KARACHI, Oct 1: Those psychiatrists who take advantage of the influence they exercise over their patients are seldom brought to justice in Pakistan.
Many psychiatrists grudgingly concede that unethical practices of members of the medical fraternity largely go unpunished. They point out that those psychiatry patients who have reason to believe that they have been abused get no redress in the country.
In addition to a number of laws already on the statute which declare the inviolability of a person’s human rights, the Mental Health Ordinance 2001, which replaced the outdated Lunacy Act 1912 two years ago, devotes a chapter to “protection of human rights of mentally disordered persons.”
Article 52 of the ordinance says: “Any person who carries out any form of inhumane treatment, on a mentally retarded disordered person which includes: trepanning, branding, scalding, beating, exorcizing, chaining to a tree, etc of any such person or subjecting a child to the cultural practice of rendering him mentally retarded, by inducing microcephaly, or subjecting any such person to physical, emotional or sexual abuse, shall be guilty of an offence, punishable with rigorous imprisonment which may extend to five years or with fine extending up to Rs50,000 or with both.”
However, the government has failed to enforce the ordinance in a proper manner. The latest report (2002) of the Human Rights Commission of Pakistan says: “Implementation of the Mental Health Ordinance, promulgated the previous year, remained poor — with limited improvements made in the working of even the institutions that existed to care for people suffering mental health.”
Senior psychiatrist Dr S. Haroon Ahmad, who is also the president of Pakistan Association for Mental Health, told Dawn that a psychiatrist could not have a sexual relationship with his patient. “But psychiatrists have to strike up a close rapport with their patients. This at times makes patients extremely dependent upon their doctors. It has been reported that some psychiatrists have exploited this condition of their patients.”
He added that a patient who felt that he had been abused by his psychiatrist could lodge a complaint with the Pakistan Medical and Dental Council. “Upon the receipt of a complaint, the PMDC initiates an inquiry against the psychiatrist accused of committing unethical practices. Since people have lost faith in the judicial system of Pakistan, few victims bother to pursue their cases. I, for one, have not seen a psychiatrist taken to task for committing unethical practices.”
Psychiatrist Dr S. Ali Wasif said he had seen sane people declared deranged by psychiatrists so that they could be deprived of their property or bequest. “Psychiatrists do this in collusion with family members who offer the doctors inducements. Another malpractice involves liberal use of Pentathol, an intravenous injection under whose influence patients do not remember what is being done to them. In this state of mind, patients have been abused by unscrupulous psychiatrists.”
Psychiatrist Dr Uzma Ambreen, who has treated victims of abuse at the hands of doctors, said quite often patients were hospitalized against their wishes. “A lot of families want psychiatry patients to be hospitalized as soon as possible. They ask psychiatrists to recommend hospitalization even if it is not necessary. A patient should be admitted to hospital only if he poses a threat to himself or to others. Those psychiatrists who recommend unnecessary hospitalization of patients in collusion with families commit a grave malpractice. Similarly those hospitals which admit patients without a psychiatrist’s recommendation are also guilty of unethical practices.”
She pointed out that psychiatrists often asked their well- connected and influential patients for favours. This practice, she added, was so prevalent that it was not even considered unethical.