The first part of my summer internship working as a Business Analyst for Ericsson began with a long explanation of what needs to be done before I arrive to the office at the end of the month. First things first, Ericsson is a company with 100,000 employees spread across the globe whose primary business is production and implementation of telecommunications radio equipment. Ericsson worked with most of the carriers you are very familiar with to enable you to read this blog using their LTE technology, for example. As setting up an antenna with radio equipment isn’t cheap, business cases need to be developed for almost each and every spot where the carrier thinks it would be beneficial to provide coverage. With no previous experience in the telecommunications industry, I was assigned to research two carriers and compare them on several criteria. The first part of the research was focusing on press releases and social media presence to determine the presence of both carriers and their interaction with the consumers. My mentor checks in with me once a week to set goals for the next week, discuss deliverables and explain the plan for the next part of the research. I’m really looking forward to meeting him in person in a few weeks.
The Truth about “Not Guilty By Reason of Insanity.”
People have always been fascinated by individuals with mental illness. Legal movies have especially glamorized mentally ill criminals who plead not guilty by reason of insanity. They are portrayed to do the crime and not do the time. But in real life, it appears that NGI clients are doing anything but “getting away with it.”
The truth is, NGI clients have it bad. But before I get into the details, here’s a brief summary of how it works. When someone is brought to criminal court, they have the option to plead not guilty by reason of insanity. This means that if the court finds them not guilty by reason of insanity (NGI), it opens a mental health case. Subsequently, NGI clients are committed to a hospital for psychiatric treatment. This commitment is indefinite.
Let me clarify what “indefinite” means; the patient stays in the hospital for an undefined amount of time, meaning that for the foreseeable future they are given a sentence without an expiration date. The point of this type of commitment is the treatment for the defendant’s illness, as opposed to punishment for a crime.
The minute this happens, the legal rights of the mentally ill shrink to a mere opportunity to petition the court for release every 6 months. In reality, this petition rarely works for the advantage of the NGI patient. One of my mentors informed me that in the Public Defender Service for the past 30 years there have been 2-3 NGI patients that won through petitioning. So the chances of an NGI patient being released because of one of these hearings are minute.
The “Other” Death Row
Committing people who are not dangerous for a week or a month seems unjust. So then what do you call it when people are committed for what is practically a life sentence without even knowing it? During my training at the Public Defender Service , my supervisor Carolyn Slenska, Investigations coordinator at the Mental Health Division, informed me that the average stay for an NGI client is 30 years. Throughout my internship, I have read about and even met NGI clients who have been committed for 30 years and counting.
Last week, there was a film showing on NGI patients in the D.C. Superior Court. In the documentary, “Voices from Within,” Joy Haynes follows the commitments of four NGI patients at St. Elizabeth’s Hospital. She and her crew gave cameras to patients at St. E’s who volunteered to participate in a video diary project. They trained them and asked them to record their stories. The documentary presented the real lives of 4 mental health patients who collectively spent 160 years in commitment after being found NGI.
When you sit down and watch the documentary, you forget that you’re following the lives of patients who are supposed to be dangers to themselves or others. You see four high functioning, coherent, cooperative, funny, and relatable human beings. You see men that don’t belong in the hospital. So why are they there? And until when do they have to stay?
Lew, one of the NGI patients, said, “I’m sitting on death row, I just don’t know it.” Tragically, after 47 years of commitment, Lew passed away at 71 years of age. In fact, three of the four men featured in the 2010 documentary have since passed while still in commitment.
Lew also shared a disturbing conversation he had with one of the staff members at the hospital. He states that a staff member told him, “You just stay crazy, you’re putting my kid through school.” All four men featured in the film wanted their freedom. The commitment in the psychiatric hospital is supposed to be about treatment. But after these men get better, after they no longer pose a danger to themselves or other, why are they still there?
Which Side Are You On?
The other day I noticed there is a quotation framed on the walls of the Psychiatric Institute of Washington (PIW). It reads: “Take my will and my life. Guide me in my recovery. Show me how to live.” (Note: Coincidentally, I recently visited PIW and after certain renovations, the plaque is off their walls!)
Then I read the quotation in the back of our business cards: “The mission of the Public Defender Service for the District of Columbia is to provide and promote quality legal representation to indigent adults and children facing a loss of liberty…and thereby protect society’s interest in the fair administration of justice.”
It then became so clear that the mental health system has not escaped the grasp of the adversarial system. There is a clear application of the adversarial process in mental health cases – as in any type of case. On one side, we have the Public Defender Service who tries to get its clients out of the hospital, and on the other side, we have the hospitals that detain and commit people as psychiatric patients. One fights against the loss of individuals’ liberties and the other fights because they know what’s good for the patient. It’s the ultimate battle of lawyers vs. doctors.
