The Decapitation of Care: The Healthcare Manifesto

February, 7, 2020 | 12 Comments


  1. “Responsibility, Care and Neuroscience”.

    Compelling Lecture, thank you.

    Slides very useful, especially those relating to the “misleading” randomised controlled trials.

    Why is it seemingly so difficult for prescribers to appreciate what is really happening? At least recognise bias by design? Implications just too enormous to even contemplate?
    Prescribers who are so reluctant to understand and recognise akathisia, and then continue to misdiagnose akathisia as “Serious Mental Illness”?

    Like PSSD. PGAD. all the other ADRs endured, or unendurable, the prescriber denial of our suffering adds to the endless grieving and unending sense of avoidable loss.

    Perhaps “The Pharmacist” series may inspire some greater understanding of the modus operandi of Pharma Marketing?

    I bought the Kindle version of “The Decapitation of Care”, but received only a small part, brilliant illustrations and the excellent reviews. Technical gliche? Will re-order.

    • Good Tim, this article goes a long way in support of ‘Decapitation of Care’ and the difficulties…

      “What kind of world is this?”

      The very fact that patients are organising themselves in survivor groups and various withdrawal-related initiatives around the world is a clear sign that psychiatrists ignore them, and Cochrane is no exception.

      James Moore Retweeted

      PAST (Prescription Awareness & Support Team) Wales

      More than 100 million people worldwide receive these pills every year. About half of the patients, or over 50 million people, will experience withdrawal reactions when they try to stop, and in half of these, the symptoms are severe.1

      The Review on Antidepressant Withdrawal That Cochrane Won’t Publish
      Peter Gøtzsche and Anders Sørensen on trying to get a review of methods for safe antidepressant withdrawal published in Cochrane: “They sent us on a mission that was impossible to accomplish” to “protect the psychiatric guild.”

      We changed “terrible” to “severe” and noted that the UK Royal College of Psychiatrists was recently forced to change their position totally, after the College had previously trivialised these symptoms.7

      It is very sad. This pattern often develops over time, not only in religious sects but also in charities like Cochrane.

  2. So Panorama do a show on Callie Lewis seeking to show ‘understaffed and overstretched system’. She was almost certainly on psych drugs: Is it known what she was on, for how long and if she was subject to polypharmacy? In an akathisic state the suicide ideation and compulsion is overwhelming.

    “Callie’s death comes at a time when many people with mental health issues continue to complain about their struggle to connect with the services they need.”

    If things stand as they are and if more money is pumped into the same system it will only lead to more psych drug induced deaths.

    When will the BBC understand that psych – and many other drugs – drug induced akathisia is an extremely serious condition that will bring people to this point, especially when they realise that the help they sought came in the form of a pill – forced onto them by the authority of the NHS system corrupted by pharma and other ‘stake holders’ – that did this to them and when they tried to tell the so called ‘experts’, were not only not believed but seen as having a worsening of the ‘illness’. They then see no way out… no help; forced to take a drug – as so often happens in psychiatric situations – becomes utter and total hell. The suicide forums obviously are not good, but that is not where this issue really is. It is being skillfully and craftily used by psych and these charities that have ‘popped up’ to deflect from the truth which is afferent to themselves.

    • Annie, I wonder if you could find the link for Worcester News, Saturday 15th Feb by Grace Walton, page 4, entitled something like ‘Mum speaks out, drug changed him’ It is my effort to raise the AKATHISIA awareness banner again, so it chimes well with Chris’s comment here. ‘Why are prescribers so reluctant to recognise…..’
      If we can’t get the prescribers to wake up, at least we can alert the general public using the axample of the suicide one of their own, someone wellknown and well respected in their town. We’ve had some interested and very supportive comments where the article has been shared. And amazingly, no counter diatribe from the manufacturers. Perhaps they haven’t noticed it yet….

      • So glad to help out, Heather

        We know the devastation that Olly experienced, by experience, and so glad this article had an impact

        ‘The drug changed him’ – Mum speaks out on what would have been son’s 40th birthday

        “There is no pain like the deep shock and sadness of losing your child by suicide. But over time, the emptiness and pain changes to a longing to do something to celebrate the lives of these brave youngsters, to further any aims they had to help others, to write about them, remember them, and to help each other see a positive way forward.—mum-speaks-sons-40th-birthday/

        sending thoughts at this incredibly sad time, and admiration as to what you have achieved.

