In general, the current situation in psychiatry looks as follows:
There are psychiatric hospitals where people are treated according to the practices established, which implies possible application of strong drugs and electroconvulsive therapy (ECT) if the case is considered serious enough.
A number of problems emerge in this connection:
On the other side, the former mental patients put in an isolation because of that common prejudice are apt to yield to the social pressure and blame psychiatrists for the harm they presumably made to their patients. Since social activism has become popular all over the world, former mental patients start to call themselves survivors and organize into numerous groups fighting against psychiatry in general or some of its practices.
Several levels could be distinguished in this opposition.
The most radical part of survivors say that psychiatry is mass murder and demand the abolishment of all the means of medication available to psychiatrists, and thus psychiatry itself. Also, there are specialized movements of this kind aiming to banning (or cutting funds on) some particular procedure (e.g. ECT).
Less tough groups of survivors are not demanding the complete abolishment of psychiatry (or some of its methods), but rather restricting its applications, subduing it to a kind of public control preventing forced medication. Some psychiatrists sympathize to this movement considering it quite democratic in nature.
A lower grade of tension is associated with the activism suggesting that forced medication may take place under strictly controlled conditions only, and by specially trained personal, qualified enough to reduce the possible harm of the procedure to the least degree achievable. The specialists usually agree with such statements, though there are often hidden differences in the attitude.
Some survivor groups shift the accent to the social premises of their relative isolation and speak of a complex rehabilitation system for mental patients demanding that the others treat them like ordinary people.
I will briefly discuss the problems arising with each of these types of survivor activism in turn.
Another point is that any categorization is socially biased, and any diagnosis will reflect both objective symptoms and the society's attitude to them. So, what is considered quite normal in one society may be considered as illness in another, or as a crime in yet another one. The example of alcoholism is well-known. Some narcotic drugs are near to be legalized in many countries, thus changing the very notion of drug dependence. The situation is much more complex with mental deviations, and psychiatric diagnosis can always be questioned, with no universally accepted answer possible. For example, suicidal ideation may be treated as anti-social act, so that forced medication shall be prescribed at any suspicion. In another social environment, suicide may be a normal way of quitting one's life and be supported with officially provided procedures (hara-kiri in Japan, bath ritual in the Ancient Rome, parent smothering at chukchi, euthanasia etc.).
The problem is that social regulation may contradict to the interests of an individual, suppressing personal inclinations to preserve the social structure. Thus, in class societies, suicide is rarely allowed for the representatives of the lower classes, since the well-being of the ruling class is based on mass exploitation, while suicide would allow the exploited escape from working for their master. That is why the ideas of the higher value of human life and post-mortem punishment for bad behavior are being implanted in the minds of the people.
In the individual consciousness, the opposition of the person and the society is reflected as oppression, with some social layers forcing the individual to the alien ways. No wonder that such oppressed individuals use to unite in defending themselves from whom they find guilty in their hard experiences. However, individual (and group) consciousness is not necessarily correct in detecting the cause of the trouble, and attacks people and things that are just superficially related to the problem. Thus, anti-psychiatry movement blames psychiatrists where it should be concerned with the economic and social issues determining their work. No wonder that psychiatrists try to defend themselves from the unjust criticizing, and become involved in a team game against their patients.
Another aspect of it is whether there is such thing as (mental) disease, or it is just an artifact of the medical paradigm, based on the rigid opposition of illness and health. One might argue that health is very individual, and strong variations in mentality should not be called a disease. However, the argument becomes meaningless if restricted to the parameters of the individual only the solution is to look at the individual's functionality within the society. If one is unable to do what is socially expected under given economic and social conditions, this is what will be called a deviation from normality; if such deviation becomes socially destructive, it is called disease. For example, one's inability to do one's work (imposed by the society) is a sign of illness; one may go on doing what one is obliged to do, despite the bad headache then one will be considered as slightly uneasy but not ill.
Note that there is a difference between "illness" and "feeling sick". The latter is subjective, and may be quite uncorrelated with social performance. One may have to work feeling extremely bad on the contrary, one may feel fine while the society would diagnose a dangerous disease (which is especially characteristic of psychiatry). If medication is applied to such subjectively healthy person, it will inevitably be felt as repressive, and the treatment will appear forced. Under different circumstances, subjective attitude to similar methods may be different, and hence any judgment should keep within the appropriate cultural limits, so that one would not project one's own experience onto a quite different mentality.
