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November 23, 2013
Security for Alice in a Mass Killer's Wonderland
By C. S. Herrman
This articles demonstrates that every significant legal theme of the last thousand years denies courts to permit known threats to the public to exist without enforced responsibilities to mitigate such threats. Permitting deranged persons to roam freely without medications but with guns, is one of the clearest violations in recent memory, and one requiring remedy.
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The true extent of the difficulties back then was doubtless hidden beyond reach of accountability. In 1975 those who were experimenting with legal abduction and imprisonment were finally and officially furloughed. It has been decades since Alice investigated the matter of difficult and disruptive types in need of 'safe time'. "They've a temper," said Humpty Dumpty, "some of them -- particularly verbs, they're the proudest; however, I can manage the whole lot of them!" Today things are different. Those 'at risk' of doing harm to self or others can be competently assessed in advance. Apart from that, however, the difficult are trending more dangerous, and the dangerous are more difficult to restrain. Logic, after all, is vital to nonsense.
Alice in Wonderland
Once upon a time people could be so selfish and self-absorbed as to finagle the removal of a 'difficult' person to a mental ward. "'I'm not a serpent!' said Alice indignantly. 'Leave me alone!'" It worked simply enough: three votes and you're off -- to see the wizard and the white coats whose professional facilities delivered wide variations in care; and doubtless kept raps on recidivism, psychotic episodes, malaise, even escapes. I once personally ushered a paranoid schizophrenic escapee to a nearby hospital, where the desk person looked at my charge and said, "Oh, this is the nut case." Whereat my charge bolted, making my task much more difficult but at all events useless, because pointless. Then and there I was officially educated: the system was hopelessly rigged, mostly in the wrong ways.
The high arbiter of law in Wonderland was called, after an old English court of equity, the Star Chamber. It was because the Chamber justices were genuinely outraged at the license taken with innocents and unfortunates alike that the victims were rewarded with law's equivalent of the lottery (O'Connor v. Donaldson, 422 U.S. 563, 1975). As for the law, it got a bloody nose for the Chamber's misplaced wisdom. To be fair, thirty years ago the psychiatric community was pretty sorry. Back then, Alice wasn't comfortable forcing the difficult to undergo long-term treatment. That would change. But first, she reviewed the legal facts. From the decision (see also a cumulative case summary here) --
1) But the mere presence of mental illness does not disqualify a person from preferring his home to the comforts of an institution.
2) Mere public intolerance or animosity cannot constitutionally justify the deprivation of a person's physical liberty.
3) A State cannot constitutionally confine "a non-dangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends".
Determining 'at risk' status fully and competently addresses the first two concerns. The third presumes what is preposterous, namely, that a 'non-dangerous' person can be presumed to live safely in freedom without medications. Excuse me? "'Oh, there's no use in talking to him,' said Alice desperately; 'he's perfectly idiotic!'" And mental illness is just a walk in the park even absent psychotropics? Did anyone ask their families? It is this, Alice fumed, that overturned about a thousand years of legal tradition.
Wonderland was soon enough in worse condition than the penguins and polar bears; the ice pack on which Alice floated was melting beneath her feet, whole chunks falling away with every mass shooting. Cracks were widening, inevitably isolating her still further as her family (and countless thousands of others), no longer assured of treatment for a difficult relative, discovered a small army of hungry orcas with 'wave-hunting orgy' on the brain. Preserving the luxury to dodge responsibility was taking its toll. "'But I don't want to go among mad people', Alice remarked."
Others get religion, Alice gets law
Alice took aim at conventional legal learning, determined to learn the way law was intended to be learned: from initial examination of ethico-moral common denominators (jurality) for 'probative' mythic value, followed by a study of parallels between theory and practice under differing contexts.
She learned from Lord Coke's (1552-1634) reporting on Judge Littleton that when a cow -- at the time the single most important possession of a family -- wandered off through damaged fences or neglected stone walls, therein was created a marvelously easy way for neighbors to turn violent and for violence to spawn feuds. Alice drew a parallel between those refusing needed psychotropics and homesteaders refusing to exercise the responsibility to maintain their fences and walls. Medications, Alice saw, were the walls and fences separating healthy from troubled dispositions -- neighboring pastures of the mind. She proudly recited from Robert Frost's Mending Wall --
Good fences make good neighbors.
