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Comment by mvzink | Hacker News Reader

Foucault's treatment of psychiatry comes to mind. He raises the possibility that psychiatry/psychoanalysis and mental normalcy are effects of bourgeois dominance/the capitalist system: on some level, we care about individual behavior to the extent that it affects productivity.

I've often helped my dad as he volunteers with the homeless, and many of them are 'not productive members of society' due to mental illness (often brought on by drugs, including addiction but extending to permanent neurological damage). My dad, and many others, are searching for ways to make productive niches in society for people with 'mental disabilities'. I'm not sure I can endorse addict pride exactly, but I certainly think cultural acceptance of neurodiversity and addiction is a step in the right direction.

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> to the extent that it affects productivity

I believe that's the key. In a similar fashion, we (society) don't want kids to interfere with productivity, so we stuff them in kindergartens and schools so they are out of our way until they reach their 20s and can be regarded as fully productive. And we put old people in nursing homes for the same reason.

I wonder if the current practice of everyone hiring only "the best of the best" is suboptimal for society as a whole, since it leaves a lot of potential productivity on the society table: Someone with a disability might be (say) only 5-10% as productive as the average healthy adult, but add up everyone with some sort of disability and it sums to a nontrivial amount of underutilized capacity.

But I'm not sure. It's a game of numbers: There are administrative costs to hiring and managing (say) 10-20 people to do one person's job. If the "less productive" part of the population is small enough and the productivity difference between "less productive" and "more productive" is large enough, it could be a net productivity win to pay the "less productive" some small amount of money to go away and stop bothering the "more productive".

Which is essentially what we do today.

What I think's particularly problematic is that it's a very specific kind of institutionally-oriented productivity as well. Now, there truly are people who cannot function in society in any reasonable way at all (severely mentally retarded, some kinds of psychosis, etc.). But there are a wide range of people where context matters a lot to how problematic or beneficial something will be. I think there are some philosophical problems with defining mental normalcy and illness so strongly based on the oddities of a particular era's employment conditions, even if descriptively it's true that someone out of sync with them will have practical problems.

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