Tom Szasz on Terri Schiavo

Nick Gillespie | November 17, 2006

Reason "Hero of Freedom" and Contributing Editor Thomas Szasz weighs in on the Terri Schiavo case in this post-election postmortem column by Worldnet's Ilana Mercer. Says Szasz:

In the Schiavo controversy, the courts upheld the fiction that Terri's autonomy required that she be medically killed, in her own best interest. In view of the fact that we live in a country whose laws prohibit suicide and often deny patients with terminal illnesses the pain-killers they need, the doctors' and courts' sensitivities to patient autonomy were, in this case, touching to say the least. Michael requested the court to attribute to Terri the de facto right to physician-assisted suicide. That this decision favored Michael's personal and financial interests, and the taxpayers' economic interests, was purely coincidental.

...the principal issue in the Schiavo case – besides the economics of Terri's care – was the conflict between two parties both claiming undying love and loyalty to her: her husband who wanted her dead, and her parents who wanted to keep her alive. In this circumstance, the commandment against killing should alone have been enough to tilt the balance in the parents' favor.

Those comments are bundled within Mercer's own analysis and I'm not sure where/when Tom said/wrote them. But it's a different take than you get from most libertarians. Whole thing here.

Comments

|11.17.06 @ 11:01AM|#

It's really stupid when those courts enforce those stupid laws from those stupid legislators who are elected by those stupid people. Let's say "de facto" a lot. Who cares that we're talking about a very much de jure proceeding. We'll just make up something inflammatory and say "de facto" in front of it. Michael Schiavo is a de facto murderer. Terry's parents are the de facto second coming of Joseph and Mary.

Szasz says that Schiavo was "medically killed" by removing the medicine. That's your first indication of Szasz's illogical case. Perhaps he could classify it as "killing" but certainly not "medical killing." Let's keep this straight. Szasz acts like nobody cares about "Thou Shalt Not Kill" in Florida, but Pinellas Park is a religious place. Also, he equates giving somebody a fatal dose of pills (actively doing something) to doing nothing (removing artificial life support). There is a reason that the country, even appropriately "erring on the side of life", let Terry Schiavo go. It's time Thomas Szasz did the same.

|11.17.06 @ 11:07AM|#

That's your first indication of Szasz's illogical case.

First? I thought Szasz was full of it a long time ago. His views on mental health sound like something you'd read in a publication from the Church of Scientology. Why Reason associates itself with that quack is beyond me.

|11.17.06 @ 11:13AM|#

But it's a different take than you get from most libertarians.

It is certainly different than my take on the situation.

Let's see, she's married. Her husband is next of kin. She is incapable of articulating her own feelings on the subject. Her next of kin states she had stated she would not like to live(?) like this. People have the right to refuse medical treatment. Where does all this lead? To the the decision that was belatedly, but correctly arrived at.

brian423|11.17.06 @ 11:13AM|#

Akira,
On the subject of "mental illness," Scientology is the proverbial broken clock that is right twice a day. Don't smear Szasz with guilt by association. The attribution of certain attitudes, beliefs, and behavior patterns to "diseases" for which the "patient" must be "treated" whether he wants to be or not is certainly a threat to civil liberties and personal accountability. No quackery there.

|11.17.06 @ 11:17AM|#

The conflict was between the husband, who -- motivated by his fact-based belief that she was dead -- wanted to give her a decent burial, and her parents, who wanted the rest of humanity -- especially Florida taxpayers -- to indulge their faith-based belief that she was still alive.

Terri herself was not saying anything. The law identified someone else to substitute a judgment for hers in these circumstances. The law, wisely, identified her spouse -- a person chosen by her to become her spouse -- over her parents, people to whom she did not choose to be born.

Tell us, Dr. Szasz, is brain death just another "mythological" mental illness?

|11.17.06 @ 11:29AM|#

Don't smear Szasz with guilt by association.

'Nuff said. He's a quack.

brian423|11.17.06 @ 11:39AM|#

Is that the best you can do, Akira? Better tell the American Medical Association that he got his picture taken with a movie star, a clear violation of the Hippocratic Oath.

The Onion groks Szasz. Bullshit "disorders" are routinely used to imprison people or otherwise restrict their freedom without due process.

|11.17.06 @ 11:46AM|#

Akira has proven nothing. Of course, Akira appears to be correct, but let's not let that get in the way of a good polemic.

|11.17.06 @ 11:48AM|#

What a moron. Refusing medical care is NOT SUICIDE. This is a pretty basic principle of medicine. People with DNR orders are not suicidal. People who do not want modern medicine to make them into the living dead, as it can increasingly do, are not suicidal. They simply do not want continued interventions past the point where they are productive. This is such a basic and important civil right that I have a hard time understanding why so many people today seem not to understand it. Doctors do not have the right to cut you open, tool around with your brain, pump you full of drugs, and so forth, without your informed consent. They don't even have the right to strap you to a bed and funnel fluids into your stomach for more than a decade. That is a choice the patient has the right to refuse: not to commit suicide, but to leave the body alone to do as best it can.

"Terri herself was not saying anything. The law identified someone else to substitute a judgment for hers in these circumstances. The law, wisely, identified her spouse -- a person chosen by her to become her spouse -- over her parents, people to whom she did not choose to be born."

It's worth noting that this isn't true. Michael DID have the right to exercise medical judgment on her behalf, but he INSTEAD ceded this to the state to determine. The court was the one that ruled, not on his opinion of her condition and what he wanted done, but rather on whether HER WISHES could be determined. That is what brought about the ruling. Michael, in fact, past that point did not have direct authority over removing her feeding tube. It was a court order that was in force, not his wishes.

|11.17.06 @ 11:48AM|#

Michael should not have been the next of kin making the decisions. He was de facto (!) married to another woman. There was a conflict of interest.

|11.17.06 @ 11:50AM|#

Sigh... Szasz is desperately trying to cling on the superstitious belief that there is some sort of mystical separation between mind and body (i.e. "soul," "mind," "body theatans," etc.).

Here's a bit of libertarian heresy: Just like there is no God, there is probably no "free will" either. We are nothing but meat robots, programmed by millions of years of evolution and genetics. All of our behaviors, our beliefs, and our attitudes are the result of material, bio-chemical processes, not some magical ghost who lives inside of us pulling the strings. While certain "glitches" in the programming are acceptable provided they do no harm, when certain bugs start damaging the whole of civilization, then the men in the white coats and the pills are obligated to step in and do something up to and including putting the defective human against their mythological "will" into a rubber room until such time they can be repaired, if ever.

Once that reality sinks in, then you'll realize that Szasz is full of shit.

|11.17.06 @ 11:50AM|#

btw, what is the justification for calling Szasz a libertarian. Is it now a "libertarian" position that state-employed doctors and courts know best what can be done to the body?

Is it libertarian to flat out lie about the difference between refusing life-prolonging care, and actually causing death a la Kevorkian?

|11.17.06 @ 11:51AM|#

Something often overlooked in the Schiavo affair is her age. Had Terri been 80 or 90 years old and facing the same problem, would she have received as much attention?

Simply put, Congress went too far. When the American people saw them going out of their way to pass a law that only affected one person, they rightly objected to what that could lead to.

|11.17.06 @ 11:54AM|#

"Michael should not have been the next of kin making the decisions. He was de facto (!) married to another woman. There was a conflict of interest."

Another divinely ridiculous argument. This "other woman" came about after Terri's loving parents convinced him to move on because Terri was "gone." That was, of course, before they learned that they wouldn't be getting any settlement money, at which point Terri miraculously was no longer "gone" and the woman Michael was dating, who they approved of, met, and who spent more time at Terri's bedside than her own brother, became a "conflict of interest."

Given that Michael was offered millions to keep Terri alive, I'd say that he had a conflict of interest to keep her alive... which he resisted.

brian423|11.17.06 @ 11:55AM|#

Lamar,
I know this blog is called Hit and Run, but your comment seems a bit, well, hit-and-run. In what way does Akira appear correct (not about Szasz's take on the Schiavo case, but about "mental illness" in general)?

brian423|11.17.06 @ 12:05PM|#

While certain "glitches" in the programming are acceptable provided they do no harm, when certain bugs start damaging the whole of civilization, then the men in the white coats and the pills are obligated to step in and do something up to and including putting the defective human against their mythological "will" into a rubber room until such time they can be repaired, if ever.

