| Tuesday, January
18, 2011
I am way behind but catching up. Sort of.
Freedom and Madness, Continued
I continue to be amazed that there is still debate and discussion about
the motives of the Tucson shooter, and whose fault it was that he was able
to carry out his attack. There wasn't anything like that much discussion of
the Fort Hood Massacre, where the motive was clear -- he was shouting his
jihidist sentiments even as he fired -- and his affiliations with Muslim
jihadists were easily discovered. His behavior had disturbed many of his
colleagues and superiors. Because we simply refuse to believe that Muslim
jihadists can recruit agents within our armed forces, or that we are allowed
to do anything about them lest we be accused of profiling and discrimination
and mopery and dopery, we are not supposed to talk about remedies to an
obvious threat; but we are supposed to think of ways to profile the mad and
lock them away.
I find that I am not making myself as clear on this issue as I might be:
Involuntary Commitment
Jerry,
You are cherry-picking your examples of involuntary
psych commitments. I can cite far more cases where somebody dangerous
should have been committed/treated (if we had the system for that anymore)
but are allowed on the street and they continue to harm themselves or
others. Yes, these people have already proven themselves dangerous but due
to our current psychiatric/criminal justice system they continue to remain
in public where they continue to cause serious harm to themselves and
others.
I agree there were people who did not commit
felonies or harm others before they were committed, that does not mean
that there should not be a mechanism for examining people to determine
danger/competency.
By your same argument, one can never prosecute or
lock up felons. Some of them are undoubtedly innocent yet we still lock up
felons.
Loughner was not some 'harmless crank' making weird
statements. He threatened to kill people, he was such a disturbance in
school that police had to make him leave, he was abusing drugs, etc. There
were enough warning signs that in a rational society we could have had him
committed for three days or a week to determine if he was dangerous.
If he was determined to not be a danger, then we
could have let him go live with his family, rant on the internet, and
smoke ganga until his brain became resin coated. If he was dangerous,
(e.g. believed that his congressman was a doppelganger and needed to be
killed to be exposed) we would have laws preventing him from purchasing a
gun and perhaps a court could mandate a monitored medication regime as a
requirement for living outside the institution.
Freedom isn't free, that's why some people in any
society have to 'take one for the team'. If somebody is making clear death
threats, cannot self monitor to the point they are escorted out of places
by police, and have many other indications they are a danger to themselves
or others they can suffer a temporary loss of liberty so we can have some
assurance they will not harm themselves or others. Innocent people
convicted of crimes go to jail, we as a society acknowledge it and move
on. If in these cases some 'harmless' people were committed long enough to
determine their possible danger we as a society can pay that price.
In a free society we can ask that adults who cannot
monitor their own behavior in public to the point they are obviously
disturbed and committing crimes to let us determine if they are a danger.
A week long commitment to an institution is not a minor thing but if you
made the police agency pay for the initial commitment most agencies would
monitor the commitment carefully. Nothing is perfect, the criminal justice
system is perfect but few want to scrap it wholesale or make it voluntary.
Neither should the mental health system be totally voluntary (which it
virtually is at this time). Those people who are locked up on an
involuntary basis have been committed because they committed crimes but
are too disturbed even for jail.
Freedom isn't free, I agree. I understand somebody
your age will have a visceral dislike of mental institutions (they were
remarkably ugly in ages past and are not pretty now). That is no reason to
let your own personal likes and dislikes blind you to the obligations of a
free society.
In a free society can an innocent man run from
police, assault them, maybe kill them to prevent his arrest? After all he
knows he is innocent. Can an innocent man break the law and escape from
prison? Can he assault guards because he is innocent and they are
depriving him of liberty? Can he damage property to protest his innocence
by burning down the prison? No, the man must pay the price society has
wrongly meted out. All of these cases are serious violations of a person's
dignity and liberty.
These cases are just as egregious and more
unpleasant to the person involved than a three day commitment to determine
competency but we as a society allow them to happen every day. We must or
we would have no criminal justice system. We as a society accept that this
will happen and most of us never even think about it.
We lose no liberty if instead of doing nothing when
someone has made direct death threats, shown serious signs of mental
illness, and has had multiple run-ins with police, we get them assessed
and maybe some help. No one I am aware of wants to round up the mentally
ill and put them in indiscriminately in institutions. What a rational and
free society does with its dangerous mentally ill is a harder question
then what do we do with criminals but we need to do something. Letting
them out to harm themselves and others is not courageous or rational.
