This can be broken down into
the following elements:
1. Severe physical or mental pain or
suffering
2. Intentionally inflicted
3. For purposes such as:
Obtaining information or a confession
Punishment
Intimidation or coercion
Any
reason based on discrimination of any kind
4. By or at the instigation of or with
consent or acquiescence of a public official
Often people make a distinction between
physical and mental torture. But in reality there is little difference in the
effects on the person tortured because the goal is to break the personality of
the person tortured in order to gain his/her submission to power. Whether
physical means or psychological means are practiced makes little difference in
the ultimate character of what constitutes torture. The long lasting effects of
brutal physical means of torture are mainly psychological. In addition physical
pain is often used to augment psychological means of torture. The result is the
same, a breakdown of the person's perception of self, a disintegration of their
individual personality and destruction of their self will.
What is Torture of a Disabled Person?
The torture of prisoners was one of the
early concerns of human rights defenders such as the use of medical
examinations during police interrogations. But torture does not only apply to
those who are prisoners of war but also to all persons who are kept imprisoned,
including those in mental health institutions, and rehabilitation treatment
centers where disabled, children and elderly persons are detained, isolated
from the outside world and dependent on their captors.
In an Annex IV to the UN Declaration of
Human Rights of the Disabled, Theresia Degenerstated "It is no secret
that the most vulnerable members of society are most likely to be affected by
torture and ill treatment. While the average non-disabled white man is only
vulnerable when deprived of his freedom and weapons, most persons with
disabilities are vulnerable everywhere and at all times."

Ill treatment of disabled persons has routinely occurred due to
the prevailing medical model of disability. Because within the context of the
medical model of disability human rights violations can be disguised by medical
treatment, torture and ill treatment are legitimized or ignored by seeing the
disabled person as a problem not as a right holder. The standard belief held by
many in the medical community is that the disabled person is the
"problem" thus sees medical intervention as the solution which is
imposed from outside on the disabled individual and often times
without patient informed consent. The current prevailing medical model sees the
"problem" of disability within the person and sees the solution as
medical intervention (often forced). Instead the human rights model is willing
to locate the "problem" outside the individual and recognizes the
possibility of torture and ill-treatment of disabled persons must be guarded
against. It will take a considerable change in attitudes to embrace this
paradigm shift from the medical model to the human rights model of disability.
Nonconsensual psychiatric and medical
interventions have been contemplated as torture or cruel, inhuman or degrading
treatment in treaty negotiations and by U.N. Special Rapporteurs. United
Nations Consultant, Theresia Degener, states in her Recommendations
to the Special Rapporteur in Annex IV to state that "Today we have
heard about the atrocities which happen worldwide to persons with disabilities
in- and outside of institutions. We have heard that torture and cruel, inhuman
and degrading treatment may result in impairments, may aggravate existing
impairments and that torture and similar forms of treatment may take different
forms when it comes to the treatment of disabled persons."
Torture is never acceptable. The physical
scars of torture are not as damaging in the long run as the psychological scars
which last a life time. It is a highly effective means of controlling
populations: torture destroys leaders, disintegrates opposition and terrorizes
communities. Torture is not an effective means of interrogation and does not
yield useful or truthful information in prison interrogations or in psychiatric
evaluations. The goal of torture is actually to cause the integrity of a
person's personality to disintegrate and to make the person submissive to the
persons in power. Discrimination against the victim of torture contributes to
dehumanizing the victim, and can make victims less credible or not fully
entitled to equal protection in the eyes of police or other authorities to whom
they might complain for redress. Thus psychological torture can be used to
silence those who are whistleblowers and raising legitimate concerns about
social and governmental problems.
Personal accounts attest to long term
life altering effects of both physical and mental pain and suffering caused by
nonconsensual administration of neuroleptic drugs, electroshock, and other
psychiatric interventions, when it occurred and for a long time afterwards. The
Inter-American
Convention to Prevent and Punish Torture goes the farthest of any human
rights instruments in directly prohibiting the use of these techniques aimed at
the disintegration of the personality or reduction of physical or mental
capacities, which would include psychotropic drugs and brain-damaging
procedures like electroshock and psychosurgery. [iv]
In the Recommendations in Annex IV
Theresia Degener states "Thus, we may conclude that there are two
typical categories of torture and ill treatment with respect to persons with
disabilities. The first could be called torture through medicalization of
inhuman and degrading treatment, the second could be called torture through
neglect."
