Thursday, November 1, 2012
I live in Florida. Those of you familiar with practical politics here in the US should have some idea of what this means regarding the significance of my vote.
Guess what? I chose to make my voice heard in a far more significant way than a mere blog post.
It took, as it happens, about forty minutes, most of which was spent in a line. For those of you who go, I recommend bringing a book -- the paper kind -- because the legality of cell phones and the like in voting areas is... well, an issue. It's illegal to use them here; no idea about elsewhere.
And, if the person reading this happens to be a politician? Yes, people with disabilities vote.
And that means that we can vote for (or against) you.
In the end, as I said, that's far more important than a mere blog post. Today, for me, was not just Autistics Speaking Day.
It was Autistics Voting Day.
Wednesday, September 19, 2012
Sunday, July 22, 2012
This would be a lot less problematic if the law -- or legal research, for that matter -- was simple and/or straightforward. Simply put, it is not.
While child abuse is illegal in every state, the statutes vary. Even when they're the same or similar, the case law (or legal precedents) vary as well. In practical terms, this means that while child abuse is illegal in every state... the meaning of the term isn't the same in each.
For instance, in Michigan, the relevant definition (§ 722.622, for those of you interested in looking it up) reads:
'Child abuse' means harm or threatened harm to a child's health or welfare that occurs through nonaccidental physical or mental injury, sexual abuse, sexual exploitation, or maltreatment by a parent, a legal guardian, or any other person responsible for the child's health or welfare or by a teacher, a teacher's aide, or a member of the clergy.Alternately, there's another definition in § 722.602:
“Child abuse” means harm or threatened harm to a child's health or welfare by a person responsible for the child's health or welfare, which harm occurs or is threatened through nonaccidental physical or mental injury; sexual abuse, which includes a violation of section 145c of the Michigan penal code, Act No. 328 of the Public Acts of 1931, being section 750.145c of the Michigan Compiled Laws.
Of course, this doesn't explain just what does (or doesn't) count as "nonaccidental" injury or "maltreatment". That's what case law is for.
I live in Florida, however, so the Florida statutes are of somewhat greater personal interest to me. This is especially true given the corollary of my residence: most of the kids I personally care about and have worked with live here, too.
Here, the statute (s. 827.03, for those of you who want to look it up -- or you can just go here) reads:
(1) “Child abuse” means:
(a) Intentional infliction of physical or mental injury upon a child;
(b) An intentional act that could reasonably be expected to result in physical or mental injury
to a child; or
(c) Active encouragement of any person to commit an act that results or could reasonably be
expected to result in physical or mental injury to a child.
A person who knowingly or willfully abuses a child without causing great bodily harm, permanent disability, or permanent disfigurement to the child commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
(2) “Aggravated child abuse” occurs when a person:
(a) Commits aggravated battery on a child;
(b) Willfully tortures, maliciously punishes, or willfully and unlawfully cages a child; or
(c) Knowingly or willfully abuses a child and in so doing causes great bodily harm, permanent
disability, or permanent disfigurement to the child.
A person who commits aggravated child abuse commits a felony of the first degree, punishableFrankly, I like the Florida statute far better than I do the Michigan equivalent. This is for a variety of reasons... but that's an entirely different discussion.
as provided in s. 775.082, s. 775.083, or s. 775.084.
As always, however, there are points where the seemingly-straightforward law becomes ambiguous. For instance, what does it mean to "willfully torture" someone? Then there's the reasonableness standards which pop up throughout. Perhaps by necessity, there's a great deal of vagueness there.
One of the major purposes of case law is to clarify this vagueness. Unfortunately, however, case law is a tangled, overcomplicated mess at the best of times. I -- to be blunt -- hate having to delve into the topic.
This does not, however, mean that I am unwilling to do so. I just prefer to leave it to the professionals.
In fact, I am aware of a number of cases which impact on the definition provided above. I've actually read a couple of them in their entirety while researching a specific issue.
The first of these, Nicholson v. State, was decided by the Florida's Supreme Court in 1992. I will not bother detailing the circumstances of the case (they're extraordinarily disgusting, and listed in the decision I linked anyway), and the reasoning of the decision depends on a definition which has since been removed from the statute. That said, the court ruled that "willful torture" under the statute explicitly included acts of omission -- such as failure to provide food -- provided they were committed with the willful intent to cause unnecessary or unjustifiable pain or suffering.
