Dear Sister, please take your lithium.

[Chas.E]

Dear Debbie:

Yes, we, your family, know you are bipolar. We know you're not taking your medication anymore, and we know you're in denial and claim you are no longer affected. No, that homeopathic medicine the quack is selling you doesn't do squat, as is obvious from your appearance today, in a hyperactive, manic state, screaming at people, spouting obscenities, and generally throwing a fit. Perhaps you could arrange to crash and enter the depressive phase by the time thanksgiving dinner starts? It would be much less stressful for the rest of us.

We know you've worked hard to erase unpleasant memories from your broken mind. However, we still remember them. In particular, I remember a few thanksgivings ago, when you had a completely unprovoked psychotic episode, and threatened to slash your arm with the carving knife and then call the police and tell them I did it. Perhaps you did not know that after this incident, I consulted an attorney and attempted to get a restraining order against you, requiring you to stay 500 feet away from me. Alas, the attorney said that I had no physical evidence, no independent witnesses to your behavior. Perhaps you have not noticed that ever since that time, I have never been alone in a room with you. My attorney advised me to never be in the same room with you unless there was another witness present, and that if you followed me alone into a room, I should leave the room, and if necessary, the house.
We also remember your 5 suicide attempts, the repeated, forcible incarcerations in a mental institution, your messy divorce, and your failed business that ended up draining my father's life savings before you finally went bankrupt. We remember when you called the police on our neighbor when you were visiting, insisting that he was peeping in the window at you (he was out of town at the time). We remember the time you tried to kill me because I wouldn't let you change the TV channel. We remember your manic episode when you swiped Mom's Neiman-Marcus card and bought $2000 worth of christmas cookies, then gave them to HER. What a nice Christmas present, you didn't have to spend a dime of your own money, it only took Mom 2 years to pay it all off! And I have only scratched the surface of all the insane things you did, and still continue to do.
Yes Debbie, we remember, and we still observe it happening, even if you don't. Apparently we know more about bipolar disorder than you do. We all read the books, particularly one series of essays by a PhD Psychologist who is herself afflicted with bipolar disorder. She says that she doesn't like the side-effects of lithium, for the same reason you refuse to take it, it makes you sluggish and you get fat, but that you have to take it anyway. Too bad you're such a vain person (even though you're pretty damn homely and have no rational reason for vanity). The PhD asserts that there are only two paths for a bipolar person: either you take lithium every day for the rest of your life, or you commit suicide. She says there is no way out, it is an absolute certainty that every single manic-depressive person will, without medication, kill themselves. So if you're not going to take your lithium anymore, would you please hurry up and kill yourself? At least then, your ex-husband would get custody of your child, and since you are the least fit parent on the face of this earth, that can only be a good thing. Yes Debbie, we remember when we phoned you one night and your little 5 year old child answered the phone and said you did something bad and won't wake up. You should have known you can't commit suicide with a bottle of Prozac and a bottle of wine. If you're going to try to kill yourself again, please have the courtesy to at LEAST not do it in front of your child again. She is already traumatized enough just from living around you, let alone witnessing your repeated suicide attempts. Since you are eventually going to kill yourself and inflict greivous mental damage on your child, perhaps you could arrange to do it somewhere besides right in front of the child?
Sorry if it seems harsh that I wish you would kill yourself. But that's not really what I, and all the other members of our family really wish. What we REALLY wish is that you had never been born. But alas, this cannot happen. If only it could, all the unending horror that you've inflicted on us over the years would not have taken place. Yes, Dear Sister, the world would be a better place without you in it. Our house is a better place without you in it. So after Thanksgiving dinner, you are cordially invited to FUCK OFF and go back home, IMMEDIATELY. Go do whatever it is you do with your life, just do it AWAY from us. Far FAR away.

[OpalCat]

ouch.

I hope that not everyone thinks that way of me... (it sounds pretty similar to the way I can act when I miss my medication--which sends me almost instantly into "the depths")

Maybe she should try different medication? I started off on lithium but only took it for a year. I was taking it with Paxil, then I went to Paxil only and did just fine. Now I'm on Celexa, which I think is better than Paxil (and if I miss a day I don't have the insta-psychosis thing, it's more gradual)

[Chas.E]

This was not intended as a sneer at bipolar victims in general, Opal, just at my horrid sister. She's been insane on a level far beyond manic depression, ever since she was a small child. I cannot concieve of anyone on earth being as horrid as she is, you could not possibly be as bad as her..

Alas, she refuses to take ANY medication, she is convinced she is not affected by any mental disorder. She will remain convinced of her sanity right up until the next time she gets institutionalized again.

[Billy Rubin]

I know from personal experience what bipolar is like, had to have the wife hospitalized a couple of years ago because of it. We have a small child also, and she wouldn't act responsibly around her either.

Fortunately, the S.O. does take her lithium, she has a good doctor who has tweaked her dosage and given her other medications to help with the side effects. Finding a good enough doctor in and of itself can be a real struggle.

My thoughts and prayers go to you this season, and to that child. I hope the situation gets resolved for everyone's sake, and gets resolved without causing other problems.

And Opal, your knowledge and awareness of your difficulties is what separates you from Chas.E's sis. Just keep after it, okay? Hope the celexa keeps working for you.

b.

[Chas.E]

Originally posted by Billy Rubin
And Opal, your knowledge and awareness of your difficulties is what separates you from Chas.E's sis. Just keep after it, okay? Hope the celexa keeps working for you.

Thanks for that, I should have said it that way. Funny though, I thought my sister got past that denial stage about 3 institutionalizations ago. But here we are again, back at square one.

