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Comment by wpietri | Hacker News Reader

Really interesting article. This for me is the crux of it:

> "Being psychotic is not an exercise of free will. It is the inability to exercise free will.”

I get why people are nervous about state power. But there are a variety of conditions, including slavery, addiction, and psychosis, where people may voluntarily enter them but then cannot leave without help. It's a dilemma with no simple answers. But if we're serious about freedom, I think it's incumbent on us to grapple with the complex, inevitably messy issues involved.

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I find this a very hard point to deal with as well.

If sickness is defined as a function of your own perception of how it limits you (analogous to "freedom"), that's fine for all illnesses that don't affect your perception.

But in some cases like psychosis and schizophrenia, the illness directly affects your perception... your definiton of freedom; your definition of illness; it doesn't work anymore.

Instead of calling it "curing", one could view it as "self improvement".

As an analogy: most children don't like to go to school, and have no intuitive feeling of why it is useful, but of course they should have proper education.

Does going to school actually help them enough to justify the unpleasantness of it? What I've read from unschoolers suggests: often not.

Reminds me of the famous Pink Floyd song.

Your own free will and speech is usually bounded by the assumption that you will not encroach on others' personal rights and freedoms. Schizophrenia may carry some risk that one individual will incorrectly perceive reality, and cause harm to another person or animal. It is this risk that makes mandatory treatment necessary.

Not really. Many schizophrenics are perfectly harmless. And there are many abusive people who are not schizophrenic at all. If risk of harm to others were the only thing that justified mandatory treatment, we could reasonably treat anybody with a conviction for a great number of crimes.

Imagine if one group was more prone to psychosis then the other. I do not think the state makes for a good gatekeeper here.

I think relatives should access the right for a psychotic person and act as a guardian.

Another interesting thing- at what point is it more merciful to leave somebody in psychosis? This is the coma patient, waking up, only to find his life been gone, his youth being spend, his family to be gone.

Is it not more merciful to leave somebody in the delusion until his/her final moments?

> But there are a variety of conditions, including slavery, addiction, and psychosis, where people may voluntarily enter them but then cannot leave without help.

In the case of slavery, the slave doesn't want to do something, but is forced to. In the case of addiction and psychosis, you don't want someone to do something, but he's allowed to.

In the case of all three, it's a condition people can enter into nominally through their own choice. Sex slavery, for example, often starts with women taking misleading distant jobs. And a lot of what was effectively slavery has been justified through a gloss of choice: http://www.pbs.org/tpt/slavery-by-another-name/home/

I don't deny that people sometimes make bad choices, and sometimes need help because of that. I'm just pointing out that there's a difference between involuntarily committing someone to a psychiatric hospital, forcing him to take drugs, electroshocking him, etc. and freeing him from slavery and I question whether the word help is appropriate for the former.

The US had 4m+ slaves. If you asked every one of those about emancipation, I doubt all of them would have said yes. Given the failure to give them all sufficient resources to survive independently (e.g., 40 acres and a mule), and given how many struggled after emancipation [1], it's not clear that the word help is appropriate there either.

And for the people trapped in things that are like slavery but have a gloss of voluntary acceptance, I'm sure that even more of those people would say they don't want outside help. Learned helplessness is a real phenomenon.

If you're saying these issues are complex, sure, all of them are complex. But I don't think economics and primate power dynamics are any less complex than addiction and mental illness.

[1] https://www.theguardian.com/world/2012/jun/16/slavery-starva...

Learned helplessness means that people gave up trying to help themselves, it doesn't mean that people will not accept help.

Someone who wants to do anything someone else tells him to is free to do so, even if he isn't enslaved. So freeing a slave is not equivalent to "treating" an addict, because in that case the addict is not left free to do what he wants, to "submit" voluntarily to his desire for heroin.

I don't think you have a very good understanding of addiction. Many addicts spend a long period thinking about quitting before quitting. Many addicts try and fail main times to quit. Many addicts who have quit relapse. "Voluntary" is not a binary state.

I agree they aren't identical, but they all share an important commonality.

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