Medical Paternalism and Institutional Progress

Throughout history, vulnerable individuals have often been denied their full autonomy. In mental health care, this took the form of forced sterilization programs, involuntary institutionalization, and social segregation stemming from the stigma of mental disorders. This stigma allowed for medical paternalism, which is the tendency for medical professionals to make decisions based on what they believe to be in the patient’s best interest, without the patient’s input or full consent. Medical paternalism in mental health care is harmful because it tries to excuse any and all actions of those classified as mental health professionals. This practice has resulted in many human rights violations against the mentally ill and disabled. In light of this, it is important to examine archived primary source material to gain insight into the culture which allowed these human rights abuses to happen, and the motivations which pushed for progress in mental health care.

Items in this section were selected from the Elizabeth F. Gardner papers and the Mental Health Association in Texas records at the Dolph Briscoe Center for American History, the José Angel Gutiérrez inventory at the LLILAS Latin American Studies and Collections, and other materials from UT Libraries. Elizabeth F. Gardner served as executive secretary for the Texas Society for Mental Hygiene in the 1940s and 1950s. Her papers document the changing tides of the perception of mental illness in society and efforts to improve mental health care in Texas. The Mental Health Association in Texas records document the establishment of the association (as the Texas Society for Mental Hygiene) in response to the mental hygiene movement, and how the efforts of the organization changed with the times (renamed to the Texas Society for Mental Health in 1950,  later renamed the Mental Health Association in Texas, and finally renamed to Mental Health America of Texas before its disbanding in 2017). The Gutiérrez papers provide direct evidence of medical paternalism via involuntary institutional commitment and involuntary treatment in Texas patient records. Other materials from UT Libraries provide insight into life behind the confines of Texas mental institutions and into the activities of Texas mental health organizations combating stigma and pushing for reform through public education. Together, these items allow viewers to conceptualize a societal atmosphere which embraced eugenics and the stripping of patient autonomy under the care of medical professionals.