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European Association of Psychoanalysis


 Psychiatry's War on Responsibility

 To renounce the pains and penalties of exhaustive research is to remain a victim of ill-informed and designing writers, and to authorities that have worked for ages to build up the vast tradition of conventional mendacity.
        Lord Acton (1834-1902)

 The insanity plea -- that is, the assertion of a defendant, typically charged with murder, that he is not criminally responsible for his offense because he was insane at the time when he committed the illegal act -- is the oldest and most obvious instance of the medicalization of the law. As formal medical-legal procedures, the insanity defense and civil commitment are symmetrical tactics: in one case, the idea of  mental illness is used to excuse a guilty person of his crime and incarcerate him in a mental hospital; in the other, the ideas of mental illness is used to incriminate an innocent person as "dangerously ill" and incarcerate him in a mental hospital. Psychiatry rests on these two procedures and would disappear in their absence.  
 I have criticized the medicalizations of the law in previous publications.
In this essay I will present the story of a murder trial where the plea was insanity. It is an atypical example. When an offender or his lawyer raises insanity as a defense, the prosecution often does not contest the defendant's psychiatric claim; instead, in effect it directs the jury to bring in a verdict of not guilty by reason of insanity and acquiesces in disposing of the defendant by confining him indefinitely in an insane asylum. Alternatively, the prosecution may contest the defense by asserting that albeit the defendant is mentally ill, his illness is not of sufficient severity to exempt him from the penalties of the criminal law. In the present case, the prosecution pursued a bolder course.

 In November 1980, Darlin June Cromer, a 34-year-old white woman, was tried in Oakland, California, for the kidnapping and murder of Reginald Williams, a 5-year-old African-American boy. The charge was "first-degree murder with aggravating circumstances," the aggravating circumstances being racial motives for the killing. Cromer pleaded not guilty by reason of insanity.
 The facts about the case were not in dispute. On February 5, 1980, Reginald Williams was abducted from a supermarket. Suspicion quickly pointed to Cromer, known for previous attempts to lure black children into her car and making comments about "killing niggers." When the police visited Cromer, she eagerly confessed luring Reginald into her car, strangling him, and burying his body in a shallow grave on the grounds of a water treatment plant near her home.
 Who was Darlin June Cromer? She was a 34-year-old white woman who had spent her entire adult life as a card-carrying mental patient. Diagnosed "schizophrenic" decades earlier, she was in and out of "treatment facilities." In 1980, she was placed on probation for having assaulted a Chinese woman in San Francisco in 1977. 
 At the trial, three young black children gave vivid testimony about how, the day Williams was killed and also the day before, Cromer tried to entice them into her car. Two refused. One, Steven Willis, accepted Cromer's offer to drive him to his school, but saved himself. "After the car passed his school and stopped at an intersection, Willis jumped out and ran several blocks to his school, and told a teacher what had happened." 
 The prosecution argued that Cromer's motive, as she herself claimed, was racial hatred. Assistant Public Defender Dean Beaupre, disagreed. He stated: "There is no question that the defendant did kill this little boy on February 5, 1980. ... However, this case does not involve racism, it involves insanity. The defendant is insane." This was a patent falsehood. If Cromer had been legally insane when Beaupre made his statement, she would not have been on trial: the judge would have had to declare her mentally incompetent to stand trial. What Beaupre was saying, and what four of the most eminent forensic psychiatrists in California were to say in their sworn testimony, was that Cromer was insane in February 1980, some 11 months before she came to trial. Neither Beaupre nor the psychiatrists knew Cromer then; hence, they could not possibly have had any knowledge about her mental state at that time. This contention was the focus of my testimony.