Why do we need men in white coats with pills to do that job when we already have men and women in blue uniforms and guns to do it? People who pose threats to society belong in jail, regardless of the scientific explanation for their behavior. I trust the police and the criminal justice system to do the job better than shrinks, because they're somewhat easier to hold accountable to the Bill of Rights. Your philosophical observations on free will vs. determinism don't make much difference here.

|11.17.06 @ 12:05PM|#

DISCLAIMER: I'm in a very nihilistic mood this morning folks. I'd apolegize for anything I might say, but they'd probably be meaningless.

|11.17.06 @ 12:06PM|#

He poo-pooing of schizophrenia is pure quackery. Skepticism of modern psychiatry is no crime, but negating established disorders is wrong. He says that psychiatrists aren't really doctors, but the successors to priests, i.e., "soul doctors." While this is probably true in a lot of cases, the fact is that there are serious mental illnesses that he refuses to acknowledge. He's so intent on making his political statement that he throws out the baby with the bathwater.

|11.17.06 @ 12:06PM|#

Michael DID have the right to exercise medical judgment on her behalf, but he INSTEAD ceded this to the state to determine.

Is this true?

If memory serves me, he didn't cede it, the state took it away from him after her parents filed suit. I may be wrong, but I don't think he voluntarily ceded the right to excersize medical judgement.

|11.17.06 @ 12:10PM|#

"What is the justification for calling Szasz a libertarian?"

I have a bunch of his books. Here's a quote from Ceremonial Chemistry:

"Why is self-control, autonomy, such a threat to authority? Because the person who controls himself, who is his own master, has no need for an authority to be his master. This, then, renders authority unemployed. What is he to do if he cannot control others? To be sure, he could mind his own business. But this is a fatuous answer, for those who are satified to mind their own business do not aspire to become authorities. In short, authority needs subjects, persons not in command of themselves, - just as parents need children and physicians need patients."

Akira:

Szasz doesn't cling to superstitious beliefs. Your ignorance is profound.

Jim Henley|11.17.06 @ 12:11PM|#

Never been to a marriage ceremony yet that didn't emphasize that the parties were entering a new family and were to cleave to it. When Terri married Michael Schiavo she was, as we all are in those circumstances, choosing the person she wanted to make such decisions on her behalf. Her parents had no more standing once she was wed.

Marriage is a really really important step, kids.

|11.17.06 @ 12:12PM|#

Szasz is actually an atheist. His fight has been for patient autonomy. Can't fault that. However, when Tom Cruise called Matt Lauer glib, and said Lauer didn't know the history of psychology....that might have been Szasz speaking.

|11.17.06 @ 12:14PM|#

Why do we need men in white coats with pills to do that job when we already have men and women in blue uniforms and guns to do it?

Because the idea of "crime" perpetuates the insane notion that there is "good" and "evil." Why put the thief, the murder, or the rapist into a small locked room for years on end when it would be much better more efficient to repair the psychological damage that resulted in the "crime" and send them back on their way. When our computer crashes, we don't lock it away in prison, we fix it. Why can't the same be said for the machine we call "human?"

|11.17.06 @ 12:15PM|#

"I have a bunch of his books."

Well, I have a quote from him here saying the exact opposite, implying that he knows better than the patient what treatment they should get, and that's that, only more recently. I win?

Oh, and lying about the difference between physician assisted suicide and refusing medical care. Does he say anything about why that is justified in his books?

brian423|11.17.06 @ 12:16PM|#

Lamar,
If schizophrenia is so well "established," how do you explain the embarrassment of the Rosenhan experiment? If psychiatrists are so gullible, maybe shizophrenics are vulnerable, socially awkward people who make the mistake of telling the wrong people about the voices they (metaphorically) hear.

|11.17.06 @ 12:17PM|#

"If memory serves me, he didn't cede it, the state took it away from him after her parents filed suit. I may be wrong, but I don't think he voluntarily ceded the right to excersize medical judgement."

I'm pretty sure he did. Her parents certainly filed suit, but it was Michael that, instead of fighting them on that front, agreed to the court system's arbitration process as a way to settle the matter. He didn't have to do that: he could have simply fought her parents right to have custody taken away from him.

|11.17.06 @ 12:18PM|#

Szasz doesn't cling to superstitious beliefs. Your ignorance is profound.

He is denying scientific fact. That which is not science is superstition. Ergo, Szasz is superstitious.

Tell me Buckshot, what's your OT Level?

|11.17.06 @ 12:22PM|#

I think Spitzer's criticism of Rosenhan from the article is pretty dead on. Quoted:

"If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a peptic ulcer, I doubt I could argue convincingly that medical science does not know how to diagnose that condition."

Rosenhan demonstrated that the admission and initial diagnosis procedures of many mental health hospitals are easy to fool. But lots of medical conditions are easy to fake. That doesn't prove that there are no such things as mental problems in the first place. It doesn't even come CLOSE to knocking down all the in-depth case studies, brain scans, drug tests, and other things done to diagnose the existence of and plumb the causes of mental illness.

The Wine Commonsewer|11.17.06 @ 12:27PM|#

But it's a different take than you get from most libertarians.

I'll give you that not all commenters are libertarian, but as I recall these pages were aflame with views that you might not consider to be the views of most libertarians.

brian423|11.17.06 @ 12:28PM|#

When our computer crashes, we don't lock it away in prison, we fix it. Why can't the same be said for the machine we call "human?"

Two reasons I can think of:

1.) Psychiatry and psychopharmacology don't yet understand the human brain well enough to do the necessary "repair." In the meantime, we have to rely on punishment-not because of any belief in supernatural good and evil, but because of its power to deter certain acts with a credible threat of unpleasant consequences.

2.) Human nature being what it is, "treatment" rather than "punishment" for criminals may give the general impression that the state doesn't punish anyone, which could make society more violent if people feel the need to exact retribution themselves.

|11.17.06 @ 12:29PM|#

Akira has proven nothing. Of course, Akira appears to be correct, but let's not let that get in the way of a good polemic.

I'm actually not trying to prove anything. I'm in a fugly mood about life and existance right now and Szasz's little tirade about Schiavo set me off. Let this meat machine rant for a bit, for it's in my programming.

Of course, I'm more than willing to entertain notions that mental illness doesn't really exist, that mentaly ill people are faking it; that substance dualism, morality, and free will exist, and that life has any real meaning... provided you have peer reviewed, falsifiable evidence to back it up.

|11.17.06 @ 12:30PM|#

brian423:
Thank you for your medical insight. If you've proven that schizophrenia doesn't exist, I missed it. You seem to be saying that the diagnosis process is shoddy and therefore schizophrenia doesn't exist. That, in my opinion, is a weak argument. Diagosis IS shoddy, and a lot of people ARE misdiagnosed because psychiatrists need patients. This is not a negation of the existence of real cases of the condition. But I guess you and Tom Cruise know the history of psychiatry....

Franklin Harris|11.17.06 @ 12:33PM|#

DISCLAIMER: I'm in a very nihilistic mood this morning folks. I'd apolegize for anything I might say, but they'd probably be meaningless.

Don't apologize. You just saved me the trouble of a long post along the same lines as: "Szasz is desperately trying to cling on the superstitious belief that there is some sort of mystical separation between mind and body (i.e. "soul," "mind," "body theatans," etc.)."

That is exactly what his worldview implies, even if he claims to be an atheist.

That's what makes his comments in the Schiavo case unsurprising, if still totally inane. She was just another ghost in a shell, as far as Szasz is concerned, because his worldview doesn't permit the brain to be physically damaged in any way that would affect the mind/"soul".

brian423|11.17.06 @ 12:40PM|#

"If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behavior of the staff would be quite predictable. If they labeled and treated me as having a peptic ulcer, I doubt I could argue convincingly that medical science does not know how to diagnose that condition."

Take Spitzer's analogy just a little bit further, and it completely falls apart. From Wikipedia's account of the experiment: "During their stay, hospital notes indicated that staff interpreted much of the pseudopatient's behaviour in terms of mental illness. For example, the note-taking of one individual was listed as 'writing behaviour' and considered pathological." Very quickly, and beyond a shadow of a doubt, a good hospital would rule out the diagnosis of a peptic ulcer. None of the practical joker's subsequent actions would be interpreted as evidence of a peptic ulcer. He would be the boy who cried wolf.

When I consider human subjectivity, human self-interest, and human malice, I find it easy to believe that "schizophrenics" need "hospitalization" just as witches once needed burning.

|11.17.06 @ 12:46PM|#

Brian423: You still haven't explained how people who faked an illness proved that the real thing doesn't exist.

|11.17.06 @ 12:46PM|#

when certain bugs start damaging the whole of civilization, then the men in the white coats and the pills are obligated to step in and do something up to and including putting the defective human against their mythological "will" into a rubber room until such time they can be repaired, if ever.

