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公民人權委員會(CCHR)共同創辦人:
—湯瑪斯‧薩茲博士(Thomas Szasz)
湯瑪斯‧薩茲博士(Thomas Szasz 1920-2012)是紐約州立大學的精神病學榮譽教授、加圖智庫機構的客座學者,也是美國精神醫學會(APA)的終身會員。
他的傑出成就,從他獲得的眾多學術表揚、資格證明、榮譽、著作以及獎項,便不言可諭。薩茲博士被眾多學者及學術機構,譽為精神病學最具權威的評論家。他在此主題上共有35本著作,其第一本書名為《精神疾病的神話》,五十多年前一出版,就撼動了精神病學的根基。
身為精神病學的專家及終身會員,薩茲博士反對的是精神醫學中的強制介入、欺瞞及脅迫等等違反人權的作為,他並不反對合約或兩廂情願的精神分析,心理治療,或諮詢,只要指定的客戶端能夠在任何時間解僱他們的治療師即可。
薩茲對於他所共同創辦的公民人權委員會CCHR,曾經表示:「我們應該向 CCHR 致敬,因為在人類歷史上,這是第一次有人在國際間,建構了強而有力的政治、社會發聲管道,來對抗精神病學。對人類來說,這是史無前例的創舉。」
薩茲博士談司法體系中的精神病學
Professor Thomas Szasz On Psychiatry In Our Justice System
“It is unlikely that toxicologists would be tolerated in courts of law if one would observe that he found a large quantity of arsenic in the body of a deceased person, and another stated that he found by the same operation none. Yet this sorry spectacle is commonplace in regard to psychiatric findings.”
「如果一位毒物學家在死者的屍體中發現了大量的砷,而另一位做了同樣的程序,卻說他沒有發現任何砷,那毒物學家大概不會見容於法庭。然而,就精神病學來說,這種令人遺憾的景象卻是司空見慣。」
“The introduction of psychiatric considerations into the administration of the criminal law—for example, the insanity plea and verdict, diagnoses of mental incompetence to stand trial, and so forth—corrupt the law and victimize the subject on whose behalf they are employed.”
「將精神病學的考量導入刑法的執法程序,例如精神失常的抗辯和判決、診斷某人在心智上無能力接受審判等等,這些作為不但敗壞法律,也使精神科所代理的行為人成為受害者。」
“All criminal behavior should be controlled by means of the criminal law, from the administration of which psychiatrists ought to be excluded.”
「所有犯罪行為都應該用刑法來管控,不該讓精神病學參與執法。」
“My belief that the insanity defense should be abolished is based partly on a conceptual critique and partly on a practical one. Now the conceptual one, very briefly, is that insanity is a dubious term which can refer to one of two things: First, to a brain disease, and I will say something about that; and secondly, to misbehavior. Well, disease, brain disease, does not cause criminal acts. Epilepsy as a brain disease does not cause criminal acts. Epileptics may or may not, just like other people, commit crime. Now, insofar as the term insanity refers to behavior, it is a fiction. It is not a disease, and doctors have no competence in judging that. It’s usually determined after a person commits a crime; usually if something gets upsetting socially. My second basis for objecting to it is that the consequences of the insanity defense typically is incarceration in the name of diagnosis, disease, and treatment. And that is a charade and a misuse of the medical profession for depriving people of liberty who are nominally declared to be innocent.”
「我認為應該廢除精神失常辯護,這個批判一部分基於學理,另一部分基於實務考量。在學理上,非常簡單地說,精神失常是一個有爭議的用語,它可以指兩件事:第一是腦部疾病,這我會稍微說明;第二種,是不良行為。
好,疾病,腦部的疾病,不會導致犯罪行為。癲癇作為一種腦部疾病不會導致犯罪行為。癲癇患者可能會也可能不會犯罪,就像其他人一樣。
再來,精神失常就行為而言,是虛構的用語。它不是一種疾病,醫師們沒有能力下那個判斷。精神失常通常是在一個人犯罪之後決定的,通常是在某個事件造成社會不安之後。我反對的第二個依據是,為精神失常辯護的後果,通常是以診斷、疾病、治療的名義,監禁此人。這是一種欺騙,也是濫用醫學專業,名義上宣佈他們無罪,卻剝奪他們的自由。」
“I have long maintained that the institution of psychiatry rests on civil commitment and the insanity defense and that each is a paradigm of the perversion of power. If the person called ‘patient’ breaks no law, he has a right to liberty. And if he breaks the law, he ought to be tried and declared guilty or not guilty by the criminal justice system…. Some people assault, rape, rob and kill others and thus endanger society. What does psychiatry contribute to their management? Civil commitment, which is a euphemism for preventive detention; and the insanity defense-and-disposition, which is a euphemism for defining incarceration as treatment (or a strategy for excusing guilt). These two procedures are the pillars on which psychiatric power rests. Each authenticates the fiction of psychiatric expertise to manage ‘dangerousness.’ Each creates and confirms the illusion that we are coping wisely and well with vexing social problems, when in fact we are obfuscating and aggravating them. Psychiatric power thus corrupts not only the psychiatrists who wield it and the patients who are subjected to it, but the community that supports it as well…. There is neither justification nor need for involuntary psychiatric interventions….”