Why do they make good neighbors? Isn't it
Where there are cows?
She moved along to O. W. Holmes Jr.'s survey of the Common Law: "Nowadays a man is bound at his peril to keep his cattle from trespassing, and he is liable for damage if he has notice of a tendency in the brute to do the harm complained of [her emphasis, Dover ed., 20]." Natch, thought Alice, who wanted medically 'certifiable' sorts to have more merely than a diagnosis but also an appraisal of the intrinsic and extrinsic 'at risk' factors constituting 'notice of a tendency'.
Personal liability for failure to maintain fencing is on the books as early as the code of King Ine of Wessex (688-726). Alice saw this as some thirteen hundred years and some odd decades worth of experience, the lesson of which is the need for law to enforce maintenance of that which in disrepair is apt to result in problems (what would happen if suddenly the required elevator inspections were cancelled?). To argue that this jural precept should not apply to the owner of one's mind seems perverted, she thought. Add 'notice of a tendency' and the perversion is upped a few notches to the obscene. If for the same jural principal we turn from omission of propriety to commission of impropriety we encounter the likes of 'subway vigilante' Bernard Goetz waltzing with exposed electronics through drug- and gang-infested territory: "Here, come get me so then I can complain that the authorities don't protect me." More on Mr. Goetz anon.
And if all precautions fail, and a cow ambles on over into a neighboring pasture, the law required the neighbor to practice the stewardship of an ad hoc office: take and care for the cow for a specified time to enable the owner to claim the beast. If the owner was dilatory he could be fined for showing contempt for the law that had preserved his property, and for the rights of the neighbor who was out resources and energy. If for some reason the owner never came, the cow would forfeit to the state, which would with few exceptions give it to the finder for his pains and expense.
Where wrongs are dealt with by fines or forfeiture, the jural ground typically includes 'unjust enrichment' (the charge will undoubtedly be different). If a finder doesn't release the object to the owner according to law, the finder is wrongfully enriched. If the owner finagles release of his property without the finder's expenses accounted for, again there is unjust enrichment. Here is an example from 1871 highlighted by Alice: "Since the owner of a boat has been unjustly enriched by the plaintiff, who found the boat adrift and, at his own expense, took care of it for the owner, the owner must compensate the plaintiff" (Summers & Kelly, Oxford J. Leg. Studies, 1(2) 1981, 214).
For the same case but from the Supreme Judicial Court of Massachusetts: "And the single question is, whether a promise is to be implied by law, from the owner of a boat, upon taking it from a person who has found it adrift on tide water and brought it to shore, to pay him for the necessary expenses of preserving the boat while in his possession. We are of the opinion that such a promise is to be implied" (from the decision, in Lawson, Cases on Quasi-Contracts, 1904, 351). When the law implies a promise it's often called a quasi-contract, she read. What percentage of that category also implied the ad hoc office remained unknown to her, but no matter, the implications were huge regardless.
Because every office implies adverse reliance -- lawfully undertaken risk of harm in reliance of promised (lawful) objectives -- any stewardship violation entails unjust enrichment somewhere. Should the law cease use of such promises/offices, protection from unjust enrichment would cease along with the office. Which Alice inferred to mean that when this happens on a broad scale very many harms ordinarily protected against would leave potential victims exposed and unprotected; as, for example, the public vis-a-vis ticking human time bombs that the law has assured us will be outfitted with powder, flint, and trigger -- oh, and hollow points. "'Nonsense!' said Alice, very loudly and decidedly, and the Queen was silent."
Alice felt that the government's at-the-time rationale was, if innocent, not thought through. The idea seems to have been that the advances making cows and other capricious creatures things of the past would leave us with tamed, domestic material goods under supervision of bright people. Right or not, the vacant logic of this was not lost on her. Man was far more capricious than any beast of burden. Thus the greater the reliance on material objects, the greater, not the lesser, caprice would befall the public from man's irresponsible use or abuse of otherwise innocent toys. With the Industrial Revolution greed was now in the driver's seat; and despite intermittent advances of dignity-based values, it has since continually cycled, ebbing and waning about a high baseline.
