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Panhandling, Misguided Moralizing and the Bank of Canada

On a downtown streetcorner, a piercing voice disrupted my chat with friends. Across the road, a thin, unkempt woman berated a cabbie for refusing her a free ride, and demanded money from people. We quietly condemned the woman’s rude aggressiveness. But as the taxi departed, we stared aghast as the woman collapsed to the concrete, sobbing violently. In the same instant, one of my friends realized he knew her, and dashed over. It turned out the woman was homeless and had minutes earlier been raped. She was shattered and in shock, and had hoped the passing taxi could take her to the hospital.

My friend called an ambulance. I pondered how, habitually, in the absence of facts and understanding about others, we moralize.

I recalled this when reading a recent editorial in a local newspaper defending BC’s new Safe Streets Act outlawing “aggressive” panhandling. As the writer assailed the unemployed with phrases about “government largesse”, “honest day’s work”, “sucking at the public trough”, and “preying on people’s compassion”, it became obvious our culture’s moralistic reactions against panhandling have become so habitual they’re now hackneyed clichés. Meanwhile, these automatic judgments reflect a complete lack of understanding of basic economic facts.

The diatribes typically go like this: Hey, I was poor once. And I’ve worked hard–damn hard–to get where I am. I’m proud of what I’ve achieved, and I resent people who’re trying to get a free ride. Sure, some deserve compassion–like that elderly, learning-disabled schizophrenic with multiple sclerosis. But many don’t deserve sympathy. The drinkers, addicts, and fakers. And I have proof many are lazy no-goods exploiting passers-by and our overly-generous welfare system.

Then, following several under-investigated examples of panhandlers declining a menial two-hour job, or apparently discussing spending their lucrative earnings on high-end consumer products, the lectures inevitably conclude, “Panhandler, get a job!”

This entire hyper-moralistic argument, however, ignores a simple fact. Governments and central banks in most major economies today work hard to maintain high unemployment rates. Many able, willing people cannot get jobs.

For example, recently the Bank of Canada, our economy’s pilot ship, raised interest rates to slow the economy by making it harder to borrow. Canadian Press explained, “A jump in job-creation last month pushed unemployment down… and built the case for the Bank of Canada to increase interest rates.”

That’s right–a mere 0.1% drop in unemployment prompted immediate action to slow the economy. The logic: When there are plenty of unemployed people struggling to get by, that keeps unions weak and wage demands throughout society low. This, in turn, helps keep prices down, and inflation minimized. This benefits those with substantial monetary assets, like banks, investors, and well-to-do people, by protecting the value of savings from being eroded by inflation. It’s less evidently beneficial to the unemployed and working poor.

This isn’t a wacky, communist interpretation of the policy. It’s the policy. An economy’s “Natural Rate of Unemployment”, explains BMO Financial Group in their website economics glossary, is “the rate of joblessness that is consistent with stable inflation.” The Bank of Canada’s mandate is to maintain “low and stable inflation” of 1-3% annually; reducing unemployment isn’t mentioned. To the contrary, as an executive from the similarly-mandated U.S. Federal Reserve once explained frankly to a group of businesspeople, “pushing unemployment below [the Natural Rate of Unemployment] would cause inflation to rise and thereby run afoul of… stable prices, which is our only objective[.]”

Essentially, whenever panhandlers get jobs, our central bank’s mission is to quickly create new panhandlers to replace them. Even if everyone was impeccably-qualified and eager to work, 7-10% of us would still be unemployed, and another 10-20% underemployed, because this “Natural Rate of Unemployment” is what’s currently considered optimal for Canada’s economy. Maintaining uncomfortable, widespread poverty is a vital anti-inflationary measure.

Far from being “natural”, though, the accepted unemployment rate is a creature of political expediency. Economists vehemently disagree about which inflation or unemployment rates are truly necessary or preponderantly beneficial. So the question becomes, how much pressure is the government under to reduce unemployment or, conversely, lower inflation? And what political sympathies steer the arms-length central bank?

It’s time we focused public attention on these economic facts, instead of on imagined moral failings of the poor. Perhaps we need a guaranteed livable income, slightly higher inflation, reduced work hours, more job-sharing. With mechanization, maybe the work ethic is passé; some “laziness” may even be a noble trait and social asset. After all, is the workaholic chewing through resources to produce throwaway products and pollution truly more worthy of respect than the person who just hangs out at the beach? Which is less destructive? Indeed, it’s ironic any professional politician or writer imagines his embittered, uninformed attacks on panhandlers benefit society more than the panhandlers who actually hold our whole economic system together.

Fortunately, few lawyers believe our latest moralistic assault, the Safe Streets Act, will stand in court. One reason is, the Act has basically made it illegal to plead for assistance in an emergency. Now, if you’re freezing or starving–or have just been raped and need money to get to a hospital–you’ll be breaking the law if you plead for help near an ATM or bus stop, or are persistent. Is that the kind of community we’re working to create?

I, for one, am hitting the beach to reflect on that question.

 

Rob Wipond is always trying to scrounge up other work because he thinks panhandling looks like a very tough job. Originally published in Focus, January 2004.

 

 

For Your Own Good

(Originally published in Monday Magazine, June 10-16, 1999)
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An irritated neighbour, worried sibling or angry landlord could set you up for a mental health check-up. After a visit from “the team”, you could end up with fewer rights than a criminal.
*
*
THEY don’t want you to know that your neighbours, teachers and landlord can send “the team” after you. That the helpline may tip authorities to trace your number. That staff at the shelter to which you flee may help incarcerate you without trial.

They don’t want you to know, because that might hurt their chances of helping you in your time of crisis. So if you read this article, goes the argument of some of Victoria’s mental health professionals, Monday will have done you a grave disservice.

But ever since Frank Kingsley found out, he’s been convinced everyone should know.

As Kingsley tells it (names and certain details in several testimonies have been changed to preserve anonymity), his story began three nights after he was assaulted by his girlfriend’s ex-lover. The investigating police officer appeared at his door, escorting two plainclothed women. One began asking Kingsley questions. The other took notes.

“Are you suffering from stress, Mr. Kingsley?” he recalls the woman asking. “Do you take medication? Have you ever smoked marijuana?”

Kingsley says he answered casually. But when he was asked about his sex life and his relationship with his mother, he began to feel uncomfortable.

“What is today’s date?” continued the woman.

Kingsley wondered aloud why he was being asked such questions. The woman responded cryptically: “Do you have a problem with it?”

Eventually, Kingsley was told the woman and her partner were mental health professionals. They were worried he might be suffering trauma from the assault.

Kingsley says he thanked them for their concern. But he was stunned by the questions that followed.

“What’s the relationship between an apple and a banana?” asked the woman. “What’s the similarity between a canoe and a bicycle?”

“I started to get a really funny feeling that this wasn’t quite right,” Kingsley recalls now. “It sounded like they were asking questions to check on whether I was a nutcase or not, rather than worrying about me suffering from trauma and wanting to help me.”

Kingsley asked the police officer what was going on. The officer explained that his assailant had confessed, but asserted that Kingsley was dangerously mentally unstable. The two women were “assessing” Kingsley to decide whether he needed treatment.

Kingsley was flabbergasted. A 53-year-old professional, he had never been in contact with any mental health worker, and had never before been involved in a physical altercation. Was this just another way for his assailant to lash out at him?

This suggestion was greeted with silence.

“What does it mean that people who live in glass houses shouldn’t throw rocks?” continued the woman.

“It’s like you’re walking on a razor’s edge,” explains Kingsley. “Your normal reaction as a citizen, or a human being, is to get angry with this bullshit, and tell them to get the hell out of your apartment. But you’re afraid to actually get angry, because you’re sure they’ll use that against you.