Obligated? Don't you mean "compelled by their bio-chemistry"?

What meaning do words like "glitch" "bug" "defective" and "repair" have to a biomechanical machine? A welding robot in an automobile factory can have a "glitch". This means that it is not working the way it was designed to work.

Akira, I presume you think the human machine had no designer, so what makes any one machine broken?

brian423|11.17.06 @ 12:57PM|#

Of course, I'm more than willing to entertain notions that mental illness doesn't really exist, that mentaly ill people are faking it; that substance dualism, morality, and free will exist, and that life has any real meaning... provided you have peer reviewed, falsifiable evidence to back it up.

To wander off topic a bit, Steven Pinker explains that atheistic materialism is not incompatible with a qualified, nuanced rhetoric of free will in his book The Blank Slate. (I have subtle problems with his atheistic materialism, but that's another issue for another day.)

Peer review is a powerful but flawed tool. When the overwhelming majority of a profession operate under epistemologically dubious premises-that attitudes and behaviors serve as proof of diseases, for example-then peer review only reinforces those unquestioned assumptions as a tyranny of the majority. For a freethinking atheist, you seem to be under the hypnotic spell of psychiatrists' badges of authority.

This is not a negation of the existence of real cases of the condition.

If I understand it correctly, your argument for the reality of schizophrenia is circular. People with medical degrees frequently diagnose people with schizophrenia, therefore schizophrenia must exist.

|11.17.06 @ 1:00PM|#

plunge --

You may be technically correct, but it would not change my point: One chooses one's spouse, but one does not choose one's parents.

And if the court is exercising substituted judgment for the person silenced by brain death, deciding what she would have wanted, one important consideration is the answer to this question: Did she set aside and earmark enough money, or did she buy adequate insurance, to fund the maintenance of her body's life functions, and for how long?

Jay --

If Terri's parents had other children, was that a "conflict of interests" too? Exactly how is it a conflict of interests to have a new relationship after one's wife's brain has died?

Are you one of those who argue that the husband should have "divorced" his brain-dead wife before beginning a new relationship? (If so, on what grounds? How can he claim "irreconcilable differences" with someone in Terri's condition?

brian423 --

Schizophrenia consists of more symptoms than just hallucinations. And there is no state intervention unless the totality of the symptoms interferes materially with decision-making ability or causes dangerous behavior.

We in a free society don't send "men and women in blue uniforms and guns" to do anything until someone does something deserving of punishment. If someone does something harmful -- or is about to do something harmful, because he or she has a misperception of reality founded in uncontrollable delusions or hallucinations, they do not deserve punishment, for if their perception were correct their conduct might be laudatory.

The legitimate role of the state is to protect rights from intrusion by others. That may be done by "white coats and pills" or blue uniforms and guns. The circumstances determine which is appropriate.

If Szasz if of the opinion that it's cops and guns in all cases, he's a very ignorant libertarian at best.

|11.17.06 @ 1:00PM|#

This "other woman" came about after Terri's loving parents convinced him to move on because Terri was "gone." That was, of course, before they learned that they wouldn't be getting any settlement money, at which point Terri miraculously was no longer "gone" and the woman Michael was dating, who they approved of, met, and who spent more time at Terri's bedside than her own brother, became a "conflict of interest."

Let's turn this into an ordinary episode of "Law & Order"--except Terri is healthy;

This "other woman" came about after Terri's loving parents convinced him to move on because Terri was "stupid." That was, of course, before they learned that they wouldn't be getting any settlement money, at which point Terri miraculously was no longer "stupid" and the woman Michael was dating, who they approved of and met became a "conflict of interest."

Soon after, Terri was found dead in a parking garage of a gunshot wound.

Michael would be a prime suspect because he had a woman on the side. He had motive.

I am making no judgements as to Michael's decision to move on, just that he should have done so completely.

|11.17.06 @ 1:05PM|#

Akira- Why make free will dependent on a ghost in the machine?

|11.17.06 @ 1:16PM|#

Jay --

You are right that Michael should have moved on "completely". That's what he did by having his wife buried. You have to disconnect the feeding tubes to do that, though.

I repeat: If you insist that he should have gotten a "divorce" from this brain-dead woman, on what legal ground? He could not have had irreconcilable differences of any kind after she became brain-dead. She was not cheating on him. So --- answer

brian423|11.17.06 @ 1:16PM|#

Peter K.:
We in a free society don't send "men and women in blue uniforms and guns" to do anything until someone does something deserving of punishment.

I'm astonished. Have you never heard of the war on drugs, which is often rationalized because of the "mental illness" we call drug addiction?

If someone does something harmful -- or is about to do something harmful, because he or she has a misperception of reality founded in uncontrollable delusions or hallucinations, they do not deserve punishment, for if their perception were correct their conduct might be laudatory.

Since misperception of reality founded in delusions is a symptom of schizophrenia, let's get everyone who believes marijuana possession should be a crime involuntarily committed. Then those assholes won't be able to vote. No cop or psychiatrist can ever empirically determine whether someone is really hallucinating or just acting weird, so it cannot play a role in any diagnosis.

|11.17.06 @ 1:16PM|#

Someone can delete my last post if they want. I was much more callous then I should have been. Life is not an episode of Law & Order.

|11.17.06 @ 1:18PM|#

Brian:

To wander off topic a bit, Steven Pinker explains that atheistic materialism is not incompatible with a qualified, nuanced rhetoric of free will in his book The Blank Slate. (I have subtle problems with his atheistic materialism, but that's another issue for another day.)

I'll have to look that one up. Thanks Brain.

Number 6,

Akira- Why make free will dependent on a ghost in the machine?

Because if the brain really is functionalist as I believe it is, certain chemical processes have to lead to inevitable conclusions that can't be changed or stopped. It's just a like a computer, due to it's programming the machine will only do what it's told to do without self-corrective deviation. If you type the words "Now is the winter of our discontent," the computer can't "choose" to display anything else on the screen. It does what it is told.

The same goes for the brain. It's been shown that removing certain portions of the brain can have a profound effect on personality, memory, and intelligence. Take out of change one part, you change the "mind" as it were, the brain can't "choose" to operate anyway other way.

brian423|11.17.06 @ 1:19PM|#

Akira- Why make free will dependent on a ghost in the machine?

Thank you, Number 6. To make a long story short, Pinker says you don't have to-at least as far as the idea of free will influences ethics and politics.

|11.17.06 @ 1:19PM|#

Of course, if you can show me I'm wrong, please do. But I can't operate on "faith," I need solid empirical proof.

|11.17.06 @ 1:21PM|#

Szasz certainly doesn't think that damage to the brain does not constitute disease. This is why he privliges neurology over psychiatry, because neurological disorders have demonstrable lesions. So he certainly does not separate mind from meat.
What one should take from Szasz as a libertarian is that making pathologies out of unusual behaviors is another means of social control. And the history of psychiatry does give one pause, homosexuality was a mental disorder until recently and a nobel prize was given to Moniz for developing the lobotomy, which certainly was used as a means of control for everything form schizophrenia to ADHD. these facts do not make psychiatry an illegitamate enterprise but they do mean it warrants scrutiny from people who proport to be concerned with individual liberty. In that vein, what I have read of Szasz suggests he was much more concerned with the abuses of psychiatry practiced in the old soviet bloc than he was with the western mode.

|11.17.06 @ 1:25PM|#

"For a freethinking atheist, you seem to be under the hypnotic spell of psychiatrists' badges of authority."

A is A. If science is shows something to be true, then it is true. All the "freethought" won't change that and it delusional to poo-poo those who wear the "badges of authority" who point out reality simply because we don't like the conclusions.

brian423|11.17.06 @ 1:26PM|#

You're welcome, Akira. I think you'll like The Blank Slate.

|11.17.06 @ 1:28PM|#

It is interesting how blood thursty people are. The case really boils down to Shiavo's wishes. I think most people would agree that it is perfectly within a person's rights to decide that they no longer want to live in a vegitative state. The problem of course is that we do not know what Shiavo wanted. She didn't leave a living will. Her husband said she didn't but the parents who were in just as much of a position to know said she didn't. There is no way to know with any certainty. This was not a case about personal autonomy. Terri Shiavo couldn't assert her autonomy and there was no clear evidence what she would have done if she had been able to. This case was about killing someone who no longer met our definition of personhood. It was a mercy killing, not a suicide.

