Who Is Responsible?

Post Reply New Topic

Families, Churches, Businesses or the State? Which should be charged with taking care of individuals who can not take care of themselves?

"Families" means parents, siblings, and offspring.

"Churches" also includes any not-for-profit religious institution or "House of Worship".

"Businesses" includes any for-profit corporate entity that is not an individual.

"The State" includes municipal, county, state or federal governments.

It should be a shared responsibility of all of them to the extent that they can afford it.

I voted other, partly because I believe it is the responsibility of both the Church and families, and also because I believe that it is also partly the responsibility of everyone - not as something that they should be forced to support, but as something that is a morally good action to do. But I think people have a duty to their family members (usually, assuming nothing has been done to break this), and the Church ought to practice true religion, caring for the orphans and widows, and indeed anyone who cannot help themselves.

It does get me quite riled up when I see statistics that claim that 10% of the population are regular churchgoers, and a good fraction of them Christians, because I don't see the sort of society that I would expect from those statistics. If 10% of the population claim to follow Christ, there should be no problem finding good homes for children, and women who are considering abortion should be able to know that there will be a loving family waiting for the child if they choose not to abort. There shouldn't be homeless people, unless they've made that choice and refuse any help offered. There shouldn't be lonely old people who no-one ever comes to visit.

Idealy, the community but since they generally haven't been built yet. The state for now.

I put State.

While Family is the default, sometimes this is not possible and other times it is dangerous to the person who can't take care of themselves. Giving the State the responsibility makes Child Protective Services (as it is called in the U.S.) and public education possible. Parents are the default but the State can override the parents if the parents are found to be breaking negligence, abuse or truancy laws.

When a person who can't take care of themselves is an adult, Family is preferred default but is frequently just not possible. The person who can't take care of themselves is likely to outlive their parents and even prior to that is likely to outlive their parents ability to be caretakers. Siblings don't necessarily even exist as potential caretakers. Then there is the matter of abusive or negligent family taking care of a disabled adult. The State should retain the ability to remove the disabled person from that situation.

I framed this all as Family/State. I don't think Church and Business are relevent to this. Churches often do collect charity to take care of people who can't take care of themselves and some have done it to a great extent. As far as I know, they actually preceded the State in doing this and by centuries. But charging them with that responsibility means they have to have enough members to actually always be able to do that which makes atheism/agnosticism or even unwillingness to donate a literal threat to disabled people. That is not a safe situation. It forces religion to be Statelike. Religion actually was Statelike throughout much of history and still is in many places. And as such they did set up a lot of care facilities. But depending on them keeps people tied to religion.

All of the above. We all should look after our brothers/sisters.

We just all need to be a little bit less selfish.

Actually, I'll take the state off that list. State assistance just gives the others an excuse not to help others.
People will just make the excuse, "well, I pay my taxes, so I've already done my part. let them go on welfare."
But tax money goes into one big pool and gets improperly divided up into the various programs & departments.

If people, churches, businesses, & non profit orgs we're the only way to do charity, then the assistance would be more direct to those who need it and less would be lost in administration. The state just can't be trusted to manage anything properly, it is incompetent.

By default, or by reason?


In practical terms, why should that be the case?

Personally, I think that the family should be the first to step up -- siblings, parents and children -- and the State should step in only when the family can no longer support one of their own.

I hadn't included "Community", since the only community I had when I was homeless was other homeless people, and they were in no position to support themselves, much less to support anyone else.

No one has selected "Churches" or "Businesses" yet ...

are you asking who really is responsible? if it is good and right to abandon the useless on a mountain to die, it is because we agree that it is. whoever decides to take responsibility is responsible, or whoever we decide to give responsibility to is responsible if they agree to go along with it. it's a matter of desire and consensus; there's no fact of the matter, as far as i can tell.

It all depends on the individual and their situation. In some cases, it's better if a dependent individual is taken care of by their family, in other cases it's better if they're taken care of by a state-run program.

The churches would have religious expectations from the individuals.

Buisnesses operate within markets and giving too much would hurt its bottom line.

The state is a great source of help in this context, becuase its impossible for it to go bankrupt.

But the community should trimph becuase, states behave irrationaly and will randomly dicide to pull the rug while you are not looking. We have natural emotions like solidarity that can be revitalized.

