schizophrenia - modifying: antipsychotic: ethical implications

Question 1

side effects

Answer 1

P: A key ethical issue with antipsychotic drugs is the severe side effects associated with their use, such as tardive dyskinesia, Parkinsonism, and agranulocytosis.
E: Research by Kane et al. (1988) showed that up to 30% of patients using conventional antipsychotics develop tardive dyskinesia, a potentially irreversible condition characterized by involuntary movements. Additionally, clozapine, an atypical antipsychotic, carries a 1-2% risk of agranulocytosis, a life-threatening drop in white blood cells.
T: This is a weakness because the severity and long-term nature of these side effects pose significant risks to patients’ quality of life and physical health, raising questions about whether the benefits of treatment outweigh these harms.
COUNTER: While side effects are significant, advancements in monitoring (e.g., regular blood tests for clozapine) and newer medications with fewer side effects have mitigated some of these risks, offering patients safer treatment options.

Question 2

reduce stress

Answer 2

P: A key ethical strength of antipsychotic drugs is their ability to reduce hallucinations and other positive symptoms of schizophrenia, which can alleviate distress and significantly improve patients’ mental health and quality of life.
E: Research demonstrates that antipsychotic treatment reduces hallucinations in approximately 60-70% of patients with schizophrenia, leading to a notable decrease in feelings of fear, confusion, and distress (Leucht et al., 2012). This improved mental state can also enhance their ability to engage in meaningful relationships and daily activities.
T: This is an ethical strength because by mitigating distress caused by hallucinations, these medications help patients regain a sense of stability and control over their lives.
COUNTER: However, critics might argue that the side effects and potential overreliance on medication could overshadow these benefits, as some patients may feel sedated or emotionally disconnected despite reduced hallucinations.

Question 3

straitjackets

Answer 3

P: Critics argue that antipsychotics act as “chemical straitjackets,” not to alleviate suffering but to enforce conformity with societal norms, an issue raised prominently by Thomas Szasz in the anti-psychiatry movement.
E: Szasz (1960) contended that psychiatric treatments, including antipsychotics, are coercive tools used to manage behavior rather than address underlying distress, likening their use to social control rather than genuine therapy. Supporting this, a meta-analysis found that patients often report feeling sedated and emotionally numbed by antipsychotics, suggesting they suppress symptoms without necessarily improving the patient’s quality of life (Moncrieff et al., 2006).
T: This perspective underscores an ethical weakness, as it implies that antipsychotic drugs may prioritize societal convenience over the well-being and dignity of the individual.
COUNTER: Advocates might counter that symptom stabilization allows patients to function more effectively in society, and without antipsychotics, many individuals might face greater distress and stigma.