 What evidence did the prosecution have for maintaining that Cromer's act was motivated and goal-directed, not "meaningless," as newspapers typically characterize murder committed by persons they call "mental patients"? This was some of it:
 In the third day of the trial, a deputy sheriff recounted a free-swinging jail-house conversation she had with Cromer only hours after Cromer's arrest for the murder of Reginald Williams ... Deputy Dorothy Soto said Cromer "wanted to talk about niggers," and even though Soto didn't encourage her, began a long, rambling diatribe against blacks. Soto, who wrote it all down later, read her recollections to the jury yesterday. She said Cromer sat on a table, talking lucidly. "It is the duty of every white woman to kill a nigger child," Soto quoted Cramer. "I've already killed mine." She said Cromer urged her to kill a black herself.
 Mr. Beaupre did not put his client on the stand to reject these charges. Instead, he explained that "his client killed because she is consumed by schizophrenic paranoia, not hate for blacks." However, a prison psychologist testified that Cromer told him "she thought the killing of a black child from Alameda would cause a `snowball' effect in reaction to `blacks taking over.'" 
 On February 23, 1981, Newsweek ran a feature article on the trial. The reporters characterized Cromer as a "twisted woman," and stated that her attorney, Dean Beaupre, argued that his client was an "acute schizophrenic" who should be acquitted because she was insane:
 "That boy [he told the jury] died because Ms. Cromer was about as psychotic as she could be." ... Stanford Professor Donald Lunde described her belief that blacks were like animals, meant to be eaten. "If she isn't crazy,' he
concluded, `who is?" .... Prosecutor Albert Meloling ... tried to make light of what he called "the mystic knights of psychiatry." He imported his own gladiator, maverick psychiatrist and professional debunker Thomas Szasz, who contended that the defendant was "suffering from the consequences of having lived a life badly, stupidly, evilly from the time of her teens."
 On January 17, 1981, the jury found Darlin June Cromer guilty of first-degree murder because "she knew what she was doing." She was sentenced to life imprisonment without parole.
 Different observers drew different conclusions from this outcome. Dean Beaupre maintained that Cromer was so insane "that she thought she was committing a `positive act' when she killed the boy." Albert Meloling noted that the jury returned its verdict in a relatively short time and said, "It's obvious that these jurors are saying psychiatrists do not belong in the court room."  Newsweek  conceded that the verdict "will serve one useful purpose: it will keep Darlin June Cromer off the streets for the rest of her life."

 How did I get involved in the Cromer case? I am not a forensic psychiatrist. I am a critic of psychiatry and especially forensic psychiatry. Ever since the mid-1950s, I have been writing critical essays and books about the role of psychiatry in law. In 1963, Law, Liberty, and Psychiatry was published. It was widely and favorably reviewed and became required reading in many law schools. In 1965, Psychiatric Justice was published. I continued to publish widely in law review journals. I thus became known in legal circles as a psychiatrist with a principled opposition against both civil commitment and the insanity defense.
 In the 1960s and 1970s, I testified in court a few times on behalf of persons incarcerated in mental hospitals trying to regain their liberty. During the same period, I also testified a few times for prosecutors who wished to rebut the plea of "not guilty by reason of insanity." As I have noted earlier, in most such cases -- exemplified by the trial and John W. Hinckley, Jr. -- prosecutor and defense attorney collude, both satisfied with incarcerating the defendant in an insane asylum. The Oakland district attorney, Albert Meloling, was not such a prosecutor. This was a high-profile trial. Meloling was incensed by the deliberate, carefully planned, racially motivated murder of a black boy,
especially since the crime was committed in the largely black city of Oakland, California. He was familiar with my views and contacted me. I agreed to testify, provided he was willing to meet one condition: I would not participate in the charade of "examining the patient." Here I must briefly explain why I regard this non-participation -- which my critics have invariably interpreted as a medical incompetence and irresponsibility or worse -- as crucially important for me, both morally and professionally.
