Mon 22 Oct 2007
Back when I used to be active in competitive debating I attended a lecture at LU on case construction. One of the concepts that I still recall is that of pairs of philosophical concepts which generally are opposites during debate. An example would be Justice vs. Mercy while the one I want to talk about in a very specific context is Freedom vs. Security.
The topic in which I want to discuss this dual with is that of Involuntary Admission, specifically in the case of possible harm to self. Suicide ceased to a crime in Canada in 1961, and within the Canadian Criminal Code the only mention of it is the criminalization of assisted suicide or counselling someone to commit suicide. What distresses me is that within the Ontario Mental Health Act (OMHA) there are provisions for involuntary admission on the basis of self harm.
I suspect that the vast majority of people believe that such a provision is reasonable, so I pose the question: Is it acceptable to hold someone against their will for something they have not done but on the suspicion that they may commit a legal act? I am taking issue here only with self harm as the act is legal while harm of another person is not. They are entirely separate cases. Harm of another person comes down to the security of the public over the freedom of a patient (another debate altogether), while in the case of potential self harm the claim is that security of the patient trumps the freedom of the patient.
Under the OMHA, revised in 2000 with “Brian’s Law“, physicians have the ability to hold a patient involuntarily for 3 days without appeal by just filling out a form, with the provisions for longer times with additional forms (though requiring another doctor). It is worth noting that the patient can refuse treatment during that time, so this can literally result in a patient being held in a locked down facility for having not committed any crime. An issue like this is about freedom of choice. We don’t lock people up for wanting to have an abortion, a self inflicted amputation of sorts (and I don’t suggest we do), but we do for the mentally ill. Such a law could impede assessment and treatment as a voluntary patient may sanitize his response in fear of being processed as an involuntary patient.
Some people may argue that such a patient cannot make decisions of freedom due to their mental illness. I would note then that such an individual is allowed under law to make decisions regarding their treatment. Why not allow the same of their freedom? A person with mental illness, even with suicide ideation, is still frequently capable of making rational decisions. There is a big difference between voluntary admission and involuntary admission in terms of freedoms for a patient. It is completely rational for a patient to want to perseve their freedoms while seeking treatment. To me, it is one who gives up their freedoms willingly who is irrational.
Currently Listening to: Lay All Your Love On Me - ABBA
Random Wikipedia Article: Sola fide
October 23rd, 2007 at 2:46 pm
I have a new look on this subject after reading your article. Also an appreciation for living in the United States. It is astonishing to me how it was said..”the claim is that security of the patient trumps the freedom of the patient.” Being a former cutter and having some suicidal thoughts i guess is where the disturbing feelings come from that they(Canada Law) is more worried about supposed security instead of the persons freedom and forcing your believes of someone else’s security and making them give up their freedom would probably then drive the person to comment the illegal act.
I do believe that most people feel this way and that Canada just put forth the action;this is what i have come across when i was struggling with the thoughts of suicide myself. Very little understanding of the person and the laziness of others then results in such laws being passed.
October 23rd, 2007 at 3:29 pm
Freedom,
The current state of (Ontarian) law is quite unfortunate. I have met several people who have been held under these laws and while I won’t deny that the doctor’s/legislator’s intentions are most likely honourable, it is a fine line you tread when you take away someone’s freedoms in the name of security.
Brian’s law was adopted in response to a mentally ill person harming another person, Brian Smith. In the passion of legislating to quell to public uproar, individuals who pose no harm to others were lumped into the group and provisions to remove their freedoms were codified.
Some quick research unfortunately indicates that such laws are common in the US as well, differing from state to state. An example is Florida’s Baker Act. Even within Canada with it’s recent tradition of civil libertarianism as a result of the Charter, such a law has passed and is accepted. While it was passed by Harris’ Conservative government, I doubt the Liberals will reopen it.
-Jeff