The international system for the protection of human rights was developed after the second world war, largely in response to Nazi atrocities. The Nazis had held a collective belief that the German nation was a living organism and that its well-being was threatened by ‘useless eaters’ and ‘life unworthy of life’.[40] German doctors, 45 per cent of whom belonged to the Nazi Party in the early 1930s, were empowered to tend to the health of the national organism. The psychiatric branch of the profession led the way by ‘medically killing’ some 80,000–100,000 hospitalised mental patients. The expertise the Nazi psychiatrists acquired in killing off their mental patients was later applied to Jewish people.[41]
In modern democratic societies psychiatry treads a very fine line between benefiting and harming the exercise of human rights. While the basic principle of human rights is to set limits on the degree of social authority which is allowed to be imposed on individuals, the speciality of psychiatry is to fit ‘difficult’ individuals into the social fabric. In this way psychiatry can become opposed to human rights, even in the most benign political conditions.
When ‘difficult’ individuals acknowledge that they have a mental problem and seek treatment for it, psychiatry is not directly opposed to human rights. Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) concerns ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.’ Signatory nations are instructed to provide for ‘[t]he creation of conditions which would assure to all medical service and medical attention in the event of sickness’.[42] These human rights are the basis for the ‘right to treatment’ which is often promoted by advocates of drug treatment as being the most important human right that relates to psychiatry.
But the ‘right to treatment’ can have a hollow ring to it when psychiatry is practised on people against their will. Involuntary mental patients often find themselves in a situation in which they are incarcerated for an indefinite period without being charged with a criminal offence. They can be interrogated, coerced into changing their thoughts and beliefs, subjected to painful and uncomfortable treatments if they cannot or will not make the required mental changes, and denied freedom until their self-identity has been sufficiently modified. It is in this context that questions arise about whether certain psychiatric practices might violate other human rights that are more fundamental than the 'right to treatment'.
Next: Soviet Psychiatry
[40] Robert Jay Lifton, The Nazi Doctors: medical killing and the psychology of genocide, p. 46.
[41] Ibid., pp. 34, 134–44.
[42] United Nations, ‘International Covenant on Economic, Social and Cultural Rights’, Article 12 (1), p. 16.