The argument is that the tie ought to always go towards life. Absent a clear indication otherwise, treatment should always be continued. The fact that so many libertarians were so quick to side with killing this woman is a pretty sad commentary on libertarians.

brian423|11.17.06 @ 1:31PM|#

Akira,
As Hunter has pointed out, science, i.e. psychiatry, "knew" that homosexuality was a disease until recently. But according to you, scientists are always right.

|11.17.06 @ 1:35PM|#

brian423 --

Yes, I have heard of the war on drugs, and I'm against it.

I guess I should have said

"We libertarians who believe in the ideal of a free society don't send 'men and women in blue uniforms and guns' to do anything until someone does something deserving of punishment."

The remainder of your remark means that you would favor punishing someone who may have been in a delusional or hallucinatory state when he or she acted, simply because no one could -- in your view -- "empirically determine" the existence of the delusion or hallucination.

That places the burden of proof on the wrong party in a criminal case. And in a civil commitment case, it would set loose an imminently dangerous person to cause irreparable damage to life and property, which he himself does not intend.

How is any or all of that consistent with libertarianism?

|11.17.06 @ 1:40PM|#

John,

Lot of assumptions in your post there. Too many. In the end, Michael Schiavo said that Terri did not want to be resuscitated. Her parents admitted that they didn't know, but that as a Roman Catholic, a DNR order would have been against her faith. So, while Michael and the parents would have been the same position to know, it was only Michael that did actually know. If you knew what this guy went through to save Terri, you'd be a little less smug.

brian423|11.17.06 @ 1:41PM|#

Peter K.,
I have to leave my computer now, so I'll leave you with this Reason article to consider. More from me later.

|11.17.06 @ 1:42PM|#

Actually Akira, as a scientist who studies psychiatric disorders I have to correct you and say that science can only disprove things, and that scientific truths are only as good as our ability to disprove them. I think we are very close to the point where we will be able to make such demonstrations with regard to a number of psychaitric disorders but, quite frankly, we aren't there yet. When we are I would like to think Dr. Szasz will come on board for those disorders where we can demonstrate a lesion. Till then his criticisms have a place in keeping the field honest.

I really don't know what he's about on the schiavo thing, except perhaps the sort of radical (or merely literal)hippocratic position he tends to take on almost everything medical.

|11.17.06 @ 1:43PM|#

John, you are pushing the same old nonsense:

"The problem of course is that we do not know what Shiavo wanted. She didn't leave a living will. Her husband said she didn't but the parents who were in just as much of a position to know said she didn't. There is no way to know with any certainty."

This is not the actual situation. The court heard from _several_ different witnesses, not just her husband. Furthermore, it found for various reasons that the testimony of her parents was not credible. In short, the court found that her wishes COULD be known. You can disagree with that finding, but it's simply grossly misleading to represent it as "husband's word vs. the parents."

|11.17.06 @ 1:51PM|#

Thanks for the comment, hunter, you said it better than I could.

Akira:

I've never seen scientific proof that there is no free will, I think there is. You might be a meat-robot, I'm not, I have free will.
If there is no free will, where do scientific progress an invention come from? Who decides my next move?
You seem to think everything has been decided and it's superstitious to disagree.
You say we shouldn't lock up criminals because there is someting wrong with them and we should fix it. You don't really understand humanbeings at all, you think we're biological computers. People use their free will to do bad things, they're not crazy, they're criminals and should be punished. If someone assaults you or me, they should pay the legal price, not recieve medical/psychiatric help. Put them in jail, not the hospital.

|11.17.06 @ 1:51PM|#

Jay, your analogy simply doesn't work. Terry wasn't murdered, and she wasn't stupid. She was effectively brain dead and was taken off treatment that was artificially prolonging her life. The issue is carrying out her medical wishes. And for goodness sakes, MICHAEL WASN'T IN CHARGE AFTER THE COURT RULING. For the last time. Who he had sex at any point with had NO BEARING on the court ruling that she should be taken off life support. Trying to equate any of this to a back alley murder is just outrageously false.

"I am making no judgements as to Michael's decision to move on, just that he should have done so completely."

Part of moving on was fulfilling his final duty as her guardian in seeing that her wishes were carried out. If he wanted to just get out of there and cavort with his new wife, nothing would have stopped him. He could have gotten Terri's parents appointed as legal guardians, got them to initiate a divorce, taken the millions being offered to him to do so, and go live on a cruise-line resort. Instead, he stuck around and tried to make sure she wasn't treated in a way she wouldn't have wanted to be treated. That's loyalty, not conflict of interest.

|11.17.06 @ 2:00PM|#

"As Hunter has pointed out, science, i.e. psychiatry, "knew" that homosexuality was a disease until recently. But according to you, scientists are always right."

The point is not that science is always right, but rather that when there is a large scientific consensus on something, you have to do more than handwave to dismiss it: you have to actually get down and dirty with the research and show what it's wrong.

So far, the arguments I've seen against mental illness existing fly in the face of not only virtually all available research, but common sense. The idea that all people are stable mentally but no amount of changes to their brain will, short of death, alter anything about their "soul" (material or spiritual or whatever) just doesn't seem to be consistent with anyone's experience of either their own brain or countless people with damaged brains. Are alzheimer's patients just lazy?

Worse, people here are citing scientific discussions of free will in total apparent ignorance of what those discussions contain (hint, they don't deny mental illness, and in fact rely upon it quite heavily to demonstrate the ways in which brains can work differently)

|11.17.06 @ 2:06PM|#

Akira,

I normally love what you have to say however, apologies in advance, I'm a little sour today, too.

You say:

"The same goes for the brain. It's been shown that removing certain portions of the brain can have a profound effect on personality, memory, and intelligence. Take out of change one part, you change the "mind" as it were, the brain can't "choose" to operate anyway other way.

Of course, if you can show me I'm wrong, please do. But I can't operate on "faith," I need solid empirical proof."

I have neither the time nor the motivation to go hang around google scholar to find the relevant studies but I will offer an anecdote to point the way. A 'good friend' has a son that is now three years old. When the child was born he was typical in every physical way. At one month old the child contracted *something*, most likely some virus, that physicians were never able to culture from numerous blood samples. The infection traveled to the meneses (meningitis) and developed into encephalitis. This infection ravaged the childs brain leading to massive tissue loss, particulary of the parietal lobes. Later cat scans indicated almost complete obliteration of the parietal lobes and global loss of brain matter of about 25%.

This child is now in pre-school and with ot, pt and speech therapy has recovered to the point of 'normalcy.' Point your browser at google scholar and look for "brain plasticity". It ain't faith.

|11.17.06 @ 2:06PM|#

"I've never seen scientific proof that there is no free will, I think there is."

I bet you can't even define what free will is, or describe how it would operate in a way different from determinism/and/or/random chance. So how can you claim that something exists when it can't even be defined? How would you know?

"You might be a meat-robot, I'm not, I have free will."

What does that mean? How, functionally, does this "free will" thing play into the process of making decisions? What role does it play?

"If there is no free will, where do scientific progress an invention come from? Who decides my next move?"

Neither of these questions have anything to do with the debate over free will. Who decides your actions? You do. Denying free will doesn't mean that you aren't a mind capable of making decisions based on its nature. Denying free will means rejecting the incoherent claim that these decisions are made INDEPENDENT of its nature, which at the very least, would make them very hard to attribute to ANYTHING, much less be things you can take responsibility for making.

"People use their free will to do bad things,"

Why? What makes those people different from those that use it to do good things. The kicker is that any attempt to answer the question will rely on either random events, or a deterministic explanation: NEITHER of which are consistent with the idea that the people are somehow free from their own selves.

"they're not crazy, they're criminals and should be punished."

Why? What is the purpose of responding to harm by causing more harm, once we leave out the "safeguarding the public" and the "rehabilitation" motives? What is the purpose of punishment in and of itself? Revenge? Trying to play act out the criminal situation with a person who was once part of it?

dhex|11.17.06 @ 2:08PM|#

man, get your healthcare proxy cards in order, folks. that's all i can say about this whole sad sorry affair that doesn't devolve into howling at the moon.

|11.17.06 @ 2:09PM|#

Lamar,

The evidence was heresay and he had every reason lie. Michael Shiavo's word alone should not have been enough.

|11.17.06 @ 2:12PM|#

John, I'm not sure what you think that proves. If anything, it demonstrates precisely that physical brain function is important, because it involves growing and rewiring brain tissue. He recovered because his brain physically did stuff to compensate, not because his soul magically stored his personality apart from the damage and kept going afterwards.