More was lost with the blessings of private autonomy than merely the ad hoc office. An invaluable, if inchoate, philosophy of law was at risk. When wayward cows appeared on the law's radar it was to the law of bailments that their fate redounded. Unjust enrichment regarding owners and finders was likewise grist for bailment law -- "[F]inders of lost property on land are entitled to receive full compensation for all reasonable and necessary expenses incurred about the things found and preserved by them." This is from Commentaries on the Law of Bailments by Joseph Story, as in the Justice, published posthumously in 1863 (8th ed, p. 627).
With legally sanction worship of all things private, the bailment survived in piecemeal; its theory -- capable of delivering the jural roots of most of tort, criminal, and public law, and all of contracts -- arrived as detritus in the land of desuetude, prefiguring an apt locution: 'The day the law died'. Bailments were nothing if not the synecdoche for all that the 'Law of the Office' could be. Nothing before or since reflects the concepts of office that made bailments the ideal springboard to modern law.
It was as if the concept and rule book of baseball were marginalized by a wild uptick in tiddlywinks, leaving ball, gloves, uniforms, bases and bats strewn about, whereat the law gathered them up and, as if de novo, created -- a composite of cricket and lacrosse! (modern torts and contracts). "What we possess, if this view is true," opined Alasdaire MacIntyre, "are the fragments of a conceptual scheme, parts which now lack those contexts from which their significance derived" (After Virtue, 1981, 2).
One cannot blithely neglect to protect the public from mental illness (or pollution, or...) without having first dismissed what bailment law tried to bequeath to legal posterity. And because most of these jural concepts were within equity jurisprudence (in fact gave rise to it) and thus not to the advantage of wealthy capitalists -- who prefer to exert influence on the making of positive law and then advocating rigorous adherence to it with all the conviction of a spiritual fundamentalist -- law was left with accepting governmental agency regulations (sort of) and inviolable private cowboy shoot-'em-up prerogatives. The latter not only gave rise to the specter of institutional abuse of the mentally ill, but then underwrote giving these same sick souls all the privileges of the capitalist gods.
Law careened from one extremity to the other, a sure sign that the fundamentals had been lost. They remain lost. And the legal community? They not only haven't been to the clue store, they have yet to realize its existence. Only the psychiatric profession has a worse track record (part of which, to be fair, has in the last decade been patched up -- at the inexcusable tardiness of a mere fifty years).
Alice identifies the two paths to ruin
All of this must inevitably lead, thought Alice, to the first of two dreadful conclusions. First, unjust enrichment would be replaced with 'unjust degradation' (what Alice's Gryphon called Uglification), the inevitable outcome of unabridged, unmitigated, and unregulated adverse reliance in which a largely defenseless public lies prostrate before a small but determined army of self-absorbed corporate gifts of God. Alice took notes: "I don't think they play at all fairly and they quarrel so dreadfully and they don't seem to have any rules in particular."
Such is the atmosphere that encouraged rascals to sideline whomever they cared to define as difficult or troubled; the same that sold us on the idea that zombies were better off just as they were. The second road to ruin could only be the litigiousness expected when private will is licensed to self-police, to define excess and then duck behind hired lawyers once the stench is unbearable. Alice recollected the words of Fury to Mouse: "We must have a trial; for really this morning I've nothing to do." Law had become almost as glib in its prepossession as its corporate clients. Pollution causing cancer? "Well, it's them or us; you choose". Fall-out from financial panic? "You just don't get it, do you?" Mass killings? "Have to have guns, son, just the cost of doing business."
In the event, the public found improvements to their protection slow coming and hard-fought for when arriving. Bye the bye the Chamber Pot (as Alice had taken to calling them) recognized implied warranties, thus briefly resurrecting the ad hoc office; belatedly it recognized the private and public right to sue corporations, whence the fictive 'personhood'; and belatedly it responded -- piecemeal over fifteen years -- to outrage over false imprisonment of incorrigibles and mistreatment of those otherwise justly constrained.
As one might guess, unjust degradation is a very broad category, encompassing everything from pollution, white-collar crime, business fraud, and privileged second-party rights variously evading their responsibility to first parties (banks and corporations the big winners: companies avoid implied warranties by having third parties market their wares; banks got a hefty portion of third-party sales of derivatives declassified to "arms' length" to avoid stewardship responsibilities (fiduciary in this case); not content with that, they took it upon themselves to ignore responsibilities to mortgagors, whence all those lost contracts).
