at the mouth to this day when stating that they were slandered, that they did not give dissidents diagnoses-sentences, or that, at least, these cases were isolated and not at all related to their personal activities, no matter how the doctors, if one may call them so, try to rebut hundreds if not thousands of real facts, it is undoable. in 2004, savenko stated that the passed law on the state expert activity and the introduction of the profession of forensic expert psychiatrist actually destroyed adversary-based examinations and that the serbsky center turned into the complete monopolist of forensic examination, which it had never been under soviet rule. formerly, the court could include any psychiatrist in a commission of experts, but now the court only chooses an expert institution. the expert has the right to participate only in commissions that he is included in by the head of his expert institution, and can receive the certificate of qualification as an expert only after having worked in a state expert institution for three years. the director of the serbsky center dmitrieva was, at the same time, the head of the forensic psychiatry department which is the only one in the country and is located in her center. no one had ever had such a monopoly. according to savenko, the serbsky center has long labored to legalize its monopolistic position of the main expert institution of the country. the ambition and permissiveness—which, due to proximity to power, allow the serbsky center to get in touch over the telephone with the judges and explain to them who is who and what is the guideline, although the judges themselves have already learned it—have turned out to be a considerable drop in the level of the expert reports on many positions. such a drop was inevitable and foreseeable in the context of the serbsky center efforts to eliminate adversary character of the expert reports of the parties, then to maximally degrade the role of the specialist as a reviewer and critic of the presented expert report, and to legalize the state of affairs. lyubov vinogradova believes there has been a continuous diminution in patients' rights as independent experts are now excluded from processes, cannot speak in court and can do nothing against the state experts. on 28 may 2009, yuri savenko wrote to the then president of the russian federation dmitry medvedev an open letter, in which savenko asked medvedev to submit to the state duma a draft law prepared by the independent psychiatric association of russia to address the sharp drop in the level of forensic psychiatric examinations, which savenko attributed to the lack of competition within the sector and its increasing nationalization. the open letter says that the level of the expert reports has dropped to such an extent that it is often a matter of not only the absence of entire sections of the report, even such as the substantiation of its findings, and not only the gross contradiction of its findings to the descriptive section of the report, but it is often a matter of concrete statements which are so contrary to generally accepted scientific terms that doubts about the disinterestedness of the experts arise. according to the letter, courts, in violation of procedural rules, do not analyze the expert report, its coherence and consistency in all its parts, do not check experts' findings for their accuracy, completeness, and objectivity. on 15 june 2009, the working group chaired by the director of the serbsky center tatyana dmitrieva sent the supreme court of the russian federation a joint application whose purport was to declare appealing against the forensic expert reports of state expert institutions illegal and prohibit courts from receiving lawsuits filed to appeal against the reports. the reason put forward for the proposal was that the appeals against the expert reports were allegedly filed "without regard for the scope of the case" and that one must appeal against the expert report "only together with the sentence." in other words, according to yuri savenko, all professional errors and omissions are presented as untouchable by virtue of the fact that they were infiltrated into the sentence. that is cynicism of administrative resources, cynicism of power, he says. the draft of the application to the supreme court of the russian federation was considered in the paper "current legal issues relevant to forensic-psychiatric expert evaluation" by yelena shchukina and sergey shishkov focusing on the inadmissibility of appealing against the expert report without regard for the scope of the evaluated case. while talking about appealing against "the reports", the authors of the paper, according to lawyer dmitry bartenev, mistakenly identify the reports with actions of the experts (or an expert institution) and justify the impossibility of the "parallel" examination and evaluation of the actions of the experts without regard for the scope of the evaluated case. such a conclusion made by the authors appears clearly erroneous because abuse by the experts of rights and legitimate interests of citizens including trial participants, of course, may be a subject for a separate appeal. according to the warning made in 2010 by yuri savenko at the same congress, prof. anatoly smulevich, author of the monographs problema paranoyi (the problem of paranoia) (1972) and maloprogredientnaya shizofreniya (continuous sluggish schizophrenia) (1987), which had contributed to the hyperdiagnosis of "sluggish schizophrenia", again began to play the same role he played before. recently, under his influence therapists began to widely use antidepressants and antipsychotics but often in inadequate cases and in inappropriate doses, without consulting psychiatrists. this situation has opened up a huge new market for pharmaceutical firms, with their unlimited capabilities, and the flow of the mentally ill to internists. smulevich bases the diagnosis of continuous sluggish schizophrenia, in particular, on appearance and lifestyle and stresses that the forefront in the picture of negative changes is given to the contrast between retaining mental activity (and sometimes quite high capacity for work) and mannerism, unusualness of one's appearance and entire lifestyle. according to the commentary by the independent psychiatric association of russia on the 2007 text by vladimir rotstein, a doctrinist of snezhnevsky's school, there are sufficient patients with delusion of reformism in psychiatric inpatient facilities for involuntary treatment. in 2012, delusion of reformism was mentioned as a symptom of mental