James Grigson aka "Doctor Death," "The Hanging Psychiatrist," and "The Doctor of Doom"

If you have read some of my other posts on this blog, you know that I get offended by the author of this book. Frequently. He has a lot of animosity toward psychology, and it shows in sarcastic quotes like, "Because life is hard, society has designated mental health practitioners as the experts on all of life's problems." Then I read this chapter, about a psychiatrist called the "Hanging Psychiatrist." James Grigson, a Dallas boy, certified by the American Board of Neurology (and a graduate of Baylor! Although the book might mean Baylor Medical School, it's not too clear about that...), has recommended the death penalty for about 60 criminals on the grounds that the defendant is a sociopath, incurable and likely to commit violent acts again.

Sounds reasonable, right? I mean, criminals who commit violent acts surely have some sort of mental illness? Isn't it likely that sociopathy could be a good explanation? And furthermore, couldn't a psychiatrist give some insight on how likely it would be for a criminal to commit more violent acts? Well, for one thing, the APA had dropped sociopathy from the Diagnostic and Statistical Manual (DSM) 10 years ago when Dr. Grigson was investigated. In addition, an APA task force concluded that psychiatrists were not capable of making conclusive judgments about the likelihood for a person to commit more violent acts. The APA also limited the power of psychiatric testimony, which had become common in Texas and other states and, as Grigson's example choice, may not give the best grounds for tough decisions like the death penalty.

This interesting chapter brings up two ethical ideas. One is the importance of honesty and citing your sources. Earlier this week in discussion board we talked about how we are "consumers of information." A lot of us have the unfortunate tendency to take everything we say at face value, especially facts about science or medicine. This makes sense...science can be difficult to understand (I had a D in chemistry to prove that last year). Not many of us own a copy of a DSM or even a basic biology textbook. Although we should always fact check when we can and take any information we get with a grain of salt, this also means that "experts" have a duty to present the facts and back them up. Throwing out a lot of technical jargon and a diagnosis that "sounds right" to me does a great disservice to whatever field you are an expert in and, in the case of James Grigson, puts someone's life in your hands. Grigson had the power to persuade or dissuade juries with one use of a technical term and a reasonable prediction. It is a responsibility that cannot be taken lightly.

The other ethical issue is interesting and a little more complicated. In this chapter, Winslade offers ab explanation of why Grigson used the diagnosis sociopath when he knew it was no longer used: "Grigson's use of the sociopath diagnosis as well as his willingness to be very certain about his judgements of future mental illness are...closely related to the idea of mental illness as sin than to the idea of mental illness as disease."

Is mental illness sin? Or, rather, are the things people do as a consequence of mental illness sin? Are the two things mutually exclusive? This blog has been more about how things should go in court with insanity pleas, but I think this has been an underlying issue in all of it. Usually when I make this argument (especially about cold-blooded killers like Charles Manson) I ask...Is a rabid dog a sinner (just assume for a minute that most dogs have higher functionality)? I think most people would say no, but what about the mostly stable guy with episodes of intense anxiety who beats someone in a fit of rage...before he snaps out of it? Is sin only a function of how much remorse you are capable of feeling?

Finally, along those lines, the author brings up a point about homosexuality. Homosexuality actually used to be in the DSM as a mental disorder but was taken out because of all the ambiguities surrounding it. Is homosexuality a mental disorder? If so, can it be cured? Is homosexuality a sin? Or both? Or neither?

I'm asking far more questions than I'm answering but I think that's the point for this case. One thing that has always fascinated me (and annoyed me) is the fact that, no matter how much psychology tries to categorize people and disorders (and really anything that can be boiled down to statistics and labels) this task is simply impossible. People are not categories. They are moral beings with selfish desires and mood swings and disordered, sometimes pathological thinking. They may be diagnosed with a well-established mental disorder but it may look completely different form the person who has the same disorder. They may be empathetic or have a difficult time relating to people. They may kill and walk away without remorse or let their acts weigh on their consciousness forever. The fact is...we don't know. People aren't one or the other and in the case of psychological diagnostics this tends to raise more questions than answers.

~Kelsey