The case also continues to be cited as precedent by other cases despite the statutory change.
The second of these, Cox v. State, was decided by the Second District Court of Appeal in 2009. A couple of the more relevant passages:
Aggravated child abuse is largely determined on a case-by-case basis rather than with bright-line rules as to what conduct does and does not constitute aggravated child abuse. Herbert v. State, 526 So.2d 709, 712 (Fla. 4th DCA 1988). This flexibility is critical to allow for consideration of such factors as the age of the victim, the frequency of prohibited conduct, and other circumstances relevant to a particular case. It is clear, however, that “the first-degree felony of aggravated child abuse [is] preserved for truly aggravated circumstances.”
However, this court has held that aggravated child abuse for malicious punishment is reserved for “cases involving parental discipline that results in great bodily harm or permanent disabilities and disfigurements or that demonstrates actual malice on the part of the parent and not merely a momentary anger or frustration.” McDonald, 785 So.2d at 646
I leave further case-law research to the legal scholars... who are, frankly, generally far better at it than I am.
I bring all of this up because of the latest inane fad "treatment" for autism -- the bleach enema.
Giving your child an enema is very definitely an intentional act -- it's rather difficult to unintentionally take a bag and shove fluid up your child's posterior. In the case of bleach enemas, it also could reasonably be expected to result in physical or mental injury.
This means that, under section (b) of the definition above, the act of giving a child a bleach enema constitutes child abuse under Florida law.
Or, at least, that's my reading of the matter. As I noted before, I'm neither a lawyer nor a judge, so people don't -- and shouldn't -- particularly care about my opinion in legal matters. Anyone who has a different interpretation is more than welcome to elaborate on it or discuss it in the comments.
Does it, however, constitute aggravated child abuse? That's a thornier question, and the ultimate goal of my legal research. If the process includes aggravated battery, or actually causes "causes great bodily harm, permanent disability, or permanent disfigurement," then I believe it would.
If it doesn't? Maybe. It depends on the legal meaning of "willful torture" in this context, and that's fuzzy enough. I suppose it could easily depend on the lawyers involved.
You'll note that I'm including a lot of statements like "I believe" and "I suppose" here. I pretty much have to. There are reasons why I hate legal research. These are the sort of points which lawyers have been known to debate endlessly in courtrooms, and legal textbooks often take multiple chapters to answer them in the most circuitous and tentative ways imaginable.
In any case, the more interesting part of the definition is part (c). According to this, even actively encouraging people to commit child abuse constitutes child abuse in and of itself. I would argue that promoting bleach enemas as an autism treatment qualifies.
On top of all of this, we have Florida's mandated reporter statute. Without getting into the details, it requires people who know of or suspect child abuse to report it to a Florida abuse hotline (1-800-96-ABUSE). This requirement is (on the statutory level) taken quite seriously -- failing to make a report when required to do so is a third degree felony. Making a false report is also a criminal act (also a third-degree felony), but people acting in good faith are immune from prosecution.
What all of this means is that -- at least according to my own reading of the statute -- anyone who has reason to suspect that a child is being "treated" with bleach is legally required to call the hotline.
Whether the laws will actually be enforced in practice is an entirely different matter... and, frankly, one that I'm in no mood to discuss.
In large part, this mood goes back to the beginning of this blog post, where I noted that things vary by jurisdiction: I did not choose Michigan's laws as an example by random chance.
As I write this, I am looking at a letter, from the Michigan Department of Human Services, written on official letterhead... whose contents boil down to a statement that, under the Michigan Child Protection Law, repeatedly giving your child bleach enemas in the name of autism "treatment" does not qualify as child abuse.
Saturday, June 2, 2012
The fact that people get swindled as a result is among the least appalling aspects of this.
The list of things which have been promoted as such -- and which parents have tried -- is absurdly long and often just plain absurd. Seriously, it almost mocks itself at times. If it wasn't for the fact that parents are actually doing these things to their kids (which I cannot emphasize enough) out of desperation to "cure" or "recover" their children, it would actually be comedic.
