Institutionalized ignorance in court: Involuntary care and citizenship(s)

When changes in Swedish law were proposed that affected the professional jurisdiction regarding involuntary care, reactions from the medical community were strong. The chairman of the parliamentary committee responsible for the proposal described how he was met by "a thousand psychiatrists booing" when presenting the suggestions to a Swedish psychiatry congress four decades ago. That psychiatrists would have to make an application in court arguing for the necessity of involuntary care measures was regarded by the profession as deeply subversive. Fast forward to today, where several studies have shown that the administrative courts rule according to the psychiatrist's recommendation in nearly 100% of cases. This state of affairs has warranted attention from several fields. In this paper I discuss findings from a transdisciplinary project on decision-making practices regarding involuntary care. Applying the lense of empirical ethics, my examination focuses on how the central value of legal certainty rättssäkerhet is achieved as a matter of practice, that is how it is enacted when a variety of actors discuss decision-making and assessment in and around court hearings. Heeding the call for careful and symmetrical tending not only to practices and institutional arrangements of knowing but to those of not knowing, I draw on work from agnotology and the sociology of ignorance (Proctor 2012). I argue that for legal certainty to be brought about it requires acts and infrastructures of not knowing.