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Comment by thaumaturgy | Hacker News Reader

I will muster every ounce of decorum I can manage in responding to some random person's rebuttal to a post written by someone who actually knew and lived with Aaron (seriously, what are you thinking?!), and simply retort:

"That program crashed because it halted. It was the proximate cause of its own crash so to speak. Are there other factors without which it wouldn't have crashed? Indeed, there are an infinite number of them. An infinite number of things could have happened to change the course of the program execution. Indeed, ultimately you can trace the blame all the way back to the program's previous versions (the bug is quite heritable)."

Your comment is not enlightening. It is not insightful. It falls flat on its face if you bother to do even two minutes' Googling to find that while somewhere between 1 in 10 and 1 in 20 Americans suffer from depression (http://www.cdc.gov/features/dsdepression/), "only" 38,000 die of suicide each year (http://www.cdc.gov/nchs/fastats/suicide.htm).

Saying, "that person committed suicide because they were depressed" is ... I have no polite things to say about it. Saying that to the loved one of someone who just committed suicide is really, fucking, wrong. "Tracing the blame back to his parents" -- i.e., blaming his parents -- is simply, horribly, awfully, inhumane.

If Taren is saying that she doesn't think Aaron would've committed suicide at this time if it weren't for the way that the case was progressing, we have no damn business telling her otherwise, and your completely vacuous comment certainly shouldn't be at the top of the thread about it.

Is it possible maybe that your background as an attorney is coloring your judgement of this case? That you find it uncomfortable that someone else in the legal profession is being faulted for the way that they handled a case that resulted in someone else's completely preventable death?

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Yes. But. (and this post doesn't intend to argue Aaron was depressed, just thinks about the premise that he might have been)

As someone who suffers a lot with depression, it is quite possible to be depressed and for no one close to you to notice. We can be damn good at hiding it, especially with practice, especially with people we know well.

Some time ago I was living with my partner and she had no clue I had been depressed for months. Then we went out with a couple we hadn't seen for a little while, and afterwards the girl took my partner aside and asked if I was OK.

Taren obviously knows him best, and I agree that if she says Aaron wouldn't have committed suicide if it weren't for the case then clearly that is true. However, I think she is dismissing the impact of depression, or at least dismissing the possibility, to readily. You could turn around and suggest that if he hadn't been in depression (if indeed he was) then the case may have not driven him to suicide.

Depression is a horrible, and terrible thing. Those close to depressed individuals certainly have a lot of insight, but it is still nearly impossible to communicate what it is like even to them.

EDIT: I'm cautious to add this, because it is "one guy on the internet", but reading Taren's post again some of the things she describes strike me as telltale signs of secreted depression. Disappearing on a whim for a hike, for example, is a favourite of mine.

EDIT2: It is also worth noting she describes one common set of symptoms of depression (low activity, disinterest, etc.). However, I for one don't often get them (for example) but I do become deeply involved in subjects for periods of time before moving on. Similar to how she describes. This is a very very common symptom of depression and if you see a friend become obsessed with a string of new things take a second to think about how they might be.

I would have loved to have seen this comment of yours at the top of the thread instead; I agree with everything in it. Further, I'll also step forward as someone who also deals regularly with crippling depression; being more open about it is what I've resolved to do after Aaron's suicide, and the suicide in November of one of my clients. (I've written only a very little about it before, http://www.robsheldon.com/blog/depression-programming/)

You're absolutely right that we can be sneaky. A huge part of that is the stigma associated with depression. I'm certain that if all of my clients knew about it, I'd lose some of them for the simple fact that they'd consider me unreliable in the long term.

So, when Taren mentioned that she'd been "reading up" on depression, and concluded that that wasn't what Aaron was suffering from, I did cringe a little. I came to the comments here expecting to find some discussion of depression; what I didn't expect was the top comment completely dismissing Aaron's suicide as being only about depression.

Depression is probably different for different people, like most things. Mine simply makes me more susceptible to struggling when life gets hard. I'm rarely depressed when the sun is shining and there's money in the bank account and my car is working and my business is good and my friends and family are happy. When too many of those things are off, I feel it intensely and my default biochemical response is to crawl into a hole and want to disappear. I have to fight my way back out of that, every time.