Among other things, the horrific list of things which parents have done includes (but is by no means limited to):
- Feeding their kids massive overdoses of vitamins to the point that they suffer from or risk vitamin poisoning.
- Putting their kids into a potentially explosive tube full of compressed air for a prolonged period of time (usually around an hour per session).
- Getting their kids high on marijuana.
- Forgoing protection against potentially deadly diseases.
- Strapping their kids down for several hours while they pump an irritant into said child's veins.
- Deliberately infesting their children with intestinal parasites.
- Chemically castrating their children.
- Feeding their kids an industrial chemical which has never been subjected to proper safety testing.
- Making their children drink an industrial bleaching agent.
- Giving their children bleach enemas.
This is a highly incomplete list.
When I say that the stigmatization and panic-mongering that organizations like Autism Speaks engage in has real consequences for autistic people... the above is just one of the things I'm talking about.
Take this as you will.
Edit: Was corrected on a relatively minor point.
Tuesday, November 1, 2011
He'll automatically comply to whatever my signal command may be, whether it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit appropriately and eat your food,'" she says. "It's made him a human being, a civilized human being.
Wednesday, September 28, 2011
Monday, September 12, 2011
Because diseases are abstractions based on cause (or "etiology" in medical language), a diagnosis serves as an explanation of the symptoms involved. This might sound rather sophisticated and/or complicated, but it's really not. If you go to the doctor's office and complain that your stomach hurts, "indigestion" is an explanation because it refers to a causal process (that is, why your stomach hurts). Were the doctor to use an abstraction based on symptomology (such as "stomachache"), it would not.
Of course, the doctor's explanation for the symptoms can be wrong. Throughout most of medicine, this is referred to as "misdiagnosis". There are also syndromes and the like which we don't know the causes of and times when the doctor can't figure out what's going on. While we know some things about these syndromes and cases (e.g. epilepsy tends to be chronic problem), these "diagnoses" aren't explanations of the symptoms -- they're descriptions of them.
Once you get it, this is really pretty simple. An answer to the question of why your symptoms exist (in more technical language, an "etiological construct") can explain them; a description of the symptoms themselves (in more technical language, a "symptomolgoical construct") can't. Despite this, however, people often make this mistake in a wide variety of ways. There's even a formal name for doing so: "nominal fallacy".
Put yet another way, you cannot say that your stomach hurts because you have a stomachache. "Stomachache" is a symptomological construct -- a label for the stomach pain. You cannot say that you are having difficulty sleeping because you have insomnia. The statement that you "have insomnia" is simply another way of saying that you have trouble sleeping. Neither serves as an explanation. This isn't to say that terms and concepts like "stomachache" or "insomnia" can't be useful, but they can't answer most questions of "why"... because they have nothing whatsoever to do with cause.
I'm making this as clear as possible because there is one field of medicine where the definition of the term "diagnosis" I provided does not apply. That field is psychiatry.
"Mental disorders", as used in psychiatry, are not etiological constructs. They are symptomological constructs. To use my earlier analogy, they are not akin to "indigestion" and are more akin to "stomachache". When a psychiatrist "diagnoses" a mental disorder, they are emphatically not saying anything about the cause of the symptoms you present them with -- they are simply deciding how to describe those symptoms in the standardized and highly formalized language of psychiatry.
The psychiatric "diagnosis" of "major depressive disorder" is simply another way of saying that someone is depressed... only it's far more precise (among other things, it distinguishes "major depression" from less severe or more transient types of depression). The psychiatric "diagnosis" of "bipolar disorder" basically means that someone goes through 'episodes' during which his mood is different from normal (in a clinically significant way). Similarly, the psychiatric "diagnosis" of "autism" basically means that someone isn't following the developmental psychologists' often-bigoted (and why I call it that is a whole 'nother blog post) One True Developmental Path for human beings.
When looked at this way, the way that people tend to accumulate multiple psychiatric diagnoses is easily understood -- for many of the same reasons that I don't think people would be surprised to learn that people with stomachaches also have fevers much more frequently than people who do not. This is simply because fevers and stomachaches can be caused by many of the same things.
The easiest of these to resolve are simply matters of degree -- for instance, what constitutes "markedly diminished interest or pleasure in... activities"? Where do you draw the line between what's "markedly" diminished and what's just diminished?
