Unit 1 Psychological Conditions and Treatments
Issue 1. Is Forced Treatment of Seriously Mentally Ill Individuals Justifiable? YES: Samuel J. Brakel, from Overriding Mental Health Treatment Refusals: How Much Process Is “Due”? (The Berkeley Electronic Press, 2007) NO: James B. Gottstein, from “How the Legal System Can Help Create a Recovery Culture in Mental Health Systems,” Leading the Transformation to Recovery (2005)
Attorney Samuel J. Brakel asserts that society has a responsibility to take care of seriously mentally ill individuals who are incapable of making an informed decision about their need for care and treatment. Attorney James B. Gottstein contends that forced treatment of mentally ill citizens represents a curtailment of liberty which leads a large number of people down a road to permanent disability and poverty.
Issue 2. Should Individuals with Anorexia Nervosa Have the Right to Refuse Life-Sustaining Treatment? YES: Heather Draper, from “Anorexia Nervosa and Respecting a Refusal of Life-Prolonging Therapy: A Limited Justification,” Bioethics (April 1, 2000) NO: J. L. Werth, Jr., Kimberly S. Wright, Rita J. Archambault, and Rebekah J. Bardash, from “When Does the ‘Duty to Protect’ Apply with a Client Who Has Anorexia Nervosa?” The Counseling Psychologist (July 2003)
Heather Draper argues that clinicians need to accept the fact that individuals with anorexia nervosa may be competent, and may have legitimate reasons for refusing therapy. In such cases, therapists should respect the individual’s wishes and should refrain from administering life-sustaining treatment. James Werth, Jr. and his colleagues contend that, due to the very nature of anorexia nervosa, individuals with anorexia cannot make rational decisions about nutrition and feeding. Because the behaviors of anorexics have such potential for health damage or even death, clinicians have a duty to protect the lives of their patients, even if it calls for compulsory treatment.
Issue 3. Is Psychological Debriefing a Harmful Intervention for Survivors of Trauma? YES: Grant J. Devilly and Peter Cotton, from “Psychological Debriefing and the Workplace: Defining a Concept, Controversies and Guidelines for Intervention,” Australian Psychologist (July 2003) NO: J. T. Mitchell, from “A Response to Devilly and Cotton Article ‘Psychological Debriefing and the Workplace’,” Australian Psychologist (March 2004)
Psychologists Grant J. Devilly and Peter Cotton assert that critical incident stress debriefing (CISD) is poorly defined and has been shown to do more harm than good. They propose alternative approaches for responding to trauma survivors, which they consider more effective. Jeffrey T. Mitchell of the International Critical Incident Stress Foundation (ICISF) argues that Devilly and Cotton have misrepresented important information about psychological debriefing and have confused several aspects of this system of responding to trauma survivors.
Issue 4. Are Blocked and Recovered Memories Valid Phenomena? YES: David H. Gleaves, Steven M. Smith, Lisa D. Butler, and David Spiegel, from “False and Recovered Memories in the Laboratory and Clinic: A Review of Experimental and Clinical Evidence,” Clinical Psychology: Science and Practice (Spring 2004) NO: John F. Kihlstrom, from “An Unbalanced Balancing Act: Blocked, Recovered, and False Memories in the Laboratory and Clinic,” Clinical Psychology: Science and Practice (Spring 2004)
Psychologist David Gleaves and his colleagues assert that for some people, memories of traumatic events are blocked but may subsequently be recovered. Psychologist John Kihlstrom disputes the validity of blocked and recovered memories. He views the phenomenon of “false memories” as a serious problem in contemporary society.
Issue 5. Is Attention-Deficit/Hyperactivity Disorder (ADHD) a Real Disorder? YES: National Institute of Mental Health, from Attention Deficit Hyperactivity Disorder (NIH Publication No. 3572), Bethesda, MD: National Institute of Mental Health, U.S. Department of Health and Human Services (2006) NO: Rogers H. Wright, from “Attention Deficit Hyperactivity Disorder: What It Is and What It Is Not,” in Rogers H. Wright and Nicholas A. Cummings, eds., Destructive Trends in Mental Health: The Well Intentioned Path to Harm (Routledge, 2005)
NIMH views ADHD as a valid disorder affecting between 3 and 5 percent of American children, many of whom will continue to deal with symptoms of this condition into adulthood. According to NIMH, ADHD warrants careful diagnosis and treatment by skilled professionals. Psychologist Rogers H. Wright argues that ADHD has vague diagnostic criteria that lead to over-diagnosis and over-medication of an excessive number of people.
