Mental hospitals of the type I worked at when writing that post only keep patients for a few days, maybe a few weeks at tops. This means there’s no long-term constituency for fighting them, and the cost of errors is (comparatively) low.
The procedures for these hospitals would be hard to change. It’s hard to have a law like “you need a judge to approve sending someone to a mental hospital”, because maybe someone’s trying to kill themselves right now and the soonest a judge has an opening is three days from now. So the standard rule is “use your own judgment and a judge will review it in a week or two”, but most psychiatric cases resolve before then and never have to see a judge. In theory patients can sue doctors if they think they were being held improperly, but they almost never get around to doing this and when they do they almost never win, for a combination of “they’re usually wrong about the law and sometimes obviously insane” and “judges are biased towards doctors because they seem to know what they’re talking about”. Also, the law just got done instituting extremely severe and unpredictable punishments to any doctor who doesn’t commit someone to a mental hospital and then that person does anything bad ever, and the law has kindly decided not to be extremely severe on both sides.
There are other mental hospitals that keep people for months or years, but these do have very strict requirements for getting someone into them and are much more careful.
The procedures for these hospitals would be hard to change.
Hard in the sense that there’s a lot of lobbying power behind the legacy system but that’s not for lack of alternatives.
Prediction-based medicine where one doctor makes predictions about what’s likely to happen when the patient doesn’t get hospitalized and what happens with them when they are hospitalized and then letting another doctor make the decision to hospitalize or not hospitalize isn’t very hard.
Then you fire those people who make bad predictions because they are unqualified to do their job.
I think it’s perfectly fine to require the opinion of two doctors to take away the freedom as taking freedom away is a major move and I think it’s reasonable to require the ability to make accurate predictions about harm to justify taking away someones freedom.
Mental hospitals of the type I worked at when writing that post only keep patients for a few days, maybe a few weeks at tops. This means there’s no long-term constituency for fighting them, and the cost of errors is (comparatively) low.
The procedures for these hospitals would be hard to change. It’s hard to have a law like “you need a judge to approve sending someone to a mental hospital”, because maybe someone’s trying to kill themselves right now and the soonest a judge has an opening is three days from now. So the standard rule is “use your own judgment and a judge will review it in a week or two”, but most psychiatric cases resolve before then and never have to see a judge. In theory patients can sue doctors if they think they were being held improperly, but they almost never get around to doing this and when they do they almost never win, for a combination of “they’re usually wrong about the law and sometimes obviously insane” and “judges are biased towards doctors because they seem to know what they’re talking about”. Also, the law just got done instituting extremely severe and unpredictable punishments to any doctor who doesn’t commit someone to a mental hospital and then that person does anything bad ever, and the law has kindly decided not to be extremely severe on both sides.
There are other mental hospitals that keep people for months or years, but these do have very strict requirements for getting someone into them and are much more careful.
Hard in the sense that there’s a lot of lobbying power behind the legacy system but that’s not for lack of alternatives.
Prediction-based medicine where one doctor makes predictions about what’s likely to happen when the patient doesn’t get hospitalized and what happens with them when they are hospitalized and then letting another doctor make the decision to hospitalize or not hospitalize isn’t very hard.
Then you fire those people who make bad predictions because they are unqualified to do their job.
I think it’s perfectly fine to require the opinion of two doctors to take away the freedom as taking freedom away is a major move and I think it’s reasonable to require the ability to make accurate predictions about harm to justify taking away someones freedom.