Alas, there is almost zero chance of having a good holiday. But I appreciate the sentiments. If we just manage to get through the holiday without bloodshed, I will consider it a success. But the dread I feel for my poor little niece will remain.

[AHunter3]

They have to take it for their own reasons, of their own (unpressured) volition, in light of their own independent conclusion that they'd rather be on lithium than off it.

(I have friends in the movement who are bipolar but choose to remain unmedicated. Some of them aren't much fun to be around, but that's also true of some of the medicated ones The important thing is that they accept the consequences of their actions, and don't try to have it both ways, e.g., "You can't have me arrested for that, I did it because I'm SICK")

Ultimately it is their brains and their biochemistry and they have the unalienable human (and in most places in the US, legal) right to make this rather basic choice. My friends tell me that lithium "flattens" what they feel to the point that no horrible consequence of a possible manic episode outweighs the lure of actually feeling something with some degree of intensity once again.

You certainly have the right to say "I don't want to have anything to do with you, you tried to have me locked up as an assailant", though, and you may find that you have to. Sorry your Thanksgiving is being marred by this.

[Qadgop the Mercotan]

Originally posted by AHunter3
Ultimately it is their brains and their biochemistry and they have the unalienable human (and in most places in the US, legal) right to make this rather basic choice.

And the damage they do to their children? Is that their right too? Refusal to comply with their therapeutic regimen (when said refusal impacts minor children) should be grounds for termination of all parental rights. I have seen too many things too horrible to mention here happen to children of psychotic parents.

Qadgop, MD

[DPWhite]

Attempting suicide in front of a child is probably grounds for changing custody in every state of the union. Chas, please look into getting that poor child into a better environment.

[AHunter3]

And the damage they do to their children? Is that their right too?

The allegedly "differently minded" should have the same rights, and be subject to the same restrictions, pertaining to how they treat their children. If one hurts one's children, protective services should step in, and in many cases one should lose one's custody.

Whether one does or does not take the advice of a medical professional regarding what one does or does not put into one's own body is not, in and of itself, relevant here.

I just consulted my girlfriend, who has MS and Hashimoto's Thyroiditis, her opinion of the notion that citizens should not have the right to choose not to take medications prescribed for them. She said "Good God, I'd be dead by now if I took everthing that has been prescribed for me!"

In the case of psychiatric medications and prescriptions, I say this is is more applicable, not less. The potential invasiveness of the medication is more personal, the etiological understanding of the medical professionals is more questionable, and the social opportunities for using such an apparatus for the benefit of others rather than the benefit of the patient are frightening.

[Chas.E]

In case everybody is curious, after my sister had her fit last night, she grabbed a tallboy beer from the fridge, popped it open, ran out to her car, and burned rubber out of the driveway, beer in hand. She was not heard from until midday today. I figured she wrapped her car around a phone pole somewhere (or maybe it was only wishful thinking). Suddenly she shows up for thanksgiving dinner with a special uninvited guest: her ATTORNEY. The attorney mostly sat silently in the corner of a room, watching me like a hawk while pretending to read a book. I don't know what lies she told her attorney last night, but she must have screamed for hours because she is very hoarse and can barely speak today. Hooray for small mercies!
I told my mom, I felt underrepresented at the table, I want my attorney present too, before I was prepared to begin the First Circuit Court of Thanksgiving Dinner.

But worst of all, dinner was over 2 hours ago and she's STILL HERE!

Anyway, thanks for your support, everyone, and at least you guys know that no matter how crappy Thanksgiving was, with the traditional family conflicts of the season, there was someone out there who had a worse holiday than you did. Oh.. I should make some other quickie responses.

Billy, yeah, she had some of the finest doctors in the world, courtesy of our local university. That's why she moved 2000 miles away from here, so she could find some quack that would tell her what she wanted to hear. Now she claims she never was bipolar, it was just overwork and hypoglycemia. She got this tactic by conning a nurse on the psych ward into telling her how to fake her way through a psych exam. Since then, we've been unable to keep her locked up, she just fakes her way back out. Oooh is she devious. What I don't understand is how she managed to get custody, since the hearing was about 1 month after she conned her way out of the looney bin. Why didn't her ex-husband contest it harder?

Yes DPW, I desperately desire to get my little niece out of that environment, hopefully back to her father. But I have been thwarted by my mother, who believes that a child belongs with the mother, no matter what. At least we've been able to get more visitation for the father, who lives in a different city, so he gets months of custody at a time. I hope he's able to undo some of the damage, and give her a safe place.

AHunter3, you may have a valid point, but at the same time, I keep hearing the voice of the judge from the first mental competency hearing, saying the words "a danger to oneself and others." And this is so clearly the case. Her right to not medicate herself ends at a certain point, just as your right to swing your fists ends where my nose begins. I'm not talking about someone "differently minded," I'm talking about someone "broken-minded." She can become violent or suicidal at any moment. She has the right to choose not to take medication, but that should have made her completely ineligible for custody of a child.

[AHunter3]

mental competency hearing

That changes everything. (And sorry about your miserable Thanksgiving, Chas E )

A mental competency hearing is due process; a person can be diagnosed bipolar, schizophrenic, paranoic, hebephrenic, etc., until the shrink is blue in the face, but still retains the right to decide for him- or herself whether or not to take the pills...UNTIL AND UNLESS a competency hearing determines that she or he lacks capacity to decide. A competency hearing is a setting in which the alleged incompetent has full access to representation by an attorney and standards of evidence protect even schizzies and manics from unfair inferences.