A medical diagnosis or impairment as
such should never be a legitimate ground for forced intervention, treatment or
detention. The
Committee of the Disability Rights Convention (CRDP) encompasses such a norm
in Article 14 where it says "that the existence of a disability shall
in no case justify a deprivation of liberty." This is a very
important normative standard to be implemented in psychiatric and other
facilities. A human rights model of disability demands that forced intervention
should not be made merely on a medical diagnosis but instead on the behavior of
the individual patient. Nondisabled persons by law usually have recourse to the
courts and thus judicial review of their case if subjected to detention or any
form of forced intervention.The normative standard in Article 15 (2) of CRPD
demands that prevention of persons with disabilities from being subject to
torture or cruel, inhuman or degrading treatment or punishment shall be
"on an equal basis with others." Thus to provide disabled persons
with full and equal human rights protection there needs to be checks and
balances in the control of the executive branch as well as full investigation
of any violation of human rights law.
Mind-control techniques, including the
use of chemical substances,[v] have been used
increasingly by those who do torture. Some of these mind control substances
have permanent debilitating consequences on the prisoner/patient. Neuroleptic
drugs can have an effect of perception that causes loss or separation from
self, causing terror and panic that may lead to desperate acts such as homicide
and suicide. [vi] Neuroleptic drugs
have the signature effects EPS (extra-pyramidal symptoms)[vii] such as psychic
apathy or numbing and movement disorders such as akathisia [viii] (extreme
restlessness and agitation) with a psychological as well as physical
manifestation. Akathisia [ix] can be described as
a severe overwhelming sense of gloom and anxiety, an inability to sit still, an
intense sense of restlessness and even an almost indescribable sense of terror.
When this problem is visible it can manifest itself as a shifting of weight
from foot to foot, walking around in the same spot or inability to keep the
legs still. This can and is in clinical settings often mistaken for psychotic
agitation which then may result in an increase in the dosage of neuroleptic
medication thus leading to suicide and homicide. In addition the neuroleptic
medications can cause a dysphoric mental state which causes a paralysis of
will. So it is no surprise that governments have used these drugs to subject
political prisoners to their will and through the effects of mind altering
chemicals forced captives to obey them. These drugs can be used make captives
sign fabricated statements and to force compliance in video interviews of false
confessions. Neuroleptics can also cause a variety of "tardive"[x] or late-appearing
syndromes, particularly movement disorders that are frequently irreversible. [xi] Tardive dyskinesia
is a neurological syndrome caused by the long-term use of neuroleptic drugs,
characterized by repetitive, involuntary, purposeless movements. Symptoms of
tardive dyskinesia may remain long after discontinuation of neuroleptic drugs.
Overcoming of resistance by intimidation or physical force in order to
administer such substances against a person's will, can only be seen as a
hostile act, within the meaning of intentional infliction of severe mental or
physical pain or suffering. [xii]
Within the context of nonconsensual
psychiatric interventions, there is loss of liberty and the length of detention
is indeterminate and may depend on one's apparent compliance with arbitrary
standards. Persons may be taken in their late teens or early twenties, before
they have had a chance to experience their full adult powers and competencies,
and thus be able to exert their constitutional rights and advocate for their
human rights. Sometimes they were involuntarily detained while they were in the
midst of intense psychological experiences, and thus the additional suffering
caused by psychological mistreatment and torture can be unbearable. The
destruction of a person's identity, self-concept, personal relationship to the
world, and their inner subjective experience, may be a process of growth when
embarked on by choice. But personality change forced by powerful mind altering
drugs imposed by another person, is a violent and extreme human rights
violation irrespective of the rationale of the perpetrator. This can lead to
patient suicide.
For users and survivors of psychiatry,
the disclosure of nonconsensual interventions may itself lead to greater
discrimination, including the risk of additional periods of incarceration and
forced interventions. So silence blankets this routine abusive treatment and
leads to continuation of the practice. In addition the elderly, physically
disabled and those with cognitive impairments are often captive to their care
givers and are thus particularly vulnerable to violations of their human rights
especially when these violations are presented as "medical
treatment". The involuntary use of psychotropic medications for restraint
and control is common. These drugs have been used to allow nursing homes to
decrease night time staffing levels by administering drugs to all the patients
to keep them in their beds and to prevent evening demands on the nursing staff.
This use of drugs for the convenience of nursing staff, or to increase the
profit margin of a nursing facility, constitutes a violation of the human
rights of the patients. Many individuals have strong feelings and beliefs
against the use of psychotropic medication and thus their use constitutes a
violation of their constitutional right to religious practice and belief.
There needs to be two forms of legal
protection against torture or ill treatment:
1.
Review and control of medical action
Where the medical doctors sufficiently
independent and unbiased in their prognosis and diagnosis?
