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-*Presented at the Round Table on Social Aspects of Mental Retardation, XII International Congress of Pediatrics, Mexico City, December 1968.-

-**Professor of Human Development, The Florence Heller Graduate School for Advanced Studies in Social Welfare, Brandeis University. Waltham, Mass. 02154.-

Fifteen years ago when Grover F. Powers, the distinguished American pediatrician, was presented by the American Pediatric Society with the John Rowland Medal, he greatly surprised his colleagues by devoting his acceptance address to a treatise on "the retarded child and his family as a challenge to pediatric practice, research and education." (1) He said at the outset "I offer no apology for my subject. Here are major problems perhaps as old as human life itself but still too low on the totem poles of medical respectability and of scientific concern. We have recognized the problems but too many of us have done as the priest and Levite in the ancient parable -- we have 'passed by on the other side.'"

After pointing up the quantitative impact of mental retardation as one of the major, if not the major area of childhood disability, and contrasting it with the inadequate response from the field of practice. Dr. Powers went on to say , "When there is no cure, we doctors sometimes capitulate too easily to therapeutic defeatism forgetting that the physician is just as responsible for alleviating as for curing; action is just less urgent, not less vital."

There is no question that since Dr. Powers issued this challenge in 1953 there has been a very substantial increase of interest in mental retardation on the part of individual pediatricians as much as on the part of the American Academy of Pediatrics, and the pages of the pediatric journals bear testimony to this.

In studying mental retardation problems and services during the past several years in some thirty countries around the globe, my wife and I have found a similar development almost everywhere. In India or in Poland, in Australia and in Brazil, we are requested to report on new developments in the field of mental retardation. However, the requests are coming from the large university hospitals and clinics and from public health officials -- there is very considerable evidence that private practitioners continue to shy away from the mentally retarded child. The significance of this neglect and its underlying cause was highlighted by Paul Pearson when he called the mentally retarded child "The Forgotten Patient," (2) pointing out that "the physician's traditional concern for his patient seems to have been displaced by his concern for the parents and other members of the patient's family or even the community. In other words, after he makes the initial diagnosis and neatly classifies the retarded, the physician's role as it pertains to treatment becomes focused on the parents."

Obviously, the reasons for such continued rejection of the mentally retarded are to be found in the broader socio-cultural area. Other professions such as education, social work, psychology and sociology have similarly pushed aside the mentally retarded, but perhaps this can be observed most clearly in the field of law because of the exacting nature of its formulations. It is undeniable that in the field of mental retardation the cruelties and superstitions of medieval thinking are still clearly reflected not only in popular beliefs but also in public life and legal provisions and processes. There are, of course, striking differences from country to country as advances in knowledge promote a better understanding but frequently one can encounter remnants of the old views which essentially denied the mentally retarded person basic attributes as a human being and, in many ways, treated him as a "non-person", and as a social menace. Thus Tizard characterized the English mental deficiency laws as having a "semi-protective, semi-punitive character" (3) , while Kirschen desribes the corresponding legal situation in Belgium as insufficient, incoherent and inappropriate for the specific needs of the mentally retarded. (4)

(4) Kirschen, Gilbert, L'Arriere Mental Devant La Loi, in: L'Arriere Mental Adulte, Bruxelles, Association Nationale pour l'Aide aux Enfants Retardes, 1964.

It is against this unfavorable background that in the most recent years a major effort is being made to arrive at a radically different legal basis for safeguarding the well-being of the mentally retarded and their families, with due consideration to the interests of society. Indeed, this new effort is a complete departure from the previous formulation of "the State versus the mentally retarded", recognizing that the well-being of the State is dependent on the well-being of all its citizens, no matter how gifted or how limited, how healthy or how disabled. Much of the initiative and the force behind this has come, nationally and internationally, from the movement beginning in the late 1940s by parents of the mentally retarded in countries around the world.