Moral Theory and Medical Practice - Essay Example

Mental health essay Customer Inserts His/Her Name Customer Inserts Grade Course Customer Inserts Tutor’s Name 1st October, 2010 Girl, Interrupted (2005): Synopsis of the Movie In this movie, Susanna Kaysen, an eighteen year old lady who takes herself to Claymoore Hospital after an overdose of aspirin and ends up staying there for a year. Though accusations from many say that she was trying to commit suicide, she denies it. She befriends fellow patients and forms a group of troubled women in her ward. Lisa befriends Susanna after realizing that one her good friend had taken her own life away through suicide. Susanna’s boyfriend, Tobias, comes to visits her, His intention being to convince Susanna to join him and run away to Canada but Susanna declined. Polly, one of Susanna’s fellow patients, reflects on her own unattractiveness and starts screaming. Lisa and Susanna later console her. The next morning, Susanna is analyzed again and was diagnosed with borderline personality disorder (Murphy, 2006). Lisa is also taken in to see the doctors but never returns. This sends Susanna into depression. Lisa returns and together with Susanna, they break out of Claymoore. They had their night out at Daisy’s house, Daisy who had recently been released but whom Lisa thought was normal. The following morning, Daisy hangs herself after being accused of having sex with Lisa’s father. Lisa runs away but Susanna later calls the police. She adopts Daisy’s cat. After some days of refusal to adhere to her therapy and even refusal to take medicine, she suddenly began to behave well and cooperated responded to her therapy. She was then scheduled to be released. At this point, Lisa was caught and returned by the police where she now targets to ridicule Susanna and abuse her emotionally. With this pending dispute, Lisa threatens to stub herself with a hypodermic needle. Lisa was suffering from nervous breakdown. Susanna and Lisa later reconcile. Susanna is released the next day. Before she leaves; she visits Lisa and talks to her again. The movie ends with Susanna reconciling with the rest of the patients and away she goes. Signs and Symptoms of the Highlighted Mental Disorders Mental health is a level of cognitive and emotional wellbeing, or simply absence of mental disorder. Mental illness is generally defined as disturbances of thought, experience, and emotion, serious enough to cause impairment in people functionally, which eventually makes it difficult for them to maintain and sustain relationships and carry this to their work places resulting in destructive behaviour and eventually suicide (Alexander, & Sillen, 1998). These mental disorders can cause serious disabilities (Szasz, 1999). From the movie Girl interrupted, Susanna took an overdose of aspirin. It can not actually be ascertained whether it was a mistake or she was actually committing suicide. Moreover, more than one case is seen. Daisy commits suicide out of her emotions in reaction to what Lisa accuses her of. Mental illnesses can be classified depending on the conditions. There are questions of concern and are primary. These questions include; In the future, will professionals be able to classify mental illnesses according to their causes, just as it is in medical fields? Since it mental illnesses are classified on symptomatic grounds, rather than the causes, are their reasons to assume that our current diagnostic categories correspond with natural kinds? Is it possible for all classification schemes to be purely scientific? Therefore it can be concluded that, mental illness is a disorder. A condition is normally a disorder if; if the conditions deprives one of the benefit to the person if judgement of a person’s culture (Mele, 1996).There are principles and assumptions that are normally made in the entire analysis and study of mental health (Edwards, 1997). For instance, an examination of the brains all day by whatever means chosen can be conducted, but it cannot be concluded that someone is a drug addict unless he acted like a drug addict (Leshner, 1997). Leshner (1997) also asserts that, “The nature of the mental illness is normally the basis of the diagnosis and that the brain is depicted as the main culprit in mental illness, according to current thinking”. According to The Surgeon General (1999) Pharmacotherapy has been used for mental illness and has been proven effective. Pharmacotherapy has therefore been exaggerated in a way that all the trust is given to a drug which may fail to work, and will certainly not cure the disorder involved. An organism is healthy at any moment. A disease is an internal state of this organism that interferes with its performance of some natural function characteristic of its age. (Bolton, 2008) According to Murphy (2006), “there has always been a big debate about the causes and treatment of borderline personality”. It could be one of the disorders Susanna was suffering from. Many say it’s linked to childhood experiences such as abuse. Moderate claims are that multiple personality is not a separate case, but rather an unusual form of familiar disorders such as manic depression, schizophrenia or borderline personality disorder (Engel, 1977). Philosophers have discussed a number of these mental disorders. Current Prevalence of the Condition of the Mentioned Disorders Borderline personality disorder: This is a disorder that is characterized by ingrained and patterns of inflexible, maladaptive or antisocial behaviour. This personality disorder is not strictly illness, since it does not involve the disruption of emotional, intellectual or perceptual reasoning. In most cases, someone does not seek to be treated unless he or she is pressurized to do so. In the above mentioned movie, Susanna actually took herself, out of choice, to seek treatment. Persons with this disorder usually accept