One of the most hotly debated issues before American Psychiatry is what ought properly to be the fate of large state mental hospitals.1,2 There are forces within the profession itself, as well as within the general public, which strongly resist the efforts to dissolve completely these large institutions and to replace them with other types of institutions. The considerations brought to bear against dissolution appear on balance to be less clinical and more pragmatic; whereas the arguments for their dissolution seem to be phrased principally in psychiatric terms—the large state hospitals are criticized as organizationally inadequate for giving proper psychiatric treatment. But—we shall attempt to point out in this paper—both sides are addressing themselves to the issues not merely as psychiatrists but as members of society at a particular point in history; both sides are deeply implicated, whether explicitly or implicitly, in a