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Ethical Theory and Moral Practice

, Volume 16, Issue 4, pp 829–843 | Cite as

Is There a Right to Hold a Delusion? Delusions as a Challenge for Human Rights Discussion

  • Mari Stenlund
Article

Abstract

The analysis presented in this article reveals an ambiguity and tension in human rights theory concerning the delusional person’s freedom of belief and thought. Firstly, it would appear that the concepts ‘opinion’ and ‘thought’ are defined in human rights discussion in such a way that they do include delusions. Secondly, the internal freedom to hold opinions and thoughts is defined in human rights discussion and international human rights covenants as an absolute human right which should not be restricted in any situation for any reason. These views, if understood literally, imply that a person has an absolute right to hold a delusion. However, this kind of conclusion has not been made in mental health laws, the ethical principles guiding psychiatric care or the practice of psychiatry. Instead, they assume that the use of involuntary antipsychotic medication is justified even thought its purpose is to influence delusions. The ambiguity and tension in human rights theory concerning the freedom of belief and thought challenge us to develop this theory within an interdisciplinary discussion so that people with delusions are taken into account properly.

Keywords

Freedom of opinion Freedom of thought Delusions Psychosis Antipsychotic medication 

Notes

Acknowledgements

I’m grateful to professor Jaana Hallamaa and assistant professor Ville Päivänsalo for their comments and suggestions. I am also grateful to the reviewers for bringing various important points to my attention.

Conflict of Interests Declaration

I have no conflicts of interests.

Funding Statement

This work was supported by the Alfred Kordelin Foundation.