their condition. The causes of this particular disorder are unknown, though there are hereditary elements involved. Personality traits are to greeter extent permanent by definition and therefore personality disorders are only partially amenable to treatment. The most effective treatment combines various therapies which include behaviour therapy, rehabilitation therapy and occupational therapy. Palliative care is also done hand in hand with the above therapies in order to alleviate periodic anxiety, depression and emotional instability among others. Depression, another diagnosis in mental health that has also been revealed in the movie, is another mental disorder. In general psychology, depression is marked by a mood or emotional state that is marked by feelings of low self-esteem or guilt and a reduced ability to enjoy life. A person who is depressed usually experiences most of the following symptoms; feelings of sadness, hopelessness, pessimism, lowered self-worth, slowness of thought among others. Depression is twice prevalent in women than in men. The typical age of onset is in the twenties but it can occur at any age. The course of the disorder is variable from person to person; it may be mild, severe or acute. Psychosocial issues that may have impacted on the individual: In my particular case study, Daisy is a victim of depression which eventually leads to her committing suicide. Depression can have many causes. Unfavourable life events can increase a person’s vulnerability to depression. Negative thoughts about one-self are also important in producing and maintaining depression symptoms. Depression can be treated using psychotherapy and psychotropic medication, specifically antidepressants. According to National Institute of Medical Health (1988) “Mental illness affects one in every four United States of America’s families”. A further, 2.8 percent (1.5 million) of adults in the United States have some type of mental illness. (National Advisory Mental Health Control, 1992) According to the World Health Organization, twenty five percent of individuals develop some mental disorder at one stage in life. National Advisory Mental Health Control, (1992) also indicates that, “Today, 450 individuals suffer from mental disorders in both developing and developed nations”. These illnesses do not discriminate; they can affect anyone at any given time. Mental illnesses represent 5 out of 10 leading causes of disability. According to the world health organization, “Mental disorders have great economic implication and that the disorders have led to increased poverty especially in developing countries and created a huge burden to governments and families. Psychosocial issues that may impact on their family, friends and their workplace: Negative attitudes towards mental illness have been existence throughout history. The society in general has rejected persons with mental illness at one point. Mentally ill patients have been faced with adverse discrimination especially in the society and when they visit the outpatient hospital services. This negative attitude affects the possibility of employment of these individuals with mental illness. Many of them have the ability to contribute to society. Some of them already have job skills. The whole circle of discrimination, whether direct or indirect may be due to perceived cause of disability. Rubin and Roessler, (1995) suggested that, “the willingness of the society as a whole to carter to the needs of persons with disability is as a result of factors such as the socio-economic & socio-cultural philosophy which is depicted in the way the communities perceive the mentally challenged and sick”. Treatment Modalities of the Two Disorders Borderline personality and depression disorders can be treated in a number of ways. 1. Use of Mood stabilizing drugs: These disorders can be treated using antidepressants such as Elavil and Prozac. These drugs treat major depressive illnesses and take only three weeks to take full effect. They have related side effects which range from dryness of the mouth, gain of weight to drowsiness. They are non-addictive. Mood stabilizing drugs can also be administered. They alter the normal functioning of neurotransmitters. The most commonly known is Lithium. Another treatment for mental illnesses includes anti-anxiety drugs. They lessen the level of anxiety which normally causes some mental disorders. They are similar to CNS depressants. They include Xanax and Serax 2. Administering Behavioural therapy: this is a supported treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underline such thinking. For instance, a person who is depressed may feel worthless. Behavioural therapy has demonstrated its usefulness to a wide variety of problems, including personality disorders, mood disorders, and substance abuse disorders among others. With a therapist’s help, the individual is encouraged to view such beliefs as hypotheses rather than facts. 3. Conducting an Occupational therapy: this is also used to help patients with mental disorders by providing them with the tools needed to live as independently as possible. This kind of therapy focuses on issues such as employment, community involvement and managing medications among others. This therapy can also help patients control their feelings. 