Trading Autonomy for Therapy

Dallas M. Ducar
The City Board of Supervisors of San Francisco County is considering implementing a law which would mandate "Assisted Outpatient Therapy," known to many as involuntary treatment of mental health patients on an outpatient basis.[1] This law would specifically target those who have refused aid from San Francisco County. The law was originally passed by the California State Legislature in 2002, however, for it to be authorized the city'sCounty Board of Supervisors must first authorize it locally
more » ... horize it locally and pass a resolution. While 44 U.S States have authorized similar laws, only two counties within California have passed a resolution on Laura's Law. San Francisco County had already denied passage of the law once after public health officials claimed that compelled medication was necessary for Laura's Law to have its intended effect. The law specifically attempts to break the cycle of patients wandering from the streets and then to the hospital or jail, and back again. Advocates for the law claim that it will save the city money in the long-run, and ensure more mental health patients are receiving the aid they require. However, in 2001 the Rand Corporation reviewed the effectiveness of involuntary outpatient treatment and concluded that they could not assertively declare whether the treatment is effective or not.[2] Still, advocates of the law claim that it has the possibility to preclude further calamities, such as the killing of Laura Wilcox, for whom the law is named after, or additional mass shootings. But how effective will a treatment be when the patient is opposed to the clinician? Mental health treatment depends on a fiduciary relationship between clinician and patient, one that is unlikely to form when the patient is forced into treatment. Leaving efficacy off the table, deeper ethical issues are at stake here. While many groups throughout the county have been included in the discussion regarding Laura's Law, one group omitted has been the mental health patients themselves. Perhaps the county should be going to the [...]
doi:10.7916/vib.v1i.6587 fatcat:fwaw3yv6pja7re3an5y3ejbaym