 Meloling also knew of me because of my behind-the-scenes  participation in the prosecution of one of the most sensational mass murders in our times, the 1969 trial of Leslie van Houten, one of the "Manson girls." Van Houten's lawyer called several psychiatrists to testify that she was patently crazy: she believed that Manson was God, carved a large  X on her forehead, and committed brutalities that "no sane person could commit." The prosecutor solicited my help. I flew to Los Angeles, discussed the case with him, and  suggested that he needed no psychiatric expert on his side at all. There was no need put me on the stand. Instead, he should concentrate on undermining the credibility of the defense psychiatrists, expose them as quacks always ready to testify that the defendant is not responsible for his crimes and "needs treatment," and rely on the jury's common sense that our basic moral sense demands that such cold-blooded and brutal crimes ought to be punished, and not "excused" by psychiatrists."  That is what happened. Leslie van Houten is still in prison. That is the context in which my testimony in the Cromer trial must be viewed.

 When a defendant pleads insanity to a charge of murder and when the fact that he committed the murder is not contested, the psychiatric expert is expected to testify about the mental state of the defendant not at the time of his
examination of the "patient," but at the time when the defendant committed the crime, typically many months before. In the Cromer case, the interval between the crime and the defense psychiatrists' examination of the defendant was
approximately ten months.
 Psychiatrists regard this practice as medically sound and scientific, and courts and society accept it as similar to expert testimony given by other medical specialists, for example forensic pathologists. I regard the practice as the epitome of junk science and refuse to participate in it.  In the first place, there is no objective test for mental illness, as there is for melanoma or pneumonia. What psychiatrists pretentiously call an "examination" is a conversation with the subject and observation of his behavior. The psychiatrist's conclusion is his opinion about the subject's mental state, at the time of the examination. The claim that a psychiatrist is able to determine the mental state of a defendant, say, on January 15, whom he first encounters and examines, say, on November 15, is prima facie absurd. However, our legal-psychiatric system accepts, indeed insists, that this fiction is scientific truth. Few people, and few if any psychiatrists, question this charade. Thus, for a prosecutor who is genuinely determined to prevail against the insanity defense, the best tactic is to unmask the defense psychiatrists as quacks, hired guns masquerading as medical experts. Meloling had no respect for the insanity defense or for psychiatrists always ready to call killers "crazy" and agreed with my suggestion to pursue such a course.  As it turned out, my insistence on not examining the defendant and rejecting the option of offering another retroactive diagnosis, different from the diagnosis proffered by the defense experts, proved crucial in convincing the jurors that the defense psychiatrists were deceiving them. The day after the Cromer trial ended, the San Francisco Chronicle reported: 
 The last witness, called by the prosecution yesterday at a cost of $3,000 was an eminent New York psychiatrist who brought defense lawyers to the edges of their seats when he disputed the previous testimony of four defense experts. ... Called on rebuttal, Dr. Szasz is author of 17 books, a recognized authority on psychiatry and legal issues and a professor at the State University of New York. He based his testimony on a review of Cromer's extensive medical records. He added that it would not assist him to examine the defendant. When asked why by Meloling, Szasz said: "Because I could only determine [what] her mental state is now, not on the day of the murder. That is the nature of psychiatry." The long list of defense psychiatrists ... offered a retroactive diagnosis that Cromer was suffering from psychotic delusions.

 For reasons I shall describe presently, in 1982 The American Journal of Forensic Psychiatry reprinted the verbatim transcript of my entire testimony in the Cromer trial. It begins with the so-called "Direct Examination." I am on the witness stand and the prosecutor, Albert Meloling, is questioning me.  Q. Have you previously testified in the courts in this country on the subject of psychiatric conditions and responsibility?
 A: Yes, I have, on a few occasions.
 Q. Did you assist the District Attorney in Los Angeles County in the case  involving one of the Manson Group, that is, the case involving Leslie van Houten?
