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Steven J. Taylor. Acts of Conscience: World War II, Mental Institutions, and Religious Objectors.
Syracuse: Syracuse University Press, 2009. xv + 484 pp. $45.00 (cloth), ISBN 978-0-8156-09155.
Reviewed by Allison Carey (Shippensburg University)
Published on H-Disability (January, 2010)
Commissioned by Iain C. Hutchison
War, Pacificism, and the Fight for Social Justice in America’s Mental Institutions
What factors lead people to strive for social
change? What factors enable such attempts to be effective and long lasting? In Acts of Conscience, Steve J.
Taylor tackles these tough questions through a historical
analysis of World War II conscientious objectors (COs)
and their fight to improve conditions at America’s mental institutions. Taylor creates a fascinating account of
the processes by which internal motivations and external
opportunities intersect to encourage or discourage largescale social change.
objectors, entered this situation. COs disagreed with the
use of violence and asked to fulfill their national duty
through placement in a variety of service positions, one
of which became the mental institution. At least fifteen
hundred COs worked in mental institutions by the end
of 1945. Taylor documents the tension that emerged for
these men: they tended to have strong religious convictions stressing peace and love, yet violence, force, and
neglect were typical features of daily life in a mental
institution. How could they justify using or even allowing violence to be committed against innocent huAccording to Taylor, such reformers as Dorothea Dix
mans when they had refused to use violence against a
advocated for the creation of mental institutions to enwartime enemy? COs felt a moral duty to restructure
sure the provision of humane care and effective treatthe institutional environment to decrease violence and
ment to individuals with mental illness; however, insti- encourage the provision of care to patients. Taylor artutions quickly devolved into overcrowded, understaffed gues that, in addition to a sense of moral imperative,
warehouses with rampant abuse and neglect. In the the collective work of COs provided support for reform
1940s, administrators, the broader mental health commuefforts. Whereas isolated individuals might have been
nity, attendants, and even some families understood the
overwhelmed by the complex institutional structure and
severity of the problems facing America’s mental instiintimidated by the credentials of mental health experts
tutions, but excused away such problems as isolated in- who defended institutional care, COs served within units
cidents or a temporary crisis due to the war. Content of fellow COs and these units existed at multiple instituto assume that the mental health profession was offering tions, creating a network of men with similar Christian
the best care possible under the circumstances, Amerivalues facing similar dilemmas who could share inforcans turned a blind eye to the human rights atrocities
mation and develop common strategies of reform within
committed in their own country, even while defending
and across institutions. Moreover, COs exercised some
democracy overseas.
leverage within institutions as they tended to be diliWorld War II created the conditions through which gent workers, and their labor was sorely needed due to
an unlikely group of potential reformers, conscientious wartime staff shortages. In their efforts to create change,
COs utilized a variety of techniques including working
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with institutional administrators and, more famously, using the media to expose the horrific realities of institutional life to create pressure for change. Their goals typically centered on improving patient care through such
initiatives as increasing funding for institutions, advocating for the training attendants, reducing the use of restraints and force, and advocating for individualized care.
Taylor’s detailed analysis takes the reader from institution to institution, recounting the ways in which COs
challenged the system and built a repertoire of strategies
to achieve reform. By the end of the war, it seemed COs
had made a real difference.
COs to more effective reform movements that began in
the 1970s. He points to at least two sociopolitical differences between the movements. First, COs sought to improve institutional conditions but offered no substantial
alternative to the institution. According to Taylor, improvements in funding, attendant training and programming were necessarily insufficient because the nature of
the institution itself dehumanizes through its focus on efficiency and mass service delivery. In contrast, reformers
in the 1970s developed pathbreaking ways to think about
disability and treatment, demanding that people with disabilities be guaranteed civil rights and be included in all
facets of social life within their communities. Second,
This wave of reform was short-lived. Taylor argues,
COs drew on a narrow activist base consisting largely of
“Although many of the ideas of leaders of the national fellow COs and never systematically sought to include
foundation emerged later in mental health and develop- patients, former patients, their families, or attendants as
mental disabilities, the new versions of these ideas cannot key activists within their movement. In later reform efbe traced to that organization. The ideas were rediscov- forts, these constituencies came to the political table and
ered and not inherited or passed down over time to be
demonstrated a clear, zealous, and lasting interest in sorefined by a new generation of reformers” (p. 393). As
cial reform.
