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ric Association in 1977 for their abuse of psychiatric knowledge, and power of a psychiatrist betraying their oath and commitment to the ethics of our profession.
I want to point out, Mr. Chairman, that even after the Second World War, when the uses and misuses of medicine, including experimentation on human beings, deprivation of life, frivolous experimentation of every kind, sterilization, and the like, conducted and controlled by German doctors, and doctors in several occupied territories, when these atrocities were publicized, I call to your attention the fact that not a single international or national medical society or specialty society of any kind condemned their colleagues for the practices in which they participated.
To my knowledge, the resolution adopted by the World Psychiatry Association with active participation of American Psychiatric Association in 1977, in Honolulu, was a historic landmark.
Thank you very much.
Mr. YATRON. Thank you, Dr. Zoubok, for your excellent statement.
Now we would like to call on Mr. Reddaway. Mr. Reddaway, you may proceed, sir. STATEMENT OF PETER REDDAWAY, FELLOW AT THE KENNAN
INSTITUTE OF ADVANCED RUSSIAN STUDIES, WOODROW
I am grateful to have this opportunity to speak to your subcommittee. The main basis of what I have to say will be two books that I have published jointly with a psychiatrist, Dr. Sidney Bloch, one of which was referred to earlier by Mr. Fairbanks. The second volume is currently in the press.
It is also based on my active involvement in the Paris-based International Association on the Political Use of Psychiatry, which has existed for the last 3 years, and is rather active.
I will limit my statement to three aspects of the subject. Its size and scope, the political context of the U.S.S.R.'s forced resignation from the World Psychiatric Association (WPA) in January of this year, and my thoughts on possible future trends in official policy.
The practice of political psychiatry is based on the close collaboration between the police authorities of the U.S.S.R. and selected members of the psychiatric profession, the latter being regarded like other professions as a branch of the civil service. A careful selection has to be made, however, because although most Soviet psychiatrists have been trained in the dubious psychiatric theories of Dr. Snezhnevsky, which Dr. Reich has just presented to us and which justify the practice, and have not been trained in other theories-despite this, many of them instinctively sense that there is something wrong about the practice of political psychiatry and try to avoid personal involvement in it.
Moreover, a small, but apparently growing number resist it in various ways by refusing to assess individual dissenters as mentally ill, or by facilitating their early release, or by covertly supplying information on local cases to the Soviet human rights movement,
or even by speaking out publicly against the practice, thereby courting a heavy jail sentence.
An exceptional situation obtains in one large city where the practice is virtually nonexistent thanks to the known opposition of a powerful and prestigious local psychiatrist. Yet other psychiatrists have emigrated or defected because of their distaste for a fundamental perversion of medical ethics.
The system relies in the main on the domination of all Soviet forensic psychiatry by Moscow's Serbsky Institute of General and Forensic Psychiatry, which you have just seen pictured, on the ready collaboration of a few socially or politically ambitious psychiatrists in each of the main psychiatric facilities, and on a number, seemingly small, of their colleagues who genuinely believe that criticism of Government policy is a symptom of mental illness.
The victims of the system of psychiatric abuse can be divided into three main types. Those who are incarcerated and treated in institutions even though they are sane. Those who are imprisoned and otherwise persecuted because of their attempts to help these people and to oppose politicized psychiatry. And, third, many Soviet citizens who have lost trust in the integrity of all psychiatrists, regarding them as agents of an oppressive state, rather than honorable healers of individual suffering. These citizens, therefore reject their services, and the aid and comfort which many of them would in fact provide, and which the citizens do, in fact, need.
I will speak now briefly about the second category of victims, because the first is better known and other people have mentioned it. The second category of victims of political psychiatry are indirect victims, but nonetheless real for that. They are citizens who have been persecuted for their attempts to oppose such psychiatry. Most notable among them are the members of the Moscow-based Working Commission to Investigate the Use of Psychiatry for Political Purposes who have accomplished a prodigious amount of research and humanitarian work between 1977 and 1981.
In my statement, I elaborate on the current fate of several members of this working commission-Dr. Koryagin, Alexander Podrabinek, and Irina Grivnina—who are in particularly difficult situations of persecution at the moment. But I will not elaborate now, because I gather that Professor Fireside of Amnesty International will speak about them more a little later.
I will turn now to the recent political context, both domestic and international, in which the abuse has been occurring.
Internationally the issue was mainly debated from 1981 to 1983 in the context of a movement by some national psychiatric associations, including those of the USA and Britain, aimed at expelling or suspending the U.S.S.R. from the World Psychiatric Association at the latest World Congress in Vienna in July of this year.
The national associations rightly took the view that 10 years of quiet diplomacy, private conversations with Soviet official psychiatrists, and mild public protests had produced no substantial change in the level of Soviet abuses, and that this approach had, therefore, failed.
In January 1983, the number of member associations of the World Psychiatry Association, voting for the U.S.S.R.'s expulsion or suspension, rose to nine. As these associations would wield half the votes in the WPA's governing body, the U.S.S.R. was now, in January, almost certain to be voted out in July.