By the way, plasticity is something children can do easily, and adults cannot do very well. It's also worth noting that in such cases, the loss of tissue is not total in any one area: it often involves parts, and known "redundant" parts of many areas. It's not like his hippocampus was completely destroy and then his occipital lobe simply grew a new one.

|11.17.06 @ 2:13PM|#

Calling this a "medical killing" and "physician-assisted suicide" shows such a marked ignorance of the facts of the case and of basic medical and ethical principles that the mind boggles.


Leaving aside the question of whether she was already brain-dead, it is not "killing" and it is not "physician-assisted suicide" to withdraw care.

Anyone who uses these terms in connection with Schiavo case is pushing an agenda, not dealing with what actually happened. If you can't tell the medical, legal and ethical difference between pushing a massive dose of sodium pentothal into an IV and, well, not doing anything, then you really should show a little more reluctance to display your ignorance. For your own sake.

|11.17.06 @ 2:15PM|#

"The evidence was heresay and he had every reason lie."

Er, why? What reason? Again, it seems like just the opposite: he had every reason to take the money and run, and let her parents continue fondling her body and playing dress up.

"Michael Shiavo's word alone should not have been enough."

Again, claiming that the court ruling was based solely on Michael's testimony is, simply put, a lie. Somehow, whenever it comes to these sorts of issues, whether it be medical treatment rights, stem-cells, or what have you, the religious right side of things just can't be bothered with the actual facts: they HAVE to lie.

|11.17.06 @ 2:34PM|#

John,

Michael's words were backed up by a lot of her friends, and the courts found him to be credible. It's a bit odd that you'll second guess a proceeding that happened years ago, when you weren't there or even following the case then. You say that Michael Schiavo lied about his wife's wishes, but you don't mention how he became a nurse to be by his wife, or the extensive experimental procedures he tried to get some response from Terri. Michael Schiavo's current wife also stayed by Terri's bedside. Quite frankly, you are a lot like Bill Frist, diagnosing Schiavo from the floor of the Senate without a real idea of what you are saying.

|11.17.06 @ 2:36PM|#

According to quantum theory, everthing can NOT be predetermined. I'm not ready to make the case, philosophically, that this relates to free will yet, but I have a nagging feeling there is a connection.

|11.17.06 @ 2:44PM|#

"According to quantum theory, everthing can NOT be predetermined. I'm not ready to make the case, philosophically, that this relates to free will yet, but I have a nagging feeling there is a connection."

Before you hint that there is a case, you must make some sketch of exactly what free will is, functionally. Only then can you talk about how this or that fact about the physical (even a spiritual!) world makes it more or less likely. how would you know?

As far as I can see, both determinism, indeterminism, and any mix of the two are all incompatible with the strong concept of free will (i.e. the idea that we make choices for which we are directly and solely responsible, but we are also free from them being determined by our natures). That's probably because the concept is, in many ways, self-contradictory before it even gets out of the gate.

|11.17.06 @ 2:53PM|#

Plunge:

Free will means I can choose to think or not think, act in a particular way, or not. Make moral decisions based on what I have determined to be right or wrong. Free will means that I am not subject to automatic assumptions or agreements or beliefs. I am neither a robot nor a beast. I am responsible for the decisions I make.

If this isn't a good enough definition for you, if you think I dont't understand what free will is, fine with me.

The questions you ask me indicate to me that you don't know what free will is or what motivates people to behave the way they do. What makes bad people different from good people? Their behavior, which is a product of their decision making, which is free will.

Without free will, the world would never change, there would be no progress. This is obvious to me, people have to think new thoughts to change the world, how can this be if we are pre-programmed to think only certain thoughts.
I don't know what "determinism" is, but if it means our thoughts are pre-determined, I'm no determinist.

"What is the purpose of responding to harm by causing more harm?"

The response to harm by punishment is to even the score, not increase the harm. If you hurt me, I have the moral right to break your arm, and I would do it. You impressed me with your intelligence until that last paragraph. In the real world, there are bad people who are criminals and they should be hurt or killed.

Robert|11.17.06 @ 3:24PM|#

Tom wasn't the only radical libertarian I know of to take that side in the Schiavo controversy. Kathy Greene did too.

|11.17.06 @ 3:24PM|#

"Are you one of those who argue that the husband should have "divorced" his brain-dead wife before beginning a new relationship? (If so, on what grounds? How can he claim "irreconcilable differences" with someone in Terri's condition?)"

"Mental Incapacity" for at least 3 years before the divorce is a legal grounds for divorce in Florida. Terry had been mentally incapacitated for 8 by the time he started trying to disconnect her, and it was more like 14 by the time it was over. Not that he should have done that, but he did have grounds.

|11.17.06 @ 3:25PM|#

If psychiatrists are so gullible, maybe shizophrenics are vulnerable, socially awkward people who make the mistake of telling the wrong people about the voices they (metaphorically) hear.

Metaphorically? The problem isn't the metaphorical voices, it's the ones that don't seem so metaphorical. I imagine conversations all the time, but I also (usually when under major stress) occasionally hear voices. I assure you that that I can tell the difference, and that there's nothing metaphorical about the voices I hear. Fortunately, it's not intrusive enough to have ever caused me any embarrassment, much less cause me any real problems. But if I were hearing those voices more often? If they were talking to me about what I was doing or should be doing? It wouldn't be a metaphorical problem . . . .

Do you really think a person who is simply shy and awkward is going to wind up hospitalized for mental illness because of mentioning that they'd imagined someone saying something? They wind up hospitalized because they hear voices that seem real to them, and they're not simply shy and awkward but have real barriers to interaction as well as barriers to functioning independently in the world the rest of us share. The fact that someone who knows something about those barriers (and how they manifest) can fool a psychiatrist well enough that the psychiatrist continues to interpret behavior in light of that initial impression/understanding doesn't mean that there isn't a real illness that people suffer from.

|11.17.06 @ 4:12PM|#

"Free will means I can choose to think or not think, act in a particular way, or not."

Take the word "free will" out of that sentence, and it still works just fine. You can talk about choosing to think or not think, act in a particular way or not, all without the extraneous concept of free will. Again, what is free will and how does it have anything to do with any of those things?

"Make moral decisions based on what I have determined to be right or wrong. Free will means that I am not subject to automatic assumptions or agreements or beliefs."

Really? How would you even know whether or not you were subject to them?"

"I am neither a robot nor a beast. I am responsible for the decisions I make."

How can YOU be responsible for them if they are not a result of some basic nature that you have that is, specifically you, as opposed to some other being, or opposed to random occurances?

"If this isn't a good enough definition for you, if you think I don't understand what free will is, fine with me."

But it's not fine: you are insisting that this concept is important, and yet you cannot define it, cannot explain what it does, how it differs from making choices without it, etc.

"The questions you ask me indicate to me that you don't know what free will is or what motivates people to behave the way they do."

No I asked YOU what it was, and so far you haven't even really tried to define it: you've just used it in a bunch of sentences with making clear what it is doing or what role it is playing.

I indeed DON'T claim to know what free will is, because I think the concept is simply incoherent and meaningless: I don't think it CAN be defined. I mean, what is your will free FROM? Itself? How can that be? How can something be free from itself: what does that even mean? And how can you be responsible for your will in the first place if it is free from any definition of what you are?

"What makes bad people different from good people? Their behavior, which is a product of their decision making, which is free will."

Don't you see how circular that is? If there really is a difference, then SOMETHING makes them different, and hence something DETERMINES that they will act differently. The only other alternative is that there is NO REASON why they behave differently, in which case, in what way are they really responsible for the difference? Why blame them for the actions they choose when they are basically random rather than anyone's doing?

"Without free will, the world would never change, there would be no progress."

Why? That makes no sense. Heck, even inanimate things change all the time, and no one claims they have "free will." Again, nothing about growing, changing, innovating, thinking, progressing, improving and so on requires any extra extraneous things like "free will." All are perfectly explicable in a more mundane sense.

"This is obvious to me, people have to think new thoughts to change the world, how can this be if we are pre-programmed to think only certain thoughts."

Ever seen a genetic algorithm at work? All pre-programmed, but capable of innovating in response to different environments. Again, changing and thinking and so forth doesn't require anything special. Things do that naturally whether or not they even have minds much less whatever "free will" is.

And again: you still haven't defined what "free will" is or how IT explains how people "think new thoughts" or "change the world." If your explanation is really better, you should be able to explain how it does what it does in the first place.

"The response to harm by punishment is to even the score, not increase the harm."

What score?

"If you hurt me, I have the moral right to break your arm, and I would do it."

Why? What does that accomplish? If breaking your arm was wrong for me to do, why is the world a better place if there are then two broken arms where once there was only one? Once a bad thing is done, it's done. Moving forward, we can try to heal the wrong, or try to impose restrictions or levys that deter it from happening again, and so forth.