 Like any good lawyer, Meloling asked his witness only questions to which he knew the answer. Note that he used the term "assist" instead of testify." The defense objected to the question as "irrelevant," the judge sustained the objection, and I did not answer the question. After a brief "Voir Dire" examination by Dean Beaupre for the defense, Meloling resumed questioning me. After letting me answer questions about how I became familiar with the circumstances of the crime, he continued:
 Q. Now you haven't examined the defendant, have you?
 A. No, sir.
 Q. Would it assist you in testifying to examine her now?
 A. No, sir.
 Q. You understand that what we are concerned with is her mental condition on February 5 of last year?
 A. That is my understanding.
 Q. Why would it not help you to examine her now to determine what her mental condition was on February 5, last year?
 A. Because I could only determine by examining her now what her mental condition is now.
 Q. What is the reason for that?
 A. That is the nature of a psychiatric examination. I don't know what her mental condition was six months ago. I wouldn't know what it would be six months from now.
 Note that this information -- elicited from me by the prosecutor for whom I was testifying -- was essential for showing the jury that the defense experts had no way of knowing what Cromer's mental condition was at the time of her offense. My crime against psychiatric dogma -- namely, not examining the defendant to whom psychiatrists always refer as "patient" -- was brought forth and emphasized as part of the prosecution's tactic to secure a conviction. It was not elicited, as is an "admission," by a prosecutor questioning a guilty defendant or a plaintiff's attorney questioning a hostile witness.
 Why, then, have psychiatrists and other supporters of psychiatric coercions and excuses ever since accused me of a "failure to examine the defendant" and define my behavior as an "admission" of a wrongdoing? There are three possible answers. One is that my accusers are so convinced of their being in possession of the truth about mental illness that they are deaf to what I say and write. Another possibility is that the critics seize on my deliberate departure from standard forensic-psychiatric practice as evidence, ipso facto, of psychiatric malfeasance. The third possibility is that they hear my message and understand it only too well, and believe that the best defense is an offense and, instead of engaging my argument, slander me.
 After a series of other questions, Meloling asked:
 Q. You said that the question of whether or not a person was suffering from schizophrenia is really not relevant to the question of whether or not they are responsible?
 A. That is correct. ... Schizophrenics can be and are responsible ... it is now general practice not to lock them up. So they have all the rights and freedoms of you and me and, therefore, all the responsibilities of you and me to be held responsible for what they do. After a series of questions intended to clarify for the jury Cromer's reference to blacks as animals, and her wanting to eat her victim, Meloling asked:
 Q. You said it is quite common in everyday language to call items by different names?
 A. We all do that, all the time, sooner or later we call things by some figure of speech, some so-called metaphor, some other image. I mean if you don't like somebody, you say "You are a son of a bitch." We don't mean that literally
he is the son of a bitch. We call somebody "The apple of my eye." We don't mean that you are an apple.
 (Laughter )
 A: (Continuing) We say to our daughter, "You look so sweet, I can eat you up." That's a figure of speech. The fact that she [Cromer] may have said something like that, obviously she didn't eat the person, so a statement she was going to eat it becomes, in my  opinion, an outright lie. If she wanted to eat the person, she had plenty of time to eat him.
 (Continuing) And when people use figures of speech, that  becomes a matter of speech for juries to determine, not for  psychiatrists.
 Meloling then turned to the issue of Cromer referring to blacks as animals, one psychiatrist claiming that "she was grossly delusional and that her believing things about blacks and Chinese far exceeds simple prejudice."
 Q. ... What is the difference between prejudice and a delusion? Is there a difference?
 A. Yes. ... But obviously this is an utterly subjective and politically and morally loaded question because the idea that blacks are not human or that Jews are not human or that non-Christians, for that matter, are not human, I mean this is what history has been all about, that people see other people as animals, and are ready to kill them....   Finally, Meloling asked the ritually required question of his expert.
