Eleven psychiatrists disciplined at Japanese hospital – fraudulent applications. Newspaper “astounded by the lack of morals”

From The Yomiuri Shimbun [Japan News] (google translate)

We are astounded by the lack of morals of people engaged in medical services at a hospital. It is vital that a thorough investigation is conducted into whether inappropriate medical examinations or treatments were carried out.

At St. Marianna University School of Medicine Hospital in Kawasaki, 11 doctors were recently found to have made fraudulent applications to the Health, Labor and Welfare Ministry to acquire the special status of designated psychiatrist. The health ministry stripped 20 psychiatrists at the hospital, including attending doctors, of the special status. It is believed to be unprecedented for such a large number of doctors to be disciplined for involvement in acquiring the special status by fraudulent means.

There are 14,630 designated psychiatrists working across the country. Through the authority of a prefectural governor or an equivalent official, these psychiatrists are allowed to decide whether mental patients should be “involuntarily hospitalized” to ensure that they do not hurt themselves or others. They are also permitted to decide on “hospitalization for medical protection” for mental patients after receiving consent from the patients’ relatives. As designated psychiatrists have the authority to restrict a patient’s movements, doctors with sufficient knowledge and ample experience in this field are designated by the health minister, on the basis of the Mental Health and Welfare Law. Seeking this status through fraudulent applications is as if the status certification system is not being taken seriously.

To apply for the special status, applicants must have at least three years of working experience as a psychiatrist and to have submitted case reports on at least eight of their patients. The 11 doctors had rewritten the reports of cases treated by senior doctors and submitted them to the ministry as if they themselves had treated the cases. This is abominable.

‘Normal’ practice

What must not be overlooked is that such methods were used so often they had become a normal practice. The hospital has admitted that the transfer of data entered in the reports was carried out by these doctors. The attending doctors also failed in their function of checking such practices. This is indeed a serious problem.

The hospital reportedly became aware of the fraudulent applications of these doctors after the health ministry pointed out striking similarities in the reports. Doctors who obtained the special status fraudulently have decided on involuntary hospitalization of four mental patients and hospitalization for medical protection of about 100 patients.

If doctors made wrong medical judgments to forcibly hospitalize patients, this would constitute a serious human rights problem. Both the Kawasaki city government and the hospital need to delve deeply into the matter to clarify the situation. A designated psychiatrist is eligible for preferential treatment in terms of remuneration for medical services. With the fraudulent acquisition of the special status by these doctors, the hospital received about ¥1.7 million more than it normally would through the treatment of outpatients. Naturally, the hospital has said it will return the money.

With the retraction of the status, the hospital has scaled down treatment in its neuropsychiatric department. As a result, local medical services have been affected.

To prevent a recurrence of fraudulent applications, the health ministry plans to speed up its efforts to make a database of submitted reports in order to determine whether reports have distinct similarities. The ministry will also investigate whether there are similar illicit activities at other hospitals.

Psychiatrist arrested - Leaked client statements and psychiatric data to a freelance journalist who later published them

As seen in the Asia Media News Daily

A psychiatrist is under arrest on suspicion of leaking information to a freelance journalist about a teenager institutionalized after setting his home in Nara Prefecture on fire last year. The teen's stepmother and two siblings were killed.

Arrested Sunday, Morimitsu Sakihama, 49, is suspecting of giving statements made by the teen during the investigation as well as a copy of his psychiatric evaluation to journalist Atsuko Kusanagi last October.

Prosecutors allege that Sakihama handed over the confidential information at his home in Kyoto and at a hotel.

Sakihama was asked by the Nara Family Court to assess the teen's psychiatric condition and was granted access to the teen's previous statements.

In May, Kusanagi published a book about the arson-murder in which she claimed to have obtained around 3,000 pages of investigation materials, including statements made by the teen, which she quoted.

Before his arrest by the Nara District Public Prosecutor's Office, Sakihama was quoted as saying, "I never thought it would be published in such form." Following his arrest, he admitted to the allegations, according to investigative sources.

Kusanagi, who has also been questioned by investigators over the case, said in a statement issued by publisher Kodansha Ltd., "I cannot say if the source of information was the psychiatric examiner who has been arrested, but I offer my apologies for causing tremendous inconvenience as a result of investigations concerning my work."

On her source, Kusanagi said earlier she was given access to investigation documents with the permission of a person she did not name, and she photographed some of them.