So I find Aaron's case very easy to empathize with. If I were in his situation -- inasmuch as I understand his situation at this point -- I'm honestly not sure what I would do. I can tell you that I'd feel overpowered, hopeless, and defeated. I can also tell you that I would want to punch anyone in the face who said that if I chose to commit suicide as a result of the situation, it would be primarily because of my depression.

Do you know how psychiatrists or clinical psychologists diagnose depression? Have you read the DSM? Do you know how they come up with the criteria for psychiatric disorders in DSM? Do you know the controversies behind DSM? Do you know few decades ago homosexuality was regarded as a mental disorder? Do you know that there are researchers who want to introduce a new "psychiatric disorder" (i.e., hypersexual disorder) in the next edition of DSM for people who have sex more than 7 times a week ?

Here is the criteria for major depression: Diagnostic criteria:

Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day

1. Depressed mood most of the day.

2. Diminished interest or pleasure in all or most activities.

3. Significant unintentional weight loss or gain.

4. Insomnia or sleeping too much.

5. Agitation or psychomotor retardation noticed by others.

6. Fatigue or loss of energy.

7. Feelings of worthlessness or excessive guilt.

8. Diminished ability to think or concentrate, or indecisiveness.

9. Recurrent thoughts of death (APA, 2000, p. 356).

I am sure everyone has met some of its criteria at some point in their life. Without a real diagnosis, you really can't say if the person has a major depression. Even with a diagnosis, how do you know the doctor is making the right diagnosis with SUCH VAGUE criteria?

Edit: I am very aware of what DanBC has pointed out about the other criteria: i) at least 2 weeks ii) and at least five of the following symptoms iii) clinically significant impairment in social, work, or other important areas of functioning almost every day.

BUT THEN, the question becomes "Why 2 week?" "Why at least five of the symptoms?" Who came up with the numbers? Let me tell you, the DSM committee have a lot of disagreement about those. Those numbers are not some magic numbers that once you pass that threshold, you suddenly become clinical depressed.

I've always felt depression is only somewhat understood, as you say it's hard to diagnose.

For example, #7 is a common one for me - and you simply can't see it or diagnose it unless I tell you. But you can usually tell from other things; like the fact I get obsessed with ideas and spend a lot of time walking (i.e. thinking/brooding).

I agree with you; and I wasn't exactly trying to make a diagnosis over the internet. I was trying to point out that although Taren seems so certain he was not depressed, she makes some claims which are very much not the be-all-and-end-all of depression. And that some of the activities she describes are common tells for depression.

My point being; it's not simple, and depression is a complex and evil thing.

> I am sure everyone has met some of its criteria at some point in their life

It is incredibly frustrating that you say this, even while quoting the DSM which says:

i) at least 2 weeks

ii) and at least five of the following symptoms

iii) clinically significant impairment in social, work, or other important areas of functioning almost every day.

These symptoms are not vague. Unless you take one symptom, and ignore the significant impairment clause.

> These symptoms are not vague.

Of course they are. And there's a lot of variability in diagnosis between practitioners. Some even say that depression isn't really a disease at all.

There is an excellent book on this topic that I cannot recommend highly enough:

Title: "Manufacturing Depression: The Secret History of a Modern Disease"

Link: http://books.google.com/books?id=U-lvlVSGeEEC

Quote: (about Congitive-behavioral therapy) “a method of indoctrination into the pieties of American optimism, an ideology as much as a medical treatment.”

Here's a discussion of the book (and topic) at the New Yorker entitled "Head Case": http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100...

> Do you know how psychiatrists or clinical psychologists diagnose depression?

Yes, and do you know how much variability exists between practitioners? Diagnosis is largely a matter of personal opinion, not science.

The reason for that, in turn, is because no on knows what causes depression -- it's not like a medical condition with an identified pathogen and clinically validated treatment.

But the vague state of depression as an illness with an unknown cause doesn't prevent psychiatry and clinical psychology from offering therapy and drugs of dubious efficacy.

Antidepression drugs have been shown to be ineffective in most cases --

Link: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

Title: "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration"

Quote: "Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance."

The story is that drug companies publish only studies that support their belief in their drugs' efficacy. But when completed but unpublished studies are included, the evidence for the efficacy of antidepression drugs evaporates.

The study's authors don't say the drug companies deliberately suppressed negative findings -- they leave that conclusion to the reader.

