Individualism is Not a Right to Be Forever Hands Off

(11 am. – promoted by DDadmin)

No definitive profile of the Arizona shooter, Jared Loughner, has yet been complied.  Nevertheless, what has been released thus far shows a profoundly troubled individual in desperate need of adequate help and treatment.  Yes, medication and therapy alone are not necessarily a silver bullet in all circumstances, but something should have been done well before Saturday.  From what I have already read, it is not as though warning signs had not been present for quite some time.  Every single time a tragedy along these lines takes place, we mourn, we try to make sense of the carnage, we seek to understand the reasons why a violent act took place, but we stop short of proposing solutions to keep them from reoccurring.      

In 1989, the Supreme Court of the United States made a controversial ruling regarding the state’s role in preventing violence of a slightly different sort.  Though the case involved a father who beat his young son so severely that the child suffered severe brain trauma, the lessons drawn from it reflect the current situation.  DeShaney v. Winnebago County hinged on whether the Department of Social Services of Winnebago County, Wyoming, should have returned a child to the custody of a father who had been well-documented as being physically abusive.  Specifically, my thoughts return to Justice Harry Blackmun’s famous dissent against the majority opinion.

“Poor Joshua! Victim of repeated attacks by an irresponsible, bullying, cowardly, and intemperate father, and abandoned by respondents who placed him in a dangerous predicament and who knew or learned what was going on, and yet did essentially nothing except, as the Court revealingly observes, ante, at 193, “dutifully recorded these incidents in [their] files.” It is a sad commentary upon American life, and constitutional principles – so full of late of patriotic fervor and proud proclamations about “liberty and justice for all” – that this child, Joshua DeShaney, now is assigned to live out the remainder of his life profoundly retarded.

Loughner may have targeted Arizona Congresswoman Gabrielle Giffords for no other reason than she did not validate his own incoherent soapbox argument.  

At an event roughly three years ago, Rep. Gabrielle Giffords took a question from Jared Loughner, the man accused of trying to assassinate her and killing six other people. According to two of his high school friends the question was essentially this: “What is government if words have no meaning?”

Loughner was angry about her response – she read the question and didn’t have much to say.

In reading this, I’m reminded of one of the most ancient of stories.  As some of you may recall, once, eons ago, two brothers worked together in a field.  The effort and offerings of one brother found favor in the eyes of God, but this was not so with the other.  

“Why are you so angry?” the LORD asked Cain. “Why do you look so dejected? You will be accepted if you do what is right. But if you refuse to do what is right, then watch out! Sin is crouching at the door, eager to control you. But you must subdue it and be its master.”  

One day Cain suggested to his brother, “Let’s go out into the fields.” And while they were in the field, Cain attacked his brother, Abel, and killed him.

Knowing that something terribly wrong had happened, God calls out to Cain.  “Where is your brother Abel?”  Coldly, flippantly, sarcastically, I imagine, he replies, “I don’t know. “Am I my brother’s keeper?”

The most massive flaw in the SCOTUS case mentioned above is that it places the burden upon the individual, not the state.  This is well and good, unless, of course, individuals are not willing to report violations themselves.  If that does not occur, then the entire system no longer functions as designed.  A majority of justices in this decision were not willing to place full responsibility upon the state agency assigned to Joshua’s case.  This to me has always felt like passing the buck, no matter what legal precedent one uses as justification.  Regardless of who ought to be liable, government or individuals must intervene in circumstances of abused children, or the severely mentally ill.    

The American mindset has always been that of great skepticism towards centralized power in any form.  I know if a decision were made today that would, in effect, force the mentally ill into treatment facilities, many would protest that individual rights were being trampled upon in the process.  Their concerns would have merit, but when any individual crosses a line into psychosis, which actually means that they are no longer in touch with reality, then they simply aren’t well enough to be able to make proper decisions for themselves.  We are all fortunate that Loughner’s actions are relatively rare.  While many severely mentally ill people are cared for by relatives, poverty often forces others to the streets, living without a home.  I myself pass by the homeless nearly every day on my way back and forth.  In my discomfort, I never fail to reflect upon the tragedy of their own circumstance.

Primarily, our stumbling blocks are money and time.  Treatment for those who desperately need it is not inexpensive, nor short-term in duration.  The costs of most medications to resolve conditions like paranoid schizophrenia are prohibitively high, and even if Medicaid or local programs pick up most, if not the whole cost, a month’s supply often exceeds $1000 per month.  One cannot make anyone act in his or her own best interest, but we can certainly do a better job than we’re doing now.  This also means fully funding clinics who provide mental health services, hiring enough workers and staff, and making sure sufficient funds are available in the system to supply medication on time.  Loughner lived with family, but his need was no less urgent.

Moreover, until we are willing to ask difficult questions of ourselves, we will not make much progress.  Had someone, long before now, thought to ensure that Jared Loughner undergo a full psychiatric evaluation, we might not be in this awful situation today.  While it is easy to be heavy-handed and cavalier in saying so, I hardly think it improper to at least evaluate those who are unwell.  If we don’t at least do the minimum, we should never expect anything to change for the better.  When additional details come to light about Loughner’s psychiatrist history, or lack thereof, I will be interested to see how he was treated.  Those details likely will not provide a complete answer, but I am curious to see what was tried and what was not tried.        