4. Administering a Rehabilitation therapy: A majority of severely mentally ill people would like to work and there are compelling ethical, social and clinical reasons for helping them to achieve this goal. Pre-vocational Training and Supported Employment are two different approaches to helping mentally ill people obtain recovery. Ethical Issues That Were Raised For the Treatment in the Case Study The scenario in the movie girl interrupted depicts an ethical issue arising from the treatment of the patients. There is gross loss of patients freedom during he course of treatment which is seen in the way the ward are organized in order to restrain the patients and expose the patients to doctors and health workers scrutiny at all times. Due to the frequent checks by the nurse at short intervals the patient is essentially placed in public which brings out a reality of violation of patients privacy which is an ethical issue. Promotion &Prevention of Mental Health Universally there are so many ways in which people can prevent or cope with metal illness or disorders. Each individually should be a beneficiary from the possible measures so as to promote their mental health and prevent mental disorders. This includes mental health promotion efforts and mental disorders prevention efforts. This can be implemented through promoting behaviours that contribute to enhancing and maintaining mental well being. It can also be done through finding out and initiating appropriate corrective measures to do away with the causes of the disorders. Everyone has a right to accessing basic mental health care. This care should be offered in a better way in order to protect the dignity and privacy of the patient, it should be able also to give accurate and correct diagnosis and treatment aimed at reducing the impact of the disorder and enhance the general life of the patient. The care should also be affordable. Mental health care should also be available on voluntary basis. This can be implemented through; having a specific provision in the law that guarantees quality health care. Mental health care should be offered ensuring that it is culturally acceptable. Private health insurance systems should be enhanced in order to assist the government initiatives in addressing the health issues of the mentally challenged and sick. Above all, this mental healthcare should be geographically accessible by making it closer to the patients and having appropriate drugs. Mental health assessments should be done in line with internationally accepted best practices and principles. This includes diagnosis, choice of treatment, determination of competence, determination that one may cause to self or others as a result of mental disorders. This could be done by promoting clinical training in the general use of internationally accepted principles. Persons with mental illnesses should be provided with medication that is least restrictive. This will depend on the disorder involved, the available treatment, the patient’s level of autonomy, the patient’s acceptance. This could be done through training health care personnel. It can also be said that there are delusions about mental disorders. Many say that mental illnesses are all associated madness among other. Mental illnesses are not sickness. They are just disorders which include the feelings and thoughts in our minds. Consent is required before interference with a person can occur. Interference could be bodily and mental integrity. Health care providers should not therefore consider a patient to be unable to make decisions. Mental illnesses consequentially lead to a number of issues. Statistically, mental illness is the attributing case of suicide. And it is true that suicide causes more deaths that war worldwide. Mental illness leads to poverty. This is because of the huge cost that comes with it. It also makes the individuals who suffer from these conditions to loose productivity in the society. As far as mental health is concerned, it is now possible conclude that, mental health has everything to do with the mind. It has its building blocks in the brain of the individual. Using the case study, it is easier to comprehend how the mind works differently in different individuals and thereby resulting in different behaviour that in most cases affects the victim negatively. Some people see life as a battle, but others see it as an adventure. How individuals think, act and cope with life is what positions us as being healthy mentally. This will eventually determine how people handle stress. It can also be deduced that everyone feels worried, anxious and stressed sometimes. With a mental illness, such kind of state and feeling is permanent and it becomes part and parcel of an individual who has the condition. It is therefore crucial that people see psychiatrists when necessary. Even with the numerous strategies that are underway to deal with mental illnesses, its hard to shy away from the fact that our mind is the real cure of all these disorders. References American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association. Edwards, R. B. 1997. Ethics of Psychiatry: Insanity, Rational Autonomy, and Mental Health Care. Amherst, NY: Prometheus Books. Engel, L. 1977. “The Need for a New Medical Model: A Challenge for Biomedicine.” Science, 196, 129–136. Fingarette, H. 1988. Alcoholism as a disease, Berkeley. California, USA: University of California Press. Fulford, K. W. M. 1989. Moral Theory and Medical Practice. Cambridge, UK: Cambridge University Press. Ghaemi, S. N. 2003. The Concepts of Psychiatry: A Pluralistic Approach to the Mind and Mental Illness. Baltimore: Johns Hopkins University Press. Jellinek, E. M. 1960. The Disease Concept of Alcoholism. New Haven: Hill house. Kleinman, A. 1988. Rethinking Psychiatry: From Cultural Category to Personal Experience. New York: Free Press. Leshner, A. 1997. “Addiction is a Brain Disease, and It Matters.” Science, 278: 45–47. Mele, A. R. 1996. “Addiction and Self-Control.” Behaviour and Philosophy, 24: 99–117. Murphy, D. 2006. Psychiatry in the Scientific Image. Cambridge: MIT Press. Szasz, T. 1999. The Myth and reality of Mental Illness. New York: Harper and Row. Alexander, T. and Sillen, S. 1998. Racism & Psychiatry. New York: Citadel Press. Thornton, T. 2007. ` Essential Philosophy of Psychiatry. Oxford, UK: Oxford University Press. Warner, R., 2004. Recovery from Schizophrenia: Psychiatry and Political Economy. New York: Routledge. Read More