I have many bad things to say about many antidepressant. E.g., they all have very annoying side effects, at least for me, and some of the side-effects (e.g., vivid dreams) require benzos to counter. And then benzo addiction is really no fun at all.

Other side effects I experienced were clearly under-reported by the pharmaceutical companies. E.g., negative sexual side effects for Prozac that my doctor wouldn't even believe were real and not psychosomatic, until it later turned out that 25%-50% of all patients suffered these side effects, and the pharmaceutical company had neglected to inform anyone.

On other other hand, Remeron surely saved my life. I have no doubt about this. I had been in the most miserable state you could ever possibly imagine and then some, and had been this way for months, and then within a day or two of starting Remeron, I was utterly fine. (Though ironically, it may have been another antidepressant that put me in this terrible state to begin with, as I had to go off it cold turkey due to it causing a different dangerous side effect.)

As for diagnosing depression, it may certainly be the case that many cases are difficult to diagnose correctly. And there may be cases where there is no fact of the matter as to whether the particular symptoms count as depression. On the other hand, there are certainly cases where there is no question at all as to whether it's depression. I have been there quite a few times, and it's been as cut and dried as anything can be in this world.

> On the other hand, there are certainly cases where there is no question at all as to whether it's depression.

Yes, absolutely, but saying "it was depression" is not the same as saying "depression is a disease with a proximate cause that can be identified, diagnosed and treated."

The present debate surrounding depression is global in scope. No one knows whether depression is a disease in the way that a cold is a disease, or is an extreme case of normal emotion, not amenable to any kind of diagnosis or treatment.

None of this is meant to argue that depression isn't a disease in the way that a cold is a disease -- only to say there's no reliable science behind the claims.

But we do know this -- in controlled scientific studies, antidepression drugs don't actually work for the majority of patients:

Link: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

Title: "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration"

Quote: "Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance." [Emphasis added]

Comment: Drug companies have been only publishing studies that supported their drugs, and discarding those that didn't. This study compares the outcomes for all the studies, published and unpublished, and the result is that antidepression drugs do not work for the majority of patients.

>the result is that antidepression drugs do not work for the majority of patients.

I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos. The patient's patience is especially relevant since when you are depressed, the last thing in the world that you need is to add extra suffering from side-effects to your list of woes. Or at least that has been my personal experience. After a few bad experiences, I was very reluctant to try additional antidepressants, and after having become dependent on Ativan once, I vowed to never allow that to happen again either.

Ultimately though, I tried just about every modern antidepressant before finding one that worked, and I know people who had to go to tricyclics, which has caused them to become fat, but happy. Each of the antidepressants I tried affected me differently. But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me. Knowing that is a huge weight off of my shoulders. Though having to look forward to weaning off of benzos again puts some of that weight back.

More recently I tried ketamine when I was worried that I was going to become depressed due to an unfortunate life circumstance. I'm here to say that it apparently worked as well as hyped since I never became at all depressed during a situation that would typically have sent me into a downward spiral. And with no ill side effects too boot. Too bad it's not legal....

Of course, trying many different antidepressants is not without its risks, as I alluded to previously.

> I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos.

No, no, we're talking about controlled studies overseen by scientists, not psychologists or psychiatrists in ordinary clinical practice. Typically, such a study has an experimental and control group. The experimental group gets the drug under test and the control group gets a placebo. To minimize the possibility of bias, during the study neither the experimenters nor the subjects know which subjects are controls.

After the study, the histories of the subjects are compared, and the groups to which they belong are finally revealed. Every precaution is taken to limit bias and emotional attachments to any outcome.

As it turns out, when such studies are conducted and compared to other similarly disciplined studies, the efficacy of antidepressants evaporates. In plain English, they do not work.

That's the scientific finding. It's not an opinion, like much of psychology, it is a scientific result.

> But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me.

Yes -- and so does astrology, but only if you sincerely believe it does.

The fact that Remeron worked for me has absolutely nothing to do with belief or placebo affect. In fact, I was absolutely certain at the time that Remeron would not work, due to my previous bad experiences with antidepressants and my terribly negative state of mind. Also, there is absolutely no scientific evidence that the placebo affect can have such a drastic and lasting effect. I was not just a little blue; I was out of my mind @#%$ing batshit crazy. For months and months, and then a few days later, completely cured. A cure that has lasted for years.

