Amentia Properly So Called

Today amentia properly so called is reduced, for the most part, to two species, namely endogenous psychoses and exogenous psychoses. The latter lead to complete intellectual degeneration or dementia; not so the former.

I. Endogenous psychoses have the cause of their origin in the very physical habitual disposition of the subject. But exogenous psychoses come from an added cause, namely from the fact that the cerebral cells are affected by certain poisonous materials, which either come from outside or are produced by the body itself. To endogenous psychoses are reduced: manic-depressive psychosis and paranoia.

1. Manic-depressive psychosis occurs in a twofold way, namely as mania and as depressive or melancholic psychosis.

a) The manifestations of mania are cheerfulness and mobility, which exceed the ordinary and normal mode.

b) The sign of depressive psychosis is the highest melancholy. This psychosis carries with it great danger of suicide, since the one affected by this psychosis is vexed by various thoughts of desperation and anxiety.

c) Both mania and depressive psychosis usually remit after an intervening time; nevertheless, it can happen that they endure chronically.

2. Paranoia is a certain chronic amentia by which a certain delusional persuasion rules the whole life. The operation of the intellect, especially at the beginning of the disease, is not immediately ruined; from this it happens that such sick persons, if there is question of matters which are not found within the sphere of the disease, can judge perfectly. Gradually one idea or another invades the soul more and more, so that at last they hold fictive and vain things for true. These fictive things have various objects. Some persuade themselves that they are suffering persecution; others, that they have been called to great things; others, that some person, especially a noble one, has been seized with love for them; others finally are disturbed by religious ideas. They think that they converse with angels and saints, whose voices they perceive; they wish always to be occupied with vocal prayer, etc.

II. Exogenous psychoses. To exogenous psychoses belong: 1. schizophrenia or dementia praecox; 2. paralytic dementia; 3. epilepsy.

1. Schizophrenia, or dementia praecox, generally arising at a rather younger age, usually before the thirty-fifth year of age, ends in total hebetude, or dementia. The distinctive marks of this disease are: the dissolution of the unity and coherence which, in the normal condition, exist among a person's thoughts, affections, and actions, and the loss of the sense of the reality of things.

2. Paralytic dementia, which is a consequence of syphilis. About three percent of those who suffer from syphilis fall into this psychosis. It generally appears eight to ten years after the infection has begun, and at first it is manifested by the greatest forgetfulness and carelessness. Generally it progresses quickly and after two or three years brings on death. They say, nevertheless, that a remedy by which it is checked has been found.

3. Epilepsy is a disturbance of the nerves which periodically recurs and brings on a crisis in which the patient is not master of himself. When the crises take place rather rarely, sick persons of this sort, outside the time of the attack, enjoy an almost normal use of the intellectual faculties. But if the crises recur more often, the soul is changed at its foundation, so that there can be discussion of an epileptic character.

Corollary. Concerning the moral responsibility of the insane, two very expert physicians speak thus: "In the demented, whose sensitive life, both cognitive and concupiscible, is disturbed, for this reason almost never can full moral responsibility be present. It is clear that moral responsibility is especially diminished with respect to those acts which cohere directly with psychic abnormalities; hence it is evident that the temptation to kill someone cannot be imputed to him who, either because of hallucination, thinks that this has been commanded him, or imagines that someone is persecuting him. Partial responsibility can be present in those acts which do not cohere with psychic abnormalities."¹

¹ Schim van der Loeff and Barnhoorn, o.c., p. 94.

I. All human beings are subject to the natural law, even infants and the perpetually insane. The reason is that the natural law is founded in human nature itself (n. 81). Hence neither infants nor the perpetually insane may be induced to violate the natural law¹ (St. Alphonsus, I, 153).

¹ There are, nevertheless, acts which, when placed by infants or by the perpetually insane, or by those who lack reason only actually, for example by the drunk, lose their objective disorder, such as insulting words (St. Alphonsus, V, 78). Nevertheless, it is difficult to determine precisely which acts ought to be referred to this class.

III. In order that someone be subject to positive law, it is required that he be the subject of the respective legislator, and, if there is question of human law, that he habitually enjoy the use of reason. I said:

1. That he be the subject of the respective legislator, that is, that he be subject to his jurisdiction in such matter.

2. That, if there is question of human law, he habitually enjoy the use of reason. Namely:

a) The divine legislator can bind all, at least in first act, and, as authors commonly seem to teach, He has in fact bound all.

b) A legislator lower than God is not considered to have received the power of binding, not even in first act, those human beings who cannot know the law and be directed by it. Therefore infants and the perpetually insane are excluded; but not the half-witted or those who have lucid intervals, nor those who lack the use of reason only actually, such as the drunk or sleeping. One who induces these latter, for example a drunk man, to violate positive law does not of itself commit the sin of scandal, because the drunk man lacks formal fault, but he sins against the law to whose material transgression he incites him. Moreover, observe that a perpetually insane person, although he is not subject to the directive obligation of law, nevertheless participates in the rights and other effects of laws. Thus, for example, their acts, that is, acts placed in their name by a guardian, can be invalidated, etc.