disorder in psychiatry. national manual edited by tatyana dmitrieva, valery krasnov, nikolai neznanov, valentin semke, and alexander tiganov. in the same year, vladimir pashkovsky in his paper reported that he diagnosed 4.7 percent of 300 patients with delusion of reform. as russian sociologist alexander tarasov notes, you will be treated in a hospital so that you and all your acquaintances get to learn forever that only such people as anatoly chubais or german gref can be occupied with reforming in our country; and you are suffering from "syndrome of litigiousness" if in addition you wrote to the capital city complaints, which can be written only by a reviewing authority or lawyer. according to doctor of legal sciences vladimir ovchinsky, regional differences in forensic psychiatric expert reports are striking. for example, in some regions of russia, 8 or 9 percent of all examinees are pronounced sane; in other regions up to 75 percent of all examinees are pronounced sane. in some regions less than 2 percent of examinees are declared schizophrenics; in other regions up to 80 percent of examinees are declared schizophrenics. in april 1995, the state duma considered the first draft of a law that would have established a state medical commission with a psychiatrist to certify the competence of the president, the prime minister, and high federal political officials to fulfill the responsibilities of their positions. in 2002, ukrainian psychiatrist ada korotenko stated that today the question was raised about the use of psychiatry to settle political accounts and establish psychiatric control over people competing for power in the country. obviously, one will find supporters of the feasibility of such a filter, she said, though is it worthwhile to substitute experts' medical reports for elections? in 2003, the suggestion of using psychiatry to prevent and dismiss officials from their positions was supported by alexander podrabinek, author of the book punitive medicine, a 265-page monograph covering political abuses of psychiatry in the soviet union. he suggested that people who seek high positions or run for the legislature should bring from the psychiatric dispensary a reference that they are not on the psychiatric registry and should be subjected to psychiatric examination in the event of inappropriate behavior. concerned about the problem, authorities ruled that the russian mental health law should not be applied to senior officials and the judiciary on the ground that they are vested with parliamentary or judicial immunity. a psychiatrist who violates this rule can be deprived of his diploma and sentenced to imprisonment. in 2011, russian psychiatrists again tried to promote the idea that one's marked aspiration in itself for power can be referred to psychopathic symptoms and that there are statistics about 60 percent of current leaders of states suffering from various forms of mental abnormalities. documents and memoirs the evidence for the misuse of psychiatry for political purposes in the soviet union was documented in a number of articles and books. several national psychiatric associations examined and acted upon this documentation. the widely known sources including published and written memoirs by victims of psychiatric arbitrariness convey moral and physical sufferings experienced by the victims in special psychiatric hospitals of the ussr. samizdat documentation in august 1969, natalya gorbanevskaya completed noon ("полдень"), her book about the case of the 25 august 1968 demonstration on red square and began circulating it in samizdat. it was translated into english and published under the title red square at noon. parts of the book describe special psychiatric hospitals and psychiatric examinations of dissidents. the book includes "on special psychiatric hospitals", an article written by pyotr grigorenko in 1968. in 1971, twin brothers zhores medvedev and roy medvedev published in london their joint account of zhores' incarceration in a psychiatric hospital and the soviet practice of diagnosing political oppositionists as the mentally ill in london, in both english a question of madness: repression by psychiatry in the soviet union and russian (who is mad? "кто сумасшедший") editions. yury maltsev's report from a madhouse, his memoirs in russian ("репортаж из сумасшедшего дома"), were issued by the new york-based novy zhurnal publishing house in 1974. 1975 saw the article "my five years in mental hospitals" by viktor fainberg, who had emigrated to france the previous year after four years in the leningrad special psychiatric hospital. in 1976, viktor nekipelov published in samizdat his book institute of fools: notes on the serbsky institute documenting his personal experiences during two months' examination at the serbsky institute in moscow. in 1980, the book was translated and published in english. the book was first published in russia in 2005. professional associations and human rights groups various documents and reports were published in the information bulletin of the working commission on the abuse of psychiatry for political purposes, and circulated in the samizdat periodical chronicle of current events. other sources were documents by the moscow helsinki group and in books by alexander podrabinek (punitive medicine, 1979) anatoly prokopenko (mad psychiatry, 1997, "безумная психитрия") by and vladimir bukovsky (judgment in moscow, 1994). to these may be added soviet psychiatry – fallacies and fantasy by ada korotenko and natalia alikina ("советская психиатрия. заблуждения и умысел") and executed by madness, 1971 ("казнимые сумасшествием"). in 1972, 1975, 1976, 1984, and 1988 the united states government printing office published documents on political abuse of psychiatry in the soviet union . from 1987 to 1991, the international association on the political use of psychiatry (iapup) published forty-two volumes of documents on the political abuse of psychiatry in the ussr. today these are preserved by the columbia university libraries in the archival collection entitled human rights watch records: helsinki watch, 1952–2003, series vii: chris panico files, 1979–1992, ussr, psychiatry, international association on the political use of psychiatry, box 16, folder 5–8 (english version) and box 16, folder 9–11 (russian version). in 1992, the british medical association published certain some documents on the subject in medicine betrayed: the participation of doctors in human rights abuses. memoirs in 1978, the book i vozvrashchaetsa veter... 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