Wednesday, May 30, 2007


There was a very interesting article in the May 18, 2007 issue of Psychiatric News titled “Court Still Clarifying Rules for Executing Mentally Ill”. I am going to go to the end of the article. There is other important information in it, but it was the ending that really caught my attention.

According to this article the American Psychiatric Association, the American Psychological Association and the National Alliance on Mental Illness have filed an amicus curiae brief urging the US Supreme Court to rule against Texas and order a death sentence commuted. The brief says that folks as ill as this person “cannot rationally understand the reasons for their executions as they frequently suffer from bizarre delusions that disrupt their understanding of reality.”

Now I think it is “bizarre reality” that we still have the death penalty in this country at all. We know we have put innocent people to death and that others were saved before their wrongful executions I also find it disturbing to know folks are advocating for only some people to be saved from this barbaric punishment that we as a nation don’t seem to be able to move beyond.

Their main argument is also bizarre. My next statement may be the most controversial I have ever made on this blog. Here goes. There is no objective way to determine if a person is suffering from “bizarre delusions” or not. There is not a single scientific or medical test I know of to prove if a person is or is not delusional. You can even argue about what reality is, but I am making a more basic point than that. The psychiatric techniques to make such a determination are more art, experience and intuition on the part of the practitioner than true science. Observation is used, but you must remember that one of the main sources of information about these delusions comes from the words of the person.

From the article; “One of the key issues in Panetti is whether being aware of the acts one committed equates with mental competence. Panetti is aware of why he is facing execution, namely, that he killed his wife's parents, but suffers from religiously based delusions in which he maintains that the people planning to put him to death are part of a conspiracy to prevent him from preaching the gospel.”

How does one determine the truth of what “he maintains”? The question is important to all of us with a serious mental illness.

The struggle by the mind to understand and define the brain has been a tough one, but neurobiology, new brain imagining equipment, biopsychiatry and pharmacological psychiatry have made great gains in understanding the brain and the disorders and diseases of the brain. Biopsychosocial approaches as well as self-help approaches have helped to ease the pain of living with a brain disorder. I am not trying to be dismissive of the gains made, but rather trying to get you to look at the limits of what any psychiatrist, psychologist or other mental health professional can testify to in court as truth.

Why? Because courts are used not just to determine if we should die for a crime, they are also used to lock us up on mental wards involuntarily. They are also used in some states for what is called community commitment. Therefore; it is important to be truthful about the limitations of their knowledge.

Those of you who have been reading this blog for awhile know I have been locked away myself. Mostly I have gone voluntarily just before I would have been going involuntarily. I have watched some of my fellow sojourners say what they knew they needed to say to get in the hospital and then say what they needed to say to get out when they were ready to leave. Since I know this can be done and since I know the psychiatrist has no real way of knowing when he or she is being told the truth or a falsehood, then how could any of them go into court and swear to anything?

Let me be clear. I am against the death penalty for everyone. Seriously mentally ill folks like me, the developmentally disabled or the chronically normal folks who are in the majority in this world. I simply oppose it for anyone. I also oppose mental health professionals going into court and swearing an oath to tell the truth and then saying they know for a fact whether a person is delusional or not or swearing to anything else they don’t know.

The person testifying in the above case could say the person says they are trying to prevent him from preaching by putting him to death. They might even go on to say that they believe him, but my dear friends they can not say whether it is true or not. They simply do not know.

It is as important to know what you don’t know as it is to know what you do know. Some of the most dangerous people in the world are those who do not know the limitations of their knowledge. I may be one of those people in your mind, but at least I know you can’t tell if I am delusional or not and I know I can’t tell if you are.

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