In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. (+info)
Actions, causes, and psychiatry: a reply to Szasz.
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In a recent paper, it was argued forcefully by Thomas Szasz that it is crucial to the scientific credibility of psychiatry that it abandon talk of the behaviour of the mentally "ill" in terms of causes: such behaviour is not caused by their condition--it simply has reasons, which are discounted by the medical model. It is argued in this paper that Szasz's theory is incomplete for two reasons: first, in assuming that reasons are radically different from causes, it cannot account for the possibility that "sane" behaviour might be just as much caused as "insane"; and second, it tacitly assumes that the origin of behaviour always lies with the agent--a view that arguably is an accident of grammar. Hence while there is no mental illness, this is because there is nothing that could be ill--and this means that there is no such thing as mental "health" either. (+info)
"Idiots, infants, and the insane": mental illness and legal incompetence.
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Prior to the second world war, most persons confined in insane asylums were regarded as legally incompetent and had guardians appointed for them. Today, most persons confined in mental hospitals (or treated involuntarily, committed to outpatient treatment) are, in law, competent; nevertheless, in fact, they are treated as if they were incompetent. Should the goal of mental health policy be providing better psychiatric services to more and more people, or the reduction and ultimate elimination of the number of persons in the population treated as mentally ill? (+info)
Secular humanism and "scientific psychiatry".
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The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. (+info)
The rhetorician's craft, distinctions in science, and political morality.
(5/30)
In his response to Szasz' Secular Humanism and Scientific Psychiatry, the author considers the use of rhetorical devices in Szasz' work, Szasz' avoidance of acknowledging psychiatry's scientific distinctions, and Szaszian libertarianism versus liberalism. (+info)
Alcoholism and homicide with respect to the classification systems of Lesch and Cloninger.
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AIMS: Worldwide criminal statistics show a disproportionately high incidence of violent offences committed under the influence of alcohol. A psychopathological subtyping of alcohol dependence in offenders who committed homicide has mainly been related to impulsive and dissocial personalities up to now. METHODS: In an investigation on 48 alcohol-dependent offenders who committed homicide, a subtyping according to the multidimensional classification systems of Lesch and Cloninger has now been conducted for the first time. RESULTS: In Lesch's classification, there was a high incidence of homicides committed by type II and type III subjects with the comorbidity anxiety and cyclothymia. While type III offenders were more often repeat offenders, there was a remarkably high rate of first offenders among type II subjects (Chi-squared test; chi(2) = 30.0, df = 3, P < 0.001). With respect to Lesch's typology, the blood alcohol concentrations did differ significantly in the group of offenders (Kruskal-Wallis, chi(2) = 18.3, df = 3, P < 0.001), whereas the blood alcohol concentration of type II offenders at the time of offence was significantly lower than in type III offenders (Mann-Whitney-U, Z = -3.47; P = 0.001). Regarding to the Cloninger's typology, no significant differences in the aforementioned parameters could be found. DISCUSSION: An excessive noradrenergic reaction of anxiety offenders with initial withdrawal is discussed as a possible explanatory model. (+info)
The impossible dialogue between psychiatry and the judicial system: a language problem.
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The interface between psychiatry and law is complex and has the potential for gross misunderstanding. Each discipline has its own concerns with regard to the psychiatric patient, and there is a significant language gap between the two disciplines. The language of the medical discipline describes the patient's state on a continuum that ranges from extremely ill to completely healthy. The judicial language, on the other hand, is a binary language: the patient is either competent or incompetent, either dangerous or not dangerous. This article describes three potential areas for discourse in the Israeli context: involuntary hospitalization, criminal responsibility and legal representation of involuntarily hospitalized patients. The two systems can be complementary only if both sides make a serious effort to communicate and respect each other's principles and language. (+info)
Criminal responsibility in Asperger's syndrome.
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BACKGROUND: Asperger's syndrome (AS) has been of much interest in the last two decades. Most people with AS are law abiding and are not involved in any violence. Over the years, however, there is increasing evidence of violent behavior and criminal acts committed by some people with AS. The characteristics of the link between AS and violation of the law requires identification and definition and the question regarding the criminal responsibility to be attributed to these offenders needs to be clarified. DATA: We present three cases that illustrate how the special characteristics of this syndrome and particularly the inability to assess social situations and appreciate others' point of view constitute the main cause for the violent behavior and the criminal offences. For this specific behavior, the AS patients lack the criminal intent or the intent to cause harm (mens rea), which is essential for criminal responsibility. Thus it is reasonable to consider some AS sufferers not criminally responsible for their actions and unfit to stand trial. This approach has been accepted by the courts. CONCLUSION: It can be inferred that people with AS may not be criminally responsible despite not suffering from a psychotic illness. (+info)