 Q. You have an opinion as to what Ms. Cromer was suffering from, if anything, on February 5 of this year?
 A. Yes, I do.
 Q. What is that opinion?
 A. That opinion is that she was suffering from the consequences of having lived a life very badly, very stupidly. Very evilly; that from the time of her teens, for reasons which I don't know, she had, whatever she had done, she has done very badly. She was a bad student. There is no evidence that she was a particularly good daughter, sister. She was a bad wife. She was a bad mother. She was a bad employee insofar as she was employable. Then she started to engage [in taking] illegal drugs, then she escalated to illegal assault, and finally she committed this murder. ... Life is a task. You either cope with it or it gets you ... If you do not know how to build, you can always destroy. These are the people that destroy us in society, our society, and other people. Then I was questioned again by Beaupre. He tried to discredit me by arguing that psychiatric diagnoses were just as reliable as medical diagnoses, and my testimony by establishing that I had not read all of the records pertaining to the case, and had been paid $3,000 for my work plus expenses. Meloling didn't let that go unchallenged.
 Q. Dr. Szasz, is a psychiatric diagnosis as accurate as a medical diagnosis?
 A. Not usually, no.
 Q. What is the reason for that?
 A. Medical diagnoses deal with objective and demonstrable lesions of the body, broken bones, diseased livers, kidneys, and so on. Psychiatric diagnoses deal with behaviors that human beings display, and they have to be interpreted in moral, cultural, and legal terms and, therefore, different interpreters will arrive at different judgments. ... Homosexuality was recognized as a mental disease until a few years ago. And now it is no longer a mental disease. ... but last year, smoking is a disease.
 Q. Smoking is now a psychiatric condition?
 A. Not condition, sir, a disease.
 Q. A disease?
 A. A disease. Since January 1980. So is gambling.
 Q. Pardon?
 A. Gambling is also a disease.
 Q. How do you treat that, that is, gambling, do you take away of the money?
 At this point, the judge became so amused by the humor intrinsic to what psychiatrists call a disease, that he answered the question:
 Court: You win.
 Witness: That's right. That's my recommendation also.
 Mr. Meloling: I have nothing further.
 It was not a good day for the defense. In 1989, the public defender's office appealed Cromer's conviction. "Deputy public defender Colleen Rohann said ... Cromer had a 20-tear history of mental illness and belonged in a psychiatric
institution, not a prison." The appeal charged that "Albert Meloling had committed gross misconduct when he called defense psychiatrists `con men' who were a `social cancer in society that has to come out.' ... Cromer had a nearly
two-decade history of mental problems and four defense experts said she was insane." The state Supreme Court refused to overturn the murder conviction.

 As might be expected, my testimony enraged the psychiatric community. Donald Lunde was one of the most famous and respected forensic psychiatrist in America. My contradicting his expert opinion was an impertinence. Cromer was a certified lunatic. Who could doubt that she was crazy and "belonged" in a mental hospital, not a prison?
 Psychiatrists are sore losers. After the trial, they had no trouble -- in their own journals and debates -- overturning the jury's verdict and, in effect, indicting me of psychiatric malpractice: I didn't examine the "patient," and perhaps worse still, I instilled humor into the proceedings.
 Every trial -- and surely every sensational murder trial -- is theater. It is not possible to understand or appreciate the play without seeing it performed or least reading the text of it. Clearly, Lunde viewed the Cromer trial as a duel in which I bested him by foul means. He wrote a letter to the editor of The American Journal of Forensic Psychiatry, suggesting publishing the transcript of my testimony accompanied by critical comments by experts in forensic psychiatry. Entitled,"The Psychiatrist in Court: People of the State of California v. Darlin June Cromer," this material was published in The  American  Journal of Forensic Psychiatry in 1982.
 The document runs to 41 pages. I will try to summarize its highlights, in the order in which they appear. In his letter to Ed Miller, the editor of the journal, Lunde suggests that "a reviewer might address ... the facts that: (1) Dr. Szasz admits [sic] that he never examined the defendant, yet renders an opinion about her. (2) Dr. Szasz admits [sic] that he did not review all her medical records, yet renders an opinion. (3) Dr. Szasz testifies as an expert in psychiatry that there is no such thing as mental disease."
