Time to bring back asylums? • Hacker News Board

Re: Time to bring back asylums?

#341

Post by michaelmrose » Sun, Jul 23, 2023, 4:53 PM UTC

sbuttgereit wrote: post #80

michaelmrose wrote: post #46

Earlier quoted context omitted.

What if most of the people you wish were interred there are competent enough to decide they don't want to be there but not competent enough to meaningfully integrate with society. This can even be true of some who definitely not competent now but would become sufficiently lucid to disinter themselves before discontinuing medication and resuming drinking and drugging.

".. competent enough to decide they don't want to be there but not competent enough to meaningfully integrate with society..." At some level these should be mutually exclusive conditions; one (unable to integrate) is the major fact that disproves the other (competent enough for self-determination). "but would become sufficiently lucid to disinter themselves before discontinuing medication and resuming drinking and dr…

> one (unable to integrate) is the major fact that disproves the other (competent enough for self-determination).

Except that just isn't even remotely anything like true. Every adult is presumed competent until a court has declared the converse and merely mental illness is not by itself sufficient to provide this.

https://www.law.cornell.edu/wex/mental_competence

It has a legal meaning that isn't malleable to meet what you think ought to be true. Merely being a loser who wants to live in a tent and do meth doesn't make one legally incompetent and in fact any attempt to patch that bug with law alone will probably run into constitutional challenges

Re: Time to bring back asylums?

#342

Post by coffeebeqn » Sun, Jul 23, 2023, 5:34 PM UTC

creata wrote: post #87

m463 wrote: post #65

Earlier quoted context omitted.

As someone with direct experience with someone that has a mental illness, there needs to be something better than the present system. I think something went right, then wrong with the treatment of mental illness in california. Years ago, when the laws were changed to allow mentally-ill but benign or even non-ill people to escape the "snake pits", lots of people could recover. But later state mental illness funding wa…

> lots of mentally ill people don't get proper treatment, yet are still a huge burden on the health care system. I'm not saying you're right or wrong, but why do you believe that?

Overdosing and living on the streets surrounded by maniacs generally is very dangerous

Re: Time to bring back asylums?

#343

Post by coffeebeqn » Sun, Jul 23, 2023, 5:48 PM UTC

kelnos wrote: post #190

bitwize wrote: post #158

Earlier quoted context omitted.

And prisons don't have to be. Think of the resorts rich white collar criminals get put away in.

Sure, but the difference is compassion. Unfortunately, many people have little compassion for those sent to prison, so they don't particularly care what kind of conditions prisoners face. It's terrible, but that's just how many humans are. I think most people wouldn't find it hard to show compassion toward an Alzheimer's patient, and want them to be in a safe place with good conditions and good medical care. Why is i…

The nature of mental illness makes it very difficult to keep the serious cases in consistent care. Even with my own fairly mild (on a scale to psychotic) anxiety attacks I didn’t really want to go into new and challenging situations like seeing a doctor. And I had family, job, healthcare.

Re: Time to bring back asylums?

#344

Post by coffeebeqn » Sun, Jul 23, 2023, 5:52 PM UTC

soligern wrote: post #150

amadeuspagel wrote: post #11

Asylums still exist. What this person wants to bring back is the ability to lock people up and keep people locked up there with little recourse. A typical case from this time[1]: > [Cramer] frankly discusses the “regimented, often hopeless conditions of state mental hospitals”, talks about a hospital in Alabama where “care was worse than simply inadequate: one psychiatrist for 5000 patients; astonishingly low funding…

For that one example of abuse, there are a thousand cases where a mentally ill person didn’t assault someone on the street or break into their vehicle. I’m all for preventing abuse but there must be a way for asylums to exist with high bars for entry and stringent regulation to keep the abuse at bay. The current situation in untenable- 50 seriously mentally ill people can ruin entire cities for the millions that live…

That’s just the tip of the iceberg. I do still have empathy for the people themselves too. It is certainly not fun to have serious un/poorly treated mental illness and being thrown on the streets to fend for yourself. Most aren’t attacking people, they’re just suffering in their own hell.

Being in a controlled environment where they’ll have to take appropriate medication and treatment would be much better for themselves

Re: Time to bring back asylums?

#345

Post by [deleted] » Sun, Jul 23, 2023, 5:53 PM UTC

baremetal wrote: post #331

thebooktocome wrote: post #135

Earlier quoted context omitted.

The Nuremberg Code is about medical experimentation, not vaccination programs. The Nuremberg Code is not really relevant to modern medical ethics, or even to the history of medical ethics--its authors plagiarized [1] half of it from the 1931 Guidelines for Human Experimentation [2]. The relevant standard these days is the seventh revision of the Declaration of Helsinki, by the World Medical Association. No, the use o…

Emergency use authorization is experimental. Otherwise it wouldn't be "emergency use".

[deleted]

Re: Time to bring back asylums?

#346

Post by thebooktocome » Sun, Jul 23, 2023, 6:16 PM UTC

baremetal wrote: post #331

thebooktocome wrote: post #135

Earlier quoted context omitted.

The Nuremberg Code is about medical experimentation, not vaccination programs. The Nuremberg Code is not really relevant to modern medical ethics, or even to the history of medical ethics--its authors plagiarized [1] half of it from the 1931 Guidelines for Human Experimentation [2]. The relevant standard these days is the seventh revision of the Declaration of Helsinki, by the World Medical Association. No, the use o…

Emergency use authorization is experimental. Otherwise it wouldn't be "emergency use".