Corollary I. All human beings are subject to universal divine positive law. Hence Christ declares: "Going, teach all nations... teaching them to observe all things whatsoever I have commanded you."¹

Corollary II. All baptized persons habitually enjoying the use of reason are subject to universal ecclesiastical law (cf. can. 12). So, at least generally.

Therefore unbelievers are excluded, as those who are not subject to the jurisdiction of the Church. Hence the Apostle says: "What is it to me to judge those who are outside?"² Therefore it is licit, for example, to set meat before the aforesaid persons on days of abstinence.

I said: so, at least generally; for 1. concerning some, certain special things must be noted, which we shall do in § III; 2. concerning subjects of the Eastern Church, can. 1 is to be observed: although in the Code of Canon Law the discipline of the Eastern Church also is often referred to, nevertheless the Code regards only the Latin Church and does not oblige the Eastern Church, unless there is question of those things which from the very nature of the matter affect the Eastern Church also.

Corollary III. To a particular law, whether ecclesiastical or civil, there are subject those who habitually enjoy the use of reason and, if there is question of a law established for a territorial community,³ are both of the territory and in the territory, with the prescription of can. 14 remaining firm. I said:

1. They are of the territory; in other words, it is required that they have domicile or quasi-domicile in the territory of the community. This condition, if there is question of an inferior legislator, for example of a bishop, is necessary, because only through domicile or quasi-domicile is someone constituted a subject of an inferior legislator placed over a territorial community (can. 94). But if the Supreme Pontiff imposes a law on a community of this sort, he is presumed to bind only those who are subjects of the governor of that community, and therefore have domicile or quasi-domicile in his territory.

2. They are in the territory; in other words, it is required that they actually dwell in the territory of the community, namely, a territorial law does not affect subjects except by means of the territory. And this holds also as regards those who have gone out of the territory in fraud of the law, as it is said, that is, for the purpose of being exempted from the law.

3. With the prescription of can. 14 remaining firm, which canon concerns travelers and vagi; considering that canon, some are at times held by territorial law, although they are not in the territory or lack domicile or quasi-domicile in it (n. 131).

¹ Matt. 28:19-20.

² 1 Cor. 5:12.

³ For example, for a diocese.

IV. Fuller exposition; this is especially set forth by a fuller exposition both of the object of justice, that is, as is clear from the definition handed down, right,¹ and of its subject.

1. Notion of right. The word right is taken in different senses, for example for a moral and inviolable faculty in regard to something, that is, in regard to some thing or some action, whether one's own or another's; for a law granting some moral faculty in regard to something; for a body of laws, as when someone is said to study law; for the sentence of a judge, who therefore is said to declare the law; for the place in which sentence is pronounced, whence someone is said to appear in court.

Now right, insofar as it is the object of justice, is a thing due to someone according to some equality; namely the material object is the thing due, and the formal object is the character of debt. Moreover, under the name of thing we also comprehend an action or omission.

2. Source of right. The remote source of every right is law, whether natural or positive, and ultimately the eternal law, which is the origin of all laws according to these words of St. Alphonsus: "The will of God alone, as being most holy, most wise, most upright, is the one source of every law, of every rule, and of the measure of honesty" (Dichiarazione del sistema, n. 18). The proximate source of right is the moral faculty itself, on account of which some thing is due to someone. I said moral faculty, by which is understood some power with respect to some thing.

3. Division of right. Right, insofar as it is the object of justice, is divided:

a) By reason of origin, into natural right and positive right, according as it flows from natural law (n. 82) or from positive law (n. 89).

b) By reason of subject, into individual right and social right, according as it belongs to man as an individual, or as part of a whole, or as a member of society.

c) By reason of the title in which it is proximately founded, into right founded in the title of devinction or quasi-devinction² of a thing to some person, and this is the object of commutative justice; into right founded in the title of capacity, dignity, merit, or necessity, on account of which some good, for example an office, ought to be granted by the whole, that is, by the prince, to some member of society, and this is the object of distributive justice; into right founded in the ordination of subjects and of the prince to society, and this is the object of legal justice.

d) By reason of efficacy, into strict right and less strict right, according as it is founded in the title of devinction or quasi-devinction of a thing to some person, or in another of the titles just assigned.

