Hypothetical Scenario-what would you tell this patient?

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whopper

whopper

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Say you got a patient with a very close older relative who directly knew one of the most identifiable people in world history?
This older relative has several pieces of property that should be in a museum. E.g. pictures of this historical figure, notes, personal items owned by this person.

And say this patient told you that when the older relative dies she's going to get all of it in the inheritance and plans on destroying all of it because she hates her relative?

Would it be unethical that I recommend she instead give this stuff away to a museum or at least sell it (and it could go for millions) though a verified 3rd party that could catalog it for history's sake and then at least donate the money to a charitable cause? So let's say you agree with me that the recommendation itself isn't bad, even good. Would you then push that argument to even impress upon the patient that she really should do it because it's terrible to destroy pieces of history?

I have such a situation with a patient and my wife who is a mental health professional told me I shouldn't tell her anything on what to do with this property. We had an argument about it where my wife got ticked off with me where I told her at least a gentle recommendation should be done.
 
Take this opportunity to engage in therapy with the patient. Perhaps the response she is hoping to get by destroying the objects actually may never come to fruition...thereby her choosing not to destroy the objects?
 
I'm sure you're not the first person she's told this to. You could be the first to be less interested in her connection to this famous figure.
 
Cause this would be the equivalent IMHO of burning unpublished photos, dairies, notes of someone such as Abraham Lincoln, Winston Churchill, Adolph Hitler, Joseph Stalin, Robert E Lee, Joseph McCarthy, FDR, JFK, John Lennon, Karl Marx.

I'm not going to say who the person is but will say it's one of the above. I will also include we had this discussion long before the current political climate where several statues have been destroyed. These are pieces of property that IMHO people across the spectrum would want preserved just as I'm sure that at least 90% of people, if asked, would want a concentration camp, a photo of Lincoln, the pistol that shot him, a film reel never before seen of JFK being shot, or an unknown chapter of Karl Marx's writings, or a song by John Lennon never known to have existed being found, preserved and presented to the world for the sake of knowledge.

To completely disregard the historical importance IMHO is just too simplistic and as people committed to knowledge not something we can disregard lightly.

Her onus in destroying the property, per her, is that her older relative is a hateful person, and a large part of the relative's hate is directly attributed to the historical person. My patient directly suffered due to this hate. My patient says she believes destroying the property will be a personal catharsis for her.

My wife's argument was that I as her health provider have no responsibility over the property and really should just be for the patient's best outcome and should bear no weight to the historical importance of this property.

I'm pretty sure this situation is not BS and not some fanciful story she made up. She's not an educated person and brought up things and situations regarding her relatives' connection to the historical person that you'd only expect of someone who knew what they were talking about.
 
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Your obligation is to the patient. Her property is her property. If she wants smores on the front lawn with priceless artifacts, so be it.

History gets destroyed all the time. One only needs to watch the news.

City of Cleveland had millionaires destroy their own homes in their wills upon their death.
 
I used to mention this story on the forum years ago and it was true. One time a rather impulsive, low IQ, frequent flyer, cluster B but also with real Bipolar Disorder patient showed up to my psych unit with a suitcase with close to $1 million in it. A relative died and left her their house. The patient immediately sold it and took all the money out in cash and put it in the suitcase. She would always be discharged to the local homeless shelter, she'd stop her meds, get into some type of borderline dysphoric dilemma, and end up back on the unit within a few weeks.

I told the attending (remember I'm a resident at this time) that we need to get her a guardian cause she has all this money and we were certain in a few weeks she was going to lose all of it. She, however, didn't meet the criteria for guardianship, but was just above it. A homeless person, impulsive, low IQ but not low enough to have a guardian or qualify for any assistance.

I kept joking to the nurses during lunch that when we discharge her, a guy in a black ninja outfit of my height, weight, and build will mysteriously run to her, grab the suitcase and in seconds be out of sight. Then all of a sudden about 10 minutes later I'll come to the unit with a big smile on my face.