I agree completely that if she has been judged incompetent, the court should be able to determine what medications she needs to take (including, but not limited to, lithium, Vitamin C, heart pills, etc), the same as if she were in the latter stages of Alzheimer's. And her kids should have a responsible adult in charge of them, which a legally incompetent person, by definition, is not.

I am completely and totally in favor of competency hearings, and it is the bypassing of them, and the substitution of psychiatric diagnostic opinion (and mental hygiene commitment hearings, which are yet another animal) for them, that I oppose.

I apologize if I have added to your grief or frustration today.

[Chas.E]

Originally posted by AHunter3
I apologize if I have added to your grief or frustration today.

Far from it. Even if you had, I am just numb from dealing with Miss Psycho-Sis, it wouldn't matter.

[DPWhite]

Well Chas, if you are in California, I'd be happy to sit in next year and stare down her attorney for you. We could posture and make faces. I charge $250 per hour and dinner would have to be included. I would say a lot "as your attorney, I must advise your to..." use gravey, not eat cranberry sauce, no a la mode, etc.

[Angel of the Lord]

Originally posted by AHunter3
My friends tell me that lithium "flattens" what they feel to the point that no horrible consequence of a possible manic episode outweighs the lure of actually feeling something with some degree of intensity once again

I would have to agree with that...I've spent an amount of time on lithium, and I hated it. I suppose it's because I'm hypercritical of my thoughts, actions, and reactions...I knew that I wasn't feeling, and that bothered me. Then again, I was a minor, and the it kept me from kicking a(nother) bloody hole in the wall.

This time, I'm not on Lithium, after having *insisted* that they try something else. God, I hope no one I know reads this place.

[Chas.E]

yeah, I can see it now...

Her: Could you please pass the salt?

(DP, sitting at my immediate left, leans forward and whispers in my ear, with a grave look on his face)

Me: I've been advised not to answer that question.

[Zenster]

You have my deepest sympathies, Chas. Someone needs to wise your mother up as to just how fucked over your neice will be from watching her mommy melt down over and over again. Near term decisions may well affect the survival of this little girl. My heart goes out to you.

[Derleth]

This is why I like the idea of implantable pumps giving medications. Imagine: A little pump with a little resivoir of lithium or prozac or whatever, giving the drug on a dosage schedule (or maybe continuously) automatically. No missed doses, no irrational refusal, no life-or-death hostage situations that could have been prevented with 50 mg of a damn drug. Simple office procedure under local anasthetic (think minor dental work) to refill/replace the resivoir, simple schedule of infrequent office appointments to adjust dosages/drugs, and freedom 90% of the time while the pump does its thing and the person does theirs.

Diabetics already use it for insulin. Why can't the insane use it for their meds?

[AHunter3]

Charming.

Or we could just bring back lobotomies.

[Cat Whisperer]

Chas.E, you need to look after yourself, and it sounds like you need to stay away from your toxic sister to do that. Visit the rest of your family as much as you like, but don't come to the family gatherings where you know she will be present. It looks like she has a special hatred for you, and as cunning as she appears to be, I don't think it will end well for you. Protect yourself, and stay away from her. What a rotten family situation; you have my whole-hearted sympathy for the lack of good choices you have here.

[TwistofFate]

Miss Psycho-Sis

If you dont hear anything good for the rest of the day, let me just comment you on some excellent wordplay.


Sorry to hear about the Sis. Have you tried talking to her ex about going for custody?

[Derleth]

Originally posted by AHunter3
Charming.

Or we could just bring back lobotomies.

Tell me, please, how implanting a pump to administer medicines the person should already be taking compares to the irreversible physcial mutilation of a lobotomy?

[BoBettie]

For what it's worth, a lot of people who are mentally ill are very much against any sort of forced incarceration/meds and believe they have the right to refuse medicine just like a diabetic can. This would probably make an excellent Great Debate if anyone wants to post it there with both sides of the arguement.

Zette

[Farkle]

Originally posted by Chas.E
The PhD asserts that there are only two paths for a bipolar person: either you take lithium every day for the rest of your life, or you commit suicide. She says there is no way out, it is an absolute certainty that every single manic-depressive person will, without medication, kill themselves.

Not to diminish the problems you have within your family but please know this PHD is full of shit. Bipolar effects everyone who has it differently and that is an extremely broad stroke that is incredibly wrong. Not all those with bipolar become suicidally depressed or even consider suicide a valid option, not all with bipolar spend wads of cash either, there are as many differences in symptomology as there are people with the disorder.

[Broomstick]

Particularly since an implanted medication pump is at least potentially reversible, and a lobotomy is not?

I had a mentally ill sister who, fortunately, was not a danger to others although in the end she most certainly was a danger to herself. (Hence, use of "had" instead of "have")

We allowed her to go her own way, to use or not use what medication was available. Then again, she chose not to become a mother and stayed away from the neices and nephews when having a bad episode. She was, despite the mental problems, very intelligent and rational even though her emotions could run amok.

Each mentally ill or "mentally different" person is unique and each situation needs to be evaluated on it's own merits. But, while a person may have the right to refuse treatment they do NOT have the right to endanger or inflict pain on another. It's a sign of how fucked up our society is that many people do not recognize mental pain and suffering as REAL pain and suffering, just as real as physical damage.

If a young child is involved that changes the picture. The child needs an environment that's best for the child, not an environment to appease adult agendas.

[AHunter3]

If you tried to hook me up with such a pump without my permission, I would be within my moral rights to kill you, and would do so.

To force someone to take mind-altering chemicals on an ongoing basis without their consent is considerably more of a violation than anything that should be remotely legal.

