History and Moral Development of Mental Health Treatment and Involuntary Commitment

10383 words 42 pages
History and Moral Development of Mental Health Treatment and Involuntary Commitment

The history of involuntary commitment has been developed and created through the history of mental illness and the constructs of society. Government policy has been created to treat mental illness and this philosophy of mental illness and its treatment goes as far back as Greek Mythology. The belief about mental illness has changed throughout history and at times thought to be due to, possession of demons, reversion to an animalistic level of consciousness, a sinful state of the soul, a chemical imbalance, and as reported recently in the medical journal Nature and Genetics, a defect in chromosome number six (at least as far as schizophrenia is
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1998).
Aristotle defined the legal principle of informed consent, which is essentially unchanged to this day, and underlies the two legal justifications for involuntary commitment of certain persons who are mentally ill. Aristotle, in his work the Nicomachean Ethics, essentially defined informed consent as a person's actions, which are done with knowledge, rationality, and without coercion. It is still a matter of a person's ability to receive and absorb the relevant knowledge, intelligently evaluate the risk and benefits of the decision, and to be free from any coercion. These same three legal elements still form the basis of court decisions, statutes, and they were endorsed by the Report of President's Commission for the Study of Ethical Problems in Medicine and on Biomedical and Behavioral Research (Medical Health Care Decisions, 1982).
In ancient Greece and Rome, care of mentally ill and retarded individuals was largely the responsibility of those persons' families, relatives or close friends. Centuries later, involuntary commitment became a formalized governmental procedure to isolate socially undesirable persons and only later to treat mental disability as an illness. It wasn't until the second half of the twentieth century, 1963, President John F. Kennedy believed that primary prevention and reduction in state hospitals could be achieved through community mental health centers. In Kennedy's speech THE DREAM, he began with

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