Thanks for your great site,
Don
Which is disturbing. Of course I was choosing examples of maximum
ambiguity. That was the point. It's clear enough that if someone stands about
waving a gun and shouting that he's going to kill the Mayor because the
Mayor kidnapped his son, we have good reason to act. It's the hard cases
that make bad law, and I have been inviting those who think it's simple to
contemplate that.
Regarding the possibility of jailing -- or executing for that matter --
an innocent man, I thought that was my point: we don't do that after a
closed hearing before experts. It takes a judge and jury. Involuntary
commitment without that safeguard was, I thought, what we were discussing.
Jailing a felon requires a charge, a specification, indictment or
preliminary hearing, and conviction involving a judge and the option of a
jury. Locking someone away for "observation" requires a lot less than
indictment: and unless there are rules, extending the "protection" of the
society by locking away a madman is a fairly simple matter. Of course I
chose the cases intended to make the point. Why shouldn't I/
As to the obligations of a free society, I thought that this was the
point of the discussion. A free society may have the "obligation" to protect
people from madmen who have not yet committed a crime, but doing so on the
basis of the findings of an expert who can find a correspondence between the
individual's behavior and a "disorder" in the DSM is probably not a good
idea.
I had no idea that anyone was aware of "direct death threats" made by
the Tucson madman. I find no evidence that this is the case. And I do not
think he had done anything that would warrant a search warrant that would
have found the ravings on his copy of the letter that the Congresswoman had
sent him.
I would hope that your statement "No one
I am aware of wants to round up the mentally ill and put them in
indiscriminately in institutions," is true, but I fear I do know of
such people, some in the mental health professions; and when you have a
board consisting of a policeman, a police psychiatrist, and the chief
medical officer of a mental institution given the power to send people for
involuntary treatment I would contend that you have conflicts of interest.
It's very easy to say that letting people out to harm
themselves or others is not rational. At what probability will you set this?
If there is a 99% probability that someone will go berserk the decision is
easy. Suppose the probability is only 60%? What about 10%? At some point
there is a probability that anyone you meet might go berserk and harm
himself or others, or take drugs that will induce that state. Leaving aside
the difficulty of measuring the probabilities (who does it, and how? By
comparing behavior to DSM disorders?) can we not at least discuss the levels
of probability? At what level is preventive detention both rational and
courageous?
In a free society we can ask that adults
who cannot monitor their own behavior in public to the point they are
obviously disturbed and committing crimes to let us determine if they are a
danger.
But surely the trick is to find a reliable way to determine
who can and who cannot monitor his own behavior, and at what point is
someone obviously so disturbed? Is it walking down the street talking loudly
to no one? (Once we determine it's not a cell phone...) Or pretending to
have a cell phone conversation with God or the Devil? Now I know: sometimes
people are just acting nuts; we can't define it but we know it when we see
it. We have laws against being drunk and dirty in public, and those can
often be used to get someone off the streets even when they aren't really
drunk.
I do wish such things were as obvious to me as they are to
you. === Meanwhile, I
would think it more important to look into ways to prevent another Fort Hood
massacre, or Times Square Bombing. It seems to me odd that there is more
concerned with involuntary commitment of madmen than in detecting and
disarming conspirators. And yes, I know very well that this is an even
larger can of worms, and those familiar with my writings will not suspect
that I am arguing for new empowerments for the secret police. It does seem
odd that there is more national concern and debate about Tucson than Fort
Hood -- or Waco. =============== A note: I am
aware of the "modern" psychiatric terminology with its various DSM "disorders."
I don't find them either more or less useful than the older designations of
psychotic behavior. They (the new labels of 'disorders') aren't more predictive
(than the older diagnoses of schizophrenia and manic-depressive psycholsis), and they don't seem to be
based on any superior theories. I do not find the Diagnostic and Statistical
Manual particularly useful, and I am not pleased by the insurance companies'
reliance on this expert system data base, which allows us to apply the term
"disorder" to many behaviors that previously would simply have been thought
odd or eccentric, or even (in the case of adolescent boys) rather typical.
Psychology theory is in a mess nowadays. We have made progress in showing
the unscientific nature of the great integrative theories of Freud, Jung. Horney, Hubbard, and the like; but we haven't got much to replace them with,
and the DSM isn't in my judgment a particularly good substitute. At least
Freud and Hubbard offered explanations even when they weren't particularly
useful for prediction.
===============
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