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WPA Continues to Pursue Concerns About Chinese Psychiatric Abuses

Published Online:https://doi.org/10.1176/pn.40.3.00400024

The December 3, 2004, issue of Psychiatric News contained a letter to the editor by Dr. Raymond Freebury, former chair of APA's Committee on International Abuse of Psychiatry. He called for the expulsion of the Chinese Society of Psychiatry (CSP) from the World Psychiatric Association (WPA) in view of alleged abuse of psychiatry against Falun Gong followers, drawing parallels to psychiatric abuse in the former Soviet Union and stating that “there are times when it is indeed better to be cruel in the present to be kind in the long run.”

I would first like to remind readers of the WPA's efforts in pursuing the case of the Falun Gong, which were outlined in detail on the WPA electronic bulletin.

A delegation of the current, past, and future presidents of the WPA and the chair of the WPA Review Committee met with our CSP colleagues and the Chinese vice minister of health in January 2004. We agreed on a WPA/CSP joint meeting in Beijing for examining records, interviewing patients and their families, or interviewing doctors who were involved in the examination of some of the patients. However, because of disagreement regarding the terms of reference of the mission, we felt it prudent to suspend the WPA delegation visit.

The next meeting was on May 4, 2004, with the CSP president and vice president. The CSP again acknowledged that it had identified instances in which Chinese psychiatrists had failed to distinguish between spiritual-cultural beliefs and delusions, and as a result persons had been misdiagnosed and mistreated. The CSP explained that this was due to lack of training and professional skills of some psychiatrists rather than the result of systematic abuse of psychiatry. The CSP has undertaken steps to educate its members and is looking forward to the WPA's assistance in correcting this situation.

I would like to draw the attention of readers to the fact that Soviet psychiatrists resigned from the WPA and were not expelled and that the“ improvement” of the situation in the former Soviet Union was not because of WPA pressure but because of regime change. The resignation of Soviet psychiatrists did not reduce the malpractice or provide Soviet psychiatrists with protection in case they decided to challenge their government. Furthermore, at the time Soviet psychiatrists did not show any form of collaboration with the WPA as currently shown by our Chinese colleagues throughout this long investigative process.

We need to be clear about what we want the WPA to achieve on the Falun Gong case: an end to alleged abuse and helping our Chinese colleagues out of a situation that involves a lot of political pressure, or making a“ sensational,” “historic” decision. The question deserves a responsible answer.

The Madrid Declaration is concerned with the protection of the rights of our patients and the nonabuse of our profession. But we also identified the right of our colleagues to be protected from harassment that might follow.

I believe that the demand put on Chinese psychiatrists without WPA support would be a fatal blow to colleagues who serve about one-third of the world's population. As an organization committed to the well-being of patients and the dignity of our profession, we are committed to helping our colleagues and our patients, not to cornering them for the self-satisfaction of having made an“ abstract,” politically correct decision.

There is no reason why the WPA should be blamed. We shall continue our investigation in a way that can support our colleagues and their patients without losing them to a political suicide that may appeal to some colleagues. This month a WPA delegation will meet again with our Chinese colleagues to discuss issues of clinical diagnosis, classification, human rights, ethical issues, and forensic psychiatry, as we continue moving the process forward.

In a final note, we should remember the chaotic nature of the world in which we live. None of us is immune from the politics of our governments. The recent news about widespread torture is sobering. We might face evidence of involvement of some of our colleagues in some of those atrocious events. It would be all too simple to expel their associations from the WPA on the basis of their oppression by their governments or armies. Our real challenge is to professionally help our colleagues defy those abuses, protected by the solidarity and support of their colleagues worldwide. ▪

Ahmed Okasha, M.D., is president of the World Psychiatric Association.