「我一直主張,精神病院是靠民事安置和精神失常辯護支撐的。這兩件事,都是濫用權力的典型事例。如果所謂的“病患”沒有違法,他就該有權享有自由。如果他犯了法,他就該接受刑事系統的審判,宣布有罪或無罪…… 有些人用暴力攻擊、強姦、搶劫、殺人,對社會造成危害。精神病學對管理他們有什麼貢獻?暫行安置,這是預先拘留比較委婉的說法;精神失常的辯護和處置,這是把監禁定義為治療(或許是消除罪惡感的一種策略),也是說法好聽點而已。這兩種程序,是精神病學強權賴以生存的支柱。兩者都驗證了精神病學對『危險』的專業管控純屬虛構。兩者都創造並且強化一種幻覺,那就是我們很聰明,把棘手的社會問題應付得不錯,但實際上,我們是在混淆是非,讓問題更加惡化。因此,精神病學強權不僅腐化了行使它的精神科醫生和接受它的患者,也敗壞了支持它的社區…… 精神病學的強制干預,既沒有正當理由也沒有必要……」
“If he who breaks the law is not punished, he who obeys it is cheated. This, and this alone, is why lawbreakers ought to be punished: to authenticate as good, and to encourage as useful, law-abiding behavior. The aim of criminal law cannot be correction or deterrence; it can only be the maintenance of the legal order.”
「對違法者不罰,等於是對守法者的欺騙。違法者應當受到懲罰,只有一個原因,那就是認證守法行為是好的,推崇守法行為的價值。刑法的目的不能只是矯正或嚇阻;維護法律秩序才是它唯一的宗旨。」
其他人對薩茲博士的讚揚:
“There are few of us who have devoted our entire lives to fighting man’s inhumanity to man. Thomas Szasz was one of those few and now joins the rest of those freedom fighters who belong to history.” — Dr. Keith Hoeller, Editor, Existential Psychology & Psychiatry
「我們之中很少人會傾注一生的心力,去對抗人類加諸於人類身上的不人道待遇。湯瑪斯.薩茲就是少數這樣的人,如今他已和歷史上其他著名的自由鬥士並駕齊驅。」──《存在心理學與精神病學》雜誌編輯基斯.霍勒博士
“One of the smartest and most thorough defenders of autonomy and liberty of our time.” — Brian Doherty, Senior Editor, Reason Magazine
「當代自由人權最精明、最徹底的捍衛者之一」──《理性》雜誌總編布萊恩.杜賀帝
“Throughout his long life, he did not simply fight the good fight, he fought a truly magnificent fight.” — Professor Richard E. Vatz, Towson University
「終其一生,他在漫長的生命中,不只打了一場美好的戰役,更打了一場真正非凡的戰役。」──托森大學理察‧法茲教授
“No one attacks loose-thinking and folly with half the precision and zest of Thomas Szasz.”— John Leo, social science editor for U.S. News & World Report
「薩茲博士對於不嚴謹思想及愚蠢行為的抨擊,有著他人望塵莫及的精準與力道。」──約翰‧ 里歐,《美國新聞及世界報導》社會科學部編輯
“Thomas S. Szasz has steadfastly defended the values of humanism and personal autonomy against all who would constrain human freedom with shackles formed out of conceptual confusion, error, and willful deception.” — Dr. Richard E. Vatz, Professor, Towson State University
「湯瑪斯‧ 薩茲堅定地捍衛人道主義的價值、維護個人自主意識,讓有心人士無法利用混淆的觀念、錯誤,以及刻意的欺騙來禁錮人類的自由。」──理察.法茲教授,托森州立大學
“Arguably, Szasz has had more impact on the actual practice of psychiatry in this country than anyone since Freud.” — The Journal of Psychiatry & Law
「應該可以說,薩茲博士是自佛洛依德以來,對美國精神病學實務最具影響力的人。」──《精神病學與法學期刊》
薩茲博士的名言:
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論及《心理失調診斷與統計手冊》(DSM)
“The primary function and goal of the DSMs is to lend credibility to the claim that certain behaviors, or more correctly, misbehaviors, are mental disorders and that such disorders are, therefore, medical diseases. Thus, pathological gambling enjoys the same status as myocardial infarction (blood clot in heart artery). In effect, the APA maintains that betting is something the patient cannot control; and that, generally, all psychiatric ‘symptoms’ or ‘disorders’ are outside the patient’s control. I reject that claim as patently false.”
