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Speaker: Anita L. Allen-Castellitto, Henry R. Silverman Professor of Law, University of Pennsylvania
In the first lecture of the year, Morality and Mental Illness, Anita Allen presented her argument that ethicists ought to pay more attention to the moral agency of the mentally ill. She argued that because such a high percentage of the adult, white, literate population (26%) (not including those who are already hospitalized, minority groups or the homeless) can be classified as mentally ill (illness here including mood-, conduct- and personality disorders), the failure to take the particular moral agency of this significant group of people into account is problematic and needs to be addressed. It cannot be assumed, Allen argued, that the mentally ill are capable of the same kind of moral agency as are the non-mentally ill. This distinction, she claimed, needs to be taken into consideration when assessing moral blameworthiness and, in cases of infringements of the law on the part of people who could be classified as mentally incapacitated, when assessing appropriate punishment. We have to ask ourselves what a mentally-ill person feels like when engaging in conduct which under "normal" circumstances might be considered wrongful or immoral. How much more difficult is it for such a person (as opposed to a non-mentally ill person) to act in an "appropriate" or socially acceptable manner?
Allen contended that the mentally ill belong to the same moral discourse as non-mentally ill: that the mentally ill experience feelings of guilt, regret and shame. The problem is that they often cannot “healthily” discriminate between different choices. However, “sober” mentally ill people are not necessarily dangerous and, providing they have access to therapy and medication, they can live responsible and “full” lives with jobs and families.
Instead of thinking that the mentally ill have the same responsibilities as have the non-mentally ill, scholars thinking about moral responsibility should rather assume that they have only partial responsibility. Allen gave the example of the man who has a rage attack at his workplace; it may not be “fair” to hold him fully accountable for this action and require or expect him to ask for an apology. She pleaded for more recognition of the fact that a significant number of our fellow citizens, workers and friends may be suffering at any given time from a mental illness (albeit temporary); moreover, once their disability has become clear to us, we ought to be more inclusive. We, as a society, need to offer them help and assistance. Once we do that, we could quite rightly blame a mentally ill person for not seeking help or for not accepting advice/help. Whether we can formulate a duty for a mentally ill person to take medication remains an open question.
The talk was followed by a lively debate. One of the main issues raised was how to disaggregate the term “mentally ill” (indeed, how to define it, especially if it manifests itself as, for example, temporary depression) and differentiate between kinds of conditions and disorders. Psychiatrists in the audience also pointed out that some of these conditions, such as bipolar disorder, rarely appear by themselves. Another issue that was hotly debated concerned what kind of theory of the person would be implied by acknowledging that some people (and a significant number of them) can be held only partially accountable for their actions.
Summary by Anja Karnein, Graduate Fellow in Ethics 2005-06