Introduction and Instructions for DBQ's

There have been many atrocities in the course of American history, and many of them have occurred in institutions or at the hands of doctors that were meant to improve the lives and conditions of those who they cared for. Documents and witnesses exist that can attest to the darker side of medicine in our nation, and it is important for students to examine the evidence that exists to gain a better understanding of a past that is not so distant. Primary sources provide a historical document that represents a portrayal of the past that could represent multiple identities, viewpoints, and motives, and can be interpreted in many different ways. This DBQ activity provides students with 18 different sources that represent different topics or issues that have existed in our national history of mental health practices and institutions. For each document there are questions to activate and engage the viewer or reader to analyze the documents to gain better perspective and develop their own opinions. I believe that this activity will promote a deeper understanding on the past presented in these documents and that it will leave the participant with a desire to explore more into the mental health practices and institutions of the 20th century.

To complete the activity, it is necessary to start at the bottom with Document 1 and move up through the questions consecutively. Answer the questions for each document, and list any questions that arise as you complete the activity.

APA citations are in the comment section of each document.

Document 18

https://www.youtube.com/watch?v=Nshj9rCTPdE

• Elaine Riddick gave birth to her child, and without her consent, was sterilized after  giving birth. What emotions would surround giving life while at the same time being stripped of your reproductive rights?
• Between 1929-1974, 7,600 men, women, and children were determined to be feeble minded or promiscuous in North Carolina and sterilized against there will. What are your reactions to the reasons for why people were sterilized and the staggering numbers of those who were sterilized?
• 31 states had legal eugenics programs. Determine what motives the government would have to enact sterilization programs.
• The "Human Betterment League" was made up of some of the wealthiest people in America. Determine the motives that wealthy people would have for supporting eugenics and sterilization programs.
• What was the role that income level, gender, and race played in sterilization programs?
• Do you agree with the comment made in the interview that the sterilization of Americans borders on genocide? Explain why or why not?

Document 17

Watch the clip:
https://www.youtube.com/watch?v=_0aNILW6ILk

• One of the men in the video describes Walter Freemans procedure as "science going of the rails." What factors do you think led to the overwhelming use of a procedure that was perfected two weeks prior to being performed on its first patient? Infer why you believe so many were proponents of a medical operation that was essentially performed by an ice pick and a hammer?
• Walter Freeman was proud of the fact that fellow doctors would vomit or faint at observing the lobotomy performed. One doctor even walked out without saying a word. Infer what you think these men's professional opinion of the lobotomy was. What was your reaction to seeing the clips of the lobotomy being performed on the women? What emotions did it elicit?
• In the clip is says that there was an "endless supply of willing patients." Do you think the majority of patients were willing, unwilling, or unaware for the lobotomy procedure? What reasons would people want a lobotomy or not want a lobotomy during the historical period discussed in the video?
• What is your reaction to the fact that Walter Freeman performed 2,900 ice pick lobotomies before his last killed a patient. 19 children under the age of 18, including a 4 year old were lobotomized by Walter Freeman. Do you think the parents who lobotomized their children stand by their decisions after this procedure is now considered "infamous?"
• At the end of the clip it is revealed that a modified form of the lobotomy is still performed around the world in certain cases of OCD. Would there be any circumstance that you would receive a modified lobotomy or have your child receive a modified lobotomy if all other avenues had failed in treatment? Why or why not?

Document 16

Watch the clip:
https://www.youtube.com/watch?v=2KxU3dPeink

• Determine the perspective and purpose of this broadcast.
• The man in the video was being treated for depression. What are the most common treatments for depression today? Is it possible that ECT is still used to treat depression. Would you allow yourself to be treated by ECT for depression? Why or why not?
• What differences do you see in the reenactment of the ECT or electroshock therapy than you saw in Document 5? What are the similarities?
• What impact do you think this broadcast may have had on public opinion of electroshock therapy?
• Do you think the patient that was interviewed was providing an accurate account of his electroshock therapy? What would be motives for the patient to skew his story for the broadcast?

Document 15

Read article below:

http://articles.orlandosentinel.com/1986-02-16/news/0200130230_1_mental-health-mental-patients-mental-illnesses

• Determine the differences between the precautions being taken in the 1980's for the care of mental patients and the precautions that were taken in Document 13.
• What would be the reasons why the public would be asked to foster former mental patients?
• What are possible motives that people would have to foster former mental patients?
• What would be the advantages and disadvantages of former mental patients being fostered in the home setting for the former patient?
• Do you think that this "foster patient" plan was successful? Why  or why not?



Document 14

 

From the March 11, 1979 Rockford newspaper.

• How much does a name lend to a persons identity?
• How do you think it was determined that the woman was a former teacher when she couldn't remember her name?
• What do you think are possible causes for the women's loss of memories?
• What do you think the experience would be of someone who wasn't insane and wasn't a criminal being placed in a mental institution?
• What would be the reasons that they would medicate "Mary Doefour" if she was not criminally insane?

Document 13

 

Read article linked below:
Bedlam 1946

• The author of this article points out that Pennsylvania's Byberry Hospital's nickname is the "dungeon" and that across the nation states mental hospitals are in a state similar to concentration camps. After reading the article draw parallels between the mental institutions and dungeons and concentration camps and list them.
• The article lists incidents of extreme beatings by attendants on patients, and even cases of murder. Does it surprise you that an attendant charged with the murder of a patient was only sentenced to five years? What factors would lead a judge to give this sentence in this case? Do you think that the same sentence could be handed down today?
• The article discusses instances of patients being restrained by sheet restraints for days at a time, often without being toileted. List the mental and physical consequences this could have on the patient.