Zette:

For what it's worth, a lot of people who are mentally ill are very much against any sort of forced incarceration/meds and believe they have the right to refuse medicine just like a diabetic can.

Thank you Zette. Yes, we're mad and we're organized. (Well, sort of. Please ignore the state of our current nationals But we are politically active at any rate)

Glancing back over this thread once more, I am struck by the following:

If Chas E's sister has indeed been deemed incompetent in a competency hearing (a legal process of which I approve), she by definition can't possibly be the legal guardian of her children and for that matter does, again by definition, have someone appointed to be her own guardian, unless the hearing has JUST transpired and the final determinations of guardianship have not been completed. That is the nature of a competency hearing.

If Chas E was equivocating (unintentionally if so, I would imagine) between a competency hearing and a psychiatric commitment hearing, I must point out that even a person who has been deemed to be "mentally ill and a danger to self and/or others" (the traditional commitment standard) has the legal right to refuse medication even in a locked inpatient setting. This right was established in New York in the court case Rivers & Zatz vs Katz; legal opinions in other states (let along outside of the United States) may vary.

But they should not. In fact, commitment hearings themselves should be unconstitutional, since they are mechanisms for locking up a person involuntarily on the basis of what they might do. In the absence of a competency hearing, (which, as I said previously, respects due process and protects individual rights), the individual, whether "normal", "schizophrenic", "bipolar", or discernably nuts in some other fashion, is entitled to the legal assumption of being capable of making decisions (and living with their consequences).

The potential for abuse of the power to commit (and to impose forced treatment) is not hypothetical, we're talking real world and genuinely nasty abuse here, folks.

So you know what you can do with your pump, right?

[Chas.E]

Originally posted by Farkle
Not to diminish the problems you have within your family but please know this PHD is full of shit. Bipolar effects everyone who has it differently and that is an extremely broad stroke that is incredibly wrong. Not all those with bipolar become suicidally depressed or even consider suicide a valid option, not all with bipolar spend wads of cash either, there are as many differences in symptomology as there are people with the disorder.

Yes, I made a broader generalization here than the book really did, but her assertion is that seriously bipolar cases with a record of suicide attempts will eventually succeed unless they continue on meds. Of course the less serious cases are not necessarily terminal, and perhaps many even go undiagnosed. But I'm talking about extreme, serious cases here.
But ooh those spending binges.. The PhD wrote about her own experiences. She described how she was thinking of taking a vacation out west, and became posessed with the idea she would encounter poisonous snakes. Before she came down from her manic binge, she bought thousands of dollars of books on herpetology and six snake bite kits. And of course she never ever got out west on vacation. So whenever we see incidents like sis buying $2000 of christmas cookies, we just roll our eyes and ask each other, "what, no snake bite kits?"
Anyway, she is gone and far far away, where other people have to deal with her. I wish them luck. They'll need it.

[Derleth]

AHunter3:
If you try to kill me because you aren't on your meds (assuming for the nonce you are, in fact, a candidate for the kind of meds I'm talking about) I would be well within my rights to kill you. If you try to kill anyone else when I'm around, I would be within my moral rights (if not my legal rights) to kill you.

I do not like the idea of killing people.

Are you telling me that we as a society don't have the power to stop you from being, and I quote, 'dangerous to yourself or others'? I would say we do. We lock people up in state-run locked mental wards all the time. We do this as a humane alternative to prison for those who we think would benefit by therapy.

A locked ward implies that the patients cannot be trusted to use their own judgement to check themselves out.

Drugs have very benefical effects on people with certain illnesses, physical and mental (and, commonly, illnesses where the physical and the mental have a junction). A person can be sentenced to receive medication while on parole or house arrest. This is even more humane than the locked ward scenario (I know people who have worked in locked wards. That is the impression I get.) because it allows the person to enter society. If the person does not take the drugs, that person risks time in a place where they physically restrain him to get him to take his meds (such as a locked ward).

Again, the person is not trusted to make his own decisions regarding his treatment.

So, if the person is going to be sentenced to either a locked ward or parole on the condition that he take his meds, he has no say in the matter anyway. He will take his meds, or he will be put in a position where big men restrain him and force his mouth open and check under his tongue to see that he has, in fact, taken his meds.

If those are the options, an implantable pump is the humane thing to sentence someone to. Why? It's the best of the house arrest scenario with no need to confine the person to a house where a responsible person can remind him of dosage schedules. A person with a pump could quite easily take up international travel, as long as he is back in the clinic for refills and, possibly, adjustments.

Does he have a right to refuse?

No.

Why?

He does not have a right to be a danger to others.

To use an example in the thread, Chas's sister has no right to threaten to blame her suicide on him. She has no right to mentally damage her child by attempting suicide in front of him (or her). Debbie has no right to be dangerous by refusing to take her meds.

No person has a right to be a danger to others. That is why we have prisons. Human compassion is the reason we have locked wards. Going back 200 years, we chained the crazies in dungeons and beat them at the change of the lunar phase. Nobody wants to go back to that. Effective psychoactive drugs exist. Curing these diseases is within our reach. The pump is a convenience. The drugs are a necessity. The alternatives are unthinkable.

[AHunter3]

Derleth:

Are you telling me that we as a society don't have the power to stop you from being, and I quote, 'dangerous to yourself or others'?

Yeah.

The "dangerous to yourself or others" finding is an opinion about what a person might do.

You most certainly do not have the right to mess around with my brain, interfering with my thoughts and my feelings, on the basis of your opinion (or Dr. Shrink's professionally informed opinion for that matter) that I, in my current state of mind, might hurt someone if you don't.