“It’s degrading,” he continues. “I felt intimidated, and afraid . . . It was the fact that they could just come like that at any time, bang on your door, charge in, and possibly haul you away.”

Twenty minutes after their arrival, the three stood to leave. They indicated that they’d “check out” some of Kingsley’s answers. That was Kingsley’s first–and so far his only–visit from a local emergency mental health response team.

Psychiatric emergency response teams have existed in B.C. for well over a decade, says Vancouver General Hospital’s Dr. Dan Bilsker, a psychologist and member of a B.C. Ministry of Health-appointed group studying mental health crisis response. But as part of an international trend in “assertive community management”, says Bilsker, the use of emergency response teams and other community mental health workers to get people into early treatment is increasing.

“In the last 10 years it’s become very dominant,” says Bilsker.

In the Victoria area, the Capital Health Region’s emergency mental health services (EMHS) department oversees 15 staff that operate in two-person emergency response teams, each consisting of a community nurse and a social worker.

According to an EMHS pamphlet, the teams’ primary mandate is to aid and protect people undergoing psychiatric crises or “severe situational difficulties” who are in risk of doing harm to themselves.

For example, a mobile team should be called in, says the pamphlet, when a person expresses suicidal thoughts or exhibits more subtle symptoms of harmful behaviour, like “an inability to attend to work”.

According to their procedural manuals, the team may meet with you (with or without police alongside), talk with people who know you, attempt to solve problems or provide therapy, refer you to a community agency or mental health professional, accompany you through the admissions procedure of a psychiatric hospital, or even advise police to take you to hospital by force.

Although the EMHS contact number is “not public”, the number is widely available. Aside from police, mental health workers, family physicians and relatives of mentally ill people, many lawyers, landlords, school teachers, employers, clergy, staff at community organizations and ordinary people now have the number. Any third party can ask the team to consider visiting anyone else.

There are undoubtedly people with mental disorders who need EMHS assistance. But critics like Kingsley note that the emergency response teams can act as a mechanism to allow ordinary people to submit each other to psychiatric assessments. In turn, those assessments could lead to incarceration and treatment with drugs or electroshock under B.C.’s Mental Health Act. To Kingsley, such serious potential consequences point to a need for health units to be closely monitored.

His primary question is simple: How do teams assess who should go to hospital?

EMHS manager Nancy Panagabko refused to answer questions or to allow Monday to interview anyone involved with the emergency response teams. Even Capital Health Region spokesman Andrew Hume would answer only select questions, even when submitted in writing.

In answer to questions about psychiatric assessments, Hume pointed to the textbook collection of the Eric Martin Pavilion psychiatric hospital. In these books’ pages, Kingsley’s story of his strange interrogation unfolds as a standard “mental status examination”, cited as the most important assessment tool of the emergency mental health professional. Assessors are advised to consider factors like whether the interviewee has the potential to commit homicide or suicide, has good reasons to explain wearing “bizarre” clothing, is “normally responsive to cues”, or “laughs appropriately”.

EMHS training documents also include a “Crisis Triage Rating Scale”. Using this system, even if you have no notions of doing harm to yourself or others, merely refusing to cooperate with mental health professionals and having limited family or friend support would place you in the category of “hospital is indicated”.

As B.C.’s approach to mental health care becomes increasingly aggressive, more and more ordinary people like Kingsley are being submitted to such assessments in unexpected situations. Every year, thousands of Victorians come into contact with organizations that use EMHS regularly, and according to EMHS statistics, mental health teams visit over 200 Victorians every month.

Victims of “people crimes” like sexual assault, home burglaries or even auto accidents can expect calls or visits from volunteers with Greater Victoria Victim Services. According to Marlline Halisheff, the director of the non-profit society, volunteers arrive at crime scenes by listening to police radio, and police routinely pass them names, addresses, crime summaries and other confidential details.

Although volunteers come to give victims emotional support, if a person needs more support “than we’re trained to handle”, says Halisheff, a call may be made to EMHS.

Representatives from most of Victoria’s emergency shelters say they may call EMHS when someone overstretches the overworked staff’s ability to provide care–examples given by shelter staff ranged from people hallucinating and not eating to those acting in ways that were “not congruent with normal behaviour”.

The NEED Crisis and Information Line’s use of emergency mental health response teams has increased fourfold since 1992, to about 35 times monthly in 1997-98. But, assures clinical director Linda Stanton, “We never refer to emergency mental health services without the caller’s permission.” She acknowledges, though, that the caller isn’t always the person whom EMHS might come to assess.

Several mental health patients and professionals also expressed concern about calls to the NEED Crisis line apparently being traced, and police arriving and taking callers to the psychiatric hospital against their wills.

Asked about these concerns, Stanton points out that the NEED Crisis line is also a suicide prevention centre. “We are highly trained here to do crisis intervention work, where our volunteers make a risk assessment and we do whatever we can to ensure that people remain safe. And that may involve contacting the police.”

Stanton explains that out of the 15,896 calls to the crisis line last year, around 500 involved referrals to outside agencies like EMHS and poison control centres–and of those, only a small number involved call tracing and police action. (In subsequent investigations, Monday discovered that many “anonymous” crisis lines across North America have policies and practices for having certain calls traced to facilitate police interventions, but most news media have voluntarily agreed not to publicize that fact.)

While people experiencing a serious problem or calling for help may be surprised to receive a visit from police or “the team”, others say they were surprised that anyone thought they were in an emergency situation at all.

Recently divorced and laid off at the age of 35, Joan Mackay became depressed. She wasn’t suicidal, she says, but had been finding it challenging to get out of bed. Meanwhile, longstanding conflicts between her and her father were intensifying.

Earlier this year, two people arrived at her door with two policemen, she says. Always an “anxious” person, Joan admits she backed away. A male officer then clutched her arm while a woman introduced herself as a social worker who wanted to talk. Confused and afraid, Joan refused.

Joan was promptly taken to the Royal Jubilee Hospital emergency ward and then transferred to the Eric Martin Pavilion. Her purse was searched, she says, her requests to contact a lawyer were denied, and no one informed her of her rights. She says that despite complaining about being kept against her will, she was not informed that a complaints process was available to her.

Finally, she says, she came up with a strategy. “I just thought, if I remain calm and go along with this, this will all end at some point.”

Joan says a psychiatrist informed her that her father had contacted EMHS and the Eric Martin Pavilion and had described Joan as threatening and suicidal. For her part, Joan describes her elderly father as an easily frustrated, domineering man who has “lost some of his reasoning skills and memory”. She believes his call to EMHS was a way of getting back at her for cruel things she’d said in the heat of argument. What likely played a significant role in Joan’s release from hospital four weeks later was that another close relative presented herself to hospital staff and backed up Joan’s side of the story.

The experience has left indelible scars on Joan.

“I want to cry because it’s so horrible,” she says of how easily she was involuntarily committed and treated with medications, apparently as a result of a family feud and an interview with a psychiatrist which she says was conducted while she was still in “utter shock”.

Her picture of our society has changed dramatically, too. “Where do you separate the medical team and the police?” she wonders. “I find it very frightening that our government has encouraged this.”

In fact, says Staff Sergeant John Smith of the Victoria police department, the police and EMHS do share many common goals and a common complaint about the mental health system: that not enough people are being kept in hospital.

“There seems to be some sort of, let’s say, a professional difference of opinion,” says Smith, referring to people who’ve been brought in by police and/or EMHS and promptly sent home by hospital doctors.

Smith, the department’s emergency mental health liaison, acknowledges that the bulk of Mental Health Act arrests involve “a big grey area” of interpretation. Often, neighbours will complain about someone’s all-night banging or unhygienic living conditions and police will “err on the side of caution” and take the person to a hospital for a psychiatric assessment, says Smith.

Most people and organizations interviewed by Monday said the most common cause for contacting EMHS is when they observe people whose behaviour is so far outside social norms that they seem to be placing themselves in danger.