"You impressed me with your intelligence until that last paragraph. In the real world, there are bad people who are criminals and they should be hurt or killed."

Maybe, but for reasons like preventing them from continuing to harm more people, not "just because."

brian423|11.17.06 @ 5:51PM|#

plunge:
So far, the arguments I've seen against mental illness existing fly in the face of not only virtually all available research, but common sense. The idea that all people are stable mentally but no amount of changes to their brain will, short of death, alter anything about their "soul" (material or spiritual or whatever) just doesn't seem to be consistent with anyone's experience of either their own brain or countless people with damaged brains. Are alzheimer's patients just lazy?

That's not at all what Szasz says. He gladly concedes the existence of Alzheimer's and other conditions that can be shown to do physical damage to the brain. But schizophrenia is another thing entirely. Neurologists have tried and failed to find any particular physical problem with the brains of people with that diagnosis.

jen:
Do you really think a person who is simply shy and awkward is going to wind up hospitalized for mental illness because of mentioning that they'd imagined someone saying something?

Yes, I do believe it happens. An awkward, eccentric person in conflict with one or more overbearing conformists can essentially be bullied into a psychiatric diagnosis. It's certainly an effective way for the conformists to prevail in the conflict. Anything the eccentric says from then on can be dismissed as the illness talking. In that case, the psychiatrist is a hired gun for one side of a conflict within a family or other social circle. Can you understand why some of us libertarians think psychiatrists shouldn't have the authority to essentially jail people without due process?

|11.17.06 @ 6:52PM|#

"Can you understand why some of us libertarians think psychiatrists shouldn't have the authority to essentially jail people without due process?"

I can certainly agree with this while still disagreeing with the premise that mental disorders don't exist.

|11.17.06 @ 7:15PM|#

As Hunter has pointed out, science, i.e. psychiatry, "knew" that homosexuality was a disease until recently. But according to you, scientists are always right.

Brian, I don't deny that science changes as we get more information. However, there comes a point when we have a enough data that we can make a conclusion. For instance the ptolemic model of the universe with Earth at it's center was established science until Copernicus, Tycho, and Galileo came along and showed us that the Earth wasn't even in the center of our own solar system, much less the universe. We now know that this is a fact and no one in their right mind would come forward and claim that somehow that the heliocentric model of the solar system was wrong.

Now, here we have a doctor who is willing to take over a century of data from Freud (for all his faults) to now and claim that there is no mental illness and people with obvious handicaps like schizophrenia are really just "behaving badly?" Well, for me it's sort of like taking Creationists or GW-deniers seriously.

But schizophrenia is another thing entirely. Neurologists have tried and failed to find any particular physical problem with the brains of people with that diagnosis.

Well SOMETHING has to cause it.

|11.17.06 @ 7:30PM|#

No functional causes for schizophrenia, eh? While science isn't 100% sure what the exact cause of it is, there have been noted differences in the brains of schizophrenic causes AND there is considerable evidence that it's genetic condition.

|11.17.06 @ 7:30PM|#

rvman --

Thanks for the clarification of Florida law.

However, my original point (in response to Jay)was that Michael Shiavo had no "conflict of interest" arising from his subsequent relationship with another woman. That still stands. What you have pointed out shows that he did not need to have Terri die to marry the subsequent lover, inasmuch as he could have divorced Terri.

brian423 --

The book review, to which you linked earlier in the day, does not contain a single reference to anyone suffering from a delusion or an hallucination, only to a white murder defendant with a homicidal attitude toward persons of African descent.

That only shows that criminal defendants can make false claims to an insanity defense; not that there is no such thing as an insanity which truly makes a person not responsible for an act otherwise criminal. That defendant knew she was killing a person, and was under no delusion about the circumstances.

If that defendant had been so disordered, hallucinatory or delusional that she thought she was shooting Martian invaders intent on capturing us as farm animals to be eaten, that would have been a mental disorder relieving her of responsibility.

Juries can, and do, sort these things out. What you and Dr. Szasz would do is deny some very disturbed people the right to have thoose juries do their job.

So Dr. Szasz "gladly concedes the existence of Alzheimer's and other conditions that can be shown to do physical damage to the brain"? Good for him!

But such persons were plainly acting bizarrely and doing damage because of their ailments in the centuries before the physical damage was shown. Would it therefore have been just to punish them, putting the burden of proof on them to show the physical damage upon which you and Szasz now insist?

What exactly is your "libertarian" understanding of due process and the burden of proof?

|11.17.06 @ 7:58PM|#

Plunge:

You haven't taught me anything, all you do is ask questions. I give you answers and you say they're not good enough, then you say I haven't answered. All these DEMANDS of your's for me to explain myself to you comes across as arrogant and condecending, and I don't like it.

"Once a bad thing is done, it's done, move on". You don't even know what people are, or even what justice is. You think we're all just a bunch of algorithms!

"Something makes them different, something DETERMINES that they will act differently".
Yes, FREE WILL, that thing you said don't believe in.

What score? Do I have to explain life to you?
I take back what I said about your intelligence, you don't seem to understand what people are, and I don't have any respect for your opinion.

brian423|11.17.06 @ 8:09PM|#

If that defendant had been so disordered, hallucinatory or delusional that she thought she was shooting Martian invaders intent on capturing us as farm animals to be eaten, that would have been a mental disorder relieving her of responsibility.

What practical difference does it make whether the perpetrator is responsible in that sense? A delusional murderer and a lucid murderer pose the same threat to society, so why not treat them the same? (I'm against the death penalty anyway, so I would lock both of them up.)

brian423|11.17.06 @ 8:25PM|#

While science isn't 100% sure what the exact cause of it is, there have been noted differences in the brains of schizophrenic causes AND there is considerable evidence that it's genetic condition.

The same appears to be true of homosexuality, but it doesn't follow that it's a disease. All personality traits are influenced (though not completely determined, of course) by genes. If some individuals inherit an inclination to deny responsibility for taking care of themselves by talking nonsense, it could account for the hereditary component of the behavior pattern labeled schizophrenia.

|11.17.06 @ 8:46PM|#

Tom wasn't the only radical libertarian I know of to take that side in the Schiavo controversy. Kathy Greene did too.

So did Claire Wolfe and while not exactly a libertarian, so did Nat Hentoff*.

*I like him 'cause he wrote a Civil Liberties column for the late, lamented Inquiry magazine many years ago, besides he writes great jazz commentary.

Such people simply lead me to reflection that opinion on this issue is not uniform. I still believe that the eventual outcome was proper.

|11.17.06 @ 9:09PM|#

"You haven't taught me anything, all you do is ask questions."

And explain why I'm asking them and how you could go about answering them.

"I give you answers and you say they're not good enough, then you say I haven't answered."

I pretty clearly explained why simply using a concept in a sentence is not the same thing as explaining what it is. You say we have something you call "free will." I'm asking, quite reasonably, for you to explain what that actually means, when you get down to brass tacks. What does free will do, functionally?

"All these DEMANDS of your's for me to explain myself to you comes across as arrogant and condecending, and I don't like it."

Well, tough. These are BASIC requirements for a philosophical claim. If you can't meet them, then I have every reason to lecture you on why that's BS.

"You don't even know what people are, or even what justice is."

Of course I know what justice is. Justice is preventing bad things from happening, making sure that life is _just_. Revenge is not the same thing as justice.

"You think we're all just a bunch of algorithms!"

Maybe. I'm not sure you appreciate what that would mean, and furthermore, you've offered NO ALTERNATIVE EXPLANATION.

"Yes, FREE WILL, that thing you said don't believe in."

You might as well have said "Yes, MORTH BLURPPORT, the thing you said don't believe in." Again, if you aren't prepared to explain how free will makes that difference, then you are just talking nonsense.

You don't seem to be grasping the philosophical conundrum here. Two people. One does bad, one does good. SOMETHING has to explain why one does good, and the other bad. Saying that they freely chose differently doesn't explain anything at all. I'm asking WHY they chose differently. Basically repeating the question back to me is not the same as answering it.

"What score?"

Yes: what score? When something bad happens to you, why is there a "score" being kept? By whom? If you do something bad to me, what is the actual purpose of "evening the score" vs. say, seeking restitution, or seeking assurance that I cannot or will not do it again?

"Do I have to explain life to you?"

You certainly do have to explain your concept of what it is, yes. It seems like your concept of life contains a whole lot of completely unquestioned assumptions and stand-in words for concepts you can't explain.

|11.17.06 @ 9:16PM|#

"What practical difference does it make whether the perpetrator is responsible in that sense? A delusional murderer and a lucid murderer pose the same threat to society, so why not treat them the same? (I'm against the death penalty anyway, so I would lock both of them up.)"