I have an acquaintance who is an "anarchist". Not the same way I'm an anarchist, i.e., a person who believes a social order not based on a hierarchy of authority is both practical and desirable, but someone who believes in sabotage of industry and vandalism against the property of multinational corporations. He supports actions agains the international trade organizations.

Guess what? It isn't legal to inject him with chemicals that would numb his mind to the point that he would be unable to maintain the anger and the clearheadedness of strategic planning necessary to carry out such activities.

In part, because he hasn't done anything yet.

But guess what else? Even if he actually DOES something and gets arrested for it, tried, convicted, and imprisoned for these illegal activities, you still can't shoot him up with chemicals as described without his consent.

We are entitled to the same rights. Our biochemistry is none of your goddam business, and even if we've disturbed the hell out of you with our disruptive behaviors, we should be subject to the same laws governing permissible and arrestible offenses and the rest of you. In short, schizophrenics, bipolars, paranoiacs, and depressives should have the same right to act like a jerk and not be incarcerated for it as salesmen, fraternity brothers, and sailors on shore leave.

The population of people diagnosed with some form of mental illness are not spectacularly more violent than a comparable control group, and we tend to suffer violence at the hands of "normal" people as often as vice versa.

If you try to kill me because you aren't on your meds (assuming for the nonce you are, in fact, a candidate for the kind of meds I'm talking about) I would be well within my rights to kill you. If you try to kill anyone else when I'm around, I would be within my moral rights (if not my legal rights) to kill you.

If you come after me with the intention and equipment to forcibly medicate me with psychiatric meds, I already assume you would kill me, as you are in the process of attempting something comparable. If you come after someone else with similar intent, and that person appeals to me for help, I woudl be within my moral rights (if not my legal rights) to kill you then, too. (Given the opportunity, though, I'd inject you with the stuff you brought with you instead and see how well you like a headful of Prolixin)

[AHunter3]

Actually, before the mutual Death Threats get out of hand here--


a) I do not anticipate that you intend on physically forcing medication on me or anyone in my immediate environs;

b) I would never kill anyone if other options for ensuring my freedom were available to me, even if I deemed it to be within my rights to kill;

c) My main purpose in making these rather forceful statements was to convey the strength with which I hold these particular convictions, and, in particular, to convey to you how serious a threat I regard the suggestion of forcibly medicating psychiatrically diagnosed people against our will

d) I do not feel personally threatened by anyone who has participated in this thread, and regard any mention of the right to kill me as having been made in the same spirit.

e) I appreciate the existence of SDMB as a forum in which people with vastly divergent viewpoints and strong feelings on the subjects at hand can listen and learn from each other, even in the process of yelling and being very confrontational. I would ask that anyone reading through this thread experience it in this spirit.

[Derleth]

So locking up felons isn't rational because we can't know what they might do? Nonsense! Past actions are the best guide to future behavior.

If someone comes at me, or anyone else I'm around, with mudererous intent, that person will be killed. No questions asked, no analysis of biochemistry done, no debating of philosophy performed. It is called self-defense. No, fuck that, it's called SELF-PRESERVATION. A basic biological imperative.

I have more right to live than you have right to refuse medication.

I don't know how to phrase it better than that. If you have a history of violent tendencies when not medicated, you have no right to be a potential threat by refusing medication.

Murderers are locked up, sometimes executed, because society (composed of individuals, remember) has a right to self-preservation. Society is a collective term for 'the humans in a specific region'. As an individual has a right to ensure his own survival, a society has a right to ensure the survival of the individuals that comprise it. Medicating the violent has been shown to do that by reducing violent tendancies.

If you don't like your medications, I feel for you. But not enough to risk my life or the lives of others. Pick the drugs that help you best. But take them, or else we will have to take more drastic measures.

The right of a person to defend himself is inalienable. Prisons, locked wards, state-mandated medication, etc. are self-defense by proxy, the proxy being the state (states are representatives of the people with powers delegated to them by their population). If a person is dangerous without medication, and has proven that by their prior actions, the state is within its rights to mandate the most effective treatment for that person. Self-defense by proxy. I am simply advocating another option that might make the most inconvenient aspects of that (locked wards, house arrest, prison) obsolete for some people.

Self-defense is fudamental, whether it is applied directly person-to-person or via the proxy of the state. You won't convince me otherwise.

And if I'm coming at you with medications, I'm trying to help you. That's why I'm using medicines, not a gun.

[Billy Rubin]

[Marlin Perkins]Jim and I have stalked the elusive bipolar Manic Depressive through the streets of Chicago. Now that he's cornered in the new section of Lower Wacker Drive, I'll stand back while Jim goes in for the injection[/marlin Perkins]

[Jim][struggling with bipolar]Marlin, damn you, you bluehaired insurance huckster, why can't we use the dart gun like every other time mmmffmmeee wfffmmmmmmmmmThis guy's gonna stranglegggrrthfff me!!![/jim]
[Marlin Perkins]Jim has an excellent point. I'll just load up my dart gun and inject the dose(fires) Oh, no! I've accidently shot jim in the head![/marlin perkins]
(fade to driveway)
[quentin tarentino]Marlin, is there a sign on my house that says Dead Jim Disposal?[/quentin tarentino]

[Young Dr. Frankenstein]Kidding! I'm Kidding! Don't you people know a joke when you hear one?Hahaha!!![/Young Dr. Frankenstein]

b.

Hope things improve by next turkey day, Chas E.

[AHunter3]

If someone comes at me, or anyone else I'm around, with mudererous intent, that person will be killed.