 Note how naturally the language of the KGB agent comes to Lunde's lips. To say that a person admits X, implies that doing X is immoral, illegal, an affront against legitimate Authority, in a word. A person does not admit to doing good. We don't say that a person admits that he told the truth; we only say that he admits that he has lied.
 I explained already why I regard examining the defendant in such cases and testifying under oath about his mental state many months or years earlier as scientifically contemptible and morally wicked. Regarding Lunde's second charge, that I did not examine all of her records, we must keep in mind that Cromer had been a mental patient for more than 20 years. Examining all of her records --  assuming that all of them were available, which is doubtful -- would probably have taken weeks. Lunde's third charge is, perhaps, the most telling: I am an expert in theology, yet I say there is no God. 
 The forensic psychiatric establishment decided to rewrite the Cromer case, with the murderer cast as an innocent, sick patient, and I cast as a callous, irresponsible, and wicked psychiatrist. After reviewing the transcript of my testimony, Selwyn M. Smith, M.D., Professor of Psychiatry and Psychiatrist-in-Chief at Royal Ottawa Hospital, offered this opinion:  
 Dr. Thomas Szasz's views are well known ... disagreements concerning [his] views have been well documents in the psychiatric literature. ... The preparation by Dr. Szasz prior to giving testimony was in my opinion extremely superficial and contrary to acceptable standards of practice. ... he came to court to testify and in many ways utilized the witness box as a forum for a presentation of his particular views. ... This flippancy was compounded by his own statement that he saw no need to examine the defendant. Surely when requested to offer an opinion involving one's expertise as a physician and psychiatrist, one should indeed be prepared to examine the defendant ... This is particularly true if one is being handsomely paid as was the situation here. I found Dr. Szasz's stance particularly troubling and certainly demeaning to the profession of medicine in general, and psychiatry in particular.
 What mattered to Smith was not the truth but the dignity of a psychiatry guilty of charlatanry. As my testimony shows, I said nothing demeaning about medicine. To be sure, I said some  unflattering things about psychiatry and the practice of offering psychiatric excuses for murderers in the court room. Smith's comments illustrate that psychiatrists, like other despots, do not tolerate disagreement. If the person who disagrees with them is a mental patient, they punish him with ever more demeaning diagnoses and destructive treatments. If the person is a fellow professional testifying in a court room -- where he is safe from the psychiatrists' direct retribution -- they punish him by slander and declaring his conduct "unprofessional" and "harmful for patients."
 "Dr. Szasz," Smith continued, "is a Professor of Psychiatry, and yet I found his comments pertaining to psychiatry in general and schizophrenia in particular, simplistic, unrealistic, and unscientific.... In my opinion, such comments were not helpful to the court. ... His testimony in general exhibited a poor command of medical-legal principles and a callous disregard for an ill person". Smith's remarks are a typical example of psychiatric arrogance. A white person charged with the crime of the racially motivated murder of a black child is here transformed, by psychiatric fiat, into an "ill person," and I am slandered as showing "callous disregard" for the ill. A neat trick, if you can get away with it. Psychiatrists have gotten away with it for the better part of three hundred years, never more successfully than today.
  The next contributor to this offensive against me was Joseph C. Finney, LL.B., M.D., Loyola University Medical Center, Maywood, Illinois. Before I turn to his critique, I want to say a few words about the charge that I inappropriately injected humor into what ought to be a somber proceeding. I am blessed with a good sense of humor and am quite capable, if I want to, of introducing witticism into virtually any verbal communication, spoken or written. However, in this case, laughter in the courtroom  began -- as the transcript shows -- not because I said something witty. Instead, it began when I described how psychiatrists make and unmake diagnoses of mental illnesses, citing smoking and gambling as newly minted diseases. At which point Albert Meloling, the prosecutor, asked me: "How do you treat that, that is, gambling, do you take away of the money?" That precipitated laughter in the court room, facilitated by the judge himself breaking out into laughter and volunteering a humorous answer to
Meloling's question: "Court: You win." This provoked more laughter. I then answered the question: "That's right. That's my recommendation also," and there was still more laughter. Ridicule is, of course, the most effective weapon against arrogant stupidity. The psychiatrists were not amused.
