The Libertarian Hard Cases, Part II: Mental Incapacityby Doug Mataconis
About a week ago, I began a discussion of what I call the “hard cases” for libertarian ideas with some open questions about the status of children under a libertarian theory of natural rights. The comments to that post, as well as the follow-up Monday Open Thread, yielded some interesting ideas that I intend to respond to in the near future.
Before that, though, the second part of the discussion I wanted to start involves a similar subject — how would a libertarian society protect the rights of adults who are mentally or physically incapacitated and unable to provide for themselves and protect their rights ?
Judging Mental Incapacity
What determines when an individual has become mentally incapacitated to such a degree that they are incapable of making the decisions that people are usually assumed to be able to make on their own ?
In some cases, the determination would seem to be rather easy. An elderly person with full-blown Alzheimer’s Disease or some other form of dementia, or suffering from severe brain damage after a stroke, would clearly seem to fall into this category. Persons in that category are clearly suffering from some form of brain damage as a result of illness or injury that has left them without the ability to think rationally.
But what about some of the other forms of mental illness that we’ve become familiar with, such as schizophrenia ?
There are those, such as Thomas Szasz, who would argue that these “lesser” forms of mental illness don’t exist at all and that forced hospitalization of people that psychiatrists and psychologists refer to as “mentally ill” is a form of state-supported imprisonment of someone who hasn’t committed any offense other than behaving strangely.
On the other hand, there is the argument that someone who is a danger to themselves or, potentially, others should not be permitted to simply roam the streets without being treated.
Leaving Szasz to the side, is there a libertarian argument in favor of forced treatment of the mentally ill, and, if so, under what circumstances should such forced treatment be permitted to occur ?
The Role Of The State
There are issues that come into play here that are similar to those that arise with children. Who is responsible for the care and safety of a mentally incompetent adult ? The first choice is always the family, obviously, but, just was with children (and perhaps even more so here) the potential for abuse and neglect exists — not to mention the fact that many families may not be able, financially or otherwise, to do everything that needs to be done to provide for a person in this condition.
At what point, if ever, should the state step into a family situation such as this and say that the family is not acting in the best interests of the incompetent adult ?
There are several other issues that could fit into this topic — most notably the issue of insanity and criminal responsibility, which is worthy of a post all it’s own — but this should be enough to get things started.