The Dilemma of Public Safety and Human Rights Violations - Book Report/Review Example

Contemporary Issues Essay: Public Safety versus Human Rights Table of Contents Introduction Numbers 2 Trying to Define the Problem 2 Personal Responsibility 7 Conclusion 8 References 10 Contemporary Issues Essay: Public Safety versus Human Rights Introduction In 1999, the Home office released a white paper that created momentous controversy. Entitled, Managing dangerous people with severe personality disorder: Proposals for policy development, this paper described the problems created by people who perpetrate sickening acts of violence on unwitting members of society. Often legal strategies have been unable to protect the public from such individuals. Home office (1999, 3) asserted that in many cases known risky people have been returned to the community in spite of even dramatic crimes that would qualify them for life sentences. Mental health has been up to now ineffective. Most often, these individuals are not usually amenable to mental health care. The types of people who commit such actions are not sent to hospital because they are assessed as unlikely to benefit from treatment. Instead, they are released unsupervised to their communities. The first idea in the Home Office proposal was to keep dangerous severely personality disordered people incarcerated in prison or hospital until it is safe to release them into the community. The second suggestion in this paper was to use "indeterminate detention" in both civil and criminal proceedings (Home Office, 1999, 3). This leads to multiple ethical, moral, legal, health, and mental health questions and issues. In society's attempts to process the actions of a minority, there are discussions of mental disorder, definitions, good and evil, responsibility, morality, as well as human rights and whose rights are most important. One overriding issue was chosen for discussion. This paper explains why it is important to decide what discipline, language and constructs are the most adequate for discussing such questions. Further, it is the opinion of this writer that the criminal justice system focus upon responsibility for one's actions is the best frame for thinking about people who commit shocking crimes against others. Numbers As determined by Home Office (1999, 3), "There are estimated to be just over 2000 people who would fall into this group in England and Wales. Over 98% of these people are men, and at any time most are in prison or in secure hospitals. An article in The Practitioner (Pitfalls in detaining the, 2002) asserts that "around ten per cent of the population fulfils ICD10 criteria for personality disorder". The only people with personality disorders that are of issue are the small minority of those that engage in dangerous and severe antisocial behaviour (Home Office, 1999, 3). Trying to Define the Problem One major problem in this debate is a serious need for people to decide which discipline or paradigm will frame the conversation. Should it be the field of criminal justice, mental health, public safety, or religion When this is decided, then, a plan to create a dynamic balance between protecting public safety and respecting human rights can be developed. At the same time, this writer endorses an older criminal theory and approach for such crimes. The law of Talion, as discussed in Crews, G. A., Gillespie, W., and Stanko, S. (2004), proposes that the consequences of criminal actions should equal in severity to the damage to the victim. This appears to be the most equitable for such crimes. In spite of humanity's advances, it is entirely probable that there will always be those who are dangerous predators in society. These actions that stir public passions are the actions that could just as easily be labelled as evil or criminal or insanity (Ruffles, 2004). All societies find ways to contain these risks. Morse (2004) explains that the amount of containment and the manner in which people are contained is dependent upon society's norms, morals and politics. In this case, society has to decide which norm, mores and political frame of reference to utilize in regard to violent predators. Criminal justice. The answers to the question of how does society deal with criminal behaviour have varied throughout recorded history within the field of criminology. There have been periods where any of the following ideas were prominent: vengeance, balance or something known as the "law of Talion", power, privilege and class control, religious redemption versus sin and punitive consequences, punishment as prevention, or rehabilitation (Crews, G. A., Gillespie, W., & Stanko, S., 2004). Each of these depends to some extent upon how such behaviour is explained (Tittle, Charles R., 2000). This concept of balance, of applying consequences that are equal to the damage inflicted by the crime does appear to this writer to be the most equitable. It is also one of the most likely to contribute to public safety. Violent predatory murder, for example, costs the person their life, and their entire social system their life with him or her. Serial violent child sexual abuse can also be seen to affect the entire rest of the children's lives. This extends to the full range of behaviours committed by people thought of as having severe dangerous personality disorder. Life in prison, at the very least, does seem equitable. This is, of course, only if the actual and full range damages to a victim of such violent crimes are understood. If this were routinely done, there would be little need for preventative detention. Mental health. The same history as above is true for mental disorders. There are as many explanations for behaviour that is out of the norm. Only a few are pertinent here. In the 1999 white paper, Home Office (1999, 26) explained that originally these individuals were labelled as psychopathic (Appelbaum, 2005) and that this involved "a persistent disorder or disability of mind which results in abnormally aggressive or seriously irresponsible conduct." Later they were given the