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hand for legislative regulation. As it is more than manifest that legislators can never have too much knowledge upon arty subject on which they undertake to legislate, and seldom indeed have enough, it is equally manifest that their minds should lie completely open to the reception of knowledge; that they should be incessantly and eagerly on the search for it; and that they can seldom look to any source so prolific in assistance as the press.
With an attention exerted, as that of British legislators now is, to the state of the provisions for the treatment of the insane, there is evidently no occasion to stimulate them to new legislative exertions. Perhaps it is more necessary to caution them against legislating too much. It is well known that this is an error into which legislatures have great temptation to run : it is also well known that it is an error of a very mischievous nature, from which many of the worst effects of legislation daily proceed: and it is an error, from the danger of which we are not able to regard the British legislature, on the present occasion, as altogether exempt. We deem it highly expedient to enter a caveat against it.
The class of persons for whose care a proper system of provisions is now required, is the class of those whose minds are in such a state that they are not fit to be entrusted with their own actions; and who, therefore, require to be placed under a guard. The mental infirmity may be such as to produce actions hurtful to themselves, or hurtful to others.
The objects, it is evident, at which, in such a case, legislative regulation should aim, are three : In the first place, that all those persons, who require this species of guard, should be placed under it: In the second place, that none but those who require it should be placed under it: In the third place, that all those who are placed under it, should be placed in circumstances as favourable to their well-being and recovery as possible. We shall offer a few remarks under each of these heads.
1. Provision ought to be made, that all those persons, the state of whose minds is such that they are unfit to be trusted with their own actions, should, without any exception, be placed under the proper restraint. This is the more necessary to be strongly recommended, as it has, hitherto, been almost entirely overlooked, while, in point of importance, it would be difficult to place it too high. Let us endeavour to conceive what would happen if insane persons were left to wander without controul; We shall then have a conception of the evil in its totality. Would not society be rendered almost insupportable? That portion of the insane whose disease produces actions hurtful to others, would place every man under the dread of assassination, into whose presence any of them were liable to come; and men would be compelled to destroy them like other dangerous animals, or be destroyed by their means.
With regard to the other class of the insane, whose infirmity produces actions hurtful to themselves, it is enough to say, that no state of suffering in which they can be placed by others, can surpass that in which the greater part of them would place themselves. A large proportion of them, indeed, would place themselves beyond the reach of suffering by a voluntary death. It is, therefore, abundantly certain, that both the well-being of society at large, and the well-being of the unhappy subjects of the disease, require that none of them should be left at liberty; and in no country in which the legislation is universally good, will an effectual provision for this purpose be wanting.
In the present state of this country, there is no great danger that madmen, known to be dangerous, should be left in possession of their liberty. The fear which is felt for themselves by men who can put in execution the powers of restraint, insures the application of them. There are two cases which chiefly require to be looked after. The first is that of indigent persons, not dangerous to others, of whom nobody takes charge. Of these it ought to be rendered imperative on their relations, when in adequate circumstances, or on parishes, when they are not, to take the proper care.
The next case is that of incipient madness, for which we are aware that an adequate provision is not easy to be made. It will be something to have called to it the attention of the legislature, and to bave produced a deeper sense of its importance than hitherto men in general appear to have possessed. If attention were paid to the number of murders perpetrated by the insane, upon themselves, their relatives, and others, either before they have been conceived to be insane, or before the disease has been conceived to be so violent as to require constraint, they would be found to surpass, in every year, the number of those who suffer a violent death in this country, by all other means taken together. The mass of mischief which is annually incurred by inattention to the beginnings of madness, and by leaving those on whom mental disease is encroaching, too long exempt from controul, is perhaps the greatest to which the calamity of madness, in the present state of its management in this country, really and truly gives birth. An act of parliament therefore ought, at the very least, to afford every encouragement for the application of restraint to persons in the very earliest stages of madness. Even mistakes, in this case, where no bad intention is rendered sufficiently probable, ought, in all cases, to be venial. The danger to personal liberty which may thence be apprehended, would, under a proper system of inspec
tion, be so very small, that it is altogether unworthy of comparison with the evil which it would prevent. A proper system of inspection would effectually cut off all the motives which any individual could have for the wrongful confinement of another; and it scarcely can be conceived that an attempt, from which nothing could be expected but detection, disgrace, and punishment, would ever be made. At the same time the decision ought not to be left entirely to relatives; whom frequently a false tenderness, and more frequently a false shame, induce to disguise the appearances of the disease, and bear with the patient, till the mischief is produced. A proper tribunal ought to be created, to which, in the case of any individual, it should be competent for any body to make application. As soon as the existence of disease is rendered probable, temporary restraint should be employed; because, if necessary, it need not be long: and the inconvenience to the individual is nothing, compared with the danger from which he himself, or others, are saved. How this tribunal is to be formed, it is for the practical wisdom of the legislature to decide.
2. Provision ought to be made sufficient to prevent the confinement of persons, as insane, for whom no such confinement is required. To this case the whole force in this country of legislative exertion, hitherto bestowed on the subject, has almost exclusively been applied. We are a people to whom it has become habitual to make the application of restraint to the individual a matter of prodigious importance; and our usual language, and usual feelings, confound two cases which are remarkably distinct.
