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Law and Mental Competency in Late Medieval England

Law and Mental Competency in Late Medieval England

By Eliza Buhrer

Reading Medieval Studies, Volume 40, 2014

Head showing the medieval cell doctrine.
Credit: Wellcome Library

Introduction: In 1839, John Elliotson, a phrenologist, mesmerist, Dean of the Faculty of Medicine at University College London, and then President of the Royal Medical and Chirurgical Society, lamented what he saw as an unfortunate tendency amongst his colleagues in the psychiatric profession: they had largely adopted an understanding of idiocy that originated in English law. At the root of Elliot son’s discontent was the fact that the law’s requiremcnts for idiocy did not confonn to the reality witnessed in his clinical practice. For the law held:

‘The individual, in order to be constituted an idiot, must be unable to number to twenty, or to tell his age, or to answer any common question; by which it may plainly appear, that the person has not reason sufficient to discern what is for his advantage or disadvantage.’

Yet Elliotson had found that idiots could oftcn diffcrentiate between numbers, size, distance, and even count above twenty, ‘notwithstanding what the law says’. Meanwhile other people could ‘never be made to calculate; and some persons can scarcely keep their own accounts, though otherwise they are reflecting and very clear-headed persons’.

Ironically, given his concern that psychiatry be preserved from outside influence, around the time his thoughts on idiocy appeared in print, Elliotson was forced to give up his offices at University College London and the University College Hospital due to his excessive enthusiasm for mesmerism and other practices which his colleagues rejected as pseudo-science.


In highlighting the dissonance between legal and medical understandings of mental incompetence, however, Elliotson was on to something. For, unbeknownst to him, the criteria to which he so objected were not invented by modem jurists seeking to accurately describe a well understood medical condition. Instead, they first emerged in mental competency inquisitions held in England during the later Middle Ages, centuries before a concept of intellectual disability even existed in medical thought.

Click here to read this article from the University of Reading

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