Strict right, that is, the object of commutative justice, is distinguished into ius in re, or real right, and ius ad rem, according as a thing has already been bound to someone, or someone has a right that a thing, still bound to another, be bound to himself. This right is sometimes called ius in personam, insofar, namely, as some person, from commutative justice, is obliged to render some thing to someone (St. Alphonsus, III, 486).

4. Subject of right. A rational being, and it alone, is the subject of right. For right is a thing due to someone according to some equality. But something can be due only to a rational being.

The Minor is proved. Something can be due only to him who has a moral faculty in regard to something. But a moral faculty in regard to something belongs to a rational being, and to it alone.

The subsumed Minor is proved. A moral faculty belongs to him, and to him alone, who can and ought to direct himself to the ultimate end; for such a one and such a one alone enjoys the faculty of choosing means to the ultimate end, a faculty, I say, of which others ought to take account. But a rational being, as free, and it alone can and ought to direct itself to the ultimate end; irrational beings, as lacking liberty, cannot direct themselves. Therefore a moral faculty belongs to a rational being, and to it alone.

Corollary I. Even infants and the insane are capable of rights. This is clear: 1. from Sacred Scripture: "For as long as the heir is a little child, he differs nothing from a servant, although he is lord of all; but he is under tutors and governors until the time predetermined by the father";³ 2. from the consent of all nations and laws; 3. from the fact that nothing prevents some thing from being destined to the special utility of someone and therefore owed to him, even if in the use of the thing he must be directed by the reason and will of another.

Corollary II. Not only physical persons, but also moral persons, can be the subject of right, or at least be regarded as if they were the subject of right;⁴ concerning these we shall speak specifically later.

Corollary III. The capacity of acquiring a right can be restricted by authority, both civil and ecclesiastical, and this both directly, for example if someone is deprived of the usufruct of his own thing (n. 764), or is rendered incapable by reason of a solemn vow of poverty; and indirectly, insofar as certain things are placed outside commerce. The state in which someone exists deprived of the capacity of right is called civil death.

And with these things having been premised concerning justice taken more generally, let us proceed to the treatment of commutative justice, speaking, as we have already noted, first of commutative justice itself, then of injustice and restitution. We shall add a double appendix, the former on distributive justice, the latter on legal justice.

¹ Cf. Lijdsman, C.SS.R., Introductio in Ius Canonicum, vol. I, n. 1.

² By quasi-devinction I understand the power which belongs to a private person, so that some thing may be bound to him (ius ad rem).

³ Gal. 4:1-2.

⁴ It is disputed: 1. whether and 2. in what precise sense a moral person can be called the subject of right. Cf. Brinz, Pandekten, III, § 432-454; Ihering, Der Geist des Romischen Rechts; Vermeersch, Quaestiones de Iustitia, XIV; F. C. von Savigny, System des heutigen Romischen Rechts, II, § 85-103; d'Annibale, Summula Theologiae Moralis, I, n. 43; Waffelaert, Etude de theologie morale sur l'obligation en conscience des lois civiles, p. 157-184; Cathrein, Moralphilosophie, II, p. 394-395; Gierke, Das Deutsche Genossenschaftsrecht, cited by Duynstee, n. 22.

In little children and the perpetually insane no disposition is required. In adults these things are required:

Note. It is pleasing to explain briefly how far the sacraments can be ministered to little children, the insane, and the partially insane, and received by the aforesaid.

I. Little children and the perpetually insane, as was already said (n. 38), are capable of receiving Baptism, Confirmation, the Holy Eucharist, and Order. Yet not all are conferred on them.

II. To the insane who previously possessed the use of reason, those things must be applied which we said generally concerning adults. Hence, for example, for valid reception it is required that before insanity they had the intention and did not retract it. For the rest, consult what is to be said concerning the individual sacraments.

III. The partially insane are not of themselves to be kept away from the sacraments. Namely:

1. Baptism must be conferred on them even outside danger of death; nor is so much instruction prerequired in them as in others.

2. Confirmation can be conferred, even if they have been instructed less than others.

3. Absolution should be granted, in doubt about sufficient use of reason or disposition under condition: 1. in danger of death; 2. at Easter; 3. as often as they have confessed a doubtfully grave sin; indeed, 4. several times, even if they have declared only light sins (St. Alphonsus, VI, 432; IV, 3).

