The psychiatrist's dilemma: a conflict of roles in legal executions*
* Alfred M. Freedman,
* Abraham L. Halpern
Alfred M.Freedman
Chairman and Professor of Psychiatry Emeritus (Correspondence)
*This paper in part was presented at the Congress of the World Association for Social Psychiatry
(WASP) held in Vancouver, Canada, in August 1998.
1148 Fifth Avenue, New York, New York 10128, United States of America. Email: <
[log in to unmask]>
Abraham L. Halpern, Professor of Psychiatry Emeritus
New York Medical College, New York, United States of America
Abstract
In the United States, a critical controversy is taking place in regard to psychiatrists' and other
physicians' participation in legal executions. Under pressure from the criminal justice system and
legislatures to expedite executions, some forensic psychiatrists have succeeded in loosening
traditional prohibitions against such participation. Further, there has been a weakening of the
prohibition against treatment designed to facilitate immediate execution of those condemned to
death. The rationale offered for these departures from current psychiatric ethical codes is the
novel notion that when a psychiatrist acts in the court or criminal justice situation, that
individual is no longer a psychiatrist and is not bound by psychiatric ethics. Rather, the forensic
psychiatrist, termed a 'forensicist', serves as an assistant in the 'administration of justice' or
'an agent of the State' and thus works in a different ethical framework from the ordinary
psychiatrist. This justification has similarities to the rationale offered by physicians involved in
human experiments and other criminal acts in Nazi Germany, as well as psychiatrists in the former
Soviet Union who explained their involvement in psychiatric abuse as a result of being agents of the
State and thus not responsible for carrying out orders. Clearly, this controversy could be
eliminated by a campaign for the abolition of capital punishment, characterised by the American
Psychiatric Association as 'anachronistic, brutalizing and] ineffective'. Such a campaign should
serve as a call for psychiatrists and other physicians to join in the struggle to uphold ethical and
moral principles.
> -----Original Message-----
> From: The Disability-Research Discussion List
> [mailto:[log in to unmask]] On Behalf Of Erik Leipoldt
> Sent: 04 February 2008 04:45
> To: [log in to unmask]
> Subject: Re: Media's Report on 'Mentally Disabled" Iraqi
> Suicide Bombers Now Questioned
>
> Assuming I understand your point and that these suicide
> bombers had a developmental disability, of course such people
> do also have "misguided passions." It is quite something else
> to suggest that it is discrimination to therefore "disallow
> that disabled people can break laws, be extremists, commit
> acts of terror." In many civilised justice systems there _is_
> an allowance for actions committed under some kind of mental
> incapacity or lack of full capacity and therefore being less
> able to make reasonable decisions for oneself, resulting in
> diminished culpability. The extension of what you appear to
> be saying Michelle, is that such people should feel the force
> of the law equally to anyone else
> - some kind of "inclusion?" A civilised society treads a
> careful balance between supporting and guiding people with
> impaired capacity and allowing them to make certain decisions
> for themselves. Allowing them a right to equally engage in
> breaking laws, including acts of brutality is ultimate
> neglect of their welfare.
>
> It is another leap to make from this use of mentally impaired
> people to discrimination of all disabled people, in the way
> you suggest, because many people with disabilities have no
> mental impairment.
>
> It is, I think highly likely that some people with impaired
> capacity have been manipulated to be suicide bombers at
> different times, given the low social value that is attached
> to people with disabilities everywhere, perhaps in particular
> in a country where it seems the fittest only survive. And,
> yes, Larry, economic rationales have a long history in the
> abuse of people with disabilities - your example is quite plausible.
>
> Cheers
>
> Erik Leipoldt
>
>
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