Mental Illness or Moral Illness?
This past week two events, both involving victims, created headlines: the massacre in Aurora, Colorado, and the judgment against Penn State for their leadership’s failure to report sexual predator Jerry Sandusky to the police.
As I read the news about last week’s horrific shooting, I wondered how suspect James Holmes would be portrayed in the media. The media are prone to jump to conclusions about a suspect’s mental health, as if reporters are expects on criminal motivation and mental health. I’ve written about this tendency twice before: A Second Arizona Tragedy and Sadly, Here We Go Again.
Surprisingly, I have seen very little speculation about shooting suspect James Holmes’ mental health. Instead of speculating whether or not Holmes was mentally ill, it would be more fitting to have a national discussion about moral illness. We talk about “physical illness” and “mental illness”, but not “moral illness”. A quick search on Google yielded 1.7 million hits for “physical illness” and over 31 million hits for “mental illness” but less than 15,000 for “moral illness”, and many of these were references to one book which has that term in its title.
My friend Herm Keizer has been doing good work on the moral challenges that military personnel face in the line of duty which he calls “moral injury.” If people can be injured morally, and I believe we can, why can we not also become ill morally?
Health and illness are not distinct categories but are part of a continuum. No one has perfect physical or mental health. But somewhere on that continuum, professionals need to make a judgment call whether a condition someone lives with needs to be treated as an illness or not. Medical doctors have specific criteria to use to determine whether to begin treating a physical illness. Similarly, psychiatrists and psychologists have specific criteria spelled out in the DSM-IV to determine whether someone has mental illness.
However, determining the criteria for labeling someone “mentally ill” or whether or not to label some set of symptoms as “mental illness” is highly controversial, as the raging debate about the upcoming DSM-V shows. If this is true about mental illness, it would be much more true if we began talking about moral illness.
Here are two challenges in talking about moral illnesses. First, determining criteria for moral illness assumes that some standard exists for moral health. Although nearly all people have codes of conduct, those codes are idiosyncratic. It would be impossible for a society to agree upon a set of criteria that would establish that someone is, beyond reasonable doubt, morally ill. Second, to modify the word “illness” with the word “moral” stretches the definition of both. Usually, we think of “illness” as a condition that comes upon a person over which he had little choice. In contrast, we talk about “moral” as having to do with one’s volition. “Moral illness” implies both volition and the lack of it, and therefore it implies that one is both responsible for his actions and not responsible.
Still, I wonder if “moral illness” is a term and concept that needs to become part of our dialog about human depravity. I think of moral illness as a condition of the soul in which one has so abused his concept of right and wrong for so long, that his choices descend further and further from common mores into a dark world where people can commit mass murder or sexually abuse young boys.
Did a sexual predator like Jerry Sandusky begin his career at Penn State with the hope that he would be able to uses the perks of his position to sexually abuse boys? Maybe. But maybe through the series of little rationalizations over a long period of time he move from brief fantasies into out and out abuse. Did Joe Paterno and the other leadership at Penn State decide one day, “Let’s engage in a systematic cover up to protect our friend and assistant coach, even though he will likely harm more young victims in years to come”? Maybe. More likely, little decisions and small rationalizations grew a morally ill culture among the Penn State leadership so that Sandusky could continue in his predatory ways for years.
Murder suspect, James Holmes, is described by the people who grew up with him as quiet, withdrawn, and very smart. One of his high school classmates describe Holmes as “a little nerdy. He was really shy, really quiet, but really nice and sweet.” Did this “really nice and sweet” young man decide one day to become a mass murderer? Maybe. Did a mental illness so consume him the he did not know that killing people is wrong (the heart of an insanity defense)? Maybe. Or maybe little decisions along the way, little rationalizations, allowed him to drift so far from societal mores that he booby-trapped his apartment then headed to a movie theater and opened fire on a crowd?
What do you think? Should we talk more about moral illness? How would you define it? How does one become morally ill?