Hanganu-Bresch Cristina
Writing Programs, University of the Sciences, Philadelphia, Pennsylvania.
J Nerv Ment Dis. 2019 Sep;207(9):805-814. doi: 10.1097/NMD.0000000000001035.
The diagnosis of moral insanity was primarily used through the best part of the 19th century to define and justify the psychiatric treatment of a particular type of conduct in which the patient seemed otherwise rational but displayed certain inexplicable and undesirable behaviors deemed socially perverse or "unfit." This article traces the history of this highly contested concept, which mirrors a historical arc in which psychiatry emerges as a discipline and stakes territorial claims on defining and regulating moral behavior. As illustration, I focus on the Hinchman Conspiracy Trial of 1849 as a less known case of wrongful confinement that hinged on proving the diagnosis of moral insanity in court. Moral insanity is a case study of the efforts to medicalize human ethical conduct, an effort starkly resisted by both the courts and the public. Some of the legacies of the term are the contemporary use of insanity as a legal defense, and the ability of patients to dispute psychiatric ward confinement orders in court.
在19世纪的大部分时间里，“道德疯狂”的诊断主要用于定义和证明对特定行为类型的精神科治疗，在这类行为中，患者在其他方面似乎是理性的，但却表现出某些被认为是社会反常或“不适当”的、无法解释且不受欢迎的行为。本文追溯了这个极具争议的概念的历史，它反映了精神病学作为一门学科出现并在定义和规范道德行为方面划定领域主张的历史轨迹。作为例证，我将重点讲述1849年的欣奇曼阴谋审判，这是一个鲜为人知的非法监禁案件，其关键在于在法庭上证明“道德疯狂”的诊断。“道德疯狂”是将人类道德行为医学化努力的一个案例研究，这一努力遭到了法院和公众的强烈抵制。该术语遗留下来的一些影响包括当代将精神错乱用作法律辩护，以及患者在法庭上对精神病病房禁闭令提出质疑的能力。