The way we’ve been doing things up to now certainly isn’t working.  Returning to the example of the homeless, here is an instance of a typical half-measure.  Recently, in DC, there had been problems with homeless people sleeping on benches underneath bus shelters.  In response, the benches were completely redesigned to be curved and ridged, in effect making sleeping on them uncomfortable, if not impossible.  That solved the cosmetics of a problem, but it didn’t exactly do much to stop the greater issue of homelessness.  Instead, it just shuffled a contentious issue from one side of town to another.  I mention this because mental illness among those without a place to go is enormously common.  So this time, I hope we make sensible, humane, intelligent plans towards preventing another horrible event like we have just observed.  

When a Congresswoman is shot, it makes major news, but workplace shootings have become so commonplace now that they barely inspire two hours’ worth of coverage on the cable news networks.  We can talk all we want about the impact of toxic political speech, but that is only an additional conduit and an intensifying factor.  Measuring at what point someone snapped seems to be a foolish exercise.  Once a human being reaches a state at which conduct of this magnitude is being seriously considered, we ought to focus more on bringing said person back to sanity first.  Otherwise, we are merely enamored with sensationalism, which grows orgiastic and unproductive.  If we are our brother’s keeper, or our sister’s keeper, we are required to act in ways that keep us all safe from harm.


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    • RiaD on January 10, 2011 at 17:34

    lately we seem to be finding solutions to symptoms rather than causes. while the former looks good quickly, the latter would do more good. which is more cost effective?

    a sideline question- does medication really cost so very much to make or is it the outrageous bonuses of CEO’s & other admin that make it so?

  1. I can guarantee you that we do very little as a society to help the mentally ill.

    My daughter has now received two denials for social security.  We are on appeal again.  Fortunately she is on some program that pays for her meds, and she gets food stamps, but my wife and I pay her mortgage, pay for her car, pay for her insurance (health insurance is not available) and all of her other expenses, including therapy.

    When she gets really depressed, she is a danger to herself and not to society, except for the harm her death would cause her family and friends.

    I have an MD friend who is an addictionologist, and the addicted have the same problem.

    As an attorney I spent some time representing the mentally ill in mental commitment hearings and also spent some time defending some criminally accused.  Many times I concluded that the criminally accused are just mentally abnormal and that had they been thinking in a more normal fashion, would not have committed the crimes they did.  

    I think many of the people in prison today are there for mental reasons.  I don’t think they really comprehend the difference between right and wrong, or if they do, seem to be biologically/mentally unable to stop their antisocial behavior.  I think nature trumps nurture far more often than we like to believe.  It is convenient (and many would say, cost effective), I am sure, to put the blame on someone who really can not help himself/herself.  Then it only becomes society’s problem when we get a Tuscon incident.  

    • rossl on January 11, 2011 at 00:19

    mental health is just one more corporatized, sickly prioritized business for us.  The poor are ignored, cast aside, left to suffer and unable to afford proper treatment, ruining countless lives.  The rich are equally dysfunctional, just in different ways – their empty, materialistic lives are so often filled with medication and shallow diagnoses (Prozac for depression, Aderall for ADD, whatever it’s called for “restless leg syndrome”) instead of spiritual fulfillment and genuine contentedness with life and their relationships.  If you’re lucky enough to pull yourself out of poverty in this nation, you’re lucky enough to move from being completely undertreated to being entirely overtreated…we’ve got a nation of increasingly unstable people on our hands, but it’s all good, ’cause the pharmaceutical industry is making a killing.

  2. about ratcheting up the level of involuntary commitment of the mentally ill, I suggest you look at the track record of the conditi0ns and treatment to which the involuntarily committed were routinely subjected to in the past when it was the more prevalent approach.  Then pause to consider this:  that was at a time when this nation actually had a streak of liberalism and some small smidgen of a culture of social justice and caring for others, for strangers.  And that was the best we could do in that sort of America.  What happens in the cold, self-centered, miserly, hate-filled, selfish America of today if we return to the practice of mass involuntary commitment?

    • RUKind on January 12, 2011 at 00:57

    I think Americans may be the only country paying MSRP. We provide the bilk of the profit because the price game is fixed by our political campaign contribution rules. Now that we have no rules at all, world-wide pharma companies can buy their own congress critters.

    It’s the ads and hyper-aggressive drug pushing by sales reps that gets me. Those people are constantly pushing samples on doctors and offering reward programs for volume of scrips for certain new drugs.

    Personally, I make use of those free samples. I always ask at each visit for any freebies available. The sales reps always make sure the docs have plenty.

    As for the production equipment, some can be repurposed and some has to be custom. Filling capsules and stamping pills is simple. Make sure you have the proper mixture and put in a new die stamp per drug.

    There was a great 20/20 or 60Min or some news show in the last two weeks about a pPuerto Rican pharma lab (read tax break) that was out of control with QA problems. Very scary and worth finding on YouTube. Bttomline, if you got a drug packaged at this plant you were playing Russian roulette.

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