Whereas ad hoc offices coaxed the public into stewardship responsibilities, litigiousness would accomplish quite the opposite. Whence everything reverted quite spontaneously to -- fear. Fear of litigation spread like a designer bird virus. Liability cast a chill so deep that even common-sense aspirations were paralyzed, including the enforced treatment of ticking time bombs. Privately sponsored stewardship was thought likely to expose the best of intentions to private law suits. For some, faith in the legal system flat-lined. Doctors feeling spurned by courts and legislatures stopped attending to injured motorists. At the time of Alice's writing two states were reduced to legislating doctors back to their vows -- with the requested insurance against liability.
Litigiousness and fear of liability caused the healthcare crisis; they account for the dearth of programs at the local level to determine criteria for at-risk difficult persons and to implement a court-ordered longitudinal pilot study of the efficacy of enforced medical maintenance. Since lawyers write up the plethora of reasons why not to breathe too heavily, and since they are relied upon by everyone else naturally afraid of the slippery slope of liability, it is no wonder we are getting nowhere in a hurry. Alice is in despair.
Alice becomes a dignitarian
There are two kinds of culture in the world. Each recognizes the ide as we call honor and dignity. One cultural type holds honor in first place, while assigning to dignity the duties that in stewardship guarantee trustworthiness and integrity. The other culture holds dignity in the first position where it serves as the raison d'etre for individual rights as well as claims upon the legal system to address wrongs. Whereas dignity serves the purposes of honor in the first, or 'honor-based' groups, honor enables the ends of dignity in the (dignity-based) second category. No stewardship, no adequate complement of dignity . So simple to say, so hard to discern even after law claims to have been its advocate.
Suddenly everything is about deterrence and fitting remedies to the crimes that, however reasonable on the surface, often misplace the ruling principle of dignity. One place the criminal-justice system got it right, however, was the recognition that inmates had reduced wherewithal in regard of mental health, something very difficult to explain without this concept of dignity. "Prisoners have only a very limited right to refuse psychotropic medications in prison. The needs of the institution take precedence over the prisoners' rights." But the public is not to be so privileged?
Stewardship always entails a zero-sum relation between power and obligation. Why? Because stewardship is what gives life to the office, otherwise a mere platform -- better still a green room -- for a benefactor's grant of authority. Stewardship is why professionals operate at exceptional levels of care and diligence. It is why they take active measures to ensure safety and security, and also why, if negligent, they can be punished. Throughout, stewardship maintains the dignity of the office, as also that of the grantor, her vision, the officer and of course the client (all of which, because never having been explicit in the outward language of law, caused bailment theory and equity generally, to take a severe hit).
When someone inflicts injury or damage s/he reduces the victim's experience, hence enjoyment, of dignity. Rape, for example, is a theft of dignity, as is robbery. People feel unnaturally exposed after such invasive crimes. In every culture the world over, law steps up to the plate and evens the score by restricting the criminal's rights in one way or another -- another way of indicating that their dignity, too, is rendered less complete. It's hard to manifest a lot of dignity from a posture of dishonor, discomfiture, or disgrace.
Most of this is not deterrence-oriented, because most of it operates via stewardship norms rather than fear-mongering. When stewardship is in place, people self-police where otherwise fear holds them frozen in place or has no hold over them whatsoever. Ad hoc offices are actually the next best thing to 'individual initiative', but without the downsides. Thus only those who freeze are ever actually deterred. The rest are dissuaded or not.
From another vantage law maintains the dignity of any office by chastising those who would impair the office in any way. Just as law has always recognized the value of offices, so has it just as consistently failed to admit its dependence on stewardship. The relation was crystal clear, however, to John Selden, who maintained that 'ignorance of the law is no excuse'. He knew as Steward of the Earl of Kent that most of the law's impact on everyday affairs involves the common offices (marriage, citizenship, professions, etc.) -- the stewardship responsibilities of which require no special education or training, hence cannot offer up ignorance as an excuse.