Of course I didn't steal her money, but had I done it I don't think I would've felt bad at all. The day of her discharge, the nurses took her suitcase out of the safe on the unit, we all knew what was in it and we gave it to her just like we were supposed to do, all of us thinking she was likely actually worse off for having all that money on her. She of course pretty much lost all the money in weeks.
 
How much do you think you could change her mind anyway? Assuming the older relative dies first, assuming the older relative really does bequeath her these items, how much will what you say now affect what your patient will do in the future? I guess if she is coming to you asking you what to do, it might. How did it come up?

You don't have any patients with a thick Russian accent going by the name of Anastasia do you?

JK . . .
 
I think my recommendation would have strong effect. She has seen psychiatrists for several years and told me I was the only patient that got her over 50% better. I told her I attributed it to me actually listening to her. She told me she's had several that only spent about 5-10 minutes/session. We spend real time doing psychotherapy. The other reason is the psychopharm treatments I gave were rational. E.g. she has Bipolar Depression so guess what? I actually tried meds approved/evidence for Bipolar Depression. Geez how simple is that (most of us know there's plenty of psychiatrists out there that don't seem to know what they're doing with meds).

So she has a lot of trust in me. If I insisted she not destroy the items I think she would listen to me, but I question if that is something I should even do. I think at best I can only gently recommend she donate the property to institution that can preserve them.

The older relative in question is not in great health but is not expected to die anytime in the near future.
 
whopper said:
I have such a situation with a patient and my wife who is a mental health professional told me I shouldn't tell her anything on what to do with this property. We had an argument about it where my wife got ticked off with me where I told her at least a gentle recommendation should be done.
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I don't know who else you shared this story with, but have you found anyone to agree with you over your wife yet?

I don't think you should be directive like this as her psychiatrist. But you're also a person who's allowed to have opinions and express them. It wouldn't be malpractice. Would it effects your work with her in the future? Would it be ethically wrong to try to use your influence as her doctor in this way?
 
Haven't shared it with anyone other than my wife and this forum. I already know if I asked most people they won't understand cause they know this isn't something clarified in our own profession.

I'm also not being very specific cause it could give enough information to identify my patient but the historical person is one of the most recognized names in history and I bet you if this stuff was sold each item would go for tens of thousands of dollars and there's several several items. She's not wealthy and I posed the idea that she could sell the items and do something constructive with the money she'd get but (e.g. donate it to an organization that would fight the hate/ignorance she suffered) but she said she'd still rather have them destroyed.

This situation is causing me a lot of counter-transference cause I'd be very frustrated if the stuff got destroyed. As a former professor, artist, fine arts major, and history buff I'd find it extremely upsetting to see something that deserves to be preserved destroyed, but there are no clear professional guidelines on this.

A few years ago a local temple showed me a copy of the Torah that survived the Holocaust and in fact it was a copy that survived cause the Nazis were planning on exterminating the Jews and keeping some items saved to be a historical reference for the future as a race they proudly destroyed. To me that Torah was sacred. I get the same emotional kick in the gut on the idea she might destroy this stuff as I would if I found out someone broke into that temple and burned that Torah.
 
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Your wife is right. Your job is to help the patient cope with his or her symptoms, not satisfy your own desires or feelings. It sounds like the patient knows full well the value of the objects. Most likely, the patient will make a less destructive choice if the patient finds some peace. I've seen it happen many times. You are not the first or only psychiatrist who has treated celebrities or important people or people with access to wealth or valuable items. Continue to be ethical. If you cannot, you should refer this patient to someone who will. This patient does not owe you or the world anything.
 
I’m not sure it’s unethical per se to want to save historical artifacts. We have duties other than our duty to our patient (e.g. duty to warn, triage, resource management, etc.) and preserving cultural artifacts for future humans is not without value. I don’t see what’s wrong with exploring this more with the patient. I wouldn’t pressure someone, but I would want to know why they are not considering other options.
 
whopper said:
She's not wealthy and I posed the idea that she could sell the items and do something constructive with the money she'd get but (e.g. donate it to an organization that would fight the hate/ignorance she suffered) but she said she'd still rather have them destroyed.
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There's really no debate then, right? You already gave her the advice. In the earlier posts I got the impression you were weighing whether to advise her, but here it sounds like you already did.
 
