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Comment by delichon | Hacker News Reader

  Most doctors agree that people in the throes of a psychological crisis must sometimes be detained against their will to stabilize them and prevent harm. These can be tough calls, balancing patients’ safety with their civil rights.

IMHO it's acceptable sometimes to balance others' safety with a patients' civil rights. But it's not acceptable to trump someone's civil rights with concerns about their own safety. That balance can certainly result in tragedy when people make horrible choices. But it preserves the concept of civil rights against the incompatible alternative of overruling them in the name of safety. We can't get the benefits of freedom by only allowing "good" choices, because those benefits flow largely from learning from the bad ones. We are very capable of collectively making bad choices (from slavery to lobotomies) and defining them as good. Civil rights are a way to counterbalance those.

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I’m guessing you’ve never had to deal with a loved one in the throws of addiction or severe mental illness. We are not perfectly rational beings and sometimes we make very bad choices, especially when we suffer from a mental illness like addiction. If I had the choice between seeing a loved one temporarily institutionalized versus having them die of an overdose, I would take the former. It isn’t ideal, but sometimes you have to choose the least awful thing.

What does “temporary institutionalization” look like in that choice? One of the highest risk periods for overdose is after leaving jail or rehab. Do you support proposals to reduce the risk of overdoses that don’t rely on complete abstinence, such as drug test kits, safe injection rooms or even legal supply?

While there is a place for such things, its hardly a replacement for rehab.

We have all those for alcohol and yet alcoholism still causes massive problems.

I generally agree with you, but how far should we take this? Like if a loved one has been diagnosed with hyperlipidemia and makes the very bad choice of refusing to take their prescribed statins, should they be forcibly institutionalized? They are likely to die early, although it isn't an "imminent" threat.

> That balance can certainly result in tragedy when people make horrible choices.

The thing is, someone may not be rational enough to make that choice. I’ve been suicidal in the past. Reasoning goes out the window and you can easily make a decision you never wanted to make. You simply can’t choose to stay alive any longer.

I’ve lost a friend because they couldn’t hold out long enough for things to get better. They killed themselves because of a temporary situation they could have easily recovered from.

I’ve saved a friend by preventing him from going down that route. It took over a year for him to be healthy. He doesn’t want to die now.

I’m always going to side with stopping people from suicide until they’ve had a chance to be mentally sound enough to make an informed decision.

There have been people I’ve known who did make that decision and did so rationally. All of them had medical conditions they could never recover from without divine intervention. In their case, they wanted to spare themselves and others from a long, painful death. They should be able to make that choice.

> I’m always going to side with stopping people from suicide until they’ve had a chance to be mentally sound enough to make an informed decision.

The problem is that “mentally sound” is partially defined as not wanting to die. It doesn't matter how stable and coherent you are, as long as you keep saying “on net, I don't feel like my life has been worth living and I would prefer to end it painlessly if I could”, they will not let you out. Getting out is a process of learning the lies you need to tell the doctors and nurses.

My understanding is that for many (not all) suicidal people, the time period of actually wanting to die can be remarkably short. Like on the order of 20 minutes, and then thought passes (at least for a little while)

If you mean at extreme risk of carrying through with a plan, that seems fairly accurate in my experience. I had a number of safety plans I’d use to remove myself from the means I’d use until I could get back to passively suicidal instead of actively suicidal.

The fact the current process isn’t perfect doesn’t change how I think things should work. Determining another person’s mental state is difficult and you’ll always run into problems.

On a whole, more people ultimately wish to live afterwards than those who want to die. So any system is going to err on the side of caution.

As I mentioned, there are situations in which a rational decision is easy to understand and verify. Our current system in the US does not allow for these cases.

> The problem is that “mentally sound” is partially defined as not wanting to die.

Unless, of course, you have an illness that happens to be something other than mental illness.

Because pain and suffering can only come from physical ailments /s

Make assisted suicide for mental illness legal. There are plenty of treatment resistant or life-long illnesses that should qualify.

Helping clinically depressed people act on their most-awful impulses - this doesn't seem likely to yield whatever positive outcomes you're thinking of.

Why do you believe life-long pain and suffering limited to physical ailments?

Not all depression can be cured or even easily managed. Not all mental illnesses consist of depression.

> Why do you believe life-long pain and suffering limited to physical ailments?

Why do you think I believe that?

> Not all depression can be cured or even easily managed. Not all mental illnesses consist of depression.

Okay.

    source:25y as caregiver of mentally ill spouse. source:7y PTSD support group asst.

This fantasy libertarian nonsense doesn't fly in the real world. Check out how bad the MAID program has been in Canada.

The program has been a wild success and your belief that it isn’t is as a result of your consumption of conservative media

I'm as big a libertarian as anyone, and I see the logic and morality of this argument.

Still, I can't be against violating people's rights by stopping them from suicide, and keeping them locked up for a while afterward. A close friend is alive because this.

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