O'Neill Institute Papers


From a Civil Libertarian to a Sanitarian

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This autobiographical article recounts Dean Lawrence Gostin’s professional journey from the rights of mental health patients, to the civil liberties of individuals and groups, through to the broad welfare of large populations. In this article, Dean Gostin discusses the role that Erving Goffman’s Asylums played in shaping his professional path. A truly observant advocate sees the power imbalances, the loss of a self-worth, the absence of pleasure and comfort, and the sheer dreariness of everyday life.

This article uses news events of the time to reconstruct the author’s approach to reforming the Mental Health Act of 1959 and litigation against psychiatric institutions. During his years at MIND (National Association for Mental Health) in the United Kingdom, the author wrote much of the Mental Health Act, and litigated foundational cases in the domestic courts and before the European Court of Human Rights, including the landmark case of X v. the United Kingdom. The author went on to lead the National Council of Civil Liberties (NCCL) (now called Liberty, which is the equivalent to the ACLU) through its 50th Anniversary, launching the “Liberty Campaign” among leading public figures. He chaired the Independent Inquiry into the National Miners Dispute, which resulted in his public resignation from NCCL and his move to Harvard University.

The article ends with a discussion of the values the author brings to national and global health, animated by a single profound question: If impoverished communities are suffering and dying young from avoidable illnesses such as AIDS, TB, diabetes, or heart disease, what does justice require? His answer is that the poor would gladly trade a small intrusion on autonomy and privacy for the chance to lead a healthier, more secure, life.

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