Thomas Szasz

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Peter Barach

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Dec 23, 1994, 9:59:47 PM12/23/94
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I heard that Szasz settled an $800,000 lawsuit. Anyone
know any more information about this?
--
Peter M. Barach, Ph.D. (aa...@cleveland.freenet.edu)
5851 Pearl Road, Suite 305 Parma Heights, Ohio 44130 USA
Voice: 216-845-9011 (press 6 if you get voice mail)
Fax: 216-845-9013

Ivan Goldberg

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Dec 24, 1994, 9:17:11 AM12/24/94
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Peter Barach (aa...@cleveland.Freenet.Edu) wrote:

: I heard that Szasz settled an $800,000 lawsuit. Anyone


: know any more information about this?

The settlement was reported in a very recent issue of
Psychiatric News. Briefly, a physician diagnosed as
having Bipolar Disorder and who was being treated with
lithium went to Szasz for treatment. Szasz saw him,
as I recall, 20+ times. Szasz advised him to stop the
lithium. He did, and completed suicide some time later.
His family brought an action against Szasz, and Szasz
settled for about $650,000.

- ivan -

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Stephen Landman

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Dec 24, 1994, 9:41:36 AM12/24/94
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In article <3dg2r3$l...@usenet.INS.CWRU.Edu>,


What I heard is that a friend of his, a psychiatrist, had
been diagnosed with bipolar disorder and was on medication
for it. Szasz told him that he didn't need the medication.
The man stopped the meds, and later killed himself. The
man's family collected from Szasz. I haven't read anything
substantive on this, but this is what I was told.

Stephen Landman

John M. Grohol

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Dec 24, 1994, 12:34:11 PM12/24/94
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psy...@netcom.com (Ivan Goldberg) writes:

> The settlement was reported in a very recent issue of
> Psychiatric News. Briefly, a physician diagnosed as
> having Bipolar Disorder and who was being treated with
> lithium went to Szasz for treatment. Szasz saw him,
> as I recall, 20+ times. Szasz advised him to stop the
> lithium. He did, and completed suicide some time later.
> His family brought an action against Szasz, and Szasz
> settled for about $650,000.

Let's clarify the facts. The physician was in fact another psychiatrist.
One would think one could and would take responsibility for one's own
knowledge of mental illness (eg.- everyone's responsibile for his or her
own decisions). Szasz himself did not settle; his insurance company did.
Insurance comapnies often settle out of court to reduce their chances of
having to pay out a larger sum at a later date, even if they believe their
claimant. The article also stated from one of Szasz's attorneys,
"Extrinsic evidence was produced by the defense to establish that Dr.
Klein [the psychiatrist] discontinued use of lithium on his own intiative
before he ever consulted Dr. Szasz."

I am not a defender of Thomas Szasz's teachings (I do not agree with most
of his arguments); I do, however, like the clear statement of facts.

-jmg
--
John M. Grohol Co-moderator sci.psychology.research
Assistant Editor, InterPsych Newsletter
Center for Psychological Studies, Nova Southeastern University, Florida
Dutchess County Department of Mental Hygiene, Poughkeepsie, New York

Ivan Goldberg

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Dec 24, 1994, 7:32:14 PM12/24/94
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John M. Grohol (gro...@alpha.acast.nova.edu) wrote:

: psy...@netcom.com (Ivan Goldberg) writes:

: > The settlement was reported in a very recent issue of
: > Psychiatric News. Briefly, a physician diagnosed as
: > having Bipolar Disorder and who was being treated with
: > lithium went to Szasz for treatment. Szasz saw him,
: > as I recall, 20+ times. Szasz advised him to stop the
: > lithium. He did, and completed suicide some time later.
: > His family brought an action against Szasz, and Szasz
: > settled for about $650,000.

: Let's clarify the facts.

John . . .

As you should know (it was in the Psychiatric News article)
about the settlement, Szasz was insured by the insurance
company that writes policies for members of the American
Psychiatric Association. It is a provision of that policy
that no settlements can be made without the written permission
of the insured psychiatrist. I am sure that not only did
Szasz sign such a permission, but that his (as opposed to the
insurance company's) lawyer advised him to settle.

Whether or not the physician who completed suicide was also
a psychiatrist is irrelevant. When a doctor gives bad advice
he cannot evade responsibility by claiming that the patient
is an adult and has to take responsibility for listening to
the advice. People are NOT responsible for their decisions
when their decision making process may be impaired by the
cognitive effects of severe depression. Since many people
with severe depressions (including physicians/psychiatrists)
have unrealistically negative expectations concerning the
possibility of recovery, and the efficacy of medications,
there is no way psychiatrists (and in the future, possibly
psychologists) can evade responsibility for irresponsible
advice by dumping all responsibility on the patient. If that
was the model society were using, there would be no need to
license professionals. People would solicit advice from
whomever they wished, and we would not have certified/licensed
pholks who could be held responsible for the advice they
dispensed. If you are in the kitchen you not only have to
stand the heat, but you have to take responsibility for what
you say to and do with your patients.