As to your claim that "they do not work", the scientific evidence that they work may be questionable, but lack of scientific proof is not the same thing as scientific disproof. You have no proof that they do not work for many people, despite your claim, as the way the drugs are used in double-blind studies do not perfectly mirror their use in the actual world. E.g., combination with other drugs, such a benzos, and/or other antidpressants, and trials of a number of different drugs to find which one is best of that particular person's brain chemistry.

Furthermore, one doesn't need scientific evidence to know certain things. I don't need published double-blind scientific evidence to know that if I hit my toe with a hammer that it will hurt. I don't need scientific evidence to know that my wife loves me.

Another point of evidence: Paxil also cured my depression within a day or two, on a different occasion, but it also had many other effects on me that were highly undesirable. It removed all pleasurable sexual sensations. It made me hypomanic and not care about how I treated other people. I felt as if everyone else in the world was an asshole who didn't give a shit about me, and so I was free not to give a shit about them. I felt absolutely no affinity any more for the people that I loved. I only found them annoying. I.e., my normal personality was turned completely upside down.

I don't need scientific evidence to know that this is how Paxil effected me, any more than I need scientific evidence to tell me how alcohol or marijuana make me feel. These are not subtle things, and the effect of Paxil on me, and the affect of Remeron on me were anything but subtle. They were as psychoactive as any substance can be.

Now since my evidence is not scientific, I am not stating that you should be convinced. On the other hand, you have no grounds to assert that I was cured by the placebo effect. You don't know me and you don't have access to the personal experiential information I have. I, personally, have plenty of information to make an accurate and rational conclusion here. And I have.

> The fact that Remeron worked for me has absolutely nothing to do with belief or placebo affect.

With all respect, you cannot make this claim. The only way this claim could become scientific would be with a double-blind scientific study. Such a study would compare the drug with ... a placebo.

And, as I have pointed out, the studies that have been conducted do not support the claim that antidepressants work for the majority of people -- indeed, studies demonstrate the opposite conclusion, that they do not work.

> On the other hand, you have no grounds to assert that I was cured by the placebo effect.

Yes, which means it's a good thing that I never said that anywhere. And why would I? The claim makes no sense -- no one is ever "cured" by the placebo effect.

> I don't need scientific evidence to know that this is how Paxil effected me ...

Wow. The drug companies must love clients like you.

> I, personally, have plenty of information to make an accurate and rational conclusion here.

You are ignoring the readily available scientific findings, so no, your conclusion is neither accurate nor rational.

This is an excellent capsule summary of modern psychological research -- no electron micrographs, no useful in vitro results, no objective evidence. No known causes for diagnosed conditions, and subjective diagnostic criteria. Instead, a nearly complete reliance on the self-reporting of clients, who insist that the drugs do or do not work, or the therapy works or doesn't work.

No matter how sincerely psychologists and psychiatrists want to help people, this charade will continue until real science begins to be done, and for that, we'll probably have to completely switch away from psychology to neuroscience. As it happens, Thomas R. Insel, the sitting director of the NIMH, agrees with this view:

Link: http://www.scientificamerican.com/article.cfm?id=faulty-circ...

Quote: "In most areas of medicine, doctors have historically tried to glean something about the underlying cause of a patient's illness before figuring out a treatment that addresses the source of the problem. When it came to mental or behavioral disorders in the past, however, no physical cause was detectable so the problem was long assumed by doctors to be solely "mental," and psychological therapies followed suit. Today scientific approaches based on modern biology, neuroscience and genomics are replacing nearly a century of purely psychological theories, yielding new approaches to the treatment of mental illnesses."

> With all respect, you cannot make this claim.

With all respect, I most certainly can. I know myself well enough to know how I respond to drugs. I'm sorry if that is not the case for you. I also know that I don't suddenly pop from the depths of the worst despair imaginable to being completely normal in a day or two on a hope and a dream. If that were the case, many other things would have cured me. Such as the dozen or two medications I tried before Remeron, for instance.

> The only way this claim could become scientific would be with a double-blind scientific study. Such a study would compare the drug with ... a placebo

I specifically stated that my claim was not scientific. All knowledge does not come via science. As I already mentioned, I cannot prove scientifically that my wife loves me, and yet I know this to be true. You may have no good reason to believe me about that, but that has no bearing on what I know to be true.