Oh good grief. They DON'T pose the same threat to society. A delusional person cannot be held responsible for their actions while delusional in the same way a lucid murderer can. This is because in the state they are in, they aren't capable of understanding the consequences of their own actions.

The delusional murderer can, furthermore, potentially be CURED of delusions, at which point they DON'T pose a threat any longer.

That is why they are treated differently. And only crackpots like Szasz who are willing to simply chuck out virtually every piece of evidence for mental illness unaddressed have any problem with this.

Mental illness is real. It isn't caused by lack of exposure to Scientology. Do me a favor: walk into a closed ward at a mental hospital and tell me that those people are basically just the same as the rest of us, but are faking it. Anyone that KNOWS people with real mental illness find the idea not only ridiculous, but downright insulting.

|11.17.06 @ 9:24PM|#

Haven't read all the comments, but if we're resuscitating this case, I'd compare Michael Schiavo to a judge holding Microsoft stock who hears a case involving Microsoft. Could such a judge be impartial? It's perfectly possible in an individual case, but the temptations *not* to be even-handed are so great that the law doesn't let judges decide cases in such situations. Michael Schiavo was like that judge. Even if he's totally pure in heart, he shouldn't have been the legal guardian of Wife #1 while living with a woman who was serving, in effect, as Wife #2. We're not talking about his subjective feelings, but about what rule should apply in these cases. I think they applied the wrong rule by keeping him as guardian.

brian423|11.17.06 @ 11:45PM|#

Mental illness is real. It isn't caused by lack of exposure to Scientology.

Another cheap shot. The persistent, snide references to Scientology from your side of the debate suggest intellectual bankruptcy.

Do me a favor: walk into a closed ward at a mental hospital and tell me that those people are basically just the same as the rest of us, but are faking it. Anyone that KNOWS people with real mental illness find the idea not only ridiculous, but downright insulting.

A year or two ago, when I worked with medical-marijuana activists (of all people), some of them JUST KNEW that methamphetamine prohibition was justified because they thought they saw people's lives ruined by it. Sorry, but personal experience doesn't necessarily provide clarity in these matters. Without careful thinking to separate cause from effect and fact from inference, people can misinterpret what they see and hear. I don't care if they find my skepticism ridiculous or insulting.

And I don't consider it an accurate paraphrase to say I think mental patients are "faking it." I think that people exhibit the behaviors we call symptoms of mental illness because they have unarticulated reasons to deny the roles and responsibilities that the people around them would otherwise place on them-and I don't necessarily pass judgment on their reasons for doing so. Frankly, I think I show them more respect than the psychiatric establishment does.

|11.18.06 @ 11:24AM|#

Obligatory cheap shot at the religion/science of scientology. Way back in the seventies, in Seattle WA, a guy who worked for me became a scientology acolyte. One of the techniques scientology used back then (I am blissfully unaware of present practices) to recruit members/converts/victims was sleep deprivation, a classic brainwashing technique. I observerd this up close and personal, so, please, don't question my veracity.

|11.18.06 @ 12:00PM|#

brian423 --

I think you have to forgive people for thinking that you think schizophrenics are faking it. Thay must've jumped to that conclusion when you implied that schizophrenics are faking it. You said they have an "inclination to deny responsibility for taking care of themselves by talking nonsense".

It has been you -- not plunge or I -- who insisted that schizophrenia cannot be "real" because, you have said, there is nothing physical.

Now you concede there may be brain differences and a "genetic component". Yet you still insist it is not "real".

By the way, genes are physical.

You then state that if schizophrenia is a real illness, then homosexuality must be one too.

No. Not true. Homosexuality is real, and not chosen. Heterosexuality is real, and not chosen. Neither of them are illnesses. They do not threaten the lives or functioning of the persons who have the condition, or anyone else.

Schizophrenia is also real, and not chosen. It, however, is an illness. It does threaten the lives or functioning of the persons who have the condition, and others.

It is also treatable to some extent.

But more to the point, you cannot expect to dissuade the dangerous behavior associated with schizophrenia in florid psychosis by the threat of a prison sentence.

|11.18.06 @ 12:10PM|#

I must point out that you have not responded to question I put to you earlier in this thread.

You and I know that you have no answer which would not be an embarrassment to your position, that of a supposed libertarian flatly insisting that mental illness exists.

However, just to make that clear to everyone else, I repeat the questions together with the context in which I posed them.

"Juries can, and do, sort these things [faked vs. real mental illness] out. What you and Dr. Szasz would do is deny some very disturbed people the right to have those juries do their jobs.

"So Dr. Szasz 'gladly concedes the existence of Alzheimer's and other conditions that can be shown to do physical damage to the brain'? Good for him!

"But such persons were plainly acting bizarrely and doing damage because of their ailments in the centuries before the physical damage was shown. Would it therefore have been just to punish them, putting the burden of proof on them to show the physical damage upon which you and Szasz now insist?

"What exactly is your 'libertarian' understanding of due process and the burden of proof?"

brian423|11.18.06 @ 6:35PM|#

Peter K.,
You're wildly misquoting me. I say that szhizophrenia isn't really a disease. I don't say that the people labeled schizophrenic don't really act that way. (But at least some of their behavior is a collective self-fulfilling prophecy, as in the Stanford prison experiment.)

The idea of mental illness creates two problems for civil liberties and criminal justice:
1.) It creates a legal loophole by which violent criminals can evade their appropriately severe punishment.
2.) It seems to justify involuntary commitment and involuntary treatment, which can never be honestly justified by any libertarian worthy of the name, in my opinion.

brian423|11.18.06 @ 6:50PM|#

Money quote from the link in my last comment: "Uncontrollable crying and disorganized thinking were common among the prisoners." Makes you think, doesn't it?

brian423|11.18.06 @ 7:46PM|#

Correction: In one of my earlier comments, I misleadingly put the parenthetical statement "of all people" in the wrong place in the sentence. I meant that, of all people, medical-marijuana advocates wouldn't be on the side of the prohibition of any drug if they understood their own best interests.

|11.18.06 @ 8:00PM|#

Mad Max-Which is why he *wasn't* It was up to the courts of the State of Florida to decide what her wishes were. He was able to testify, but the decision did not rest with him. Please learn the specifics before you pontificate. Doing otherwise just does more to drag the name of a good man caught in a horrible situation through the mud.

|11.18.06 @ 9:08PM|#

brian423 --

Sorry if I "wildly misquoted" you. I guess that just happens when I use the terribly unreliable "cut and paste" feature on this here computer to lift your words from your posts and put them in quoatation marks in mine.

You still have not responded to the two questions I have now posed to you twice. The third time appears below.

In the guise of discussing schizophrenia, suppsedly to support your notion that the afflicted exhibit "behavior is a collective self-fulfilling prophecy", you linked to an article on an experiment in a prison. Interestingly the article had nothing to do with schizophrenia, and it failed to show any self-fulfilling prophesy.

Please, if you can, give an example of how the idea of mental illness "creates a legal loophole by which violent criminals can evade their appropriately severe punishment".

Or, since you can't do that, just ignore it just as you have ignored the other questions for which you have no non-embarrassing answer.

Libertarianism is not anarchism. It holds that government's legitmate role is to prevent violations of rights. Involuntary commitments and treatment prevent dangerously mentally ill people from unintentionally violating the rights of others, just as punishment is a disincentive from intentional violations.

Once again:

"Juries can, and do, sort these things [faked vs. real mental illness] out. What you and Dr. Szasz would do is deny some very disturbed people the right to have those juries do their jobs.

"So Dr. Szasz 'gladly concedes the existence of Alzheimer's and other conditions that can be shown to do physical damage to the brain'? Good for him!

"But such persons were plainly acting bizarrely and doing damage because of their ailments in the centuries before the physical damage was shown. Would it therefore have been just to punish them, putting the burden of proof on them to show the physical damage upon which you and Szasz now insist?

"What exactly is your 'libertarian' understanding of due process and the burden of proof?"

|11.18.06 @ 10:55PM|#

"(But at least some of their behavior is a collective self-fulfilling prophecy, as in the Stanford prison experiment.)"

You have a real habit of citing studies that simply do not substantiate your claims, and confusingly are hard to even figure out how they relate to them. For someone claiming to know better than the entire medical mainstream community, you'd think that you'd have a bit more rigor to your critique.

I have a hard time believing that you have ever met or interacted with a person with schizophrenia.

