The Apostle Paul writes:

I do not understand my own actions. For I do not do what I want, but I do the very thing I hate. Now if I do what I do not want, I agree that the law is good. But in fact it is no longer I that do it, but sin that dwells within me. For I know that nothing good dwells within me, that is, in my flesh. I can will what is right, but I cannot do it. For I do not do the good I want, but the evil I do not want is what I do. Now if I do what I do not want, it is no longer I that do it, but sin that dwells within me. So I find it to be a law that when I want to do what is good, evil lies close at hand. For I delight in the law of God in my inmost self, but I see in my members another law at war with the law of my mind, making me captive to the law of sin that dwells in my members. (Romans 7:15-23)

Christians understand that evil is a reality, both personal and cosmic, that is chosen through free will, but what is the line between evil and mental illness? I should state strongly and unequivocally that I am not suggesting that mental illness is by definition "evil" or that people suffering from mental illnesses are "evil," but Eliot Cohen has raised this question in Psychology Today in his post "Are Evil People Crazy?"  He raises a number of intriguing points and questions in his post, some of which are difficult to answer definitively, such as the defintion of someone with Antisocial Personality Disorder:

According to the DSM 4-TR,"The essential feature of Antisocial Personality Disorder is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." (p. 701)

So here is a mental disorder that is, in fact, defined in terms of moral deviance.

Does this defintion simply describe someone who acts against agreed upon moral codes, who chooses willingly to break God's law - this is my language, not Cohen's - or is such behavior grounded in a real disease? Personal responsibility would seem to at stake here.

Cohen raises in this regard the critique of Thomas Szasz, who for decades has argued against the psychiatric establishment:

But some "anti-psychiatrists," notably Thomas Szasz, would argue that mental illness is itself a myth; and that therefore terms such as "sociopath" and "Antisocial Personality Disorder" are themselves just moral judgments disguised as empirically verifiable psychiatric disorders. "We call people mentally ill," argues Sasz, "when their personal conduct violates certain ethical, political, and social norms."  Is this view correct?  Is calling someone a sociopath, or saying that the person has Antisocial Personality Disorder, merely a concealed way of calling the person evil?

On the other hand, from the ancient world until now, many thinkers would argue that to disobey the dictates of reason persistently would render one "ill":

Ancient natural law theorists such as Aristotle, medieval theorists such as Saint Thomas Aquinas, and contemporary theorists such as Eric Fromm would not have a problem with making the stated assumption.  For these theorists, there are certain basic human tendencies that are "normal" and those who deviate from them are, in effect, mentally ill.  Thus all of the aforementioned theorists hold that human beings are by nature social creatures. So, people who kill, rape, and steal from others are transgressing this moral order of nature. 

Cohen also notes that certain thinkers have also opted for moral standards as "relativistic" and humanly created, having no natural or divine origin. It seems to me that there are then a number of approaches one could take from Cohen's article: evil is always simply a moral choice and so one remains personally responsible; persistent evil is the result of a definable "illness" which renders one less (or not) responsible for one's behavior; defining evil as illness masks personal reponsibility (Thomas Szasz's approach); or evil is a human construct.

Missing from Cohen's discussion, as it is not a discussion of religion, is Paul's solution to evil: "Wretched man that I am! Who will rescue me from this body of death? Thanks be to God through Jesus Christ our Lord!" (Romans 7:24-25a). On the other hand, most of the approaches noted in his article, apart from the relativistic approach, can find a home in a Christian understanding of evil such as Paul's just described. Yet a question still remains: if someone is suffering from a genuine illness which leads to evil acts as a result of that illness, to what extent does this person remain personally responsible?

John W. Martens

Follow Me on Twitter @johnwmartens

Comments

Anonymous | 9/8/2011 - 11:05am
This is one of those classic catch-22 discussions that are always worth having, so thanks for bringing it up.

To the degree anyone is compelled by some mental or physical disorder or disease to do or fail to do something, their free will or volition/self-control is reduced and hence, also is their moral culpability.