4. The Holy Eucharist should be conferred: 1. in danger of death; 2. at Easter; 3. several times, if they show devotion (St. Alphonsus, VI, 303).

5. Extreme Unction should be furnished to those lying dangerously ill; under condition if there is doubt about the use of reason had both now and previously.

6. Order is not to be administered to them.

7. They can indeed enter Matrimony if they understand the substance of the contract; nevertheless they are generally to be turned away from it.

2. The insane are some perpetually insane, others not perpetually insane, others insane only about one or another point, and others semi-insane.

a) The perpetually insane. To these, since they are equated with little children, the Holy Eucharist cannot be ministered,¹ not even in danger of death. The reason for the prohibition is that they neither have, nor ever had, knowledge and taste of the Holy Eucharist.

b) The insane, but not perpetually so, the delirious, epileptics, the possessed, and those obsessed.

First, outside danger of death, the Eucharist cannot be ministered to the aforesaid while they are not in possession of themselves. "Nevertheless it will be permitted, if at some time they have lucid intervals and show devotion while they remain in that state, if there is no danger of unworthiness"² (St. Alphonsus, VI, 302).

Second, in danger of death it should not be given: 1. if it is sufficiently certain that they are constituted in sin and impenitent, for example if in the act of sin, or after a scandalous life, they have fallen into insanity, delirium, or deprivation of the senses; 2. if a danger of positive irreverence is present. In doubt whether such danger is present, that is, the danger that the sick person may expel the Sacred Host or move indecently during the ministration, it is useful to give him an unconsecrated particle before the Holy Eucharist; 3. if it is clear that they lack and have always lacked sufficient knowledge and devotion toward the Eucharist (St. Thomas, III, q. 80, a. 9; St. Alphonsus, VI, 302). Nevertheless imperfect knowledge suffices; likewise devotion broadly taken, or such that someone can be presumed to will to receive the Eucharist in danger of death. Outside the enumerated cases, according to the opinion of almost all authors, it is permitted to minister the Eucharist to them.³

For the rest, nothing can obstruct liceity except the defect of actual devotion in the one receiving or the prohibition of the Church. But since the sacraments are for human beings, the greatest good of the one receiving prevails over the reverence owed in itself (St. Alphonsus, loc. cit.). The Roman Ritual⁴ can be understood of ordinary circumstances, that is, abstracting from danger of death. But it is disputed whether there is an obligation of giving Viaticum to the aforesaid. Now with St. Thomas (III, q. 80, a. 9), St. Alphonsus (loc. cit.), and most theologians, against some, it must be affirmed. For if it is permitted to give that greatest good to the dying person, there is also an obligation of giving it; all the more because the dying person must be said at least implicitly to ask for the sacrament, namely because his intention or profession of the Christian religion involves at least an implicit petition for Viaticum (St. Alphonsus, loc. cit.). From these things it follows that the practice of not ministering Viaticum to the persons of whom we have spoken is truly an abuse.

c) Those insane only about one or another point can communicate at least sometimes, provided the insanity does not regard the substance of the Holy Eucharist. The reason is that at least it is doubtful whether human beings of this kind lack the faculty of placing human acts; and in doubt, favor must be shown to them.

d) The semi-insane and the elderly becoming childish again. Communion is to be given to these: 1. in danger of death; 2. at Easter (St. Alphonsus, VI, 303); 3. if they enjoy greater discretion, they can also communicate more often. These things also hold of those deaf and mute from birth, unless they have been specially instructed in some institute (St. Alphonsus, loc. cit.).

¹ Cf. Roman Ritual, title IV, chapter 1, n. 10.

² Roman Ritual, loc. cit.

³ Cf. Fourth Council of Carthage (cause 26, question 6, chapter Is qui poenitentiam); First Council of Orange (cause 26, question 6, chapter Qui recedunt); Decretals of Gregory IX (De poenitentiis et remissionibus, chapter Quod in te), and the Roman Catechism (De Eucharistia, n. 64).

⁴ Title IV, chapter 1, n. 10.

Does ignorance cause the involuntary? - Ignorance with which someone acts either has itself causally in relation to that which is done, or has itself merely concomitantly with respect to that which is done. It has itself concomitantly "when ignorance concerns that which is done; nevertheless, even if it were known, it would still be done. For then ignorance does not induce one to willing that this be done, but it happens at the same time that something is done and unknown; as... when someone would indeed wish to kill an enemy, but, ignorant, kills him, thinking he is killing a deer. And such ignorance does not make the involuntary" (namely contrariwise), "because it does not cause something that is repugnant to the will; but it makes the non-voluntary" (or the involuntary merely privatively), "because what is unknown cannot be actually willed." S. Th. 1. 2. q. 6. a. 8.

