Five cardinal questions on administrative psychiatry / by J. Mundy.

  • Mundy, Jaromir, Freiherr von, 1822-1894.
Date:
1861
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Licence: Public Domain Mark

Credit: Five cardinal questions on administrative psychiatry / by J. Mundy. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The committee of mauagemeut ordinarily consists of several government officials, or benevolent persons, a secretaiy, and now and then a physician, who, as before said, is scarcely ever an asylum physician, or one looked up to as an authority in tliis special de- partment of medicine. In many countries there is no higher superintending authority over asylums, except that supphed by members of the provincial sanitary boards. Many states again only delegate, as cases arise, some individual government official to undertake the particular control of the treatment of the insane. With what want of design such arrangements are made can be further perceived from the fact, that in different coimtries of Europe lunatic asylums are included in the jurisdiction of the Minister of Justice, or in that of the Minister of Public Instruction, or again, in the department of the Interior; indeed, we know of one state where a short time ago the lunatic asylums were entrusted to the Minister of Commerce. We must not forget to mention the several provincial, district, or county committees, in the composition of which likewise, as a rule, physicians are excluded. These local committees, however, interpose the greatest obstacles to practical and speedy reform in the administration of asylum treat- ment. They are the drags to rational progress. What passion and weakness may not be found among their members ! And hence arise those continual collisions between the professional supeiin- tendence and the administrative management of the institutions. These committees commonly act only as a permanent opposition, paralyse the authority of the physician, make him appear as a very subordinate instriunent, and often manifest themselves only as an element of disorder in the whole conduct of the institution. What asylum physician has not the saddest expenence of this ? Divided authority is to the physician a som-ce of great evil, whilst a subordinate position (as, for example, in private establisliments belonging to non-medical men) annihilates his usefulness altogether. We need devote several sheets to illustrate and exhaust this chapter, but as we fear lest our essay should become too voluminous, we shall pause here, and briefly ^scuss the other cardinal ques- tions. Besides, we believe enough has been aheady stated to demonstrate that, for the purj)ose of securing effective supervision this priiici])le must be accepted, “that the position of the physician must be independent,'' and, as far as possible, officials and all the stall be always subordinate to liim. In our opinion, moreov(;r, the control of lunatic asyhuns requires that th(! juesident of tlie committee should always be. a member of the profession of autliority in this specialty; and the majorily of its
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