Here’s a simple metaphor to illustrate the difference, if we’re going to argue the meaning of terms of art by their dictionary definitions.

When Sully Sullenberger pulled off the Miracle on the Hudson, that was an emergency use of the airplane’s water landing capability.

It wasn’t experimental. Airbus designed a “ditching” button for the A320, they knew more or less what it would do, and the regulators (here the FAA) agreed that having such a capability was less risky than not having it, even if it wasn’t vetted and maintained at the same level of rigor as, e.g., the landing gear.

Therefore something can be “emergency use” without being “experimental”, even if we stick to the simple common meaning of both terms.

Re: Time to bring back asylums?

#347

Post by EatingWithForks » Sun, Jul 23, 2023, 6:19 PM UTC

imgabe wrote: post #258

abenga wrote: post #251

Earlier quoted context omitted.

The point is _right now, as we speak_ there is a concerted effort to roll back rights and freedoms women and gay people have enjoyed for years; you should not give people doing this more tools to harm people.

There is also right now an epidemic of homeless people harassing, assaulting, and even murdering people and generally making major cities nearly unlivable. So when you create a false dichotomy between "treat mentally ill people who might murder you" or "lock up gay people", YOU are in fact giving tools to the people who want to lock up gay people. However much your average, non-gay person supports rights for gay peop…

I live in a major city that is constantly described as having an epidemic of homeless people. I am far more annoyed by delinquent, housed teenagers than I am of the homeless population here. And more people die from reckless drivers than are murdered by insane homeless people-- in fact, a little girl was killed in a hit and run this year a few streets from me, and 0 murders by insane homeless people have happened in the meantime.

I'm pointing out that you must absolutely contend with the fact that marginalized people have historically been labeled mentally ill when they fight for equality, and that asylums have historically been used as a tool for this purpose. If your concern is to address homeless insane people, one of the major causes of insanity is being homeless for more than a few months, and yet our homeless shelters are still under-resourced and we are still creating more homeless people by seeing housing as an investment that must always grow, pricing out more and more people.

If anything, I am pointing out we must address the "false positive" issue, where the population of people who are under threat of being institutionalized as insane even though they are just a marginalized person reasonably reacting to their own oppression might be greater than the insane homeless we want to address. And that "we just won't do that because regulation" is a straight up delusional belief, with zero basis in actual reality, and is more or less saying you hate homeless people more than you care about marginalized people losing their rights.

Re: Time to bring back asylums?

#348

Post by iancmceachern » Sun, Jul 23, 2023, 6:29 PM UTC

nradov wrote: post #332

kelnos wrote: post #178

Earlier quoted context omitted.

I agree, but band-aids at least stop the bleeding while the bigger issues are being taken care of. Changing those conditions, even if everyone could agree on what needs to be done, and the political will were there, right now, will be a multi-year -- perhaps multi-decade -- process. I don't think we should let people suffer while we wait for that to happen. I think we should start committing mentally ill homeless peo…

Higher minimum wages are the last thing those people need. We're talking about the least productive workers. If minimum wage is $20 and their labor is only worth $10 then no one will hire them at all. They will remain dependent on handouts and never have the opportunity to gain real work experience. Under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, medical insurers are already required to cove…

You, nradov, are the problem.

Paying people a living wage is not a handout. Raising the minimum wage is not a handout.

These people are working, hard, harder than you do, for way less. These people are being taken advantage of. It's not just fast food workers, it's bank tellers, it's farm workers, it's orderliness and custodians at hospitals, it's the backbone of our society.

What do you get paid to do? I would argue that what you get paid for what you do is more of a handout than raising the minimum wage of a janitor, which isn't a handout at all.

Re: Time to bring back asylums?

#349

Post by EatingWithForks » Sun, Jul 23, 2023, 6:29 PM UTC

phendrenad2 wrote: post #211

EatingWithForks wrote: post #126

Earlier quoted context omitted.

You cannot advocate to bring back an institution and then lie about what that institution was. The asylum institution was a way to label people as insane regardless of their sanity and then subject them to heinous mistreatment for which they had no recourse. Unless you directly address this, you are simply advocating for the re-implementation of institutional abuse.

You cannot interpret people's meaning however you want. If someone wants to "bring back asylums" it's entirely possible (and from the context here, very likely) that they want to bring "back" a version of asylums that never technically existed, but nevertheless both this new thing and the old thing are in the "asylums" category.

If you want to "bring back" something that never existed, you have to address what the thing actually was that you want to bring back-- and more importantly emphasize what will actually be different. You cannot merely lie about what that thing was you're bringing back, or handwave that its different now because the year is different. There is ample evidence that government officials will sexually assault people, traffic children, forcibly sterilize women, and starve/torture/kill/enslave men that they are responsible for in current day.

Re: Time to bring back asylums?

#350

Post by iancmceachern » Sun, Jul 23, 2023, 6:31 PM UTC

cvwright wrote: post #325

coldtea wrote: post #133

Earlier quoted context omitted.

And how is not going for that "moonshot" work out for you?

A hell of a lot better than in most places that have tried a “moonshot”. Russia in 1917 being the major example.

Don't you remember Apollo? That was more recent, and was successful, and widely considered as a good idea.

It's weird to choose an obscure, older historical reference to suit your point, while the literal best example possible, the example that created the term, is sitting right there.