薩茲博士談司法體系中的精神病學

Professor Thomas Szasz On Psychiatry In Our Justice System

“It is unlikely that toxicologists would be tolerated in courts of law if one would observe that he found a large quantity of arsenic in the body of a deceased person, and another stated that he found by the same operation none. Yet this sorry spectacle is commonplace in regard to psychiatric findings.”

「如果一位毒物學家在死者的屍體中發現了大量的砷，而另一位做了同樣的程序，卻說他沒有發現任何砷，那毒物學家大概不會見容於法庭。然而，就精神病學來說，這種令人遺憾的景象卻是司空見慣。」

“The introduction of psychiatric considerations into the administration of the criminal law—for example, the insanity plea and verdict, diagnoses of mental incompetence to stand trial, and so forth—corrupt the law and victimize the subject on whose behalf they are employed.”

「將精神病學的考量導入刑法的執法程序，例如精神失常的抗辯和判決、診斷某人在心智上無能力接受審判等等，這些作為不但敗壞法律，也使精神科所代理的行為人成為受害者。」

“All criminal behavior should be controlled by means of the criminal law, from the administration of which psychiatrists ought to be excluded.”

「所有犯罪行為都應該用刑法來管控，不該讓精神病學參與執法。」

“My belief that the insanity defense should be abolished is based partly on a conceptual critique and partly on a practical one. Now the conceptual one, very briefly, is that insanity is a dubious term which can refer to one of two things: First, to a brain disease, and I will say something about that; and secondly, to misbehavior. Well, disease, brain disease, does not cause criminal acts. Epilepsy as a brain disease does not cause criminal acts. Epileptics may or may not, just like other people, commit crime. Now, insofar as the term insanity refers to behavior, it is a fiction. It is not a disease, and doctors have no competence in judging that. It’s usually determined after a person commits a crime; usually if something gets upsetting socially. My second basis for objecting to it is that the consequences of the insanity defense typically is incarceration in the name of diagnosis, disease, and treatment. And that is a charade and a misuse of the medical profession for depriving people of liberty who are nominally declared to be innocent.”

「我認為應該廢除精神失常辯護，這個批判一部分基於學理，另一部分基於實務考量。在學理上，非常簡單地說，精神失常是一個有爭議的用語，它可以指兩件事：第一是腦部疾病，這我會稍微說明；第二種，是不良行為。

好，疾病，腦部的疾病，不會導致犯罪行為。癲癇作為一種腦部疾病不會導致犯罪行為。癲癇患者可能會也可能不會犯罪，就像其他人一樣。

再來，精神失常就行為而言，是虛構的用語。它不是一種疾病，醫師們沒有能力下那個判斷。精神失常通常是在一個人犯罪之後決定的，通常是在某個事件造成社會不安之後。我反對的第二個依據是，為精神失常辯護的後果，通常是以診斷、疾病、治療的名義，監禁此人。這是一種欺騙，也是濫用醫學專業，名義上宣佈他們無罪，卻剝奪他們的自由。」

“I have long maintained that the institution of psychiatry rests on civil commitment and the insanity defense and that each is a paradigm of the perversion of power. If the person called ‘patient’ breaks no law, he has a right to liberty. And if he breaks the law, he ought to be tried and declared guilty or not guilty by the criminal justice system…. Some people assault, rape, rob and kill others and thus endanger society. What does psychiatry contribute to their management? Civil commitment, which is a euphemism for preventive detention; and the insanity defense-and-disposition, which is a euphemism for defining incarceration as treatment (or a strategy for excusing guilt). These two procedures are the pillars on which psychiatric power rests. Each authenticates the fiction of psychiatric expertise to manage ‘dangerousness.’ Each creates and confirms the illusion that we are coping wisely and well with vexing social problems, when in fact we are obfuscating and aggravating them. Psychiatric power thus corrupts not only the psychiatrists who wield it and the patients who are subjected to it, but the community that supports it as well…. There is neither justification nor need for involuntary psychiatric interventions….”

「我一直主張，精神病院是靠民事安置和精神失常辯護支撐的。這兩件事，都是濫用權力的典型事例。如果所謂的“病患”沒有違法，他就該有權享有自由。如果他犯了法，他就該接受刑事系統的審判，宣布有罪或無罪…… 有些人用暴力攻擊、強姦、搶劫、殺人，對社會造成危害。精神病學對管理他們有什麼貢獻？暫行安置，這是預先拘留比較委婉的說法；精神失常的辯護和處置，這是把監禁定義為治療（或許是消除罪惡感的一種策略），也是說法好聽點而已。這兩種程序，是精神病學強權賴以生存的支柱。兩者都驗證了精神病學對『危險』的專業管控純屬虛構。兩者都創造並且強化一種幻覺，那就是我們很聰明，把棘手的社會問題應付得不錯，但實際上，我們是在混淆是非，讓問題更加惡化。因此，精神病學強權不僅腐化了行使它的精神科醫生和接受它的患者，也敗壞了支持它的社區…… 精神病學的強制干預，既沒有正當理由也沒有必要……」

“If he who breaks the law is not punished, he who obeys it is cheated. This, and this alone, is why lawbreakers ought to be punished: to authenticate as good, and to encourage as useful, law-abiding behavior. The aim of criminal law cannot be correction or deterrence; it can only be the maintenance of the legal order.”

「對違法者不罰，等於是對守法者的欺騙。違法者應當受到懲罰，只有一個原因，那就是認證守法行為是好的，推崇守法行為的價值。刑法的目的不能只是矯正或嚇阻；維護法律秩序才是它唯一的宗旨。」

原文網址：https://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/quotes-on-psychiatry-in-our-justice-system/