> Yes, which means it's a good thing that I never said that anywhere. And why would I? The claim makes no sense -- no one is ever "cured" by the placebo effect.

The placebo affect is real, so it can certainly act as a cure for minor ailments of certain sorts. I have no desire to argue semantics with you. On the other hand, it was Remeron that cured me, and I'm as sure of that as I am that I am not conversing right now with an AI program, though I can't prove that scientifically, either.

As I also mentioned, you do have not have any particularly good reason to believe me, but for reasons I have stated, you also have no good reason not to believe me. If you were not an ideologue, you would remain agnostic.

> Wow. The drug companies must love clients like you.

Your assertion is that a drug company would love me because I am willing to testify to the fact that Paxil made me hypomanic and I would assert to anyone that it is a dangerous drug and I would advise them to stay away from it if my experience is at all representative? You have a strange notion of what drug companies might love.

I've been told by doctors that I had a phobia of antidepressants because I was so utterly resistant to trying anymore after my terrible experiences with them. You sound like them: The hypomania was all in my head. The sexual dysfunction from Prozac was all in my head! Welcome to the club of quack shrinks!

> You are ignoring the readily available scientific findings, so no, your conclusion is neither accurate nor rational.

I am ignoring nothing. If you actually read what I wrote, you would know that.

As to your claims that neuroscience research will likely be hugely beneficial to our understanding. Well, of course. That verges on tautology.

>> With all respect, you cannot make this claim.

> With all respect, I most certainly can.

I recommend a refresher course in science.

> I recommend a refresher course in science.

I recommend that you learn to read. And how to not be a jerk.

> And, as I have pointed out, the studies that have been conducted do not support the claim that antidepressants work for the majority of people -- indeed, studies demonstrate the opposite conclusion, that they do not work.

Furthermore, you are misrepresenting the strength of the scientific data that supports your claims: (1) The meta-analysis did show clinical significance in severely depressed patients. (2) The meta-analysis only looked at SSRI's. Remeron is not an SSRI. And most of the people that I know who are satisfied with their antidepressants are not taking SSRI's. (3) This is a single study. Individual studies are often contradicted by further studies.

From my experience with side-effects, I would not recommend anti-depressants for anyone who was not suffering from a major depression anyway. The risk is not worth the reward for just being down in the dumps. For mild cases of depression, it's not even clear to me that accurate diagnosis is possible. How can doctors accurately differentiate between mild depression and just being sad due to unfortunate life circumstances? Until we can do brain scans or blood tests to identify depression, I don't see how they could. And without the ability to make accurate diagnoses for mild cases, it's not clear to me that the data on drug effectiveness for mild cases can mean much anyway.

I think you misunderstood me a bit. I asked that question to suggest exactly what you have said. The way they diagnose people with all the vague criteria is not scientific at all. I completely agree with you. And yes, I am also aware of the variability among practitioners.

I should have read your post more carefully before assuming there was any significant division between our views.

For what it's worth, I kinda agree with what I think you're getting at -- that the diagnosis for depression needs a lot of work and the DSM isn't infallible -- but your comment here is easy to interpret as a skepticism of the existence of depression, which might be why it's getting downvoted.

Fortunately, there have been some recent advancements in neuroscience that can give us hope for improved diagnosis in the future (once the field is able to agree on what depression is, anyway).

I went through a period of depression two years back. My family and friends were the last people to notice it. I put on a strong face for them and went out of my way not to worry them. The people who did notice were professors and classmates, people who I didn't make much of an effort to "impress". When those close to me started to realize they all began to rationalize it as being the result of drugs or sleep loss or a recent break up. You just aren't the type of person to be depressed they said, it's not like you. Sad as it may be, they knew even less about how I was than random strangers on the bus. I suspect a lot of it had to do with how they viewed depression and the stigma surrounding it.

Thanks for these thoughts. It makes me wonder about Jody Sherman. I didn't know the man, yet every thing I've read about him sounds like he would be amazing to be around--and a great friend. He, maybe more so than Aaron, had even more to look forward to (i.e. no federal lawsuit, etc). And yet, Jody chose the same end. So sad.