An Impossible Burden — Michael Jones v. United States (1983)
Attorneys around the office often bring up this monumental court case, Michael Jones v. US According to this Jones v. US, a patient “has the burden of proving by a preponderance of the evidence that he is no longer mentally ill or dangerous.” (Source: http://www.law.cornell.edu/supremecourt/text/463/354). The significance of this case, however, lies in the decision that the length of the commitment to a psychiatric hospital is not related to the length of time that the defendant would have spent if he were convicted.
Here’s an example: John Doe steals bubblegum from a candy store and the court finds him not guilty be reason of insanity. He gets an indefinite sentence at a psychiatric ward. In an alternate reality, Mr. Doe would have been found guilty for the misdemeanor. Let’s say Mr. Doe is a repeat offender and gets jail time for 2 years. Regardless of the fact that his criminal conviction would have yielded a 2 year sentence, the psychiatric commitment can “until such time as he has regained his sanity or is no longer a danger to himself or society.” (Jones v. US, 1983). This decision makes sense — the whole process sounds fair enough on paper. Well, in reality the burden that is placed on the patients is immense and nearly impossible to meet.
I see the process as having 3 stages. First, an NGI patient has to be examined by his or her treatment team. If the treatment team recommends the patient’s release, we move onto the second stage. On the second stage, the clinical board reviews the patient’s case and makes a determination. If the clinical review is for the release, we move to the last stage. On the third stage, the clinical review board submits the petition to the court asking for the patient’s release.
Here’s where things get complicated: NGI patients have committed crimes. This means that the government is involved in their case. On the third stage, the government can agree or disagree with the hospital’s recommendation to release the NGI patient. If they agree, then it’s up to the court to decide whether the patient can be released or not. If they disagree, it’s still up to the court, but it’s practically impossible to win release. In other words, the government’s agreement is integral for a real chance at NGI patients’ release.
A Necessary Battle
It would be easy to see the situation as a black and white, good vs. bad, where what we do at PDS is good and what the doctors do is bad. But that’s simply not the case. In the real life of mental health cases, lawyers vs. doctors is a necessary “battle.” PDS has developed strong relationships with the majority of psychiatric and medical doctors in D.C. mental health hospitals and psychiatric wards. The adversarial process is set so that each side fights for the client’s best interest. The attorneys at PDS are assigned to represent the clients. Many patients want to be free, many of them want to get out no matter what. So the attorneys do the best they can to advocate for the clients’ decisions. On the other side of the system, if the patients are in risk or hurting themselves or others, someone has to fight to keep them in the hospital until they get better. So medical staff members do the best they can for the clients’ well being.
In conclusion, when an individual with a mental illness is in court, the judge or jury should be deciding between the two best alternatives for the client – that’s what the adversarial system is supposed to accomplish anyway. Sometimes the court deems it necessary to detain a patient until their mental illness is not a danger. Other times, there is no danger and the court honors the patients’ choices and freedom.
Even so, it seems that NGI patients are giving up their entire lives just waiting to “get better.” There also seems to be no standard for what “better” looks like — it’s a very subjective evaluation with very little accountability attached to the evaluators. In NGI cases, the necessity of a vigorous advocate is evident. After a month at the Mental Health Division of PDS, I have come to appreciate the attorneys’ ability to advocate for exactly what a client asks for, without the insertion of their personal beliefs, the doctors’ recommendations, or a subjective bias. In order for the system to work, I guess each player must do what he or she does best – lawyers fight to get clients out, and doctors fight to keep them in – in the hope that the adversarial process is saving more lives than it condemns.
-Gina Gkoulgkountina, ‘15
Small companies are great places for summer internships! My experience so far at NYCSCC will help explain why.
One of my WOW learning goals is to network at my internship. While interning at NYCSCC, I met a fellow Brandeis student, Corey Shapiro. Corey is a rising senior and is an intern at a small web development company, Hudson Horizons. When I asked him what his internship duties were, he excitedly explained them to me. One of the projects that he completed involved testing the mobile application of one of Hudson Horizon’s clients. Corey also did research online and found a few potential clients for Hudson Horizons. He said that although there are challenges, his supervisor and his mentor are always there to help him overcome them. When Corey spoke about this support at his internship site, I related it to the intimacy I feel and the guidance I receive at NYCSCC.
Due to the size of NYCSCC, I get to know all my coworkers and can truly collaborate as a team. Furthermore, I get to speak with one of the owners on a weekly basis and have picked up plenty of advice and knowledge based on his experiences. I expect to keep in touch with him and all my coworkers even after my internship ends.