label of personality disorder and described as demonstrating either antisocial or dissocial personality disorder. The International Classification of Diseases as reported by Home Office (1999, 33) describes them as having limited empathy, severe irresponsibility, no ability to feel guilty, and an inability for relationships. They remain easily frustrated, are severely likely to become aggressive, unable to learn from experiences, and unwilling to take responsibility for themselves. Such people are constantly irritable and blame others for their problems. As yet, science does not know the causes of this condition; only that it begins in childhood and persists over a lifetime. These are offenders who challenge moral notions of humanity and decencyThe fact remains that there exists a spectrum of "bad deeds" which confront the criminal courts and at the extreme end of this spectrum sit those crimes that are so disturbing that they seem intrinsically different from the more usual crimes (Ruffles, 2004). Such individuals who commit dreadful criminal acts can be diagnosed as "people who have an identifiable personality disorder to a severe degree, who pose a high risk to other people because of serious antisocial behaviour resulting from their disorder" (Home Office, 1999, 5). They have "committed serious offences such as murder, manslaughter, arson, serious sex offences, or grievous bodily harm" (Home Office, 1999, 5). Naming Instead of Solving. Violent predatory crimes are not the ordinary deeds of criminals or even the normal behaviours of people with personality disorders. In point of fact, the arguments for using mental health constructs for discussing severe and violent aggressive behaviour simply engage in another form of labelling. Ruffles (2004) suggests that diagnoses of ASPD and psychopathy are simply "legal synonyms for the concept of evil" and are just as vulnerable to moral judgments as concepts of good and bad. Other people insist that this is a diagnosis that has been made up for political reasons (Mason, 2006). Eastman & Starling (2005) describe concerns by many psychiatrists that such definitions of mental disorder are too broad. Ruffles (2004) explains that this is a form of labelling that only results in predictions of future serious bad actions, not amenable to treatment, needing heavier sentencing, and concerns about community safety. It may not even be accurate (Mason, 2006; Pitfalls in detaining the, 2002). Mullen (1999) suggests that dangerous actions are just that-actions or behaviours rather than an outgrowth of deeper character structure. Labels do nothing for the person who has been labelled. There are concerns that these labels will be applied to people who are simply outside the norm. This can become political and an abuse of the power inherent in the application of mental health services. All psychiatric diagnoses involve an application of personal, community and social values (Eastman & Starling, 2005). This writer asserts that the discussion of what to call people who engage in sickening and terrible behaviour is a red herring. It takes the discussion away from the problem at hand. Szasz (2003) explains that the controversy in the issue of compulsory detention and dangerous personality disordered persons are being discussed in a superstitious manner so as to pretend to ward off the dangers inherent in life. Whether society labels them as persons with a mental disorder, criminals, evil or 'XYZ with no redemptive value', they continue to exist. And the question persists: How does society face the reality of and frame horrific crimes Labels simply determine which construct to use. If society names them psychopathic criminals, we might consider forensic mental health constructs. The perpetrator would be housed in a prison that has mental health facilities or a hospital with prison facilities. If society names them Antisocial Personality Disorder and considers this a mental condition, the only place for such people would be hospitals. These hospitals may or may not have any criminal justice containment procedures. If they are labelled as evil, morality and religion are the fields of responsibility. Where they would be housed is a matter of real conjecture. Good versus evil. Viewing severe and violent criminal behaviour within the frame of good versus evil does bring something helpful to the dialogue. When using the construct of evil, it follows logically to discuss some people who are irredeemable and not salvageable. These ideas, then, allow for a discussion of how big a risk these people represent to public safety. It further includes the realities that these risks are ongoing and will not go away over time or with treatment. These are concepts which do include the possibilities of indeterminate or very lengthy sentencing and preventative detention (Ruffles, 2004). Courts avoid examining this thread due to the likelihood of adding morality to legalities. Most modern legal systems prefer to think of themselves as rational and logical, without emotional overtones. When we use the criminal justice system logic, a person must deserve the punishment rather than simply prevention of future harm. When we use the psychiatric system logic, the person must be not responsible for their actions in order to intervene in a way that might protect the public. (S. J. Morse, 2004) Ruffles (2004) asserts that when legal venues avoid the concept of evil, they gravitate toward mental health professionals to explain extreme and dreadful acts. Mental health experts, then, avoid the concept of evil and instead look to explanations that are pragmatic, practical and can be scientifically measured in some manner. The mental health field responds with diagnoses of antisocial personality disorder and psychopathy (Ruffles, 2004). Personal Responsibility There is a dilemma with regard to severe and violent personality disorders. People who commit crimes that most ordinary citizens would call evil are not in actually crazy, insane or mad. They know the difference between right and wrong. This issue