Is the medical diagnosis correct?
Based on the behavior of the patient is
the detention and coercion truly necessary?
Has the coercion and detention been
reviewed by an outside human rights expert to have been necessary?
2. Provision of reasonable accommodation
- Prevention of neglect
Effective prevention requires
elimination of conditions that give rise to or facilitate nonconsensual
psychiatric interventions. This means such actions as deprivation of liberty
and loss of control over personal decision-making, and bundling of services that
requires individuals to choose between accepting unwanted psychiatric
interventions and losing a home or losing services that are wanted.
Our obligations to human rights also
extend to reparations, [xiii] which
have both an individual and a collective dimension. Individuals may require
compensation, restoration of previous status and possessions, to the extent
possible, and rehabilitation (meaning recovery and reintegration services in this
context).
Thus this discussion regarding torture
is important to every person, as each of us are vulnerable to exploitation and
abuse within the medical system if there are not adequate safeguards to prevent
it. Please see the following references for further information:
[i] http://www.unhchr.ch/huricane/huricane.nsf/view01
/F4CE93317605BF3BC12572A50055EE03?opendocument
[ii] Charter of
Fundamental Rights of the European Union art. 3, 2000 O.J. (C 364) 1, 9.
Article 3 reads in full: Right to
the integrity of the person
1) Everyone has the right to respect for
his or her physical and mental integrity.
2) In the fields of medicine and
biology, the following must be respected in particular:
the free and informed consent of the
person concerned, according to the procedures laid down by law, the
prohibition of eugenic practices, in particular those aiming at the selection
of persons, the prohibition on making the human body and its parts as such a
source of financial gain, the prohibition of the reproductive cloning of human
beings.
[iii] Convention
Against Torture, and Other Cruel, Inhuman or Degrading Treatment or
Punishment, G.A. Res. 39/46, at 1, U.N.
Doc. A/RES/39/46 (Dec. 10, 1984) [hereinafter CAT].
[iv] Andrew Byrnes, Torture
and other Ofenses Involving the Violation of the Physical or Mental Integrity
of the Human Person, in SUBSTANTIVE AND PROCEDURAL ASPECTS OF
INTERNATIONAL CRIMINAL LAW 214 (Gabrielle Kirk McDonald et al. eds.,
2000).
[v] David Cohen, A
Critique of the Use of Neuroleptic Drugs in Psychiatry, in FROM
PLACEBO TO PANACEA: PUTTING PSYCHIATRIC
DRUGS TO THE TEST 202 (Seymour Fisher and Roger P. Greenberg, eds., 1997).
[vi] Healy D,
Herxheimer A, Menkes DB (2006). "Antidepressants
and violence: problems at the interface of medicine and law". PLoS
Med. 3 (9): e372. doi:10.1371/journal.pmed.0030372.
PMID 16968128.
[vii] Canadian
Movement Disorders Group, Drug Induced Movement Disorders: Neuroleptic
Malignant Syndrome, http://www.cmdg.org/Movement_/drug/Neuroleptic_Malignant_Syndrome/neuroleptic_malignant_syndrome.htm
[viii] Akagi H, Kumar
TM (2002). "Lesson
of the week: Akathisia: overlooked at a cost". BMJ 324
(7352): 15067. doi:10.1136/bmj.324.7352.1506.
PMID 12077042
[ix] Szabadi E
(1986). "Akathisia--or
not sitting". British medical journal (Clinical research ed.)
292 (6527): 10345. doi:10.1136/bmj.292.6527.1034.
PMID 2870759.
[x] National
Institute of Neurological Disorders and Stroke, NINDS Tardive Dyskinesia
Information Page http://www.ninds.nih.gov/disorders/tardive/tardive.htm
[xi]
Dystonia fact sheet: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm
[xii] Tina Minkowitz
,The United Nations Convention of the Rights of Persons with Disabilities
and the right to be free from nonconsensual psychiatric interventions,Syracuse
J. Int'l L. & Com.,Vol. 34:405-428 http://psychrights.org/Countries/UN/TMinkowitzOnNonconsensualPsychInterventions.pdf
[xiii] Basic
Principles and Guidelines on the Right to a Remedy and Reparation for Victims
of Gross Violations of International Human Rights Law and Serious Violations of
International Humanitarian Law, Human Rights Res. 2005/35, U.N. Doc.
E/CN.4/RES/2005/35 (April 19, 2005).
"Happiness is that state of
consciousness which proceeds from the achievement of one's values."
Ayn Rand 1905 - 1982, US Russian-born
novelist