Since capitalism is based on the universal division of labor, it makes forced medication as universal. The caste of professionals won't listen to the opinions of non-experts, and the patient would not be allowed to doubt the regimen prescribed. When knowledge and skill become the articles of trade, they serve to support the lives of doctors rather than of their patients, which are treated as raw material for making the doctor's money. One cannot expect much compassion and kindness to the patient, and tolerance to the patient's peculiar views. This means that any medication tends to be forced under capitalism.
The survivor activists fighting against forced medication appeal to personal freedom as an argument. Conscious people should decide themselves which way of treatment they would prefer, provided the agreement about the basic social values is achieved, and the disease can be distinguished from the normality in a generally accepted way. Beside the already mentioned relativity of such a distinction, there are many more narrow places in this approach.
First, an individual who never studied medicine can hardly make a conscious choice, and the only criteria left are economic considerations, common prejudices, or personal sympathies. Thus, poor people will definitely prefer a cheaper (though not necessarily adequate) treatment, while the rich are socially compelled to use more expensive (though quite inefficient) drugs or procedures. The general medical ignorance serves for the benefit of numerous healers, sorcerers, shamans, exorcists, miracle-workers and God's fools. Serious medicine is less spectacular than an occult show, and hence less convincing for an ignorant person. To compete on the market, doctors have to make show of their work, thus wasting the resources that could be better spared for the people in need. Thus the health of the society gets eroded. This is just the other side of bourgeois democracy, which gives the means control into the hands of those who look better, despite of utter incompetence and corruption; virtually, a "good look" is a matter of money.
One more difficulty is that the ability of judgment is tightly bound to health. People are not abstract spirits observing the body from the holy heights. The state of the body affects feelings and reasoning. For example, one may perfectly know that a bad tooth is dangerous and requires medication but the fear of pain would not let them go to the dentist, until the toothache overweighs the pain of treatment. The more so with psychiatry, where therapy is often more distressing for the individual than the symptoms of disease.
Yes, medication may cause pain but it often helps. So people have to be forced into medical treatment, and they enjoy health after it. Of course, the appearance of more efficient and safe methods of medication would lead to less fears and more consent from the patients. Meanwhile, numerous means of masking the negative sides of treatment are being applied, from autosuggestion to narcotic drugs. Hardly anybody will decline narcotizing on the operation table just because the drugs are altering the normal functioning of the organism.
If the patient is unable to understand their actual condition, their consent to treatment is worthless. Moreover, because of the dependence of judgment on the state of the organism, it could be dangerous for the patient if the doctor asked their opinion before doing anything. Is it fare to reload the burden of decision to a sick person and thus free doctors from responsibility? Virtually, doctors are to heal people this is their job. The patients must be brought into treatment first of all, and be relieved of their sickness before being asked of anything. When a surgeon has to amputate a leg of an unknown person delivered in the unconscious state, it is considerations of the person's survival that are of importance, and never one's consent to become an invalid. Disasters don't ask people when to occur.
The ability of the patient to give conscious consent may strongly depend on their social status as well. Thus, in most societies children have no voice in deciding their fate, and hence all treatment on children is forced. Again, the negative sides may be masked but the matter is still the same: children are made to accept medication. In general, this is merely a part of the acculturation process, when a child is forced to do a great many of things, like wearing the clothes, using the toilet, eating with forks and spoons, going to school etc.
Now, the question becomes: what does it it mean to be forced or coerced into anything? There are various grades of coercion in everything people shall do as the members of the group, social layer, or ethnos. It is the matter of economic and social organization that local or global acculturation would loose its forced character and become a smooth process though the smoothness can hardly ever be absolute, due to the dialectical nature of any development. One of the manifestations of free will may be a deliberate limitation of free will, allowing for forced treatment when it is socially required.
What kind of a problem is it? Its minor part is the abuse from ill-minded doctors, seeking for profit, following the perverted sense of caste honesty, or just indifferent to the patient's feelings (which is a kind of professional illness in long-experienced practitioners). The criminal use of various kinds of medication belongs to this category as well. Actually, this side of medication abuse is common to the abusive use of anything else, since anything that is alienated from the people in the ill society can be used against them. Psychiatry can also used in a criminal way though the notion of crime completely depends on the kind of society. However, forced psychiatric treatment is much less efficient as a means of control than, say, forced drug dependence or the threat of death. So, it can hardly be very frequent in practice hence it becomes more sensational, and more fit for manipulating public opinion.