I certainly wouldn't presume to tell someone close to the situation what the cause was, but that doesn't mean I uncritically accept their view. Having a history of depression and having made a couple of suicide attempts in the (now-distant) past, here are some things that come to mind while reading her argument that Aaronsw didn't exhibit the typical clinical markers of depression:

a) having a list of symptoms doesn't fully equip someone to make clinical decisions about their presence or absence, especially when one is trying to wrap one's head around them in the wake of a tragic event. Psychiatry is nowhere near being an exact science, but a list of symptoms doesn't put one the same plane as a psychiatrist who is familiar with the terms of art, statistical methods and so forth that go into the development of evaluation scales. Psychiatry may grope its way through the dark, but it does attempt to do so in a systematic fashion.

b) one might argue that the 'the Aaron she knew' didn't exhibit the typical symptoms of exhaustion either.

c) depression isn't some amorphous thing that follows one around like a personal raincloud independent of circumstances, but is rather a factor that weights a person's thought processes to varying degrees depending on time and context. Phrases such as 'pessimistic arrogance' loom large to me, as does this example:

Sam gave Aaron a quick overview of Australian politics; Aaron expressed astonishment at how easy it would be to “take over Australia”, but concluded that a country of only 20 million probably wouldn’t be worth it.

Self-esteem, needless to say, was definitely not Aaron’s problem.

Sometimes, statements tell you more about the person making them than the ostensible subject. This doesn't mean that the person is lying or concealing their feelings, but that those feelings are unconsciously attached to external subjects in order to give them an outlet. Arrogance is not a good proxy for self-esteem at all in my own case; quite the reverse.

d) What people tell you and what they do don't always match; sometimes they may conceal the truth about their feelings of activities for reasons ranging from embarrassment, to pessimism about the ability of others to understand, to not wishing to be a burden. When one is depressed, even other people's expressions of love and support can be exhausting to deal with and it may be preferable to avert them by cultivating an air of positivity. This isn't a case of dishonesty so much as trying to think oneself healthy again.

e) profound capacity for pleasure in everyday life...finely honed aesthetic sense Again, I don't find this incompatible with the presence of depression. The stars shine particularly brightly at night, so to speak.

There are a lot of factors that lead into a person's choice to commit suicide, and they're not IMHO amenable to simple binary decompositions. Just as the number of people with depression vastly exceeds the number of people who commit suicide, so does the number of people who are confronted with alarming legal burdens, both civil and criminal.

Please consider the points above as an attempt at supplementation rather than disputation.

Absolutely, on all points. If anyone thinks I'm arguing that prosecution leads to suicide (even aggressive prosecution), or that Ortiz or anyone in her office is solely responsible for his suicide, then I apologize: that wasn't my intent.

I do think that there are some fundamental questions about the circumstances though:

- Was the prosecution disproportionate to the crime? (I think it was; I'd be interested to hear articulate opinions to the contrary.)

- In Aaron's specific case, should the prosecution have taken his mental health into consideration? (I think so; I can't figure out how to argue this from a moral standpoint, because I can't think of any common ground I'd have with a person who disagreed morally. However, there is at least a legal basis for it: law already considers insanity to be a suitable defense under certain circumstances, so I can't think of a legal reason why in principle Aaron's mental state should not have been a consideration in his case, especially given my opinion on the first point above.)

- In the general case, is there room for reform of overzealous prosecution? (I think so, yes.)

- In Aaron's specific case, does Ortiz's office share some responsibility for Aaron's death? (I think so, unquestionably. I think a plausible test for responsibility is whether one's actions could have been different, whether those actions should have been different, whether the actions were reasonable given the facts at the time, and whether different actions could have resulted in a better outcome. On the first point, I think it's been made clear that there was room for a reasonable plea bargain, and the prosecutors rejected it. The second point goes back to whether or not law should recognize mental health issues in cases like Aaron's, which is perhaps still debatable, though I think it should. On the third point, no, I don't think the actions of the office were, or are, reasonable: I don't think that Heymann's response to Aaron's attorney when notified of the potential for suicide should have essentially been "go piss up a rope", and I don't think that Ortiz, during the fallout from this case, should have said essentially, "there is nothing that my office could have done better." On the final point, Taren seems to be making a strong argument that the most immediate cause for Aaron's suicide was the circumstances of his case, and I don't think I'm in a position to doubt her judgement on this point.)

