October 14, 1998
 

When a Killer Blames His Doctor

 

To the Editor:
The case of Wendell Williamson, the psychotic killer who was awarded $500,000 by a North Carolina jury that held his psychiatrist responsible for his crimes (front page, Oct. 10), illustrates the problems a lay jury has in understanding complex medical and civil rights issues.
Williamson claimed that Dr. Myron B. Liptzin was "wishy-washy" in explaining how sick he was. What the jury did not appreciate is the skill required to persuade a paranoid patient to take his medication. It is the psychotic patient's denial of illness, rather than the psychiatrist's failure, that leads to a patient's stopping medication and falling ill again.
Current mental health laws permit involuntary treatment only for dangerous patients. With a patient who is not demonstrably dangerous, a psychiatrist can only try to persuade him to take medication or to continue treatment.
ITAMAR SALAMON, M.D.
Bronx, Oct. 10, 1998
The writer is an associate clinical professor of psychiatry at Albert Einstein College of Medicine.
 
That killers can successfully blame their therapists for their actions (front page, Oct. 10) is the consequence of the fiction of mental illness and the junk science of psychiatry that it supports.
Although lawyers, psychiatrists and society conspire in the twin charades of civil commitment and the insanity defense, the main culprits are the mental health professionals. If they believed in personal responsibility rather than in mental illness -- and rejected the practices of depriving innocent people of liberty and excusing guilty people of crimes -- we would be spared the spectacle of criminals' being acquitted of crimes and collecting damages as if they were the victims of untreated diseases.
THOMAS SZASZ, M.D.
Syracuse, Oct. 10, 1998
The writer is professor emeritus of psychiatry at SUNY Health Science Center.
As a psychiatrist who works exclusively with the chronically mentally ill, I read with frustration in "Killer Blames His Therapist, and Jury Agrees" (front page, Oct. 10) that "psychiatrists here and around the country say the verdict may discourage therapists from treating psychotic patients."
"May" discourage? Psychiatrists stopped treating the chronically mentally ill about 30 years ago when the mental hospitals were closed and the thinking was that all patients could live safely as outpatients.
At least 200,000 of our "patients" now live in the streets, shelters and jails, with little access to mental health care. Psychologists do not have the medical training to treat these disorders.
When will psychiatrists start doing what they are trained to do?
LAURA D 'ANGELO, M.D.
Smyrna, Tenn., Oct. 10, 1998
Wendell Williamson is wrong -- there is no guarantee that the murders he committed would not have happened if, as he says, his psychiatrist had done his job properly (front page, Oct. 10). Mental health professionals are not considered responsible for crimes committed by their patients and former patients. However, they can be held responsible for ethical breaches and professional lapses that have direct causal relationship to harm caused by their patients.
It is important to point out that the victims' families can sue Williamson for the costs and pain and suffering he has caused them, entitling them along with the state hospital to any money he might be awarded.
SUSAN SARNOFF
Athens, Ohio, Oct. 10, 1998
The writer is an assistant professor of social work at Ohio University.
Why did a jury hold a psychiatrist, Myron B. Liptzin, accountable for Wendell Williamson's murderous acts (front page, Oct. 10)? Because psychiatrists invented and perpetuate the myth of mental illness.
As long as people believe in mental illness as a cause for behavior, those who receive such a "diagnosis" will be exculpated -- and someone else will be culpable.
Since psychiatrists removed the blame, it is only fitting that they should be saddled with it.
JEFFREY A. SCHALER
Silver Spring, Md., Oct. 10, 1998
The writer is an adjunct professor of justice, law and society at American University.