Everyone knows without being formally educated that the public deserves to be maintained in peace. This was an extension of what had for 'time out of mind' applied to the private affairs of a man and his 'castle' and whose 'peace' was inviolable as was its future extension to the King; on the other hand, both he and his King were required to preserve the safety and security of visitors and passers-by. This is what legalists mean by the quasi-contract and what Alice meant by its deployment of an ad hoc office. Disrespecting the Peace with force of arms (vi et armis) was held to impute contempt, so that the combination of act and imputation defined felony in what was simultaneously the birth of both public and criminal law.
Problem people, difficult people, are no different from anyone else in the fundamentals. They have a right to peace, and are required to provide safety to others they commune with. There is, however, a difference in 'culture'. The difficult person is the result of being born to a mother carrying exposure to stress on the epigenome (and perhaps elsewhere in the genes), or from what Hans Selye called 'the stress of life', or from both together. It presents as a very different cultural milieu. These folks live with minds over-alive to exposures, over-attentive to desiring this, and avoiding that, stimuli. "'I can't explain myself, I'm afraid, sir,' said Alice, 'because I'm not myself, you see.'" And with this comes an elevated responsibility to keep others safe and secure.
Families and public are now treated as if they owed deference to the diminished rights of dignity of those rejecting their responsibility. The only other social stakeholders that are required to accept such levels of adverse reliance are soldiers, policemen, and firemen. The difference is that the professionals have legally recognized safeguards that families and society have been deprived of. There is only one bullet-proof vest for such a family. Let's call it enforced medical maintenance (EMM). It is not a violation of anybody's right or a diminution of anybody's dignity to compromise the rights of a compromised dignity.
Rights are only as effective as the dignity giving them competence; denying other's rights reduces the level at which dignity can justify claims to plenary rights. IF a patient is defined by professionals as 'at risk' and IF s/he denies medication without medical reasons for doing so, the state, speaking for families and the public, is fully entitled, indeed obligated, to commit said person to extended medical maintenance. This is a bedrock principle that was never intended to be subject to negotiation. Alice had her own grateful experience with medicine: "I'll just see what this bottle does. I do hope it'll make me large again, for really I'm quite tired of being such a tiny li ttle thing!" The dignity enlarged with medicine does truly enlarge the spirit.
Giving the Chamber a chance to make this right
Alice successfully lobbied for a tet-a-tet with the Star Chamber. Confirmed was her suspicion that they had since learned to expect and hate these mass shootings; confirmed also was the guess that they were nonplussed that lower-court challenges were so few that they had nothing of value to accept on certiorari. It should not, however, be blindly assumed that they are so stupid that they can't appreciate the jural principles discussed here. They simply need to be brutally reminded that they have no earthly right to be ignoring them.
Much can still be done against legal/legislative paralysis simply by sitting down around a table and examining the criteria that might reasonably qualify a diagnosed person for 'at risk' status and thus EMM. Here, then, might be the results of such a discussion. The 'at risk' might possibly be defined as those with medical findings of illness plus one or more of these co-factors; those 1) with felony conviction(s); 2) with unstable conditions (medications found less effective than anticipated but still essential); 3) having publicly announced themselves as dangerous as reported by trusted observers (teachers, for example, have proven to be reliable), and 4) with guns in proximity whether or not owned by the involved person.
Despite the controversies over the true numbers of mentally ill, the categories for 'at risk' persons will, even when the dust has settled, amount perhaps to one percent of the whole group. In other words, this business is aiming very narrowly, and the garden variety of bipolar, schizophrenic, schizoaffective, and so on, need not worry that anyone is 'coming after them'. Those demonstrating considerable responsibility can be given provisional/probationary release from enforced maintenance. Some will own guns as or more responsibly than anybody else.
The only exigent argument, legal or otherwise, against EMM is a worry over the professional competence to identity and gauge risk factors, and to establish and gauge success in treatment. As to the first, even I, a ceaseless critic of the profession, am ready to acknowledge their competence here. A veritable cadre of sub-professions has taken up the pathology of psychopathy and sociopathy with great effort and to great effect. As a theorist in the area I can generalize their findings in my own way: The off-balance person who plans and plots mass-killings is characterized by a deadly composite of 1) paranoia; 2) insensitivity and insecurity of dominance (IID), and 3) generalized contempt for categories, large or small, of humanity. As a rule, schizoidal personalities get angry, not contemptuous. They do, however, have the upper hand on paranoia. The bipolar crowd carries the contempt card but can also manifest a serious amount of paranoia. Both syndromes illustrate IID, though bipolars come to it as a weltanschauung, the schizoids in reaction to threat.