Much more typical (and more dangerous) is unintended abuse, often related to indirect coercion. Thus, if medication is to be paid for, those who do not have enough money are forced to stick to the only source of medical treatment available, and they have to obey any prescriptions just from the fear of all treatment and support being withdrawn. Most medication may seem quite voluntary on the face of it, with a deep feeling of abuse beneath. This feeling may be inadequate, reflecting the vulnerability of the patient's position rather than any actual malpractice: the powerless may easily feel forced to make decisions they don't understand. Still, it makes the claims of more control on forced medication more attractive to the poorer layers of society.
Though many practitioners are honest enough and really willing to help people, they cannot ignore social pressure and act as they feel right, discarding the other's opinions. This pressure may be due to either the tradition of treatment or the prejudices of the patient. Risk of being blamed for malpractice for not doing like other specialists do is more strong for psychiatrists, though it is quite real for any other medical profession too, since tradition still lies in the foundation of modern medicine. Also, there are a number of medical schools strictly controlling the activities of their members. Doctors have to live and support their families and they cannot be expected to sacrifice their well-being for the interests of a stranger. On the other side, the patients often have some conceptions about how they should be treated; these common conceptions are usually induced by the current medical practice as well as by the advertising by the competing companies producing drugs, medical equipment etc. If a doctor does not prescribe what has been expected, he/she may be suspected in following a wrong line, and all the treatment would seem forced, without any connection to its actual efficiency.
Yet another source of indirect coercion is the dependence of hospitals on external funding. Thus, if a hospital is sponsored by a pharmaceutical company, the medical personal has to preferably use the medicines produced by this company, being just a part of its advertising campaign. The same effect can be observed when there exist restrictions on material provision, staff formation etc.
Is there any way to establish an efficient control over forced medication? This idea is most popular in the old capitalist countries, where centuries of propaganda have formed public mentality which utterly cannot conceive anything beyond the bourgeois democracy. The democratic idea of coercion control is to establish one more system of coercion that would neutralize the possible malpractice in medicine; the rule is: like cures like, and many bad things are hoped to balance each other so that the result would be at least tolerable.
Different levels of coercion control system could be considered. Thus, common people are accustomed to expect that the state would guarantee their human rights and take over the coercion control. This appears to introduce no new social force, since the state is an apparatus of coercion already, and it could just have one more task to perform. Within certain limits, the state may defend the rights of its citizens (by the expense of the rights of all the non-citizens, of course). However, the main purpose of the bourgeois state is quite different from satisfying the needs of the people, and it would much more readily used in the interests of the competeing groups practicing forced treatment, rather than for protecting the interests of the patients. In particular, any legal regulations and court proceedings are sure to mainly serve the richer part of the society, and ignore the poorer part. Since the state is mainly the mechanism of preserving the already existing social organization, it would rather stay on the side of professional castes, supporting their self-determination by the expense of the clients' health.
On the lower level, the activists often suggest the creation of various control organizations (employing themselves as true experts). Such commissions would consider every particular case and sanction forced medication when it is really needed. The application of potentially harmful methods of medication would thus be restricted, and the negative interference of the state would be neutralized in a part. The control organizations are conceived as open for the wide public and ruled by it, in the interests of all the people.
However, such institutionalized control would mean just one more social force, which should be somehow controlled too, the chain of mutually controlling organizations unfolding to infinity. Nothing prevents the formation of numerous commissions each one pretending to be the highest instance and arguing for that right with the rest of the world. Small specialized organizations are almost sure to fall under the influence of more powerful and diversified social groups, becoming mere mouthpiece of their opinions.
Another side of it is the lack of competent judgment. Public control in the conditions of the division of labor would necessarily mean the dominance of incompetent views of the crowd over the sober professional consideration. Professionals would hardly be any assistance for the organizations created in the opposition to them, and the knowledge and experience they monopolize would not be shared with the public controls. Of course, there may be talented amateurs who would study medicine to be competent enough; still, they will always have a choice between either admitted to the practice of medication and the experience associated with it (thus becoming the representatives of the medical caste), or remaining only partially educated and hence incompetent. Typically, the public commissions are a field for a wide employment of the numerous survivors, bringing in their subjective feelings and exaggerated apprehensions as the basis for decision making.