In a small company, I have many internship responsibilities and projects. I have learned to “wear multiple hats” just because there are not enough people to fulfill all of the business functions. Not only am I exploring the company’s finances, I am also helping out in event operations and writing blog posts for the Flatiron Hot! News, a company partnership. As a result of doing a little bit of everything, I am gaining skills that I never thought I would gain this summer.
I have quickly learned that the challenges that small companies face are different from the ones that big companies face. Small companies do not have the same resources as big companies. As an intern, I can provide my coworkers with a fresh, outsider’s perspective. I offer suggestions on what the company is doing well and what it could do better to maximize its resources. I feel valuable. I know that every suggestion I make and every project I do count. By the time my internship ends, I know that I will have an impact on this company.
Both Corey and my experiences show the benefits of interning at small companies. Even though not all small companies come to Brandeis to recruit students, these companies are always looking for interns throughout the year. There are so many opportunities for students to gain knowledge and develop skills at these companies. Students just have to be proactive and look for them.
– Tifani Ng ’16
Social Justice and Industrial Accidents
There are many different ways that large multinational corporations affect local communities in developing countries- environmentally, physically and psychologically (Labunska et al, 1999; Mitchell, 1996). Yet it is only when this global industrialization results in a catastrophic event where people’s lives and health are at risk that the world’s media and legal systems pay attention. However, such attention is often short-lived and lacks any depth of study to monitor the lasting effects on people and communities. Such is often the story with industrial accidents in the developing world- countries with lower safety measures and a greater economic need to win over a large profitable contract are both more likely to harbor an industrial accident (Mitchell, 1996) and less likely to be able to appropriately manage and deal with one. At Sambhavna Trust in Bhopal, I am looking at issues of social justice and health promotion in the context of developing countries affected by industrial accidents, and in particular, the legacy of the industrial accident in Bhopal. I am looking for a definition of social justice that looks to the future, one that aims for a just reaction and response to industrial accidents. The industrial accident in Bhopal, India and its repercussions has been termed ‘the world’s worst industrial disaster’ (Hanna et al, 2005, p.6) and provides a great starting point to explore such a definition of social justice.
Five past midnight in Bhopal
At five past midnight on 3rd December 1984 a pesticide plant in Bhopal owned by the American company Union Carbide leaked 40 tons of methyl isocyanate gas (MIC) into the surrounding environment (Broughton, 2005; Hanna et al, 2005; Mitchell, 1996). MIC is highly toxic and can be fatal. Short term effects on people’s health include burning in the respiratory tract and eyes, blepharospasm, breathlessness, stomach pains and vomiting. These acute symptoms can lead to death by choking, reflexogenic circulatory collapse and pulmonary pedema, as well as damaging the kidneys, liver and reproductive organs (Sriramachari, 2004). Through the night of 3rd December 1984 thousands of people died- the official number remains unknown; the Government of India declares the death toll to be at least 3800 (Broughton, 2005), while other estimations by independent organizations, NGOs and the International Campaign for Justice in Bhopal (ICJB) vary between 10,000 and 30,000 (ICJB, 2010; Eckerman, 2005). A further 100,000- 150,000 people are estimated to have permanent injuries as a result of the MIC exposure and the stillbirth rate in those affected increased by up to 300% (Eckerman, 2005). The overwhelming majority of those affected were living in bastis (local term for temporary, substandard accommodation communes) surrounding the factory, where birth records were rare and number of inhabitants unknown. Mass cremations and burials began the day after the accident. There are varying reports on the specific causes of the gas leak though it is clear that poor maintenance of the plant since it ceased production months earlier, led to the magnitude of the problem; several key safety systems were switched off under Union Carbide Corporation’s instruction, including the MIC tank refrigeration system, in order to save money (Eckerman, 2005; ICJB, 2010; Hanna et al, 2005).
The deserted Union Carbide factory still stands, unvisited except for the occasional journalist or trespassing children since the accident. The site of the disaster was never cleared or cleaned of its toxic waste. The factory continues to omit toxic, poisonous gases from the many abandoned sheds, storerooms and solar evaporation ponds holding up to 27 tons of MIC and other gases (ICJB, 2010; Hanna et al, 2005). These chemicals have leaked into the soil, contamination the groundwater source for approximately 25,000 Bhopalis who live nearby (Bhopal Medical Appeal, 2010; ICJB, 2010). A Greenpeace study found chloroform, lead, mercury and a series of other chemicals in the breast milk of mothers living in proximity to the factory (Labunska et al, 1999). The factory and the chemicals within continue to cause death, breathing difficulties, damaged eyesight, reproductive complications, growth stunting, accelerated cancers and a range of other ailments and malformations for survivors and their children (Hanna et al, 2005).
