Libertarianism and Mental Illness
Dr. Thomas Szasz is a prolific writer in the field of mental illness. His opinion on the matter is encapsulated in the title of his most famous book, “The Myth of Mental Illness.” Dr. Szasz is also well-known for his libertarian principles. This is exemplified by the terms “pharmacracy” and “the therapeutic state” coined by him.
To put it concisely, Dr. Szasz believes that:
1. mental illness does not exist;
2. the state should not interfere in health care or other personal matters.
As Dr. Szasz has written profusely on these two subjects, usually together, some people have jumped to the conclusion that rejecting the existence of mental illness and libertarianism are somehow connected. This is not necessarily so. A person can believe that mental illness does not exist, and yet not be a libertarian. On the other hand, in his recently published book “Faith in Freedom,” Dr. Szasz demonstrates that most famous people identified with libertarianism did/do, in fact, believe in the existence of mental illness.
The point that Dr. Szasz has dedicated his life to making, is that the concept of health and illness does not justify state interference. He endorses separation of Medicine and State, just as he endorses separation of Church and State.
So what does justify state interference? Does the concept of evil justify state interference? My opinion is that it does not. Good and evil are concepts borrowed from religion, even when they are used by atheists, just as health and illness are concepts borrowed from medicine, even when they are used by lay people. Neither concept is a valid base for coercion of individuals by the state, whether law-abiding or not.
Coercion by the state is justified only when someone has violated the freedom of another person, that is, violated the other person’s right to life, liberty, or property. This we call a crime. (A victimless act is not a crime, and should not be criminalized.) It is reasonable to assume that whoever commits such a violation may do it again, and must therefore be stopped, which requires coercion. Protecting the liberty of its non-criminal citizens is the state’s proper responsibility.
The state should not, and indeed cannot delve into the reason for the crime, except in the case of self-defense. Ascribing it to illness poses the risk that a violent criminal will be declared recovered, and released to strike again. Ascribing it to evil poses the risk that a violent criminal will be declared reformed, and released to strike again. Conversely, state recognition of illness or evil may criminalize acts that are not crimes. Furthermore, as illness and evil are concepts that are rightly separate from the state, a judge has no tools for determining them.
Criminals should be released only when they have completed their sentence. If the sentence was short, the crime must have been light, thus the released criminal does not pose a serious risk to others. When the crime was so grave that a life sentence is imposed, there should never be a release, whether recovered/reformed or not. It is wholly compatible with human rights to provide a convicted criminal with medical and/or spiritual assistance while he is serving his sentence, provided he asks for it. This then becomes a private matter between the convict and his doctor and/or spiritual advisor.
In summary, in my opinion both illness and evil are concepts borrowed from institutions which are, or should be, separate from the state, and therefore cannot be invoked either to absolve a person suspected of a crime or to convict him. Both concepts are irrelevant to the state.