      • I’m really sorry to read that Heather. I’ve had Akathisia.. it is beyond the most extreme horrific experience anyone could imagine. I think we all have a kill switch and being toxic on drugs switches it on… the suicide ideation from akathisia is something way beyond what ever the circumstances that may have led a person in a distressed anxious state to seek help and recieved a drug. GP’s, Psychiatry, coroners, pharma have gotten away with this because they can always say it was ‘mental illness’. I tell you all here and now: AKATHISIA is THE main cause of suicide today. You never ever want to go there to find out.

  3. Limit of efficacy -yes the solution is saturated and causing precipitant to the likes of nuclear fallout. Problem though -there’s no explosion. We don’t know the full extent of how many early deaths are caused by polypharmacy imo. The cure for type II DM is diet and exercise which in turn lead to weight loss and in most cures the disease. Yet we see Drs on symposium panels discussing Januvia, SGL2inh etc etc & the latest and greatest RCTs as causing some weight loss, better heart health blah blah blah. Nothing on harms. If you are here in the US or New Zealand then let’s not forget the advertising that promotes the drug with model like people who’d never need the drug in the first place. The couple on the Viagra commercial does not exist and if they did, they wouldn’t need Viagra as they look like movie stars who seem to marry often enough that I’ll assume they likely aren’t having sexual issues not of that sort anyhow. What we should have is Drs telling patients this drug can do x y & z but will not cure your DM and may cause pancreatitis, increased risk of limb amputation & ketoacidosis or a very serious infection for very little gain. A missing limb is important if it’s your limb. The gold standard for treating DM type II now (not 1) is diet exercise but we have symposiums on RCT for drugs that don’t cure anything! Fabulous. Hocus pocus & the doctors believe it. Interestingly I read an article on SGL2 inh & the mechanism by which they cause euglycemic ketoacidosis. I was curious. It is not a condition we see in DM II but we do commonly see in Type 1 and it’s quite serious. We try to avoid it at all costs & it needs to be treated with insulin (a drug that works) & fluids, management of electrolytes etc. At any rate the SGL2 inhs cause ketoacidosis in T2DM & it is now recognized as an ADR of this class of drugs. There was a suggestion in the article for using SGL2 as possible txment in DM type1 because of heart benefits. I read a follow up article on this idea then between two expert endocrinologists -one making the case for this and the other against. To me seemed a terrible idea which is why I read the second article. As I was reading this I said to myself “can’t wait to see the drug company disclosures for the guy speaking to use these drugs in type 1s”. Sure enough the guy proposing we use these drugs for type 1s had three or four drug co. disclosures. The gentleman from Harvard against had none. But this is what happens. They are trying to convince normal rationale people that using a drug that causes the very condition ketoacidosis that we try to avoid in type 1s is a swell idea. Mind blowing. A sacrament indeed. Hypnosis. Doctors feel they always have to do something and they’ve been taught that that involves prescribing. Less is more.

  4. This little book is a gem.  Good for you for stepping around those who want to dictate what can and cannot be published.  I haven’t read very far but this is put together so well and it’s great that people are able to enjoy a hard copy. 

    I’d never heard of Sir William Petty but now that I’ve investigated, I like to imagine there’s a bit of hidden meaning to why he was chosen for the cover (aside from the skull which I don’t yet know the original meaning).

    It sounds like he’d be a great asset to just about any organization churning out fake news today.  If I’ve interpreted correctly it’s a delightful find, an opportunity to find humor in something that is otherwise deplorable. My son calls these Easter eggs and I’m hoping there are more for us to discover.  At any rate, great job to both of you for putting together a creative and unique publication.

    • The artist, had his fingers, on a book…

      Painted when Petty was in his twenties, this portrait shows him holding a skull in one hand with the other resting upon an edition of Adriaan van der Spiegel’s De Humani Corporis Fabrica (On the Fabric of the Human Body), 1627,open at Plate 3.

