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Poll: Compassionate Coercion

Lara went to my LiveJournal expecting to see pictures of her new baby. Instead she found a bunch of political junk. I expect some of our collective family have had or will have the same reaction, so I'm tucking this entry behind a cut tag.

I've posted this item from the Libertarian Party platform before, but responses to my most recent post lead me to the conclusion that another visit to this issue might prove useful.

Government and Mental Health

The Issue: Individuals are forcibly medicated or denied medication, not based on medical need, but based rather on a social agenda as enforced by government.

The Principle: Medication must be voluntary.

Solutions: We oppose the involuntary commitment of any person to or involuntary treatment in a mental institution. We strongly condemn Involuntary Outpatient Commitment (IOC), where the patient is ordered to accept treatment, or else be committed to a mental institution and forcibly treated. We oppose government pressure requiring parents to obtain counseling or psychiatric drugs for their children. We also oppose forced treatment for the elderly, the head-injured, or those with diminished capacity. We are against the invasion of people's homes and privacy by health officials or law enforcement to either require or deny drug taking.

Transitional Action: We advocate an end to the spending of tax money for any program of psychiatric, psychological, or behavioral research or treatment. We favor an end to the acceptance of criminal defenses based on "insanity" or "diminished capacity" which absolve the guilty of their responsibility.

On a related note:

Compassionate Coercion--'Good Drugs' Fighting 'Bad Drugs'

In addition to waging a “war on drugs,” the federal government is now working to eradicate the “disease” of drug use. These metaphors, notes the CCLE report, play an important role in driving federal drug control policy because they frame the remedies available to the government.

For example, the 2003 National Drug Control Strategy casts users of illegal drugs as “vectors of contagion” who are “in denial” about their “disease” and who need treatment before “transmitting the disease to others.” Such language, says the CCLE report, lends itself to coercive treatment wherein the government feels justified in “medicating” drug users through policies of ‘compassionate coercion.’ “Coercion, whether ‘compassionate’ or otherwise, is still coercion,” cautions the CCLE report.

Bodily Integrity & Freedom of Thought

The CCLE report examines the pharmacotherapy drugs currently under development, and also highlights the legal rights that would be violated if a government were to require certain persons (such as prisoners, probationers or public assistance recipients) to take the anti-drug medications. The implicated legal rights include the right to bodily integrity, the right to privacy, the right to make one’s own informed and voluntary medical decisions, and the right to freedom of thought.

The report concludes with policy recommendations, which underscore the importance of restricting pharmacotherapy medications to voluntary use. “In the absence of “extraordinary circumstances,” notes the report, “the government should be barred from coercing a peaceful person to take a pharmacotherapy drug.”

link: http://www.cognitiveliberty.org/news/Pharma_press_release.html

Poll #322348 Compassionate Coercion

A fundamental tenent of libertarian philosophy repudiates the initiatory use of force or coercion against peaceful people. On the subject of thoughts and/or beliefs that I judge deviate distinctly from what I consider objective reality, I maintain that...

Until someone violates the rights of another, his mental life is his business and the libertarian principle remains in effect.
Some thoughts are dangerous, and even if a person has committed no action that violates the rights of another, the holding of certain beliefs negates their right to live free of coercion.
At present, the government and the psychiatric experts it licenses use their coercive powers more often than they should, but in some cases it's necessary to coerce people for their own good even if they have not violated anyone else's rights.


( 4 comments — Leave a comment )
Jul. 17th, 2004 12:07 pm (UTC)
I still maintain that many of the mentally induced issues such as workplace violence and mass or spree murders could be averted if the person were noticed to be pressure cooking beforehand and intervention taken. In the same way, many suicides might be averted, or instances of domestic abuse, molestation or rape. There are signs of the approaching storm in these people, or you wouldn't be able to profile them to capture them after they commit crimes.

Isn't that preventative social order? Why treat the disease rather than prevent it from developing? Since the law does not do a good job of protecting the mentally ill from actions they commit that I consider almost involuntary, I think removing any treatment or medication from them is dangerous and foolhardy, not to mention unfair to them, especially if they are victim to unpleasant sensations or hallucinations.

