Theoretical Medicine and Bioethics

, Volume 31, Issue 1, pp 93–105

Madness versus badness: the ethical tension between the recovery movement and forensic psychiatry


DOI: 10.1007/s11017-010-9138-9

Cite this article as:
Pouncey, C.L. & Lukens, J.M. Theor Med Bioeth (2010) 31: 93. doi:10.1007/s11017-010-9138-9


The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs.


Recovery movement Bioethics Psychiatry Social policy Moral agency 

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Center for BioethicsUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.School of Social Policy and Practice, Center for BioethicsUniversity of PennsylvaniaPhiladelphiaUSA

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