「DSM主要的功能與目標,就是將某些行為,更正確地說,是將某些不良行為,認定為心理失調,好讓這些心理失調成為醫學上的疾病。DSM讓這樣的論述顯得有根據。如此一來,病態的賭博,即享有與心肌梗塞(心臟動脈的血塊堵塞)一樣的地位。事實上,美國精神醫學會認定,賭博這種行為是病人無法控制的,而且整體來說,所有的精神『症狀』或『失調』,都在病人的控制範圍以外。我認為這種說法是睜眼說瞎話。」
“The ostensible validity of the DSM is reinforced by psychiatry’s claim that mental illnesses are brain diseases—a claim supposedly based on recent discoveries in neuroscience, made possible by imaging techniques for diagnosis and pharmacological agents for treatment. This is not true. There are no objective diagnostic tests to confirm or disconfirm the diagnosis of depression; the diagnosis can and must be made solely on the basis of the patient’s appearance and behavior and the reports of others about his behavior.”
「精神病學聲稱心理疾病是腦部疾病,更強化了DSM表面上的正當性。一般認為這種主張是基於近年神經學的發現,是影像診斷技術及治療藥物改進的結果。其實不然。目前並沒有客觀的診斷測試,能夠確認或推翻憂鬱症的診斷。憂鬱症診斷完全只能根據病人的外觀及行為,以及旁人對其行為提出的報告。」
“The problem with psychiatric diagnoses is not that they are meaningless, but that they may be, and often are, swung as semantic blackjacks: cracking the subject’s dignity and respectability destroys him just as effectively as cracking his skull. The difference is that the man who wields a blackjack is recognized by everyone as a thug, but one who wields a psychiatric diagnosis is not.”
「精神病學診斷的問題,不在於這些診斷名稱毫無意義,而是在於這些診斷不但可能,也往往成為言語霸凌的海盜旗。揮舞旗幟的人將病患的尊嚴踩在腳下,其殺傷力就像剖開病患的頭顱一般。不同的地方在於,大家都知道揮舞旗幟的海盜是流氓鼠輩;而揮舞著精神科診斷的人,卻沒有被認出來。」
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論及精神病學科學
“The discovery that all mental diseases are brain diseases would mean the disappearance of psychiatry into neurology.”
「所有精神疾病皆為腦部疾病,這樣的發現表示,精神病學將遁入神經學中潛藏起來。」
“No behavior or misbehavior is a disease or can be a disease. There is no mental disease. Period.”
「沒有一種行為或不良行為是疾病,或可歸屬為疾病。沒有心理疾病這回事。就是這樣。」
“I don’t deny the existence of brain diseases; on the contrary, my point is that if mental illnesses are brain diseases, we ought to call them brain diseases and treat them as brain diseases—and not call them mental illnesses and treat them as such. In the 19th century, madhouses were full of people who were ‘crazy’; more than half of them, as it turned out, had brain diseases—mainly neurosyphilis, or brain injuries, intoxications, or infections. Once that was understood, neurosyphilis ceased to be a mental illness and became a brain disease. The same thing happened with epilepsy.”
「我並沒有否定腦部疾病存在的事實;相反的,我的論點是,如果心理疾病是腦部疾病的話,我們應該稱之為腦部疾病,並把它當成腦部疾病來治療──而不該稱之為心理疾病,還當作心理疾病治療。十九世紀,瘋人院裡充斥著那些所謂『瘋狂』的人;其中超過一半的人,後來發現,其實是腦部疾病患者──主要是神經梅毒,或是腦部損傷、中毒症、或感染症患者。一旦瞭解了這些疾病之後,神經梅毒就不再是精神疾病,而變成一種腦部疾病了。癲癇症也有過同樣的狀況。」
“My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.”
「我的主張就只是,心理疾病是一種迷思,它的功能在於掩蓋人際關係中的道德衝突,讓這顆苦澀的藥丸,變得比較容易下嚥。」
“If schizophrenia…turns out to have a biochemical cause and cure, schizophrenia would no longer be one of the diseases for which a person would be involuntarily committed. In fact, it would then be treated by neurologists, and psychiatrists then have no more to do with it than they do with Glioblastoma [malignant tumor], Parkinsonism, and other diseases of the brain.”