I believe the trigger for this thread is the Kelly Thomas case, the man who was beaten to death who had schizophrenia. Because of the recent focus on Kelly Thomas, the focus of what I am saying is going to be on the United States. It seems that many here are not aware of this historical context, so I will share it; in this context, schizophrenia has been the most important mental disorder. If I recall correctly, a diagnosis of schizophrenia used to mean a lifetime commitment to a state-funded mental hospital in many cases (think early to mid-20th century). In those days, psychiatrists had great power to permanently institutionalize individuals against their will. Since schizophrenia usually has onset in late adolescence to early adulthood, this would often mean decades of productive years lost, and with schizophrenia generally occurring in 1 out of 100 of the population a heavy loss of productive capacity and need for the state funding the hospitalization. Now what is schizophrenia? Schizophrenia is a neurodevelopmental disorder in which the patient may lose contact with reality, their speech and behavior may become disorganized or incoherent, and the patient may have problems with negative symptoms (a loss of functions that people normally have), to include problems with interacting socially (social withdrawal, difficulty acting appropriately), impaired emotional responses (either inappropriate or blunted, flat), being able to speak very little, and major problems with initiating and following through with actions. Cognitive problems often accompany schizophrenia, with possible major decline in IQ scores as measured at onset, and deficits in attention, working memory, verbal fluency, and other areas. (In some ways, the negative and cognitive symptoms of schizophrenia are actually a bit like autism.)

Antipsychotic medications were discovered in the 1950s, which treated the psychosis (loss of contact with reality) and disorganization (in both speech and behavior). This was a great boon to the treatment of this previously very-difficult-to-recover-from disease. Antipsychotics weren't perfect, however, and many issues still remained in patients, particularly the negative symptoms and cognitive problems; some patients responded very well and some did not respond at all. Antipsychotics could come with very unpleasant side effects which, if ignored, often lead to noncompliance; these include somnolence (excessive sleepiness) and akathisia (dysphoric restlessness). With these improvements in outcome for patients, advocates began calling for deinstitutionalization (i.e. not keeping patients locked in the hospital for decades against their will anymore) and for the state to limit the powers of psychiatrists to involuntarily commit patients to mental institutions, citing individual liberties. Under the Kennedy Administration, the main proposal was to release most patients from institutions and to provide services for them post-release in community mental health centers. This would allow patients to live independently in the community while receiving support that helps fill in the gaps of their ability to care for themselves while enabling to work, for example. In the 1970s, the Supreme Court limited the power of the states to commit people with mental illness against their will, citing Constitutional concerns. With things like the Soteria Project, there were also efforts to individualize care among patients.

Unfortunately, this was not implemented very well at all. The community mental health centers were poorly funded, as many states thought that with deinstitutionalization they could try to cut costs and skimp on the mental health care. Many of the community mental health centers went more for treating the easier cases, like those of OCD and patients with schizophrenia fell by the wayside. Because of NIMBYism, many resources for people with severe mental illness tended to be placed in bad neighborhoods, where the patients would be exposed to the dysfunctional social elements of society and given the message that they were to be shunted to the outside of society. As well, 30%-50% of patients with schizophrenia, due to the nature of their disorder, do not have insight and do not see themselves as having a disorder or as needing to take medication. (As alternatives to medication and hospitalization, Soteria houses appeared, but never received widespread funding or had widespread coverage of the population. There was some effectiveness found in those cases where such an alternative was required, however.) In the end, due to the dysfunctional social and emotional aspects of schizophrenia along with the lack of effective support, many ended up on the streets, with a 3rd to a half of those homeless suffering from severe mental illness from the 80s on; because of the confusion and agitation that result from the disorder, many would be charged with petty crimes and end up going between jail and the streets. Because of abnormal social approach occurring in many cases, they may also get into conflicts with the police in ways similar to autistic people, with essentially misunderstanding leading to misunderstanding and confusion and struggle, resulting in often longer prison terms in those cases.

Personally, I think we still need to give this idea of community support a shot. We need to work on not skimping on the hospitalization times; patients need to be both stabilized on and acclimated to the drugs they are going to be receiving, often for the rest of their natural lives. We need to provide alternatives for patients who lack insight and/or refuse medication, such as through the Soteria Project. In this way, we can take an individualized approach to treatment, giving more power to the patient and reducing the use of coercion. When patients are released, they need to have mental health support and follow-up and should not be shunted to the bad neighborhoods. The public should have better awareness and understanding of severe mental illness, and this includes the police themselves, to prevent these horrible outcomes from occurring. We need to give these proposals a serious shot.

In a way, this would require the participation of all of society, including the state, so I would put "Other."

It definitely needs to be a collective effort.

This was a good resource on schizohprenia and gave some information on the disorder and its socioeconomic impacts (emphais added):

http://www.nimh.nih.gov/about/director/ ... enia.shtml

I would say all of them. Preferably families should be the first fall back for their members. Voluntary organizations like churches clubs and foundations could be another layer of support. The last resort for those who have no families or living associates should be the State.

I think leaving people to starve is to invite violence, insurrection and crime.

ruveyn

This is pretty much exactly what I was going to write.

Here is a recent article from Schizophrenia Bulletin, a widely-cited medical journal with a focus on schizophrenia published by the Oxford University Press, on the need for greater emphasis on Soteria:

http://schizophreniabulletin.oxfordjour ... 1/181.full