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Old 02-25-2025, 07:21 PM   #23713
Makarov
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Quote:
Originally Posted by Whynotnow View Post
I have concerns, the history of governments and forcing treatment on people is not great. Forced sterilization, forced lobotomies, etc are a dark dark stain on Alberta. Would you force an obese compulsive eater to be locked up to lose weight? Other addictive behaviours or destructive behaviors next?

However, what we are doing right now is awful and we need to do way, way more. More treatment spots, more supports for those nearing poverty, more social workers, more presence in urban areas to deal with disorder, a massive crackdown on dealers, etc. There’s no single thing but we almost are doing nothing in any of the right areas.
I understand those concerns. Really. I share them.

In response, I'd just say this:

1. Any legislation permitting involuntary treatment would undoubtedly require a psychiatrist (ie, a physician bound by their fiduciary duty to their patient) to be the front-line person who decides that a person is enough of a danger to themselves to order involuntary detention and involuntary treatment.

2. Any such legislation would obviously also grant affected people (or someone appointed their power of attorney over personal care, etc) to challenge such a decision.

3. We've come a long way as a society since the late 1970s. I'd like to think that institutions that provide involuntary treatment are much more sophisticated and humane now.

4. As alluded to in my paragraph 3, every province in Canada already has legislation permitting involuntary treatment. However, most of them only permit it when the affected person lacks the capacity to consent to treatment. That's a very high test. However, there are a couple of provinces which already have legislating permitting involuntary treatment. However, those provinces have not invested in sufficient institutional space so the authority is not exercised very often.

5. All provinces already have legislation which permits involuntary detention under mental health legislation. When that legislation does not also permit involentary treatment, it actually creates the potential for a terrible situation: indefinite involuntary detention (indefinite because the affected person does not receive treatment, so continues to meet the threshold for involuntary detention).

6. Most of the studies out there on involuntary treatment compare its results to voluntary treatment. Unsurprisingly, voluntary treatment tends to yield better results than involuntary treatment. However, I think those studies miss the point (to a degree anyway). The comparison should really be between outcomes after involuntary treatment and outcomes after no treatment (sleeping rough in encampments and daily use of fentanyl).

7. People who regularly use fentanyl die. At utterly appalling rates. And even when they're saved by staff at safe consumption sites or even by shelter staff, their hearts regularly (like, multiple times a year) stop for significant periods of time, causing repeated damage to their brains.

8. I think that a sophisticated government, acting in good faith and on the advice of experts, could design involuntary treatment legislation and institutions that are humane and effective (well, at least significantly more effective than the current do-nothing approach).

Anyway, sorry for the long argument.
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Last edited by Makarov; 02-25-2025 at 07:27 PM.
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