PATHOLOGICAL STATES. - This designation generally refers to morbid conditions and organic or functional anomalies that are the cause of more or less troublesome physical, psychic, or psychophysical suffering.
I. PATHOLOGICAL STATES IN THE BROAD SENSE
They comprise first of all diseases. Considering that man's life is beset by physical agents (e.g., heat, electricity), by chemical agents (e.g., caustic acids and alkalis), by microbes, by parasites, etc., the state of health can be defined as the victorious state of the organism against the snares of the environment in which it lives, marked by the normal performance of the vital functions and by a sense of well-being. Conversely, disease is the result of the unequal struggle sustained by the organism against harmful agents.
Not in all pathological states are the signs of disease, understood in the sense indicated above, recognizable; in these cases one speaks of anomalies.
The boundaries between so-called personal variants, which move within the range of the variability of "types" (v.), and anomalies are uncertain; for this reason the statistical criterion alone is not always sufficient to decide whether one is faced with a pathological state; then other elements come to one's aid: e.g., in the case of psychopathies Jaspers gives weight to the harmfulness of the anomaly; Schneider defines the psychopathic personality (v.) as an anomalous personality that suffers and makes others suffer. The criterion of anomaly in the statistical sense also holds for physical defects that fall within the category of congenital malformations; indeed, not even to them is the definition of disease applicable, because the organism's reaction directed at restoring the state of health is lacking. The same may be said of many physical defects resulting from traumas and surgical interventions (amputations, ankyloses, etc.). Not only is it difficult in some cases to distinguish personal variants from anomalies properly so called, but it is arduous even to separate the state of disease from that of health. There exist phenomena that do not appreciably disturb subjective and objective well-being and therefore do not make the subject ill in the strict sense of the expression, although he has lost his anatomical and functional integrity. These individuals often present transient functional imbalances, brief indispositions, which are promptly repaired by recuperative powers; at other times the functional imbalances are permanent but of slight degree and slight duration: the patient's health does not appear evidently compromised and he continues to work, but the work proves unusually heavy for him, his output is lower in quantity and quality. Some pathological states can reveal themselves with external symptoms so characteristic that a generic diagnosis can be formulated and suspected on the basis of them alone.
II. PATHOLOGICAL STATES IN THE STRICT SENSE
Furthermore, "pathological states" in a narrower sense designates certain particular morbid conditions and particular physical and psychic anomalies, marked by certain characteristic symptoms.
From a general point of view, pathological states may fall within the province of medicine or of surgery. Every pathological state involves sufferings of varying intensity that are of the body and of the spirit; sometimes the latter are considerable even in physical illnesses and require a therapy that must not be neglected. The physician will fully accomplish his mission if, while treating the body, he also takes into account the needs of the spirit. But above all his office will approach the priesthood if, in the disturbances of the spirit that interfere with morality, he knows how to be for the patient a wise healer and an enlightened counselor.
III. PATHOLOGICAL STATES IN RELATION TO IMPUTABILITY
The diagnosis of pathological states, especially those that are misunderstood and of slight extent, has practical, pastoral and medico-legal importance: it avoids doing harm by demanding of an individual more than he can give; it makes timely treatment possible; it allows well-considered judgments to be expressed on responsibility for actions performed in abnormal psychophysical conditions. It is well known that, because of the relations existing between body and spirit, many illnesses and anomalies of the body are reflected upon the spirit, in such a way as to attenuate or abolish the free choice of the will. In general, imputability does not remain intact, nor is it taken away entirely (except in extraordinary cases), but it is diminished.
The enunciation of this principle in the subjects under examination concerns only the acts that are caused in them by the abnormal state, and not those that they perform outside any influence of the abnormality. Furthermore, it does not concern indirect imputability or imputability in cause, whether with regard to the abnormality itself or to its effects. Another rule to be followed in practice, so as not to worsen the state of these impaired persons, is to proceed with these subjects both in direction and in confession as in ordinary life, with gentleness, yet without either too much diminishing their imputability with nonexistent excuses, or ever prescinding entirely from the abnormal state.
In the external forum the CIC considers the extreme forms of these anomalies; but in the norm for the extreme degrees there is also contained the rule to be followed, with due proportions, in ordinary cases. "Those who are deprived of the use of reason are incapable of crime" (can. 2201 § 1). The insane, although they sometimes have lucid intervals, or in some reasonings or acts seem sound, are nevertheless presumed incapable of crime (can. 2201 § 2). A crime committed in voluntary drunkenness is not devoid of some imputability, but it is certainly less than that of one who commits the same crime in the fullness of his faculties, unless however the drunkenness was procured specifically to commit or excuse the crime; if the law is violated in involuntary drunkenness, imputability is entirely absent, if the drunkenness has entirely taken away the use of reason; it is only diminished, if the use of reason is taken away only in part. The same is to be said of other similar disturbances of mind (can. 2201 § 3). "Weakness of mind diminishes the imputability of a crime, but does not take it away completely" (can. 2204 § 4). In the light of these principles one must judge for the various subjects affected by such pathological states, and one must apply cann. 2218 and 2229 relating to penalties.
It should be remembered that according to the same CIC "all those who are habitually deprived of the use of reason are assimilated to children" (can. 88 § 3) and "the baptized who do not enjoy a sufficient use of reason are not bound by ecclesiastical laws, nor are those who, although they have reached the use of reason, have not yet completed their seventh year, unless it is expressly provided otherwise by law" (can. 12). This being established, the provisions of the CIC are easily understood regarding the domicile (v.) of minors and impaired persons (can. 93 § 1), regarding the right of suffrage, which is not granted to them (can. 167 § 1, n. 1), regarding the measures to be taken by the judge (cann. 1648 § 1 and 1650) in case of non-use of reason; and the conditions required on the part of the subject regarding Baptism (cann. 745 §§ 2, n. 1, and 754); regarding Confirmation (cann. 786, 788), the Eucharist (cann. 853, 854, 859, 860), Penance (can. 886, 887 § 1, 906); Extreme Unction (cann. 940 § 1, 941, 943, 944 and 947 § 1), Holy Orders (cann. 968, 970, n. 2); Matrimony (cann. 1081 and 1082).
Bibliography9 works
Eleuterio Boganelli