Issue 6. Should MDMA (Ecstasy) Be Prohibited, Even for Therapeutic Use? YES: Robert Mathias and Patrick Zickler, from “NIDA Conference Highlights Scientific Findings on MDMA/Ecstasy,” NIDA Notes (December 2001) NO: June Riedlinger and Michael Montagne, from “Using MDMA in the Treatment of Depression,” in Julie Holland, ed., Ecstasy: The Complete Guide (Park Street Press, 2001)
Science writers Robert Mathias and Patrick Zickler argue that MDMA has skyrocketed in popularity and that insufficient attention has been paid to the physical and psychological risks associated with its use. June Riedlinger, an assistant professor of clinical pharmacy, and Michael Montagne, a professor of pharmacy, contend that the risks associated with MDMA use have been exaggerated and that there are legitimate therapeutic uses for this substance.
Issue 7. Should Abstinence Be the Goal for Treating People with Alcohol Problems? YES: Patricia Owen, from “Should Abstinence Be the Goal for Alcohol Treatment?,” The American Journal of Addictions (Fall 2001) NO: Anne M. Fletcher, from Sober for Good: New Solutions for Drinking Problems—Advice from Those Who Have Succeeded (Houghton Mifflin Co., 2001)
Psychologist Patricia Owen asserts that abstinence is the safest and most honest treatment goal for most people who are dependent on alcohol. Health and medical writer Anne Fletcher contends that many people with alcohol problems can be successful in their efforts to control their drinking, particularly if they are given professional guidance and support.
Unit 2 The Trend Toward Biological Interventions
Issue 8. Should Memory-Dampening Drugs Be Used to Alleviate the Symptoms of Trauma? YES: Adam J. Kolber, from “Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening,” Vanderbilt Law Review (2006) NO: The President’s Council on Bioethics, Beyond Therapy: Biotechnology and the Pursuit of Happiness (October 2003)
Professor Adam Kolber asserts that victims of trauma who experience terrifying residual symptoms can benefit from drugs that make the trauma feel less horrible. Such drugs can help trauma survivors make life transformations that they would otherwise be incapable of making. The President’s Council on Bioethics, chaired by Dr. Leon Kass, objects to the use of biotechnical interventions to ease the psychic pain of bad memories, because identities are formed in part by what people undergo and suffer.
Issue 9. Are Antipsychotic Medications the Treatment of Choice for People with Psychosis? YES: E. Fuller Torrey, from Surviving Schizophrenia: A Manual for Families, Consumers, and Providers, 4th ed. (Quill 2001) NO: Robert Whitaker, from Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (Perseus 2002)
Psychiatrist E. Fuller Torrey, an outspoken advocate for the needs of the mentally ill and their families, contends that antipsychotic medications play a centrally important role in alleviating psychotic symptoms and reducing the likelihood of rehospitalization. Journalist and social critic Robert Whitaker asserts that antipsychotic medications make people chronically ill, cause serious side effects, and increase the likelihood of rehospitalization; furthermore, reliance on these medical treatments for the mentally ill neglect important questions such as what it means to be human.
Issue 10. Is Ritalin Overprescribed? YES: Peter R. Breggin, from The Ritalin Fact Book: What Your Doctor Won’t Tell You about ADHD and Stimulant Drugs (Perseus, 2002) NO: Russell A. Barkley, from Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (Guilford, 2000)
Physician Peter R. Breggin asserts that Ritalin and similar stimulants are dangerous addictive medications that should not be prescribed to children because they suppress growth and lead to a number of worrisome physical and psychological symptoms. Psychologist and prominent ADHD re-searcher Russell A. Barkley objects to criticisms of Ritalin and similar stimulants, asserting that these medications serve as important parts of interventions and aim at helping children increase their attention and concentration.