One more level of public control is often discussed, delegating the right of decision to the individuals. It is often argued that conscious clients should be partners of the doctor in medical treatment, declining all the solutions that do not satisfy them. The advocates of this line admit that the disease may sometimes lead to the loss of self-control in the patient, so that one cannot decide for oneself; in this case, the relatives or other legal guardians of that person should have the casting vote in forcing a medication on him/her.
This attitude is most attractive to many people, since it plays on their self-importance, and self-conceit. However, few people can be considered as conscious enough in making decisions where they know very little or nothing at all. Incompetence combined with too much self-esteem often leads to the self-assertive behavior of the patient tempting the doctor to force a severer treatment on them. Since the family relations are tightly linked to economic interests in the capitalist society, the relatives of the patient can rarely be expected to follow the patient's interests. Rather, they would try to arrange their own affairs, and may insist on forced medication driven by economic considerations or hidden conflicts. Thus, husbands may have their wives electroshocked for misbehavior, the aged parents may be put into asylum by their children for senile disorders, and inversely, the parents may have their children drugged for their strangeness, etc. In the world where money is the supreme power the individuals cannot trust each other enough.
To some extent, such system is present in every society, being the most developed and diversified in the leading capitalist countries. Thus, it has been recognized that it would be wasteful to loose the working power of physically injured people and various institutions are trying to enable the invalids to work and to live an active life. This task is becoming much easier due to the development of wide computer networks, as well as automation and computer control of most technological processes. The situation may be quite paradoxical sometimes, when the society chooses to exercise humanism and employ the invalids, while many normal people cannot find a job and loose their health because of the awful conditions they have to live in.
Former mental patients are a special case. Usually, they have no bodily defects, and their ability to work cannot be doubted. Still, poor knowledge of the origin and functioning of human consciousness makes the behavior of such people less predictable and potentially dangerous for other people and destructive for industrial processes. Most modern conceptions of consciousness assume that it is the property of the individual organism, and particularly the brain; any damage to the brain should then be treated as a disorganization of conscious activity, so that thus injured people could only be employed with a great care, under close observation and with all possible precautions just to be on the safe side. Naturally, such an attitude is offending the people who have already had an unpleasant experience and are reminded of it every time. This results in additional stress, which may cause a remission of the disease, thus confirming the popular prejudices about the mentally ill.
There are different levels the rehabilitation system may be set up at. Some capitalist states have already adopted the national programs of support for the physically invalidated people, but there are still no such programs for the rehabilitation of the people with deviating psychology. Many survivor activists are trying to attract the public attention to this problem creating various organizations and launching movements in support of the former mental patients' right on normal life. However, their efforts may lead to the opposite effect, since the very their formation into a separate public force enhances their difference from the ordinary people and makes the others to suspect mercenary motives behind the survivor activism.
On a wider scale, the problem is to provide the human conditions of life and the access to any activity for the people with behavior deviations. Since nobody can exactly define what is normality, it may be difficult to decide whether a particular type of behavior is socially acceptable or it should be treated as potentially destructive. It is quite easy to classify a genius or a revolutionary as mad and force a psychiatric treatment on them. There is a very dim distinction between mental illness and crime. A highly developed rehabilitation system could help many people to preserve their personality and avoid forced medication. However, no such system can be self-sufficient under capitalism, since it is concerned with the implications only, but never with the cause. In the class society, people will inevitably be divided into opposite social groups, and this fragmentation will penetrate any side of life and activity. Defending the rights of one group is only possible by the expense of the rights (and money) of all the rest of the people, so that the antagonistic nature of the society is reproduced in every kind of relations, at any level.
The richer capitalist states have more resources for the development of the rehabilitation system for invalidated people. However, these resources are not infinite, mainly depending on the ability of the developed countries to rob less developed or weaker nations. As soon as there are no more room to expand, and no more others' wealth to seize, the internal conflicts in the old capitalist countries are bound to break through, and the social programs are first to be sacrificed.