Taylor explains the failure of COs to create long-lasting
reform, he shifts from what seems to be a historical acTaylor’s comparison yields significant lessons recount of a small set of men who took on a social system of garding disability history and reform. In particular, hisoppression, to a complex analysis of the factors affecting tory has proven that sustained vigilance is required to upthe long-term success of a movement, and here Taylor hold the rights of people with disabilities, and therefore
develops the most compelling arguments of the book.
effective reform requires an unrelenting movement that
diligently and continuously defends its past successes
Taylor highlights the specific historical events, such
while pushing for future victories. Short-term zeal typas the conclusion of World War II and the dismantling ically fails to achieve long-term goals. The contrast beof the CO program, that seriously weakened reform ef- tween the reform movements is quite insightful, but limforts. After the war, most COs went back to their normal ited by the brief coverage of the later time period. Readlives, leaving the mental institutions behind them. Those ers will come away with several astute comparisons, but
who continued working in the field of mental health
not with a detailed understanding of the scope of later
confronted harsh new realities, such as the need to pay
reform movements.
salaries and build a new support base once former COs
and churches shifted their focus. The National Mental
While Taylor does not delve deeply into later moveHealth Foundation (NMHF), a national organization cre- ments, his coverage of the CO movement is exceptional.
ated by COs dedicated to patient-centered institutional He provides intricate historical detail, using an extensive
reform, faced financial crisis after the war ended and range of sources including interviews, personal papers
merged with two other national mental health organi- of former COs, and archival materials. The book opens
zations, the National Committee for Mental Hygiene and with a history of the development of the CO program,
the American Psychiatric Foundation, to create the Na- the varied backgrounds of the men who entered it, the
tional Association for Mental Health (now the National complex politics of the program, and the tensions within
Mental Health Association). Neither the passion for re- it. Of particular interest, Taylor documents the politics
form that had been the driving force of NMHF nor their of the CO status. To reduce the risk of men using the
key projects survived this merger. Thus the efforts of the CO program to evade their duties, the administration preCOs, which had seemed so promising, did not withstand ferred men with long-term institutional affiliations with
postwar conditions.
pacifist denominations rather than men whose individual
conscience forbade their participation in this particular
In the last two chapters of the book, Taylor further war effort. Thus, men from the historic peace churches
develops his argument concerning the failure to achieve including the Society of Friends (Quakers), Amish, and
long-term success by contrasting the reform efforts of Mennonites had greater success obtaining CO status than
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individuals from denominations that lacked a clear pacifist stance, such as Catholics and Episcopalians and individuals without any religious affiliation, although men
from these backgrounds did at times gain CO status. Taylor is to be particularly commended for his attention to
both general trends in CO activity as well as to variations, such as differences across religious groups and
at specific institutions. For example, Taylor points out
that while those from the Society of Friends and Mennonites expressed deep concern over institutional conditions, the religious beliefs of Friends leaned more readily to political action and confrontation than the beliefs
of Mennonites, leading to different strategies for dealing with and transforming the institutional environment.
Furthermore, while this work is primarily a history of
men, Taylor at least includes a discussion of the women
who worked at these institutions and supported the CO
movement.
morality and concepts of humanity vary culturally and
temporally, actions taken in good conscience by some
may seem shockingly immoral to others. Indeed, at various times and places people have denied individuals with
disabilities the status of human beings, and segregated
and disposed of them according to their conscience for
the improvement of “humanity.” Those who advocated
for institutionalization, sterilization, and even euthanasia of people with disabilities were not simply or always
people who acted without conscience. Indeed, the injustices committed against people with disabilities are all the
more disturbing because they are so often legitimated by
morality systems that discard the value of people with
disabilities and are committed by parents, professionals,
and others who act in “good conscience” according to the
tenets of such morality systems. Hence, actions taken
with a deep consideration of morality for the betterment
of “humanity” do not necessarily make actions worthy of
praise. While I too praise the COs for their reform efforts,
my praise is linked to my own set of values, not a stance
that supports the absolute worth of acts of conscience.
I find my greatest disagreement with Taylor’s final
sentences, where he states that “acts of conscience in the
name of benefiting humanity are always good and never
bad or even neutral. Acts of conscience are inherently
worthy and deserving of praise.” Morality is a social construction, such that the values and beliefs guiding any
given conscience vary dramatically across time, place,
and group. Taylor recognizes this when he argues that
moral beings do not always determine as immoral actions that later come to be defined this way; for example, COs who fought against systems of violence did not
at first consider the use of restraints or unpaid patient
labor to be immoral although they later came to this conclusion. Furthermore, Taylor mentions the idea that humanity is a social construction–“that the social meaning
of a person is not inherent in the qualities or characteristics of that person but dependent upon how others ’construct’ or define that person” (p. 234). Given that both
In conclusion, Acts of Conscience tells an important
piece of the history of American social reform, particularly as related to mental institutions. The literature on
disability studies is growing quickly, but there remains a
paucity of social analysis regarding the histories of mental and developmental disabilities and institutionalization. In particular, histories of institutionalization tend
to focus on the growth of institutions in the early part of
the twentieth century and deinstitutionalization beginning in the 1970s, dismissing events in the mid-century
as unimportant. Taylor’s work helps to fill in these critical gaps in our knowledge. In doing so, he offers rich
historical insight, contributes immensely to the study of
disability, and informs the broader sociological and historical literatures regarding social change and reform.
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Citation: Allison Carey. Review of Taylor, Steven J., Acts of Conscience: World War II, Mental Institutions, and Religious
Objectors. H-Disability, H-Net Reviews. January, 2010.
URL: http://www.h-net.org/reviews/showrev.php?id=29362
This work is licensed under a Creative Commons Attribution-NoncommercialNo Derivative Works 3.0 United States License.
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