The New Neurobiology of Severe Psychiatric Disorders and Its Implications for Laws Governing Involuntary Commitment and Treatment

Abstract

Every student of the law knows that changed circumstances are grounds for changing the law. Although changes in social relations are the most common form of changed circumstances, changes in beliefs about the world can also spur legal change. Among the changed beliefs about the world that can result in changed laws, is changes in scientific beliefs, including medical theory. This paper argues that such changes are now needed for laws governing the involuntary commitment and treatment of individuals with severe psychiatric disorders. Recent advances in the understanding of the neurobiology of these disorders have rendered obsolete many assumptions underlying past statutes and legal decisions. This is illustrated by using schizophrenia as an example and examining two influential situations: California's Lanterman-Petris-Short Act (1969) and Wisconsin's Lessard v. Schmidt decision (1972). It is concluded that laws governing involuntary commitment and treatment need to be updated to incorporate the current neurobiological understanding of severe psychiatric disorders. In reaching these conclusions, we consider moral justifications for our suggestions, and sketch changes in constitutional law, statutory law, and public policy that are generated by the arguments we deploy.