I respect your right to defend yourself if someone is trying to kill you.

And if I'm coming at you with medications, I'm trying to help you.

Your intent to be helpful doesn't make you so. I hope you respect my right to defend myself if someone is trying to medicate me against my will.

I have more right to live than you have right to refuse medication.

Not enough so to guarantee your continued survival if you try to force it on me. I know some women who feel similarly about being raped again.

So locking up felons isn't rational because we can't know what they might do? Nonsense!

It isn't legal, and locking up someone who has never committed a felony on the grounds that their state of mind indicates that they might most certainly isn't. Even people with a long history of violent crimes have the right not to be arrested once they have served their time, unless they actually do something once again.

If, let's say, I commit a violent crime, and am charged with it, convicted, and sentenced, and then later released on parole, a condition of my parole could be my agreement to take Prolixin. However, I would, under those circumstances, have the right to turn down the deal and serve out my time behind bars, after which time I have the right to walk the streets of my home town unmedicated.

[Broomstick]

What the hell, I'll wade in again...

While I think medications have their place in treating mental disorders I also firmly believe than NON-medication solutions be given equal, if not greater, weight. I find the recent trend among some to give out Prozac as if it were candy to be more than disturbing.

Moving right along -- in my old neighborhood in Chicago we had a person known as "Crazy Mary". Mary was, in fact, a classically crazy schizophrenic who would hallucinate in public on streetcorners, in restaurants, etc. especially after the local toughs mugged her and stole her medications for recreational purposes (although why anyone would think those drugs fun to take is beyond me). Given her situation, she couldn't reliably pick the culprits out of a line-up nor would her testimony stand up in court.

Now, even though Mary would see/hear/smell/taste/touch things that weren't there for the rest of us, and occassionally had to be removed from the center of the street to allow traffic to pass, she was, in no way, a danger to others. Disturbing, yes, but harmless. A chronic victim, in fact. She did require assistance to keep the rent paid but in fact lived in a residential area and was tolerated by the community. Yes, she was on meds but no one was forcing them down her throat - she said they helped her somewhat although she wasn't thrilled about the side effects. If you ask me, she was a pretty lucky individual, to be able to enjoy as much freedom as she did given how severe her impairments were (and presumably still are). In no way would I ever advocate locking her up or drugging her into zombiehood. Maybe hire her a bodyguard, now THAT would be a practical gift.

On the other hand - there ARE people given to violent outbursts - both those defined as mentally ill and those regarded as sane - whose conduct truly does lead one to question how safe the public is when they're about. If a person - sane, mentally ill, retarded, intelligent, whatever - has a habit of destroying property and/or assaulting people and these outbursts are becoming either more common or more violent, then there might be cause for restraining them based on what they might do. Even so, that's still based on individual conduct and not a disease or disorder. And even in that circumstance I think representation and some level of due process is called for.

In sum - I think there are times when forcible restraint is justifiable. But not as a knee-jerk reaction. Only as a last resort and with much consideration and contemplation of the alternatives.

[Derleth]

DO NOT COMPARE MEDICAL TREATMENT TO RAPE! You are lucky you live here, instead of in, say, the old USSR, where you could be confined to a urine-soaked hellhole and beated by guards medicine can't help.

I hope you respect my right to defend myself if someone is trying to medicate me against my will.

I do not respect your right to remain a danger to society. I do not respect your right to refuse court-ordered treatment for a disorder you have proven you have by, say, past violent actions.

Not enough so to guarantee your continued survival if you try to force it on me.

That's not self-defense, that's homicide. Theraputic dosages of medicine will not kill you, no matter how groggy they make you feel.

It isn't legal, and locking up someone who has never committed a felony on the grounds that their state of mind indicates that they might most certainly isn't. Even people with a long history of violent crimes have the right not to be arrested once they have served their time, unless they actually do something once again.

I agree. I'm only advocating the pump as an alternative to prison for someone convicted of a crime.

If, let's say, I commit a violent crime, and am charged with it, convicted, and sentenced, and then later released on parole, a condition of my parole could be my agreement to take Prolixin. However, I would, under those circumstances, have the right to turn down the deal and serve out my time behind bars, after which time I have the right to walk the streets of my home town unmedicated.

No. Wrong. Goddamned fucking wrong. If you are violent when you are not on Prolixin, you have no right not to take it. If you refuse to take it, you have no right to be a danger on the streets of any town.

Take it or face prison for lifetime. Take it or face execution. We will not let you remain dangerous.

I'm not about to back down on the self-defense argument. I'm perfectly happy to advocate execution, if execution is what it takes. It does not have to be that way. Drugs work. Treatment is a humane alternative to prison or execution. The pump is a convenient, humane treatment. You have a right not to like it. You have no right to be dangerous.

[AHunter3]

Derleth, who is in a dangerous frame of mind:

DO NOT COMPARE MEDICAL TREATMENT TO RAPE!

If you were a doctor and defined the insertion of your dick into your patient's orifice against your patient's will, are we to suppose it would then constitute "medical treatment"?

I do not respect your right to remain a danger to society.

Members of the board, I put it to you that Derleth, via his attitudes and in light of his statements here, is a danger to society.

I do not respect your right to refuse court-ordered treatment for a disorder you have proven you have by, say, past violent actions.

The alleged disorder justifies forced drugging on the grounds that future violence is considered a possibility, and the correctness of the diagnosis is assumed on the basis of a history of violence. Notice that the act of forcibly drugging a citizen against his will is somehow not construed as violence, but defending one's self against such an assault is?

