Unethical human experimentation

From Wikipedia, the free encyclopedia

Unethical human experimentation is human experimentation that violates the principles of medical ethics. Such practices have included denying patients the right to informed consent, using pseudoscientific frameworks such as race science, and torturing people under the guise of research. Around World War II, Imperial Japan and Nazi Germany carried out brutal experiments on prisoners and civilians through groups like Unit 731 or individuals like Josef Mengele; the Nuremberg Code was developed after the war in response to the Nazi experiments. Countries have carried out brutal experiments on marginalized populations. Examples include American abuses during Project MKUltra and the Tuskegee syphilis experiments, and the mistreatment of indigenous populations in Canada and Australia. The Declaration of Helsinki, developed by the World Medical Association (WMA), is widely regarded as the cornerstone document on human research ethics.

Nazi Germany

Nazi Germany performed human experimentation on large numbers of prisoners (including children), largely Jews from across Europe, but also Romani, Sinti, ethnic Poles, Soviet POWs, homosexuals and disabled Germans, in its concentration camps mainly in the early 1940s, during World War II and the Holocaust. Prisoners were forced into participating; they did not willingly volunteer and no consent was given for the procedures. Typically, the experiments resulted in death, trauma, illness, shortening of life, disfigurement, or permanent disability, and as such are considered as examples of medical torture since the participants had to endure mass amounts of pain.

At Auschwitz and other German camps, under the direction of Eduard Wirths, selected inmates were subjected to various hazardous experiments that were designed to help German military personnel in combat situations, develop new weapons, aid in the recovery of military personnel who had been injured, and to advance the racial ideology backed by the Third Reich. Aribert Heim conducted similar medical experiments at Mauthausen. Carl Værnet is known to have conducted experiments on homosexual prisoners in attempts to "cure" homosexuality.

After the war, these crimes were tried at what became known as the Doctors' Trial, and the abuses perpetrated led to the development of the Nuremberg Code of medical ethics. During the Nuremberg Trials, 23 Nazi doctors and scientists were tried for the unethical treatment of concentration camp inmates, who were often used as research subjects with fatal consequences. Of those 23, 16 were convicted (15 were convicted for the unethical treatment, while one of them was only convicted of SS membership), 7 were condemned to death, 9 received prison sentences from 10 years to life, and 7 were acquitted.

Before World War II

The Law for the Prevention of Genetically Defective Progeny, passed on 14 July 1933, legalized the involuntary sterilization of persons with diseases claimed to be hereditary: weak-mindedness, schizophrenia, alcohol abuse, insanity, blindness, deafness, and physical deformities. The law was used to encourage growth of the Aryan race through the sterilization of persons who fell under the quota of being genetically defective. 1% of citizens between the age of 17 to 24 had been sterilized within 2 years of the law passing. Within 4 years, 300,000 patients had been sterilized. From about March 1941 to about January 1945, sterilization experiments were conducted at Auschwitz, Ravensbrück, and other places by Dr. Carl Clauberg. The purpose of these experiments was to develop a method of sterilization which would be suitable for sterilizing millions of people with a minimum of time and effort. These experiments were conducted by means of X-ray, surgery and various drugs. Thousands of victims were sterilized. Aside from its experimentation, the Nazi government sterilized around 400,000 people as part of its compulsory sterilization program. Intravenous injections of solutions speculated to contain iodine and silver nitrate were successful, but had unwanted side effects such as vaginal bleeding, severe abdominal pain, and cervical cancer. Therefore, radiation treatment became the favored choice of sterilization. Specific amounts of exposure to radiation destroyed a person’s ability to produce ova or sperm. The radiation was administered through deception. Prisoners were brought into a room and asked to complete forms, which took two to three minutes. In this time, the radiation treatment was administered and, unknown to the prisoners, they were rendered completely sterile. Many suffered severe radiation burns.

Dr. Eugen Fischer began sterilization experimentation in German-occupied South West Africa during World War I. A supporter of forced sterilization as a means to prevent the growth of inferior populations and a member of the Nazi Party, Fischer focused his experimentation on mixed-race children in order to justify the Nazi Party's ban on interracial marriage. As a result of Fischer's research in Namibia, Germany prohibited marriages between people of different races in its colonies.

During World War II

Jewish twins were kept alive to be used in Josef Mengele's medical experiments. These children from Auschwitz were liberated by the Red Army in January 1945.

The Luftwaffe performed a series of 360 to 400 experiments at Dachau and Auschwitz, in which hypothermia was induced in 280 to 300 victims. These were conducted for the Nazi high command to simulate the conditions the armies suffered on the Eastern Front, as the German forces were ill-prepared for the cold weather they encountered. Many experiments were conducted on captured Russian troops; the Nazis wondered whether their genetics gave them superior resistance to cold. Approximately 100 people are reported to have died as a result of these experiments.

In early 1942, prisoners at Dachau concentration camp were used by Sigmund Rascher in experiments to aid German pilots who had to eject at high altitudes. A low-pressure chamber containing these prisoners was used to simulate conditions at altitudes of up to 20,000 m (66,000 ft). Of the 200 subjects, 80 died outright, and the others were executed.

