Moral Deficiency and the Persistent
- Author:
Young, M.B., Ch.B.,
Medical Officer, H.M. Prison, Wormwood Scrubs The person of strongly vicious or criminal propensities who requires care, supervision, and control for the protection of others, is not infrequently met with in the population of a prison. Mental subnormality also is not uncommon among habitual criminals, and its existence before the age of eighteen years can sometimes be proved.
The question whether moral deficiency is present is therefore of particular interest to the prison medical officer. In the Mental Deficiency Act (1927) mental defectiveness is defined as ” a condition of arrested or incomplete development of mind existing before the age of eighteen years, whether arising from inherent causes or induced by injury or disease.”
The recognition as Amentia of a condition which may be due to external causes which have come into operation during the later stages of the develop- ment of the mind raises, at once, difficulties in diagnosis which were not present in the 1913 Act. By the use of the word ” arrested,” suggesting a temporary check by force of external circumstances, and by the omission of the word ” permanent,” emphasis has been thrown on the possibility of amelioration of the condition, and from this it can be inferred that mental deficiency is not a condition which is invariably beyond remedy.
Published by permission of H.M. Commissioners of Prisons, though it does not necessarily represent their views.
The terms of the Act, by implication, do not permit of the inclusion as mental defectives of those who are suffering only from incipient psychoses, psycho-neuroses, or belong to one of the organic reaction types.
Injury or disease sustained during the plastic and unstable period of adolescence may result in insanity or nervous disorder, and where tempera- mental disturbances are prominent the differentiation between defect and one of these is not always clear. The position reached by the new act is not far distant from that suggested by the Royal Commission of 1904, which proposed that lunacy should be included in mental deficiency.
Although the existence of Moral Deficiency as a separate entity is not accepted by many authorities, it is the writer’s experience among persistent male offenders of all ages that persons are occasionally met with ” in whose case there exists mental defectiveness coupled with strongly vicious or criminal propensities, and who require care, supervision, and control for the protection of others,” and, with certain qualifications, a certificate of moral deficiency may be given in these cases.
To comply with the conditions of the Act it is necessary to prove actual defect, and not merely a degree of subnormality coupled with the anti-social propensities, and in order to assess the degree of abnormality present, a careful study must be made of the motives, nature, and outcome of the crimes com- mitted by the subject. It is also necessary for the case to be supported by a corroborative history which should extend from childhood to maturity. With- out a history of this description it is not advisable to proceed under this section of the Act.
Mental deficiency is not limited by its manifestation in intelligence or temperament, but it embraces all mental processes, and varying aspects of each. Thus a defective may shew an excess or diminution of emotion in combination with varying intelligence ratios.
Where standardised tests fail to reveal the existence of intelligental defect, has to be considered whether the abnormal conduct may not be due to in- fluences affecting the use of the intelligence as a whole. Certain types in which the response to hypothetical situations may be correct, but which does not represent what would take place if the subject were brought into contact with actual situations of the same kind, are examples of this. The intelligence may be subordinated to the emotions, and defective judgments ensue in spite of the fact that the subject is capable of making correct judgments and of appreciating mcorrect ones. There is not necessarily a lack of common-sense which brings this about, but the fact that the subject is deflected by his emotions from applying it.
Mental symptoms of another kind are found in the moral defective. Cases of this type usually shew a paucity of emotional reaction and of imagina- tion, and at the same time there may be little or no intelligential defect. The combination is one which leads to success in many spheres, but in the moral defective it is almost invariably unprofitable and results in failure. This reversal of the normal indicates that another function of the mind is affected, and this is generally regarded as a defect of wisdom.
Wisdom springs from the operation of the whole of the conscious and sub-conscious levels of the mind, and it differs from intelligence in that it does not rely so directly upon the memory of previous experiences, nor is it largely founded on the evidence of the special senses. It is not suggested that such evidence is not utilised, but that this is not the source from which wisdom is derived, or solely upon which it depends for its development.
It is distinct from intelligence in that it controls the operation of the instincts, and co-ordinates them in relation with the intelligence and the emotions so that a successful and morally justifiable line of conduct ensues. The fact that morality is interpreted differently by people of different races and different periods of time has no direct bearing on the question, for the characteristic of moral deficiency is not the deliberate repudiation of the existing moral code, nor the lack of knowledge of it, for the moral sentiment is as susceptible to cultivation as is the intellectual faculty, but it is the inability, through the absence, damage, or destruction of brain cells, to appreciate the difference between right and wrong and to reflect on the perception. This in- born capacity is not influenced by such factors as either race or period. Herein lies a fundamental distinction between the habitual criminal and the moral defective, for in the one there is no absence of capacity, however little he may have developed or exercised it, whereas in the other the capacity, either owing to germinal defect or brought about by injury or disease while the mind was immature, is so inferior as to be incapable of development and to constitute the subject a possible menace to society.