For the most part, these represent a sort of diagnostic "fuzziness" which is... resolvable, albeit not necessarily easily. Statistical methods are pretty good at dealing with this sort of issue in a research setting, although the problem remains. It remains an obstacle, but hardly an intractable one. If this problem is not understood, however, it can create a very wide variety of misconceptions.
Other problems, however, are more noteworthy -- and fundamental. For one thing, the defining feature of a "symptom" in medicine is that it's viewed as an indicator of an underlying pathology. Stomachache is a symptom of indigestion because it provides evidence in support of the idea that you are having trouble digesting food. It provides this evidence because problems with digestion tend to cause stomachaches. "Stomachache", in general, is viewed as a symptom of disease because a stomachache is a pretty clear indicator that something is going wrong in the body (even if you don't know what, and even if the problem is fairly minor).
In other words, a "mental disorder" is a disorder because it is viewed as a sign that there is something wrong with the person who exhibits it. Our judgments of what constitutes something being "wrong" with someone, however, are notoriously problematic.
We human beings have a tendency to judge other people based on our expectations and our often-prejudiced personal (and/or cultural) views on what people should be. When people fail to live up to these, we tend to conclude that there's something wrong with them, rather than concluding that the problem was with our views and expectations.
For instance, homosexuality used to be a DSM mental disorder (and even though most sources will state that it was removed in 1973, this is not entirely accurate). Moreover, its official status as such has a long history of being used to justify the torture (via abusive "treatments") both of homosexuals and people judged as being "at risk for" homosexuality.
Then there's the rather infamous (and atrocious) example of the countless ways in which psychiatry and psychiatric diagnoses have been used as a tool of institutionalized racism and of racial oppression. We can even look at the ways in which attitudes about race have affected diagnostic patterns.
Then there's the issue of so-called "diagnostic redefinition", something which is rather hard to understand for people who don't understand that psychiatric disorders are symptomological constructs.
Diagnostic redefinition is relatively easy to understand if you look at approximate analogues involving symptomological constructs in the world of general medical practice. In this case, I'm going to use the construct of obesity for the purpose of explanation.
At present, obesity is most commonly defined in terms of something called "body mass index" (BMI) -- a calculated value based on height and weight. Neither BMI nor obesity, however, are etiological constructs -- they're descriptive constructs. In the case of obesity, it's a symptomological construct, presently defined by a BMI of thirty or higher (in most countries, anyway).
If, however, medical researchers were to find that a different cutoff point -- say twenty-five (which, incidentally, is the cutoff point in Japan) or thirty-five -- was more meaningful, the cutoff point would change to reflect this. If the cutoff point was lowered, a number of people would suddenly find themselves "obese" when they weren't before -- something which is called "broadening criteria" for obesity. If the cutoff point was raised, a number of people would find themselves no longer considered "obese", due to something called "narrowing criteria".
Note that nothing would really have changed with these people themselves. Only the terms used to describe them -- the label they receive, in other words -- would have changed. This is the essence of diagnostic redefinition in psychiatry.
To continue the analogy, if we were to find that some other measure of obeisity (e.g. total body weight, percentage body fat) was more meaningful than BMI, our definition of obeisity would shift to accomodate this. Obeisity would be redefined in terms of this new metric, and a number of people would suddenly "gain" or "lose" a "diagnosis" of obeisity without changing one whit themselves. The newly "diagnosed" or "undiagnosed" wouldn't have changed -- the language used to describe them would have.
This is precisely what happens every time a new edition of the DSM comes out. Sometimes it happens more often.
Note that none of this means that the "diagnosis" of "obesity" isn't useful or meaningful. None of it means that obesity isn't real (although if one is feeling particularly philosophical, one can point out that it's only a label or descriptor, and as such the phrase "for a certain value of 'real'" applies -- it's only "real" in the sense that "redness" is; similarly, "autism" is only real in the senses that "intelligence" is).
I just hope that this helps people understand certain matters and helps clear up some of the assorted confusion regarding the topic. Countless authors -- in academia, in the blogosphere, in the print media -- clearly don't understand a lot of what I try to explain above.
Hopefully, I did not just "try".