 Interestingly, Dr. Finney based his criticism of my testimony on a psychoanalysis of what he imagined was my personal history. "It may be," he explained, "that the nature of the Cromer crime -- murder that was racially motivated, turned Dr. Szasz against the defendant as it turned the prosecutor and the jury.
... This manifest content [of racial motivation] is irrelevant to the issue of the insanity plea, but it was not irrelevant to Dr. Szasz's willingness to testify. He specifically associated from killing blacks to killing people of his own ethnic group, thus identifying himself with the victim." Finney probably never read a word I wrote and is unaware of my principled opposition against acquitting any defendant on the ground of insanity. To be sure, Finney has managed to discredit me and my testimony with what must be one of the most subtle, yet perhaps persuasive, anti-Semitic comments in contemporary American psychiatric literature.
   Finney was a good choice as critical commentator. He did not like what I said and was happy to articulate all his objections. "I find it inappropriate, offensive, and alarming that Dr. Szasz testified that Dr. Lunde's testimony was not only false, but so false as to border on perjury. ... I am appalled that he said such a thing." Being appalled is not a substitute for showing how or why what I said was untrue. Finney retried the Cromer case in his own mind
and, although he had not examined her either, found her not guilty of murder: "I strongly suspect that under our laws, Mrs. Cromer was entitled to be found not guilty by reason of insanity. ... I conclude that the defense attorney did not do a competent job in defending Mrs. Cromer ... He did not cross-examine adequately. ... I believe an appeal could be taken ... " An appeal was taken, as I noted earlier, and the verdict of the court was upheld.  A few years ago, when I had occasion to make a study of the life and work of Rudolf Virchow (1821-1902), I came across an episode in his life that closely resembles my refusal to examine Darlin June Cromer.
 Virchow, the founder of modern pathology and scientific medicine, was nominally a Protestant, but actually an atheist. The publication of his magnum opus, Cellular Pathology, in 1858, quickly made him one of most famous medical scientists in the world. "I have dissected thousands of corpses," he declared, "but found no soul in any." He was in the habit of mockingly asking his students engaged in dissection: "Mr. Candidate, have you found a soul already?"
 In 1868, Virchow was asked to examine a "patient" and refused. I describe the circumstances and import of this episode in detail in Pharmacracy, from which I quote: "In 1868, a Belgian novitiate was supposed to have miraculously survived for three years with `no sustenance except water and the communion host.' Asked by the Vatican to examine the woman and render an expert medical opinion about the claim, Virchow recognized that there was nothing to examine and refused."
 Virchow believed there was no soul that survives the body, or if there is one, it is the concern of miraculous theology, not scientific medicine. He viewed the claim that a young woman lived for three years without food as, prima facie, absurd, if not a deliberate deception. Supposing he undertook to examine the woman in question, what was he supposed to look for?
 I see my position regarding the diagnosis of mental illness much the same way. I believe there is no mental illness. No medical examination can detect such a mythical disease. I regard the psychiatrist's claim that he can examine a cold-blooded murderer, detect that, when he committed the crime, he suffered from a mental illness (so severe that it annulled his guilt for his deed), and that his so testifying, under oath, is helping the court by furnishing it with "scientific truth" as a false belief, if not a calculated lie. That the person who utters such an untruth sincerely believes that his lie serves the noble cause of "saving a life" does not alter the fact that it is a deliberate falsehood.

 Thomas Szasz
"The Medicalization of Everyday Life: Selected Essays", Syracuse University
Press, Fall 2007, n. 13

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