As a result of trait crossings between the syndromes, the overall rule is look to the bipolar whose activities leave tell-tale marks of paranoia, insecurity, low flashpoints, short fuses, over-reactions, and contempt. They may seem to take a schizoid diagnosis (some like to pigeon-hole them into Otto Kernberg's Borderline Conditions, which is roughly Asperger's on steroids), but the dangerous elements are by and large the ones associated with bipolar. The danger of schizoids is that their psychoses are occasionally directly responsible for murder. It tends not to be mass killings, however, and is in any case also occasionally seen in bipolars. Between bipolar and schizophrenia, Alice had something to say on behalf of the bipolar thesis: "But it's no use now to pretend to be two people! Why, there's hardly enough of me left to make one respectable person!"
To offer you a flavor of what is entailed, I have taken a few items from the Bernard Goetz file. The data are from Doug Linder's summary here. My discussion is in three parts: truths, half-truths and falsehoods. The point is to highlight how bipolar traits are rightly and wrongly construed, along with at-risk red flags.
Truth: District Attorney Gregory Waples, of Goetz' outlook: "very twisted and self-righteous sense of right and wrong." Untreated bipolars will hitch themselves to a cause and the twisting begins. They believe they have justice and right on their side, not only holding those in the wrong in condign contempt, but doing so despite what normals will agree is a helpless posture from which they could not meaningfully intervene.
Half-truth : Goetz: "the city doesn't care what happens to you". This is at once the conclusion of his experience, and the object aimed at in gaining that experience. When he parades around gangland with electronic equipment bulging, he is putting himself in 'protected exposure', the protection being his faith that he is right (a loaded gun helps immensely); he will be attacked and the city will have to answer for it. Basically, he's getting what he asks for in order to bring a complaint largely irrational for being impossible to carry out. It takes a bipolar to be so thoroughly impudent.
Truth: Linder's narrative: "The other 15 to 20 passengers on the car, wary of the boisterous gang, moved toward the other end of the car. At the 14th-Street station, Bernhard Goetz, age 37, entered the subway car and took a seat near the youths." More protected exposure. He did precisely opposite what normals do, and that is all we need in order to appreciate that he was willing to challenge a risk in order first to provoke, then to prove people empirically deserving of his contempt, justifying to himself whatever punishment he decides upon.
Falsehood: Linder's narrative, Goetz quoted: he used dumdum bullets because "you need maximum stopping power." With 20-30 witnesses in the car all he needed to do was display the gun and watch for a negative reaction. The bullets exemplify the willingness to match overkill with the degree of contempt. It may also speak to paranoia. This is what no one but bipolars specialize in, barring the military and the mafia (not a few of whom are bipolar in any event).
Half-Truth: Linder's narrative: "In the words of one juror, Goetz might have been reasonable or unreasonable in his feeling that he was trapped, 'but he didn't go out hunting.'" This is why experts are supposed to adjudge mental illness, not jurors. If he didn't go out hunting, he was exemplifying a tried and true pattern of placing himself in situations that would elicit the natural response of overkill that characterizes contempt in action.
Truth: Goetz: "I saw they were intending to play with me like a cat plays with a mouse." He is freely identifying a cat's toying with a contempt that ends with a kill. He was speaking about himself as much as about the boys. When a bipolar holding others in contempt sees them willing to do so to him, they have just vacated all right to his respect. Said Alice to the mouse, "I quite forgot you didn't like cats."
Falsehood: Goetz : "You seem to be doing all right; here's another [bullet]." These are words he admitted to saying at the time. It's hard to wrest more contempt out of a single comment. This is classic bipolar contempt playing the victim like a bipolar might believe a cat does its mouse (except that cats don't do contempt).
Truth: Linder's narrative: "Goetz ran for mayor of New York City in 2001 and the position of Public Advocate in 2005." Untreated bipolars are rarely ever remotely allergic to the limelight While many aggrieved normals run for office in order to do something about it, Goetz was never so much aggrieved as he was valuing his victimhood as a ticket to power and/or importance. In victimhood he found the justification to make his mark, a Zimmerman on steroids, and though the fame be fleeting, the feeling of self-righteousness it brings is a necessary satisfaction to the bipolar crusading a cause.
