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In a front-page article published by the New York Times on February 2, 2013, Alan Schwarz reported the circumstances surrounding the suicide of 22-year-old Richard Fee. The story involves addiction to prescription amphetamines, an apparently psychotic reaction, and the profound failure of the mental health system. There are many lessons to be drawn from these events regarding the excessive use of psychiatric medications and the assumptions and practices that support this excess. However, it is also a story about the link between knowledge and power in clinical work, and about the erosion of an ethic that recognizes and respects the limits of the former in order to moderate the effects of the latter.
A unique feature of Schwarz's article were the verbatim records of the clinicians treating Richard Fee, and who continued to prescribe the medications that were apparently causing him such great harm. The records were obtained by Richard Fee's father, the legal representative of his deceased son. They provide rare access to the recorded reflections of various clinicians, the ability to assess their impressions and their doubts, and to do so in relation to how the actual events unfolded in real time. They are clinical notes and thus not necessarily comprehensive, but they are candid, credible, and strongly convey a certain quality of clinical thought, a quality characterized by a tragic lack of inquiry.
We also have the story as told by Richard's parents, Rick and Kathy Fee, who were aware that their son was in trouble,