Mental health experts say a new tougher New York state gun control law might interfere with treatment of potentially dangerous people and even discourage them from seeking help.

The law would require therapists, doctors, nurses and social workers to tell government authorities if they believe a patient is likely to harm himself or others. That could lead to revoking the patient's gun permit and seizing any guns. (source)

New laws tend to have unintended consequences worse than the conditions or situations they are intended to remedy. The hysteria over the Sandy Hook Elementary School massacre has such strange bedfellows as the NRA and some of the most liberal Democrats calling for psychological or psychiatric evaluations of potential gun owners. 

Question: Does the state have enough of an interest to require a breach of the privacy normally holding between a patient and his clinician making the state an invisible presence in the conference room?

Question: Might more mayhem be prevented by letting clinicians do their job rather than imposing requirements on them.?

Question: Might imposing a reporting requirement on clinicians expose them to homicidal danger once the client realizes that his counselor has breached the shell of confidentiality holding between them?

Question: Given the ambiguities holding between what clients talk about and what they might actually do might a reporting requirement expose clinicians to needless criminal and civil sanctions if their best guess turns out to be wrong and a client they thought safe did something horrendous? The point is, it's a lot easier to judge how dangerous a patient was in retrospect and hold a clinician responsible.

Tags: control, gun, psychiatry, psycology

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And...we haven't reached the age depicted in Minority Report where we arrest citizens based on a profile indicating they may commit a crime. We all have a right to remain free unless we lose that right through an act of our own or through the evaluation of an expert that we cannot control our lethal impulses, bearing in mind that such evaluations may lack deterministic certainty with a very high likelihood of both false negatives and false positives.

Rights are not absolute, and rights can be overridden. 

That's true. Rights are not absolute. Somebody made them up although many would say rights are God-given. If we make up rights, then a right can be anything the people in power decide it is. So a right can be taken away, meaning it's not absolute.

For example, certain rights are overridden when a person is arrested.  If someone has been proven to have a mental illness, then their "rights" to guns can be overridden. 

That's what I mean by due process of law. You generally lose rights in criminal court by becoming a convicted felon, for example. Or when Presidents abuse the 'state secrets' privilege and take them away without your knowing.

Gun ownership is a right. But I don't think gun ownership ought to be a right. I think people should be allowed to own guns albeit with numerous restrictions on par with those associated with driving. Likewise, I don't think motoring or smoking ought to be rights, but neither do I want them banned either; only heavily regulated.   

If you tell people that rights result from some sort of legislation (in a democratic society) or dictum (in a dictatorship), they nod their heads in assent. When you utter the obvious corollary, that whatever human rights exist aren't inherent in man but are the result of some sort of legislation or dictum (e.g., a vote of the United Nations), their faces go white. All rights are one of two things legislated (counting dicta as a form of legislation) or imaginary. Mostly, they are imaginary. Something we aspire to, but that's not nothing.

But is that right...is it safe?

According to the college of Physicians and Surgeons (Canada):

The Personal Health Information Protection Act, 2004 (PHIPA) permits the disclosure of personal health information to prevent harm where certain criteria are met. Additionally, there are court decisions that set out separate and distinct criteria for disclosure by physicians where there is an imminent risk of serious bodily harm or death.

Furthermore, in Canada, there is a strict screening procedure that is done before anyone is allowed to purchase a gun, and handguns are strictly regulated.   Not everyone is allowed to "bear arms" here.

I agree that if there is a risk of serious harm or death, a clinician should be obligated to report it.  By doing so, clinicians would be doing their job, and reducing the mayhem. 

Doctors, psychiatrists, police officers, etc., are always at risk, and they know that.  It is also their duty to prevent the "mayhem" that you speak of.  Without them, there would be chaos. 

Oh, and I guess that, in Canada, if a clinician feels that someone is, a la Minority Report, on the verge of committing some crime of violence, they can take these person's freedom away indefinitely(?).

What about the unintended consequence, often argued, that you might, taking the long view, actually increase violence because people having such feelings and knowing the law will simply not expose themselves to indefinite incarceration?

Where is the line in the sand between sane and insane?

Who decides where the line belongs?

What criteria do they use?

Am I free to disagree if they draw the line between me and them?

As an Australian, I"m grateful for our gun laws.  Check out the statistics.

As to paedophiles, they don't deserve to breathe.  I know what "grooming" did to a member of my family.  Paedophiles shouldn't have any rights.  MAKO gave me peace of mind....they have the guts to name and shame those convicted.  I had the person listed there because he is a convicted paedophile.  

I feel for you and acknowledge your need to feel the way you do, but...

I knew a pedophile for many years who one night confessed to me about how he had these feeling and how tortured he was over them. So far he had done some very "mild" indiscretions with kids, things that could be considered innocent in nature taken alone. Some of these things were directed towards my child. Nothing he had done so far caused any of the kids any emotional harm. But he admitted to having the urges and was desperately trying to find some way out.  And I was moved by his tortured confession to me. Shortly after this he was arrested and convicted of several various counts. This was fifteen years ago and I do not remember the details, but in no case was there any sexual act, only him allowing himself to be in a situation where he viewed children undressed and was aroused by this. But enough had happened for the people to become suspicious and tip off the police who seized property and found child porn on his computer and hard copies. This was enough for him to spend 15 years in jail where he has been beaten and raped by inmates. He wrote me a few times asking for my forgiveness and understanding. BTW, my son had no idea anything unusual had happened. He had undressed in front of him, but that was all.

