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Valued Social Butterfly

Re: What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 1 of 6

To all of you that would like to apply RATIONAL approach to people that are already not rational. is somewhat ridiculous.
I haven't met  a person suffering from a mental issue whether is Schizophrenia to simple depression that will admit that they need help. 
Look, not having the institutions that helped these individuals is one of the causes of all the problems that we have seen in this society.
There will be times that the rationals will impose their will on the irrationals. 
Laws do exist the will preserve the right of the people that are sick. and if we need more then let's deal with that.
B ut  don't start by coming up with all of these rights that apply to RATIONAL people and not to the IRRATIONAL  ONES

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Valued Social Butterfly

Re: What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 2 of 6

Gail  I have seen the reaction to counseling and medications from family and friends. The ones that needed it the most are the ones that will not accept that fact.

They will be very negative to treatment to the point that will refuse treatment. Is there is a medicine that will help in this issue. by all means.  And hopefully that the pharmaceuticals will  not be so greedy as to put this drug  so costly that it wouldn't be able to reach all that they needed. it.

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Valued Social Butterfly

Re: What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 3 of 6

Since we have a legal system that allows the plea of insanity and not responsible for their actions - and also supposedly protecting others - this seems like a reasonable approach. 


If this medication is deemed to be necessary to protect the person and others, the options offered should be allow the medication or be removed from society. 

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Valued Social Butterfly

Re: What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 4 of 6

As long as the patient is made clearly aware of the fact that they are receiving these pills and the consequences of them not taking them. There should also be an option of receiving the same effective medication without the "smart" component.


Another important point would who would receive the notice that the medication is not being taken and how that information is protected. Without real strong controls on the information to protect the patient 'smart' pills should not be allowed.


As pointed out in the article, the courts and government could force the "consent" which in my opinion would be going too far. 

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Valued Social Butterfly

Re: What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 5 of 6

I think cost could be a consideration, maybe even a barrier. Those needing these drugs also need support networks, so I'd like to see more money funneled toward expanding and strengthening that.


And if it's found that someone isn't taking their meds, what's the outcome? Involuntary committment? Jail time? Does the tracking device survive on into the lower digestive tract? If it's excreted intact, what are the chances of it going through a water treatment system, and finding its way into a person who doesn't need the drug or the tracking device?


A reminder system, sort of an at-home dispensing device, might be more useful than a tracking device. (8 pages of lies and growing)
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Valued Social Butterfly

What Do You Think ? Ethics in the Treatment of Mental Disease.

Message 6 of 6

A move away from the norm here - I just would like for folks to think about this and say what they think of this pharmaceutical advancement and its benefit or not to the people who might need it for themselves and even others.


On one hand this could be a life-savior for those with these conditions and I am not just speaking about their internal mental/physical health but perhaps some violent dealing they may have with law enforcement or general public. 


However many folks with these ailments of the mind have adverse feeling about even taking such medicine - for lack of better words, it removes who they are and how they feel, not acceptable to many.  That's one of the reasons they stop taking these meds even thought this action may make their signs and symptoms come back with a vengeance creating a psychotic episode.  They are powerful meds.


STAT News 12/05/2017 - The ‘smart pill’ for schizophrenia and bipolar disorder raises tricky ethical...


"Smart pills” that can track whether or when you’ve taken your medication might be helpful for some people.   . . . .  the first smart pill approved by the Food and Drug Administration, Abilify MyCite, is a drug used to treat schizophrenia and bipolar disorder. That raises tricky ethical issues.


Decades of research and clinical experience support the fact that not taking medicines as prescribed is a significant problem across all domains of medicine.. . . .


There’s no question that mental illness kills people and shortens lives, and that medications can be helpful. . . . . Episodes of psychosis, which are common among individuals who do not take appropriate psychiatric medications, put them in additional danger by actually damaging the brain and increasing the risk of their harming themselves or others.


Sticking to a medication regimen is as important for people with mental illness as it is for those with physical illness. But what makes Abilify MyCite, a high-tech version of aripiprazole, problematic is that it could easily be incorporated into forced treatment, which ignores the values and preferences of people with mental illness. Involuntary treatment has a long and painful history in mental health. Without their consent, people with mental illness can be committed to inpatient or outpatient treatment, and sometimes forced to take medications. Only in the 1970s did the U.S. Supreme Court first address the lack of rights for people hospitalized against their will.


Though common, treatment in spite of objection may be appropriate to protect both the patient and the community. Clinicians and patients struggle to find the right balance of safety and autonomy.


University of Southern California law professor Elyn Saks describes her personal struggle with schizophrenia and its treatment in her powerful memoir, “The Center Cannot Hold.” The book chronicles her efforts not only to find the right medication regimen but also to overcome her resistance to taking medication. She stresses that for any treatment to succeed, clinicians must engage and respect patients and collaborate with them. The best medicine in the world won’t work if the patient doesn’t take it.


The new pill falls right into this struggle. Manufacturers assure us that patients will consent to using it before taking the pill and its tracking device, a tiny bead embedded in the pill. But this smart pill has an obvious allure in the legal arena. For patients with court-ordered treatment or other involvement in the courts, “consent” takes on a different meaning if exchanged for freedom, child custody, or a lighter sentence.


We need to take a hard look at the risks and benefits of Abilify MyCite. It may help some people take their medications as prescribed, but it could also serve as a high-tech form of coercion in psychiatric care. If this new drug is to improve the treatment of people with schizophrenia and bipolar disorder, there needs to be a careful consideration of exactly who will benefit and who could suffer.


Abilify MyCite was approved without any directions for its ethical use.


What's your take on the medical ethics for this "smart pill" tracking device?




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