Vic Jasin

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Dec 24, 1994, 8:58:17 PM12/24/94
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In article <psydocD1...@netcom.com> psy...@netcom.com
(Ivan Goldberg) writes:
>From: psy...@netcom.com (Ivan Goldberg)

> license professionals. People would solicit advice from
> whomever they wished, and we would not have certified/licensed
> pholks who could be held responsible for the advice they
> dispensed. If you are in the kitchen you not only have to
> stand the heat, but you have to take responsibility for what
> you say to and do with your patients.

Given that a practitioner has a "reputation" for unconventional methods and
advice, how is progress, new developments etc. to be enabled. Sure clinical
settings, but in general if one's philosophy is not 100% effective then there
will always be room for error that can exploit the legal opportunities for
malpractice. What do you suggest the profession should do? Is a disclaimer
sheet as standard practice necessary given how liberal settlements and suits
are won/awarded in the U.S. justice system.

I don't know the specifics of Szasz, but this is a question in a broad sense.
If you are a psychiatrist you would tend to go to someone you respect as being
top or most effective in your own field. If that practitioners advise is less
than mainstream his actions are target for suits given the process fails.
Shouldn't the fact that a practitioner himself/herself has been convinced on
some rationale or method that they as professionals themselve have not
disputed to the point of rejection? If you went to Szasz (God forbid) and you
were told you should try some totally unknown or radical therapy, would you be
willing to try something that you may have not tried or would you reject it
being that you personally did not consider the same option?

I agree that they must take responsibility for their actions, but if there
are no histograms or historical stats on a wide populations study to determine
a procedures efficacy, then what defense does a person have. Who the hell
would want to develop NEW procedures if they KNOW that they are open to
greater liability? This may sound cold, but given that a new method/theory is
tried no one is going to expect 100%. At what point and what is required to
categorize a person a part of the "failed" statistics that on an overall basis
are reasonable to the peers and association at large? (Especially if such a
theory is in a stage that "controversy" surrounds it.)


- Victor G.L. Jasin
ja...@uwo.ca
"iki pasirasymo!"

John M. Grohol

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Dec 25, 1994, 11:32:12 PM12/25/94
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Granted, severe depression can cause cognitive distortions.

But, I then must ask how far society is willing to go with this. Should
people who are suffering from a clinical depression be held accountable
for any of their actions? What if they kill someone?? Is the clinician
fully responsible for every harmful action a patient takes while under his
or her care?

Why hasn't Tarasoff been upheld in most state courts? Why is suicide any
different from homicide?? Exactly how good are we, as clinicians, at
predicting suicidal behavior?

-jmg
--
John M. Grohol Co-moderator sci.psychology.research

Employment Editor, InterPsych Newsletter

Center for Psychological Studies, Nova Southeastern University, Florida

gro...@alpha.acast.nova.edu jgr...@ichange.com (Interchange)

Michael McReavy

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Dec 26, 1994, 5:23:43 AM12/26/94
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In article <3dg2r3$l...@usenet.INS.CWRU.Edu>,
aa...@cleveland.Freenet.Edu (Peter Barach) wrote:

I heard that Szasz settled an $800,000 lawsuit. Anyone
know any more information about this?

Here is a copy of the article from Psychiatric News on just that subject, as I
received it from LEGA...@JUVM.STJOHNS.EDU


Sender: Topical Evaluation Network Legal List <LEGA...@SJUVM.STJOHNS.EDU>
From: DJJ...@AOL.COM
Subject: Szasz Szued ;-)

This is from Psychiatric News. I am proud that I was the one who put them on
to the story : - )
djj...@aol.com

SZASZ SETTLES SUIT FOR $650,000

Thomas Szasz, M.D., psychiatrist and
longtime critic of involuntary treatment,
agreed to pay $650,000 to the widow of a
fellow psychiatrist who committed suicide
after Szasz suggested that he discontinue
taking lithium, according to records of
the complaint recently made public.

Agreed to this spring, the
settlement was not formally filed until
August. The terms of the settlement
decreed that no voluntary publicity be
sought by either side, and attorneys for
both sides agreed to respond only after
direct inquiries by PSYCHIATRIC NEWS.

PSYCHIATRIC NEWS was able to obtain
a copy of the complaint and terms of the
settlement from the Onondaga County
Clerk's office, and Szasz, who at 74
remains a prolific author and lecturer,
has written frequently about the proper
context for a therapeutic relationship.