Great question. In considering what is best for the patient, I would highlight a number of possible scenarios and use a problem solving approach.

Eg.

1) Donating the artefacts to a museum could potentially enrich the lives of countess future visitors and ongoing generations.

2) Selling the artefacts to a private collector could result in a monetary gain and improve her own life, but reduce the public benefit.

3) Destroying the artefacts may lead to catharsis, but not change the underlying resentment.

4) Live streaming the destruction of said artefacts could result in public ridicule, death threats, hate mail etc.

5) Keeping the artefacts and handing them down to a younger generation.

Etc.

Each has their pros/cons, but ultimately it is up the patient to decide and the stance I’d take is that there are no right or wrong answers. Of course, also worth keeping in mind that once the relative passes, the patient may decide to change their mind completely so I wouldn’t be adverse to exploring potential hypotheticals. There might be the potential for other family members will challenge the will if they know this is what she intends to do and this will cause new rifts if she hasn’t considered alternative situations or negative consequences.

Have a patient who had refused quite a generous financial gift from their mother on principle over past perceived inequalities between other siblings. Picked up early on that it wasn't going to be something he'd shift on, but over the years it keeps coming up so we have looked at some hypothetical situations -still, it has taken him some time to realise that hanging on to the resentment hasn’t been psychologically beneficial, and as the family relationship continued to decline it reached a point where potentially he may have been written out of the will as other siblings took control.
 
I'm just an FP but there are two things that reading this thread made me think.

First, you already mentioned experiencing counter-transference about this. Now obviously you can't use that to try and get this person to see sense (though depending on the degree of this if the patient goes through with it this could be enough to warrant telling them to find a new psychiatrist given your feelings on their actions), but it might be worth exploring the idea of consequences in a general sense from destroying historical artifacts, especially if anyone else knows they exist and that this person will be inheriting them.

Second, this doesn't seem the healthiest coping mechanism to my admittedly untrained thinking. I know lots of people who really don't get along with various relatives, but they wouldn't burn down those relatives house if it were left to them. It seems to me that you could potentially both help the patient and preserve history by trying to find a more constructive way of dealing with his/her feelings toward that relative in relation to the property in question.

For instance, if its Robert E. Lee stuff she can donate to the polar opposite - the National Abolition Museum, for example. If its Hitler something, the Guggenheim. You get the idea. Since it seems the relative buys into the ideology of whatever historic person we're talking about, doing something like that might be worse than destroying it since it will directly benefit the people said person fought against.
 
whopper said:
Say you got a patient with a very close older relative who directly knew one of the most identifiable people in world history?
This older relative has several pieces of property that should be in a museum. E.g. pictures of this historical figure, notes, personal items owned by this person.

And say this patient told you that when the older relative dies she's going to get all of it in the inheritance and plans on destroying all of it because she hates her relative?

Would it be unethical that I recommend she instead give this stuff away to a museum or at least sell it (and it could go for millions) though a verified 3rd party that could catalog it for history's sake and then at least donate the money to a charitable cause? So let's say you agree with me that the recommendation itself isn't bad, even good. Would you then push that argument to even impress upon the patient that she really should do it because it's terrible to destroy pieces of history?

I have such a situation with a patient and my wife who is a mental health professional told me I shouldn't tell her anything on what to do with this property. We had an argument about it where my wife got ticked off with me where I told her at least a gentle recommendation should be done.
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It’s not unethical to tel her to sell it especially if she’s poor. Giving advice is part of being a doctor and this seems like obvious advice, if someone was telling you they wanted to do something stupid you should advise them against it and this is objectively stupid
 
whopper said:
Cause this would be the equivalent IMHO of burning unpublished photos, dairies, notes of someone such as Abraham Lincoln, Winston Churchill, Adolph Hitler, Joseph Stalin, Robert E Lee, Joseph McCarthy, FDR, JFK, John Lennon, Karl Marx.