Rose Henry, the director of the Victoria Street Community Association, points out that a person can become a “danger to themselves or others” merely by being extremely dysfunctional in our fast-paced, uncompassionate and dangerous society. Henry sympathizes, but has a ready response for those occasional people who have angrily blamed her for their negative experiences after her call to EMHS helped put them in hospital: “That’s better than being found in a back alley dead.”

Henry’s remark highlights something Brett Haughian, senior paralegal for the Community Legal Assistance Society’s Mental Health Law Program, has observed–that the tactics of forced psychiatry are more often used to help control people’s behaviour than to help improve how patients themselves feel.

“That’s definitely the trend,” says Haughian. “There seems to be more emphasis on trying to categorize behaviour and get it off the streets.”

As the Victoria police acknowledge, when such relatively harmless people are taken to hospital there is no requirement to inform them of their rights. The reason? The person isn’t being charged with an offense. Police and EMHS are simply trying to help.

All of which raises the question: What are a person’s rights before his or her life becomes subject to everyone else’s “differences of opinion” about his or her behaviour?

Haughian explains that the mental health unit that might arrive at your door has broad powers. Based on their own observations or information received from a third party, he says, police and EMHS together can enter your home, examine you, or take you to a psychiatrist for an examination. If you refuse to talk, states Haughian, your reticence could be used as part of the police or EMHS assessment, or even as part of the hospital psychiatrist’s diagnosis that gets you incarcerated.

“One of the problems is, there’s no definition of what an ‘examination’ is,” says Haughian. “Examination is a pretty wide open exercise.”

If society intends to provide such exceptional powers to control “unusual” behaviour or expression, and ultimately to impose psychiatric treatment onto an ever-wider variety of people, it seems important to make sure there’s solid science underlying diagnosis and treatment of mental disorders.

Unfortunately, opinion differs widely even on what constitutes a psychiatric “examination”. In fact, the entire field of mental health science and law is surrounded by a vast maze of hazy issues that provide ample room for error when applied by frontline workers.

For example, Stanton notes that the NEED Crisis line is certified by the American Association of Suicidology, and that volunteers receive six hours of training in “risk assessment”. Nevertheless, Martha, a woman who takes psychiatric medication and admits calling the crisis line often to talk about her suicidal feelings, is one person who was less than impressed with a particular crisis line volunteer’s perspicacity.

“I said I was going to commit suicide in the millennium. Not tonight, in the millennium,” says Martha. “But the police and ambulance showed up. [The volunteer] must have been a rookie or something.”

Meanwhile, a large body of evidence suggests professional psychiatric assessments and predictions of dangerous behaviour frequently prove to be inaccurate–in some cases, no more accurate than the guesses of rank amateurs.

In Stanford University psychologist David Rosenhan’s famous 1973 study “On Being Sane in Insane Places”, staff at 12 different psychiatric hospitals failed to distinguish “normal” people from other patients. Similarly, in her 1998 book Manufacturing Victims, psychologist Dr. Tana Dineen points out that the standard clinicians’ bible, the Diagnostic and Statistical Manual of Mental Disorders, “pathologizes” such behaviours as lovesickness, sleepwalking and computer addiction.

According to Principles and Practice of Emergency Medicine–a 1992 textbook in the Eric Martin Pavilion’s own library–easily detected ailments like nutritional deficiencies, infections and cardiovascular diseases have been shown to be the causes of the mental disorders of up to 30% of psychiatric hospital emergency patients. These causes usually go undetected, the text says, because less than 10% of psychiatrists ever do physical examinations.

And in 1997, Dr. Grant Harris and Dr. Marnie Rice of Ontario’s Mental Health Centre published an overview of the scientific literature on predicting violent behaviour in mental patients. The article states that psychiatric predictions of violent behaviour “are wrong twice as often as they are right”. The researchers add that “[n]o evidence has been found” to suggest that psychiatrists’ judgments are better than those of laypersons in predicting violent behaviour.

When asked in writing how they respond to such expert criticisms, spokesman Hume replied that the Capital Health Region would not respond to “unsubstantiated allegations”.

But Dr. Bilsker of Vancouver General Hospital’s psychiatric assessment unit readily confirms the general criticisms.

Bilsker explains that his health ministry crisis response working group has been carrying out extensive research to ensure that B.C.’s emergency mental health practices are “evidence-based”.

Mental health professionals, concludes Bilsker, aren’t “terribly accurate” in their predictions about the likelihood of patients doing harm to themselves or others over the long term. “No one has that ability,” he says. He feels professional predictions of risks over several days are “pretty good”, but admits no studies back up that belief.

Even if there may be short term benefits, can we feel confident about the long term benefits of subjecting depressed or emotionally volatile people to detention and forced treatment?

“There’s always a trade-off, and I know of no way around that trade-off,” he concedes.

“There’s an unrealistic notion on the part of the public, and even on the part of some mental health practitioners, about what treatments can do, and about the limitations of treatments,” Bilsker says.

For this reason, his working group will be recommending a “de-emphasizing of hospitals”. According to Bilsker, community supports, safe houses and non-medical therapies have been shown to be as effective as psychiatric treatment in helping people manage many kinds of acute mental problems.

It sounds constructive. But in fact, B.C. is undergoing unprecedented polarization between those who support individual rights, community agencies and non-medical approaches, and those who advocate greater state control through forced medication.

In 1994, B.C. ombudsman Dulcie McCallum launched the first ever independent investigation of a major Canadian psychiatric institution. She found “systemic” disregard for legitimate patient concerns at Vancouver’s Riverview hospital. She also strongly endorsed the Mental Health Law Program service of providing involuntarily hospitalized patients with free, automatic access to independent rights advice. According to Haughian, most B.C. hospitals have refused to allow the service and the B.C. government has refused to mandate it.

Meanwhile, legal advocates, civil rights groups and many community agencies vehemently protested last year’s amendments to B.C.’s Mental Health Act, some arguing the expanded criteria for involuntary treatment could apply to virtually anyone.

Proponents of forced psychiatry argue tougher laws are needed because many disordered people aren’t capable of competent decisions. In response, Haughian points out that, unlike in Ontario, B.C.’s Mental Health Act now authorizes treating people against their wills even when they’re still deemed competent.

Alex Berland, interim director of the B.C. health ministry’s adult mental health division, clarifies the government’s objective: to help patients live in their own homes while mobile caseworkers ensure those people stay on medications. And since psychiatric treatments sometimes help manage yet “almost never cure” severe mental disorders, the new plan is to use organizations like EMHS to help identify people in the early stages of illness and then intervene with drugs in the hope that disorders can be prevented from developing.

Questioned about evidence of the inaccuracy of diagnostic tools, Berland disagrees and points to this year’s Canadian Mental Health Association early intervention study–a study that, in fact, states that “nearly half of participants received an incorrect diagnosis”.

Nevertheless, Berland declares that “teams and teams” of mental health workers will be involved in the growing “assertive community treatment” project.

For now, it seems, Victorians will have to live with what Bilsker refers to as the “trade-off”.

On the one hand, some people experiencing psychological problems will be aided by forced interventions–people like Anna, who speaks for the many people helped by psychiatric treatment. Found rambling and shouting in the streets, Anna was escorted–protesting all the way–to hospital. Today, she is on medication and functioning well.

“For me, [EMHS] was a lifesaver,” she says.

But others will have to live with the other side of the trade-off: living in a society where experiencing or even just talking about emotional difficulties may expose you to the risk of incarceration or forced treatment.

Both Sandy Merriman House shelter manager Chris Downing and Victoria Street Community Association director Rose Henry observe that, even though teams tend to be compassionate and can often “ground” people and help keep them out of hospital, most people who’ve been in hospital before have negative reactions when told EMHS has been called.