Other experiments included: experiments on twins (such as sewing twins together in attempts to create conjoined twins), an experiment in repeated head injury which drove a boy insane, experiments at Buchenwald where poisons were secretly administered in food, experiments to test the effect of various pharmaceutical preparations on phosphorus burns induced with material from incendiary bombs, experiments at Ravensbrück to investigate the effectiveness of sulfonamide after infection with bacteria such as Clostridium perfringens (the causative agent in gas gangrene) and Clostridium tetani (the causative agent in tetanus), experiments conducted to attempt treatments of chemical burns induced by mustard gas and similar compounds, and experiments at Dachau to study various methods of making sea water drinkable.

Many of the subjects died as a result of the experiments, while many others were executed after the tests were completed to study the effect post mortem. Those who survived were often left mutilated, suffering permanent disability, weakened bodies, and mental distress.

The results of the Dachau freezing experiments have been used in some modern research into the treatment of hypothermia, with at least 45 publications having referenced the experiments since the Second World War. This, together with the recent use of data from Nazi research into the effects of phosgene gas, has proven controversial and presents an ethical dilemma for modern physicians who do not agree with the methods used to obtain this data. Some object on an ethical basis, and others have rejected Nazi research purely on scientific grounds, pointing out methodological inconsistencies. In an often-cited review of the Dachau hypothermia experiments, Berger states that the study has "all the ingredients of a scientific fraud" and that the data "cannot advance science or save human lives."

Several Nazi experimenters were after the war employed by the United States government in Operation Paperclip and later similar efforts.

Japan

Empire of Japan

Japanese Unit 731 Complex that used humans for experimentation for biological and chemical weapons, as well as live vivisections and other experiments

 

Human subject research in Japan began in World War II. It continued for some years after. Unit 731, a department of the Imperial Japanese Army located near Harbin (then in the puppet state of Manchukuo, in northeast China), experimented on prisoners by conducting vivisections, dismemberments, and bacterial inoculations. It induced epidemics on a very large scale from 1932 onward through the Second Sino-Japanese war. It also conducted biological and chemical weapons tests on prisoners and captured POWs. With the expansion of the empire during World War II, similar units were set up in conquered cities such as Nanking (Unit 1644), Beijing (Unit 1855), Guangzhou (Unit 8604) and Singapore (Unit 9420). After the war, Supreme Commander of the Occupation Douglas MacArthur gave immunity in the name of the United States to Shiro Ishii and all members of the units in exchange for all of the results of their experiments. The United States blocked Soviet access to this information. The Soviets prosecuted some of the Unit 731 members during its Khabarovsk War Crime Trials.

In November 2006, Doctor Akira Makino confessed to Kyodo news that he had performed surgery and amputations on condemned prisoners, including women and children, in 1944 and 1945 while he was stationed on Mindanao. Most of Makino's victims were Moro Muslims. In 2007, Doctor Ken Yuasa testified to The Japan Times and said that he believes that at least 1,000 persons working for the Shōwa regime, including surgeons, conducted surgical research on mainland China.

State of Japan

In incidents throughout the 1950s, former Unit 731 members infected prisoners and mental health patients with deadly diseases. In 1958, a large number of infants were brought to Kobe Medical School and forcibly administered sugar by having needles inserted through their noses and into their stomachs. A tube was inserted into their anuses to determine how the sugar was processed by their digestive systems. Many of the infants experienced diarrhea and anal bleeding. The parents were never informed that their children were being used as test subjects.

Aboriginal Australians

In the 1920s and 1930s, Aboriginal Australians were subject to medical experiments on how they experienced pain and where body measurements and blood samples were forcibly taken. The experiments were motivated by a system of scientific racism and were carried out by researchers from the University of Adelaide. In 2002, the vice chancellor of the university described the experiments as "degrading and in some cases barbarous" and the school issued a formal apology to Aboriginal and Torres Strait Islander groups.

Indigenous populations in Canada

Canada has historically carried out unethical medical experiments on indigenous populations in concert with its policies of forced cultural assimilation. In 1933, about 600 Native children from the reserves near Qu'Appelle, Saskatchewan were enrolled in a trial to test the tuberculosis vaccine. In both the control and treatment groups nearly a fifth died from exposure, malnutrition, and other causes. Parental consent was not sought for indigenous children, though it was sought for the non-indigenous. Between 1942 and 1952, malnourished children from six residential schools were used in experiments without consent or parental notification. They were split into treatment and control groups and denied adequate nutrition as they were used to determine whether certain combinations of supplements mitigated problems. Children died, developed anemia, and were denied dental care as they developed cavities and gingivitis. The experiments were run by the Department of Indian Affairs of Canada and directed by Percy Moore and Frederick Tisdall, a former president of the Canadian Paediatric Society. In 2014, the Society released a statement outlining guidelines for community-based participatory research involving Inuit, Métis, and First Nations youth.

