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ing to leave the Soviet Union "illegally." The Madrid Concluding Document includes a provision for the right of workers to establish and join trade unions. Cold comfort, perhaps, to Aleksei Nikitin and Vladimir Klebanov, whose labor activities have led to indefinite incarceration and inhumane treatment in the especially notorious Special Psychiatric Hospitals.

Earlier this year, the Soviet Union withdrew from the World Psychiatric Association when it became obvious that its treatment of dissidents and "complainers" would be an issue at that body's Congress in July 1983 at Vienna. By doing so, the Soviet government may have felt it was avoiding serious inquiry into this disturbing chapter in medical history. This hearing is intended to help enlighten us on this issue, and to seek ways to ensure that the Soviet government and medical authorities adhere to its international agreements and the tenets of the Hippocratic oath.

Mr. Yathon. At this time, I would like to yield to Mr. Leach, the ranking minority member of the Subcommittee on Human Rights.

Mr. Leach.

Mr. Leach. Thank you, Mr. Chairman, I will be very brief.

I just would like to commend the administration for speaking up on this subject consistently and strongly. It is so clear that a society that defines dissent as sickness is itself sick, and that is what we have with the Soviet Union today.

I welcome our witnesses and think that the real scope of the hearing will be what is said on the other side of the table. I look forward to your comments.

Mr. Yatron. Thank you, Mr. Leach.

Our first witness is Charles H. Fairbanks, Jr., Deputy Assistant Secretary of State for Human Rights and Humanitarian Affairs.

Mr. Fairbanks, we are pleased to have you again as a witness. Will you please proceed.

STATEMENT OF CHARLES H. FAIRBANKS, JR., DEPUTY ASSISTANT SECRETARY OF STATE FOR HUMAN RIGHTS AND HUMANITARIAN AFFAIRS

Mr. Fairbanks. Thank you very much, Mr. Chairman.

You have my prepared statement, and we have many experts present, so I will cover only certain issues right now. I am very grateful for this opportunity to testify before the members of the committee on the subject of psychiatric abuse.

Most human rights violations occur around the world, in many diverse countries. Psychiatric abuse is distinctive in that it is centered in the Soviet Union. There have been reports that some dissidents have undergone compulsory hospitalization for mental illness—sane dissidents that is—in a few other countries, but only in the Soviet Union has the misuse of psychiatry become widespread and systematic. For this reason, I would like to explore this afternoon the significance of this appalling human rights violation in the Soviet Union.

By psychiatric abuse, we mean the diagnosis of sane dissenters as mentally ill, and their punishment by incarceration in psychiatric hospitals. This particular human rights violation is a distinctive feature of the current stage of Soviet history.

During the 1930's, of course, the Soviet Union carried out what Leszek Kolakowski called "probably the most massive warlike operation ever conducted by a state against its own citizens."

A modest estimate of Stalin's victims would be 6.5 million, a far more likely estimate is 20 million citizens of the Soviet Union. The overwhelming majority of these victims were either murdered by Soviet security personnel, usually after a nominal trial, or consigned to a slow death in slave labor camps.

After the death of Stalin, and particularly after 1956, conditions became vastly better in the Soviet Union. There was no longer mass terror against the population, and the law began to be administered in a less arbitrary way. A dissident subculture grew up within the Soviet Union which was able to pursue opinions independent of the regime within narrow limits.

But, ironically, it is only in the post-Stalin era, when successive Soviet Governments have sought to convince the rest of the world that they brought an end to the Stalin heritage and were no longer holding political prisoners, that psychiatric abuse became a major instrument of repression.

From the regime's point of view, psychiatric commitment is a very convenient instrument of policy. It enables Soviet authorities to substitute judgments of psychiatrists for sentencing in a trial, or to avoid trial altogether. It enables the government to keep dissidents incarcerated an indefinte length of time and, of course, it enables the regime to claim that Soviet citizens who express dissatisfaction with the system are simply mentally ill.

These advantages of psychiatric abuse for the Soviet leadership are worth somewhat further examination, particularly its effects on the rule of law, which is the last barrier against arbitrary despotism.

The U.S.S.R. has laws against dissidents which the regime can rule rather freely, for instance, the law against anti-Soviet agitation and propaganda, but even totalitarian laws are a restriction on autocratic rule.

On the other hand, sentences on obviously political charges are an embarrassment to the regime which no longer wishes to appear Stalinist. In these circumstances, a method of dispensing with normal trials is very attractive, and sending dissidents to psychiatric hospitals achieves this end.

Moreover, since confinement in mental hospitals is not limited to a definite term, this technique enables Soviet officials to move into a realm of almost unlimited administrative discretion or whim, to evade the rule of law. Psychiatric abuse is a technique that perverts medicine in order to destroy law.

The diagnoses of dissidents by Soviet official psychiatrists make clear the replacement of legal standards by arbitrary whim. For example, the dissident Edvard Kuznetsov was diagnosed as suffering from "schizophrenia," because "he asserts that there is no such thing as a Communist moral code, and the credit for its creation should go to the Bible."