I'm not going to say who the person is but will say it's one of the above. I will also include we had this discussion long before the current political climate where several statues have been destroyed. These are pieces of property that IMHO people across the spectrum would want preserved just as I'm sure that at least 90% of people, if asked, would want a concentration camp, a photo of Lincoln, the pistol that shot him, a film reel never before seen of JFK being shot, or an unknown chapter of Karl Marx's writings, or a song by John Lennon never known to have existed being found, preserved and presented to the world for the sake of knowledge.

To completely disregard the historical importance IMHO is just too simplistic and as people committed to knowledge not something we can disregard lightly.

Her onus in destroying the property, per her, is that her older relative is a hateful person, and a large part of the relative's hate is directly attributed to the historical person. My patient directly suffered due to this hate. My patient says she believes destroying the property will be a personal catharsis for her.

My wife's argument was that I as her health provider have no responsibility over the property and really should just be for the patient's best outcome and should bear no weight to the historical importance of this property.

I'm pretty sure this situation is not BS and not some fanciful story she made up. She's not an educated person and brought up things and situations regarding her relatives' connection to the historical person that you'd only expect of someone who knew what they were talking about.
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So says you. Preserving history is not your job here.

You dont have a duty to Hitler, or Churchill, or whoever. You have a duty to your patient, and I would bet dollars to donuts there are more important things (to her) to focus on in your sessions.
 
If she hates her relative, she might want to work on being more honest with herself and the relative about her feelings, which are important.
Then, when the relative is aware of her strong feelings, the relative may choose to bequeath items to another - it's not really her concern beyond her own responsibility for her feelings.
 
whopper said:
Cause this would be the equivalent IMHO of burning unpublished photos, dairies, notes of someone such as Abraham Lincoln, Winston Churchill, Adolph Hitler, Joseph Stalin, Robert E Lee, Joseph McCarthy, FDR, JFK, John Lennon, Karl Marx.

I'm not going to say who the person is but will say it's one of the above. I will also include we had this discussion long before the current political climate where several statues have been destroyed. These are pieces of property that IMHO people across the spectrum would want preserved just as I'm sure that at least 90% of people, if asked, would want a concentration camp, a photo of Lincoln, the pistol that shot him, a film reel never before seen of JFK being shot, or an unknown chapter of Karl Marx's writings, or a song by John Lennon never known to have existed being found, preserved and presented to the world for the sake of knowledge.

To completely disregard the historical importance IMHO is just too simplistic and as people committed to knowledge not something we can disregard lightly.

Her onus in destroying the property, per her, is that her older relative is a hateful person, and a large part of the relative's hate is directly attributed to the historical person. My patient directly suffered due to this hate. My patient says she believes destroying the property will be a personal catharsis for her.

My wife's argument was that I as her health provider have no responsibility over the property and really should just be for the patient's best outcome and should bear no weight to the historical importance of this property.

I'm pretty sure this situation is not BS and not some fanciful story she made up. She's not an educated person and brought up things and situations regarding her relatives' connection to the historical person that you'd only expect of someone who knew what they were talking about.
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I've found that listening to my wife is always the best course of action 😉
 
Chimed said:
I've found that listening to my wife is always the best course of action 😉
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Generally, true, yeah.
What I really respect Whopper for here is that despite his strong feelings he is taking the time to examine the situation and seek other points of view that may be more objective. That takes integrity and courage.
 
wolfvgang22 said:
Generally, true, yeah.
What I really respect Whopper for here is that despite his strong feelings he is taking the time to examine the situation and seek other points of view that may be more objective. That takes integrity and courage.
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Completely agree. Never met Whopper but have always had complete respect. As a wanna be history buff myself I understand the dilemma and question. But in the end, the patient takes priority.
 