Guatemala

From 1946 to 1948 U.S. scientific researchers in Guatemala infected hundreds of mental patients with sexually transmitted diseases (STD). Researchers from the U.S. Public Health Service (PHS) conducted experiments on approximately 1,500 male and female patients housed at Guatemala's National Mental Health Hospital. The scientists injected the patients with gonorrhea and syphilis—and encouraged many of them to pass the disease on to others. The experiments were done in cooperation with the Guatemalan government. The PHS carried out the experiments under the guise of syphilis inoculations. In 2010 these experiments were revealed by Susan Reverby of Wellesley College, who was researching a book on the Tuskegee syphilis experiments. The US Secretary of State Hillary Clinton issued an official apology to Guatemala. President Barack Obama apologized to President Álvaro Colom, who had called these experiments 'a crime against humanity'.

Sweden

The Vipeholm experiments were a series of human experiments where patients of Vipeholm Hospital for intellectually disabled in Lund, Sweden, were fed large amounts of sweets to provoke dental caries between 1945 and 1955. The experiments were sponsored both by the sugar industry and dentist community, in an effort to determine whether carbohydrates affected the formation of cavities. The experiments provided extensive knowledge about dental health and resulted in enough empirical data to link the intake of sugar to dental caries. However, today they are considered to have violated the principles of medical ethics.

United Kingdom

De-classified documents of the National Archives revealed that during the 1930s and 1940s, the British Army used hundreds of British and native British Indian Army soldiers as "guinea pigs" in their experiments to determine if mustard gas inflicted greater damage on Indian skin compared to British skin. It is unclear whether the trial subjects, some of whom were hospitalised by their injuries, were all volunteers. In the 1950s, leading aircraftman Ronald Maddison was killed when he was exposed to 200 milligrams of sarin at Porton Down. He had believed that he was testing a cure for the common cold, and in 2004 a High Court ruled his death "unlawful."

Between 1940 and 1979, the Ministry of Defence secretly dispersed potentially dangerous chemicals and micro-organisms across much of the country to evaluate readiness against a biological attack from the Soviet Union. They dropped zinc cadmium sulphide from airplanes and dispersed it by land to track the spread of fluorescent particles, and also spread e.coli, bacillus globigii, and serratia marcescens bacteria.

United States

Since the late 19th century, numerous human experiments were performed in the United States, which were later characterized as unethical. They were often performed illegally, without the knowledge, consent, or informed consent of the test subjects. Examples have included the deliberate infection of people with deadly or debilitating diseases, exposing people to biological and chemical weapons, human radiation experiments, injecting people with toxic and radioactive chemicals, surgical experiments, interrogation/torture experiments, tests involving mind-altering substances, and a wide variety of others. Many of these tests were performed on children and mentally disabled individuals. In many of the studies, a large number of the subjects were poor, racial minorities, and/or prisoners. Often, subjects were sick or disabled people, whose doctors told them that they were receiving "medical treatment." They were used as the subjects of harmful and deadly experiments, without their knowledge or consent. In reaction to this, interest groups and institutions have worked to design policies and oversight to ensure that future human subject research in the United States would be ethical and legal.

During World War II, Fort Detrick in Maryland was the headquarters of US biological warfare experiments. Operation Whitecoat involved the injection of infectious agents into military forces to observe their effects in human subjects.

Public outcry over the discovery of government experiments on human subjects led to numerous congressional investigations and hearings, including the Church Committee, Rockefeller Commission, and Advisory Committee on Human Radiation Experiments, amongst others. These inquiries have not resulted in prosecutions. Not all subjects involved in the trials have been compensated or notified that they were subjects of such trials.

In the 1950s and 1960s, Chester M. Southam injected HeLa cancer cells into healthy individuals, cancer patients, and prison inmates from the Ohio Penitentiary. This experiment raised many bioethical concerns involving informed consent, non-maleficence, and beneficence. Some of Southam's subjects, namely those that already had cancer, were unaware that they were being injected with malignant cells. Additionally, in one of these patients, the cells metastasized to her lymph nodes.

In 1962, the Kefauver-Harris Drug Amendment was passed by the United States Congress. This amendment made changes to the Federal Food Drug & Consumer Act by requiring drug companies to prove both safety and effectiveness of their products. Consequently, drugs were required to have Food and Drug Administration (FDA) approval before being marketed to consumers. Additionally, informed consent became a participation requirement and rules were put into place. This regulation was influenced by the results of 1950 use of thalidomide in Western Europe for pregnant women. They were prescribed the sedative thalidomide, which was inaccurately marketed as a morning sickness treatment. Women gave birth to more than 12,000 infants born with deformities due to effects from the drug in utero.

In the Tuskegee syphilis experiment from 1932 to 1972, the United States Public Health Service contracted with the Tuskegee Institute for a long-term study of syphilis. During the study, more than 600 African-American men were studied who were not told they had syphilis. In an effort to better understand the disease, researchers denied the men access to the known treatment of the antibiotic penicillin. They recorded observations of the effects of the disease over time. Under the impression they were being treated for "bad blood", the participants were given free healthcare by the government. As ineffective treatment was given to the subjects, two-thirds of the group had died by the end of the 40-year experiment. A leak in 1972 led to cessation of the study and severe legal ramifications. It has been widely regarded as the "most infamous biomedical research study in U.S. history". Because of the public outrage, in 1974 Congress passed the National Research Act, to provide for protection of human subjects in experiments. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was established. It was tasked with establishing the boundary between research and routine practice, the role of risk-benefit analysis, guidelines for participation, and the definition of informed consent. Its Belmont Report established three tenets of ethical research: respect for persons, beneficence, and justice.