Truth: Linder's narrative: "Judge Crane sentenced Goetz to a six-month jail term, five years' probation, a $5000 fine, 200 hours of community service, and an order that he seek psychiatric help." It doesn't have to require rocket science to draw rational conclusions. Armed with red flags such as these, psychiatrists can make reliable prognostications.
Whether Goetz be denominated a 'mass killer' can be debated, probably to no real value. The facts are that he did wantonly kill, and did also deliberately, repeatedly, engage circumstances likely to make such possible. Who the hell cares how many he killed? The point is that he's an untreated bipolar looking for trouble. Do you want to be a part of that trouble? Goetz would not have committed any of those acts, nor even the risky behavior nor the killings, had he been on medication. That, and nothing else, is the gravamen.
Another person with the same psychology and with a little more generalized contempt could have skewered everyone on that car. There is no gauging in advance the extent, only the likelihood. Any psychiatrist could, with knowledge of the red flags from police reports, have determined the obvious and instigated the treatment that Goetz nonetheless had the right to refuse at any time, keeping company with perhaps as much as ninety percent or more of diagnosed bipolars.
Apart from diagnosis of syndrome and risk factors there is the issue of treatment. Any regimen has to be tailored to the patient else by definition for that patient it was neither safe nor effective. By the same token, any given group of patients can manifest deviations from a clinical norm. So treatment is somewhat a crap shoot, an experiment, a process. It is also, however, equally true that broad swaths of people are known to very well tolerate a whole slew of drugs and to experience game-changing improvements. New treatments are in the pipelines, the most exciting of which is a cannabis derivative).
As one of those 'difficult' people myself, I live a life filled with the recognition of my and other's dignity. Far from denying my plenary dignity, medications have enabled it to fulfill most of its natural potential. Prior to meds I was incapable of expressing theory into comprehensible writing; with meds I am doing quite well in that regard. My talents for creative work (which theory requires) have increased, not diminished. Yet whenever I counsel bipolars and their families there comes the usual litany: drugs are dangerous, they will ruin my talents, change my personality, or leave me a zombie. These make good propaganda -- for the under-informed.
Yes, the drugs have side effects. Some people come home from fighting for my rights without arms, legs, or both. They have it worse than do I, yet they cope. Who am I to defend what is frankly just another side of cowardice? I happen to believe strongly in the jural foundations of law and thus in the responsibilities I owe to family, friends, and society.
The late Mike Wallace of CBS and 60 Minutes was diagnosed as a depressive and put on Wellbutrin. Though this drug is well known and well tolerated, it does for some markedly depress libido. On camera, Wallace had this to say (paraphrased): "When my wife and I want to have a little fun, I just go off the medication for a couple days; we do our thing after which I am back on the medication." You play the hand you are dealt -- with dignity. There can never be dignity without responsibility. In mental illness, dignity translates to taking the prescribed medications. The only poison to be dispensed by a rational legal system is irresponsibility. Alice gets the last word -- "If you drink much from a bottle marked 'poison', it is almost sure to disagree with you, sooner or later."
A summary view
The challenges posed by an ambitious article make efforts at simplicity as welcome as necessary, for which the following may offer a buffer against confusion.
Sources in public law germane to enforced medical maintenance vis-a-vis public rights
1) Requirement to maintain structures that prevent damage to neighbors/public (from ca. 700 C.E ., absorbed into tort law).
2) The King's Peace (ca. 1100-1700 C.E.) gave rise to a category of criminal law and presuppose efforts to ensure public safety.
3) Contracts, quasi-contracts, and ad hoc offices ensure completion of desirable/socially valuable objectives while protecting public from collateral damage (ca. 1400-present).
4) Bailment law, properly considered (relative to past and present forms), governs various categories of entrusted interests via actual or ad hoc offices (governed by actual or implied contracts), which presuppose protection of public from collateral damage (ca. 1600-present).
Areas the laws of which are pertinent to mental capacity regarding dignity vis-a-vis rights
1) The consequence of violating any of the above four.
2) Laws limiting rights of those prior to age of majority.
3) Laws concerning rights of the incompetent.
4) Diminished rights of prisoners regarding mental health.
5) Laws against drunk driving.