Issue 11. Should Psychologists Prescribe Medication? YES: Robert Resnick, from “To Prescribe or Not To Prescribe—Is That the Question?” The Psychologist (April 2003) NO: William N. Robiner, et al., from “Prescriptive Authority for Psychologists: A Looming Health Hazard?” Clinical Psychology: Science and Practice (Fall 2002)
Psychologist Robert Resnick endorses the recommendation that psycho-logists be given prescription privileges in order to expand psychophar-macological availability to people needing medication. Psychologist William Robiner and his colleagues object to the notion of granting prescription privileges to psychologists, and express several concerns pertaining to training and competence.
Issue 12. Is Electroconvulsive Therapy Ethical? YES: Max Fink, from Electroshock: Restoring the Mind (Oxford University Press, 1999) NO: Leonard R. Frank, from “Shock Treatment IV: Resistance in the 1990s,” in Robert F. Morgan, ed., Electroshock: The Case Against (Morgan Foundation, 1999)
Physician Max Fink asserts that electroconvulsive therapy (ECT) is an effective intervention whose use has been limited as a result of social stigma and philosophical bias, which have been reinforced by intimidation from the pharmaceutical and managed care industries. Leonard R. Frank, editor and cofounder of the Network Against Psychiatric Assault, criticizes the use of ECT because of its disturbing side effects, some of which he personally has suffered, and asserts that its resurgence in popularity is economically based.
Unit 3 Social Issues
Issue 13. Is It Ethical to Support the Wish for Healthy Limb Amputation in People with Body Integrity Identity Disorder (BIID)? YES: Tim Bayne and Neil Levy, from “Amputees by Choice: Body Integrity Identity Disorder and the Ethics of Amputation,” Journal of Applied Philosophy (2005) NO: Wesley J. Smith, from “Secondhand Smoke: Blog of Wesley J. Smith” (2007)
Authors Tim Bayne and Neil Levy argue that people with body integrity identity disorder (BIID) are in emotional pain because of their experience of incongruity between their body image and their actual body. Such individuals should be accorded their wish, and their prerogative, to have healthy limbs amputated. Wesley Smith objects to the notion of acquiescing to the wishes for healthy limb amputation in people whom he views as severely mentally disturbed. Smith asserts that these people need treatment, not amputation.
Issue 14. Is Sexual Orientation Conversion Therapy Ethical? YES: Christopher H. Rosik, from “Motivational, Ethical, and Epistemological Foundations in the Treatment of Unwanted Homoerotic Attraction,” Journal of Marital and Family Therapy (January 2003) NO: Robert-Jay Green, from “When Therapists Do Not Want Their Clients to Be Homosexual: A Response to Rosik’s Article,” Journal of Marital and Family Therapy (January 2003)
Psychologist Christopher Rosik asserts that many clients have valid reasons for pursuing sexual orientation conversion therapy, and mental health professionals have a responsibility to work with these clients toward their goals. Psychologist Robert-Jay Green expresses concern over therapy involving sexual reorientation, cautioning that clients must understand their motivations for seeking change. He contends that there is little evidence regarding the effectiveness of such therapy.
Issue 15. Does Exposure to Media Violence Promote Aggressive Behavior? YES: Nancy Signorielli, from Violence in the Media: A Reference Handbook (ABC-CLIO, 2005) NO: Jonathan L. Freedman, from Media Violence and Its Effect on Aggression: Assessing the Scientific Evidence (University of Toronto Press, 2002)
Professor of communication Nancy Signorielli asserts that research supports the position that media violence affects viewers by fostering aggression, causing desensitization to violence, and promoting fear. Psychologist Jonathan L. Freedman argues that the scientific evidence does not support the notion that exposure to TV and film violence causes aggression, desensitization, or fear.