""The inadequacy of the patients' food is often aggravated by the assignment of the finest food to the hospital staffs. The dinner menu for the doctors at a Pennsylvania state hospital on a Tuesday in August 1945 consisted of a "prime rib roast beef with gravy, broiled potatoes, roast corn on the cob, bread (white, whole wheat, rye or raisin) with butter, salad of cucumber, lettuce and celery, apple-apricot pie and coffee, tea, iced coffee, iced tea, or milk." On the same day patients in several buildings got "hard boiled eggs, lima beans, beets, white bread without butter and milk or black coffee.""

• What are your reactions to the discrepancies between the dinner menu for the doctors of the hospital and the patients. Do you believe that it is ok to feed the patients differently than the doctors? What about in a prison setting? Should prisoners be fed differently than the guards? What are the parallels between the patients and prisoners in this article?

"A patient became ill and his rectal temperature was fond to be 105.4. The doctor who was called replied "He gets a high temperature every once in a while, so don't worry about it.'"

• What do you think a doctor at an emergency room would do if a patient came in with this temperature? In what ways is the doctor breaking the Hippocratic Oath? 

Document 12

• This law was revised into document 12 in 1974 in West Virginia. According to this document, who had the power to give permission for sterilization of people deemed mentally incompetent?
• Evaluate and list possible economic or political motives for this law.
• What other historical events surrounded a nation attempting to eradicate certain characteristics believed to be transmitted through genetics?
• What are some reasons you think that a government would support sterilization?
• This law was not repealed until 2013. What feelings do you have about legal control of health matters in individuals?

Document 11

• Can you recall other events that involved medical doctors infecting people with diseases without their knowledge to do research? If so, explain.
• Should medical testing on minors be allowed without consent of the child? What about mentally ill people. Explain your stance.
• Why do you think that this testing on the children occurred?
• Put yourselves in the position of the parents of the children. If your child had mental deficiencies, would you institutionalize your children if you did not have prior knowledge of the grim realities that occurred at this institution? What would you do if you saw your family member deteriorate in a facility like the one described?
• Do you think that these conditions could still be occurring in institutions in 2014? Why or why not?

Document 10

• What role do you think the person who wrote this fulfilled in the context of the institution?
• If you were to witness  the scene described in the excerpt, what would your reaction be to the children? What would your reaction to the attendants be?
• Do you believe it is morally acceptable to sedate children? Is their a situation that it would be acceptable. Explain your stance.
• Do you think the attendants could justify tying their children to their beds with bed sheets or shoe laces? Explain your stance.
• What parallels can you draw from the children’s treatment to torture?

Document 9

• From the way that this excerpt is written, what can you insinuate about the person who wrote this?
• What parallels can you draw from this man's treatment from the attendants to other institutions?

"I was a mental incompetent, but like many others in a similar position I was both by antecedents and training a gentleman."

•  Think of this quote from the man's perspective. Do you think that people who are deemed mentally ill are any less a gentleman, or a person than those who are not? Explain why or why not.
• Is their justification for an attendant to treat someone who is considered mentally incompetent differently than someone who is considered "sane?" Explain.
• Are there circumstances that you believe that people should receive inferior treatment than the general population? Explain your reasoning for why or why not.

Document 8

• How would you describe the emotions of the people who are speaking in the interview?
• The surgical instrument is being described as an "ice pick." What are the reactions of the individuals in the interview to the surgical instrument?
• What can you infer about this procedure from the lack of medical terms that are used in the description?
• How do you think a patient would feel if they heard this procedure described to them before it occurred?
• Hypothesize who and what this procedure is for.

Document 7

• Who do you think the writer of this excerpt is? What do you think the profession of the writer is?
• What is the writer of this excerpt advocating?
• What gender do you think the author of this excerpt is? Why?
• What is sterilization?
• Do you think the concept of sterilization was popular in the early 1900's?
• What is the perspective of the author? What is their rational?
• Who do you think would be the candidates for sterilization?

Document 6

• Describe some similarities and differences between Document 3 and Document 6.
• What reasons might some of the men be in straight-jackets?
• From the appearance of the age of this photo, is there anything that seems out off place for the time period?
• Why do you think the photo was taken?
• What do you think the men in the photo were thinking when this photo was taken?

Document 5

• What details can you describe about the patient?
• What do you think the instruments that the doctor is using are for?
• What can you infer from the men's faces that are watching?
• What emotions do you think the patient is experiencing?
• What do you think is happening to the patient in the photo?

Document 4

• What procedure do you think the doctor is performing?
• Do you think that the people are in a hospital?
• Why would there be men in suits watching?
• What clues tell you that something important is happening?
• What would be the purpose of the photographer to take this photo?
• Analyze the picture and determine the differences in this picture than what you may see in a picture of modern medicine.

Document 3

• What role do you think these men fulfill in the photo?
• What are some other roles these men could fill in the photo?
• Do you think they are in this photo by choice?
• Why do you think the men are in the picture?
• What can you infer from how the men are looking out the window?

Document 2

• What do you think this building is?
• What are some multiple purposes that this building could be used for?
• Compare some of the details of the building that you notice that are seen in other buildings. List the details for the building and list what buildings you have seen similar details in.
• What do you think this building would not be used for by its appearance?
• What emotions does this building elicit by someone who is looking at it?

Document 1

• What items in the suitcase are unusual for someone to pack?
• Who do you think the suitcase belonged to?
• Why do you think the person packed these items in the suitcase?
• What item stands out most in your opinion?
• Where do you think the person is packing for?