Is There a Right to Hold a Delusion? Delusions as a Challenge for Human Rights Discussion
- 257 Downloads
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.
KeywordsFreedom of opinion Freedom of thought Delusions Psychosis Antipsychotic medication
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.
This work was supported by the Alfred Kordelin Foundation.
- Beauchamp TL, Childress JF (1989) Principles of biomedical ethics, 3rd edn. Oxford University Press, New York and OxfordGoogle Scholar
- 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.
- Berrios GE (1991) Delusions as “wrong beliefs”: a conceptual history. Br J Psychiatry 159(14):6–13Google Scholar
- Bortolotti L (2010) Delusions and other irrational beliefs. Oxford University Press, OxfordGoogle Scholar
- 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
- 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.
- Convention on the Rights of the Child (1989) http://www2.ohchr.org/english/law/crc.htm. Accessed 22 September 2011.
- 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.
- DSM-IV-TR (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC, Text RevisionGoogle Scholar
- 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.
- Etheridge AU, Chamberlain JR (2006) Application of sell v. United states. J Am Acad Psychiatry Law 34(2):248–250Google Scholar
- 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.
- Ford MD (1980) The psychiatrist’s double bind: the right to refuse medication. Am J Psychiatry 137(3):332–339Google Scholar
- Freckelton I (2004) Coercing fitness for trial: mandating efficacious pharmacotherapy. Sell v United States. Psychiatry Psychol Law 11(1):174–179Google Scholar
- 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
- 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.
- 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
- 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
- Heinimaa M (2008) The grammar of psychosis. Doctoral dissertation. Turun yliopiston julkaisuja, sarja 823. Turun yliopisto, TurkuGoogle Scholar
- 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
- ICCPR (1966) International covenant on civil and political rights. http://www2.ohchr.org/english/law/ccpr.htm. Accessed 22 September 2011.
- Justice Stevens (1990) Washington v. Harper, 494 U. S. 210 (1990). http://supreme.justia.com/us/494/210/case.html. Accessed 22 September 2011.
- Kortteinen J (1996) Sananvapaus ihmisoikeutena. In: Nordenstreng K (ed) Sananvapaus. WSOY, Helsinki, pp 32–88Google Scholar
- 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
- Nowak M (1993) U.N. Covenant on civil and political rights. CCPR commentary. N.P Engel Publisher, Kehl, StrasbourgGoogle Scholar
- 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
- Ovey C, White RCA (2006) Jacobs & White. The European convention on human rights, 4th edn. Oxford University Press, OxfordGoogle Scholar
- 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
- 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.
- 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.
- Radden J (2011) On delusion. Routledge, London and New YorkGoogle Scholar
- Rennie v. Klein (1981) http://openjurist.org/653/f2d/836/rennie-v-klein-m-d-m-d. Accessed 22 September 2011.
- Sass LA (1994) The paradoxes of delusion. Wittgenstein, Schreber, and the Schizophrenic mind. Cornell University Press, Ithaca and LondonGoogle Scholar
- Scheinin M (2000) Freedom of thought, conscience and religion. Stud Theol 54:5–18Google Scholar
- Seppo J (2003) Uskonnonvapaus 2000-luvun Suomessa. Edita, HelsinkiGoogle Scholar
- 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
- 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
- Szazs T (1990) Law and psychiatry: the problems that will not go away. J Mind Behav 11(3–4):557–563Google Scholar
- Tahzib BG (1996) Freedom of religion or belief. Ensuring effective international legal protection. Martinus Nijhoff Publishers, HagueGoogle Scholar