Who will protect the psychiatrist?

Ukrainian psychiatrists are anxiously awaiting the elections. No, don’t get me wrong, they’re not worried about the potential candidates. It is just that their patients may become a resource, however numerically insignificant, for election abuses. It suffices to recall the recent presidential campaign. Experts say that the governor of an eastern Ukrainian oblast asked local doctors to draw up a list of all disabled patients half a year before the elections. Or consider the confusing situation that arose in a Donetsk regional hospital during the last parliamentary elections. Patients, who have the right to cast their votes, were allowed to implement it only during the elections to the Verkhovna Rada. They could not elect their candidates to the local council: because they were inmates of a regional hospital, they were not formally registered there and were thus denied the right to cast their ballots.

Today the situation is complicated by Ukraine’s laws. One of them, “On Psychiatry,” creates confidentiality, which means that it is not necessary to publicize the fact that Mr. Ivanov is a patient at a psychiatric hospital. At the same time, the Law “On Elections” insists precisely on this. Doctors are becoming hostages of this situation. Semen Hluzman, executive secretary of the Association of Ukrainian Psychiatrists, says that calls for help are coming from psychiatric hospitals. Some physicians write in desperation, asking to call off the elections. Dr. Hluzman is convinced that they can be readily understood; all they want is peace and quiet. “Imagine this situation,” says the expert. “I am a relatively healthy individual, but a few days before the elections I have an attack of delirious tremens. Several days later I recover from this crisis, but the voting is over. What should the head doctor do in this situation? I am capable of functioning, but I was prevented from expressing my will according to the above reasons.”

In other words, doctors are fighting for the law to protect both the rights of patients and medical personnel. Recently they held a roundtable with jurists to formulate a special message to the government and the Central Election Committee. In the opinion of the roundtable participants, it would be good to provide maximum opportunities for psychiatric patients to vote. True, many of them cannot make a conscious choice. But it would be better to cancel their ballot than to have it used for certain political aims. “People with psychiatric disorders won’t be able to decide the fate of one political candidate or party or another. But the unregulated nature of their voting procedure may well produce unpleasant incidents,” Hluzman says with conviction.

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A total of 1,200,000 patients live in Ukraine’s psychiatric institutions. Approximately 800,000 people suffer from alcoholism and drug addictions. In the past 15 years the rate of psychiatric illness has risen by 5 percent to 260.7 cases per 100,000 residents. In 1990, there were 248.00 cases. The situation with children looks very much the same: 228,000 psychiatric cases officially registered to date, compared to 242,500 in 1994. Twenty thousand Ukrainians are officially incapacitated due to mental illness, meaning that every fifth resident of Ukraine is in need of special health care.