"...Whether true or not the fact that the patient is in litigation and being treated in the same hospital is a conflict of interest." A recollection of the words of a Justice of the Supreme Court of Victoria, Australia. 2008
The acronym HREC is an interesting one for it stands for Human Rights and Ethics Committee.
Here is an extract from Ethics Committee Approval Collaborators.
"The Alfred- Karen Hirth et al; Austin Health-Dr. James Oliver ; Southern Health - Dr. Saji Damodaran; Thomas Embling- Dr. Ann Brennan; Eastern Health- Assoc.Prof.Paul Katz;Peninsula Health - Dr. Sean Jespersen; et al..."
"A case-control study to identify risk factors for myocarditis with clozapine.
Sixty nine days strapped to a bed... a Monash University Teaching Hospital. This surely would not have ethics approval would it? Is this possibly in violation of the International Covenant on Civil and Political Rights?
Is public service psychiatry in the State of Victoria Australia in a state of anarchy? The new
Mental Health Act 2014 (Vic) would appear to negate this assumption. There is a Mental Health Tribunal which is automatically triggered when a patient is admitted and placed under a Temporary Treatment Order (TTO) and reviews that patients status.
It is assumed that this process is there to monitor and oversee the well-being of the patient, review the criteria for inpatient status and where a question of law arises under the Mental Health Act 2014 (Vic) adopt the following protocol:-
Section 196 Questions of law.
"A question of law ( including a question of mixed fact and law) arising in a proceeding before the [Mental Health]Tribunal must be decided by the presiding member".
Section 197 Referral of question of law to Court
"...(2) A referral may be made ...on application of a party to a proceeding before the Tribunal..."
WHAT IF, a presiding member decides to answer a question of mixed fact and law without recourse to the Trial Division of the Supreme Court? WHAT IF the President decides that questions of law have never before been referred to the Supreme Court?
Does this imply that the Tribunal may act Judicially? Can the President of the Tribunal rule on a question of law simply because "that" particular question is believed to not invite interpretation by the Trial Division of the Supreme Court? Conversely...
..".(3) If a question of law has been referred to the Trial
Division of the Supreme Court, the Tribunal must not-
(a) make a determination to which the question
of law is relevant while the referral is pending; or
(c) proceed in a manner or make a determination
that is inconsistent with the opinion of the the
Trial Division of the Supreme Court on the
WHAT IF, such circumstances where the interpretation of a question of mixed fact and law is not referred? What could be the likely implications for the patient where the request is denied? Does this require a Writ of Certiorari or an Originating Motion? Who pays? Who suffers? These scenarios are worth exploring... for it is quite possible for this to occur.. or is it not?
The Mental Health Tribunal may explore these scenarios as such a situation under the current legislation is possible.
2015 - Upton House Box Hill Hospital
In a period out of restraints Garth Daniels was without
provocation attacked by patient with a knuckle duster
(metal instrument) ... Garth Daniels right forearm was broken.
The immediate assumption was that Garth Daniels initiated the incident and as a result Garth Daniels was again strapped to the bed.
Garth Daniels left little finger was also broken... surgery took place several days later. It was also later established that the other "patient" perpetrated the assault and was subsequently discharged from the ward.
In attempts to reduce the feelings of inner restlessness and to attempt to scratch himself... a result of the allergic reaction of the Clexane/Fragmin ( causes Garth's to itch)... movement restricted so the scars on the forearm reflect pressure of the restraints on the skin.
Of course, the paradox is that the restlessness appears to be interpreted as an emergence of psychosis "exacerbating" "aggressive" and "violent behaviour...". Spitting at staff and screaming at them and verbal abuse... How else do you prevent yourself from being further frustrated...?
No mention of Akathisia possibly attributed to intra-muscular injections of Zuclopenthixol (decanoate) or similar compounds of Acuphase (clopixol), is there?
[ actual photographs]
Acuphase seems to be paradoxical in that it was administered to Garth presumably to promote sleep and reduce anxiety but appeared after frequent administration to create an inner restlessness ... (inability to sit still)in clinical terms defined as Akathisia.
Criteria for compulsory treatment. Chronic schizophrenia, treatment resistance ... [not resistant ]noun the refusal to accept or comply with something... the criteria for Clozapine is to be TREATMENT RESISTANT. The label "treatment resistance is used particularly to refer to patients whose positive symptoms of schizophrenia ( including delusions and hallucinations have not responded to treatment. Medical Journal of Australia).
Pantelis C, Barnes TR. Drug strategies and treatment resistant schizophrenia. Aust N.Z.J.Psychiatry 1996; 30:20-37 [Pub.Med]
Kane J.M. Treatment restant schizophrenic patients. J.Clin.Psychiatry 1996;57 (suppl.9); 35-40 [Pub.Med]
So, therefore, Garth Daniels does not eet criteria for "treatment resistance"... Garth is not currently psychotic, deluded and hallucinating...
... in a meta analysis, clozapine rated above other second generation anti psychotics on two out of three measures of efficacy plus overall symptoms and was second only to AMISULPRIDE ... for quality of life ( Leucht et al 2009).
N.B. Garth Daniels is currently on 300mg Amisulpride ( mono-therapy ).