PATHOLOGICAL STATES. - This term generally refers to morbid conditions and organic or functional anomalies that cause physical, psychological, or psychosomatic suffering, whether mild or severe.
I. PATHOLOGICAL STATES IN A BROAD SENSE
This category first includes diseases. Considering that human life is constantly threatened by physical agents (e.g., heat, electricity), chemical agents (e.g., caustic acids and alkalis), microbes, parasites, etc., health can be defined as the state in which the organism successfully resists the dangers of its environment, marked by the normal functioning of vital processes and a sense of well-being. Conversely, disease is the result of an unequal struggle in which the organism is overwhelmed by harmful agents.Not all pathological states exhibit signs of disease in the above sense; in such cases, the term "anomalies" is used.
The boundaries between so-called personal variants—those within the range of "type" variability (v.)—and anomalies are uncertain. For this reason, statistical criteria alone are not always sufficient to determine whether a condition constitutes a pathological state; in such cases, other factors come into play. For example, in cases of psychopathy, Jaspers emphasizes the harmfulness of the anomaly, while Schneider defines the psychopathic personality (v.) as an abnormal personality that suffers and causes others to suffer. The statistical criterion of anomaly also applies to physical defects classified as congenital malformations; these cannot be defined as diseases because the organism lacks the reaction aimed at restoring health. The same holds true for many physical defects resulting from trauma or surgical interventions (e.g., amputations, ankyloses, etc.).
It is not only difficult in some cases to distinguish personal variants from true anomalies, but it is also challenging to differentiate states of disease from states of health. There are phenomena that do not significantly disturb subjective or objective well-being and therefore do not render the individual strictly "ill," even though they have lost anatomical or functional integrity. Such individuals often exhibit transient functional imbalances, brief indispositions that are quickly remedied by recuperative powers; at other times, the functional imbalances are persistent but mild and short-lived. The patient’s health does not appear significantly compromised, and they continue to work, though the work feels unusually burdensome, and their performance is diminished in quantity and quality. Some pathological states may manifest with such characteristic external symptoms that a general diagnosis can be formulated and suspected based solely on them.
II. PATHOLOGICAL STATES IN A STRICT SENSE
In a narrower sense, pathological states also refer to certain specific morbid conditions and physical or psychological anomalies marked by characteristic symptoms.From a general perspective, pathological states may pertain to either medicine or surgery. Every pathological state entails suffering of varying intensity, affecting both body and spirit; sometimes the latter is significant even in physical ailments and requires therapy that must not be neglected. The physician fulfills his mission fully when, while treating the body, he also attends to the spiritual needs of the patient. His role approaches that of a priest when, in cases of spiritual disturbances that interfere with morality, he acts as a wise healer and enlightened counselor for the patient.
III. PATHOLOGICAL STATES IN RELATION TO IMPUTABILITY
The diagnosis of pathological states—especially those mild or poorly understood—holds practical, pastoral, and medico-legal significance: it prevents harm by demanding more from an individual than they can reasonably provide; it enables timely treatment; and it allows for well-considered judgments regarding the responsibility for actions performed under abnormal psychophysical conditions. It is well known that, due to the relationship between body and spirit, many bodily diseases and anomalies affect the mind, thereby diminishing or even abolishing the free exercise of the will. In general, imputability is not entirely intact nor completely removed (except in extraordinary cases), but it is reduced.The application of this principle to the individuals in question pertains only to acts directly caused by their abnormal state, not to those performed outside the influence of the abnormality. It does not extend to indirect imputability or causal imputability concerning the abnormality itself or its effects. Another practical guideline to avoid worsening the condition of these individuals is to approach them—whether in guidance, confession, or daily life—with prudence, neither unduly diminishing their imputability with unfounded excuses nor entirely disregarding their abnormal state.
In external ecclesiastical law, the *Codex Iuris Canonici* (CIC) addresses extreme forms of these anomalies; however, the norms for extreme cases also, proportionally, apply to ordinary situations. Those deprived of the use of reason are incapable of committing a crime (can. 2201 § 1). Those who habitually lack the use of reason, even if they occasionally experience lucid intervals or appear rational in certain thoughts or actions, are presumed incapable of committing a crime (can. 2201 § 2). A crime committed in voluntary intoxication is not entirely without imputability, though it is certainly less than that of someone committing the same crime in full possession of their faculties, unless the intoxication was deliberately induced to commit or excuse the crime. If a law is violated in a state of involuntary intoxication, imputability is entirely absent if the intoxication completely deprived the individual of the use of reason; it is merely diminished if the use of reason was only partially impaired. The same applies to other similar mental disturbances (can. 2201 § 3). Mental weakness diminishes, but does not entirely remove, the imputability of a crime (can. 2204 § 4). In light of these principles, judgments must be made regarding various subjects affected by such pathological states, and the relevant canons—2218 and 2229—regarding penalties must be applied.
It should be noted that, according to the same CIC, "those who habitually lack the use of reason are assimilated to children" (can. 88 § 3), and "baptized individuals who do not possess sufficient use of reason, nor those who, though having reached the age of reason, have not yet completed their seventh year, are not bound by ecclesiastical laws, unless expressly provided otherwise by law" (can. 122). Given these provisions, the CIC’s rulings regarding the domicile (v.) of minors and those with impairments (can. 93 § 1), their right to vote—which is not granted to them (can. 167 § 1, n. 1)—the measures to be taken by a judge (can. 1648 § 1 and 1650) in cases of lack of use of reason, and the conditions required for subjects regarding Baptism (can. 745 § 2, n. 1, and 754), Confirmation (can. 786, 788), the Eucharist (can. 853, 854, 859, 860), Penance (can. 886, 887 § 1, 906), Extreme Unction (can. 940 § 1, 941, 943, 944, and 947 § 1), Holy Orders (can. 968, 970, n. 2), and Matrimony (can. 1081 and 1082) become readily comprehensible.