      Dominion of knowledge over darkness of ignorance

      Fuller was one of the most flamboyant artists of his time, producing large-scale history paintings and strikingly original portraits. He was an influential teacher and produced the earliest British drawing book (1654), but his bohemian lifestyle aroused controversy. John Evelyn described an altarpiece as ‘too full of nakeds for a chapell’ and Sir Peter Lely lamented ‘that so great a genius should besot or neglect so great a talent’. He ended his career painting decorative schemes for taverns, all of which are now lost.

      National Portrait Gallery

      The heart of medicine… Is it the caring concern of one person for another? It is detached statistical analysis? Is it motivated by love? Or driven by greed?

      Read Dr. David Healy’s parable about about a sister and a brother, and the winter and summer of medicine… The Snow Queen
      Illustration: The Heart of Medicine, © 2013 created by Billiam James. Based on original painting on Sacred Heart of Jesus with Saint Ignatius of Loyola and Saint Louis Gonzaga, circa 1770, José de Páez, Mexico, 1727-1790

      The heart of medicine…skull-capped illustrated, and, so close…

  5. ‘The BMJ should be praised in that it has always set the bar very high when it comes to whether pharmaceutical companies should be involved in influencing clinicians to use their products’ – but the bar not set so high it can’t easily be limboed under.

    Dear Editor,

    We write to ask if the BMJ should reflect on its choice of advertisements associated with the publication. This week’s edition of the BMJ (8th February 2020) came wrapped in an advert for liothyronine. The use of liothyronine (T3) for the management of hypothyroidism remains controversial, with little evidence-base for its use. Its prescription is not supported by latest NICE guidance on the management of hypothyroidism published in this week’s BMJ (BMJ 2020; 368 doi:

    Given that the power of pharmaceutical advertising is likely to promote product prescription, we question whether it is a wise decision for the BMJ to advertise a product that has a questionable evidence base. The accompanying manufacturers’ prescribing information suggests up to 60 mcg liothyronine a day, a dose not recommended by any UK or European guideline that would cost the NHS £11,576 per annum for a single patient taking 6 x 10 mcg tablets per day. By comparison, guidance recommended use of levothyroxine (T4) would cost £62 per annum for a patient requiring 100 mcg once daily receiving a prescription every 28 days (levothyroxine price obtained from the British National Formulary).

    The BMJ should be praised in that it has always set the bar very high when it comes to whether pharmaceutical companies should be involved in influencing clinicians to use their products. The cover of this week’s issue highlights an article questioning the involvement of industry in influencing indoor tanning research. The decision to advertise liothyroinine appears questionable and at odds with messages previously expressed by the BMJ. We would invite a review of the decision to advertise liothyronine in the very same issue in which guidance is published expressing caution against T3 use.

    Yours sincerely,
    Dr Augustin Brooks
    Consultant Physician Diabetes
    Royal Bournemouth Hospital

    Dr Tristan Richardson
    Consultant Physician Endocrinology
    Royal Bournemouth Hospital

  6. Abel Novoa Retweeted

    Marc Casañas Escarré

    Replying to @Firefly_fan and @AbelNovoa

    Manifesto” by @DrDavidHealy in @SamizdatHealth editorial.


    Spanish “[…] very soon after” :D.

    doing, in this case, rather than me, Ariane Denoyel for La santé décapitée and
    @AbelNovoa for El Fin del Cuidado may end up providing le mot juste, the key word, that makes a difference in the real world”:…

    “The decapitation of care: the Healthcare

  7. The Decapitation of HealthCare: Review

    February 18, 2020 by Samizdat Health Leave a Comment

    by John Dan Stone, Age of Autism, UK Editor

    A welcome for David Healy’s new, short polemical volume The Decapitation of Care. Healy as ever likes to express himself in terms of historical theatre — the comparison with oppressive political situations of past as well as the roots of this present oppressive situation in the past. Implicit in the torment of this keenly felt book is that there is still no wide recognition that this ought to be the great political issue of our time.

    By Pamela Stavropoulos

    Author: Living under Liberalism

    Significantly, psychiatrist and cultural critic David Healy characterises his most recent publication, A Short History of the Rise and Fall of Healthcare as ‘the Health care Manifesto’. Defined as ‘a written statement declaring publicly the intentions, motives, or views of its issuer’ a manifesto is generally both a short work and a clarion call.  It is relatively brief because fuelled by the urgency of conveying ideas and prescriptions in succinct and minimalist format.

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