Really unmanageable kids - can you lock them up?

[CaptainPanic]

Today, Dutch newspapers (link in Dutch) mention a case of a youth with a mental disorder (a whole bunch of mental disorders actually: ADHD, a form of autism, fear of bonding, very limited emotional skills, and a couple more). The doctors sort of gave up on the boy.

The boy (age 17 now) has essentially been chained to a wall with less than 2 meters of space to move in - essentially little or no freedom of movement. The reason seems to be that the boy is completely unmanageable. He breaks stuff all the time (voices in his head that tell him to). He is so violent that the nurses are afraid. But he is no criminal. The reason probably is that he never got the chance to do real harm, although that is speculation.

 

In this thread I'd like to talk about how far you can go with this. I do not need to know the ideal situation in utopia, where this kid would have a place to live. I need to know what is ethically acceptable in a society that is in recession, where all healthcare has to reduce spending. Our country, although very wealthy, has to deal with many people with disabilities, and we cannot provide perfect care for everyone. Spending more on cases like this means spending less on others.

 

My whole country seems to disagree with me - and I am pushing this argument a little for the sake of the discussion - but I think that a boy who is inherently violent can be treated in 2 ways: drugs or lockup. This is not a boy who might do something wrong. Doctors seem to agree that it is practically guaranteed that the boy will be violent. I think that it is correct that we spend our money on treating people with perspective. It's very unfortunate, but I think it would be wrong to spend a small fortune to improve the situation of this boy.

 

Am I a beast with poor ethics, or am I making a point and are other people driven by misplaced empathy? And where is the line?

[tomgwyther]

I'm inclined to agree with you. Occasionally you'll hear of a violent murder or murders which it later turns out were perpetrated by someone whom had a history of violent behaviour and mental problems; the first reaction of the masses after such an event is usually

"Why wasn't he locked up/ medicated etc.

Locking him up is the lesser of two evils.

[Mr Skeptic]

Assault, destruction of property... He should be glad we consider him sick.

[lemur]

Today, Dutch newspapers (link in Dutch) mention a case of a youth with a mental disorder (a whole bunch of mental disorders actually: ADHD, a form of autism, fear of bonding, very limited emotional skills, and a couple more). The doctors sort of gave up on the boy.

The boy (age 17 now) has essentially been chained to a wall with less than 2 meters of space to move in - essentially little or no freedom of movement. The reason seems to be that the boy is completely unmanageable. He breaks stuff all the time (voices in his head that tell him to). He is so violent that the nurses are afraid. But he is no criminal. The reason probably is that he never got the chance to do real harm, although that is speculation.

It sounds like he is committing vandalism with the property damage and assault if the nurses are legitimately afraid due to him actively threatening them. My guess is that he is acting out because he feels some frustration with not being able to achieve some social goal(s) but he does not know of any possible method of approaching the achievement of those goals constructively. Has anyone had a conversation with him about what he wants and what he's angry about to motivate his behavior?

 

In this thread I'd like to talk about how far you can go with this. I do not need to know the ideal situation in utopia, where this kid would have a place to live. I need to know what is ethically acceptable in a society that is in recession, where all healthcare has to reduce spending. Our country, although very wealthy, has to deal with many people with disabilities, and we cannot provide perfect care for everyone. Spending more on cases like this means spending less on others.

The economic problems I believe you're are dealing with go beyond cuts in healthcare spending and recession, imo. You are probably dealing with an economy where wealth is redistributed to promote care and leisure, which may be very humanitarian, but it promotes the expectation that care and leisure will be well-funded and compensated. This in turn promotes the culture that if people are getting paid to take care of others, they will do something else for money.

 

Think about what would happen in a REAL recession. People would not have ANY means of making money so there would be relatively few paying jobs. People would have to occupy themselves by attempting to create their own daily welfare. If they had family and/or friends in need of care, it would be up to them to help those people or not. There would be no organized "system" except for what unemployed individuals choose to do (or not) of their own volition.

 

The recession you are talking about is one in which profits from global trade are diminishing, making less imports available for wealthy economies. The budget cuts you're dealing with are people bickering over who should reduce their standard of living. Why shouldn't people who do caring work consume less and accept income cuts if other workers are as well? Why should people stop caring for others in need unless there is some direct material benefit to doing so? Why shouldn't people giving and receiving care also perform other kinds of work, like farming, to provide their own food? They don't have to be slaves to the general population, but if they can contribute to their own sustenance, why shouldn't they be allowed to? The reason most people aren't in modern culture is because work is organized in a way that there is relatively little (if any) freedom to provide for your own needs. If the only choice you're given is to conform to an authoritarian economy or be relegated to a position of dependency on that economy's generosity, how is it ethical to overweigh how to treat such persons? Once you take away someone's freedom, you become responsible for their welfare, don't you?

 

My whole country seems to disagree with me - and I am pushing this argument a little for the sake of the discussion - but I think that a boy who is inherently violent can be treated in 2 ways: drugs or lockup. This is not a boy who might do something wrong. Doctors seem to agree that it is practically guaranteed that the boy will be violent. I think that it is correct that we spend our money on treating people with perspective. It's very unfortunate, but I think it would be wrong to spend a small fortune to improve the situation of this boy.