Project MKUltra — sometimes referred to as the "CIA's mind control program" — was the code name given to an illegal program of experiments on human subjects, designed and undertaken by the United States Central Intelligence Agency (CIA). Experiments on humans were intended to identify and develop drugs and procedures to be used in interrogations and torture, in order to weaken the individual to force confessions through mind control. Organized through the Scientific Intelligence Division of the CIA, the project coordinated with the Special Operations Division of the U.S. Army's Chemical Corps. The program began in the early 1950s, was officially sanctioned in 1953, was reduced in scope in 1964, further curtailed in 1967 and officially halted in 1973. The program engaged in many illegal activities; in particular it used unwitting U.S. and Canadian citizens as its test subjects, which led to controversy regarding its legitimacy. MKUltra used numerous methodologies to manipulate people's mental states and alter brain functions, including the surreptitious administration of drugs (especially LSD) and other chemicals, hypnosis, sensory deprivation, isolation, verbal and sexual abuse, as well as various forms of torture.

Beecher Paper

In a 1966 paper noted Harvard anesthesiologist Henry K. Beecher described 22 published medical studies in which patients had been subjects with no expected benefit to the patient of the experiment. This has been characterized as unethical. For example, patients infused with live cancer cells had been told in one study that they were receiving "some cells," without being told this was cancer. Though identities of the authors and institutions had been stripped, the 22 studies were later identified as having been conducted by mainstream researchers and published in prestigious journals within approximately the previous decade. The 22 cases had been selected from a set of 50 that Beecher had collected. He presented evidence that such unethical studies were widespread and represented a systemic problem in medical research rather than exceptions.

Beecher had been writing about human experimentation and publicizing cases that he considered to be bad practice for nearly a decade. His 1965 briefing to science writers and his 1966 paper gained widespread news coverage and stimulated public reaction. The paper has been described as "the most influential single paper ever written about experimentation involving human subjects." The United States Office for Human Research Protections credits Beecher through this paper as "ultimately contributing to the impetus for the first NIH and FDA regulations."

Beecher was instrumental in developing solutions to such abuses. He noted that a common element in these studies was that some experimental subjects, such as military personnel or mentally handicapped children in institutions, were not in a position to freely decline consent. Beecher believed that rules requiring informed consent were not alone sufficient, as truly informed consent was an unattainable ideal. He worked both to define the rules and conditions for informed consent, and to establish institutional review boards as an additional layer of oversight regarding research protocols.

International drug trials

Since the late 20th century, African nations have often been the sites of clinical testing by large international pharmaceutical companies. In some cases, rural communities have developed iatrophobia (fear of doctors) after undergoing or learning of highly controversial medical experimentation. The fundamental distrust lies in the potential confrontation of Hobson's choice: "Experimental medicine or no medicine at all". Multiple cases of ethically questionable experiments have been documented.

In the late 20th century, Depo-Provera was clinically tested on Zimbabwean women. Once approved, the drug was used as a population control measure in the 1970s. Commercial farm owners put pressure on native women workers to accept the use of Depo-Provera. Population control interests motivated many of the family planning programs. This led to its eventual ban in Zimbabwe.

A 1996 clinical trial in Kano, Nigeria involving the Pfizer drug Trovan to treat meningitis resulted in 200 children being disabled and the deaths of 11. Because of these casualties, the Nigerian government sued Pfizer over whether it had appropriately obtained informed consent. Pfizer argued in court that it had met all regulations for drug testing. Many Nigerians mistrust the use of medical vaccines and also refuse to participate in medical trials.

In 1994 United States drug companies began conducting trials of the drug AZT on HIV-positive African subjects with the goal of developing treatments to reduce the transmission of HIV/AIDs during childbirth. With funding from the National Institutes of Health (NIH) and Centers for Disease Control (CDC), the program tested over 17,000 Zimbabwean women for the efficacy of AZT in preventing transmission of HIV/AIDS during childbirth. Half of the women were given a placebo rather than the drug, and the subjects were not informed of the potential dangers of the treatment. According to Peter Lamptey, the head of the AIDS Control and Prevention Program, "if you interviewed the people in the study, most wouldn't understand to what they had actually consented." An estimated 1000 newborns of women in the study contracted HIV/AIDS, although this could have been avoided by treating the women with known drugs. The testing was ceased in 1998 when the CDC claimed to have obtained sufficient data from experiments in Thailand.

Political abuse of psychiatry

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry 

 

Political abuse of psychiatry, also commonly referred to as punitive psychiatry, is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the human rights of individuals and/or groups in a society. In other words, abuse of psychiatry (including that for political purposes) is the deliberate action of having citizens psychiatrically diagnosed who need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances. Nowadays, in many countries, political prisoners are sometimes confined and abused in psychiatric hospitals.

