Way Too Much Going On Here, Mill Edition

In England, a judge who relied explicity on the writings of John Stuart Mill in his ruling granted an imprisoned mentally ill Jehovah’s Witness sex offender the right to refuse a blood transfusion after a suicide attempt.

The judge was told that [the prisoner] had been moved to hospital from prison after cutting his arm with a razor blade and opening an artery. Specialists said he had suffered significant blood loss and his haemoglobin had fallen to “an extremely life-threatening level”. They had advised a blood transfusion but the man, who had a “severe personality disorder”, refused blood products on the basis of his faith. Mr Justice Mostyn first referred to Mill’s thinking as he considered legal principles underlying the case.

What the judge did first was refer to Mill’s thinking. Of course. Just one very simple case for Mill’s “one very simple principle.” Details here and here.

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Piers Turner
Piers Turner
10 years ago

As a human being, let me just first say that this is a terrible story. As someone interested in Mill, let me say that I’d wished the judge had taken to heart that Mill’s liberty principle does not protect the mentally ill from interference. Mill refers both to ‘lunatics’ and those ‘in some state of excitement or absorption incompatible with the full use of the reflecting faculty’ as not falling under his principle. What a shame.

Dale Miller
10 years ago

While it’s been suggested in the past that the first thing I do when ordering a meal in a restaurant is to refer to Mill’s thinking, I note that that the judge actually referred to the Declaration of the Rights of Man before referring to Mill. But while everything Piers says about Mill is correct—and it’s not often that our interpretations coincide—the case may be a little more complicated than he suggests. While this individual might have had a mental illness, he had apparently belonged for his entire life to a faith that rejects transfusions. It’s not a large sect, but presumably we don’t think that being a Jehovah’s Witness is in and of itself a sign of mental illness. If he rejected the transfusion based on a long-standing belief that pre-dates his mental illness, then I’m not sure that the judge didn’t properly apply Mill’s reasoning. To do otherwise seems to imply that if he had been in a right state of mind he would have repudiated his religion as soon as he needed a transfusion, and I’m not sure on what grounds we could conclude that. (Whether he properly applied the law is a different question.)

Piers Turner
Piers Turner
Reply to  Dale Miller
10 years ago

Point taken, Dale. You are probably right that the settled, long-time religious convictions of the individual would have been decisive for Mill. Presumably, had the person appointed a proxy, that proxy would not have been mentally ill but would have shared his faith. Unfortunately, Mill was not very clear about how to go about making these decisions — whether the social or legal authority is supposed to imagine what the individual, if rational, would have chosen, or whether the authority is supposed to decide according his or her own best judgment about what is for the individual’s good. I’d also point out that it’s a fine line between rationally accepting great risk of death in light of one’s values and revealing oneself not to be in full use of the reflecting faculty. When Jehovah’s Witnesses deny treatment to their children, I tend to think that interference would be rightful. With the self-regarding medical choices of adult Jehovah’s Witnesses, I sheepishly sidestep the question of whether or not interference would be rightful in principle by noticing that interference might not be justified in practice given the great potential social cost of opening the door to interfering with people’s personal decisions in this way.