ALIEN LANDSCAPES?

A searching, humane look at the lives of the mentally ill, whose inner worlds can be alien landscapes indeed.

Examining a population of hospitalized patients in Britain, ethicist Glover (Law/King’s Coll., London; Humanity: A Moral History of the Twentieth Century, 2000) asks whether it is true that people who suffer from anti-social disorders are truly without conscience or whether it might not be that their moral world simply maps onto different territory from other people’s—an important distinction in considering such things as the ability to recognize right from wrong and accept responsibility for one’s actions. In what he calls “Socratic interviews,” Glover looks at the mechanisms of moral restraint and governance, observing that many of those diagnosed with anti-social disorders lack a “normal” sense of moral obligation. However, he notes, what constrains many of us from doing such things as parking in a handicapped spot is simply the fear of being fined or chastised, rather than the abstract rightness or wrongness of the issue. Not that the mentally ill lack understanding of right and wrong; as the author writes, “[t]here was a lot of support for capital punishment” in his interview results, and nuanced support at that. Drawing examples from art and literature and arguing to some extent against proponents of a more expressly biological and medical view of psychiatry, Glover counsels an open-minded awareness of the minds of the ill: “Biological psychiatry, citing such causes as abnormalities of brain chemistry, sometimes helps to cure or contain disorders. But it gives no intuitive understanding of how people feel from the inside.” As to treatment, the author argues that the disorder be gauged with an eye to the “kind and degree of harm it causes.”

Of substantial interest to students of psychiatry, ethics and the law alike and especially to those working in areas in which the three overlap.