Medicalizing violence: The institutional politics of trauma in Veterans Treatment Courts

Victoria Piehowski

Social Science & Medicine, 2025, vol. 380, issue C

Abstract: Criminal court actors engage in medicalization as they negotiate the balance of punitive and rehabilitative responses in their work, particularly in cases of low-level drug crime. Often, however, these legal actors regard violent crime as untreatable. This paper examines an exception to this assemblage of practice and policy: Veterans Treatment Courts (VTCs). VTCs combine judges, prosecutors, public defenders, and Veterans Affairs' (VA) professionals to provide treatment-based supervision in lieu of incarceration. In Minnesotan VTCs, court actors regard violent crime as treatable—for this population. Using interview data, I analyze how court actors medicalize violence as they legitimate veterans’ eligibility for the court and design their supervision. I find that court actors establish trauma as an institutional logic in ways that enable them to negotiate contradictions of contemporary rehabilitative punishment. This institutional logic is patterned by two core assumptions: first, that trauma presents a latent risk for crime, necessitating the extensive surveillance of this resource-intensive court; and second, that veteran trauma is particularly distinct from that of others in the criminal justice system, thereby justifying the provision of sentencing incentives and treatment resources to someone who would otherwise be deemed a violent offender. Viewing this dynamic as a process of stratified medicalization, I show how conflicts in contemporary criminal justice politics shape medicalization processes.

Date: 2025
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DOI: 10.1016/j.socscimed.2025.118170

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