- Does the HN community also share some responsibility for Aaron's suicide? (I think so, unfortunately. I think it's clear from comment threads about his case that there was not much support for him here, and I think there should have been. Disappointingly, some of the tone from those earlier threads is still present, even in this one, as with Millennium's comment at http://news.ycombinator.com/item?id=5165280. I think it's less clear whether or not a different response to his case on HN would have changed the outcome, but I don't see that as a worthwhile argument against behaving better.)

We're basically on the same page and I agree that there are a lot of questions worth considering; as someone that was rather dismissive of aaronsw's course of action in the first place, I've certainly been thinking about how I expressed those views, even though my views have not changed much since.

The only thing I'd add for consideration here is that it's not really the prosecution's job to worry about a defendant's mental state; as I understand it, it's up to the defense team to bring that sort of issue to the attention of the court (ie the judge). Not to do so, but then to bring the matter up in negotiation, looks an awful lot like an attempt at manipulation instead of a sincere concern. The whole idea of the court as a neutral finder-of-fact is to provide defendants with an unbiased ear for such issues so that they're not dependent on the good will of prosecutors.

Yeah. Just to be clear, I don't think prosecutors should have to wring their hands and back away from plea bargaining every time any defendant claims emotional distress. I do think there should be a framework for evaluating claims of defendants being at risk for self-harm and then selecting appropriate courses of action; in Aaron's case I think that prior evidence (e.g. content from his blog) as well as the nature of his crime should have been suitable grounds for an adjusted plea bargain under this hypothetical framework.

Courts are messy affairs; there's still a lot we don't know, like the disposition of the judge, so I can accept that the defense should have brought that to the court, but would rebut that we don't know that they didn't, or that they weren't able to for some reason. Either way, I don't think that completely exonerates the prosecutor's office in this case.

Thanks for the calm, reasoned discussion.

His documented behavior certainly suggested bipolar or BPD, both of which unfortunately do have a high rate of suicide.

> Your comment is not enlightening. It is not insightful. It falls flat on its face if you bother to do even two minutes' Googling to find that while somewhere between 1 in 10 and 1 in 20 Americans suffer from depression (http://www.cdc.gov/features/dsdepression/), "only" 38,000 die of suicide each year (http://www.cdc.gov/nchs/fastats/suicide.htm).

And some similarly tiny portion of people who are prosecuted commit suicide. What's your point?

> Saying, "that person committed suicide because they were depressed" is ... I have no polite things to say about it. Saying that to the loved one of someone who just committed suicide is really, fucking, wrong. "Tracing the blame back to his parents" -- i.e., blaming his parents -- is simply, horribly, awfully, inhumane.

I'm pointing out that if you confuse causation with blameworthiness, you can trace blame back to depression and genetics. I'm not saying that you should make the mistake of confusing causation with blameworthiness! That's precisely the mistake in the article that I'm arguing against.

> If Taren is saying that she doesn't think Aaron would've committed suicide at this time if it weren't for the way that the case was progressing, we have no damn business telling her otherwise, and your completely vacuous comment certainly shouldn't be at the top of the thread about it.

That's not all she's doing. She's implying that Carmen Ortiz bears some moral culpability for the suicide, because she's in the causal chain.

> Is it possible maybe that your background as an attorney is coloring your judgement of this case?

I can just as easily accuse people who knew Aaron of leaving aside their objectivity because of their emotional investment, but I don't because I don't want to walk down that road.

This'll be my last reply; I've gotta step away from this because it's getting me angry, and it's not likely that you and I will find anything to agree about.

> And some similarly tiny portion of people who are prosecuted commit suicide. What's your point?

I never made the point that prosecution leads to suicide. You, however, tried to make the point that depression leads to suicide, and that's factually wrong.

> She's implying that Carmen Ortiz bears some moral culpability for the suicide.

And I happen to agree with her. If Ortiz knew nothing at all of Aaron, and if she expressed genuine regret at the outcome and investigated her office's actions in the matter, I might maybe be able to accept that she had acted out of ignorance (if she was involved at all). But, we know that Aaron's lawyer notified Heymann at least of Aaron's possibility as a suicide risk, and the response from Heymann was, "Fine, we'll lock him up." That was wrong, and the moral culpability does lead right back to Ortiz for defending her office's actions in this case.

