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It's an argument about giving crazy people guns.
We make an effort to restrict people's rights to the minimum we can, even if it results in bad outcomes sometimes. Locking away someone indefinitely (or like, killing them) is extremely restrictive.
Giving them some rope with which to metaphorically hang themselves but not too much preserves autonomy as much as we can.
We also give the crazy people guns, cars, and their bare hands.
If someone is unsafe, the correct move is to imprison them. Full stop, end of the line. The goal is not to maximize the autonomy of dangerous people, and that you think it is confuses me. If you're, again, one med cycle away from cold blooded fucking murder of an innocent person, you are not safe, you are a sedated predator. We should no more let you walk around than we would a grizzly bear.
Lets list some of the categories of patients this kinda thing applies to.
Someone has a brief psychotic episode, has interest in killing someone but doesn't manage to do so. They have a 30% chance of not progressing into having any further episodes of psychosis.
Someone uses drugs or alcohol. While under the influence of drugs or alcohol they become homicidal or suicidal.
Someone has a medical problem like a brain tumor, dementia, or more reversible things like autoimmune encephalitis or hyperthyroidism. While medically unwell they become psychiatrically unwell.
A totally normal person has a first time manic episode with threatened or actual HI/SI. Outside the manic episode they are totally normal. They take their medication but still have a risk of problems. Maybe they have a kid and end up with sleep deprivation. Maybe the run a 5k and become dehydrated and their lithium metabolism is altered.
Schizophrenic guy who knows he is schizophrenic, takes a long acting injectable medication to make sure he doesn't forget. Symptoms are well controlled. Sometime over the course of his life his metabolism of the medicine changes and he ends up sick again (and dangerous).
You really want to lock up all of these people indefinitely?
Medicine and the legal system don't know with surety who will offend and who will be dangerous. So we try and be judicious in how much we violate rights. Summarily executing someone for being diagnosed with schizophrenia is a bit of an overshot. Locking people up indefinitely (especially when they have periods of healthy functioning that might even last decades) is also likely overshooting it.
It's also hideously expensive and drains resources that could be best used elsewhere.
They won't have guns anyway while locked up.
Why not start with less restrictive measures?
If individual autonomy isn't important to you (it certainly is to Nybbler) then the expense should certainly factor into it. How much extra in taxes do you want to pay to do this?
"70% chance of further psychosis" is a crazy way to describe a person you think is safe.
Bluntly, yeah, all those people you mentioned I'm cool with indefinitely restraining and/or killing depending on how cooperative they are with restraint. These aren't normal people. Not even the one you call normal. I won't put a price on it, as these costs aren't fixed. The death penalty can be done very cheaply, for instance. We just don't do it that way.
Bipolar + Schizophrenia + Schizoaffective disorder add up to something like 5% of the population. Not all of these people commit violence. Not all of these people end up with an involuntary commitment. Saying "you murdered someone during a manic episode I no longer feel comfortable with you living in the community" is one thing "the severity of your illness is so bad that someone thought you were going to hurt people but you didn't end up doing that, however I'm not sure I feel comfortable with you having guns even if you don't need to be in the hospital 100% of the time is another."
Plenty of people end up transiently psychotic because of things like medical illness, substance use (even caffeine!), sleep deprivation, stress, trauma and so on. Most of these do not go on to kill people. A fraction who do end up with an involuntary commitment are significantly more dangerous and risky.
I stand by my previous post even with your additions.
To be clear: you want the state to summarily execute between 5-10 percent of the population because of the presence of severe mental illness?
To be clear: I want those who are psychotically violent to be indefinitely restrained, and killed if they won't cooperate with the restraint. If for reasons of cost others refuse to let them be indefinitely restrained, I would prefer they be killed than released back into polite society to terrorize everyone else.
Okay but the problem is that psychotically violent is a transient state - at present we hold them away from others while psychotically violent and then release them when they aren't.
A good number of people have one episode of violence or violent potential and then stop.
Likewise the mental health system is somewhat optimized for trying to predict violent potential in advance and head it off. Do you count the people who have committed that "pre crime" or not?
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