I have anxiety disorders and depression. A lot of it is stress exacerbated. But there are honestly times I could just snap, and trust me, the thoughts are there. My meds don't control the thoughts, but they give me more control over myself in regard to them. What we need is to stop using the old line drugs for things like schizophrenia and sociopathic illnesses and develop new ones with fewer side effects. For the most part they are just hardcore sedation; I've seen institutionalized patients smoke with a hand over an imagined hole in their side "to keep the smoke in" and others picking at things they see in the air.

When I was about nineteen I had one patient who hovered over me while I passed meds and sniffed my head. He was over six feet tall and muscular, and had been let out of a mental facility only to be put in a nursing home by his family because they couldn't "handle" him. He shadow boxed, and licked his lips and flexed his muscles at the nurses. Scared the freak out of all of us. And we had him on Prolixin, a whopping dose of it.

I think we've discussed this before; but I have an issue with people being so ultraliberal that they lose contact with reality. Let them work with the mentally ill, not the clinic ones, but in a facility where many of them are criminally dangerous. Let them go through restraint training and self defense training. Let them work short staffed and get cracked in the head with a chair or punched in the mouth, have their arm twisted or be molested in some way. I was once nearly strangled to death in a back hall room at the hospital I worked at by an elderly lady with Alzheimers who garotted me with my own stethescope; I couldn't reach the call light to summon help, but eventually fought her off. Had she been any stronger, I might not be here to complain about it.

Anyway, mental health is a hot spot for me, because of my personal and professional background, not to mention that my father is a psychologist (not a psychiatrist, he doesn't prescribe meds, but refers to a Nurse Practitioner if they need them).
Jul. 17th, 2004 03:37 pm (UTC)
crazy people
Let them work short staffed and get cracked in the head with a chair or punched in the mouth, have their arm twisted or be molested in some way. I was once nearly strangled to death in a back hall room at the hospital I worked at by an elderly lady with Alzheimers who garotted me with my own stethescope; I couldn't reach the call light to summon help, but eventually fought her off.

I understand your passion, but a single re-reading of my post will reveal that bodily-integrity and cognitive liberty are rights reserved for those who do not harm other people. You cite examples of violent people who violate the rights of others. Even under a libertarian ethic, such be people can be legitimately coerced to keep them from assualting other people.

If you go over to the libertarianism forum where I intended to post this entry you'll find someone who claims that anybody who thinks that the state of Israel had anything to do with 9-11 is insane. The consensus in this country is that insane people must be "treated" to rid them of their "delusions" weather they agree to said "treatment" or not. Treatment can consist of incarceration, involentary drugging, even involentary surgery.

Sovient mental hospitals were filled with people who didn't think that communism was such a great idea. "Communism not a great idea? That's not just wrong, it's crazy!"
Jul. 18th, 2004 09:34 am (UTC)
This is an issue I've really struggled with, because one of the people closest to me has developed severe paranoid schizophrenia, and while she presents no danger to others she is completely incapable of judging dangers to herself. She is homeless by choice much of the time and often wanders into neighbourhoods where beautiful young women should never, ever wander alone. The police have rescued her from so many bad situations it's ridiculous, and I know they would dearly love to keep her overnight or drop her at a hospital that would keep her safe. But she insists she wants no treatment and checks herself out of hospitals every time the family tries to put her back in, and refuses to live with family members because of her paranoia that the Bad People will find her there. It's so hard on personal grounds not to say, 'she is like a child, she must be protected from herself', but at the same time, I really do struggle with my underlying belief that peaceful people should not be coerced or forced to do something against their will - no matter what. I side, very uneasily, with Option #1 here, but have total sympathy with point of view #3 as well. This is not an issue to which there is any easy or obvious answer.
Jul. 18th, 2004 09:46 am (UTC)
a tough call
This is not an issue to which there is any easy or obvious answer.

I don't have your personal experience with this issue, thought I have had close personal experience with suicides (which I consider a related issue). I'm glad you went with number 1, but in formulating number 3 I intentionally worded it so that someone with a respect for individual autonomy could still select it.
( 4 comments — Leave a comment )

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