Since any statistics is futile where the opposite economic and social interests encounter, the figures are no argument in the polemics for/against forced medication, and no quantitative references may be made. What percent of a person suffers from a medication-induced injury? Is the pain of one person less painful than the pain of the millions? Does in alter the situation if there are just hundreds of injured by ECT rather than thousands of them? Harm and relief cannot be weighed.
The typical quantitative argument is that most patients get much better after the treatment, and it is relatively few who suffer from the side effects or malpractice. Well, this might be convincing if the problem of the efficiency of the current medication techniques were considered. However, the problem of forced treatment is not purely medical, since it concerns the relations between the individual and the society, and not the patient's susceptibility to a specific kind of treatment. Of course, the proportion of side effects should be reduced as much as possible but the side effects can never be completely eliminated, and the decisions are to be socially motivated anyway. Thus, the efficiency of medication cannot be measured in numbers: one death of the hundred is in no way less distressing than ten or forty deaths, and the only valid criterion is the absence of disease which is impossible in an unhealthy societal environment.
Another quantitative approach is to stress the existence of much more urgent social problems. Thus, forced ECT is much less frequent than poverty, hunger, oppression etc. Does it mean that the associated problems should not be discussed at all? Yes, they should though there is a limit of activity above which the ethical evaluations get inverted: if ECT survivor activism attracts too much public attention (which is quite possible due to a smell of sensation associated with it), it may mask other acute problems, thus contributing to the process of pain production inherent to the current level of economic and social development.
There are two sides in every ethical problem related to forced medication. First, the medicine should help people as it can and this may assume forced treatment as well. Second, free will of the patients should be esteemed. Doctors have no moral right to reload responsibility to the people in need but they should not exploit on the patient's vulnerability too much. In ideal, the patient and the doctor should cooperate, and their interaction should be marked with tolerance and compassion, mutual kindness and honesty. Unfortunately, this is not always (if ever) possible in the capitalist society, where compassion and kindness have their market price as anything else. Cooperation with the patient may become dangerous, when the patient is disoriented by noisy advertising or sensation-inflating journalism.
Thus, in a class society, there is a contradiction between the negative goal of curing people who do not want it and the positive goal of assisting people to feel better. This contradiction is present at any level, from the nation to the individual. The dominant ideology of bourgeois individualism loads the major responsibility for the adequacy of the choice to the individuals, which are virtually never free enough to be responsible for their deeds. So, a doctor has to decide whether to use force for the patient's good, and be blamed for that, or to let the illness grow, and be blamed for that too. Most patients (the poorer ones) have little choice with capitalist medicine. Still, they have to decide whether to fight with those who treat them, or to oppose the social system that cannot guarantee them a healthy life, or at least a decent medical assistance.
There is one more ethical aspect of forced treatment: any coercion is a reduction of humanness in the people. Forced medication may heal the body, or behavior, but it will inevitably cripple a part of personality, poison the consciousness of the former patients. Heavy experiences cripple the souls though forced medication is just one possibility among many others, since all the relations between the person and the society are based on explicit or implicit coercion under capitalism. For a human being, life is not the highest value, and may be sacrificed for spiritual goals; hence, the spiritual oppression may be much more destructive for personality than physical suffering.
As a manifestation of that, any idea has to be pushed forth by private initiative, and appeal to private initiative, competing with many other ideas. However, this forced competition of ideas and projects tends to substitute the goal of economic or social improvement with a quite different goal of winning the prize, whatever it is.
This often occurs to the numerous support groups, which originally unite people who purport to broadcast truth and protect individuals from social pressure, but have to do it in such a sensational and inflated manner, that the original idea gets lost in the flood of extravagant actions and provocative claims. The activists are usually rather copious, and their works are filled with illustrative cases and statistics both being fiction rather than the results of a serious research. This fiction gradually grows into a tradition, and more recent writings refer to the older products as authentic documents.
The necessity to attract public attention (that is, to be a strong enough stimulus for the man in the street) makes the activist groups use inadequately aggressive language. Thus, psychiatric survivors glow with sacred hatred against psychiatry, speaking in the language of war and presenting every clinical error as a sign of the corruption of the profession in general. Instead of supplying the psychiatrists with a better understanding of their patients, they raise a wave of protest in the professionals; instead of educating the psychiatrists, they try to castrate them. But since any forced medication is a social rather than medical problem, there is no use to blame psychiatrists, without any trouble for those at the power.
