Ethics and Marginal Cases: the rights of the mentally handicapped

ABSTRACT  Some beings, including children, animals and the mentally handicapped, seem to deserve moral consideration, despite the fact that they are not rational or moral agents. These so-called marginal cases create a problem for theories that heavily stress the role of moral and/or rational agency in ethics: the latter seem unable to account for the former's moral status. This paper discusses the recent and original attempt of Loren Lomasky to solve this problem. It is argued that Lomasky's arguments are self-defeating because they can only succeed by relying on common-sense morality and, thus, by giving up the heavy stress on the role of rational agency in ethics.     

Character and behavior in the mentally ill and well mother

The purpose of this study was to examine character and behavior in a group of mentally ill and well mothers. Mentally ill mothers differed from well mothers in mother-child interaction in their positive involvement in the feeding context and in overall optimal mothering during feeding. On measures of intrapsychic conflict and concern, mentally ill mothers demonstrated significantly more conflict in areas of trust, anger, self-esteem, mutuality and nurturance and more concern with issues of self-esteem, and giving and caring than well mothers. For the mentally ill mothers postpartum onset of illness and number of separations from her child were related to some aspects of character and behavior.     

Guilty but mentally ill: An alternative verdict

Despite opposition from professional groups such as the American Psychiatric Association and the American Bar Association, “Guilty But Mentally Ill” (GBMI) statutes now exist in at least 12 states and are being considered in others. This paper reviews the development of the GBMI alternative to the insanity defense from a historical perspective, focusing especially on the reasons for its development in Michigan, the first state to pass GBMI legislation over 9 years ago. Using the Michigan experience, the GBMI statute is reviewed in terms of its perceived purpose and its success in accomplishing that purpose. Then recommendations for future changes are made.     

Firearms and the mentally ill: A legislative overview and jurisprudential analysis

This article examines federal and state laws that prohibit the mentally ill from possessing firearms and assesses the jurisprudence that has developed as courts have applied the federal law. It argues that although there is little or no empirical data linking the mentally ill with firearms violence, legislative activity and popular political debate invariably include such restrictions on the mentally ill. Notwithstanding the proliferation of firearms and antecedent violence, this article suggests that legislators and policy-makers must separate this issue from the broader and more emotional issue of “gun control” in order to effectuate better public policy and simultaneously protect the constitutional rights of the mentally ill.     

Treatment rights of the mentally retarded: The cost of refusal

The cost of the mentally retarded client's rights to refuse treatment, in both monetary and human terms, varies under different legal/clinical circumstances. The process of placing severely retarded clients into the community with poor or no supervision, especially those who refuse or are denied treatment, can result in devastating costs for the client and others. The complexities associated with mental retardation require sophisticated treatment considerations. Moreover, these clients often need guidance in making meaningful decisions relevant to their quality of life. In order for this process to produce desirable results, for both the mentally retarded client and society, in general, a balance must be struck between the legal and clinical factors involved.     

Ernst Kris and the art of the mentally ill1

Ernst Kris, a gifted art historian as well as an eminent psychoanalyst, had little regard for the aesthetic value of the spontaneous artistic products of the mentally ill, considering them to be of interest only for the insight they might provide about the patient's psychopathology and unconscious conflicts. Recent scholarship and developments in the art world warrant a critical review of his position, which appears to have derived from his adherence to classical and Renaissance criteria. The works of two untrained and psychiatrically disturbed artists are offered as evidence of their potential aesthetic worth.     

Outpatient civil commitment of the mentally ill: An overview and an update

Civil commitment to outpatient psychiatric treatment has only recently become the subject of significant discussion, not only in the professional literature, but also in state legislatures and mental health departments. Task Forces from the American Psychiatric Association and the National Center for State Courts have drafted detailed reports on outpatient commitment, and a growing number of states have modified their statutes and regulations governing the process. The author presents the existing research literature on outpatient commitment in practice, reports recent statutory developments, and discusses specific areas of concern for those planning to propose or implement new procedures, including the right to refuse treatment, confidentiality, and the duty to warn or protect third parties.     

Mental health needs of the chronically mentally ill elderly

The treatment histories and current social, financial, and clinical status of 111 chronically mentally ill (CMI) persons over the age of 60 were examined. Information was obtained from Ss, family, mental health records, and mental health professionals familiar with Ss. Psychiatric symptoms were observed in 74% of Ss. Many Ss experienced long periods without acute episodes of illness. Recurring episodes eventually appeared in most Ss, however, and ongoing deficits in daily functioning and social contacts were prototypical. Two thirds of the Ss were living in the community, relying heavily on family contacts; the rest lived primarily in nursing homes (23.4%) or psychiatric hospitals (7.2%). Social support was the best predictor of level of functioning. Findings suggest that failure of CMI elderly to use mental health services is not due to lack of need. Mental health services currently do not appear to be meeting the needs of this population.