“It takes quite a bit of encouragement to keep them on site until the team arrives,” states Henry.

After her own initiation to B.C.’s mental health system, Joan Mackay sympathizes with such reactions. “If I ever get suicidal,” she says, “then I’m never going to tell anyone.”

*

For Your Own Good

(Originally published in Monday Magazine, June 10, 1999.)
*
An irritated neighbour, worried sibling or angry landlord could set you up for a mental health check-up. After a visit from “the team”, you could end up with fewer rights than a criminal.
*
*
THEY don’t want you to know that your neighbours, teachers and landlord can send “the team” after you. That the helpline may tip authorities to trace your number. That staff at the shelter to which you flee may help incarcerate you without trial.

They don’t want you to know, because that might hurt their chances of helping you in your time of crisis. So if you read this article, goes the argument of some of Victoria’s mental health professionals, Monday will have done you a grave disservice.

But ever since Frank Kingsley found out, he’s been convinced everyone should know.

As Kingsley tells it (names and certain details in several testimonies have been changed to preserve anonymity), his story began three nights after he was assaulted by his girlfriend’s ex-lover. The investigating police officer appeared at his door, escorting two plainclothed women. One began asking Kingsley questions. The other took notes.

“Are you suffering from stress, Mr. Kingsley?” he recalls the woman asking. “Do you take medication? Have you ever smoked marijuana?”

Kingsley says he answered casually. But when he was asked about his sex life and his relationship with his mother, he began to feel uncomfortable.

“What is today’s date?” continued the woman.

Kingsley wondered aloud why he was being asked such questions. The woman responded cryptically: “Do you have a problem with it?”

Eventually, Kingsley was told the woman and her partner were mental health professionals. They were worried he might be suffering trauma from the assault.

Kingsley says he thanked them for their concern. But he was stunned by the questions that followed.

“What’s the relationship between an apple and a banana?” asked the woman. “What’s the similarity between a canoe and a bicycle?”

“I started to get a really funny feeling that this wasn’t quite right,” Kingsley recalls now. “It sounded like they were asking questions to check on whether I was a nutcase or not, rather than worrying about me suffering from trauma and wanting to help me.”

Kingsley asked the police officer what was going on. The officer explained that his assailant had confessed, but asserted that Kingsley was dangerously mentally unstable. The two women were “assessing” Kingsley to decide whether he needed treatment.

Kingsley was flabbergasted. A 53-year-old professional, he had never been in contact with any mental health worker, and had never before been involved in a physical altercation. Was this just another way for his assailant to lash out at him?

This suggestion was greeted with silence.

“What does it mean that people who live in glass houses shouldn’t throw rocks?” continued the woman.

“It’s like you’re walking on a razor’s edge,” explains Kingsley. “Your normal reaction as a citizen, or a human being, is to get angry with this bullshit, and tell them to get the hell out of your apartment. But you’re afraid to actually get angry, because you’re sure they’ll use that against you.

“It’s degrading,” he continues. “I felt intimidated, and afraid . . . It was the fact that they could just come like that at any time, bang on your door, charge in, and possibly haul you away.”

Twenty minutes after their arrival, the three stood to leave. They indicated that they’d “check out” some of Kingsley’s answers. That was Kingsley’s first–and so far his only–visit from a local emergency mental health response team.

 

Psychiatric emergency response teams have existed in B.C. for well over a decade, says Vancouver General Hospital’s Dr. Dan Bilsker, a psychologist and member of a B.C. Ministry of Health-appointed group studying mental health crisis response. But as part of an international trend in “assertive community management”, says Bilsker, the use of emergency response teams and other community mental health workers to get people into early treatment is increasing.

“In the last 10 years it’s become very dominant,” says Bilsker.

In the Victoria area, the Capital Health Region’s emergency mental health services (EMHS) department oversees 15 staff that operate in two-person emergency response teams, each consisting of a community nurse and a social worker.

According to an EMHS pamphlet, the teams’ primary mandate is to aid and protect people undergoing psychiatric crises or “severe situational difficulties” who are in risk of doing harm to themselves.

For example, a mobile team should be called in, says the pamphlet, when a person expresses suicidal thoughts or exhibits more subtle symptoms of harmful behaviour, like “an inability to attend to work”.

According to their procedural manuals, the team may meet with you (with or without police alongside), talk with people who know you, attempt to solve problems or provide therapy, refer you to a community agency or mental health professional, accompany you through the admissions procedure of a psychiatric hospital, or even advise police to take you to hospital by force.

Although the EMHS contact number is “not public”, the number is widely available. Aside from police, mental health workers, family physicians and relatives of mentally ill people, many lawyers, landlords, school teachers, employers, clergy, staff at community organizations and ordinary people now have the number. Any third party can ask the team to consider visiting anyone else.

There are undoubtedly people with mental disorders who need EMHS assistance. But critics like Kingsley note that the emergency response teams can act as a mechanism to allow ordinary people to submit each other to psychiatric assessments. In turn, those assessments could lead to incarceration and treatment with drugs or electroshock under B.C.’s Mental Health Act. To Kingsley, such serious potential consequences point to a need for health units to be closely monitored.

His primary question is simple: How do teams assess who should go to hospital?

EMHS manager Nancy Panagabko refused to answer questions or to allow Monday to interview anyone involved with the emergency response teams. Even Capital Health Region spokesman Andrew Hume would answer only select questions, even when submitted in writing.

In answer to questions about psychiatric assessments, Hume pointed to the textbook collection of the Eric Martin Pavilion psychiatric hospital. In these books’ pages, Kingsley’s story of his strange interrogation unfolds as a standard “mental status examination”, cited as the most important assessment tool of the emergency mental health professional. Assessors are advised to consider factors like whether the interviewee has the potential to commit homicide or suicide, has good reasons to explain wearing “bizarre” clothing, is “normally responsive to cues”, or “laughs appropriately”.

EMHS training documents also include a “Crisis Triage Rating Scale”. Using this system, even if you have no notions of doing harm to yourself or others, merely refusing to cooperate with mental health professionals and having limited family or friend support would place you in the category of “hospital is indicated”.

As B.C.’s approach to mental health care becomes increasingly aggressive, more and more ordinary people like Kingsley are being submitted to such assessments in unexpected situations. Every year, thousands of Victorians come into contact with organizations that use EMHS regularly, and according to EMHS statistics, mental health teams visit over 200 Victorians every month.

Victims of “people crimes” like sexual assault, home burglaries or even auto accidents can expect calls or visits from volunteers with Greater Victoria Victim Services. According to Marlline Halisheff, the director of the non-profit society, volunteers arrive at crime scenes by listening to police radio, and police routinely pass them names, addresses, crime summaries and other confidential details.

Although volunteers come to give victims emotional support, if a person needs more support “than we’re trained to handle”, says Halisheff, a call may be made to EMHS.

Representatives from most of Victoria’s emergency shelters say they may call EMHS when someone overstretches the overworked staff’s ability to provide care–examples given by shelter staff ranged from people hallucinating and not eating to those acting in ways that were “not congruent with normal behaviour”.

The NEED Crisis and Information Line’s use of emergency mental health response teams has increased fourfold since 1992, to about 35 times monthly in 1997-98. But, assures clinical director Linda Stanton, “We never refer to emergency mental health services without the caller’s permission.” She acknowledges, though, that the caller isn’t always the person whom EMHS might come to assess.

Several mental health patients and professionals also expressed concern about calls to the NEED Crisis line apparently being traced, and police arriving and taking callers to the psychiatric hospital against their wills.

Asked about these concerns, Stanton points out that the NEED Crisis line is also a suicide prevention centre. “We are highly trained here to do crisis intervention work, where our volunteers make a risk assessment and we do whatever we can to ensure that people remain safe. And that may involve contacting the police.”