Intensive Soviet lobbying of the associations in an effort to change their position had been in progress for a year. As, however, they insisted on strict conditions for the inspection visit to the U.S.S.R., which the Soviets offered them, this lobbying was now abandoned. It would clearly now be impossible to confuse, sidetrack or deceive the delegation as had been done more or less successfully with previous delegations, notably those from the World Psychiatric Association in 1973, Austria in 1977, and Sweden in 1981.
In these circumstances, the whole issue was undoubtedly referred up from the professional level to the political level where it had been handled some time before. The politicians now had, in January 1983, in theory at least, two options.
First, political psychiatry could be quickly abolished, its leading practitioners demoted and replaced by psychiatrists who were respected abroad, its victims released, Dr. Koryagin and his colleagues freed. This option, however, presented serious difficulties. To convince the many skeptics, the reforms would have had to be conducted quickly and thoroughly, but this is not how the Soviet bureaucracy normally operates, especially when, as in this case, it was essential to lose as little additional international face as possible. Therefore, no public admission could be made that anything done in the past had actually been wrong.
Moreover, although the advent of the new Andropov leadership potentially facilitated the action of abolition, this leadership had not yet sufficiently consolidated its power for decisive, clear-cut reforms to be feasible. So the second option, prompt resignation from WPA, was now the only realistic one.
This course, although profoundly humiliating, would avoid the even greater humiliation of Soviet expulsion in Vienna in the midst of a blaze of publicity. It would remove one particular pressure, the necessity of responding to the WPA investigators, and it would provide a breathing space-time in which to observe how the WPA and the world medical and political community would react, time in which to review policy, and time in which, if the abolition of political psychiatry then seemed the best course, to conduct the abolition quietly, gradually, and unobtrusively prior to rejoining the WPA.
So the decision was quickly taken, under close supervision by the politicians, to resign. The politicians' public explanation of this decision was remarkably mild. The spokesman for the Health Minister explained that the U.S.S.R. "disagreed with other member countries over definitions and concepts of psychiatry, and that some WPA members took an unobjective approach to psychiatric problems." This mildness suggested that the politicians were anxious not to exacerbate the situation, and wished to keep the door ajar for a future return.
It is my belief that probably a review of policy was initiated at this stage, and I have based the following section of my statement on what I believe is the likely way in which those elements of the establishment in the Soviet Union might want to argue for the abolition of political psychiatry. I think that this is quite an illuminating way of looking at the problem.
Such would-be reformers might well respond to the situation as follows:
First and foremost, the political abuse of psychiatry is not an essential instrument of our rule. As the president of Britain's Royal College of Psychiatry has rightly said about us, I don't really believe that this policy is vital to their interests. They could deal with dissidents in other ways if they wanted.” And indeed we do. We sack them, exile them, imprison them, deport them abroad, and so on.
Second, the alarming precedent of our first de facto expulsion from an international body is likely to lead on to firmer action against us in other international medical forums, as Soviet psychiatry is increasingly seen as a new version of the Lysenkoism which destroyed our reputation in biology for a generation. The trend could easily spread to other professional fields like physics, mathematics, and the churches, where our vulnerability is already clear.
So we must now do what we did to Lysenko and his empire in the 1960's and prepare for the following reforms. Morozov, Snezhnevsky, and the others must be quietly retired, or demoted, and replaced by psychiatrists respected abroad.
The theoretical and organizational stranglehold of the former on Soviet psychiatry must be gradually ended by a wide range of personnel changes in the institutes, hospitals, medical schools, ministerial bodies, publishing houses, societies, and journals.
The dissidents interned in mental hospitals must be unobtrusively released. Dr. Koryagin and his colleagues must be freed from jail. Then we will have no difficulty in rejoining the WPA.
All of this will take time as, of course, no admission of past guilt can be made, and everything must seem to be happening routinely and naturally, not in response to foreign pressure. But it must be done. For if it is not, if more workers like Aleksei Nikitin are psychiatrically interned for organizing free trade unions, if the KGB continues to have Dr. Koryagin tortured in prison in an attempt to force him to recant, and if those compromised bunglers, Morozov and Vartanian, are left in charge of our psychiatry's foreign relations, then our forced resignation from the WPA seems likely to be only the first of a mounting series of international reversals in the World Health Organization, and in other U.N. bodies, in professional associations, and in our international diplomacy as a whole.
My own conclusion is that medical, lay, and governmental bodies in the West should do everything possible in the coming years and months to assist the above arguments of the Soviet would-be reformers. That clearly means sticking to our principles and increasing the pressure on the Soviets in forums of the types just mentioned.
The Soviet resignation from the World Psychiatry Association is a step forward, if not, of course, the most desirable one. Very little has in fact been lost by it, as virtually no exchanges with honorable Soviet psychiatrists had in any case been allowed by their corrupt leaders to take place previously.
Sooner or later, the Soviet political leadership will, in my view, feel an irresistible need to come out of its present semi-isolationism, as Mr. Khrushchev did in the 1950's, and Mr. Brezhnev in the early 1970's. Then, if not before, the reforms sketched above will have their chance. In the meanwhile, the best hope of accelerating the process lies in our asserting our universally approved principles with mounting resolution in both medical and lay forums.
If we can do that, the moral victory of forcing the USSR's resignation from the World Psychiatric Association should eventually be translated into the substantive achievement of bringing to an end a deeply antihuman and potentially contagious perversion of medicine.