Read all of the above. Your input has allowed me to look at this from a different angle. Most of you told me to do what my wife told me to do, but then it shifts to the husband vs wife dynamic and that can sometimes degrade itself into an ego thing. So if one of us is right or wrong we start thinking it's not about that but about beating the other in an argument.

Here's what I'm going to do. I'll say there's benefits she needs to consider in not destroying the items (that I already did so the emphasis will not be on this) but that it's her decision. I already told her no matter what she does I'm her doctor, she's a good patient and there's no judgment against her from me no matter what she does.
 
whopper said:
Read all of the above. Your input has allowed me to look at this from a different angle. Most of you told me to do what my wife told me to do, but then it shifts to the husband vs wife dynamic and that can sometimes degrade itself into an ego thing. So if one of us is right or wrong we start thinking it's not about that but about beating the other in an argument.

Here's what I'm going to do. I'll say there's benefits she needs to consider in not destroying the items (that I already did so the emphasis will not be on this) but that it's her decision. I already told her no matter what she does I'm her doctor, she's a good patient and there's no judgment against her from me no matter what she does.
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Interesting thread though, I don't know if I would have thought of this scenario unless it happened to me directly.
 
As an adept of psychodynamic therapy, I have a different view. I don't think it matter how valuable the items are, but if the patient tells me he wants to burn his relatives socks I would try to talk about it. It's not about the item itself, but what they represent. It seems to me that burning it is just a symptom, not the real cause. My bet is that after some therapy she would see that burning something like that is pointless.
 
brazilianpsych said:
As an adept of psychodynamic therapy, I have a different view. I don't think it matter how valuable the items are, but if the patient tells me he wants to burn his relatives socks I would try to talk about it. It's not about the item itself, but what they represent. It seems to me that burning it is just a symptom, not the real cause. My bet is that after some therapy she would see that burning something like that is pointless.
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No one said not to talk about it. It is quite obviously "grist for the therapy mill." Its the OP's statement/value on the outcome of his suggestion that is the kicker here.

That said, its probably NOT the most clinically "important thing" going on here (both in terms of tx outcomes and the patient's own values and overall pathology) either.

Dr. Jones's not making sure it goes to a museum is subjectivity sad, sure (he actually didn't even accomplish that in Raiders, mind you)...but, come on. I mean, really. History is lost and/or torn down everyday in this country. How much of New Amsterdam is still around in lower Manhattan? Par for the course. You can be Dr. Jones on your own time.

And again, "pointless" seems way too subjective and icky Freudian and big brotherish for my taste. That action may psychically "set them free" for all you know. Probably not of course, but still....
 
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I'm actually a little more on @whopper 's original side of the fence. While the patient obviously comes first, I don't think there's anything wrong with encouraging her to do something more productive and meaningful with items like this instead of destroying them which is sounds like has already been done. That being said, there's a difference between encouraging a patient to do something and directing them to do it. I think encouraging a more healthy and productive coping mechanism would be beneficial while giving actual directives specifically about the items would almost certainly cross a line. I would adamantly disagree with your wife on that point, as we do have some (granted typically relatively small) amount of responsibility for the social aspect of our patient's lives.

whopper said:
The older relative in question is not in great health but is not expected to die anytime in the near future.
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You had previously mentioned that this patient feels like this will be some form of catharsis for her, but the above makes this sound much more like a form of revenge than any truly meaningful personal gain.

VA Hopeful Dr said:
Second, this doesn't seem the healthiest coping mechanism to my admittedly untrained thinking. I know lots of people who really don't get along with various relatives, but they wouldn't burn down those relatives house if it were left to them. It seems to me that you could potentially both help the patient and preserve history by trying to find a more constructive way of dealing with his/her feelings toward that relative in relation to the property in question.
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I think this gets to the crux of the matter in a way that would both benefit the patient and be most likely to preserve the items. Destruction of property, even when it becomes your own property, seems like there's some pretty malignant thought processes occurring which would need to be addressed. The way the situation has been framed very much makes it sound like there is a disconnect between the patient's emotional reaction to her relative and these items as opposed to one of actual understanding as to why this would be cathartic. The patient may not be ready to dive into the subject that deeply, but there at least seems to be a relatively big are to work on appropriate coping mechanisms, as I think someone who needs to completely destroy something to alleviate stress probably has other malignant coping mechanisms and probably could use more healthy ones. I could be totally wrong, but I don't think I've met anyone who uses destruction as a coping mechanism/reaction who didn't have some serious issues that needed to be addressed.

erg923 said:
So says you. Preserving history is not your job here.

