A Moral Framework for Analyzing the Controversy Over Aversive Behavioral Interventions for People with Severe Mental Retardation

Abstract

This article applies a systematic analysis of everyday moral decision making to the controversy surrounding the use of aversive treatments for people with severe mental retardation. The authors' aim is to provide a framework for analyzing the issue, and they take a position against the use of aversive procedures. The analysis adds some new ideas to the debate. It provides a definition of aversive procedures based upon common moral rules. The concept of protection by the moral rules is discussed and the case made that people with severe mental retardation deserve the protection of the moral rules and that this right is historically new and tenous. The importance of symbols of dehumanization is discussed in light of this tenous condition. The idea of moral agency is applied in order to clarify the kinds of societal sanctions that are and are not appropriate when a person with severe mental retardation violates a moral rule. The authors argue that data are always relevant to moral decision making and that a mounting body of evidence indicates that nonaversive alternatives are available and can replace aversive procedures in all but a very small number of highly unusual cases.