Saturday, March 24, 2012

Labotomies

A year or two ago I noticed an interesting procedure being incorporated into the plots of some movies such as Shutter Island and Sucker Punch. The plots centered around psychiatric facilities and the ultimate punishment at the end of the films was a lobotomy procedure. It sparked my interest as to why this procedure would be performed inside such facilities in the first place.
Information
A lobotomy is most commonly performed by inserting a sharp metal tool above the eyeball and through the orbital. The pick was then moved back and forth to sever grey and white tissue matter. The procedure was repeated on the other side. This procedure allowed for the severing of nerve fibers that connected the thalamus and the frontal cortex. The thalamus is what sends  sensory information to the brain. This procedure for labotomies was developed by Walter Freeman who would go on to perform thousands of these procedures on a range of patients. Most procedures were performed on mentally disturbed individuals in attempt to calm their behavior and could not be treated in any other way. Labotomy "success" ranged greatly and there was no sure way to know what the outcome would be. Some patients would experience a positive change in behavior, some would have no change, and still others ended up worse than they started. Freeman was banned from performing labotomies after his last patient died. Different types of brain surgeries are performed today, but the use of psychoactive drugs is a more reasonable solution for most mentally ill patients.
Question
Is a lobotomy really a good solution to solving behavioral problems? The results of the procedure range greatly and can be considered a chance event that depends on the circumstance of the patient and how nerves are severed. The technique calls for simply moving the metal pick back and forth. This can't be very exact. Is it ethical to perform such a procedure on a psychiatric patient, knowing the risks, when they do not have a say in the matter?

Assumptions
All mental illnesses are essentially the same and can be cured in the same way.
By severing one piece of the brain tissue you are only going to effect the patient in one way.
The patient's behavior actually needs to be altered. (12-year-old boy had the surgery performed because his stepmother said he was disobedient)
Inferences and Interpretation
The labotomy "fad" was mostly due to the irrisponsibility of psychiatrists who performed a life-altering procedure on humans after only a few tests on animals. The results of which were very inconclusive with results that could not be performed consistently over and over again. By having people believe that the procedure was the last resort, they were willing to follow through with the procedure although the outcome was unknown. Only after more reasonable, successful, scientifically proven alternatives were developed did people see the fallacies of the operation.

References
http://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-lobotomy/
http://scienceblogs.com/neurophilosophy/2007/07/inventing_the_lobotomy.php

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