chapter  5
27 Pages

The medicalization of deviance

This chapter focuses on changing social attitudes in Western society: specifically, on how these were reflected in medico-legal thinking and practice in relation to deviant behaviour. Deviance implies a lack of compliance with social norms, by a person whose conduct and mind-set differ from accepted standards; by definition, the deviant engages in activities that society frowns upon and on which it typically imposes legal sanctions. The definition of any action as deviant is thus essentially a socio-legal matter: laws are created and abolished in relation to social trends and popular beliefs, which themselves can be influenced by medical thinking. Deviance has probably never been more sharply defined than in relation to sex and death, topics which between them encompass a vast range of human activities and which in the past formed a core of medico-legal interest. In particular, infanticide, suicide and homosexuality presented problems that society had to reconcile, a process with which forensic medicine and its practitioners were closely involved. There can be no doubt of the historical importance of these topics, but a

few statistics are in order. In late eighteenth-century Paris hundreds of people killed themselves, so that suicide was allegedly becoming so common that only the most extraordinary cases attracted much attention.1 In England and Wales in 1856, nearly 22,000 inquests were held: of these, 476 resulted in a charge of homicide, 1,314 in a verdict of suicide, and nearly twice as many again were simply designated as ‘found drowned’ – frequently a euphemism for suicide.2 Judicial statistics show that the annual number of suicides and attempted suicides kept rising during the rest of the nineteenth century, and suicide is today a leading cause of death in Western countries.3 We cannot investigate why this is – that question exceeds the historian’s expertise and belongs properly to sociology and psychology – but we do need to consider the history of social and medical attitudes to suicide in order to gain a fuller understanding of the history of forensic medicine and its importance in Western society. Suicide was for centuries a criminal act, subject to harsh post-mortem

physical and financial penalties. In contrast, for centuries infanticide was treated with remarkable lenience, being within the purview of the ecclesiastical courts, which could not impose corporal punishments, until the early modern period,

when governments faced with what appeared to be a rising incidence of illegitimacy and infanticide criminalized both in an attempt to regulate female sexuality. In particular, the onus was placed on single women who gave birth in secret and whose infants subsequently died to prove they had not murdered them; those who could not provide the requisite proof were subject to capital punishment. Court cases multiplied and hundreds of convicted women perished in early modern Europe and America, but conviction rates dropped markedly during the eighteenth and nineteenth centuries even as the prevalence of violence towards infants remained disproportionately high.4 This was largely due to changing social attitudes, in which medicine had an important role to play, especially in the use of the lung test to determine whether a child had been born alive.5