Generally, the medicine is blamed for injuring the patients and forcing harmful methods on them and thus making them invalidated and inferior in the eyes of the rest of society. The pity of the ordinary people is a good card to play on. However, the very activity of the survivors may become an argument against their movement: the people who feel well enough to lead that active life, to write and publish numerous articles and books, to participate in various disputes and construct personal sites on the Internet such people do not produce an impression of disability. Few normal people can be that robust. The thought is quite logically suggested that all that noise around forced psychiatry is mere disguise, and the actual goals of the survivor activism are far from humanism and charity. Anti-psychiatry becomes a means of attaining some economic or political goals.
As division of labor is becoming the absolute principle
governing the development of capitalism, any kind of activity
may, under definite conditions, form into a special business,
obeying the laws of capitalist economy. Such transformation
is usual for various kinds of social activism, and the wide
social movements have certain economic interests behind them,
collapsing soon after they have played their role to the end.
Some survivor groups are stressing their radical
orientation, their negative attitude to the capitalists system
and desire to improve the society. They may claim themselves
the successors of the old traditions of the working movement,
and even flirt with communist ideas. The survivor
movement is said to struggle against psychiatry as an oppression
tool, employed by the ruling class to bring the people to
obedience.
Well, there may be some parallels between activism and class
struggle. Both are the manifestations of the same antagonistic
structure of capitalist society, and there is no impenetrable
wall between them. Class struggle may assume the form of
social activism, and activism may grow into class struggle.
Still, they are different social phenomena, with their own
functions within the whole. In a sense, they are complementary
and one can notice that the peak of activism coincides
with the low phase of class struggle. This is not a coincidence.
The ideology of the working movement is to change the world
by a joint effort, so that the particular sides of life would
become more bright due to the global change of social organization.
The workers are to build the new society by themselves, they are
to invent the principles and forms of the future. Quite the
opposite of this attitude is represented by the survivor
ideology of social activism. Its basic idea is the struggle of
victims against social evil associated with a limited group of
people, the professional evil-makers. The task of
activism is to throw down this social evil, without changing the
society itself the position quite close to bourgeois
liberalism. The activists may admit that the roots of the
problem are in the nature of capitalism itself but they
cannot imagine how the social system could be changed, and
so they have to conclude that all one has to do is to survive.
Thus, people are encouraged to be victims, rather than conscious
personalities able to change the rules if the rules are against
them.
But where can the victims get assistance from?
Capitalist economy is a self-balanced system, and any shift
of the balance in the interests of one social group will result
in the redistribution of the public wealth on a large scale.
Social activism thus appears to be just another side of
economic competition, with every group pulling the blanket
onto themselves and quarreling with the other aspirants.
Yes, an invalid's participation in the Olympics is a great
support for the person's spirit but the money spent
on that might draw a hundred people out of hunger.
The class roots of the working movement and social activism
are different too, since activism is almost completely based
on the intelligentsia, with its oscillations between angry
radicalism and fearful loyalty. The internal contradictions
of activism reflect this intermediate social position of
the activists. While the working movement may be progressive,
activism is merely progressist. Virtually, it often occurs that
such progressist movements serve the interests of the wealthier
capitalists, being their tool in the economic competition and
political struggle. Thus, numerous green movements
have nothing to do with ecology: their function is to support
one group of capitalists against another, to undermine the
business of a competing company or the economy of a weaker
country. One more example is the noise around forcing
psychiatric treatment on political opponents: somehow it
finally happens to fight against the communist ideas only,
quite ignoring the psychological oppression in the capitalist
countries. There is much speculation on the Stalinist regime,
and the fantasy of a bourgeois produces enough fiction
about the most sadist forms of repression which they readily
ascribe to the communists, without a slightest thought of
the evidence (which may well be invented afterwards).
In particular, Stalin is blamed for the wide use of psychiatry
to suppress the political opponents; there is no evidence
on that (except the specially invented), and there cannot be
any still, much shouting is enough to make the Philistine
tremble.
There is a significant difference between activism and Marxism
in that the survivors mostly talk about malpractice
and potential danger of common procedures, while a Marxist
would first investigate the economic and social conditions
that has lead to the very necessity of treatment. The activists
like talking about human rights in Marxism, there are no
abstract human rights at all, since the relations between people
depend on their place in the economy. For Marxist, a capitalist
has the right, say, to force medical treatment on a worker who
is not obedient enough but this right is not something
natural or inherent to the class of
capitalists, being mere implication of its economical position.