You dont have a duty to Hitler, or Churchill, or whoever. You have a duty to your patient, and I would bet dollars to donuts there are more important things (to her) to focus on in your sessions.
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Even with the duty to the patient, which I agree on, the subject seems like it's highly relevant to some form of underlying psychopathology. I don't think that the issue needs to be forced, but I also don't think it would be wrong to go down this rabbit hole a little more to get a deeper understanding of the thought process and coping mechanisms which are driving this desire (assuming this hasn't already been done).
 
Stagg737 said:
Even with the duty to the patient, which I agree on, the subject seems like it's highly relevant to some form of underlying psychopathology. I don't think that the issue needs to be forced, but I also don't think it would be wrong to go down this rabbit hole a little more to get a deeper understanding of the thought process and coping mechanisms which are driving this desire (assuming this hasn't already been done).
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See my response above. Big difference between broaching subject in therapy vs being (obviously) invested in the outcome of it.
 
Right now I'm on a waiting list for a therapist, so I'd be happy for any attention.

But to have someone care about my personal effects . . . It made me start to think about when I was younger and had moved to Europe for a year as a child and then moved back to the United States. A rumor had started while I was gone that my family was very wealthy (we were not) and that I had lots of fancy toys (I did not). Kids would show up to my doorstep wanting to come in to play. They would look around disappointed. Some stuff was in the process of being moved, which I mentioned, and they would ask when the toys were coming. These kids stopped coming around when nothing materialized.

How much worth does this patient feel over her connection to this famous person? And how much is her worthlessness over the rest of her life increasing as you pay attention to that connection?

Edit: I started thinking about it again. What if it's a test for your loyalty to her over the objects? Maybe it was unintentional when she realized how much you cared about the items.

If I heard this, "I already told her no matter what she does I'm her doctor, she's a good patient and there's no judgment against her from me no matter what she does."

I would hear something quite different from those words. That the words need to be spoken is what is saying something to the patient.
 
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What about a doctor's duty to society, protecting others from harm? I am not concerned about the financial value of the objects so much as the historical/cultural value. If the historical objects originally belonged to a civil rights hero or a leader of an indigenous group, destroying the objects could be considered damaging to that group. On the other hand, no one will care if your patient destroys Hitler's personal gold swastika cufflinks
 
Would it be unethical of me to guess? There's one that really seems like the obvious.

I guess that goes against my whole point, and others' point, that the emphasis should be on the person and not their claim to history.
 
Interesting thread, seems the fact that patient specifically told whopper they were planning in the future to destroy these hypothetical items shows the patient is probably conflicted themselves about the items and more importantly what it means to be related to this person.


(Assuming whopper wasn’t specifically pushing on this topic for his own edification which seems unlikely)

I’m always overly prone to suggest solutions, but seems like the patient putting these items in a safe deposit box nobody else knows about would give them time to process this conflict while also being distant from the items and assuring others don’t get them.
 