of responsibility is an important one. Many people who make mental health recommendations think about root causes. On the one hand, core causes are critically important in finding ways and means of helping people who suffer the pangs of mental illness. On the other, the concept of root causes is a slippery slope that leads to removal of responsibility. People are responsible for what they do; S. J. Morse (2004b) clarifies, just because their behaviour is outrageous or that there are underlying causes doesn't remove that responsibility. Additionally, it doesn't follow that a person becomes not responsible for their actions simply because we can describe or label them. The characteristics of a person vulnerable to the diagnosis of Severe Dangerous Personality Disorder were mentioned at the beginning of this paper. Having limited empathy or no sense of responsibility doesn't relieve someone of the responsibility for their actions. A low frustration tolerance or highly aggressive reactions doesn't mitigate the dreadfulness of appalling behaviours. Lack of guilt responses when doing something wrong doesn't eliminate the harm done to another. Routinely ascribing blame to others and refusing to see where one is responsible doesn't mean that it is so. These ideas are equally true for the characteristics of inability for relationships, unable to learn from experiences, and constantly irritable traits named by Home Office (2006). Furthermore, just because there may be reasons that they developed into people who lack a conscience and empathy doesn't remove their responsibility for their actions. This writer contends that the person with a severe and dangerous personality disorder makes a choice, a decision to take the actions they take. Relieving them of that responsibility through either a criminal justice or mental health paradigm is an error in this dialogue. Conclusion This has been a discussion of issues regarding people who engage in violent predatory behaviours upon individuals in society. The first issue addressed is this writer's opinion that a decision needs to be made regarding which frame of reference to use when discussing such a serious social problem. Criminal justice has a variety of theories, most of which contain a reference to responsibility for one's actions. This writer supports a balanced criminal theory where the consequences of crime match the actual damage done to individuals or society. In the mental health discipline, people are given diagnoses. This leads to labels which are really only a name or a description, not an explanation or a solution. One additional factor that arises with mental health approaches is the search for explanations and root causes. This is a practical strategy in one sense. If such explanations or causes can truly be found, they would eventually lead to solutions and ways to remedy the problem. Unfortunately, today, in the case of violent and dangerous severe personality disorders, this sort of thinking leads to excuse making and removal of responsibility. One paradigm which includes personal responsibility is that of good versus evil. Some theorists view the actions of a predator as patently evil. Issues regarding personal responsibility remain this writer's favoured concepts. In point of fact, all descriptions and labels of such violent individuals include their propensity to blame others and refuse to accept responsibility for their actions. Since they actually know right from wrong and are aware of their surroundings, they should be held accountable for their actions. Preventative detainment remains a question in this writer's mind, but life imprisonment for a predatory horrific crime does seem quite reasonable. References Appelbaum, P. (2005). Law & Psychiatry: Dangerous Severe Personality Disorders: England's Experiment in Using Psychiatry for Public Protection. Psychiatric Services, 56, 397-399. Retrieved May 5, 2007, from American Psychiatric Association: http://psychservices.psychiatryonline.org Crews, G. A., Gillespie, W., & Stanko, S. (2004). Living in prison: A history of the correctional system with an insider's view. [Retrieved April 27, 2006, from Questia database: http://www.questia.com.]. Westport, CT: Greenwood Press. Eastman, N., & Starling, B. (2005). Mental disorder ethics: Theory and empirical investigation. Investigating Ethics and Mental Disorders. Paper presented at Wellcome Trust's biomedical ethics programme. Retrieved May 1, 2007, from http://jme.bmj.com/: BMJ & JME. Home Office. (1999). Managing dangerous people with severe personality disorder: Proposals for Policy Development. Retrieved May 1, 2007, from http://www.homeoffice.gov.uk/ Mason, T. (2006). Dangerous severe personality disorder in the United Kingdom. Journal of Forensic Nursing, 2(2), 90-92. Retrieved May 2, 2007, from Health Reference Center Academic: www.galegroup.com/world Morse, S. J. (2004). Preventive Confinement of Dangerous Offenders. Journal of Law, Medicine & Ethics, 32(1). Retrieved May 2, 2007, from www.galegroup.com/world Mullen, P. E. (1999). Dangerous people with severe personality disorder: British proposals for managing them are glaringly wrong and unethical. BMJ, 3(19), 1146-1147. Retrieved May 2, 2007, from http://www.bmj.com/ Pitfalls in detaining the 'dangerous' (treatment and detention of people with severe personality disorder). (2002). The Practitioner, 145. Retrieved May 1, 2007, from Health Reference Center Academic: www.galegroup.com/world Ruffles, J. (2004). Diagnosing evil in Australian courts: Psychopathy and antisocial personality disorder as legal synonyms of evil. Psychiatry, Psychology and Law, 11(1), 113-122. Retrieved May 2, 2007, from www.galegroup.com/world Szasz, T. (2003). Psychiatry and the control of dangerousness: On the apotropaic function of the term "mental illness". Journal of Medical Ethics, 29, 227-230. Retrieved May 3, 2007, from BMJ Publishing Group & Institute of Medical Ethics: http://jme.bmj.com Tittle, Charles R., CT. (2000). Theoretical Developments in Criminology. Criminal Justice, 1, 51-101. Read More