Competence and responsibility in schizophrenia.

Abstract

In a survey of the historical background it is shown that the classical doctrine on responsibility in schizophrenia has left its mark on the wordings of the psychiatric textbooks of the different countries. Closely combined with the imputation of enduring irresponsibility in schizophrenia was the opinion that civil rights are largely suspended if a person is given the diagnosis of schizophrenia. By the more recent research results of the studies of course and long-term outcome of schizophrenia and related psychoses and the development of the basic symptom concept has shown that it is not justified on principle to summarily deprive a person, diagnosed as schizophrenia, of civil rights as well as of criminal responsibility. New directions and some guidelines for an adequate assessment of competence and responsibility in schizophrenia are described. The knowledge of the newer findings and the application and utilization of the concept of basic symptoms and non-psychotic basic stages enable to overcome the doctrines of incurability, principle heterogeneity and numinous singularity and may lead to a rather appropriate and adequate social appreciation of the disease. Insight, freedom, responsibility, and competence of a person diagnosed as schizophrenia are in the postpsychotic pure residues and basic stages much more frequently preserved and available than hitherto assumed.(ABSTRACT TRUNCATED AT 250 WORDS)