My dynamic supervisors often stressed that self-revelation, as with any intervention, should be for the benefit of the patient, not of the therapist. I'm having a hard time coming up with a way of talking about your opinion on the items that isn't just self-serving. Of course there are less revealing interventions that would be relevant in any therapy and have already been mentioned (exploring relationship with this family member, feelings about the potentially inherited items and person associated with them, etc.) Those interventions might lead, in a non-directive way, to the patient changing her mind. Or might not. But the hope is that, whatever she does, it leads to her feeling better.
 
whopper said:
My wife's argument was that I as her health provider have no responsibility over the property and really should just be for the patient's best outcome and should bear no weight to the historical importance of this property.
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Agree with your wife, speaking as a psychologist myself. Your value system and care should not enter into this. This is great grist for the mill, exploration of beliefs, societal vs. individual values, Socratic questioning type stuff, but you are treating a patient. Let your opinion of the ideal outcome go.

oldiebutgoodie1211 said:
Giving advice is part of being a doctor and this seems like obvious advice
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I am not a medical doctor, but a as psychologist, giving advice is not part of psychotherapy. That's Busch league masters level stuff. There are other ways to get at this and get them considering these things. Use all the clinical skill and trainnig you have, approach with some sophistication.

whopper said:
Here's what I'm going to do. I'll say there's benefits she needs to consider in not destroying the items (that I already did so the emphasis will not be on this) but that it's her decision. I already told her no matter what she does I'm her doctor, she's a good patient and there's no judgment against her from me no matter what she does.
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Why would you think telling a patient your opinions or your judgement of them is helpful to them? What kind of therapeutic intervention is this? I think your wife may be reasonably concerned, seems you are acting as a person here and not a provider treating a mental health condition.

michaelrack said:
What about a doctor's duty to society, protecting others from harm?
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I am not at all familiar with psychiatry ethics, but in psychology we would not view this as falling under this duty. This duty is more for imminent safety, protecting life. Our mission is to the patient.
 
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@whopper Not quite to the same level as what you're talking about, but my grandfather, on my dad's side, was quite a famous Jazz musician in South Australia. Among Jazz historians in Adelaide he is not only considered one of the legends of the early Jazz scene, but one of the pioneers of the Jazz sound in Australia. Museums of local history & music collectors would have loved to have gotten hold of even a fraction of what he left behind in terms of memorabilia & artefacts, but there are very, very few photos, or recordings, or anything at all left of my Grandfather's legacy. When he died his widow (his third wife) destroyed almost everything he had - burnt all of his sheet music, smashed up all of his instruments, destroyed his diaries, letters, etc. When she passed my Dad inherited a small amount of what was still left (one of the first microphones he had used in the 1920s, his old band leaders banner, and so on) and promptly proceeded to dump the entire lot in the backyard incinerator and torch it.

It took me a while to come to terms with what I considered to be the loss of a historic legacy, & to not automatically think, "OMG, but why? This could've gone to a museum, you could have sold this stuff and donated money to charity, you didn't have to destroy it". The thing is though there are two sides to my Grandfather's legacy; the historical side that claims him as a legendary Jazz musician and pioneer, and the reality that his family had to live with, which was a neglectful, abusive, womanising drunkard who caused long term psychological damage in my father especially. So in the end, whilst I still can't entirely agree with what happened in terms of the destruction of his physical legacy, I get why family members felt the need to go there, I understand it, and I can't fault for them it. I think it was something they really did need to do for themselves.
 
AbnormalPsych said:
I am not at all familiar with psychiatry ethics, but in psychology we would not view this as falling under this duty. This duty is more for imminent safety, protecting life. Our mission is to the patient.
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You're absolutely right in terms of traditional ethics. But things have changed. If it ends up in a newspaper/ news report that a doctor failed to stop his patient from destroying a draft of an undelivered Martin Luther king jr speech, his career and life will be destroyed. But that's just my opinion based on my observation of society over the past 6 months and I can't cite any specific legal cases.... but with the pandemic and police brutality/civil rights demonstrations, we as a nation are moving somewhat away from a notion of individual rights and more towards group rights.
 
whopper said:
Cause this would be the equivalent IMHO of burning unpublished photos, dairies, notes of someone such as Abraham Lincoln, Winston Churchill, Adolph Hitler, Joseph Stalin, Robert E Lee, Joseph McCarthy, FDR, JFK, John Lennon, Karl Marx.

