Moral Skepticism about Mental Disorders
A person is said to be suffering from a mental disorder if he or she is observed to have a change in behavioral patterns which may cause suffering or impair their ability to function in everyday life and which is not a social or developmental norm. So goes the definition by many medical professional, which forms the basis of hundreds of thousands of diagnosed mental illnesses. However, over the years, there has been a sharp criticism on the best definition of a mental condition and at what level does a person surpass the normalcy criteria and cross the border in mental disorder. Lack of coherence in the definition has, thus, rendered the diagnoses contentious, and many critics are of the idea that those people who are diagnosed as having a psychiatric problem have had their respect and dignity as autonomous individuals greatly violated. In this essay, an argument is presented in favor of those who affirm that diagnosing and labeling an individual as suffering from a mental condition is a violation of their respect as human beings since the grounds on which such decision is based are contestable. To a large extend, it could be stated there is no such thing as a mental disorder; such people only have mental disturbances.
It is not proper to classify people as having a mental disorder, because the very definition of a mental disorder fails to define who should fall within the category of a mental disorder or who should be classified as having only a mental disturbance. When a person had been labeled as having a mental disorder, it is automatically assumed that he or she is not in a capacity to make a logical decision; that his/her mental faculties are, thus, declared incompetent upon the diagnosis. Those in the neighborhood of such person start assuming that whatever the mental disorder person does, he does not bear entire responsibility for his actions. In other words, these people are no longer regarded as human beings in the mental sense, but rather as robotic human beings, recognized as being alive by virtue presence of some physiological functions like breathing, heart beating, ability to see etc., but regarded to be mentally dead. People start making decisions on their behalf, ascribing different meanings in what these ‘mental disorder’ people do instead of asking the individual to tell them. This shows that the mental dignity, respect and appreciation of a person diagnosed as suffering from a mental illness are thrown out the window the minute the diagnosis is made. Can the treatment this people receive be called respectable by any sense? The answer would be: No. If somebody walked on the street with only a pair of thongs without the damning label, by diagnosis, that she has a mental disorder, he would be assumed having a new sense of fashion. Such person would not be assumed not to be responsible for his actions. Nobody would say he walked in that piece of garment because he did not know it was ‘wrong’. Instead, such words as “freedom of choice, sense of fashion and liberalism would be used in his defense since the person made a conscious choice on how to dress. If the case is turned around so that we have a person who has been labeled as suffering from a mental disorder walking on the streets with a pair of thongs, people will not hold him responsible for the choice of clothing. Instead of saying that the person did it by choice, they will say he did it because he has a mental disorder. This shows that a person said to have a mental disorder is assumed to be ‘governed’ by the condition in all the decisions she or he makes as opposed to those who have not been labeled as suffering from a mental condition. Hence, it is clear that if we expect dignity of every individual to be preserved and for every person to be held responsible for their actions, the diagnosis of a mental disorder should be avoided and made only in the extreme cases.
The diagnosis of mental disorder in itself is based on contestable values, something that makes it contestable in itself. As stated in the definition of mental disorder above, one is considered as having a mental disorder if their behavior does not reflect social or developmental norms. It is not clear what meant by ‘social or developmental norm’ since the idea of being normal or abnormal is subjective and dependent on social and intellectual context of the definition. It can never be said that something is ‘universally’ normal in application to every person. Supposing that in a class of fifty students taking science, there is one student who, during science lectures, takes to playing guitar. And suppose that he still passes his science exams well despite not paying much attention to studies ; shall it be labeled as a mental disorder case just because he does not behave as other students during lectures given that the norm is to be attentive and quiet? The answer, some would agree, is no, given that the student is aware of his responsibility to pass his science exams despite playing guitar at lecture time. Much to our surprise, many diagnoses of attention deficit hyper-activity disorders among school children have been based on a subjective observation that people do not behave like others. For this reason, being unique is considered a mental disorder. In broad sense such comparison implicates that what many people do is to be regarded as normal while what only a few people do is to be regarded as abnormal. Thus, not wearing clothes in a nudist camp is normal, while not wearing them in other areas will be regarded as a mental disorder. Such diagnosis appeals to values that change depending on the people involved and location of an individual. Since it is not based on absolute criteria that does not change, the diagnosis of an individual as suffering from a mental condition is subjective and, as such, violation of one’s right to autonomy and responsibility in making their decisions.
The same applies to the diagnosis of somatic illnesses. Though a somatic illness is defined as the one that affects body organs or organ system making them fail to function as they should physiologically, we do not know how exactly they should be functioning (following their evolutional continuum) which renders the criteria contestable. A change from normal state, like having a fever, can be taken as somatic illness and given medical prescription despite it being a way the body fights against disease. Thus, some of the diagnoses made are deemed to be a problem to humanity. But, since we do not know how exactly the body would respond to external threat, it is unreasonable to label them as somatic illnesses. The same argument has been made concerning loss of appetite during pregnancy which might be bodily way of protecting the fetus from harmful chemicals in the food. Unfortunately, labeling suchlike deviations as a disease and administering drugs as the only way to deal with them is referred to as ‘normal’.
In my view, moral skepticism is acceptable in rejecting the diagnosis of individuals as having mental disorders. One of the reasons why I agree is that the indignity with which many of the patients are treated after the diagnosis only serves to benefit those who diagnosed them as having a mental disorder. Some of them are put in mental institutions, not because they are expected to benefit and come out better people, but rather because they are regarded as a problem or nuisance by others. Thus, this diagnosis is not made for the benefit of individuals, but for the ‘good’ of the society. In a sense, if it were not that these people are of a human species, they would have been disposed just like old machines or appliances. Additionally, they suffer indignity of being considered incapable of performing work at the same level mentally as other members of the society. The other reason why such diagnosis should not be allowed is that some of the characteristics that make the basis of the diagnosis are merely different from the norm rather than abnormal. For instance, students overtly concerned about grades hypothetically being diagnosed of grade obsessive disorder just because they have adopted a different view on how to achieve their goals. Just like the fashion designers who come up with new costumes but designed differently, an allowance should be made for every individual to behave differently without the fare of damning label of a mental disorder.
Diagnosis of mental disorder is a contentious issue with others (me included), arguing that it should be at least avoided if not excluded. In the above essay, I have provided different reasons and arguments as to why it is a violation of dignity and autonomy for people to be labeled as suffering from a mental disorder. People may have mental disturbances like depression after loss of a loved one, which would be improper to diagnose and label as a mental disorder. Thus, the term mental disorder is inappropriate, I would prefer use of the word disturbance instead.