Sin and Insanity

A friend of mine has recently crossed the border from "eccentric with spats of violence and delusion" into actual full-blown insanity. Real brain dysfunction causing emotional and cognitive problems which cannot be treated with any form of counseling and may not be responsive to psychopharmacology. I feel badly for him and worse for the people he's hurt along the way, especially his children who have grown up never knowing if they were going to be with good dad or bad dad. While good dad was often generous, supportive and loving, bad dad would bit the heads off dolls, throw things across the room or, as I once witnessed, run naked from the shower to scream and berate the children for some random, perceived misdeed. While not a fan of the government making familial decisions, I am relieved that he does not have custody of his kids. However, he does have visitation which he uses randomly and unfortunately good dad is increasingly less a part of those visits. It has reached a crisis point and I suspect my friend is going to be institutionalized.

Which brings me to this thread. I've heard a lot about souls, free-will and choices. I know the story of Adam which is a good allegory of choice and consequence in some ways. I've also read a little on what the Catholic church ahs to say on the subject of insanity, sin and responsibility. At least as far as I can find, they dodge it. The church agrees that if one is born insane, they aren't responsible for their actions and they are not sins. Actually to my mind this brings up 2 questions, 1) do the insane have a soul if they are never responsible for their actions and 2) why does god create people insane from birth? Scientifically I understand this, but from the point of view of beings with a "soul" , specifically born to make choices and go to heaven or hell it seems ... not very well thought out.

What about those that are going insane? What about people who, like my friend, are seemingly sane at some time and insane at another?

One idea is that the insane are not responsible for their actions. However, the Catholic Encyclopedia points out that, while a humane policy, it's directly in conflict with church doctrine:

The theory does, indeed, seem to disagree with the doctrine of our textbooks of moral philosophy and theology, which maintains that freedom of the will can be diminished or destroyed only through defective or confused action of the intellect.

In other words, through choices. This makes sense theologically since the soul is all about choice and if physical changes to the body can change our choices, it puts the soul and one's responsibilities into a very shaky area.

Its an interesting problem.