Illinois Psychiatric Society more concerned with income than patients' right to choose

April 1, 2011

A “Fact Sheet” recently issued by the Illinois Psychiatric Society (IPS) shows that the organization (which is the state branch of the American Psychiatric Association) is against informed consent for children in the custody of the state Department of Child and Family Services (DCFS, the state agency that oversees the care of foster children, among other things). 

What the IPS is reacting to in this Sheet is a pending bill in the state legislature which calls for a $5,000 per day penalty on child and adolescent psychiatrists for failure to comply with informed consent. 

“Informed consent” means the patient’s ability to choose a drugs or treatment based on having a complete understanding of the pros and cons of the particular treatment, applicable alternative treatments and even no treatment.  When a doctor fails to fully inform the patient, the patient is unable to make an informed decision.

Informed consent is a part of every state’s Medical Practice Act.  It is required of every doctor to obtain a patient’s informed consent for a proposed treatment.

The IPS contends that this proposed legislation “places too many restrictions on prescribing medications for DCFS wards [children in state custody]….”  They portray the legislation as creating a barrier to necessary treatment but the legislation, intended to protect children, merely creates a barrier to the psychiatrist getting paid for indiscriminate child-drugging.

Psychiatrists prescribe more mind-altering drugs to this group of kids than to children not in state custody.  A 2009 federally-funded study found that children covered by Medicaid (such as foster children) are prescribed powerful and dangerous antipsychotic drugs at a rate four times higher than children whose parents have private insurance. 

Following the suicide of seven-year-old Florida foster child Gabriel Myers, who was on several psych-prescribed mind-altering drugs, the state Department of Children and Families enacted a policy change requiring prescribing psychiatrist to get pre-approval before prescribing a psychotropic drug to a child in state custody.  Included in this pre-approval is the child’s and his guardian’s informed consent for the drug.

This resulted in a 75% drop in the number of antipsychotic drug prescriptions for children in Florida’s custody.  Certainly the IPS is aware of this.  One could easily conclude then that their disagreements have more to do with money than with “necessary treatment.”

Regardless of IPS’ justifications, informed consent must be established in policy as it was rampant violations of informed consent that led to the need for bills like these in Florida and Illinois.

(Update: This bill passed the house March 5, 2011 in an amended version which removed the $5000/day penalty but preserved requirements for informed consent and a mechanism to address childrens’ disagreement with taking a state-prescribed psychiatric drug.)