The exploited have no rights, and this is their social position
too. Of course, this scheme is much less apparent in the
developed capitalist societies; however, it can be traced in
every particular case, forced medication included.
The corollary of the Marxist approach is that the major cause of
any disease is the low level of economic development, with the
respectively underdeveloped social organization. Poverty cripples
the souls much more often than a malignant psychiatrist,
and injures the bodies long before they become injured by the
bad doctors. Ill conditions of life lead to physical
illness, while the absence of any hope results in compensatory
psychological deviations, readily becoming mental disease.
On the other side, the level of medical treatment available
depends on the thickness of the purse under capitalism, so that
those who need help most often cannot have it at all.
The bourgeois may argue that poverty is not a strong stressor
on itself, and poverty does not necessarily lead to mental
malfunction or unhappiness. There are so many poor people who
are much happier than the rich, who have so many responsibilities
and must work hard to preserve their social status. Still,
there is no bourgeois who would give all their money to the poor
and become as deprived of property and civil rights. The destructive
effect of poverty does not depend on whether one had experienced
a better life or not however, individual experience may
make a person aware of these effects, thus leading to the
conscious frustration and psychological distress.
Such people are more likely to be subjected to forced medication
for their anti-social behavior; this would be
a medical procedure, of course, and a kind of healing too
and it is the ill social system that makes them the means of
social control. There are no direct implications for class
struggle arising from forced medication rather, the
survivor activism should serve the needs of a more
global social change to become something more than the weep
of a hurt puppy.
Well, social progress implies some contribution from social
activism, though its actual role is much more modest. Class
struggle will always remain the major force of development
in the capitalist society, and all the achievements of activism
could not be possible without a strong support from the working
movement (including the international level), which is directly
linked to the economic processes. The observable reorganizations
of society are due to the drastic changes in economy, and the
corresponding adjustment of the basic social relations, in the
production sphere.
However, the role of the working movement should not be
overestimated too. In fact, the working movement and social
activism are the levels of the same hierarchy, and their
relations may be inverted in a definite context.
They are the complementary sides of the reproduction of
the capitalist social organization, and the progress they
cause cannot break the very foundations of capitalism,
leading to a new socioeconomic formation. Capitalism can
be improved, to a certain extent, as long as its internal
contradictions can be resolved within the capitalist system.
Still, the formation change is inevitable, sooner or later,
and the leading force of this change cannot be identified with
none of the basic classes of capitalism, and, of course,
none of the classes pertaining to the earlier historical stages.
Like bourgeoisie was the third force that came to power when
the class struggle between landlords and peasants had reached
its culmination, there is a new social force in the present
society, which will shape the future economic formation to
replace capitalism, and this force is different from both
bourgeoisie and the working class.
It would be premature to make any guesses until the very
economy of capitalism shows the directions where the future
od the humanity is to be sought. However, one can say with
certainty that the efficiency and progressiveness of both
the working movement and social activism depends on whether
they support the birth of the new economic formation
(and the new social system), thus preparing the conditions
for the higher stage of human development to come.
[Online texts]
[Unism Central]
Activism and class struggle
An advanced capitalist society assumes very complex
social organization. There are numerous social groups, layers
and classes, and the relations between ethnic formations
are built according to the same model: class antagonism.
This social hierarchy may unfold itself differently in
different respects, and those who belonged to the same
social group in one hierarchical structure may belong to
opposite (and conflicting) groups in another unfolding.
This complexity is far from the old conceptions of class
society, with just two main classes struggling for economic
and social dominance. Today, class struggle may be hidden
under apparent cooperation, it may affect particular aspects
of interpersonal relations only, or even be represented by
the different sides of the same personality and felt as a
subjective experience. This hierarchical complexity reflects
the hierarchy of modern capitalist economy, which has developed
with the new ways of value production and consumption.
Seeking for the future
Social activism (including the survivor movements)
purports to improve the society, making it more human and
protective for its members. Indeed, social changes of this kind
could be observed in the developed capitalist countries, and
the activists are apt to think that it was the result of their
struggle. They say that activism is to replace the
working movement and that it has become the only efficient form
of the struggle for a better social organization.
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