I ask that you give due consideration to the following speculation: Derleth has decided that persons such as myself should be incapacitated through the use of drugs, and will excuse any violence as justifiable means if it works toward those ends, while defining any resistance to that violence as a "symptom" that further justifies the success of his endeavor.

{Quoting me}

That's not self-defense, that's homicide. Theraputic dosages of medicine will not kill you, no matter how groggy they make you feel.

Here again you will note further insistence on his part that the forced drugging which he has defined as "therapeutic" would not constitute an assault, therefore making it okay for him to proceed while making it a criminal act for me to defend myself against such such an assault.

Surely you will all agree that if you assault people, they have the right to defend their person with reasonable force. I may not have the legal right to kill Derleth if I can prevent him from forcibly drugging me through simply (let's say) taking the hypodermic out of his hands, but if there is no realistic course by which I may prevent him from drugging me without using deadly force, and deadly force is available, that is indeed self-defense.

The fact that he does not understand this, or chooses to proceed as if he did not -- either way, not accepting it as a valid principle of individual self-determination in our society -- indicates to me that he could act on these delusions of therapeutic grandeur at any time, and as such constitutes a danger to others.

[pennylane]

AHunter3, could you sum up your point of view for me, please? I'm having some trouble understanding exactly what your stance is on this issue. I agree that no-one should be forced to take medication. But what should happen if a mentally ill person openly threatens another person's life? If, for example, this person tells his or her psychiatrist that he or she is plotting to kill a specific person?

[AHunter3]

Same thing that should happen if a non-mentally ill person makes the same threat, of course.

[AHunter3]

In my last reply to Derleth, I wrote:

If you were a doctor and defined the insertion of your dick into your patient's orifice against your patient's will, are we to suppose it would then constitute "medical treatment"?

That should, of course, read:

If you were a doctor and defined the insertion of your dick into your patient's orifice against your patient's will as therapeutic, are we to suppose it would then constitute "medical treatment"?

[pennylane]

Originally posted by AHunter3
Same thing that should happen if a non-mentally ill person makes the same threat, of course.

Really? But why? Someone with bipolar disorder or schizophrenia could be suffering an episode of the illness in which he has lost insight and is not fully aware of his actions. For example, he might wrongly believe that his own life is endangered by this other person. Do you really think he should be treated the same way as a person of sound mental health who makes the same threat?

[AHunter3]

Do you really think he should be treated the same way as a person of sound mental health who makes the same threat?

Of course! Do you think we are any more likely to be violent than anyone else who makes violent threats? People of "sound mind" commit violent acts all the time (a great many of them against us, those bearing a diagnosis of "mental illness").

How can you possibly defend holding us to a different behavioral standard under the law?

ONCE AGAIN, may I direct everybody's attention the existence of the competency hearing. Competency hearings are society's way of considering the possibility that a given person is not able to make their own decisions. When you lose them, you get a guardian, and you cease to be a legal adult for all practical purposes. Competency hearings are not concerned with folks' biochemistry, they are concerned with a person's ability to make an informed choice. The individual involved is entitled to due process, and is assumed competent until incompetence is demonstrated in a court of law. If you believe an allegedly "mentally ill" person should not be making his or her own decisions, then, goddammit, have a competency hearing!

Aside from that, you will kindly grant us the same civil rights as any other adult, regardless of professional medical opinions about the healthiness of our thoughts and feelings, which should not be allowed to substitute for due process of law.

[pennylane]

So who decides when a person should have a competency hearing?

AHunter3, I didn't mean to imply that a mentally ill person is more likely to carry out a violent threat than a non-mentally-ill person. But I think that the matter is more complicated in the case of the former. Certain kinds of mental illness could lead someone to threaten the people who are most dear to them, whom they would normally never dream of hurting. So I think the actual danger is different - it's more temporary, for one thing.

Anyway, what happens when a non-mentally-ill person makes this kind of threat?

[AHunter3]

Technically speaking, when the average citizen threatens violence, they are committing a crime, and the threatened person is entitled to an Order of Protection. In practice, based on my experience as an elder abuse social worker, where some of the abusers were non-relatives, criminal court will not issue an OOP unless actual damage has already been done.

In the case of family members, Family Court is an option, and Family Court is far more disposed towards issuing an OOP as a preventative measure when threats have been received.

Chas E could, for example, get an OOP against his abusive sister. It would not get her into any trouble until and unless she violates it, but if she does violate it, she is arrestible long after the fact (e.g., hours after she quits waving sharp knives around or making threats of violence) for having violated the OOP. In most states, as a result of spousal abuse issues, the system takes over at that point, i.e., charges are pressed automatically, but it would still be up to witnesses to testify. Family Court judges rely on their own (often overly lenient) judgment but tend to escalate the penalties rapidly for repetitive violations.

In my opinion, Criminal Court needs to make better provisions for being able to obtain an OOP against one's abusive neighbors and other non-relatives. I do not mean to claim that the criminal justice provides perfect and universally adequate protection. But, by God, let's have some equal protection under the law here, and if the laws need fixing, fix them for everyone. If Derleth wants violent people locked up forever unless they agree to being shot up with Prolixin, he should get mandatory sentencing laws for violent crimes enacted, but don't single us out for having a psychiatric diagnosis.

So who decides when a person should have a competency hearing?

IANAL, but I believe anyone can make an application regarding anyone else, alleging incompetence; they may also be able to apply to be guardian themselves, or, if there is no connection to the person involved, prompt the state to pursue the possibility itself. Any attorneys visiting this thread, please consider yourself invited to clarify and correct as need be.

