Sam Harris

Who can be considered as fully sovereign individuals, whose decisions others have a moral duty to “respect”, in the sense of non-interference with their choice?

And who, if any, should NOT be regarded as sovereign individuals, and therefore, can be justifiedly forced into doing something against their own wishes?

For example: Are children fully qualified to make their own decisions? Schizofrenics? Elderly suffering from dementia? Suicidals and other self-loathers?

Discuss..

arildno - 12 October 2008 09:42 AM

Who can be considered as fully sovereign individuals, whose decisions others have a moral duty to “respect”, in the sense of non-interference with their choice?

And who, if any, should NOT be regarded as sovereign individuals, and therefore, can be justifiedly forced into doing something against their own wishes?

For example: Are children fully qualified to make their own decisions? Schizofrenics? Elderly suffering from dementia? Suicidals and other self-loathers?

Discuss..

New York City, back in the early 1980s, became inundated with mentally ill people who had no place to live other than the streets. Most people I came across socially considered such people to be less worthy than pigeons, rats or cockroaches, mainly because pigeons, rats and cockroaches don’t beg for spare change, stink up buildings or remind us that humans are animals.

Ronald Reagan had recently decided that mental wards were simultaneously too expensive and too inhumane to maintain. Geraldo Rivera had exposed deplorable living conditions near Manhattan where mentally retarded people lived. Today, policy makers in the U.S. continue to wrestle with this question.

If I understand the law in California, psychiatric medications cannot be forced on adult people unless such people have a tendency to act violently to self or others. If they’re not violent, in other words, they are left to their own devices.

Arildno, does this sound like a decent policy? How is the problem addressed where you live?

What about elderly suffering from dementia who are NOT violent, either to themselves and others, but left to their own would live in their own excrements?
Do we have a moral right to interfere in their lives?

More often than not, such decision-making processes come down to what is pragmatic rather than what is ideally suited to human decency. (The squeaky wheel, and all that.) Old people who are in the process of losing their marbles often have loved ones who remain in control of their marbles, and the younger ones can become conservators of their parents or grandparents. Of course not all old people with dementia have loved ones, and I imagine that it’s a problem.

Maybe our resident attorney, Bruce Burleson, will be willing to answer your question with some authority.

arildno - 12 October 2008 09:42 AM

Who can be considered as fully sovereign individuals, whose decisions others have a moral duty to “respect”, in the sense of non-interference with their choice?

And who, if any, should NOT be regarded as sovereign individuals, and therefore, can be justifiedly forced into doing something against their own wishes?

For example: Are children fully qualified to make their own decisions? Schizofrenics? Elderly suffering from dementia? Suicidals and other self-loathers?

Discuss..

General reminder (inspired by some other comments here): philosophical discussions will not necessarily end in a solution or answer.

Of course with this question, images of Gattaca or 1984 come to mind.  Who is to determine who is fully sovereign?  It’s apparent that there are certain segments of our population who cannot function on their own, and we therefore take pity on them because we have the resources to do so.  I agree with the squeaky wheel idea - the violent and “in the way” get our attention most often.  We tend to ignore those who make us feel guilty about our lack of compassion (as we walk past the derelict on the street).

There are mathematical models used in psychiatry to measure how functional/non-functional a patient is and whether they are a real threat to themself or others.  But can a human be limited to a mathematic value?  Can’t someone receive the right encouragement or changes to allow them to break out of the rut they’re in?

I think the most reliable method at hand is through the scientific research that has been done in Mental Health, through all the age groups.  That brings up more questions: who is to moderate the decision making process?  Where is the funding to be found?  Government?  Private or publicly owned organizations?  Right now, many (probably most due to the tax incentives) corporations make large donations to various charities.

Anyway, interesting question.

Jeanie - 02 November 2008 06:10 PM

There are mathematical models used in psychiatry to measure how functional/non-functional a patient is and whether they are a real threat to themself or others.

Do you have any references to models like this?

Jeanie - 02 November 2008 06:10 PM

arildno - 12 October 2008 09:42 AM

Who can be considered as fully sovereign individuals, whose decisions others have a moral duty to “respect”, in the sense of non-interference with their choice?

And who, if any, should NOT be regarded as sovereign individuals, and therefore, can be justifiedly forced into doing something against their own wishes?

For example: Are children fully qualified to make their own decisions? Schizofrenics? Elderly suffering from dementia? Suicidals and other self-loathers?

Discuss..

General reminder (inspired by some other comments here): philosophical discussions will not necessarily end in a solution or answer.

Good reminder!
I have no illusions that a fully-fledged, readily implementable answer will be reached, and I perfectly know that I myself have no particularly brilliant answers to pull out of my sleeve.

My “Discuss..” could as well be interpreted as “Enlighten me..”, since on numerous related issues, I’m not at all sure what I ought to think, or if diametrically opposite views might still be regarded as equally justified.

Of course with this question, images of Gattaca or 1984 come to mind.  Who is to determine who is fully sovereign?

But, will not hand-wringing paralysis and a policy of non-intervention ALSO determine that question, namely be equivalent of stating “I’m in no position to judge who is NOT fully soverewign, hence I determine that EVERYONE should be judged to be fully sovereign?”
(Rather, than say, just a segment of the population).
 
However we look at it, irrespective of our preferred mode of action or non-action, we are “doomed” to determine this, one way or the other (since there are nobody else about).

It’s apparent that there are certain segments of our population who cannot function on their own,

This is certainly true, irrespective of the criteria we measure functionality by.
A possibly trivial first condition should be that only such criteria should be chosen that they can be called measurable, in an objective sense.

I’ll get back to some of the other, well thought out points you made in your post.

burt - 02 November 2008 06:28 PM

Jeanie - 02 November 2008 06:10 PM

There are mathematical models used in psychiatry to measure how functional/non-functional a patient is and whether they are a real threat to themself or others.

Do you have any references to models like this?

My knowledge comes mainly from experience as a nurse, but here’s the results I found in a quick search:

http://www.cnsforum.com/clinicalresources/ratingscales/ratingpsychiatry/disability/#SF36

http://www.massgeneral.org/schoolpsychiatry/screeningtools_table.asp

Jeanie - 02 November 2008 08:08 PM

burt - 02 November 2008 06:28 PM

Jeanie - 02 November 2008 06:10 PM

There are mathematical models used in psychiatry to measure how functional/non-functional a patient is and whether they are a real threat to themself or others.

Do you have any references to models like this?

My knowledge comes mainly from experience as a nurse, but here’s the results I found in a quick search:

http://www.cnsforum.com/clinicalresources/ratingscales/ratingpsychiatry/disability/#SF36

http://www.massgeneral.org/schoolpsychiatry/screeningtools_table.asp

Thanks Jeanie.