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August 17, 2016

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Captain Hruska Carswell, Continuance King

Silence. Another Hitler would be ok then?

Alex Lubet


On Wed, Aug 17, 2016 at 10:12 AM, Alex Lubet wrote:

I would add that people who actually have these conditions are stigmatized when public figures are "diagnosed" as euphemisms for bad character. It's a painful irony that one often reads an accusation of racism, sexism, or homophobia, which ascribes those faults to a disability (typically a mental illness). And the idea that not "diagnosing" Hitler would be giving him a pass fails to understand that the Nazis (as well as the former Soviet Union) were leaders in using diagnoses as tools of persecution. Let's not medicalize evil.

Captain Hruska Carswell, Continuance King

Alex,

Your argument is speculative. Any good, ideal, institution can be twisted to an abuse or an evil purpose. Perhaps we should "medicalize evil." Until the medical profession came out against smoking it was acceptable. Perhaps if doctors and other "trusted" medical professionals came out against guns and violence---I didn't hear the AMA or any other doctor's group call the Sandy Hook children's killing Evil. It was a deafening silence. Folks trust medical professionals. Why not use that capital and call things what they are? Trump is doing it. What if the "good guys" did it?

Alex Lubet

With all due respect, no. The speculators are those who would diagnose someone who is not their patient and whom they do not know and have not met. And even when there is an election as frightening as this one, there are certain principles that must transcend the crisis of the moment. One of them is professional ethics, perhaps medical ethics more than others. Coming out against guns and violence is one thing. Using diagnosis inappropriately is something altogether different. And if you haven't seen the AMA coming out against gun violence, it's because you haven't looked very hard, if at all. See, for example http://www.ama-assn.org/ama/pub/news/news/2016/2016-06-14-gun-violence-lobby-congress.page, from June 14, 2016.

And no, we should not medicalize evil. Not only is this what the Nazis and the former Soviet Union did (and, contrary to what you say, that does make the tactic suspect by association), we should all know better, for having seen how the right in this country has racialized (Obama and many others) and sexualized (Hillary Clinton most prominently) evil. The difference between these and the medicalization of evil, which stigmatizes millions of innocent people, is that those stigmatized by medicalization are inherenlty and not just socially vulnerable and live with conditions that are inherently and not just socially painful. Using medicalization as a tactic against Trump (who has claimed HRC is mentally fragile) is stooping to his despicable level.

There is a significant difference between the medical profession -- or any other group --calling out Trump appropriately and abusing the tools of their profession to do so. There is no need to call out Trump using unethical means, when it can be done ethically, responsibly, and in a manner far more effective than name calling (think teens labeling each other "retarded," as is unfortunately common). And hindsight aside, it would have been wrong to label smoking hazardous until it was established scientificallty that it was unhealthy. You argue that I am speculating because I eschew the sociobiological claim that evil is a medical condition before science has substantiated that claim. Not only would playing such a hunch be irresponsible in general, it would be particularly fraught given the complex relationship between psychiatric diagnosis and culture (including, of course, religion) and politics. Consider, for example, the etymology of "hysteria," "scientific racism," or the evolution of the psychiatric understanding of sexuality and gender.

Since I am new to this list (though not its only Lubet), I should note that, while I am not a legal scholar, I founded and head the University of Minnesota's disability studies research group. I have appointments in five programs, including bioethics and cognitive sciences.

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