How do you know this boy has been adequately diagnosed in the first place? You are assuming he is "inherently violent." How would you like it if someone decided they didn't like your behavior so they labelled you "inherently pathological" in some way? Also, why should it cost a fortune to inform this person of his rights and responsibilities and then set him free with the awareness that if he breaks laws, he will face criminal justice? Unless he is incapable of understanding criminal penalties, he should be able to choose for himself whether to commit crimes or not. Maybe he is just acting out to test how much of the criminal justice system he can take. Is he fully aware of the consequences and penalties of his actions?

 

Am I a beast with poor ethics, or am I making a point and are other people driven by misplaced empathy? And where is the line?

To me, the best measure of ethics is to ask yourself how you would want to be treated if you were in the situation of the person you are judging and intervening in his life. If you lapse into thoughts like, "I would never get myself into this situation in the first place," it probably means you're not regarding the person ethically. If you think to yourself, "if I was in this situation and I was given this option, I would find it reasonable and fair," that's a good sign. Then there is the ethic that individuals are not all the same, so if the person is expressing something different from the way you think about it, can you reasonably listen to their point of view and reasonable communicate about your differences and the best way to solve them? If the person refuses to communicate/negotiate and so do you, then you have left yourselves and each other with no other choice but to try to dominate each other with force. When you win, you become responsible for the welfare of the person you dominated because you are taking away his freedom, imo.

 

 

 

Assault, destruction of property... He should be glad we consider him sick.

"Considering him sick" is not (or should not be) an act of mercy for a mentally healthy criminal. Criminality should be dealt with as such and mental health problems as such. There is too much confusion between mental health and social deviance already, imo. Mental illness is when you suffer from inner anguish/pain. Social deviance is when your behavior is judged negatively according to cultural standards of those evaluating you. These are two completely different issues, although they may influence each other.

Edited January 19, 2011 by lemur

[Marat]

The most general social problem of the kind discussed here is that of children born with the results of fetal alcohol syndrome. Because of failures in the development of their nervous system in utero, they are born with a lack of ability to control their impulses or even to discipline themselves in their own best interests according to normal ideas of which actions cause what effects. As a result, through no fault of their own but rather entirely because of their alcoholic mothers drinking excessively during pregnancy, these people are simply a menace to society.

 

Legally, several issues arise here. First, violent acts committed by a child under the age of 12 are 'doli incapax,' meaning they occur at an age before the child can be held legally responsible for what he does, so he cannot be punished. However, people can be detained against their will if they are determined to be a danger to themselves and others, and the state has additional powers to intervene in such cases where the dangerous people are children, because of the 'parens patriae' doctrine, which holds that the state is the ultimate parent of all children in the society if they cannot be reared in the normal family environment.

 

With respect to the diversion of scarce healthcare resources to take care of children such as this, we first have to ask if the entire society represents a rational distribution of resources to answer real human needs, rather than just asking what the rational allocation of resources within the healthcare system should be. Since these children desperately need help for a disease which they did not cause themselves, our humanity requires us to try to help them as much as possible. Remember, the 'scarcity' of healthcare resources in the U.S. arises in a country where billions of dollars are lavished on bankers' bonuses as a reward for having destroyed the economy, so who can dare say in this context that we 'cannot afford to take care of sick children because resources are limited.' Only if the massive waste of resources on luxuries for the wealthy were redistributed to answer basic human needs could we even begin meaningfully to talk about what the real limits to resource availability for healthcare are.

[Athena]

Those were some very thoughtful answers.

 

Where I live we consider it inhumane to keep someone tied to wall, and if parents did that here, they would face criminal charges. Parents were charged for putting a child in a cage temporarily, as a form of discipline.

 

In the far past, such a person would be driven away from the tribe or killed. In fact, this child may have been killed soon after birth if the problem was notice, and I am not totally opposed to this. It is a luxury to keep non productive members of a society alive and care for their needs. Can we afford to do this? I think we can.

 

I remember when we institutionalized such people, and think we were wrong to close those institutions. Anyone opposed to how people were treated in these institutions should work in one, and then recommend what should be done. Turning everyone loose on the streets is not a good idea. Treating a mentally deficient person like a criminal, as we presently do, is not okay in my book. Leaving people who can not care for themselves on the streets and then making it criminal to sleep on the streets, is not rational. We are avoiding the reality of mental deficiency and disorders, and I think this is wrong. Our prisons are an unethical way to dealing with people who have mental disorders.

 

I am in favor of using drugs when possible, and will add to this, those who are a threat to others, unless medicated, should be in a monitored living situation, unless they prove themselves capable and willing to use their medication correctly.

[Doc. Josh]

If someone is going off the (wall) constantly then medication should be required for the personal safety of those around him or her. If meds don't work yes an institution should be the next level. these people have the ability to severly hurt or even kill people, i dont see the reason not to protect society on behalf of morality.