Humane treatment versus means of control: coercive measures in Norwegian high-security psychiatry, 1895-1978.

This article analyses the use of coercive measures in two national institutions for high-security psychiatry in Norway - Kriminalasylet (Criminal Asylum) and Reitgjerdet - during the period 1895-1978. Historical study of coercion in psychiatry is a fruitful approach to new insight into the moral and ethical considerations within the institutions. We approach the topic through a qualitative study of patient case files and ward reports from the institutions' archives, as well as a comprehensive quantification of the coercive measures used. The data show shifting considerations of humane treatment and changes in the respect for human dignity in the institutions' practices. They also show that technological developments, such as the introduction of new psychopharmaceuticals, did not necessarily lead to higher standards of treatment.

A hanseníase e a medicina do confinamento do Amazonas / Leprosy and confinement medicine in the Amazon

As medidas encontradas para enfrentar o problema da hanseníase no Brasil foram similares àquelas adotadas no resto do mundo, com o isolamento dos doentes, que se mostrou incapaz de controlar a doença e contribuiu para aumentar o estigma e o medo a ela associados.

Segregados, mas nem tanto: as experiências de isolamento compulsório de leprosos no Pará / Segregated, but not so: the experiences of compulsory isolation of lepers in Pará

Conta a criação do Hospício dos Lázaros de Tucunduba, como era mantido, a origem dos doentes. A história da lepra no Pará, assim como em outras partes do Brasil, é marcada por uma violenta política de exclusão das pessoas que contraíam essas doenças. Narrar as múltiplas formas de agência desses sujeitos constitui uma forma de valorizar suas experiências e de afirmar sua condição humana, apesar dos discursos e práticas que tentam colocá-los fora dessa condição

O Leprosário do Bonfim e a política de controle e combate à hanseníase no Maranhão / The Bonfim Leprosarium and the policy of control and fight against leprosy in Maranhão

O presente artigo visa analisar como a lepra foi alçada à condição de problemas social e definida como uma ameaça à saúde pública no Maranhão, e como o Estado executou a política nacional de isolamento compulsório dos doentes.

Entre passado e presente: da lepra à hanseníase no sertão piauiense / Between past and present: from leprosy to leprosy in the backlands of Piaui

No Piauí, já no século XIX, é possível observar a preocupação das autoridades políticas em relação à lepra. Dessa forma, discute-se a filantropia e o isolamento compulsório de doentes de lepra no Piauí analisando o tratamento no Leprosário São Lázaro e no Hospital Colônia de Carpina

Damien de Veuster (1840-1889): A life devoted to lepers.

Father Damien de Veuster, or Saint Damien of Molokai (1840-1889), was one of the pioneers of the holistic approach to care provision for leprosy patients and contributed to the overcoming of the patients' social stigmatization. He devoted his life to the lepers living in America's only leper colony, on the Hawaiian island of Molokai, where people with leprosy were required to live under government-sanctioned medical quarantine. Father Damien gained practical skills in caring for the sick, eagerly learning wound cleansing, bandaging techniques, and drug administration from a nurse. Mahatma Gandhi said that Father Damien's work had inspired his own social campaigns in India.

A review of isolation practices and procedures in healthcare settings.

The notion of 'isolation' in infectious diseases refers to the possibility of people known or suspected to be infected from the wider population, and has historically been used to control and prevent the spread of infectious diseases. Isolation practices in healthcare settings evolved over the 20th century resulting in a focus on the disruption of known routes of potential transmission. There was renewed attention to infection prevention and control (IPC) in the UK at the turn of the 20th century after high-profile reports acknowledged the importance of IPC as a key indicator of high-quality clinical care, and the impact of healthcare-acquired infections. There has been a shift away from isolation wards towards isolation in single rooms on general wards. For infections that are spread by the airborne, droplet or contact routes, placing the patient in single-room isolation is considered to be an important component of transmission-based precautions (TBPs). However, in practice isolation is complex and a number of challenges are involved in implementing IPC procedures.

'Greater good' versus civil liberties in the United States: Tuberculosis and Seattle's Firland Sanatorium.

As far back as the late 1700s, peoples in the United States were developing ways to control infectious disease without infringing on Constitutional rights. Despite acknowledgement that an infected person has certain civil liberties, the history of public health law shows that, in many instances, infectious disease isolation and quarantine proved to be scientifically questionable at best. I examine an historical example of such questionable relationship between public health and civil liberties: the locked ward at Firland Sanatorium in Seattle, Washington. Mandatory quarantine at Firland began in the late 1940s and lasted until the facility closed in the early 1970s. Can examining this history enhance understanding of the relationship between "the greater good" and an individual's civil liberties?

Lepra: doença, isolamento e segregação no contexto colonial em Moçambique / Leprosy: disease, isolation, and segregation in colonial Mozambique

Resumo A partir de documentação produzida entre a primeira metade do século XIX e a primeira metade do século XX, prioritariamente relatórios médicos, o artigo aponta as concepções vigentes na comunidade médica colonial e entre as populações locais sobre a lepra, suas manifestações e seu enfrentamento. Enfoca as tensões quanto à prática de segregação dos leprosos e suas implicações sanitárias e sociais. Para compreender as raízes dos discursos e estratégias no meio médico português e colonial, recupera-se a trajetória das definições de isolamento, segregação, lepra e suas aplicações, ou ausência de referência, na literatura de missionários, cronistas e médicos em Angola e Moçambique a partir da segunda metade do século XVII.

Abstract Drawing on documents produced between the early nineteenth and mid-twentieth centuries, mainly medical reports, this paper indicates the prevailing conceptions in the colonial medical community and local populations about leprosy, its manifestations, and how to deal with it. It focuses on the tensions concerning the practice of segregating lepers and its social and sanitation implications. To comprehend the roots of the discourses and strategies in the Portuguese and colonial medical environment, the trajectory of the definitions of isolation, segregation, and leprosy are traced, as are their use in or absence from the writings of missionaries, chroniclers, and doctors in Angola and Mozambique as of the second half of the seventeenth century.

[Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966)]. / Zwangsmaßnahmen in der Kinder- und Jugendpsychiatrie in der Nachkriegszeit am Beispiel der Pflege- und Beobachtungsstation des Psychiatrischen Landeskrankenhauses Weissenau (1951-1966).

Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

Leprosy: disease, isolation, and segregation in colonial Mozambique. / Lepra: doença, isolamento e segregação no contexto colonial em Moçambique.

Drawing on documents produced between the early nineteenth and mid-twentieth centuries, mainly medical reports, this paper indicates the prevailing conceptions in the colonial medical community and local populations about leprosy, its manifestations, and how to deal with it. It focuses on the tensions concerning the practice of segregating lepers and its social and sanitation implications. To comprehend the roots of the discourses and strategies in the Portuguese and colonial medical environment, the trajectory of the definitions of isolation, segregation, and leprosy are traced, as are their use in or absence from the writings of missionaries, chroniclers, and doctors in Angola and Mozambique as of the second half of the seventeenth century.

Hansen's disease in the state of Amazonas: policy and institutional treatment of a disease.

This article discusses the historical aspects of the policies for controlling Hansen's disease in the state of Amazonas from the second half of the nineteenth century until the dismantling of this model in 1978. We present the historical changes in the local institutions and policies, and their relationship with national policies. The history and policies related to Hansen's disease in the state of Amazonas are analyzed through the following institutions: Umirisal, the Oswaldo Cruz Dispensary, the Paricatuba Leprosarium, the Antônio Aleixo Colony, and the Gustavo Capanema Preventorium. We seek to show that these institutions cared for the people who suffered from Hansen's disease and those related to them, and were also responsible for carrying out the policies for fighting and controlling the disease.

A hanseníase no Amazonas: política e institucionalização de uma doença / Hansen's disease in the state of Amazonas: policy and institutional treatment of a disease

Resumo O artigo versa sobre os aspectos históricos da política de controle da hanseníase no estado do Amazonas, desde a segunda metade do século XIX até a desconstrução desse modelo, em 1978. Apresentamos as mudanças históricas das instituições e das políticas locais, e a relação com a política nacional. A história e a política da hanseníase no estado do Amazonas são analisadas a partir das seguintes instituições: Umirisal, Dispensário Oswaldo Cruz, Leprosaria de Paricatuba, Colônia Antônio Aleixo, Preventório Gustavo Capanema. Procuramos mostrar que essas instituições realizaram o cuidado de pessoas que viveram e conviveram com a hanseníase e foram, também, responsáveis pela execução da política de combate e controle da hanseníase.

Abstract This article discusses the historical aspects of the policies for controlling Hansen’s disease in the state of Amazonas from the second half of the nineteenth century until the dismantling of this model in 1978. We present the historical changes in the local institutions and policies, and their relationship with national policies. The history and policies related to Hansen’s disease in the state of Amazonas are analyzed through the following institutions: Umirisal, the Oswaldo Cruz Dispensary, the Paricatuba Leprosarium, the Antônio Aleixo Colony, and the Gustavo Capanema Preventorium. We seek to show that these institutions cared for the people who suffered from Hansen’s disease and those related to them, and were also responsible for carrying out the policies for fighting and controlling the disease.

Examining the preventable but predictable death of Ashley Smith.

PURPOSE: The purpose of this paper is to examine the fusion of psy-correctional discourse with the dominant risk logic to consider the implication this nexus can have on how self-injurious behaviour committed by women in prison is interpreted and responded to by the Correctional Service Canada (CSC). DESIGN/METHODOLOGY/APPROACH: The central focus of the study is an in-depth case analysis of the carceral death of Ashley Smith, a 19-year-old woman who committed suicide in her segregation cell in 2007 after enduring four years of excessively punitive treatment aimed at controlling her self-injurious behaviour. FINDINGS: Findings illustrate how the fusion of these logics creates a kind of "therapeutic-risk cloak" that reframes the behaviour as "abnormal" and "risky", which masks the punitivity of strip search and segregation interventions in the name of safety, security and treatment. ORIGINALITY/VALUE: Given that correctional officials knowingly failed to intervene when Smith tied the fatal ligature around her neck, a federal inquiry judged her death to be a homicide. By attempting to unveil the "therapeutic-risk cloak" the authors hope to challenge the underlying logic of CSC's governance and management framework, which not only denies the oppressive gendered carceral reality that is linked to self-injurious behaviour amongst women prisoners, but is also used to justify intervention responses that exacerbate the very behaviour this framework aims to control. Until systemic transformation is achieved that eradicates CSC's contradictory governance framework, there is no doubt that the authors will continue to see similar preventable deaths take place in prison.

[Discussions regarding the reconstruction of the significance of leprosy in the post-sulfone period, Minas Gerais, in the 1950s]. / Discussões em torno da reconstrução do significado da lepra no período pós-sulfônico, Minas Gerais, na década de 1950.

From a historical viewpoint, all the elements surrounding a disease, from its name to the weight of meaning attached to it, are the result of "negotiations" in which many sections of society are participants. In the case of leprosy, the discovery of sulfones in 1941 made a significant contribution towards transforming our understanding of this disease, leading to questions being raised as to the measures adopted for its prevention and control, particularly the compulsory isolation of sufferers. On the basis of these assumptions, this article examines the debate which took place regarding the process whereby the old prophylactic procedures for the control of leprosy were replaced, in an important national journal, Arquivos Mineiros de Leprologia, in the 1950s.