But it makes the non-voluntary, whether that merely concomitant ignorance is involuntary, or whether it is not merely concomitant, but voluntary. Nevertheless there is a distinction between involuntary and voluntary ignorance in the case; because involuntary concomitant ignorance, since it simply takes away the voluntary, makes something simply non-voluntary. But voluntary concomitant ignorance, since it does not simply take away the voluntary, for it is voluntary, makes that which is done with that ignorance non-voluntary indeed in itself, but voluntary in some way in the cause. S. Th. de Malo, q. 3. a. 8.

Voluntary in the cause, namely insofar as the ignorance concerns a thing which ought to have been known, and perhaps someone knowing would not do what he does ignorantly. And if certainly he would do it even knowing, the voluntary is still had indirectly in the cause, by reason of that evil disposition which the willed ignorance leaves intact, and by reason of that action, for example hunting, which was the cause of the consequent act, for example homicide. To the point Suarez, on 1. 2, tr. 2, d. 4, s. 2, n. 19: "That ignorance does not excuse from fault; therefore neither does it take away the voluntary. He is bound to expel that ignorance in order to avoid the act, and voluntarily omits to do this; therefore he also acts voluntarily, at least indirectly. Therefore it matters nothing that this ignorance is not the cause of the act, and that if knowledge were present, the act would nevertheless take place; both because, although we grant that that act is not voluntary in ignorance as in a cause, nevertheless that ignorance will be a sufficient condition for that act to be voluntary indirectly, insofar as man is bound and can avoid it and does not do so; for what he would have done if knowledge existed does not excuse him, but rather in a certain way accuses him more, because that is an evil disposition and contrary to the obligation by which he is bound to avoid the act; and also because that effect is voluntary in another act directly willed, as, for example, the killing of a man in hunting. But voluntary ignorance, although it is concomitant, is the reason or condition that that prior act of hunting be done imprudently or incautiously, and consequently that in it the effect thence following is judged to have been willed."

Indeed, notwithstanding that evil disposition, he was still then bound, indeed much more, to know; and knowing, perhaps, notwithstanding that evil disposition, he would not have committed the monstrous crime with open eyes. S. Th. 1. 2. q. 6. a. 3; Billuart, de Act. hum., diss. 1, art. 6, I say 3.

If ignorance is not merely concomitant, or does not have itself merely concomitantly in relation to that which is done, but is causing, or has itself causally, namely is the cause of doing that which is done, then that ignorance is either voluntary, or consequent upon a free act of the will, or it is not voluntary, or antecedent to a free act of the will. A free act of the will, namely concerning the ignorance itself, not concerning that which is afterward done from that ignorance. "But consequently," says S. Th. ibid., "ignorance has itself to the will insofar as it is voluntary."

Therefore when ignorance of this kind is the cause of doing that which is done, "since it is itself voluntary... it cannot cause the involuntary simply" (that is, contrariwise; since that which is done is voluntary in the cause from which it proceeds, i.e. in that willed ignorance). "Nevertheless it causes the involuntary according to a certain respect, insofar as it precedes the movement of the will to doing something, which would not be if knowledge were present," ibid.; that is, although that movement of the will is voluntary in the cause, nevertheless in itself it is altogether involuntary, for it would not be if knowledge were present. L. 1. 5. n. 4.

But if the causing ignorance, or that which is the cause of doing what is done, is not voluntary, or is antecedent, then ignorance causes the involuntary simply, since that which is done, by the very fact that it is caused by ignorance, would not be if knowledge were present, and accordingly is against the will. Nor indeed is that willed in itself; nor in any way willed in the cause. Therefore it remains totally or simply involuntary. "But antecedently," says the Holy Doctor ibid., "ignorance has itself to the will when it is not voluntary, and nevertheless is the cause of willing what otherwise one would not will; as when some man is ignorant of some circumstance of the act which he was not bound to know, and from this does something which he would not do if he knew: for example, when someone, diligence having been used, not knowing that someone is passing along the road, shoots an arrow with which he kills the passerby. And such ignorance causes the involuntary simply."

S. Th. 1. 2. q. 76. a. 1. As regards the insane, it is certainly not always established that they are not sufficiently in possession of themselves in an act of sin. Nor likewise is it established whether those who are hypnotized, and in hypnotic sleep execute the evil commands of the one hypnotizing, are not also sufficiently in possession of themselves. But in these cases the voluntary can easily be in the cause.