Ethical Issues in Milledgeville

Ethical Issues in Milledgeville

Ethical Issues in Milledgeville

Sandra Thorson

NUR510 Week 4 Assignment

January 28, 2015

Imagine being diagnosed with a mental illness. Many individuals fear of the social stigma associated with the diagnosis. Unfortunately, history tells us that patients were not treated fairly or with compassion in the past. The ethics of respect for persons, beneficence, and justice have all been violated at the once was known as the Milledgeville State Hospital (Macha & McDonough, 2012, pp. 332-333). All patients, no matter their diagnosis or disease, age or race, culture or religion, deserve to be treated with compassion and respect.

Mental illness was a misunderstood disease until early in the nineteenth century. Many people felt that lunacy was due to an individual being possessed by demons with the only treatment being punishment given by God or man. At that time, individuals were shunned by their communities, thrown in prison, handed out as slaves who would do farm work, or were taken care of by family members at home who wanted to keep the lunatic a secret (The Moonlit Road, 2013, p. 2). Many people were also misdiagnosed at the time and had to suffer the same consequences as if they had been diagnosed with the illness.

In 1842 the Georgia Lunatic Asylum opened in the capital of Milledgeville, Georgia, to serve “lunatics epileptics and idiots” (Segrest, 2011, p. 114). Due to society’s demands for reformation of the prisons, creating public schools and the need to establish state-run hospitals for the mentally ill politicians became involved (Payne, 2014, p. 1). The name was changed to Georgia State Sanitarium on September 1, 1898, to Milledgeville State Hospital in 1929 and to Central State Hospital in 1967. After the Civil War, the Asylum began to accept AfricanAmerican patients. According to U.S. Census records, by 1870 there were 62 black patients and 310 white patients at the Georgia Lunatic Asylum (Photography, 2014, p. 2). Segregation was in place at this time.

The patient population continued to increase throughout the twentieth century, which meant a decrease in the quality of care provided to the patients. Administrators and patients took care of the crops that were planted to feed them. Staff was able to meet the daily needs of the patients but unable to provide necessary and appropriate treatments for the illnesses the patients suffered (Payne, 2014, p. 2). In 1949, attendants and nurses worked sixty hours per week making as little as $74 monthly. The patients’ day room had no heat. Some patients had to go three weeks with no bath soap. A case load for a physician would be 1,400 patients. Some of the physicians said 2,000 of the patients could be sent home as they were not harmless but their families refused to assume responsibility for them (Cranford, 2008). By the 1950’s most patients that were sent to Milledgeville did not return home. Many patients suffered abuse and neglect, forced lobotomies were performed and many patients were victims of dangerous experimentation without consent (Segrest, 2011, p. 115). In the beginning of the early 1960’s the patient population rose to over 12,000. Staff would use insulin shock and electro-convulsive therapy on many of the patients for treatment until they started using medication (Payne, 2014, p. 2). In 1969 experimental drugs were tested on mentally disabled children at the hospital without the institution’s approval (Tomorrow, 2012, p. 4). This would also indicate the parents were not aware or approved of the drug testing.

Many pediatricians, pharmaceutical companies and the government are concerned with medications being used routinely in children and formal evaluations that may or may not have been done on the medications. It is unethical for children to receive medications if they have not been studied. Health care professionals who work with children have the responsibility to ensure the medications they are giving a pediatric patient are safe and the appropriate dose. It is also recommended that if an ethics committee is considering a trial involving children, they take advice from pediatricians and health care professionals that are familiar with working with children on a daily basis. Research that involves procedures on children that would submit them to an increased risk with only a slight, uncertain or no benefit to them whatsoever is also considered unethical. Children also have the right not to be tested with every new medication developed. If the medication does not affect children then they should not be used in the study (Conroy, McIntyre, Choonara, & Stephenson, 2000, pp. 1-3). It is important to remember that children have the same rights as adults in regards to receiving medications that have been studied and are shown to be effective as well as safe.

As a healthcare provider, I find it disturbing to know that children and adults were mistreated. Personally, I cannot imagine dropping off a family member at an institution like Milledgeville and just expect the staff to take care of the situation. Today we see the other side of the spectrum and realize how much patient education and involvement in their plan of care increases the outcome.

All patients, no matter their diagnosis or disease, age or race, culture or religion, deserve to be treated with compassion and respect. None of the patients were provided information on their treatment. There was no benefit whatsoever in the way they were treated and were put in harm with the treatments or lack of that they received. Benefits of the patients were not thought of in regard to treatments and procedures at Milledgeville. At times it seems like the patients were not even thought of at all.

References

Conroy, S., McIntyre, J., Choonara, I., & Stephenson, T. (2000). Drug trials in children: problems and the way forward. British Pharmacological Society, 1-7.

Cranford, P. G. (2008). But for the Grace of God. Milledgeville: Old Capital Press.

Macha, K., & McDonough, J. P. (2012). Epidemiology for Advanced Nursing Practice. Sudbury: Jones & Bartlett Learning, LLC.

Payne, D. H. (2014, September 03). Central State Hospital. New Georgia Encyclopedia, pp. 1-2.

Photography, D. i. (2014, December 1). Central State Hospital - insane asylum (Milledgeville, Georgia)- David in motion urban decay assignment. Retrieved from David in Motion Photography Atlanta: https://davidnmotion.wordpress.com/2014/11/27/central-state-hospital-insane-asylum-mi8lledgeville-georgia

Segrest, M. (2011). The Milledgeville asylum and the Georgia Surreal. Southern Quarterly, 114-150.

The Moonlit Road. (2013, September 27). Retrieved from Central State Hospital: http://themoonlitroad.com/central-state-hospital-milledgeville-georgia/

Tomorrow, D. o. (2012, November 2). Mental health and the targeted individual. Retrieved from Peacepink: http://peacepink.ning.com/profiles/blogs/mental-health-and-the-targeted-individual?xg_source=activity