Psychiatry possesses a built-in capacity for abuse that is greater than in other areas of medicine. The diagnosis of mental disease allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society. Psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. The use of hospitals instead of jails also prevents the victims from receiving legal aid before the courts in some countries, makes indefinite incarceration possible, and discredits the individuals and their ideas. In that manner, whenever open trials are undesirable, they are avoided.

The political abuse of the power entrusted to physicians, and particularly psychiatrists, has a long and abundant history, for example during the Nazi era and the Soviet rule when religious and political dissenters were labeled as "mentally ill" and subjected to inhumane "treatments". In the period from the 1960s up to 1986, abuse of psychiatry for political and ideological purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of religious and political dissidents in psychiatric hospitals in the Eastern Bloc and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China. Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes.

By country

Canada

The Duplessis Orphans were several thousand orphaned children that were falsely certified as mentally ill by the government of the province of Quebec, Canada, and confined to psychiatric institutions.

Donald Ewen Cameron's operation was running from what is today known as the Allen Memorial Institute (AMI), part of the Royal Victoria Hospital, and not to be confused with the non-governmental organization based in Montreal, AMI-Québec Agir contre la maladie mentale.

China

In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him. The British researcher Robin Munro, a sinologist who was writing his dissertation in London after a long sojourn in China, had traveled to China several times to survey libraries in provincial towns and while he was there, he had gathered a large amount of literature which bore the stamp 'secret' but at the same time, it was openly available. This literature even included historical analyses which were published during the Cultural Revolution and it concerned articles and reports on the number of people who were taken to mental hospitals because they complained about a series of issues. It was found, according to Munro, that the involuntary confinement of religious groups, political dissidents, and whistleblowers had a long history in China. The abuses began in the 1950s and 1960s, and they became extremely widespread throughout the Cultural Revolution. During the period of the Cultural Revolution, from 1966 to 1976, the political abuse of psychiatry reached its apogee in China, which was then under the rule of Mao Zedong and the Gang of Four, who established a very repressive and harsh regime. No deviance or opposition was tolerated, either in thought or in practice.

The documents described the massive abuses of psychiatry that were committed for political purposes during the rule of Mao Zedong, when millions of people were declared mentally sick. In the 1980s, according to official documents, fifteen percent of all forensic psychiatric cases had political connotations. In the early 1990s, the number of such cases had dropped to five percent, but with the beginning of the campaign against Falun Gong, the percentage of such cases increased quite rapidly.

Official Chinese psychiatric literature distinctly testifies that the Communist Party's notion of 'political dangerousness' was institutionally engrafted as the main concept in the diagnostic armory of China's psychiatry for a long time and its most important tool for suppressing opposition was the concept of psychiatric dangerousness.

Despite international criticism, the People's Republic of China seems to be continuing its political abuse of psychiatry. Political abuse of psychiatry in the People's Republic of China is high on the agenda and it has produced recurring disputes in the international psychiatric community. The abuses there appear to be even more widespread than they were in the Soviet Union in the 1970s and 1980s and they involve the incarceration of 'petitioners', human rights workers, trade union activists, members of the Falun Gong movement, and people who complain about injustices that have been committed against them by local authorities.

It also seems that, China had no known high security forensic institutions until 1989. However, since then, the Chinese authorities have constructed an entire network of special forensic mental hospitals which are called Ankang which means 'Peace and Health' in Chinese. By that time, China had 20 Ankang institutions and their staff was employed by the Ministry of State Security. The psychiatrists who worked there wore uniforms under their white coats.

The political abuse of psychiatry in China only seems to take place in the institutions which are under the authority of the police and the Ministry of State Security but it does not take place in those institutions which belong to other governmental sectors. Psychiatric care in China falls into four sectors which are hardly connected with each other. These are the Ankang institutions of the Ministry of State Security; those which belong to the police; those which fall under the authority of the Ministry of Social Affairs; those which belong to the Ministry of Health. The sectors which belong to the police and the Ministry of State Security are all closed to the public, and, consequently, information about them hardly ever leaks out. In the hospitals which belong to the Ministry of Health, psychiatrists do not have any contact with the Ankang institutions, and they have no idea of what occurred there, which means they can sincerely state that they were not informed about the political abuse of psychiatry in China.

In China, the structure of forensic psychiatry was to a great extent identical to that which existed in the USSR. On its own, it is not so strange, since psychiatrists from the Moscow Serbsky Institute visited Beijing in 1957 in order to help their Chinese 'brethren', the same psychiatrists who promoted the system of political abuse of psychiatry in the USSR. As a consequence, diagnostics in China were not much different than those which were made in the Soviet Union. The only difference was that the Soviets preferred 'sluggish schizophrenia' as a diagnosis, and the Chinese generally cleaved to the diagnosis of 'paranoia' or 'paranoid schizophrenia'. However, the results were the same: long hospitalizations in mental hospitals, involuntary treatments with neuroleptics, torture, abuse, all of which were aimed at breaking the victim's will.