Now this man was tortured by his unwanted feelings and knew they could not be acted on without harming innocent people. He refrained from doing so by most standards, yet the automatic hatred people have of pedophiles makes him a total outcast and the very definition of evil. Does he deserve this? He did not ask to have these feelings and wanted free of them.

And by writing this in his defense, I will and have had people attack me as if I am just as guilty as if I had raped a child myself. This is not as simple an issue as it seems, nor are the cases of gun violence. My daughter was a student at VA tech when the Cho shootings happened. But for a scheduling problem, she would have been in the class where most of the kids died. As it happens, I was seeing the same psychologist that had evaluated Cho earlier before he shot all those people. I asked him about this and he said that Cho seemed no more dangerous than I did. (I was seeing him about depression from having severe chronic pain). So really what could he have done other than to have locked both Cho and I both up, something that is very difficult to do under Virginia law thankfully. (He violated a bunch of rules by even talking to me about it, but I am glad he did and if for some reason someone who cares reads this, I am making it all up, he said nothing.)

My point is this: We as a society are not going to be able to stop bad things from happening, even if we take away everyone's rights and privileges. The only thing that will change is that we will not have any rights. Tonight I am contemplating my future (or lack of). The reason I am in this situation is that I have an unknown illness that is causing me terrible pain. It is somewhat controlled by narcotics, but narcotics, according to popular opinion, has been so abused that anyone taking them is now under a microscope as are the people who prescribe them. So tonight I am contemplating the day when I can no longer get the pain meds I need to make my life worth living anymore, and that day is coming soon unless some miracle happens. I never dreamed I would be in this situation and would most likely not care much if I had heard that someone else was. This is human nature. But it sure seems a shame to me now that  my life has most likely ended. I had a lot yet to give. It's not fair, but then it is not far that this guy was born with warped sexual drives, or that Cho was made fun of, or that your friend was preyed upon. God should do something about this, but as he seems not to care, we need to do our best to step outside our own shoes and see as much as we can from all perspectives, then very carefully make the changes necessary so that people like me do not unnecessarily go down in agony, or get beaten to near death for fighting against his unwanted urges, etc. A good start here is to alway live by the rule of never being motivated by the desire to punish. Prevention and punishment is seldom the same thing.

It's so so easy to make things worse...so hard to do even small improvements. I remember as a kid hearing the idea that ten guilty men should be let free to keep from having one innocent man condemned. This principle seemed odd until I got older and saw how easy it was to destroy people in witch hunts. Now after all these years of sleeping soundly believing this principle was firmly entrenched in the laws of nations, I find it has been totally abandoned. Again, this is human nature and will continue to be for long after I am gone. My wish tonight is that each and every person that reads this will never have to experience being sacrificed to the mob, will never get sick, will never suffer. But if this cannot be, then at least I hope we all find the dignity to instead of looking for someone to punish, we learn to look for someone who is suffering and we try to make that person's existence as much better as we can even of that person has just done us wrong. When each and every person has that goal, no one will every lack a hand, no one will ever be alone and what suffering remains will be greatly diminished.

Good night everyone,

Be Well,

HoP

Where is the line in the sand between sane and insane? Who decides where the line belongs?

Ultimately: heads of state, legislatures, and courts of law.

What criteria do they use?

There's no "insane" designation but legal standards have been set for determining states of mind, such as who is mentally competent to stand trial.

The American Psychiatric Association has diagnostic criteria (published in the Diagnostic and Statistical Manual of Mental Disorders) for identifying mental disorders. That includes potentially dangerous disorders such as sociopathy. Courts and legislatures generally accept this kind of testimony when deciding how the law should apply to it.  

Am I free to disagree if they draw the line between me and them?

Once it becomes a legal matter yes. You generally have the right to challenge such legal designations in court. 

"Does the state have enough of an interest..."

I don't know, and I am not sure that there is a clear or practical demand from the public which the state supposedly represents. I'd say it is unethical, but the state's interest and ethics don't always seem to go hand in hand.

"Might more mayhem be prevented by letting clinicians do their job..."

My suspicion is yes. It seems that a number of these mass murderers do try to reach out for help in some form or another, but it often isn't there. Mental health resources are already taxed, and I doubt there is any readily identifiable 'rampage shooter' trait which would expose itself on cursory examination. A policy like this will tax mental health resources further, not enable them to perform better.

The other issue is what happens after reporting an individual. Congrats! You're a psycho. We're watching you... but not really because we don't have the resources to meaningfully deal with you as a potential threat.

"Might imposing a reporting requirement on clinicians expose them to homicidal danger..."

I wouldn't assume so. Even if it earned resentment, I don't think it would make the clinician a priority target. Perhaps it depends on how reported individuals are treated.

"Given the ambiguities holding between what clients talk about and what they might actually do..."

It is a problem already. I think society is too quick to heap liability on others. A mental health professional does bear responsibility for their own performance, but their job is not to stop murders; their job is to help patients. This isn't Minority report. We cannot confidently declare pre-crimes. There is a world of difference between a patient saying 'I fantasize about killing my husband' and 'I plan to kill my husband'. With the former statement, I don't think it is reasonable to expect the clinician to predict an actual murder. Sure it sounds obvious in hindsight, but I'll bet plenty of people have such fantasies and hardly any of them ever act on those impulses.

No you're right unfortunately here on the local news they reported that gun sales went up significantly, because people who thought they might like to have a gun thought that now would be the time to buy one.  They also said that that is worrisome because a lot of the people who did buy one or more guns have no clue how to use or store them. I mean this whole thing was nuts.  Why does any person, save a person who works for the military, or the FBI or something need a multi-bullet shooting gun.  I do not need a gun that shoots more then one bullet to kill a deer or a robber!

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