[ExI] A Small Request

[Rafal Smigrodzki]

On Feb 10, 2008 7:33 PM, Stathis Papaioannou <stathisp at gmail.com> wrote:
> On 11/02/2008, samantha <sjatkins at mac.com> wrote:
>
> > Are those with seriously life limiting and dangerous memetic infections
> > effectively mentally ill?  Or is what is numerically average good
> > enough, the "normal", that it should be accepted regardless of how in
> > many respects un-sane it may be?   And what of those quite significantly
> > outside the norm that are arguably better?
>
> Mental illness is *not* the same as having strange ideas. Strange
> ideas are just one symptom indicating that there may be underlying
> brain pathology, in the same way as a severe headache might be. The
> delusions of the mentally ill are actually sometimes less bizarre and
> less dangerous than the beliefs of people who are perfectly healthy.
> Only if the strange ideas are due to disease will they respond to
> treatment.

### Being a neurologist I concur with Stathis that there are really
crazy people out there, and there are more of them than most of us
would think. Nursing homes are full of people who don't know which way
is up, but still try to go out to buy canned corn for their spouse who
died 5 years ago. With age, assuming that heart disease or cancer
doesn't get you first, your chance of losing your mind may exceed 50
%.

Being a hardcore libertarian I think that the state, of course, does
not have a legitimate duty to help a psychotic or demented person. It
is useful to divide the insane into two groups: likely to endanger
others, and likely to harm self. With the first group it's easy to
decide: since they do not respect the property of others, then by
reciprocity they do not have a claim to the full protection of their
property, such as the claim to the inviolability of their bodies and
minds. It is then acceptable to treat them against their will (whether
by a private organization or the state), although they can only to a
limited extent be subject to retributive justice.

The other group, dangerous to self, do pose a bit of a problem. I am
not very worried about the abuse of psychiatry for political reasons:
in a real tyranny they don't need a medical excuse, they just open
fire and bulldoze the bodies to a dump. Weakening regimes may abuse
psychiatry when they no longer have full control but this is a
relatively minor problem compared to all-out violence, as measured by
the body count in the last century.

Anyway, there is a continuum of being dangerous to self, from being in
an acute manic state complicated by psychotic symptomatology, through
being anorexic, to eating too much bacon as a cure for baldness. All
of the examples I gave involve some degree of impaired reality
testing, some delusions, some impaired insight, and could be the
subject of a psychiatrist's attention. When would that attention be
legitimate? If I were to come down with schizophrenia (unlikely being
a 42 year old male with negative family history....but you never
know), I would definitely want to be shot up with some neuroleptics
pronto but I don't want to be committed if somebody decided that my
driving habits are just to dangerous for me. So, the prudent person
would want to have some reasonable threshold of mental impairment
defined, beyond which qualified professionals would render help even
as you scream at them and try to bite their fingers off.

The libertarian might want to have an insurance contract with
provisions for acute mental care, with appropriate standards for
allowing intervention against resistance. As long as I have the choice
of such standards, and there is no entity (such as the state) that
legitimately could impose its own standards, I would be satisfied. I
would know I won't get locked up for endangering my life through
participation in a cryonics program, or by driving 90 to 120 mph, or
eating Hungarian salami but would still get help if I suddenly
developed frontal lobe partial status epilepticus and started
wandering around like a headless chicken. Voluntary choice of
involuntary (sic!) treatment would be ideal for me, state-controlled
standards are inferior and possibly dangerous, but being left with no
protection against my own future deranged self is even worse. After
all, if I live long enough and the singularity is late coming, I could
really need it.

BTW, if you ever visit EU, get some genuine Hungarian salami. AFAIK in
the US there are only poor counterfeits available so don't get fooled
by the label. The real thing is the pinnacle of the art of sausage -
dripping with fat, dry, so heavily smoked you can leave it at room
temperature for months without spoilage. Slice it very thin, almost
translucent, leave on the cutting board for a few minutes to oxidize,
and then nibble. The aroma is unlike anything else, it leaves your
throat burning with smoke, and makes you feel sick with all that
saturated fat and combustion products. Each slice could perhaps
shorten your life by a minute or so....highly recommended.

Rafal