We use words to label and help us comprehend the world around us. At the same time, many of the words we use are like distorting lenses: They make us misperceive and hence misjudge the object we look at. As Sir James Fitzjames Stephen, the great 19th-century English jurist, aptly put it, "Men have an all but incurable propensity to prejudge all the great questions which interest them by stamping their prejudices upon their language."
Consider the ongoing scandal involving Roman Catholic priests accused of molesting boys. American law defines sexual congress between an adult and a child as a crime. The American Psychiatric Association defines it as a disease called "pedophilia."
Crimes are acts we commit. Diseases are biological processes that happen to our bodies. Mixing these two concepts by defining behaviors we disapprove of as diseases is a bottomless source of confusion and corruption.
That confusion was illustrated by a February 8 letter to The Boston Globe in which the Rev. John F. Burns defended Boston Cardinal Bernard Law against critics who said he ought to resign. As an archbishop, Law had transferred the Rev. John J. Geoghan to a new parish despite allegations of sexual abuse. Geoghan eventually was accused of molesting more than 100 children over three decades.
"It should be noted that neither Cardinal Bernard Law nor Father John Geoghan was aware early on of the etiology or pathology of the disease of pedophilia," Burns wrote. "The cardinal did what an archbishop does best. He showed kindness and love to an apparent errant priest. Father Geoghan also did what more recent knowledge shows pedophiles do: namely, be in total denial, with hardly any remembrance or remorse for their diseased acts. Calling for the cardinal's resignation is absurd. Let the healing begin and the law take its course."
The law is taking its course not only in the suits filed against the church by the victims of Geoghan and other abusive priests. Geoghan himself has been convicted of molestation in one case and faces trial in another. But if his behavior was caused by "the disease of pedophilia," a condition that not only compelled him to fondle boys but erased his memory of those "diseased acts," how can it be just to punish him? The uncertainty introduced by viewing sexual abuse as the symptom of a disease played an important role in the church's failure to protect congregants from priests like Geoghan. In a May 8 deposition, Cardinal Law was asked how he approached molestation charges. "I viewed this as a pathology, as a psychological pathology, as an illness," he said. "Obviously, I viewed it as something that had a moral component. It was, objectively speaking, a gravely sinful act." The combination of these two irreconcilable views, medical and moral, was a recipe for inaction.
Medical Penal Establishment
Today virtually any unwanted behavior, from shopaholism and kleptomania to sexaholism and pedophilia, may be defined as a disease whose diagnosis and treatment belong in the province of the medical system. Disease-making thus has become similar to lawmaking. Politicians, responsive to tradition and popular opinion, can define any act, from teaching slaves to read to the cold-blooded murder of a bank guard, as a crime whose control belongs in the province of the criminal justice system.
Applied to behavior, especially sexual behavior, the disease label combines a description with a covert value judgment. Masturbation, homosexuality, and the use of nongenital body parts (especially the mouth and anus) for sexual gratification have, at one time or place, all been considered sins, crimes, diseases, normal behaviors, and even therapeutic measures. For many years psychiatrists imprisoned homosexuals and tried to "cure" them; now they self-righteously proclaim that homosexuality is normal and diagnose people who oppose that view as "homophobic." Psychiatrists diagnose the person who eats too much as suffering from "bulimia" and the person who eats too little as suffering from "anorexia nervosa." Similarly, the person who has too much sex suffers from "sex addiction," while the person who shows too little interest in sex suffers from "sexual aversion disorder." Yet psychiatrists do not consider celibacy a form of mental illness; celibate persons are not said to suffer from "anerotica nervosa."
Why not? Because psychiatrists, politicians, and the media respect the Roman Catholic Church's definition of celibacy as a virtue, a "gift from God," even though celibacy is at least as "abnormal" as homosexuality, which the church continues to define as a grievous sin -- an "intrinsic evil," in the words of Cardinal Anthony Bevilacqua. Regardless of how unnatural or socially destructive a pattern of sexual behavior might be, if the church declares it to be virtuous -- as with celibacy or abstinence from nonprocreative sexual acts -- psychiatrists do not classify it as a disease. Thus a religion's moral teachings shape what is ostensibly a scientific judgment.
Conversely, psychiatric diagnoses affect moral judgments. Fred Berlin, founder of the Johns Hopkins Sexual Disorders Clinic and a professor of psychiatry at the Johns Hopkins School of Medicine, declares: "Some research suggests that some genetic and hormonal abnormalities may play a role [in pedophilia]....We now recognize that it's not just a moral issue, and that nobody chooses to be sexually attracted to young people." Yet an action that affects other people is always, by definition, a moral issue, regardless of whether the actor chooses the proclivity to engage in it.
Berlin misleadingly talks about the involuntariness of being "sexually attracted to young people." The issue is not sexual attraction; it is sexual action. A healthy 20-year-old male with heterosexual interests is likely to be powerfully attracted to every halfway pretty woman he sees. This does not mean that he has, or attempts to have, sexual congress with these women, especially against their will. The entire psychiatric literature on what used to be called "sexual perversions" is permeated by the unfounded idea -- always implied, sometimes asserted -- that "abnormal" sexual impulses are harder to resist than "normal" ones.
The acceptance of this notion helps explain the widespread belief that sex offenders are more likely than other criminals to commit new crimes, an assumption that is not supported by the evidence. Tracking a sample of state prisoners who were released in 1983, the Bureau of Justice Statistics found that 52 percent of rapists and 48 percent of other sex offenders were arrested for a new crime within three years, compared to 60 percent of all violent offenders. The recidivism rates for nonviolent crimes were even higher: 70 percent for burglary and 78 percent for car theft, for example.
These numbers suggest that pedophiles resist their impulses more often than car thieves do. In any case, it is impossible to verify empirically whether an impulse is resistible. We can only say whether it was in fact resisted. But that doesn't matter, because the purpose of such a pseudomedical claim is to excuse the actor of moral and legal responsibility.
Catholic officials took advantage of this psychiatric absolution to avoid dealing decisively with priests who were guilty of sexual abuse. What do church authorities do when a priest is accused of molesting children? They send him to a prestigious psychiatric hospital -- Johns Hopkins in Baltimore, the Institute of Living in Hartford, the Menninger Foundation in Topeka -- for "treatment." In practice, the psychiatric hospital is a safe house for the sexually misbehaving priest, a place where he can be hidden until he is quietly reassigned to continue his abuse elsewhere. Berlin claims such priests are closely watched after being discharged. But a priest who commits sexual abuse is a criminal who should be imprisoned, not a patient who should be monitored by psychiatrists in the church's pay.