Stanton explains that out of the 15,896 calls to the crisis line last year, around 500 involved referrals to outside agencies like EMHS and poison control centres–and of those, only a small number involved call tracing and police action. (In subsequent investigations, Monday discovered that many “anonymous” crisis lines across North America have policies and procedures in place to have certain calls traced to facilitate police interventions, but most news media have voluntarily agreed not to publicize this fact.)

 

While people experiencing a serious problem or calling for help may be surprised to receive a visit from police or “the team”, others say they were surprised that anyone thought they were in an emergency situation at all.

Recently divorced and laid off at the age of 35, Joan Mackay became depressed. She wasn’t suicidal, she says, but had been finding it challenging to get out of bed. Meanwhile, longstanding conflicts between her and her father were intensifying.

Earlier this year, two people arrived at her door with two policemen, she says. Always an “anxious” person, Joan admits she backed away. A male officer then clutched her arm while a woman introduced herself as a social worker who wanted to talk. Confused and afraid, Joan refused.

Joan was promptly taken to the Royal Jubilee Hospital emergency ward and then transferred to the Eric Martin Pavilion. Her purse was searched, she says, her requests to contact a lawyer were denied, and no one informed her of her rights. She says that despite complaining about being kept against her will, she was not informed that a complaints process was available to her.

Finally, she says, she came up with a strategy. “I just thought, if I remain calm and go along with this, this will all end at some point.”

Joan says a psychiatrist informed her that her father had contacted EMHS and the Eric Martin Pavilion and had described Joan as threatening and suicidal. For her part, Joan describes her elderly father as an easily frustrated, domineering man who has “lost some of his reasoning skills and memory”. She believes his call to EMHS was a way of getting back at her for cruel things she’d said in the heat of argument. What likely played a significant role in Joan’s release from hospital four weeks later was that another close relative presented herself to hospital staff and backed up Joan’s side of the story.

The experience has left indelible scars on Joan.

“I want to cry because it’s so horrible,” she says of how easily she was involuntarily committed and treated with medications, apparently as a result of a family feud and an interview with a psychiatrist which she says was conducted while she was still in “utter shock”.

Her picture of our society has changed dramatically, too. “Where do you separate the medical team and the police?” she wonders. “I find it very frightening that our government has encouraged this.”

 

In fact, says Staff Sergeant John Smith of the Victoria police department, the police and EMHS do share many common goals and a common complaint about the mental health system: that not enough people are being kept in hospital.

“There seems to be some sort of, let’s say, a professional difference of opinion,” says Smith, referring to people who’ve been brought in by police and/or EMHS and promptly sent home by hospital doctors.

Smith, the department’s emergency mental health liaison, acknowledges that the bulk of Mental Health Act arrests involve “a big grey area” of interpretation. Often, neighbours will complain about someone’s all-night banging or unhygienic living conditions and police will “err on the side of caution” and take the person to a hospital for a psychiatric assessment, says Smith.

Most people and organizations interviewed by Monday said the most common cause for contacting EMHS is when they observe people whose behaviour is so far outside social norms that they seem to be placing themselves in danger.

Rose Henry, the director of the Victoria Street Community Association, points out that a person can become a “danger to themselves or others” merely by being extremely dysfunctional in our fast-paced, uncompassionate and dangerous society. Henry sympathizes, but has a ready response for those occasional people who have angrily blamed her for their negative experiences after her call to EMHS helped put them in hospital: “That’s better than being found in a back alley dead.”

Henry’s remark highlights something Brett Haughian, senior paralegal for the Community Legal Assistance Society’s Mental Health Law Program, has observed–that the tactics of forced psychiatry are more often used to help control people’s behaviour than to help improve how patients themselves feel.

“That’s definitely the trend,” says Haughian. “There seems to be more emphasis on trying to categorize behaviour and get it off the streets.”

As the Victoria police acknowledge, when such relatively harmless people are taken to hospital there is no requirement to inform them of their rights. The reason? The person isn’t being charged with an offense. Police and EMHS are simply trying to help.

All of which raises the question: What are a person’s rights before his or her life becomes subject to everyone else’s “differences of opinion” about his or her behaviour?

Haughian explains that the mental health unit that might arrive at your door has broad powers. Based on their own observations or information received from a third party, he says, police and EMHS together can enter your home, examine you, or take you to a psychiatrist for an examination. If you refuse to talk, states Haughian, your reticence could be used as part of the police or EMHS assessment, or even as part of the hospital psychiatrist’s diagnosis that gets you incarcerated.

“One of the problems is, there’s no definition of what an ‘examination’ is,” says Haughian. “Examination is a pretty wide open exercise.”

 

If society intends to provide such exceptional powers to control “unusual” behaviour or expression, and ultimately to impose psychiatric treatment onto an ever-wider variety of people, it seems important to make sure there’s solid science underlying diagnosis and treatment of mental disorders.

Unfortunately, opinion differs widely even on what constitutes a psychiatric “examination”. In fact, the entire field of mental health science and law is surrounded by a vast maze of hazy issues that provide ample room for error when applied by frontline workers.

For example, Stanton notes that the NEED Crisis line is certified by the American Association of Suicidology, and that volunteers receive six hours of training in “risk assessment”. Nevertheless, Martha, a woman who takes psychiatric medication and admits calling the crisis line often to talk about her suicidal feelings, is one person who was less than impressed with a particular crisis line volunteer’s perspicacity.

“I said I was going to commit suicide in the millennium. Not tonight, in the millennium,” says Martha. “But the police and ambulance showed up. [The volunteer] must have been a rookie or something.”

Meanwhile, a large body of evidence suggests professional psychiatric assessments and predictions of dangerous behaviour frequently prove to be inaccurate–in some cases, no more accurate than the guesses of rank amateurs.

In Stanford University psychologist David Rosenhan’s famous 1973 study “On Being Sane in Insane Places”, staff at 12 different psychiatric hospitals failed to distinguish “normal” people from other patients. Similarly, in her 1998 book Manufacturing Victims, psychologist Dr. Tana Dineen points out that the standard clinicians’ bible, the Diagnostic and Statistical Manual of Mental Disorders, “pathologizes” such behaviours as lovesickness, sleepwalking and computer addiction.

According to Principles and Practice of Emergency Medicine–a 1992 textbook in the Eric Martin Pavilion’s own library–easily detected ailments like nutritional deficiencies, infections and cardiovascular diseases have been shown to be the causes of the mental disorders of up to 30% of psychiatric hospital emergency patients. These causes usually go undetected, the text says, because less than 10% of psychiatrists ever do physical examinations.

And in 1997, Dr. Grant Harris and Dr. Marnie Rice of Ontario’s Mental Health Centre published an overview of the scientific literature on predicting violent behaviour in mental patients. The article states that psychiatric predictions of violent behaviour “are wrong twice as often as they are right”. The researchers add that “[n]o evidence has been found” to suggest that psychiatrists’ judgments are better than those of laypersons in predicting violent behaviour.

When asked in writing how they respond to such expert criticisms, spokesman Hume replied that the Capital Health Region would not respond to “unsubstantiated allegations”.

But Dr. Bilsker of Vancouver General Hospital’s psychiatric assessment unit readily confirms the general criticisms.

Bilsker explains that his health ministry crisis response working group has been carrying out extensive research to ensure that B.C.’s emergency mental health practices are “evidence-based”.

Mental health professionals, concludes Bilsker, aren’t “terribly accurate” in their predictions about the likelihood of patients doing harm to themselves or others over the long term. “No one has that ability,” he says. He feels professional predictions of risks over several days are “pretty good”, but admits no studies back up that belief.

Even if there may be short term benefits, can we feel confident about the long term benefits of subjecting depressed or emotionally volatile people to detention and forced treatment?

“There’s always a trade-off, and I know of no way around that trade-off,” he concedes.

