The Lobotomist
Contrary to the Principles of Humanity

The Lobotomist
Contrary to the Principles of Humanity
Lobotomy involves a surgical incision into the frontal lobe of the brain to sever one or more nerve tracts, a technique formerly used to treat certain mental disorders but now it is rarely performed.

Lobotomy is a neurosurgical procedure which is a form of psychosurgery, also known as a leukotomy or leucotomy.

It consists of cutting the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain.

While the procedure, initially termed a leukotomy, has been controversial since its inception in 1935, it was a mainstream procedure for more than two decades, prescribed for psychiatric (and occasionally other) conditions—this despite general recognition of frequent and serious side-effects.

The Nobel Prize for Physiology or Medicine of 1949 was awarded to António Egas Moniz "for his discovery of the therapeutic value of leucotomy in certain psychoses".

The heyday of its usage was from the early 1940s until the mid-1950s when modern neuroleptic (antipsychotic) medications were introduced.

By 1951 almost 20,000 lobotomies had been performed in the United States.

The decline of the procedure was gradual rather than precipitous.

In Ottawa's psychiatric hospitals, for instance, the 153 lobotomies performed in 1953 were reduced to 58 by 1961, after the arrival in Canada of the antipsychotic drug chlorpromazine in 1954.

As early as 1944 an author in the Journal of Nervous and Mental Disease remarked: "The history of prefrontal lobotomy has been brief and stormy. Its course has been dotted with both violent opposition and with slavish, unquestioning acceptance."

Beginning in 1947 Swedish psychiatrist Snorre Wohlfahrt evaluated early trials, reporting that it is "distinctly hazardous to leucotomize schizophrenics" and lobotomy to be "still too imperfect to enable us, with its aid, to venture on a general offensive against chronic cases of mental disorder" and stating that "Psychosurgery has as yet failed to discover its precise indications and contraindications and the methods must unfortunately still be regarded as rather crude and hazardous in many respects."

In 1948 Norbert Wiener, the author of Cybernetics: Or the Control and Communication in the Animal and the Machine, said: "Prefrontal lobotomy... has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier."

Concerns about lobotomy steadily grew.

The USSR officially banned the procedure in 1950. Doctors in the Soviet Union concluded that the procedure was "contrary to the principles of humanity" and that it turned "an insane person into an idiot."

By the 1970s, numerous countries had banned the procedure as had several US states.

Other forms of psychosurgery continued to be legally practiced in controlled and regulated US centers and in Finland, Sweden, the UK, Spain, India, Belgium and the Netherlands.

In 1977 the US Congress created the National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery—including lobotomy techniques—were used to control minorities and restrain individual rights.

It also investigated the after-effects of surgery.

The committee concluded that some extremely limited and properly performed psychosurgery could have positive effects.

By the early 1970s the practice of lobotomy had generally ceased, but some countries continued to use other forms of psychosurgery.

In 2001 there were, for example, 70 operations in Belgium, about 15 in the UK and about 15 a year at Massachusetts General Hospital in Boston, while France had carried out operations on about 5 patients a year in the early 1980s.