29/05/2014

立法委員、明星、醫師、宗教、人道或人權狂熱份子對醫學的偏執或誤解

立法委員、明星、醫師、宗教、教育界、人權狂熱份子對醫學的偏執或誤解

美國哥倫比亞大學精神醫學知名教授 Jeffrey Lieberman 曾是令人敬重的美國精神醫學會會長,他批評美國明星,例如 Jenny McCarthy 及 Tom Cruise,不考慮自身在醫學上的無知,利用其娛樂天分產生的高知名度,大談「反疫苗」、「反精神醫療」、「反過動症」,危害之深,恐怕不是他們自己可以想像的程度。

曾獲兩次Pulitzer Prize、令人敬重的New York Times 專欄作家Nicholas Kristof,也多次發表「兒童過度用藥」的文章 Drugs,Greed and a Dead Boy。文章雖然主要攻擊藥廠的貪婪,沒有直接攻擊精神科醫師,但以他在新聞界的高聲望、並舉出強而有力的個案悲劇,文中他對精神醫療的偏見和誤解,以及過去為山達基辯護的文章,恐怕仍會被廣為認同。

反(精神)醫學人士背後有部分人士是為了牟得私利,但更多出來留言、攻擊、吸引注意力的則常常是一些本人或親友就醫受過創傷者、或曾聽聞「精神科醫師專業能力不足或沒有拿捏利益衝突的分際」的「熱心人士」,其中常有立法委員、明星、醫師、教師和心理師等眾多名人投入,台灣幫忙過動症的兒童精神科醫師首當其衝。即使他們的訴求並不一定理性,但他們的情緒強烈,且親身經驗常常具有說服力。這些「知識份子」動機各有不同,但是造成的傷害是類似的,即「造成民眾拒醫、懼醫和仇醫」,造成病患更嚴重誤導和巨大傷害。

台灣也有許多偏見強烈的宗教人士、教育人士、知名教授,大肆評論「很多ADHD都是誤診、ADHD過度用藥、精神科過度診斷」等灑狗血的「熱心呼籲」,引發許多專業人士、精神科醫師和病患照顧者的憤怒。事實上,所有人不管是內行或外行,都自有一套對精神疾病成因的看法,對正規的精神治療也有不同程度的懷疑(民眾在內外科疾病方面比較不會有這類主觀的偏見)。就是因為太多無所不在、自我膨脹的「假專業人士」自以為是地「誤診」或「誤不診」,所以ADHD、憂鬱症等精神疾患,「一定要求助精神專科」!

反醫學可以造成民眾「拒醫、懼醫和仇醫」,造成嚴重誤導和巨大傷害。面對錯誤的精神醫學資訊和反精神醫學,如果沒有公開的立場、聲明和澄清,病患大眾就可能受到錯誤訊息的傷害。雖然有很多熱心的專家雖然會去投書澄清,但力量很小,建議學會成立「專屬網站刊登正式、公開的制式聲明」,整理會員投書條列澄清,拜託媒體定期報導。我們自己(會員)和其他媒體如果有興趣報導就可以直接轉貼。




以下為Jeffrey Lieberman 聲明全文




Hello. This is Dr Jeffrey Lieberman of Columbia University, speaking to you today for Medscape.

The title of my comments could be "When Celebrities Speak Out About Scientific Issues in Health and Illness." This is prompted by the recent outbreak of measles in the United States, which appears to be tied to a lack of getting vaccinations in accordance with US public healthcare standards.

The current measles outbreak seems to be occurring not among poor people or destitute people or people who don't have access to healthcare. It appears to be occurring across socioeconomic strata, and particularly in areas of high education and high socioeconomic status.

What is that all about? It seems that it is related, at least in part, to the criticism and the public accusations of celebrities about the potentially deleterious effects of vaccinations for infectious diseases, particularly as they may be a risk factor for and cause of autism and neurodevelopmental disorders.

If you don't know by now, I am referring specifically to Jenny McCarthy,[1] who has been an antivaccine spokesperson and is against mercury,[2] either thinking that it is the vaccine or the mercury-containing organic compound thimerosal, a preservative used in vaccines, that is the cause of such developmental disabilities as autism.

It demonstrates the fact that some celebrities who gain their prominence by dint of their artistic talent as entertainers then use that notoriety to speak on subjects that they may be interested in, but for which they don't necessarily have a very substantial or accurate knowledge base.