In accordance with Chinese law which contains the concept of "political harm to society" and the similar phrase dangerous mentally ill behavior, police take "political maniacs into mental hospitals, those who are defined as persons who write reactionary letters, make anti-government speeches, or "express opinions on important domestic and international affairs". Psychiatrists are frequently caught involved in such cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. As Liu's database suggests, today's most frequent victims of psychiatric abuse are political dissidents, petitioners, and Falun Gong members. In the beginning of the 2000s, Human Rights Watch accused China of locking up Falun Gong members and dissidents in a number of Chinese mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.

The WPA attempted to confine the problem by presenting it as Falung Gong issue and, at the same time, make the impression that the members of the movement were likely not mentally sound, that it was a sect which likely brainwashed its members, etc. There was even a diagnosis of 'qigong syndrome' which was used reflecting on the exercises practiced by Falung Gong. It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.

In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama. The issue of Chinese political abuse of psychiatry had been placed as one of the final items on the agenda of the General Assembly. When the issue was broached during the General Assembly, the exact nature of compromise came to light. In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China. The visit was projected for the spring of 2003 in order to assure that one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year. After the 2002 World Congress, the WPA Executive Committee's half-hearted attitude in Yokohama came to light: it was an omen of a longstanding policy of diversion and postponement. The 2003 investigative mission never took place, and when finally a visit to China did take place, this visit was more of scientific exchange. In the meantime, the political abuse of psychiatry persisted unabatedly, nevertheless the WPA did not seem to care.

Cuba

Although Cuba has been politically connected to the Soviet Union since the United States broke off relations with Cuba shortly after the dictator Fidel Castro came to power in 1959, few considerable allegations regarding the political abuse of psychiatry in this country emerged before the late 1980s.  Americas Watch and Amnesty International published reports alluding to cases of possible unwarranted hospitalization and ill-treatment of political prisoners. These reports concerned the Gustavo Machin hospital in Santiago de Cuba in the southeast of the country and the major mental hospital in Havana. In 1977, a report on alleged abuse of psychiatry in Cuba presenting cases of ill-treatment in mental hospitals going back to the 1970s came out in the United States. It presents grave allegations that prisoners end up in the forensic ward of mental hospitals in Santiago de Cuba and Havana where they undergo ill-treatment including electroconvulsive therapy without muscle relaxants or anaesthesia. The reported application of ECT in the forensic wards seems, at least in many of the cited cases, not to be an adequate clinical treatment for the diagnosed state of the prisoner — in some cases the prisoners seem not to have been diagnosed at all. Conditions in the forensic wards have been described in repulsive terms and apparently are in striking contrast to the other parts of the mental hospitals that are said to be well-kept and modern.

In August 1981, the Marxist historian Ariel Hidalgo was apprehended and accused of 'incitement against the social order, international solidarity and the Socialist State' and sentenced to eight years' imprisonment. In September 1981, he was transported from State Security Headquarters to the Carbó-Serviá (forensic) ward of Havana Psychiatric Hospital where he stayed for several weeks.

India

It was reported in June, 2012, that the Indian Government has approached NIMHANS, a well known mental health establishment in South India, to assist in suppressing anti-nuclear protests regards to building of the Kudankulam Nuclear Power Plant. The government was in talks with NIMHANS representatives to chalk up a plan to dispatch psychiatrists to Kudankulam, for counselling protesters opposed to the building of the plant. To fulfill this, NIMHANS developed a team of 6 members, all of them, from the Department of Social Psychiatry. The psychiatrists were sent to get a "peek into the protesters' minds" and help them learn the importance of the plant according to one news source.

In July, 2013, the same institution, NIMHANS, was involved in a controversy where it was alleged that it provided assistance to the Central Bureau of Investigation relating to some interrogation techniques.

Japan

Japanese psychiatric hospitals during the country's imperial era reported an abnormally large number of patient deaths, peaking in 1945 after the surrender of Japan to Allied forces. The patients of these institutions were mistreated mainly because they were considered a hindrance to society. Under the Imperial Japanese government, citizens were expected to contribute in one way or another to the war effort, and the mentally ill were unable to do so, and as such were looked down upon and abused. The main cause of death for these patients was starvation, as caretakers did not supply the patients with adequate food, likely as a form of torture and a method of sedation. Because mentally ill patients were kept secluded from the outside world, the large number of deaths went unnoticed by the general public. After the end of Allied occupation, the National Diet of Japan passed the Mental Hygiene Act (精神衛生法,, Seishin Eisei Hō) in 1950, which improved the status of the mentally ill and prohibited the domestic containment of mental patients in medical institutions. However, the Mental Hygiene Act had unforeseen consequences. Along with many other reforms, the law prevented the mentally ill from being charged with any sort of crime in Japanese courts. Anyone who was found to be mentally unstable by a qualified psychiatrist was required to be hospitalized rather than incarcerated, regardless of the severity of any crime that person may have committed. The Ministry of Justice tried several times to amend the law, but was met with opposition from those who believed the legal system should not interfere with medical science. After almost four decades, the Mental Health Act (精神保健法,, Seishin Hoken Hō) was finally passed in 1987. The new law corrected the flaws of the Mental Hygiene Act by allowing the Ministry of Health and Welfare to set regulations on the treatment of mental patients in both medical and legal settings. With the new law, the mentally ill have the right to voluntary hospitalization, the ability to be charged with a crime, and right to use the insanity defense in court, and the right to pursue legal action in the event of abuse or negligence on the part of medical professionals.