When this lack of capacity is combined with a defect of wisdom, the check normally exercised upon the forces of instinct, and the application of these forces to some object which is beneficial to society, are absent, with the result that conduct is determined by whichever instinct happens to demand expres- sion. Moral defectives do not derive their impetus from any single overwhelm- ing instinct.
Thus a characteristic of the offences of a moral defective is their variety, owing to the liberation, in crude form, of the forces of different instincts and their specific emotions in response to varying stimuli. The rapid loss of interest after the crime has been committed, and the carelessness of the con- sequences which are shewn, would appear to be due to the unchecked emergence of instinctive forces appropriate to the changing stimuli.
Sexual crimes, together with crimes of acquisition, of violence against person or property, and of defiance of discipline, occur indiscriminately in his record, while his history from an early age may include acts of cruelty to persons or animals, sexual vice, petty thieving, untrustworthiness, self-advertise- ment, and a general lack of respect or consideration for others.
As a rule they come to be recognised as abnormal early in life, and in prisons this is again evident in the attitude of other prisoners towards them, Convicts are usually disinclined to betray each other to the authorities unless they anticipate some substantial gain for themselves without undue risk.
The bond between them is largely one of fear of each other, and it results in the formation of a group or clan into which newcomers are slowly absorbed. It is interesting to observe that the moral defective is generally ex- cluded from this group, and he remains more or less unattached throughout his sentence.
This grouping, which in the writer’s view is designed as a means of pro- tecting the convict against disturbing psychic stimuli such as the responsibility of making individual adaptations and the justification to himself of his criminal conduct, is beyond the comprehension of the moral defective, and he does not feel the loss of its support in consequence. To the normal person the possession of a common grievance is less fatiguing than is the burden of an individual one. The fact that habitual criminals tend to group themselves is evidence of an ability to submit to a code of conduct however rudimentary it may be. Another indication of the habitual criminal’s fear of exciting disturbing memories is his desire for monotony. Frequent change in prison routine tends to stimulate mental processes and this the convict wishes to avoid. As a further instance of the habitual criminal’s fundamental appreciation of right and wrong, though this is rarely acknowledged, may be cited the commission of offences against prison discipline with the object, in certain cases, of relieving the mind of difficult and unprofitable introspection by substituting a grievance against the prison authorities. Destruction of prison property is not infre- quently a manifestation of this. The moral defective is incapable of rational- ising in this way.
Crime in the moral defective is not necessarily brought about by economic conditions. He often has an apparent value to the prospective employer, and succeeds in obtaining work which is denied to the ordinary convict. Tempta- tion, however, is rapidly followed by action which lacks reflection or delibera- tion. His offences, therefore, do not shew care in preparation, are usually carried out alone, and the precautions against detection, if any, are puerile in character.
The habitual criminal is disinclined to settle down to regular work, whether under compulsion or not, and although employment on release is found in a large proportion of cases, some of those who attempt to retain it ttiay be subjected to blackmail by former co-prisoners.
He is apt to repeat those forms of crime with which he is most familiar. Among the less common motives of his crimes are those of revenge, or the satisfaction of his desire for adventure or notoriety, or the temptation of a gamble, but, whatever the motive may be, his crime is designed to achieve the ?bject in view, is carried out with caution, and does not shew the wantonness 0r inadequacy of purpose which is noticeable in the crimes of a moral defec- tive. Moreover, if successful, he enjoys the profits of his enterprise.
Among the conditions predisposing to recidivism are physical defects and certain mental abnormalities, such as the enfeeblement following previous attacks of insanity, or states of mind bordering on feeble-mindedness. Mal- adaptation leading to repeated crimes may be due to the presence of neuroses, psycho-neuroses and psychopathy, and among cases of this kind are to be found the drugs addicts and the alcoholics.
The co-existence of any of these conditions with vicious or criminal pro- pensities renders a diagnosis of moral deficiency problematical. Head injuries per se are rarely a direct cause of persistent crime, though they may precede secondary amentia, mental enfeeblement, moral insanity, or one of the epilepsies.
Diseases such as Encephalitis Lethargica and Epilepsy may result in either habitual crime or moral deficiency. Among post-encephalitics seen in prison it is the writer’s experience that symptoms of cerebral irritation are more com- mon than are those resulting from a destruction of neurones, and the mental sequelae are therefore more often psychotic than defective in type. The insight which many post-encephalitics have into their condition, and the frequency with which they are found to appreciate the weakness of their inhibitions helps to draw a dividing line between instability and moral defectiveness due to this cause.
Vicious or criminal conduct may accompany or follow either Encephalitis Lcthargica or Epilepsy without co-incident amentia, but in those cases in which symptoms of amentia are present it would appear to be necessary in practice to apply the same criteria as under the Mental Deficiency Act (1913), in spite of the fact that the permanence of the condition is no longer required, and to insist upon a corroborative history extending over a prolonged period before issuing a certificate of moral deficiency.
Reference. East, W. N., ” Forensic Psychiatry.”
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