to examine psychiatry? “Crimes against humanity,” is a legal framework developed to address some of the worst excesses of capitalism in the 20th century. The Marxist critical thinker Theodore Adorno wrote in his book Minima Moralia:
“What the Nazis did to the Jews was unspeakable: language has no word for it, since even mass murder would have sounded, in face of its planned, systematic totality, like something from the good old days of the serial killer. And yet a term needed to be found if the victims — in any case too many for their names to be recalled — were to be spared the curse of having no thoughts turned unto them. So in English the concept of genocide was coined. But by being codified, as set down in the International Declaration of Human Rights, the unspeakable was made, for the sake of protest, commensurable. By its elevation to a concept, its possibility is virtually recognized: an institution to be forbidden, rejected, discussed. One day negotiations may take place in the forum of the United Nations on whether some new atrocity comes under the heading of genocide, whether nations have a right to intervene that they do not want to exercise in any case, and whether in view of the unforeseen difficulty of applying it in practice the whole concept of genocide should be removed from the statutes. Soon afterwards there are inside-page headlines in journalese: East Turkestan genocide programme nears completion.”
Adorno was commenting on how genocide is tied into how capitalism has developed and that human rights frameworks are not sufficient to move us to socialism which he saw as needed to avoid future genocides. I think crimes against humanity as a lens to critique psychiatry also fall short of what is needed to end the suffering psychiatry causes. Psychiatry was always bound up with capitalism, it was developed after the first industrial revolution as a way of getting those who were disruptive in poor houses out of the way (9). Now, as a number of critics have argued, its two main functions are to distract from the causes of misery and to provide profit for Big Pharma. Many of these causes are poverty, which Gøtzsche notes are social problems, not medical ones. Gøtzsche thinks the time to be polite has passed and that for psychiatry to reform it will need a big and effective service user/survivor movement, and I agree with that, but I add that perhaps we will need to move beyond capitalism too?
(1) https://en.wikipedia.org/wiki/Cochrane_(organisation)
(2) https://www.amazon.co.uk/Deadly-Medicines-Organised-Crime-Healthcare/dp/1846198844
(3) downloadable from this page https://www.scientificfreedom.dk/books/
(4) https://en.wikipedia.org/wiki/Crimes_against_humanity
(5) https://open-dialogue.net/
(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061302/
(9) https://www.amazon.co.uk/Museums-Madness-Organization-Insanity-Century/
Yes, but my point is that it would need a strong service user/survivor/carer movement for that to happen. Even then the financial interests of Big Pharma and the political benefits to world capitalism of people thinking their misery is caused by individual diseases and not due to social causes that a revised movement for Socialism might be required for this to happen. I was trying to open up a conversation around this.
Page 150.
“The public expects a medical speciality to be an honest purveyor of scientific findings about the benefits and harms of its interventions, and if the trial results tell of treatments that WORSEN* long term out-comes, then the medical speciality must inform the public about it and rethink its practices”.
Might this meticulously referenced book lead to a comprehensive decrease in prescription drug harms were it to become recommended reading for all new entrants into Vocational Training for General Practice?
(* In italics in published text)