Union Carbide’s response
Since December 1984 Union Carbide has consistently refused to identify the chemical agents that caused the accident for legal liability reasons- making effective treatment for survivors difficult (Bhopal Medical Appeal, 2010). In addition, the corporation has still not confirmed what was in the toxic cloud in December 1984 (Dhara & Dhara, 2002). There is a chance that the cloud also contained HCN (hydrogen cyanide- a more deadly gas formed when MIC reached 200 degrees Celsius) so patients were originally administered with sodium thiosulfate- a known therapy for cyanide poisoning but not for MIC exposure. Despite patients responding well to the sodium thiosulfate, Union Carbide withdrew an initial statement recommending its use when they realized the extra legal implications of cyanide poisoning (Mangla, 1989; Varma, 1989; Anderson, 1989; Dhara and Dhara, 2002). This is one of the many claimed ways Union Carbide attempted to manipulate, disguise and withhold scientific data to the disadvantage of victims (Broughton, 2005). To date no comprehensive scientific research has been funded or carried out into effective treatment for those affected by the accident in Bhopal (ICJB, 2010).
The American chairman of Union Carbide in 1984, Warren Anderson was arrested for culpable homicide just days after the disaster but paid USD 2000 in bail then fled India and has yet to return. Warren Anderson, along with other Union Carbide workers from the American contingent, continues to escape criminal charges. Major questions regarding safety, negligence, causes and clean up remain unanswered by those responsible.
The Indian Government declared itself the sole representative and legal spokesperson for the Bhopal ‘victims’ in an Act passed in 1985 (Broughton, 2005; Hanna et al, 2005). Union Carbide successfully brought the case to Indian courts, and after a five year legal battle made an out-of-court settlement payment to the government of USD 470 million (Broughton, 2005). Compensation channels were rife with corruption and incorrect data. Survivors facing chronic illnesses due to the gas leak received a maximum of USD 500 as compensation, if they were granted anything at all, which in most cases was not enough to cover the medical costs alone (Sarangi, 1995; ICJB, 2010). Outstanding criminal charges against Union Carbide and Warren Anderson regarding cleanup of the factory have ben brought to New York but never come to fruition. In February 2001, Dow Chemicals merged with Union Carbide forming the second largest chemical manufacturer in the world. Dow Chemicals (the name retained) claims not to accept any responsibility for a factory it never owned (despite paying liabilities for previous Union Carbide cases based in Texas, America) (ICJB, 2010).
Lying in the heart of the community of those affected by the Bhopal disaster of 1984 is the Sambhavna Trust. Just 200 meters from the abandoned union carbide factory, the Sambhavna (meaning ‘possibility’) Trust Clinic is the only facility providing free treatment to both gas and water affected persons. Since its establishment in 1996, it has provided free Western medicine, Ayurvedic and Allopathic treatments to those affected by the industrial disaster. Sambhavna also does community health outreach programs for those unable to travel to the clinic and records health data on patients to assist research studies.
Sambhavna is internationally funded by private donors and is locally managed. The clinic is also a member of the International Campaign for Justice in Bhopal (ICJB) and provides a key hub for people to obtain information and resources regarding the ongoing legal claims and their rights.
Social Justice in Bhopal
Talking to the victims of the disaster as well as the staff members, volunteers and doctors at Sambhavna, I am beginning to form a clear definition of what social justice means for the twenty five year long Union Carbide case in Bhopal and the health and wellbeing of those affected.
Anderson, N. (1989) Long term effects of methyl isocyanate, in Lancet, Vol.2, Issue 8662, p. 1259
Bhopal Medical Appeal, (2010) Online Updates and historical information. Accessed July 2013 from: http://www.bhopal.org
Broughton, E. (2005) The Bhopal Disaster and its Aftermath: A Review, in Environmental Health: A Global Access Science Source, 4:6, accessed July 2013 from: http://www.ehjournal.net/content/pdf/1476-069X-4-6.pdf
Dhara, V.R & Dhara, R. (2002) The Union Carbide Disaster in Bhopal: A review of health effects, in Archives of Environmental Health, p. 391-404.
Eckerman, I. (2005) The Bhopal gas leak: Analyses of causes and consequences by three different models, in Journal of Loss Prevention in the Process Industry, Vol 18, p. 213-217
Hanna, B; Morehouse, M & Sarangi, S. (2005) The Bhopal Reader, New York, The Apex Press
International Campaign for Justice in Bhopal (ICJB), (2010), Online updates and historical information. Accessed July 2010 from http://bhopal.net/
– Alina Pokhrel ’15