Discussion: lobotomize the patient or lobotomize the system

Thunderwolf, MSN, RN · Jan 6, 2009

This is why I am a firm believer in lobotomies for those who have been proven to be violent.

It is truly unfortunate that some folks may still hold this archaic view. But if one must point fingers, point the finger where it needs to belong. Much has to do with "the social structures within the community" which have literally fallen apart over the years via the lack of funding and haphazard planning. Indigent folks with mental illness are hit the hardest. Suggesting a lobotomy as something deserving is nothing more than "blaming the victim." The cracks in the system are not only present in our communities, but have become gaping pits all too often. This is the reality. If that is not bad enough, many folks who do go inpatient are often faced with the "revolving door syndrome"...then kicked to the street or returned back to their horrendous environments to fend for themselves. This is just further "insult to injury" IMHO. And lastly, what has contributed to this mess is the over reliance of expensive meds to "fix their problems." There is no magic pill(s). Doubt that there ever will be. And if the patient is priced out for them, what good are they any way? Over relying on meds has only shifted the attention away from the real problem...the crumbling system that the mentally ill have to face on a daily basis. Some counties/cities are much worse than others. The system needs repaired...not the patient lobotomized.

If a nurse wishes to do the most good in psychiatry, Community Mental Health nursing is where one is most needed. As a nurse, you become a multidimentional advocate for your patients. Often times, you also become "one of the bridges" that helps these patients recoup their lives once again...despite all the cracks in the system.

Peace

VickyRN, MSN, DNP, RN · Jan 6, 2009

This is just an aside, but in Eastern NC, one of the most alarming trends is for psychiatric patients with complex psychiatric diagnoses, meds, and plans of care to end up in assisted living facilities without one licensed person on site. There is one such facility in my area which has earned a very negative reputation. The residents are always getting into fights and often end up in the emergency room and/or on their way to Cherry Hospital (the "big" psych hospital in our state) as an involuntary commitment. After a few days, they are let out to return to this facility. The assisted living industry is so underregulated, that that is where many psych patients are ending up.

Jo Dirt · Jan 8, 2009

It is truly unfortunate that some folks may still hold this archaic view. But if one must point fingers, point the finger where it needs to belong. Much has to do with "the social structures within the community" which have literally fallen apart over the years via the lack of funding and haphazard planning. Indigent folks with mental illness are hit the hardest. Suggesting a lobotomy as something deserving is nothing more than "blaming the victim." The cracks in the system are not only present in our communities, but have become gaping pits all too often. This is the reality. If that is not bad enough, many folks who do go inpatient are often faced with the "revolving door syndrome"...then kicked to the street or returned back to their horrendous environments to fend for themselves. This is just further "insult to injury" IMHO. And lastly, what has contributed to this mess is the over reliance of expensive meds to "fix their problems." There is no magic pill(s). Doubt that there ever will be. And if the patient is priced out for them, what good are they any way? Over relying on meds has only shifted the attention away from the real problem...the crumbling system that the mentally ill have to face on a daily basis. Some counties/cities are much worse than others. The system needs repaired...not the patient lobotomized.
If a nurse wishes to do the most good in psychiatry, Community Mental Health nursing is where one is most needed. As a nurse, you become a multidimentional advocate for your patients. Often times, you also become "one of the bridges" that helps these patients recoup their lives once again...despite all the cracks in the system.
Peace

You can get into all the semantics and such, but the bottom line is that it doesn't do the victim of the victim of mental illness any good when they have been attacked and/or murdered.

Of all the sicknesses to have, mental sickness is the worst. I suffer from mental illness, and I have let it be known that if I become a threat or danger to others I would want this (lobotomy) done for me and mostly for the ones who might be at the receiving end of what I might do. Violence is not justified because a person is diagnosed with mental illness. Most criminals suffer some form of mental illness. Perhaps we should turn them all loose in the community and arrange for them to receive mental health services and counseling? Counseling is useless for a sociopath and medications may or may not work for a paranoid schizophrenic.

A lobotomy is not meant as a punishment. The truth is there are some very dangerous people out there and someone will be their next victim. Lobotomies are still done. We had a very combative and unmanageable patient who was sent to the psychiatric facility and came back as meek and cooperative and pleasant as can be. I can't believe someone could have seen how she was before and thought that was her right.

I will never foget the time in high school when I saw a very large special ed student suddenly draw back and nearly slap the teacher through the wall. I can't believe there are people who think that is just a part of the job and we should love and cherish these types instead of blame them. These types are menaces who are not even good for themselves. In certain areas of Europe these people are euthanized because they are considered useless eaters.

Mental illness is sad and unfortunate but if we really think there should be liberty for all whose will you take away to give liberty to the dangerous and violent/mentally ill? Truth is, you can't have liberty for all and you shouldn't.

Sterilization...well, I won't even get into that.

Thunderwolf, MSN, RN · Jan 8, 2009

New thread created from a previous side discussion on a different thread.

This discussion is now moved here for further dialog if needed.

RN007 · Jan 8, 2009

I think this is an excellent thread. I'm taking a bioethics class this semester and will consider this subject as a possible research topic.

NPAlby · Jan 10, 2009

I'm currently working on a MICA unit and have worked in various state facilities as a traveler. From my experience the patient that need the lobotomies are the ones that really wouldnt qualify for it anyway- the personality disorders. It has been those without a true axis I that have been the most frequently violent. Of course I've had patients seriously disorganized that have posed a threat and even tried to choke me. But it has been the antisocials and borderlines that have caused the most havoc on the units.

Rnalby

Jo Dirt · Jan 11, 2009

I'm currently working on a MICA unit and have worked in various state facilities as a traveler. From my experience the patient that need the lobotomies are the ones that really wouldnt qualify for it anyway- the personality disorders. It has been those without a true axis I that have been the most frequently violent. Of course I've had patients seriously disorganized that have posed a threat and even tried to choke me. But it has been the antisocials and borderlines that have caused the most havoc on the units.
Rnalby

It's a shame that doesn't qualify them for the lobotomy. Sociopathy should definitely be considered a qualifier.

It really should.

I know that my uncle had paranoid schizophrenia and my grandmother feared for her safety a lot of times. I think a lobotomy would have made things better for everyone involved.

Whispera, MSN, RN · Jan 12, 2009

Wow, I thought lobotomies went out with all sorts of other torture. I've cared for patients who have had lobotomies in the distant past. In all cases, it was a very sad situation. It makes me cringe to think people still think they are a viable alternative to help people who have psych issues.

Trauma Columnist · Jan 12, 2009

The reason forced lobotomies were stopped was because they were not felt to be effective.

Whispera, MSN, RN · Jan 12, 2009

Many times the ones doing the lobotomy just rammed a rod up a person's nose and kind of twirled it around. Yes, I know that's straight out of a movie, but it WAS done that way sometimes. The other type, where the lobe is surgically removed can cause unintended other-damage.

Quilter0225 · Jan 12, 2009

I cannot believe you are actually advocating for lobotomies. At first I thought it was just a joke in very poor taste. Our mental health system needs a lot of work, I won't argue with that. But look how far we have come. I am the mother of a bipolar child. I thank God every day that he wasn't born 50 years ago, or even 20 years ago. With the help of atypical antipsychotics he is a healthy, normal child. Without these drugs he would be totally nonfunctional, maybe even violent. My hope for others is that there is hope for them, too, in the new research that is going on even now. I know drugs are not the answer to everything, but they sure help! I think you need to consider that these are PEOPLE you are talking about doing forced brain surgery on. I hope you are just feeling discouraged right now and that is what has led you to feel this way, because that means that you can regain some hope.