Germany

By 1936, killing of the "physically and socially unfit" became accepted practice in Nazi Germany. In the 1940s, the abuse of psychiatry involved the abuse of the "duty to care" on an enormous scale: 300,000 individuals were sterilized and 77,000 killed in Germany alone and many thousands further afield, mainly in eastern Europe. Psychiatrists were instrumental in establishing a system of identifying, notifying, transporting, and killing hundreds of thousands of "racially and cognitively compromised" persons and the mentally ill in settings that ranged from centralized mental-hospitals to jails and death camps. Psychiatrists played a central and prominent role in sterilization and euthanasia, constituting two categories of the crimes against humanity. The taking of thousands of brains from euthanasia victims demonstrated the way medical research was connected to the psychiatric killings. Germany operated six psychiatric extermination centers: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. They played a crucial role in developments leading to the Holocaust.

New Zealand

On 21 October 2018 the New Zealand Member of Parliament (MP) and former member of the New Zealand National Party Jami-Lee Ross was "taken into mental health care", apparently by police. This action sidelined the MP - who had resigned from the Party (the largest represented in the New Zealand Parliament) two days earlier - in his declared campaign against corruption in the National Party. "A National Party spokesman said: 'Over the past several weeks the National Party has taken seriously the mental health concerns raised by Mr Ross and the medical professionals he has been involved with. That has included seeking advice from medical professionals and involving Police wherever necessary to ensure support is made available to Mr Ross. [...]'"

Romania

In Romania, there have been allegations of some particular cases of psychiatric abuse during over a decade. In addition to particular cases, there is evidence that mental hospitals were utilized as short-term detainment centers. For instance, before the 1982 International University Sports 'Olympiad', over 600 dissidents were detained and kept out of public view in mental hospitals. Like in the Soviet Union, on the eve of Communist holidays, potential "troublemakers" were sent to mental hospitals by busloads and discharged when the holidays had passed.

The People's Republic of Romania held to a doctrine of state atheism. Many Christians, including those from the Baptist Church and Lord's Army wing of the Orthodox Church, were forced into psychiatric hospitals where they died.

Russia

Reports on particular cases continue to come from Russia where the worsening political climate appears to create an atmosphere in which local authorities feel able, once again to use psychiatry as a means of intimidation.

Soviet Union

In 1971 detailed reports about the inmates of Soviet psychiatric hospitals who had been detained for political reasons began to reach the West. These showed that the periodic use of incarceration in psychiatric institutions during the 1960s had started to become a systematic way of dealing with dissent, political or religious. In accordance with the doctrine of state atheism, the USSR hospitalized individuals who were devout in their faith, such as many Baptist Christians.

In March 1971 Vladimir Bukovsky sent detailed diagnoses of six individuals (Natalya Gorbanevskaya and Pyotr Grigorenko among them) to psychiatrists in the West. They responded  and over the next 13 years activists inside the USSR and support groups in Britain, Europe and North America conducted a sustained campaign to expose psychiatric abuses. In 1977 the World Psychiatric Association (WPA) condemned the USSR for this practice. Six years later, the Soviet All-Union Society of Neuropathologists and Psychiatrists seceded from the WPA rather than face almost certain expulsion.

During this period reports of continuous repression multiplied, but Soviet psychiatric officials refused to allow international bodies to see the hospitals and patients in question. They denied the charges of abuse. In February 1989, however, at the height of perestroika and over the opposition of the psychiatric establishment, the Soviet government permitted a delegation of psychiatrists from the United States, representing the U.S. government, to carry out extensive interviews of suspected victims of abuse.

The delegation was able systematically to interview and assess present and past involuntarily admitted mental patients chosen by the visiting team, as well as to talk over procedures and methods of treatment with some of the patients, their friends, relatives and, sometimes, their treating psychiatrists. The delegation originally sought interviews with 48 persons, but saw only 15 hospitalized and 12 discharged patients. About half of the hospitalized patients were released in the two months between the submission of the initial list of names to the Soviet authorities and the departure from the Soviet Union of the US delegation. The delegation concluded that nine of the 15 hospitalized patients had disorders which would be classified in the United States as serious psychoses, diagnoses corresponding broadly with those used by the Soviet psychiatrists. One of the hospitalized patients had been diagnosed as having schizophrenia although the US team saw no evidence of mental disorder. Among the 12 discharged patients examined, the US delegation found that nine had no evidence of any current or past mental disorder; the remaining three had comparatively slight symptoms which would not usually warrant involuntary commitment in Western countries. According to medical records, all these patients had diagnoses of psychopathology or schizophrenia.