The most common targets are folks' parents or grandparents in situations where the elder person does not wish to turn over control of the finances / keys to the car / ownership of the family business and the younger person either believes the elder is no longer capable of assessing situations and making choices or else thinks when parents get old they oughta at least hand over the goodies and get out of the way, if they going to insist on refraining from dying like old folks should.

The job of the court is to distinguish between these situations and determine whether the allegedly incompetent person is indeed incapable of coping with life's situations and decision-making opportunities.

[pennylane]

Thanks, AHunter3, that was very informative.

[Ferrous]

Originally posted by Derleth
DO NOT COMPARE MEDICAL TREATMENT TO RAPE! You are lucky you live here, instead of in, say, the old USSR, where you could be confined to a urine-soaked hellhole and beated by guards medicine can't help.

Derleth,
I object to your use of the term "urine-soaked hellhole", when you could have used the term "pee-pee-soaked heckhole".

(D&R)

[Derleth]

AHunter3, let me summarize my points in a painfully clear way: Anyone convicted of a crime, especially a violent crime, who has been adjudged mentally ill by a competent court, shall receive any treatment a competent physician prescribes, by force if necessary. The commission of the crime has reduced that person's right to self-determination by showing him or her to be a danger to the people around him or her. The right to self defense, the fundamental right from which the government derives its power to punish in the case of criminal law, trumps any right the convicted (not accused, not suspected, convicted) has to refuse treatment. Punishment has been converted into therapy as an act of human kindness. If the convicted does not comply with treatment, the government has the power to place the convicted in a place where compliance can be forced.

Or, to put it more simply: If you do the crime, we, the people, have the right, and our duly appointed representative government has the power, to render you nonthreatening. IT IS THAT SIMPLE. Therapy is a humane alternative to, say, execution. This society likes helping people, as opposed to just lining them up and shooting them. The pump, indeed, the very idea of court-ordered therapy, is an expression of that. But it is the legal consequence of committing a crime, even if it is not punishment. Refusing it is on a level with saying serving prison time is optional.

I have gone back to first principles (self-defense), I have explained the purpose of the pump (a more humane alternative to warehousing the ill in state institutions or prisons), and I have gone to the bedrock of my own thoughts on the issue (Self-defense trumps your right to refuse medicine.). If you cannot understand my postion now, there is no reason to continue this debate.

[ultrafilter]

Originally posted by Derleth
AHunter3, let me summarize my points in a painfully clear way: Anyone convicted of a crime, especially a violent crime, who has been adjudged mentally ill by a competent court, shall receive any treatment a competent physician prescribes, by force if necessary.

Underlining mine.

I've been following this debate since the beginning, and I did not see this point in your previous posts. Now I have a very specific question for you. Suppose a convicted felon has been diagnosed "mentally ill" by a psychiatrist but has not been found legally incompetent. Would you support forced therapy of this person?

[Derleth]

ultrafilter:
If the therapy would help him, I would advocate it as an alternative to punishment. He should be given the choice of taking the medicine or serving the prison time. You see, as long as he is competent, he has that option: Medication or prison.

You would have a tough time convincing me that someone who is mentally ill and has been convicted of a violent crime is competent, but I'm not medically trained.

And I have been making that point all along, but perhaps not that clearly. For example, I said:

I'm only advocating the pump as an alternative to prison for someone convicted of a crime.

(emphasis added later) right above this post. It would make no sense to give the treatment to someone who is not mentally ill.

(And, of course, that does not preclude its use if the patient wants it, but that point has become tangental to the current thread.)

[AHunter3]

He should be given the choice of taking the medicine or serving the prison time. You see, as long as he is competent, he has that option: Medication or prison.

That is reasonable.

If you've committed a crime, they don't have the right to force you to take drugs, but they CAN damn well offer you freedom on their terms (you take the drugs) in lieu of you serving out your full sentence. If you can't do the time (or the pills) don't do the crime.

Derleth, is this is what you were saying all along, please accept my apologies as I clamber down from this soapbox.

[Derleth]

AHunter3, at the risk of taking this thread out to even further lengths, that is not what I meant. I said:

He should be given the choice of taking the medicine or serving the prison time. You see, as long as he is competent, he has that option: Medication or prison.

Note the conditional: 'As long as he is competent'. If the psychologist judges him incompetent to decide his best interests, he obviously cannot choose whether or not to take the medication. Our prisons are already overcrowded. Medication is the humane option in that case, and would be regardless of the state of our penal system. Throwing people in prison simply because they are not capable of deciding that medicine would help them is barbaric. That is the concept behind court-ordered treatment.

[irishgirl]

now, i'm not bipolar, but my best friend in college is.

as in hospitalised last year for 6 weeks, and every autumn for the past 3 years.

as in being deported from the US after a manic episode in JFK airport involving 6 cops having to restrain her.

as in only being diagnosed last year.

as in taking lithium...

as in not having side effects (other than thirst and the odd strange drug interaction with antibiotics)

as in totally normal.

as in she's completing her medical degree.

as in i spent a month backpacking around europe with her.

lithium doesn't always work...but when it does...

i also have a team mate who is bipolar.

he is also taking lithium...when he can be bothered.

he is manic about 25% of the time, even on his optimum dose.

and flat the rest of the time.

so when it doesn't work... it doesn't work.

so i am sorry about your sister and her problem, i'm sorry she acts like an asshole, and that it affects your niece.
because i know that you find it much nicer to be around her when she is acting normally.

i know it isn't easy, but pushing her away only compounds the issue.

for what it's worth

all the best

irishgirl