Using psychiatric diagnosis, treatment or detention for political purposes has been widely alleged all over the world during the twentieth century. Frequently this happens when persons in power are criticized for their corruption, political oppression committed by them, undermining basic human rights or other unlawful activities. Nazi Germany under Hitler and erstwhile USSR (Soviet Union) are the two most infamous instances in this respect. The abuse of psychiatry in Nazi Germany 60 years ago was the ‘abuse of duty to care’. In the case of Soviet Union, things attained such alarming proportion that it caused wide rift between World Psychiatric Association and the All-Union Soviet Society of Neuropathologists and Psychiatrists finally leading to latter's resignation from the WPA in 1983 and conditional return in 1989. It is estimated that approximately one-third of political prisoners in 1970s and 1980s in USSR were locked up in psychiatric hospitals. Even in the US, the country renowned for its professed freedom of speech and expression, an American General Edwin Walker was admonished in early sixties for criticizing President Eisenhower and Kennedy and was forced out of the military. At around the same time, a Soviet General Petro Grigorenko was similarly bundled out from the military for criticizing the state. In both the cases, the generals claimed to be true patriots but were charged with crimes against their state. To discredit their political activities, the sanity of both the generals was impugned and lawyers and psychiatrists co-operated in the process. Political abuse of psychiatry was reported from other socialist countries from Eastern Europe, most notably from Romania. To fight against political misuse of psychiatry, International Association on the Political Use of Psychiatry (IAPUP) was formed, which was later renamed as Geneva Initiative on Psychiatry (GIP) in 2005. Though the political use of psychiatry is less commonly reported in the twenty first century, systemic political abuse of psychiatry is alleged to happen in People's Republic of China.
Although report of such abuse is not common in our country, two cases recently came into limelight in the Indian news media in which psychiatric diagnoses were used for involuntary detention. The cases attracted more public attention due to prevailing atmosphere of resentment against corruption in the backdrop of Anna Hazare's campaign against corruption at high places. A senior police officer from Uttar Pradesh, who criticized the establishment alleging widespread corruption, was admitted in a Government general hospital reportedly on an administrative order for the stated purpose of observation to establish the diagnosis of alleged bipolar disorder. In the second case, a person who publicly slapped a senior Union Minister for alleged widespread corruption was similarly kept under involuntary detention for observation in a Government psychiatric hospital under a judicial order. As we are not in a position to go into the merit of both of these cases, it has to be presumed that our esteemed psychiatrist colleagues have used their professional acumen without any outside influence or consideration. But it must be emphasized that we psychiatrists have to remain vigilant in such cases and strictly adhere to the ethical standards to maintain the dignity and reputation of the profession. All the procedures under the law must be strictly followed and extra precaution should be taken to avoid any deviation from it. Professional skills should be applied in an absolute objective way without any bias and prejudice. Internationally accepted principles must be followed in the process of arriving at any psychiatric diagnosis. Undue influence from the government or the political establishment must not be allowed to play any role in the process.
The Indian Psychiatric Society must remain vigilant in this respect and take appropriate steps in this regard as it is committed to maintain dignity and reputation of the profession. Separate guidelines should be evolved in this respect, which can be of great help in such situations. It should also maintain a vigilant eye on individual cases and should not hesitate to take necessary measure in this regard whatever permitted within the framework of law.
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