Abstract

This dissertation is a philosophical theory of involuntary civil commitment to mental hospitals. It rationally reconstructs what the author takes to be the standard, positivistic theory of civil commitment. This requires describing the standard assumptions, criticizing them and proposing an alternative theory. Using counter-examples, the author attacks the standard theory's presupposition that certain familiar boundaries--e.g., the voluntary/involuntary boundary and the civil/criminal boundary--are fundamental. ;The first three chapters analyze the concept of norms of involuntary civil hospitalization of the mentally ill. The author contends that cognizable intervention occurs even when commitment is voluntary and that commitment can be a quasi-criminal process. Commitment works by discipline, supervision and custody as well as detention and treatment. It controls social incapacitation, not dangerous mental illness. Schizophrenia is breakdown of personal identity, but social control by commitment is not restricted to insane persons at moments of incompetence. As well as imposing involuntary controls on crazy behavior, the norms of commitment law are rational guides enforcing nondeviant behavior in sane persons and the sane moments of the mentally ill. These norms are directed at both citizens and officials. Because commitment imposes sanctions on residual deviance, the content of these norms cannot be exhaustively specified. Still, official discretion in imposing commitment can be constrained by law. ;The two standard justifications of commitment for danger to self--parens patriae theory and principles of paternalism--are inadequate. The fourth chapter proposes a theory of coercive sanctions parallel to the theory of criminal punishment. This unites the justification of commitment for danger to self with that for danger to others and combines retributive with consequentialist elements. ;One appendix traces the history of commitment, including the conceptualization of, institutional responses to and controls on insanity. The medical model, custodialism, deinstitutionalization, legal reform movements and disciplinary functions are discussed. A second appendix discusses criminalization, i.e., committing patients through the criminal justice system. This appendix verifies the author's assumption that commitment is part of a unified system of social control. A third appendix is an administrative rule for commitment, drafted by the author