PubMed · 8540585
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R Gardner, D O Jones. 1996. Validating psychiatric diagnoses.. https://doi.org/10.1176/ajp.153.1.141
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This article raises questions about the morality and value of experiments conducted mainly on psychiatric patient-subjects whose mental capacity and judgment are often impaired, making them incapable of giving informed consent. Its focus is on experimental studies in which psychotic symptoms in patients with schizophrenia have been knowingly exacerbated by suddenly withdrawing medications that they needed, administering known psychosis-producing substances such as L-dopa and apomorphine, and ignoring the treatment needs of those serving as experimental controls in placebo studies. Concerns are raised about the draft "Statement of Principles for Ethical Conduct" by the American College of Neuropsychopharmacology. Questions are also raised about the adequacy of current safeguards, including federal regulations, peer review, and the trivialization of "informed consent" by institutional review boards that operate under veils of secrecy. Implications for mental health policy are discussed, and suggestions are made for improving safeguards and reducing risks.
Mental health nurses are being increasingly encouraged to move to a more biologically oriented approach. Authors such as Professor Gournay promulgate the myth that biological psychiatry will soon be able to provide an unambiguous model of the nature of mental disorder. A closer examination of some of the biological research identified by Gournay as moving us closer to this ideal reveals, however, the confused and unconvincing nature of the results so far achieved. In the light of this it seems premature to be advocating wholesale acceptance of the biological model by nursing. Nurses should be made aware of the investigations of the biologists, but, unless they are equipped with the necessary intellectual tools to place such investigations in context, they will continue to be susceptible to the rhetoric of proselytisers such as Gournay.
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