The Bought Mind

Thoughts on Despotism as Medical Discretion

“No pious platitudes . . . can get over the fact that a bought mind is a spoiled mind.”

—George Orwell

Soon after his inauguration, President George W. Bush declared: “When we see social needs in America, my administration will look first at faith-based programs and community groups, which have proven their power to save and change lives.” Critics lost no time assailing the proposal as a threat to the separation of church and state. There is, indeed, cause for alarm here, but the real danger lies elsewhere.

The Founders’ interest in separating church and state must be seen in its historical context. During the centuries preceding the American revolution, the secular rulers of European states represented, and were expected to represent, the religious interests of the majority of their subjects, Catholic or Protestant. The result was entrenched religious persecution and war. The Founders wanted to preserve the moral authority of the churches, while creating a system of secular rule indifferent to the specific religious denomination of particular citizens. All they said on the subject, let us not forget, was that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”

Why did the Founders not mention money, that is, the government’s use of taxes to support religious organizations? The answer is simple and important. First, because religious bodies, exemplified by the Vatican, derived their income directly from their members, collected their own funds, and were often quite wealthy. The Mormon church and the Christian Science church are recent examples. Second, the Founders did not mention money because it never occurred to them that one day the United States would be so large and prosperous, and the government would tax the citizenry so heavily, that it could, if it chose, control anything it wanted by supporting the activity with money.

Responding to critics, a Bush adviser cited “provable results from faith-based social programs that address problems like substance abuse.” Mr. Bush himself says his faith saved him from abusing alcohol. No one can doubt the power of religious faith to alter human behavior. Indeed, the proposition that religion influences behavior is a sort of pleonasm; in a manner of speaking, that’s what religion is for. Christians speak of “deciding for Jesus.” Similarly, people decide for and against drinking or smoking. But decisions are not diseases. No one decides to have a real disease, such as melanoma. Nor can a real disease be effectively treated by faith healing.

Sooner or later we will have to confront the question, is ingesting illegal drugs a disease? At present, the American Medical Association, the American Psychiatric Association, and the American government maintain that it is. That is not what they maintained before World War II. If drug abuse is a disease, like diabetes, then its effective treatment by prayer is nothing short of a bona fide “miraculous cure,” such as the Catholic Church requires for beatification. And if drug abuse is not a disease, then the American Medical Association, the American Psychiatric Association, and the American government are committing a colossal fraud against the American people.

Using, abusing, and not using drugs are decisions. Using a drug (or sex) solely for the purpose of giving oneself pleasure used to be called a “sin” by Puritans, and a “bad habit” by persons less certain about God’s will. They were on the right track. Drug abuse is neither a disease (except metaphorically), nor a crime (unless we make it so). Drug abuse is a problem of desire: if people did not want drugs, there would be no drug users and no drug abusers. The desire for drugs has its source in two of the now all-but-forgotten “deadly sins,” lust and gluttony. People lust after the pleasures drugs can give, and abuse drugs as gluttonously as they abuse food, sex, and often other people.

Not So Separate

Church and state have never been, and could never be, as separate as many self-styled atheists like to believe. The danger in the government’s paying faith-based organizations to treat drug abuse is not so much that it violates the separation between church and state. It lies, rather, in that the money defiles the integrity of faith-based institutions. The adage “He who pays the piper calls the tune” has not yet been shown to be false.

Perhaps even more important, the Bush program gives further impetus to the tendency to conflate decision and disease, sin and sickness, faith healing and scientific medicine. The result is the turning of the country into a therapeutic state, the “compassionate and scientific” rule of medical discretion replacing the “harsh and unscientific” rule of law.

Examples of this metamorphosis are all around us. A so-called sex offender is apprehended, tried, found guilty, and sentenced to a long prison term. He serves his sentence. Is he set free? No. He is re-imprisoned, in a “hospital.” The Supreme Court rules that the re-imprisonment does not constitute double jeopardy, because it is a “civil” procedure, intended as treatment, not punishment.

In a Wall Street Journal editorial, a prominent drug-abuse expert writes: “As a psychiatrist who treats addicts, I have learned that legal sanctions—either imposed or threatened—may provide the leverage needed to keep them alive by keeping them in treatment. Voluntary help is often not enough.” The essay is titled: “For addicts, force is the best medicine.” The use of physical force by one individual against another is a crime called assault. The use of legal force by the state against the individual is called “law enforcement.” It is becoming the badge of intellectual sophistication to call coercion “treatment,” provided the subject is regarded as a “patient,” and doctors do the punishing.

The day Mr. Bush announced his plan for faith-based drug treatment plans (January 30, 2001), the Associated Press reported that the actor Robert Downey Jr. had been re-arrested for a violation of the drug laws. “We’re just trying to figure out what’s best for Mr. Downey,” said—who? His physician? No. His lawyer? No. The words were those of Deputy District Attorney Tamara L. Capone [sic], the prosecutor whose job, presumably, is to punish him. This is not the way prosecutors speak about inner-city black youths arrested for drug offenses. For some, three strikes and you are out. For others, whatever is “best.” The modern goddess of justice is not blindfolded. She looks at brain scans. The real danger in the faith-based programs of “help” proposed by President Bush lies in subverting religion, obstructing clear thinking, and replacing liberty under law, with despotism as medical discretion.