The confinement of individuals, at the discretion of the high officers wielding the powers of government, it is impossible to regard as of too much importance; because the friends and defenders of good government, and its securities, might be the men on whom such confinement would fall; and the loss of every security for good government might be the result.
But there is another species of restraint which mere individuals may be tempted to produce, for some private advantage to themselves. Against this injury, all reasonable securities should betaken. But provided the impossibility is created, which it easily may, of continuing this injury without detection and punishment for any considerable length of time, a greater evil ought not to be incurred for the sake of avoiding another which can in no sense be regarded as considerable.
Although it was upon this point that the whole stress of the act of the 14th of the King was made to bear, the security which it provides is exceedingly imperfect. It required that no patient of a certain class should be received into a madhouse without an attestation of madness signed by a medical man. But the signa
ture of the most ignorant apothecary is sufficient: and what is still more remarkable, -for the unhappy race of paupers no certificate is required. The officers of any parish may lodge in a madhouse whomsoever they please. Å house containing one patient needs no licence, and receives no visitation. Is any body at a loss to see that, under these circumstances, a man who has money to pay for dishonourable services, can never find it very arduous to overcome the barriers intended to prevent the confinement of improper persons in a madhouse ? Under the present mode of inspection, too, even where it is most efficiently performed about London, the inspecting commissioners themselves confess, that persons might be retained in the houses of confinement, and perfectly concealed from their view; while in the country, so imperfectly are the securities taken for official inspection, that it is hardly performed at all. Yet under all these facilities, instances of undue confinement are exceedingly rare; probably not so much as one occurs in the whole kingdom during a number of years. The reason is, that, in this country, the eye of the public is penetrating; and the voice of the public has an organ by which it can make itself be heard. In the private houses, moreover, where the reputation of the house is the fortune of the master, it would not be easy to give a bribe which would compensate the risk of detection. No; if any man meditated such an enormity, the public institutions are the places for him ; where the leading people are so little under controul, and risk so little by violating their duties.
For ourselves, we do not see that provisions of great strictness about the admission of patients can be formed, without incurring the danger of excluding incipient madness, from which at present so great a mass of evil proceeds. Nor do we see that provisions of great strictness relative to admission are at all required. The skill of the legislature should be exerted to render it impossible that undue confinement can ever be long; and if this be accomplished, a remedy for undue admission is also obtained. What is a security against the one, is an equal security against the other. Both objects may thus be gained, and gained in the best manner, by only one set of provisions. Two effects may be produced by a single cause. This is legislative ingenuity of the highest sort. A proper system of inspection-an inspection which no abuses can escape, will, it is manifest, be competent alone to the production of these effects. And without such inspection, no security which can be provided will be found adequate to the end. Inspection, therefore, an efficient machinery of inspection, is that to the formation of which the genius of the members of parliament should be strenuously bent. In this one instrument, under a few simple rules, they will find the remedy for all abuses.
3. Provision ought to be made, that all those persons who are placed in confinement, under the character of insane, shall be placed in circumstances as favourable as possible to their wellbeing, including present comfort, and future recovery.
It will not require any illustration to prove, that the chief instrument which the legislature can employ to ensure a proper treatment to patients under confinement, is that of inspection. In this case, inspection is almost the only security lying within the sphere of legislative choice. Now what is meant by inspection, in the character of a security, is a provision created by the legislature for making fully known the treatment received by every human being in the nation under confinement as insane; and rendering concealment or deception altogether impossible. Revealment, however, if made to those alone who will disregard it, and give themselves but little concern about the abuses which may exist, will be made to little purpose. It is necessary to find some class of persons in whom such inattention can have no chance of existing. We know one such class, and only one; that is, the public itself, in its great corporate capacity. If means are taken to make the public acquainted with the circumstances of every individual who is improperly treated in a madhouse, there will be no improper treatment. If this is left undone, we cannot conceive any other security, in spite of which abuses will not find a way to creep in.
The grand objection to publicity, in the case of madhouses, to an efficient, curative degree of publicity,—is the feelings of the relatives of the patients; because they have in general a violent desire to conceal from the public the existence in the family of such a disease. But it surely does deserve consideration, how far these feelings should be allowed to stand in opposition to the well-being of those very relatives who are confined; how far a purpose of deception with regard to the public, and a purpose of cruelty with regard to the relatives, should be allowed to prevail over the claim, which humanity urges for those arrangements which alone are adequate to ensure the proper treatment of the insane.
It would require a far greater space than we can now afford, to explain sufficiently our own ideas with regard to the inspection of madhouses. One thing we may state very shortly, and with some chance of its carrying its own conviction along with it ;-that the more of publicity the legislature can infuse into the system of inspection, the greater the security against all abuses will they be sure to create.
In the existing act of parliament, the College of Physicians is looked up to as the only proper instrument of inspection, at least for the principal part of the business, that about the metropolis, A similar arrangement was made in the bill of the session pre