You might think that the standard of evidence for justifying the forcing of treatment upon a patient would be higher than that where a patient is permitted to refuse treatment. But it isn’t. It’s lower. In the case of psychosomatic medicine it’s actually no evidence at all. 1/

It is precisely the lack of (or merely insufficient) objective evidence of disease that is taken as evidence FOR a psychogenic illness. And that is the rationale for stripping someone of their agency and dignity and forcing unwanted treatments upon them. 2/

You could be diagnosed with a treatable cancer and decide to forego treatment and you would be well within your patient rights to do so. But if they can’t find that cancer, or whatever it is that is making you sick, that could be grounds for psychiatric commitment. 3/

If this sounds ripe for abuse, it is. It already happens now with #MECFS patients, and unless medicine comes to their senses, it will only be a matter of time before those most severely affected by #LongCovid will be threatened with this too. 4/

As philosopher and bioethicist Diane O’Leary stated in a recent StatNews debate: “choosing a psychological explanation and approach is harmful when it’s a mistake. It’s harmful medically, and it’s harmful psychologically." 5/

Doctors often approve of this, presumably because it provides a way for them to wash their hands of those ‘problem’ patients who just wont get better. 6/

Psychiatrists in particular like this because it helps them maintain relevance in a specialty that has continued to be whittled away, as conditions that were previously viewed as psychiatric are found to have organic causes. 7/

And hospitals like this because condemning someone to inpatient psych care allows them to skirt the liability that comes with denying a very sick patient treatment and sending them home. 8/End

I'm glad so many of you found this thread intelligible. I'm wishing I worded some parts of it a little better. Brain's pretty fried today..