Newtown’s Unanswerable Questions: It is not likely that psychiatrists could have prevented the massacre.
The horrific massacre of the innocents in Newtown was bound to result in a search for preventive action so that nothing like it could ever happen again, and hence also for its real or final cause. To ward off fatalism, we tell ourselves that the massacre could, and therefore that it should, have been prevented; or alternatively, that it should, and therefore that it could, have been prevented. But as the cacophony of opinion demonstrates, the world is an irreducibly complex place. Agreement about what ought to have been done has all too predictably not been reached.
It is tempting to argue that the perpetrator must have been insane, for if such a person isn’t insane, who is? We close the circle by then explaining his action by his insanity. In other words, we know the perpetrator was insane because he did x, and that he did x because he was insane. Molière satirized such reasoning 300 years ago: the doctor explains that opium makes people sleepy because of its dormitive quality. Let us suppose for the sake of argument, however, that the perpetrator did have a psychiatric condition that could have been diagnosed before his terrible act: What follows from this?
First, he was of age (20) to refuse to see a doctor if he so wished, and he might very well have so wished. By all accounts, there were no grounds on which psychiatric attention could have been forced upon him. He was strange, he was socially isolated, his mother worried about him; but he was a good student and had committed no acts that would have justified compulsory treatment, as would have been the case if (for example) he had attacked someone under the influence of delusion.