References

  1. Bayne T, Pacherie E (2005) In defence of the doxastic conception of delusions. Mind Lang 20(2):163–188CrossRefGoogle Scholar
  2. Beauchamp TL, Childress JF (1989) Principles of biomedical ethics, 3rd edn. Oxford University Press, New York and OxfordGoogle Scholar
  3. Benson v. Terhune E (2002) 304F. 3d 874. United States Court of Appeals, Ninth Circuit. Argued and Submitted July 10, 2002. Filed September 11, 2002. http://openjurist.org/304/f3d/874/benson-v-terhune-e. Accessed 21 September 2011.
  4. Berrios GE (1991) Delusions as “wrong beliefs”: a conceptual history. Br J Psychiatry 159(14):6–13Google Scholar
  5. Bortolotti L (2010) Delusions and other irrational beliefs. Oxford University Press, OxfordGoogle Scholar
  6. Breneman DA (2004) Forcible antipsychotic medication and unfortunate side effects of sell v. United states, 539 U.S. 166, 123 S.Ct.2174 (2003). Harv J Law Publ Pol 27(3):965–984Google Scholar
  7. Campbell and Cosans v. United Kingdom (1982) Judgement of 25 February 1982. European Court of Human Rights. http://cmiskp.echr.coe.int/tkp197/view.asp?item=2&portal=hbkm&action=html&highlight=Campbell%20|%20Cosans&sessionid=78834299&skin=hudoc-en. Accessed 22 September 2011.
  8. Convention on the Rights of the Child (1989) http://www2.ohchr.org/english/law/crc.htm. Accessed 22 September 2011.
  9. Currie G, Jureidini J (2001) Delusion, rationality, empathy: commentary on martin davies et al. Philos Psychiatry Psychol 8(2/3):159–162CrossRefGoogle Scholar
  10. Currie G, Ravenscroft I (2002) Recreative minds. Imagination in philosophy and psychology. Oxford University Press, OxfordCrossRefGoogle Scholar
  11. Dichand and others v. Austria (2002) Judgement of 26 February 2002 (Final 26/05/2002). European Court of Human Rights. http://hudoc.echr.coe.int/sites/eng/pages/search.aspx?i=001-60171. Accessed 3 July 2012.
  12. DSM-IV-TR (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC, Text RevisionGoogle Scholar
  13. ECHR (1950) European convention of human rights. Convention for the Protection of Human Rights and Fundamental Freedoms. http://www.echr.coe.int/ECHR/EN/Header/Basic+Texts/The+Convention+and+additional+protocols/The+European+Convention+on+Human+Rights/. Accessed 22 September 2011.
  14. Etheridge AU, Chamberlain JR (2006) Application of sell v. United states. J Am Acad Psychiatry Law 34(2):248–250Google Scholar
  15. Evans C (2001) Freedom of religion under the ECHR. Oxford University Press, OxfordCrossRefGoogle Scholar
  16. Finnish Constitution (1999) Suomen perustuslaki 11.6.1999/731. http://www.finlex.fi/fi/laki/ajantasa/1999/19990731?search[type]=pika&search[pika]=perustuslaki. Accessed 22 September 2011.
  17. Ford MD (1980) The psychiatrist’s double bind: the right to refuse medication. Am J Psychiatry 137(3):332–339Google Scholar
  18. Freckelton I (2004) Coercing fitness for trial: mandating efficacious pharmacotherapy. Sell v United States. Psychiatry Psychol Law 11(1):174–179Google Scholar
  19. Glasgow R (2004–2005) Forced medication of criminal defendants and the unintended consequences of Sell v. United States. J Contemp Health Law Pol 21: 235–258Google Scholar
  20. Gosden R (1997) Shrinking the freedom of thought: How involuntary psychiatric treatment violates basic human rights. www.freewebs.com/administrationdelajustice/documents/gosden.pdf. Accessed 22 September 2011.
  21. Gutheil TG (1980) In search of true freedom: drug refusal, involuntary medication, and “rotting with your rights on”. Am J Psychiatry 137(3):327–328Google Scholar
  22. Hamilton A (2007) Against the belief model of delusion. In: Chung MC, Fulford KWM, Graham G (eds) Reconceiving schizophrenia. Oxford University Press, Oxford, pp 217–234Google Scholar
  23. Hayes JR (2004) Sell v. United States: is competency enough to forcibly medicate a criminal defendant? J Crim Law Criminol 94(3):657–686CrossRefGoogle Scholar
  24. Heilbrun K, Kramer GM (2005) Involuntary medication, trial competence, and clinical dilemmas: implication of Sell v. United States for psychological practice. Prof Psychol: Res Pract 36(5):459–466CrossRefGoogle Scholar
  25. Heinimaa M (2008) The grammar of psychosis. Doctoral dissertation. Turun yliopiston julkaisuja, sarja 823. Turun yliopisto, TurkuGoogle Scholar
  26. Henrichs, KL (2004–2005) Forcible antipsychotic medication: should the mentally ill criminal defendant celebrate or fear. Sell v. United States. 90 Iowa Law Rev, 2005–2005: 733–764Google Scholar
  27. ICCPR (1966) International covenant on civil and political rights. http://www2.ohchr.org/english/law/ccpr.htm. Accessed 22 September 2011.
  28. Justice Stevens (1990) Washington v. Harper, 494 U. S. 210 (1990). http://supreme.justia.com/us/494/210/case.html. Accessed 22 September 2011.
  29. Kapur S (2003) Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 160(1):13–23CrossRefGoogle Scholar
  30. Kortteinen J (1996) Sananvapaus ihmisoikeutena. In: Nordenstreng K (ed) Sananvapaus. WSOY, Helsinki, pp 32–88Google Scholar
  31. Langlaude S (2007) The right of the child to religious freedom in international Law. Martinus Nijhoff Publishers, Leiden-BostonCrossRefGoogle Scholar
  32. Lerner N (2006) Religion, Secular Beliefs and Human Rights. 25 Years After the 1981 Declaration. Martinus Nijhoff Publisher, Leiden-BostonCrossRefGoogle Scholar
  33. Lingens v. Austria (1986) Judgement of 8 July 1986. European Court of Human Rights. http://cmiskp.echr.coe.int/tkp197/view.asp?item=1&portal=hbkm&action=html&highlight=Lingens%20|%20v.%20|%20Austria&sessionid=78835789&skin=hudoc-en. Accessed 22 September 2011
  34. Nowak M (1993) U.N. Covenant on civil and political rights. CCPR commentary. N.P Engel Publisher, Kehl, StrasbourgGoogle Scholar
  35. Ojanen T, Scheinin M (2011) Uskonnon ja omantunnon vapaus (PL11§). In: Hallberg P, Ojanen T, Scheinin M, Tuori K, Viljanen VP (eds) Perusoikeudet. WSOYpro, Helsinki, pp 413–458Google Scholar
  36. Ovey C, White RCA (2006) Jacobs & White. The European convention on human rights, 4th edn. Oxford University Press, OxfordGoogle Scholar
  37. Partch KJ (1981) Freedom of conscience and expression, and political freedoms. In: Henkin L (ed) The international bill of rights. The covenant on civil and political rights. Columbia University Press, New York, pp 209–245Google Scholar
  38. Pretty v. The United Kingdom (2002) Judgement of 29 April 2002. European Court of Human Rights. http://cmiskp.echr.coe.int/tkp197/view.asp?item=1&portal=hbkm&action=html&highlight=pretty%20|%20v.%20|%20united%20|%20kingdom&sessionid=78835847&skin=hudoc-en. Accessed 22 September 2011.
  39. PPPMI (1991) Principles for the protection of persons with mental illness and the improvement of mental health care. http://www2.ohchr.org/english/law/principles.htm. Accessed 22 September 2011.
  40. Radden J (2011) On delusion. Routledge, London and New YorkGoogle Scholar
  41. Rennie v. Klein (1981) http://openjurist.org/653/f2d/836/rennie-v-klein-m-d-m-d. Accessed 22 September 2011.
  42. Sass LA (1994) The paradoxes of delusion. Wittgenstein, Schreber, and the Schizophrenic mind. Cornell University Press, Ithaca and LondonGoogle Scholar
  43. Scheinin M (2000) Freedom of thought, conscience and religion. Stud Theol 54:5–18Google Scholar
  44. Seppo J (2003) Uskonnonvapaus 2000-luvun Suomessa. Edita, HelsinkiGoogle Scholar
  45. Single G (2003–2004) United States v. Sell: Involuntary administration of antipsychotic medication. Are you dangerous or not? J Law Health 18: 297–321Google Scholar
  46. Stephens GL, Graham G (2007) The delusional stance. In: Chung MC, Fulford KWM, Graham G (eds) Reconceiving schizophrenia. Oxford University Press, Oxford, pp 193–215Google Scholar
  47. Stephens GL, Graham G (2004) Reconceiving delusion. Int Rev Psychiatry 16(3):236–241CrossRefGoogle Scholar
  48. Szazs T (1990) Law and psychiatry: the problems that will not go away. J Mind Behav 11(3–4):557–563Google Scholar
  49. Tahzib BG (1996) Freedom of religion or belief. Ensuring effective international legal protection. Martinus Nijhoff Publishers, HagueGoogle Scholar
  50. Winick BJ (1997) The right to refuse mental health treatment. American Psychological Association, Washington DCCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Department of Systematic Theology, Faculty of TheologyUniversity of HelsinkiHelsinkiFinland

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