#FreeBritney: Autonomy, Conservatorships, and Mental Health in America

Author

Jennifer L Young, PhD, Julia E H Brown, PhD, Nicole Martinez-Martin, JD, PhD

Publish date

Tag(s): Legacy post
Topic(s): Conflict of Interest Cultural Decision making Gender Disparities Justice Media Psychiatric Ethics

By Jennifer L Young, PhD, Julia E H Brown, PhD, Nicole Martinez-Martin, JD, PhD 

In a small but significant change of the tide, Britney Spears has been granted permission to have her own lawyer, to pursue her request to end her 13-year long conservatorship under the hands of her father. This has sparked a reassessment of the ethics of conservatorships, or legal guardianships, and how to distinguish between what Spears described as “conservatorship abuse” and a moral obligation to protect vulnerable people. 

After Britney Spears was hospitalized multiple times in 2008 for an unspecified mental health condition, her father filed for a conservatorship, ostensibly to protect her from causing harm to herself because of her deteriorating mental state. Britney’s conservatorship gives her father control over her finances, her everyday actions, and her body. Britney has been forced to work excessive hours, go on tour when she didn’t want to, and consume the medication lithium. Small acts of resistance towards the control over her body, such as her refusal to perform a particular dance move have made her feel “as if I planted a huge bomb somewhere” because she was not cooperating. At age 39, she is being restricted from having more children by being denied requests to have a contraceptive device removed. 

As an adult navigating the world, it’s possible Britney will make decisions that others deem concerning, but those decisions should be hers to make.

A conservatorship is an extremely restrictive legal mechanism usually reserved for people who are unable to care for themselves, make financial decisions, and understand the legal implications of entering contracts. Typically intended for individuals with severe cognitive impairment, such as older people with severe dementia, guardianships are also appointed for people with significant developmental disabilities or severe mental illness. But when is autonomy impaired such that people who have dealt with mental health challenges like Britney need to be protected this way? 

Autonomy and mental illness

Autonomy means self-determination — the idea that people have the capacity for intentional action (agency) and that they should be able to act free from coercion. In practice, autonomy is socially contingent because an individual’s circumstances and relationships shape their sense of agency and liberty. Some would argue that since her career began at such a young age, Britney has always been controlled by those with more power than herself, but in a more consensual (and autonomous) way, similar to athletes being trained starting in childhood (ie. Venus and Serena Williams). In this type of closely controlled and mentored early career, the point at which autonomy is clearly compromised is difficult to judge.

Compared to conditions like dementia, which is a degenerative condition that impairs one’s cognition and gets worse over time, mental illnesses do not impair autonomy permanently. For instance, during a psychotic episode, an individual can lose control over their behavior (and therefore lose autonomy), but they will regain this control once given appropriate treatment and support. While Britney Spears’ conservatorship was initially temporary due to her being deemed legally incompetent, her autonomy was taken away in a more permanent manner with future arrangements. In most states, there is usually a periodic review of the necessity of the conservatorship and whether less restrictive means can be used, which may sometimes involve reassessment of competency. A big problem with conservatorships is that in practice this reassessment doesn’t happen sufficiently, with judges and conservators inclined to just keep it going. Applied to the 13-year conservatorship in Britney’s case, regular reassessments did not happen and requests by the conserved were not honored. 

Social systems are complex and behavior is viewed under a different lens once a person has exhibited any signs of mental illness – even if the context renders everything understandable. It can become impossible to prove you are competent if your social system is already skeptical of you. For Britney, she was struggling with a lifestyle of partying in between long bouts of loneliness, in large part because she was only allowed short visits with her children. Things came to a head when she refused to send her infant son back to his father’s house. She went into a loosely locked bathroom, cradling her baby when it was time to hand him over and was about to release him to one of her ex-managers, but the police had already been called and the ambulance was on its way. With four helicopters over her house and a frenzy of paparazzi, firemen stormed in, Britney was put in a 5150 hold, strapped to a gurney, for involuntary psychiatric hospital admission because she was understood to be presenting a threat to herself or others. 

Britney might well have been presenting such threats in the eyes of some bystanders. Perhaps a psychiatric assessment was warranted. The leap from temporary guardianship to a long-standing conservatorship, though, is puzzling and brings into question the motives of the people around her or the people who were supposed to be “protecting” Britney. It would seem that the actions taken in regard to her mental state were not respecting her capacity to regain autonomy after the event but point to potential conflicts of interests. 

Conflict of interest

Britney Spears’ case has brought to light the many ways in which conservatorships can go wrong, by projecting ableist values onto an individual and exploiting them financially. Britney’s father, James Spears, is both her business manager and her legal guardian. For most of the conservatorship, James served as conservator over not just her life decision but also her finances. According to Forbes, Britney Spears’ net worth is approximately $60 million, and in recent years she has spent millions of dollars in legal fees to fight her conservatorship (and paid the fees of her father as part of the arrangement). James’ attorneys said in court filings that his “sole motivation has been his unconditional love for his daughter and fierce desire to protect her from those trying to take advantage of her.” While it may not initially have been intended, the conservatorship and managing Britney’s estate has become an enterprise with an ever-growing managerial team. It is thus impossible to ignore the conflicts of interests that exist for a father whose income primarily comes from his estranged daughter’s legal guardianship. One could easily imagine that conservators of the wealthy might oppose steps that would result in a loss of income to the guardian (see movie I Care a Lot). 

Conclusion

As Britney starts to gain more autonomy, she may end up behaving in ways that don’t seem conducive to her well-being — another questionable romantic relationship, getting pregnant right away, spending lots of her money — which may cause concern about her judgement. However, it is important to consider the conservatorship standard as one meant as last resort for those who are incompetent. Lots of people make questionable decisions (contrast Britney against Charlie Sheen) and her case is compounded by her gender, her celebrity and almost never having a support network that served her interests. As an adult navigating the world, it’s possible Britney will make decisions that others deem concerning, but those decisions should be hers to make.

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