In regard to Jenny McCarthy, I think this is clearly the case. She has no idea what she is talking about. What she said is misleading and harmful, and the measles outbreak is a clear indication of the response to the spread of such pseudoscientific myths.

We have seen other cases like this. Another celebrity, Tom Cruise—probably in purveying the propaganda of Scientology—denies the existence of mental illness. Many people can remember his display on national television as he derided Brooke Shields for her postpartum depression.[3]

Scientology cannot abide the existence of mental illness because it conflicts with the Dianetics philosophy. So its adherents, such as Tom Cruise, have to speak out against the idea of mental illness.

Don't get me wrong: I don't want to say that all celebrities' comments on subjects related to health and science are inappropriate or uninformative. There are many instances where there has been a vastly positive effect. In fact, when people who have fame and visibility speak out about illness, about the need for research, and particularly about mental illness, it is enormously helpful because it humanizes it for the public.

We have good examples of this, such as Glenn Close, who has been very visible in talking about the illness in her family—her sister's depression and bipolar illness, and her nephew's schizoaffecttive disorder.[4]

Patrick Kennedy, who is a celebrity of sorts, coming from the prominent political Kennedy family, has talked about his own experience with addiction and mood disorder.[5]

Bradley Cooper, who played a wonderful role in Silver Linings Playbook, has become an advocate for mental illness[6] because of his experience with a friend in school who, in retrospect, he realized had mental illness. He didn't understand that at the time, and so he wasn't able to fully support his friend.

We see this as well with celebrities and other disorders, whether it's Michael J. Fox speaking out for Parkinson disease,[7] Mary Tyler Moore for juvenile diabetes,[8] or Jerry Lewis for muscular dystrophy.[9] Those are tremendously beneficial, famous spokespersons.

I think people in the position of celebrity have to be sure of what they are saying before they wield their power. They have to be careful not to encourage views and a misunderstanding that may be detrimental to individuals and to society as a whole, as we are seeing now with the people who have railed against the benefits of vaccines.

Thank you for listening. Please leave your comments below.

1 comment:

  1. 惡意是有目的、有邏輯、並且可以預測的;你可以抵抗惡意,你可以揭下它的面具,或者憑藉力量來防止它。

    然而,面對愚蠢,根本無法防衛。要反對愚蠢,抵抗和力量都無濟於事,愚蠢根本不服從理性。假如事實與一己的偏見相左,那就不必相信事實,假如那些事實無法否認,那就可以把它們乾脆作為例外推開不理。

    德國神學家潘霍華:對於善來說,愚蠢是比惡意更加危險的敵人
    https://www.master-insight.com/德國神學家潘霍華:對於善來說,愚蠢是比惡意更/

    認識愚蠢的本來面目

    愚蠢是一種道德上的缺陷,而不是一種理智上的缺陷。有些人智力高超,但卻是蠢人,還有些人智力低下,但絕非蠢人,作為某些特定環境的產物,我們驚訝地發現了這種情況。

    我們得到的印象是:愚蠢是養成的,而不是天生的;愚蠢是在這樣一些環境中養成的,在這種環境下,人們把自己弄成蠢人,或者允許別人把自己弄成蠢人。我們還進一步注意到,比起不善交際或孤寂獨處的人來,在傾向於或注定要群居或交往的個人或團體當中,愚蠢要普遍得多(群眾效應)。

    更進一步觀察就會發現,任何暴力革命,不論是政治革命還是宗教革命,都似乎在大量的人當中造成了愚蠢的大發作。事實上,這幾乎成了心理學和社會學的一項規律。一方的力量,需要另一方的愚蠢。這並不是人的某種天生能力,例如理智上的能力遭到了阻礙或破壞。正相反,是力量的高漲已變得如此可怕,它剝奪了人的獨立判斷,人們放棄了(或多或少是無意識地放棄了)自己評價新的事態的努力。

    蠢人需要救贖

    然而正是在這個方面,我們意識到,蠢人不可能靠教育來拯救。他所需要的是救贖,此外別無他法。迄今為止,企圖用理性論證去說服他,絲毫沒有用處。在這種事態中,我們可以完全明白,為什麼試圖去發現蠢人真的在想什麼是徒勞無益的,為什麼這個問題對於負責地思考和行動的人來說也完全多餘。正如《聖經》所言:「對上帝的畏懼,就是智慧的開端。」換言之,治療愚蠢的唯一辦法,是靈性上的救贖,因為唯有這樣,才能使一個人像上帝眼中負責任的人那樣生活。

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