
  
A Model Consent Form for Children and
Psychiatric Drugs
From:
http://www.wildcolts.com/
I understand that my child has been assigned a
DSM-IV diagnostic label, based on my doctorıs
(and perhaps others) subjective observation of
my child's behavior. I am aware that there is no
medical evidence that my child has a medical
problem, and no scientific evidence that proves
the existence of the illness which my child is
said to have.
I am aware that I will never be able to remove
this diagnostic label or any other from my
child's medical record, and that this record may
interfere with possible educational and
vocational directions of my child.
I have been informed that the drug or drugs my
doctor is prescribing for my child cannot cure
whatever "illness" or "chemical imbalance" this
doctor may believe my child to have, but can
only affect "symptoms." I understand that
psychiatric drugs have not been demonstrated to
have long-term positive effects on any measure
of learning, behavior or social development in
children.
I understand that the review and approval
process of psychoactive drugs by the FDA is both
controversial and complicated, and that,
therefore, all psychiatric drugs must be
considered experimental. I have been informed of
all the known effects of any recommended drug,
and I have a copy of the current information
listed on these drugs in the Physicians Desk
Reference. I also am aware of the up-to-date
accumulation of FDA adverse reaction reports of
any prescribed drug; I understand that it is
necessary to multiply the number of reported
reactions by up to 100 to estimate the actual
incidence of these reactions. I understand that
these drugs are addictive and create dependency,
and that drug withdrawal can pose serious
problems.
I understand that taking psychiatric drugs may
cause severe pain and discomfort to my child,
worsen my childıs condition, or even cause my
child permanent damage or death. I also
understand that no body of research clearly
shows that the problems indicated by my childıs
diagnosis require or respond more favorably to
drug treatment than to one or more forms of
non-drug treatment.
I understand that this brief statement is only
the "tip of the iceberg" regarding psychiatric
diagnosis and drug treatment of my child, and
that it is my responsibility to take the
necessary time and trouble to fully research the
relevant necessary information in order to make
an informed decision on behalf of my child.
I understand that since psychiatric diagnosis
and drug treatment of children is considered
customary and usual medical practice, doctors
are generally not held liable for harm resulting
from such treatment. Therefore, I understand
that the effects of such treatment are,
practically speaking, my complete responsibility
as a parent.
Signature of Parent or Guardian:
______________________________________ |
Page Last Updated May 17,
2006
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