Returning home after a visit of more than two weeks, the delegation members wrote a report which was highly damaging to the Soviet authorities. The delegation established that there had been systematic political abuse of psychiatry in the past and that it had not yet come to an end. Victims continued to be held in mental hospitals, while the Soviet authorities and the Soviet Society of Psychiatrists and Neuropathologists in particular still denied that psychiatry had been employed as a method of repression.

The American report and other pressures, domestic and external, led the Politburo to pass a resolution (15 November 1989) "On improvements in Soviet law concerning procedures for the treatment of psychiatric patients".

United States

• Drapetomania was a supposed mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity. In addition to inventing drapetomania, Cartwright prescribed a remedy. His feeling was that with "proper medical advice, strictly followed, this troublesome practice that many Negroes have of running away can be almost entirely prevented." In the case of slaves "sulky and dissatisfied without cause"—a warning sign of imminent flight—Cartwright prescribed "whipping the devil out of them" as a "preventative measure". As a remedy for this disease, doctors also made running a physical impossibility by prescribing the removal of both big toes.
• In the United States, political dissenters have been involuntarily committed. For example, in 1927 a demonstrator named Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of Sacco and Vanzetti.
• When Clennon W. King, Jr., an African-American pastor and activist of the Civil Rights Movement, attempted to enroll at the all-white University of Mississippi for summer graduate courses in 1958, the Mississippi police arrested him on the grounds that "any nigger who tried to enter Ole Miss must be crazy." Keeping King's whereabouts secret for 48 hours, the Mississippi authorities kept him confined to a mental hospital for twelve days before a panel of doctors established the activist's sanity.
• In the 1964 election, Fact magazine polled American Psychiatric Association members on whether Barry Goldwater was fit to be president and published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." This led to the banning of diagnosing public figures when you have not performed an examination or been authorized to release information by the patient. This became the Goldwater rule.
• In the 1970s, Martha Beall Mitchell, wife of U.S. Attorney General John Mitchell, was diagnosed with a paranoid mental disorder for claiming that the administration of President Richard M. Nixon was engaged in illegal activities. Many of her claims were later proved correct, and the term "Martha Mitchell effect" was coined to describe mental health misdiagnoses when accurate claims are dismissed as delusional.
• In 1972 Thomas Eagleton was forced to withdraw as a vice presidential candidate for being treated for depression.
• In 2010, the book The Protest Psychosis: How Schizophrenia Became a Black Disease by psychiatrist Jonathan Metzl (who also has a Ph.D. in American studies) was published. The book covers the history of the 1960s Ionia State Hospital located in Ionia, Michigan and now converted to a prison and focuses on exposing the trend of this hospital to diagnose African Americans with schizophrenia because of their civil rights ideas. The book suggests that in part the sudden influx of such diagnoses could be traced to a change in wording in the DSM-II, which compared to the previous edition added "hostility" and "aggression" as signs of the disorder.
• Clinical psychologist Bruce E. Levine, argues that Oppositional Defiant Disorder, which can be easily used to pathologize anti-authoritarianism, is an abuse of psychiatry.
• In 2014, Mercury News published a series of articles detailing questionable use of psychotropic drugs within California's foster care system where bad behavior is attributed to various mental conditions, and little care is provided besides drugs. Likewise, many experts questioned the long-term effects of high dosages on developing brains, and some former patients reported permanent side effects even after stopping the meds.
• According to law professor Jonathan Turley and Newsweek magazine, in June 2015, U.S. District Judge Richard M. Berman ordered conservative film maker and activist Dinesh D'Souza to continue psychological counseling for a four-year period despite numerous recommendations to the contrary by well-respected private and court appointed mental health personnel. D'Souza pleaded guilty to a single count of making illegal contributions in the name of others as part of the campaign of Wendy Long for New York Senate. This occurred during a post-confinenment hearing. D'Souza was seeking to reduce the four-year community service sentence by reference to his home confinement period. Berman balked and said that he said the two periods as distinct—a position that courts would likely take in similar cases. In referring to the psychological counseling aspect, D'Souza's counsel submitted evidence that the court-ordered psychiatrist found no indication of depression or reason for medication. His own retained psychologist also provided a written statement concluding there was no need to continue the consultation. However, Judge Berman disagreed and said that he thought more counseling will help while noting that this is not punishment: "I only insisted on psychological counseling as part of Mr. D'Souza's sentence because I wanted to be helpful. I am requiring Mr. D'Souza to see a new psychological counselor and to continue the weekly psychological consultation not as part of his punishment or to be retributive." The court insisted "I'm not singling out Mr. D'Souza to pick on him. A requirement for psychological counseling often comes up in my hearings in cases where I find it hard to understand why someone did what they did."

California

• "5150 (involuntary psychiatric hold)" – There are many instances of usage of California law section 5150, which allows for involuntary psychiatric hold based on the opinion of a law enforcement official, psychological professional (or many other individuals who hold no qualification for making psychological assessment), which have been challenged as being unrelated to safety, and misused as an extension of political power.

New York

Whistleblowers who part ranks with their organizations have had their mental stability questioned, such as, for example, NYPD veteran Adrian Schoolcraft who was coerced to falsify crime statistics in his department and then became a whistleblower. He was forcibly committed to a psychiatric hospital.