「假如精神分裂症 ……被發現有生物化學上的起因及治療方式,精神分裂症就不再是能讓人強制住院的疾病之一,而是神經科醫師治療的對象。然後精神科醫師就管不到這種病人了,就像他們也管不到膠質母細胞瘤(一種惡性腫瘤)、巴金森氏症,以及其他的腦部疾病一樣。」
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論及精神病學對人權及人性的違反
“Psychiatry does not commit human rights abuse. It is a human rights abuse.”
「精神科並沒有刻意違反人權。它的存在就已經違反人權了。」
“It’s not science. It’s politics and economics. That’s what psychiatry is: politics and economics. Behavior control, it is not science, it is not medicine.”
「這不是一門科學,這是政治與經濟學。那就是精神病學的真面目:政治與經濟學。它是行為控制,不是科學,更不是醫學。」
“It’s an epidemic of psychiatry that we are dealing with. We don’t have an epidemic of mental illness, we have an epidemic of psychiatry.”
「我們面對的是精神病學的蔓延。實際發生的,不是精神疾病的蔓延,而是精神病學的蔓延。」
“Schizophrenia is defined so vaguely that, in actuality, it is a term often applied to almost any kind of behavior of which the speaker disapproves.”
「精神分裂症(思覺失調)的定義十分模糊,實際上,經常有人用這個詞,來指稱他不認同的任何行為。」
“In my view, involuntary hospitalization and the insanity defense ought to be abolished, exactly as slavery was abolished, or the disfranchisement of women was abolished, or the persecution of homosexuals was abolished. Only then could we begin to examine so-called ‘mental illnesses’ as forms of behavior, like other behaviors.”
「在我看來,強制住院,還有為精神失常者辯護,這兩者都該廢除,就像廢除奴隸制度、廢除對女性的投票限制,還有廢除對同性戀的迫害一樣。只有這樣,我們才能開始檢視所謂的『心理疾病』,把它當作某種行為來看待,就跟其他的行為一樣。」
“For centuries, involuntary psychiatric interventions were regarded as things done for the so-called patient rather than as things done to him…increasing numbers of persons, both in the mental-health professions and in public life, have come to acknowledge that involuntary psychiatric intervention are methods of social control. On both moral and practical grounds, I advocate the abolition of all involuntary psychiatry.”
「數世紀以來,一般認為精神科的強制介入,是把對方當成所謂的『病人』所做的行為,而非把他當成『個體』所做的行為……有越來越多人,不管是心理健康的專業者,或一般大眾,都已經逐漸認知到,精神科的強制介入是社會控制的手段。不管在道德層面或實務面來說,我都大力提倡廢除所有精神科的強制手段。」
“Modern psychiatry dehumanizes man by denying …the existence, or even the possibility, of personal responsibility of man as a moral agent… (the psychiatric mandate) is precisely to obscure, and indeed deny, the ethical dilemmas of life, and to transform these into medicalized and technicalized problems susceptible to ‘professional solutions.’”
「現代精神病學削減人性,否定……個人責任的存在,甚至否定個人的責任感可以是人類道德的展現……(精神科的權威作為)完全是為了掩飾生命中的品格難題,更否認有這些狀況存在,並且將這些難題巧妙地轉換為醫療及技術上的問題,必須『由專業者來解決』。」
“Psychiatrists and other behavioral scientists continue to pour out an uninterrupted stream of articles and books allegedly demonstrating that man has no free will. By debunking free will and responsibility, professionals in the mental health discipline seek to legitimize themselves as bona fide scientists; at the same time, they also try to endear themselves to the politicians and the public by promising to control crime, which they call excessive violence….”
「精神病學家及其他行為學家不斷地提出文獻及書籍資料,聲稱人類並無自由意志存在。藉由貶低自由意志及責任感,心理健康領域的從業者試圖鞏固自身地位,成為貨真價實的『科學家』;同時,他們也試著迎合政治人物及社會大眾,承諾他們可以控制犯罪,同時卻將『犯罪』美化為『過度的暴力』……」
“Mental patients do not need mental hospitals; they need asylums—places of refuge where they would be protected from coercion by persecutors posing as protectors.”
「精神病患並不需要精神病院;他們需要的是庇護所,一個可以保護他們的避難地點,讓那些假扮成保護者的加害人,無法壓迫他們。」