“There’s an unrealistic notion on the part of the public, and even on the part of some mental health practitioners, about what treatments can do, and about the limitations of treatments,” Bilsker says.

For this reason, his working group will be recommending a “de-emphasizing of hospitals”. According to Bilsker, community supports, safe houses and non-medical therapies have been shown to be as effective as psychiatric treatment in helping people manage many kinds of acute mental problems.

It sounds constructive. But in fact, B.C. is undergoing unprecedented polarization between those who support individual rights, community agencies and non-medical approaches, and those who advocate greater state control through forced medication.

In 1994, B.C. ombudsman Dulcie McCallum launched the first ever independent investigation of a major Canadian psychiatric institution. She found “systemic” disregard for legitimate patient concerns at Vancouver’s Riverview hospital. She also strongly endorsed the Mental Health Law Program service of providing involuntarily hospitalized patients with free, automatic access to independent rights advice. According to Haughian, most B.C. hospitals have refused to allow the service and the B.C. government has refused to mandate it.

Meanwhile, legal advocates, civil rights groups and many community agencies vehemently protested last year’s amendments to B.C.’s Mental Health Act, some arguing the expanded criteria for involuntary treatment could apply to virtually anyone.

Proponents of forced psychiatry argue tougher laws are needed because many disordered people aren’t capable of competent decisions. In response, Haughian points out that, unlike in Ontario, B.C.’s Mental Health Act now authorizes treating people against their wills even when they’re still deemed competent.

Alex Berland, interim director of the B.C. health ministry’s adult mental health division, clarifies the government’s objective: to help patients live in their own homes while mobile caseworkers ensure those people stay on medications. And since psychiatric treatments sometimes help manage yet “almost never cure” severe mental disorders, the new plan is to use organizations like EMHS to help identify people in the early stages of illness and then intervene with drugs in the hope that disorders can be prevented from developing.

Questioned about evidence of the inaccuracy of diagnostic tools, Berland disagrees and points to this year’s Canadian Mental Health Association early intervention study–a study that, in fact, states that “nearly half of participants received an incorrect diagnosis”.

Nevertheless, Berland declares that “teams and teams” of mental health workers will be involved in the growing “assertive community treatment” project.

 

For now, it seems, Victorians will have to live with what Bilsker refers to as the “trade-off”.

On the one hand, some people experiencing psychological problems will be aided by forced interventions–people like Anna, who speaks for the many people helped by psychiatric treatment. Found rambling and shouting in the streets, Anna was escorted–protesting all the way–to hospital. Today, she is on medication and functioning well.

“For me, [EMHS] was a lifesaver,” she says.

But others will have to live with the other side of the trade-off: living in a society where experiencing or even just talking about emotional difficulties may expose you to the risk of incarceration or forced treatment.

Both Sandy Merriman House shelter manager Chris Downing and Victoria Street Community Association director Rose Henry observe that, even though teams tend to be compassionate and can often “ground” people and help keep them out of hospital, most people who’ve been in hospital before have negative reactions when told EMHS has been called.

“It takes quite a bit of encouragement to keep them on site until the team arrives,” states Henry.

After her own initiation to B.C.’s mental health system, Joan Mackay sympathizes with such reactions. “If I ever get suicidal,” she says, “then I’m never going to tell anyone.”

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Doctor Banned in Ontario, Back at Work in Victoria

Originally published in Monday Magazine, 1998. Connected to 2008 story, “Our Government’s Deliberate Helplessness”.

A FORMER chief of psychiatry at Eric Martin Pavilion psychiatric hospital whose licence was permanently revoked in Ontario after he was found to have drugged and repeatedly sexually assaulted a patient, is currently practising in Victoria.

Dr. Frank Gordon Johnson worked in Ontario during the 1970s before moving to Victoria. He maintained a private psychiatric practice here from 1979-91, was a staff member of the Eric Martin Pavilion during that time, and held the position of EMP chief of psychiatry from 1983-89.

In 1993, the Ontario College of Physicians and Surgeons found Johnson guilty of medical incompetence and sexual impropriety, and declared him “unfit to continue in practice”.

From hospital notes as well as patient and expert testimony, the Ontario tribunal concluded that Johnson had kept Jean Halliwell in a London, Ontario, psychiatric hospital for months at a time during the ’70s, and that he ignored professional criticism about the “wide variety and large doses” of drugs he was administering to her.

The drugs put Halliwell into a “zombie-like” state, according to hearing testimony, while Johnson repeatedly forced her into oral sex and intercourse. Another former patient also testified to having been repeatedly assaulted by Johnson in a similar manner.

Yet in March of this year, Johnson was granted a one-year renewable licence to practise in this province by the B.C. College of Physicians and Surgeons.

“My lawyer has asked that any questions get directed to him,” said Johnson last week in reply to a request for an interview. His lawyer, however, did not return calls. Halliwell’s lawyers also advised her not to speak, as she is currently suing Johnson. Representatives from the Capital Health Region and B.C. Ministry of Health denied having any responsibility or authority in the matter. Even Sandy McLellan of the Victoria Women’s Sexual Assault Centre declined to comment on the situation.

But B.C. advocacy groups for survivors of psychiatric treatments aren’t mincing words.
“I’m angry and disgusted,” says Gerry McVeigh of Victoria’s Anti-psychiatry Movement for Alternative Approaches and Directions, pointing out that in his new private practice, Johnson could be treating victims of sexual abuse.

“It’s astonishing to me that they’d let him practise,” says Irit Shimrat of Vancouver’s Lunatics Liberation Front. “I think it’s really strange and grotesque that B.C. doesn’t think there’s something wrong with that.”

According to the B.C. College of Physicians and Surgeons, the physician-run organization with authority for licensing and maintaining professional standards, Johnson is “a member in good standing”.

Deputy registrar Morris Van Andel says the physicians’ organization granted the licence after an investigation including three expert assessments and an interview with Johnson. Previous precedents in B.C., the fact the Ontario verdict related to events from 20 years ago, and the psychiatrist’s clean record in Victoria previously, all played a role in the decision, Van Andel explains.

The Ontario case was not considered in detail, and such out-of-province disciplinary actions are never put on a doctor’s publicly available record in B.C., Van Andel confirms. He notes that regulations and standards differ from province to province, and when a licence is revoked elsewhere, it doesn’t necessarily mean the doctor will lose his or her licence–or be refused one–in B.C.

As for Johnson’s record in Victoria, for the public, the question is largely one of faith. Most professional records regarding Johnson’s work in Victoria are confidential, and according to Janice Martinez, regional director for mental health, actual information on sexual abuse allegations within Eric Martin Pavilion would be difficult to gather because it would be scattered through a variety of records–virtually none of which are available to the public. Recent complaints lodged with the B.C. college would not be public information, either.

In any case, Van Andel says that in B.C. and most other provinces, suspensions beyond three years are uncommon, and permanent revocations are reserved for only the most extreme cases.

“If [Johnson] had committed the same offence here, he would have already been practising,” says Van Andel.

In fact, Van Andel feels the Ontario College was out of line when it revoked Johnson’s licence with no opportunity to re-apply for five years.

“A suspension of practice for five years is an extremely heavy punishment,” he says. “You can kill somebody and be out before then.”

He adds that the Ontario college is “very aggressive” in cases like Johnson’s, and calls their “zero tolerance” approach “somewhat hawkish”.

“That’s a fairly interesting statement for someone to say,” responds Jill Hefley of the Ontario College of Physicians and Surgeons. “I’m not sure whether the public is well-served by allowing physicians who’ve been found guilty of sexual abuse and medical incompetence to continue practising.”

McVeigh is blunter: “My god! What do you have to do to get your licence permanently revoked in B.C.?”