"1.) It creates a legal loophole by which violent criminals can evade their appropriately severe punishment."

There is no evidence that this is a "loophole" that's widely abused at all. These sorts of defenses are very rare, and they often fail even for people WITH diagnosed mental illness, much less those that try to fake it. Your characterization seems to have a lot more to do with Law and Order than the legal system. Mental hospitals are not filled with murderers who are secretly chuckling that they got away with it.

"2.) It seems to justify involuntary commitment and involuntary treatment, which can never be honestly justified by any libertarian worthy of the name, in my opinion."

This is just bullshit. To be a libertarian, must you also be against the idea that people with temporary dementia be allowed to make important medical decisions? IF mental illness is real, then there is a perfectly legitimate case for the non-competency of individuals.

Next you'll be telling us that if five year olds decide they want to jump off the roof of their house to see if they can fly, we as libertarians must let them make such a choice.

"Money quote from the link in my last comment: "Uncontrollable crying and disorganized thinking were common among the prisoners." Makes you think, doesn't it?"

Yes, it makes me think that you are an idiot. People that are super stressed out do often exhibit disorganized thinking, but not in any way comparable to the way untreated schizophrenics have "disorganized thinking" and long lasting, repeating delusions. Again, if you spent ten minutes trying to hold a conversation with someone with the disease, I think you'd quickly realize this.

Robert Goodman|11.19.06 @ 1:46AM|#

Libertarians tend to be smarter than the avg. bear, but I still see a lot of knee-jerk oppositional and other superficial thinking among us about issues. I think that's what's happened with same-sex marriage, for example. I'd've expected libertarians to be about 50-50 on the Schiavo affair, but they wound up reacting oppositionally to Congress and other organized groups.

brian423|11.19.06 @ 7:50PM|#

Peter K. and plunge,
If I don't answer every single one of your points, it's because some of them are red herrings.

If someone wanted to have you locked away, they wouldn't need to frame you for a crime you didn't commit to the satisfaction of a prosecuting attorney and twelve jurors. They would only need to convince a judge and a court-appointed psychiatrist that you had a disease with diagnostic criteria so subjective that you could never prove you don't have it. A malicious person could have you jailed without benefit of trial. You might be locked up for life, because everything you said or did from then on would likely be interpreted as signs of your "illness." Although some people certainly get themselves committed because they don't wish to take care of themselves, I have no doubt that others have been corralled into mental hospitals by overbearing family members and such. (I'm sure that adolescents are particularly vulnerable targets, since teenagers are the new niggers.)

|11.20.06 @ 11:41AM|#

"They would only need to convince a judge and a court-appointed psychiatrist that you had a disease with diagnostic criteria so subjective that you could never prove you don't have it."

You keep waving this supposedly scary scenario around without any evidence that it's even a widespread problem or that most of or even any of the folks in mental hospitals are faking or normal people stuck there and continually misdiagnosed. The fact is, almost every person committed in this way has VERY severe mental illness and usually some sort of ongoing "break." Trying to make them out as sane rational people who are logically opposing their commitment like Jimmy Stewart in Congress is just lying. Most of these people argue their case by demanding that Mickey Mouse stop sending phone calls into their brains: they can't even comprehend the court proceedings in the first place.

Your illusions would very very quickly be shattered if you actually went into a locked ward and saw the condition of the folks there. Half of them DON'T EVEN KNOW WHERE THEY ARE.

"If I don't answer every single one of your points, it's because some of them are red herrings."

No, it's because your argument is so lousy that it cannot stand up to requests for evidence or logic. You can't simply handwave objections as red herrings without explaining why. If they are illegitimate, then you need to explain why, not just lazily dodge them.

brian423|11.20.06 @ 12:00PM|#

Most of these people argue their case by demanding that Mickey Mouse stop sending phone calls into their brains: they can't even comprehend the court proceedings in the first place.

The statement after the colon doesn't necessarily follow from the statement before it. Without evidence of neurological damage, it's an inference rather than an empirical fact.

|11.20.06 @ 1:22PM|#

brian423 --

You did not decline to answer the question about burden of proof in a criminal case because it is a red herring. You declined to answer it because you hold an anti-libertarian point of view on this issue. You and Dr. Szasz believe that a person who causes another harm -- allegedly because of a mental illness -- should be punished unless he or she can prove the existence of the mental illness. Libertarians place the burden of proof on the government in all cases where an individual's loss of life, liberty or property is at stake.

Quit dodging that issue, and admit it.

You are correct that juries do not decide civil commitments to mental hospitals. I agree that jury fact-finding should be a recognized right.

You are wrong about everything else.

In any kind of trial, criminal or civil, in law or equity, the finder of fact -- judge or jury -- can and does make factual findings based on inference. This is equally true in mental health cases. If a mental patient appears to be screaming at a person who is not present, and appears not to be able to respond rationally -- even to the lawyer assigned to defend him -- it is a rational inference that his thinking is disordered and that he is experiencing hallucinations. If he is given an antipsychotic medication, and the behavior changes, and he responds rationally, and he reeports that he had been experiencing hallucinations, a rational inference is that the medication worked.

As a lawyer, I defend mental patients against commitments, treatment without consent and guardianships.

You say that all it takes to commit someone to a mental hospital is "to convince a judge and a court-appointed psychiatrist that you had a disease with diagnostic criteria so subjective that you could never prove you don't have it."

Not true. After a statutorily brief observation period (in my state, 3 days plus intervening weekends and holidays), the hospital must petition a court for permission to continue to hold a person. At the hearing, the burden of proof -- which must be born by the petitioner -- is the same as in criminal cases: Beyond a reasonable doubt. The patient does not have to "prove" anything.

To prepare for the hearing, the patient can have an independent evaluation by a clinician selected by him or his defense counsel. That clinician can be called by the patient as a defense witness.

Most importantly, the petitioner has to prove more than just the existence of a mental illness:

There must be proof that the discharge of the patient would cause imminent danger of death or serious bodily harm to a human being (or that it would cause a reasonable person to be put in fear of same by the patient) or that the patient would be so unable to protect and care for himself in the community that harm to the patient himself is very likely.

Finally, there must be proof of a causal connection between the two, the mental illness and the the likelihood of harm.

|11.20.06 @ 7:45PM|#

Peter K.:

Thanks for the, er, sanity.

brian423|11.20.06 @ 7:51PM|#

Peter,
You take "burden of proof" out of its proper context. It means only that it's the state's job to prove that someone committed a crime. It does not mean that the state is burdened with proving any particular theory about why the person did it.

I'll admit that Jacob Sullum raises important qualifications and reservations about Szasz's ideas. My main goal here is to argue that Szasz is not a crackpot but someone to be taken seriously.

|11.23.06 @ 9:31AM|#

brian423 --

No, from time immemorial in English common law, the government has had the burden of proving, in criminal cases, a perticular theory as to why someone did the act. Ever hear of such terms as "intent"? "Malice Aforethought"? "Knowingly"?

brian423|11.23.06 @ 9:59PM|#

Peter,
I concede your point about English common law. Are you willing to concede that Szasz makes valid points about how questionable most psychiatric diagnoses are?

mnuez|11.25.06 @ 5:47PM|#

Okay, I know no one will actually read this far down so as to read this, but som fo the abovely written stupidity got my bile boiling so let's have a go at it.

------------------------

How's about this folks?

Schiavo is dead. That means that she has no wishes. For all intents and purposes then we can feed her to cattle.

We don't do such things if of course because that would open a big can of worms in society of (superstitious) folks felt that they couldn't trust society at large with their remains once they're dead. Fine, so we respect the rights of the formerly living to do with their earthly remains post-mortem as they see fit. Even going so far as to allow them to keep such remains pumping blood even after there's no human left in the system. Fair enough - in fact doubly fair, because swearing up and down that she's dead, dead, dead and can in no case return is probably bullshit. We know little enough about the brain to make such pronouncments with certainty. At least I do.

In any event she's probably dead and no longer has any will of any sort. Oh, and her prior wills regarding just such a state are unclear too. In such a case we might to defer to the taxpayer and take the body off life support. Or not. Deferring to the taxpayer with regards to any matters that even resemble issues of life and death is a pretty bad idea.

In such a case, all that we're left with are the feelings of two different parties. Michael Schiavo and the Schindlers.

One party created, carried, bore, raised, loved for decades and cared for Terry and the other party married another and has a different family at this time. In other words, he's 'moved on' - with the exception of course of releasing his hold on his "rights" vis a vis the body of his ex wife.

In other words, one party is delusional and the other is scum.

Vote Delusion.