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bioethics
Developing World Bioethics ISSN 1471-8731 (print); 1471-8847 (online) Volume 14 Number 1 2014 p ii
doi:10.1111/dewb.12048
EDITORIAL
BIOETHICS AND FORENSIC PSYCHIATRY Almerindo is an old man. He has been living in a forensic hospital for the last 32 years of his life. When he was 18 years old, he threw a stone at a boy in order to steal the boy’s bike. In medical terms, he is a psychiatric patient; in criminal terms, he is an offender who did not receive a criminal sentence, but compulsory psychiatric treatment. In the overlap between forensic psychiatry and criminal law, Almerindo becomes a ‘dangerous man’ no longer allowed to live freely in Brazilian society. He falls into the hybrid category of the psychiatric offender. I met him while shooting my documentary ‘The House of the Dead’.1 He is now an abandoned man, with no place to go, no family ties, and in his own terms: ‘with no name’.2 Almerindo is not alone and his story is not reminiscent of an inglorious past when the sick, the disabled or the insane were confined in asylums. We still have old and new forms of total institutions for abandoned people – places where we believe they are cared for, but in fact, they are kept away from the basic right of being in the world. I cannot generalize the ambivalence of the ‘house of the dead’ I visited while conducting the national census of forensic hospitals in Brazil.3 But I know that with different nuances the overlap between psychiatric and 1 Debora Diniz. The House of the Dead. 23’. Documentary Film. Brasília: ImagensLivres. 2 Giorgio Agamben. Il potere sovrano e la nuda vita. Torino. Picola Biblioteca Einaudi. 2005. 3 Debora Diniz & Maria Tavares. Mental Illness and Crime in Brazil. The Lancet, Volume 382, Issue 9908: 1877–1878, 7 December 2013.
criminal law poses several ethical questions to bioethics. And, curiously, we are silent about them – not only from a developing world perspective, in which these questions should be more prominently related to care, or from other perspectives, especially in societies with a strong carceral mentality, such as the United States. Forensic psychiatry has a long history as a medical practice that receives criticism from philosophers and historians, which makes the bioethical silence even more intriguing. The typical patient is not someone who will claim his rights, form an interest group or sue his physician – he is separate from the social game that traditionally moves bioethics and its characters. In Brazil, for instance, he is a black man, poor and illiterate, with a diagnosis of schizophrenia, whose main criminal offense was against property or the homicide of a family member. He is confined to an institution that is neither a hospital nor a prison – a total institution where some of them will live for their whole life. We need to broaden the boundaries of bioethics to places and populations where the politics of life show a more dramatic face – the institutions of control in which medical and criminal powers overlap, such as prisons, corrections facilities or asylums. In Agambenian terms, we will find different faces of the abandoned people living in these places. I know that researchers will have several barriers to accessing data, but this is a reality that is in need of being understood and revealed. Almerindo is not only a character in the documentary; he is a psychiatric patient who has been waiting for more than three decades to be cared for.
DEBORA DINIZ
© 2014 John Wiley & Sons Ltd
bs_bs_banner
bioethics
Developing World Bioethics ISSN 1471-8731 (print); 1471-8847 (online) Volume 14 Number 1 2014 p ii
doi:10.1111/dewb.12048
EDITORIAL
BIOETHICS AND FORENSIC PSYCHIATRY Almerindo is an old man. He has been living in a forensic hospital for the last 32 years of his life. When he was 18 years old, he threw a stone at a boy in order to steal the boy’s bike. In medical terms, he is a psychiatric patient; in criminal terms, he is an offender who did not receive a criminal sentence, but compulsory psychiatric treatment. In the overlap between forensic psychiatry and criminal law, Almerindo becomes a ‘dangerous man’ no longer allowed to live freely in Brazilian society. He falls into the hybrid category of the psychiatric offender. I met him while shooting my documentary ‘The House of the Dead’.1 He is now an abandoned man, with no place to go, no family ties, and in his own terms: ‘with no name’.2 Almerindo is not alone and his story is not reminiscent of an inglorious past when the sick, the disabled or the insane were confined in asylums. We still have old and new forms of total institutions for abandoned people – places where we believe they are cared for, but in fact, they are kept away from the basic right of being in the world. I cannot generalize the ambivalence of the ‘house of the dead’ I visited while conducting the national census of forensic hospitals in Brazil.3 But I know that with different nuances the overlap between psychiatric and 1 Debora Diniz. The House of the Dead. 23’. Documentary Film. Brasília: ImagensLivres. 2 Giorgio Agamben. Il potere sovrano e la nuda vita. Torino. Picola Biblioteca Einaudi. 2005. 3 Debora Diniz & Maria Tavares. Mental Illness and Crime in Brazil. The Lancet, Volume 382, Issue 9908: 1877–1878, 7 December 2013.
criminal law poses several ethical questions to bioethics. And, curiously, we are silent about them – not only from a developing world perspective, in which these questions should be more prominently related to care, or from other perspectives, especially in societies with a strong carceral mentality, such as the United States. Forensic psychiatry has a long history as a medical practice that receives criticism from philosophers and historians, which makes the bioethical silence even more intriguing. The typical patient is not someone who will claim his rights, form an interest group or sue his physician – he is separate from the social game that traditionally moves bioethics and its characters. In Brazil, for instance, he is a black man, poor and illiterate, with a diagnosis of schizophrenia, whose main criminal offense was against property or the homicide of a family member. He is confined to an institution that is neither a hospital nor a prison – a total institution where some of them will live for their whole life. We need to broaden the boundaries of bioethics to places and populations where the politics of life show a more dramatic face – the institutions of control in which medical and criminal powers overlap, such as prisons, corrections facilities or asylums. In Agambenian terms, we will find different faces of the abandoned people living in these places. I know that researchers will have several barriers to accessing data, but this is a reality that is in need of being understood and revealed. Almerindo is not only a character in the documentary; he is a psychiatric patient who has been waiting for more than three decades to be cared for.
DEBORA DINIZ
© 2014 John Wiley & Sons Ltd