I'm not going to say who the person is but will say it's one of the above. I will also include we had this discussion long before the current political climate where several statues have been destroyed. These are pieces of property that IMHO people across the spectrum would want preserved just as I'm sure that at least 90% of people, if asked, would want a concentration camp, a photo of Lincoln, the pistol that shot him, a film reel never before seen of JFK being shot, or an unknown chapter of Karl Marx's writings, or a song by John Lennon never known to have existed being found, preserved and presented to the world for the sake of knowledge.

To completely disregard the historical importance IMHO is just too simplistic and as people committed to knowledge not something we can disregard lightly.

Her onus in destroying the property, per her, is that her older relative is a hateful person, and a large part of the relative's hate is directly attributed to the historical person. My patient directly suffered due to this hate. My patient says she believes destroying the property will be a personal catharsis for her.

My wife's argument was that I as her health provider have no responsibility over the property and really should just be for the patient's best outcome and should bear no weight to the historical importance of this property.

I'm pretty sure this situation is not BS and not some fanciful story she made up. She's not an educated person and brought up things and situations regarding her relatives' connection to the historical person that you'd only expect of someone who knew what they were talking about.
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Sounds like my family. We're descendants of Robert E. Lee and he was a bastard and a half, but a lot of the family views him as a hero and the Confederacy as their legacy due to the revisionism that took place after the war. With that comes a whole lot of racism and hatred of liberal ideals. I'm glad they turned his home into a cemetary, and if given the chance I'd destroy every artifact related to him I could save for those that showed him as the cruel, even by the standards of the day, slave owner he was. Maybe that's selfish, but I've seen the harm that clinging to symbols such as these does to people. In an ideal world such objects could be locked away in a museum for hundreds of years until the world had moved on and they were just curious historic relics with little meaning in the modern era. In our current troubled reality though, I feel most comfortable with all of it reduced to ash.
 
michaelrack said:
If it ends up in a newspaper/ news report that a doctor failed to stop his patient from destroying a draft of an undelivered Martin Luther king jr speech, his career and life will be destroyed.
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I don't think this makes much sense. In such a hypothetical how would the person's doctor even become involved in the reporting? They have nothing to do with the situation.
 
hamstergang said:
I don't think this makes much sense. In such a hypothetical how would the person's doctor even become involved in the reporting? They have nothing to do with the situation.
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Sorry NBC, due to hippa I cannot even confirm if I have ever treated that person. No comment
 
Mad Jack said:
Sounds like my family. We're descendants of Robert E. Lee and he was a bastard and a half, but a lot of the family views him as a hero and the Confederacy as their legacy due to the revisionism that took place after the war. With that comes a whole lot of racism and hatred of liberal ideals. I'm glad they turned his home into a cemetary, and if given the chance I'd destroy every artifact related to him I could save for those that showed him as the cruel, even by the standards of the day, slave owner he was. Maybe that's selfish, but I've seen the harm that clinging to symbols such as these does to people. In an ideal world such objects could be locked away in a museum for hundreds of years until the world had moved on and they were just curious historic relics with little meaning in the modern era. In our current troubled reality though, I feel most comfortable with all of it reduced to ash.
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So you're a fan of book burning?
 
VA Hopeful Dr said:
So you're a fan of book burning?
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This is my own personal relationship with one particular bastard. I can't speak in generalities. Books are fine, glorifying memorabilia of a monster? Not so much. You want a book or notes written by Hitler to understand him, sure, but destroy his medals and melt down his statues
 
Wow! What a great thread this is! I need to wander into this forum more often.

I can already think of several good interview questions arising from this clinical scenario.

Does an obligation to History (note the capital H) ever outweigh the strict norms of the doctor-patient relationship outlined above?
 
Goro said:
Does an obligation to History (note the capital H) ever outweigh the strict norms of the doctor-patient relationship outlined above?
Click to expand...

Imo no. Treatment of the patient comes second only to the physician's personal safety. Personally, if a piece of history can be saved by helping a patient deal with underlying issues and finding healthier/more beneficial ways to cope, then great. I don't think History should come before the patient's well-being though.
 
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