> And if she doesn't want to hear opposing opinions on the subject she shouldn't post her thoughts on the internet for public consumption.

What a pile of ox manure. I would love to see you leave comments like this on threads about sexism: "Well, if she didn't want doctored pornographic photos of her online, she never should have posted her face on the internet for public consumption!"

Someone writing their opinion on a subject never gives anyone else a pass to be an asshole.

> I can just as easily accuse people who knew Aaron of leaving aside their objectivity because of their emotional investment, but I don't because I don't want to walk down that road.

If you had said that, it would have been more valuable as a comment than the one you wrote instead.

> I never made the point that prosecution leads to suicide. You, however, tried to make the point that depression leads to suicide, and that's factually wrong.

The premise of the article this thread is attached to is, as I understand it, is that aggressive prosecution lead to Aaron's suicide.

> But, we know that Aaron's lawyer notified Heymann at least of Aaron's possibility as a suicide risk, and the response from Heymann was, "Fine, we'll lock him up."

What was she supposed to do? Treat alleged suicide risks specially?

> What a pile of ox manure. I would love to see you leave comments like this on threads about sexism: "Well, if she didn't want doctored pornographic photos of her online, she never should have posted her face on the internet for public consumption!" Someone writing their opinion on a subject never gives anyone else a pass to be an asshole.

That's an utterly ridiculous comparison and you know it. I'm not being an asshole to challenge a public opinion on its own merits. You're acting like I walked into some private memorial service instead of responding on its merits to a public posting implying that a public official was culpable for a person's suicide.

Also: it's tremendously bad form to turn a private tragedy into a public cause then raise that tragedy as a defense to any criticism of the cause.

> If you had said that, it would have been more valuable as a comment than the one you wrote instead.

No, it would be ad hominem, vacuous, and senseless just like the stuff you have been posting.

"What was she supposed to do? Treat alleged suicide risks specially?"

This is entirely separate from the rest of the injustices surrounding Aaron's persecution and suicide, but: yes, yes she should have. It's incomprehensible to me that you're suggesting otherwise: if someone is known as being a suicide risk, you make attempts to eliminate or mitigate as much as possible that risk. Even if it gets in the way of some secondary goals like career advancement or can be manipulated by certain malefactors.

Taren's wrong on this in some ways: Aaron's depression, or at least his unique mental disposition, definitely played a big part in everything. But that doesn't exonerate the prosecutors; it puts more blood on their hands.

We'll have to agree to disagree. I think short of being faced with someone who is such a high suicide risk that he should be committed for his own safety, prosecutors have no special duty to treat possible suicide risks specially.

What I find odd is that you think it "incomprehensible" that anyone would disagree with you. I think lots of people would disagree with you on this point. Indeed, I think the majority of Americans would disagree with you. We put people in jail for stealing to feed their kids, we put people in jail for killing abusive husbands, etc. We go out of our way to treat defendants uniformly.

What was she supposed to do? Treat alleged suicide risks specially?

Flight risks are treated differently: they have different or non-existent bail. Systemic risk cases are treated differently: they enjoy a reduced likelihood of indictment and incur non-judicial penalties.

> She's implying that Carmen Ortiz bears some moral culpability for the suicide,

Suicide accounts for almost a 3rd of all deaths in US local jails. Things are much better in state prisons - "only" 6% of deaths are from suicide. (Behind AIDS at 9% and illness at 80%). (These are old, but accurate, figures. (http://bjs.ojp.usdoj.gov/content/pub/pdf/shsplj.pdf) )

Aaron meets some of the risk factors for suicide. Male, history of mental illness (and suicidal ideation), significant life event, potential institutionalisation, and being bullied.

Ms Ortiz owed a duty of care to Aaron, if only to ensure he survived long enough to face trial. When they were told that he was suicidal, and had a history of depression, they should have at least obtained medical reports. They did not. They continued to aggressively pursue this young man (for an alleged crime that neither of the victims wanted to be prosecuted) and threatened to remove him from any support that he had by locking him up.

For almost a third of local jail deaths to be from suicide (and almost half of those occurring in the first week of admission) is pretty shocking.

I can't agree you more on this! People talk about depression as if it is the only cause of suicide. People talk about the cause of depression as if depression is only caused by mental weakness. Aaron has already left us. Can we just show more understanding, compassion, empathy and sympathy to what has happened to him?

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