Similarly, the dissident Vladimir Borisov was diagnosed as suffering from "a disturbed sense of orientation and an incorrect interpretation of his surroundings. Thus, he takes the hospital for a concentration camp and the doctors for sadists."

This overall sequence of events shows the complexity of de-Stalinization in the Soviet Union. Overall conditions are much better than under Stalin, but some Soviet dissidents are subjected to terrors which were not used during the Stalin period, or very little used, as part of the very attempt to conceal or to legitimize surviving elements of Stalinism in the Soviet regime.

To give the distinguished members of this committee a clearer idea of what psychiatric abuse entails for the people subjected to it, let me quote from Amnesty International's report on psychiatric abuse.

In its discussion of the drugs which are used on dissenters placed in psychiatric hospitals, Amnesty International said that "the drugs most commonly used . . . are powerful tranquilizers. Each of these drugs can cause serious negative side effects.

It goes on to discuss the use of so-called insulin shock therapy, which induces hypoglycemic coma, and is often used for 25 or 30 such administrations in succession. There is wide use of the drug sulfazin, formerly used in Western psychiatric practice, but now generally abandoned because of its side effects and lack of usefulness. Sulfazin, Amnesty International notes, caused great physical discomfort: Raging fever so intense that the patient is virtually incapacitated for up to 3 days after an injection.

Most former inmates of Soviet psychiatric hospitals who have given an account of their incarceration, have reported that sulfazin is regularly used as a punishment, not as a treatment but as a punishment, for violation of discipline, with the victim sometimes being subjected to injections of it every day for several days.

As with the other treatments, the medical personnel administering this drug have often done so without proper assessment of whether the subject was physically able to stand the treatment.

Two important conclusions, I think, flow from the types of drugs which are used in Soviet psychiatric abuse. First, psychiatric abuse is in fact a form of torture. Second, it is a form of punishment that must be particularly terrifying to those who are undergoing it. It uses not the crude strength of a bully, but the entire vast storehouse of resources of modern medicine to affect its victims. It uses those vast resources not simply to wound, to humiliate, or to force confessions, but to intrude into the most hidden recesses of the whole human personality.

This is what the victims of Soviet psychiatric abuse cannot but fear: that the drugs and the treatment will change their entire personality. After all, the very diagnosis implies that such an effort will be made, because the diagnosis regards political opinions not merely as opinions, but as indications of a pervasive personality disorder, a psychosis.

Most human rights violations attempt to compel only an outward compliance with repressive government. Psychiatric abuse goes far beyond that. It attempts to touch the very springs of thinking and feeling. So this is a particularly totalitarian type of human rights violation.

Most of the horrors which are inflicted by man on man extend through a great range of political regimes, but this one is more distinctive. The very notion that mental health can be identified with holding specific political opinions belongs to the political culture of totalitarianism.

Finally, Mr. Chairman, the Government of the United States deeply deplores the pervasive misuse of psychiatric incarceration as an instrument of political repression. We have repeatedly condemned this flagrant human rights abuse in the Madrid CSCE (Commission on Security and Cooperation in Europe) Review Conference, in the U.N. Human Rights Commission, and the U.N. General Assembly.

We will continue to work in every appropriate way to alleviate the plight of Soviet citizens deprived of their liberty and subjected to cruel and inhumane punishment for merely seeking to exercise their elementary human rights in a totalitarian society.

Thank you.

[Mr. Fairbanks' prepared statement follows:]

Prepared Statement Of Dr. Charles H. Fairbanks, Jr., Deputy Assistant SecreTary Of State For Human Rights And Humanitarian Affairs

I am grateful for this opportunity to testify before members of this committee on the subject of psychiatric abuse. Most human rights violations occur in many diverse countries; psychiatric abuse is centered in the Soviet Union. There have been reports that sane dissidents have undergone compulsory hospitalization for mental illness in a few other countries. But only in the Soviet Union has the misuse of psychiatry become widespread and systematic. For this reason,' this morning I would like to explore the significance of this appalling human rights violation in the Soviet Union.

By psychiatric abuse we mean the diagnosis of sane dissenters as mentally ill, and their punishment by incarceration in psychiatric hospitals. This human rights violation is a distinctive feature of the current stage of Soviet history. Of course, the fact that reports of Soviet psychiatric abuse only began to reach the West in the 1960's does not mean that there were no examples of Soviet psychiatric abuse prior to that time. In fact, even in the earliest years of Bolshevik rule, there were a few cases of perfectly sane critics of the regime being interned by the government in psychiatric institutions. As far as we know, however, such cases were few and far between. During the 1920's and thirties, the Soviet government carried out what the Polish-born scholar, Leszek Kolakowski, has called 'probably the most massive warlike operation over conducted by a state against its own citizens." The most modest estimate of Stalin's victims places their number at six and one half million Soviet citizens. A far more likely estimate is twenty million Soviet citizens. The overwhelming majority of these victims were either murdered by Soviet security personnel, usually after a nominal trial, or were consigned to a

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