He points out that it’s one thing to allow someone found to have committed sexual assault the right to rehabilitate and start a new life, but quite another to grant that person a licence to practise psychiatry.

“In the mental health system psychiatrists are the most powerful people there are,” argues McVeigh. “All [psychiatric patients] are in a very vulnerable state, and suggestible.”
Despite such criticisms, Van Andel says the B.C. college is “here to represent the public, not to protect doctors”.

Most college investigations are confidential, with details unavailable to reporters even under B.C.’s freedom of information laws. One of the few publicly available examples of a B.C. college reprimand in a severe case involves Victoria native Dr. James Tyhurst, former head of the UBC department of psychiatry. In 1981, a female patient testified that her “therapy” involved having to strip naked, kneel and call Tyhurst “master”.

The college interviewed the psychiatrist and then issued a letter of reprimand, advising Tyhurst that “the degree of subjugation was unwarranted and its effectiveness questionable”. Tyhurst didn’t stop practising until 1991, when four more female ex-patients testified during his criminal trial to being subjected to hundreds of whipping sessions and forced oral sex.

Also revealing is the B.C. college’s own 1992 province-wide study of sexual misconduct. In it, 3.5% of B.C. physicians (psychiatrists themselves were about one per cent lower) admitted they’d had sex with a person who was their patient at the time. Extrapolating from that statistic, there would be dozens of doctors and psychiatrists in Greater Victoria who would admit to having had sex with patients they were treating.

In the report’s introduction, the college-appointed team of researchers state that the problem of sexual misconduct in B.C. “is serious”–but not primarily because of the actual incidence rate of exploitation.

Rather, “[I]t has eroded the public’s confidence in the medical profession and it has placed doubts in patients’ minds about their trust in their physicians and about the profession’s ability to ‘police’ itself,” the report’s authors declare.

Shimrat says the B.C. college’s handling of the Johnson case reveals a similar “self-centredness”: “It shows horrible disrespect to potential patients to have [Johnson] practising here.”

The World is Round (and other Mythologies of Modern Science)

A challenge to the common Humanist argument that science is not like a religion

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Author’s Note: This article of mine exploring the similarities between science and religion, or rather exploring the ways that science and religion are typically thought of and operate in the world, was published in 1997 in The Humanist, the magazine of the American Humanist Association. The article has been one of the most frequently quoted I’ve ever written, and has been the subject of some rather “interesting” attacks and interpretations around the internet — usually based in some pretty fantastical misinterpretations of my ideas or strange assumptions about who I am and what I believe. There was also an article that was written by a woman who is either my coincidental parallel universe soulmate or simply someone lifting my ideas very generously without deeming fit to cite me or pay me a royalty, in a 2006 Harper’s Magazine review of Dawkins’ book, The God Delusion.  Anyway, since Richard Dawkins, Christopher Hitchens and the whole pseudo-scientific “rational” attack on “religion” has only snowballed into mega-fame since then, I’m re-posting my old article about the topic.

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Contrary to popular belief, the world is not round.  And the tale of the world’s alleged roundness is not the only mythology that modern science has passed onto mass culture.  It is this dubious role as “mythological web spinner” that science and rational thinking play in our broader culture and in actual human lives which many Humanists often avoid exploring.

The 1996 Humanist of the Year, Richard Dawkins, for example, in his article, “Is Science a Religion?” in the January/February, 1997 issue of The Humanist, has a tendency to speak very glowingly about Science with a capital ‘S’ and Rational thinking with a capital ‘R’.   He speaks about Science being “based upon verifiable evidence,” and “one of the most moral, one of the most honest disciplines,” and about it having “none of [religion’s] vices.”  But is all this the actual reality of science as it is practiced in the world, or is all this a reified, idealized, and almost mystically fantastical dream about What Science Might Be In a Perfect World?  After all, if we distill almost any prominent religion down to its capital ‘R’ form, it will always claim to be about living intelligently, rightly, honestly, based in Truth, etc.  Sounds pretty nice.  But of course, when we assess religion as a whole, we look at what it is in actual practice.  We factor in the advocation of genocide on page 237, the way the hierarchy of experts creates blind followers, and the way the whole vast conceptual structure is founded on some highly questionable assumptions which often lead to unnecessary wars.  Humanists go through this process because in the final analysis, Humanists care most not about idealized concepts, but about real people and actual lives.  So if we want to compare science and religion fairly and objectively, let us not compare Science The Fantasized Ideal to religion in human reality, but science in human reality to religion in human reality.  And here is where the role of science as spinner of myths, as deluder of the masses, as intensely repressive force, must be confronted.

So let us look for a moment at the actual role of science and rational thinking in human society.

Scientists once widely believed that the world was flat.  ‘There is ample proof,’ they said.  And they had proof.  Objectively, the world looked pretty flat, particularly on prairies and next to oceans.  People did not fall off or feel like they were upside-down anywhere on the planet.  No one had proof they had ever gone around the world.  In fact, people had so much confidence in this line of rational thinking that when others began to argue the world was round, they were often looked upon with extreme skepticism, as evangelical believers in fantastical gobbledygook.

‘Rational thinkers’ have not always been the most insightful and open-minded of people.  Throughout history, ‘thinking rationally’ has often become a guise for repressive attitudes towards the new or unconventional.

Indeed, science and rational thinking have had a dubious and ragged history in our culture, exhibiting a constant and sometimes savage battle between the ‘rational’ and the ‘radical.’  Pasteur was widely ridiculed for his speculations about invisible creatures that caused illnesses.  Even by the time Einstein was being awarded the Nobel Prize, relativistic mechanics was still so controversial amongst physicists that he was instead given the award for other aspects of his work.  Which is to say, well into this century a plethora of top scientists still believed in Newtonian mechanics as the best model for activity in the universe and were much more interested in adapting the old model to the new evidence than in accepting a radically new model.  Which is not at all unlike the process religious institutions have often used as they have tried to adapt to changing times: retain the old system of beliefs, but slightly revise it so it coincides more readily with new, contemporary beliefs and observations.  And indeed, the history of science does not, as Dawkins implies, show simply a vast group of reasonable people testing each other’s theories in warm camaraderie.  The history of science has often been and continues to be and will continue to be a history of completely debunking established belief systems by positing entirely new belief systems in their place, or significant progress more often by revolution than evolution.  And because science has always been so heavily founded in vast, systemic views of the world, the mainstream scientific community has always been extremely, I would argue repressively, conservative when confronted with radical new notions which threaten to change too much too fast.  Again, it acts much like its institutional brethren in the religious field.  Americans need only look to the 1950’s and 60’s in their own country to see a virtual plague of cases of scientists involved in advocating the banning of scientific books and the dismissal of professors, victims including the likes of Wilhelm Reich, Timothy Leary and Linus Pauling.

Meanwhile, through all the political struggling over the years, the ultimate issues of Fact and Truth have remained elusive due to fundamental problems within the whole nature of Science and Rationality (with a capital ‘S’ and a capital ‘R’).  These deep quandaries within science and rational thinking are perhaps best made explicit with reference to Descartes, that quintessential enlightenment thinker.  Descartes sought to remove all mythologies and assumptions in order to build a philosophical system based on objectively verifiable fact.  When he felt he had removed all his assumptions, he stated that all he knew for certain was that he existed.  He thought and felt that he existed, after all, and even if he were utterly insane, there would still have to be some thing which was insane; therefore he must, indeed, one way or another, exist.  From this cornerstone in objectively verifiable, undeniably rational, scientific fact, Descartes went on to rationally build an entire philosophical system which even, amazingly enough, proposed the existence of God.  There was only one problem.  Descartes forgot all about the second option: that he might actually be utterly insane.  After step one, he simply ceased considering that as a possibility.

