The decline came from two directions simultaneously. Chlorpromazine — marketed as Thorazine — was introduced in the United States in 1954. It was the first antipsychotic medication to offer genuine relief for psychotic symptoms, and its availability gave psychiatrists a tool that could address severe mental illness without the permanent destruction of brain function. The need for lobotomy’s extreme intervention became less compelling.
At the same time, evidence was accumulating that the procedure’s effects were not what Freeman had claimed. A controlled study published in 1961 found no significant difference in outcomes between patients who had received lobotomies and those who had not. The procedure’s purported benefits were being reconsidered, and its documented harms — personality changes, loss of initiative, cognitive impairment, incontinence, seizures, death — were harder to dismiss.
Freeman continued performing transorbital lobotomies through the 1960s. In 1967, he performed his final surgery, on a patient named Helen Mortensen, who died of a cerebral hemorrhage. The hospital that had hosted his practice then banned him from further surgery. He died in 1972, still defending the procedure he had spent his career promoting.
The medical consensus that had crystallized by the 1970s was essentially the reverse of what Freeman had asserted for three decades: lobotomy was a brutal and unreliable intervention that caused irreversible harm in the name of management and control, and that the populations on whom it had most often been performed — people with intellectual disabilities, women, poor patients in state institutions — were populations with the least power to resist or refuse.