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August 27, 1973

Sane: Insane The Patient as Judge

JAMA. 1973;225(9):1123. doi:10.1001/jama.1973.03220370061029

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To the Editor.—  Ever since the appearance of your EDITORIAL "Sane: Insane" (223:1272, 1973), I have followed with interest the responding letters. Rosenhan's findings certainly convey a multitude of messages, but one has been overlooked so far: his observation that "a number of patients on the admission wards readily recognized that the pseudopatients were sane." This is an important message in view of the accompanying evidence that the task of diagnosing sanity or insanity with any degree of accuracy is seemingly very tricky.Since psychiatric disorders are impossible to lay bare by means of blood studies or roentgenograms, why shouldn't we use an obvious and available resource—the fellow patient—as a diagnostic aid?As a registered nurse, I sat in on many of those sessions where a patient considered for discharge is brought into a conference room full of psychiatrists and nurses who ask him certain strategic questions calculated to reveal