‘Insane’ seems a bit of a harsh moniker to toss on a long-deceased gentleman philosopher, but certainly one could argue that he was not being altogether clearheaded.  His momentary lapse of rigor let him go on to continuously neglect a host of assumptions he was making: that he was rational, that thinking was a reliable tool, that it was not worth questioning what “I”, “to think,” and “to exist” really meant, and so on.

And this brings us to the basic, underlying problem of science and rational thinking as a whole.  It may all just be plain wrong.  Ultimately, what we call ‘rational thinking’ may just be a highly sophisticated and powerful method of self?delusion, and we do not have an experiment we can conduct to definitively prove or disprove that.

In typical Humanist fashion, Dawkins asserts: “Science is based upon verifiable evidence.”  This is partly misleading.  Science uses verifiable evidence, but in the final analysis it is based on  working assumptions and faith.  For example, let us use his example of evolutionary theory, which is, of course, also a cornerstone of much Humanist thought.  Dawkins says that he believes in evolution because the evidence for it is “overwhelmingly strong.”  In this case, he is using the apparent facts to concoct a theory.  This is acceptable science.  But his facts may be wrong or misinterpreted, and his theory may be misguided.  A Creationist could simply say, “God has made it appear as though evolution has occurred.”  Yes, indeed, this argument gives us a hypothesis based in blind faith that is extremely difficult to verify or rebut, but then, it merely exposes how much the belief in evolutionary theory is ultimately based on a similar kind of blind faith.  It shows there is no definitive, final proof for evolution, either.  There are just a lot of suggestive facts that make some of us formulate an argument, every bit as tautological as the quote-the-Bible-to-prove-Creationism-is-right arguments, which goes something like this: “Evolution seems to have occurred; therefore, evolution has occurred.”

In truth, what proof do we have that anything about science is correct?  Most of us point to technology as evidence, but technology is also just a reflection of science successfully using apparent facts, not establishing their Objective Truth.  Technologies may come about as a result of scientific discoveries and hypotheses, but just because something works does not mean our theory about why it works is right.  Just because we all get monthly electric bills for our toasters does not conclusively prove that our current model of electronic activity is correct.  It simply means that, regardless of whether we are right or not, our suppositions work well enough for us to not really care.  Toast is toast and we are hungry.  And that is remarkably similar to what many religious believers may say, is it not?  Christians know they cannot objectively prove that God does indeed enter the hearts of all who truly believe in Him, but as far as the believers are concerned the process works well enough!  Believe He is in ye, and ye do indeed feel Him in ye.  The religious joy of the television audience unravels and the checks roll in, and they do not really care that they do not ‘ultimately, objectively’ know.  They are hungry, and wafers are wafers.

As we see, then, religion in our society is a rather pragmatic, rational activity, albeit one based on some inherently questionable presuppositions.  And that is a reasonable description of technology as well.

When it comes right down to it, we do not have a clue if our current model of electricity is ultimately correct or not, any more than we can be completely certain of anything else.  Sure, we have lots of evidence to suggest our theories might be close to being accurate about certain things, but ultimately, we could be simply insane.  Or, to put it in more scientifically-friendly and historically verifiable terms, we may not be quite insightful enough yet. We do not know what is holding this universe together or blowing it apart, and we do not know what the essence of material substance is nor where to find it.  We do not know why there is something as opposed to nothing at all, nor why that ‘something’ seems to obey certain physical laws at times.

Still, Dawkins contends that “the main vice of religion . . . is faith”, and by that he implies blind faith, or faith which allows no questioning at all.  When contrasted with blind faith, science is clearly a more open?minded pastime.  But it may not be that blind faith is religion’s main vice, because it is arguable whether that is even the kind of faith that most religious believers have.  As Dawkins himself points out a little further on, religion, in a sense, has always been “bad science.”  Religion has sought to “offer a cosmology and a biology, a theory of life, a theory of origins, and reasons for existence.”  This is the point.  For the vast majority of people, religion is not a blind faith; it is more like a messy hodgepodge of rational and mystical beliefs, unconscious assumptions and genuine convictions borne of differing amounts of analysis and reflection.  This is the main vice of religion, and it is precisely here that we see the dividing line between religion and science fading completely.  Because science does not exist in a perfect world, either.  Scientists can be tired, ornery and incredibly irrational when they wake up in the morning; they do lie, they do falsify data, they do have moral beliefs strongly directing their investigations, they can be greedy, they may well have weak powers of logic while no one else has the time or money to debunk their arguments, they may well use statistical data that is misleading or that can be misinterpreted, etc etc.

Dawkins does have a response to this, however.  He suggests that the definitive difference between scientific zealots and religious ones, is that scientists are “content to argue with those who disagree with us.  We don’t kill them.”  Well, many, many religious believers are content to simply argue, too.  So it is with acute irony that Dawkins interprets the troubles in Northern Ireland and the Middle East as evidence of the dangerous “virus of faith,” while failing to note the extraordinarily important and equally powerful role played in the physical violence and emotional fervor in these places by modern weaponry and communications systems; by the relentless march of science and technology through cultures.  Which is truly more destructive, the half-baked religious belief that fires a missile, or the half?baked rationality that constructed the missile in the first place?

The central problem with rational thinking then, is that it may not work much better than religion when it comes to fundamental issues of truth and understanding of life.  Just because we believe it works better, we think it works better, and people who believe in rational thinking believe they have proof that it works better, does not necessarily raise rational thinking above the level of a remotely tolerant religion.

Rational thinking is a tool which seems to help with powerful effectiveness on a very superficial level of human functioning.  (You want toast, we can give you toast.)  But a total prescription for understanding oneself, the world, or for founding a philosophy of life it is not.  (What is toast?  Should toast be considered the be?all and end?all?)  Not unless you are the kind of person who is content to merely believe moral and ontological statements without much questioning, until someone convinces you to believe something else.  If you are not that kind of person, if you are eager to live a life based on continually learning and discovering and not on accumulating beliefs of any kind, then you must confront the shaky foundations upon which rationality is based as you explore the essence and nature of life and existence.

If we really wish to go beyond the mythologies and illusions that the mind projects, beyond the half-baked theories it routinely spews, fights to defend, and only much later discovers to be false, then we must find ways to understand the world and ourselves which go beyond rational thinking.  Rational thinking obviously has an important role to play in the modern world, in thinking, in science, in functioning, and in discussion, but the truly serious person must at all times be skeptical.  We must always be exploring and discovering that which lies beyond the rational, inside and outside ourselves; we must be open to the possibility of the new and the radical.  Such a person can then be touched by art, by meditation, by the experience of the sensual and so much more.  Many well?known rational thinkers, like Einstein, have spoken much of sudden inspiration and spontaneous insight; quasi?indefinable things which apparently also reach beyond the rational.

And why is it so important to always be exploring that which lies beyond the rational?  Because we want to understand the world, and rationality alone cannot do that.  Rationality possesses dangerously deceptive qualities due to its inherent superficiality and its need to always have working assumptions.  It must be tempered with far less tangible things like eager open-mindedness, sensitivity, insight, enduring affection, and rigorous skepticism.  Truly straight lines, after all, are just a mythological theory.  Nobody has ever seen one.  And contrary to the popular myth that science has propagated, the world is not round.  From a distance, it looks somewhat like a pie.  Other learned knowledge will suggest a sphere.  The actual fact of the matter seems to be that it is a rugged, erratic, uneven, unnamable shape which, when its surface is made relative to its overall bulk, gives the appearance from a distance of being somewhat round?like.

Now, if you are the kind of person who always calls a line that runs from the floor of Death Valley up across the Himalayas and down into the deepest holes of the Pacific ocean and back up across the Rockies ­a smooth and constant convex curve, then hey, I yield to your mystical, God-given level of insight into these matters.  But I still might suggest we go out for a long, meditative hike one day and explore it for ourselves before we start telling people what shape the world is, and how best to look at it.

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