The boy, who was 16, was arrested two days after his home burned down June 20, 2006, killing his stepmother and his younger brother and sister through carbon monoxide poisoning. The father was not home at the time of the fire.

The Nara Family Court decided last October to send the teen to a juvenile reformatory after he was diagnosed as having a disorder in developing communication and social skills.

The publication of Kusanagi's book in May drew a strong reaction from law enforcement. The next month, then Justice Minister Jinen Nagase called it "a challenge to the order of justice and the Juvenile Law." The Justice Ministry's Tokyo Regional Legal Affairs Bureau cautioned the Tokyo-based publisher and the journalist, saying the book "evidently went beyond what is permissible in the name of freedom of publications."

The teen and his father filed a complaint over the information leak.

Kodansha said it can't ignore the actions taken by Nara prosecutors in the name of investigating the information leak and lodged a stern protest over Sakihama's arrest.

The arrest also triggered various reactions from experts on media issues.

"Holding (the psychiatrist) in custody will probably have a tremendous impact in the sense it will stifle the flow of information by stepping up control and restrictions on the source of reports and information," said Yasuhiko Tajima, a professor of media law at Sophia University in Tokyo.

Journalist Akihiro Otani said he cannot condone the arrest for its potential impact on journalism but criticized Kusanagi and Kodansha.

"Because the image of the investigation document was used on the book cover, it was obvious the book would cause inconvenience to the reporter's source," Otani said, adding that a journalist must deal carefully with materials provided by a source who wants anonymity.

Journalists and authors have been challenged in court over their reports and publications, but these cases have primarily been civil lawsuits. The only notable incident that developed into a criminal case and the arrest of a reporter was a leak of confidential information from the Foreign Ministry in 1972, one expert said.

The Penal Code provides for six months in prison or a fine of ¥100,000 if a doctor, pharmacist, lawyer or other professional leaks secret information they obtained professionally and a complaint by victims of such a leak is filed.

Japan Says Suicidal Cases Increase Among Takers of Paxil

As seen in this report

The number of patients who committed suicide or planned suicide after taking GlaxoSmithKline Plc's antidepressant Paxil rose to 39 last year, Japan's Ministry of Health, Labor and Welfare said.

The number of patients who killed themselves after taking Paxil increased to 15 cases in fiscal year 2006 from 1 in 2004, a health ministry official said in a telephone interview today. Those who thought about or attempted to commit suicide increased to 24 cases last year from 2 cases, according to reports by doctors to the Pharmaceuticals and Medical Devices Agency.

Patients suffering from depression were about 920,000 in 2005 in Japan, the health ministry said. Glaxo, which started selling Paxil in 2000, sold an estimated Paxil 56 billion yen ($455 million) in Japan last year, according to Glaxo's unit in Tokyo. Paxil's global sales reached $1.24 billion last year.

``We have been telling doctors to be cautious with the amounts they prescribe,'' Yuko Fuke, a spokeswoman at Glaxo's Japan unit in Tokyo, said by telephone. ``Package inserts warn doctors to be careful. We have been also reporting the risks of the drug to the ministry.''

Japan teen took mom's head to Internet cafe

Given other recent killings, we wonder what drugs the psychiatrist had the kid on.As reported by Reuter's in England

A 17-year-old Japanese boy suspected of killing and beheading his mother went to an Internet cafe with her head in a bag and watched a music DVD before turning himself in, media reports said on Wednesday.

The teenager, arrested on Tuesday on suspicion of murder, spent about two hours at the cafe and watched a DVD of a hip-hop group in his cubicle, and then took a taxi to a local police station, the reports said.

The teen -- who had not been attending school recently and was being treated by a psychiatrist -- told police he killed his mother on Monday evening while she was asleep, media said.

Japan has been shocked by a number of sensational and gruesome crimes by youths in recent years, including the murder and beheading of an 11-year-old boy by a 14-year-old schoolboy in the western city of Kobe in 1997.

In 2004, an 11-year-old schoolgirl stabbed a classmate to death at their school, prompting calls for harsher punishment against juvenile crime.

A bill to lower the age at which minors can be sent to reformatories to 12 from 14 was passed by the lower house of parliament last month. The bill remains controversial, and still needs approval from the upper house before becoming law.

Government statistics show that overall juvenile crime including murder by minors -- those under 20 -- have declined in recent years.