Issue 16. Would Legalization of Virtual Child Pornography Reduce Sexual Exploitation of Children? YES: Arnold H. Loewy, from “Taking Free Speech Seriously: The United States Supreme Court and Virtual Child Pornography,” UNC Public Law Research Paper No. 02-17 (November 2002) NO: Diana E. H. Russell and Natalie J. Purcell, from “Exposure to Pornography as a Cause of Child Sexual Victimization,” in Nancy E. Dowd, Dorothy G. Singer, and Robin Fretwell Wilson, eds., Handbook of Children, Culture, and Violence (Sage Publication Inc., 2006)
Attorney Arnold Loewy views the issue of virtual child pornography from a legal perspective, asserting that such material is a form of free speech that ought to be constitutionally protected. He also contends that legalizing virtual child pornography would reduce the extent to which real children would be exploited. Writers Diana Russell and Natalie Purcell express vehement objections to any forms of pornography involving images of children, asserting that Internet users with no previous sexual interest in children may find themselves drawn into a world in which the societal prohibition against adult-child sex is undermined.
Issue 17. Does Evolution Explain Why Men Rape? YES: Randy Thornhill and Craig T. Palmer, from “Why Men Rape,” The Sciences (January/February 2000) NO: Susan Brownmiller, from Against Our Will: Men, Women and Rape (Simon & Schuster, 1975)
Evolutionary biologist Randy Thornhill and evolutionary anthropologist Craig T. Palmer assert that the reasons why men rape are misunderstood. They contend that, rather than an act of gratuitous violence, rape can be understood as a biologically determined behavior in which socially disenfranchised men resort to this extreme act in order to gain access to women. Journalist Susan Brownmiller argues that rape is an exempli-fication of the male-female struggle in which men humiliate and degrade women in a blunt and ugly expression of physical power.
Issue 18. Should Mental Health Professionals Serve as Gatekeepers for Physician-Assisted Suicide? YES: Rhea K. Farberman, from “Terminal Illness and Hastened Death Requests: The Important Role of the Mental Health Professional,” Professional Psychology: Research and Practice (1997) NO: Mark D. Sullivan, Linda Ganzini, and Stuart J. Youngner, from “Should Psychiatrists Serve as Gatekeepers for Physician-Assisted Suicide?” The Hastings Center Report (July/August 1998)
Rhea K. Farberman, director of public communications for the American Psychological Association, makes the case that mental health profes-sionals should be called upon to assess terminally ill people who request hastened death in order to ensure that decision making is rational and free of coercion. Psychiatrists Mark D. Sullivan, Linda Ganzini, and Stuart J. Youngner argue that the reliance on mental health professionals to be suicide gatekeepers involves an inappropriate use of clinical procedures to disguise society’s ambivalence about suicide itself.
Issue 19. Must Mentally Ill Murderers Have a RationalUnderstanding of Why They Are Being Sentenced to Death? YES: American Psychological Association, American Psychiatric Association, and National Alliance on Mental Illness, from “Brief for Amici Curiae American Psychological Association, American Psychiatric Association, and National Alliance on Mental Illness in Support of Petitioner,” Scott Louis Panetti v. Nathaniel Quaterman, Director, Texas Department of Criminal Justic, Correctional Institutions Division, U.S. Supreme Court, No. 06-6407 (2007) NO: Greg Abbott, et al., from “On Writ of Certiorari to the United States Court of Appeals for the Fifth Circuit: Brief for the Respondent,” Scott Louis Panetti v. Nathaniel Quaterman, Director, Texas Department of Criminal Justice, Correctional Institutions Division, U.S. Supreme Court, No. 06-6407 (2007)
The American Psychological Association, American Psychiatric Asso-ciation, and the National Alliance on Mental Illness collaborated in the preparation of an amici curiae brief pertaining to the case of Scott Panetti who was sentenced to death for murder. In this brief the argument is made that mentally ill convicts should not be executed if their disability significantly impairs their capacity to understand the nature and purpose of their punishment, or to appreciate why the punishment is being imposed on them. An opposing argument is made by Nathaniel Quarterman who asserts that punishment for murder does not depend on the rational understanding of the convicted individual, but rather on the convict’s moral culpability at the time the crime was committed.