Szasz, best known as the author of
THE MYTH OF MENTAL ILLNESS, has long
maintained that mental illness is a
misnomer, and there is no firm evidence
of underlying, organic causation of
behavioral disorders. Rather, according
to Szasz, such disorders are
manifestations of the free will of
individuals who choose to behave in ways
deemed unacceptable by the rest of
society. Szasz has further argued
repeatedly that since there is no
evidence of underlying organic causation,
it makes no sense to give people powerful
drugs such as lithium and that use of
such drugs represents not therapy, but
pharmacological coercion.

"Unlike Nazi psychiatrists,
democratic psychiatrists do not literally
kill their patients. They kill them
metaphorically, by incarcerating,
shocking, and drugging them," writes
Szasz in his most recent book, CRUEL
COMPASSION: PSYCHIATRIC CONTROL OF
SOCIETYUS UNWANTED (John Wiley Sons
Inc., New York, 1994).

(Photo of Szasz with following caption:
"Thomas Szasz, M.D., believes that the
free market in mental health services has
effectively been abolished.")

Szasz further argues in the same
book that the free market in mental
health services has effectively been
abolished. "The reason is simple.
Market relations imply the renunciation
of the use of force. But unless the
psychiatrist is willing to run the risk
of being sued for malpractice, he can no
longer assume this posture. Today,
psychiatric practice, both in the office
and the hospital, rests on the premise
that it is the therapist's duty to
protect the patient from killing himself
or others, by force if necessary. The
result is that the patient, his
relatives, and the psychiatrist are
enmeshed in a relationship that is,
actually or potentially, coercive.
Specifically, the therapist coerces the
patient he deems to be 'dangerous to
himself or others,' by incarcerating him
in a mental hospital; reciprocally, the
patient who 'threatens' to kill himself
or others coerces the therapist, because,
if he carries out his threat, his
relatives or his victims can sue the
psychiatrist for malpractice. The milieu
for market relations has thus been
destroyed."

According to the public record,
Michael Klein was a patient at the
Benjamin Rush Center from April 12, 1990,
through May 9, 1990, under the care of
Yasser Zikry, M.D. Zikry was treating
Klein for bipolar illness and prescribed
lithium.

Klein purchased a prescription of
lithium shortly after his discharge on
May 9, 1990, and commenced taking the
medication as prescribed at about that
time, the record shows. About two weeks
later, on May 24, 1990, Klein sought care
from Szasz. He continued to see Szasz
through December 9, 1990, visiting him
approximately 27 times during this
period.

Klein's death at age 49 left his
wife, Hilde, and two sons, Eric, then age
16, and Daniel, then age 13, without any
means of support.

The complaint states that early in
the course of treatment, "on or about
June 14," Klein, "pursuant to the
instructions and advice" of Szasz,
stopped taking the lithium.

But according to Szasz's attorney,
Terrence Connors, J.D., of Connors and
Villardo, Klein stopped using lithium
prior to consulting Szasz.

"Extrinsic evidence was produced by
the defense to establish that Dr. Klein

discontinued the use of lithium on his
own initiative before he ever consulted
Dr. Szasz," Connors told PSYCHIATRIC
NEWS. "The result after that information
was discovered and disclosed was a
settlement of a disputed claim. And Dr.
Szasz did not concede in any way that he
committed malpractice."

Hilde Klein's attorney, Victor
Mazzotti, J.D., of Martin, Harding, and
Mazzotti, said that despite the
settlement, he and his client believe
that "the evidence would have supported
the plaintiff's allegations. We felt
that the evidence would have shown that
Dr. Klein's cessation of lithium therapy
was based on Dr. Szasz's advice. We
stand by the allegation that the evidence
would have shown that he failed to
provide psychiatric care in conformity
with the customary and accepted standards
of medical care prevailing."

On December 17, 1990, Klein
committed suicide by hanging himself with
battery cables.

The complaint asserts that "the
negligence and medical malpractice of the
defendant" consisted of "carelessly and
negligently" failing to provide
psychiatric care and treatment "in
conformity with the customary and
accepted sound standards of medical care
then and there prevailing."

The record further states that Szasz
failed to diagnose and treat Klein's
condition properly, failed to keep
adequate records, and "failed to
establish, follow, or provide proper
accepted psychiatric practice for the
treatment of patients, such as the
decedent, which would have resulted in
the making of the correct diagnosis and
the proper treatment of the decedent's
condition."

The final settlement stated that
Professional Risk Management Services
(PRMS) would pay $650,000 to Hilde Klein.
As a member of APA, Szasz was eligible
for the PRMS insurance coverage available
to all APA members.

As part of the final settlement,
Klein agreed to withdraw the "conscious
pain and suffering cause of action"
alleged in her initial complaint against
Szasz. --R.B.K.

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