“We can get stuck in this argument that people with addictions have free will and we should respect their human rights, but the nature of being addicted means we don’t have full free will,” [Dr. Grant Charles] said.
Admittedly, I had to read that a few times out loud to really get it. And still, I don’t really get it. The philosophy of free will is so complex - how can we apply it to the maze that is the mental health care system in Canada?
This week an article from the Globe and Mail explores the debate over expanding mandatory treatment for mental health and addiction in British Columbia.
On the one hand, proponents of mandatory treatment argue that it can be a life-saving intervention for people struggling with severe mental health and addiction issues. They say it’s necessary to intervene in cases where people are at risk of harming themselves or others, and that involuntary treatment can provide them with the support and care they need to recover.
On the other hand, opponents of mandatory treatment argue that it can violate people's autonomy and right to self-determination. Plus, involuntary treatment can be traumatic, and couldn’t it lead to a loss of trust in the mental health system? They argue that treatment should be voluntary, and that people should have the right to make their own decisions about their care.
So, does addiction mean that a person has no free will?
Here is a link to the article.
Another important concern is the potential for discrimination against certain groups, particularly marginalized communities such as Indigenous people and people of colour. There is a risk that mandatory treatment may be disproportionately applied to these groups, who already face significant barriers to accessing mental health and addiction services.
As a Canadian bioethicist, the principle of autonomy might as well be tattooed on my arm, so alarm bells are bound to ring any time I hear the terms “mandatory” and “treatment” put together. Yet, it’s still important to recognize the efforts going into caring for people with addictions and mental illness. I figure - at least they’re trying? Bringing awareness? While long-term solutions are more favourable, they do require significant funding. Once again, money talks.
If you are interested in these related concepts of free will and addiction, check out these two articles below:
‘A philosopher explains why addiction isn’t a moral failure.’ from Vox
There is more (of course) on MAID this week, but I won’t be critically analyzing it in depth, since many of my previous newsletters have covered most of my thoughts so far! I think the information in the following article speaks for itself.
I’ve been thinking for a long time in my career about the limits of beneficent paternalism - in other words, how much can you impede upon someone’s autonomy if you simply mean well? Could you nudge them in a certain direction? Is it ever ethically permissible to gate-keep treatment under certain circumstances? What if you have a moral obligation to them?
As we have learned from the article on addiction above, the line between protection and paternalism is very blurry.
I sometimes have to remind myself of the Ontario Health Care Consent Act when one of my girlfriends is dating an obviously shady character: Capable individuals are allowed to make decisions that you necessarily wouldn’t make for them. It applies in health care, it applies in relationships.
So when I came across this article from the Guardian this morning - I was intrigued.
Do you see the connection? Do you also see the connection to MAID? The debate often revolves around balancing the desire of those in power to improve the lives of the less fortunate, with the risk of overreaching and unduly limiting their freedom of choice, right?
I’ll end the newsletter there for now. I definitely want to think more about it this!
Hope you all have a beautiful, restful weekend. :)
-Nipa
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