But only in extremely rare cases and conditions is someone's culpability reduced to zero. Sleep walking while on Ambien (i.e. out of your 'right' mind but still acting with some level of intelligence, skill, etc.) comes to mind.

The alcoholic suffers from a debilitating and terminal disease of the brain which involves serious physiological and psychological compulsions towards drinking alcohol. He or she cannot control these urges and once they take their first drink, the disease takes them... so their only window of volition/self-control and hence, moral self-direction happens during the "temptation" to drink.

Once they drink their disease takes over and while they are still intelligent and 'functional' their free will is seriously impaired. What they say or do while drunk is not "their right mind". It may certainly be objectively hurtful, harmful, and illegal, but subjectively their culpability is reduced (though usually not obliterated).

Take the hot button issues of the day and how both "sides" refer to the "other" in terms not of evil but in terms of illness. The Church says that same sex attraction is a mental disorder. I.e. NOT evil per se, the only morally relevant element would be sexual actions taken outside of heterosexual monogamous marriage. 

Having the compulsion or attraction is not evil or sinful. It's just a disease. But what a person does with that compulsion MAY be evil/sinful.

Ditto with the Church's teaching about masturbation - the urge itself is neutral, the exercise of the urge is objectively wrong (as it's outside of the marital embrace) but the moral culpability of the subject can be reduced by circumstances, the power of habit, or other psychological impairment. It's still a sin but it may not necessarily be a mortal sin.

We make this distinction all the time in the way we look at the death of people: sometimes it's accidental manslaughter, other times negligent homicide, other times it may be murder but not pre-meditated (i.e. in the heat of the moment, temporary insanity - such as finding one's daughter being raped by a stranger). The act is objectively person A killing person B but the circumstances change the moral culpability of person A.

On the other hand, the hedonistic world claims that SSA is perfectly healthy and so is virtually any form of sexual action in or out of marriage - while the real "disease" is homophobia or any "repression" of any sexual urge.

Well, fine. But if that's the case that those who disagree with hedonism are indeed "sick" then you can't also claim they are "evil" and hence prosecutable by hate-crime legislation for the mere act of disagreeing verbally with someone!

Robert Dean | 9/6/2011 - 7:52pm
Antisocial Personality Dsorder isn't defined in the DSM-IV-TR in terms of moral deviance.  It's defined in terms of what the DSM describes:  disregard for the rights and welfare of others.  Although they unquestionably do bad things on occasion, that's not their intent.  Antisocials (by definition) are so severely damaged and disordered that they just don't "get" the human interpersonal contract, and the milk of human kindness is not in them.  From a psychiatric standpoint, they're not immoral as such;it's worse than that: they've been deprived of the opportunity to become fully human.
NORMA NUNAG | 9/4/2011 - 1:55pm
Now you got me thinking!
ed gleason | 9/2/2011 - 4:05pm
I have no doubt that  mentally disturbed people do really evil things.. from early childhood on.
But how about the fact that there are some who come to do extreme evil in their  adulthood. Men who showed no early disturbance.  Men, particularly, that also come to suddenly have the charisma to attract/seduce the elite, the well educated, the well placed. I give as examples Hitler, Jim Jones,[Jonestown]  and David Koresh[Waco].
each had a loyal following of educated rational people. From whence did these men get their 'power'?? All were known as young men to be losers.. Hitler lasted a 4 year war with immense casualties and only rose in rank and leadership to corporal. I met someone who knew the early Charles Manson when he was a sad. shy young man who lived in crash pad basements in the Haight Asbury. He was the epitome of the street loser. From whence did they get charisma and power over others? I have posited that maybe it was a diabolical deal with the Evil One that each of these men made. Not scientific I know, but I still think it's reasonable until I get a better rational answer for their behavior. From whence did they get the power/attraction and what was the 'deal'. ??? I throw  Marciel in the pot  for good measure..