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Involuntary commitment

June 16, 2007

Re "Hiding behind 'free will,' " Opinion, June 10

It is perhaps not so surprising that a physician working in a Venice free clinic and at UCLA's David Geffen School of Medicine does not know the evolution of the laws relating to involuntary commitment of obviously incapable persons like "William."

In a string of cases from the mid-1970s to the mid-'80s, California courts established very stringent limitations on the right of public agencies to commit persons with medical problems of various sorts against their will. As a result, the California Welfare and Institutions Code includes rights and procedures intended to ensure that no one capable of comprehending the commitment process will be incarcerated and medicated, if he or she can express a contrary desire.

Before accusing taxpayers of despicable pocket protectionism, Susan Partovi should perhaps consult with the American Civil Liberties Union, which filed many amicus briefs on those cases.

LISALEE A. WELLS

Long Beach

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The problem with using the standard of "at risk of harming him/herself" as the basis for mandatory medical or psychiatric interventions as Partovi suggests is that it could equally be used to enforce interventions on people who smoke, live on fast food or fail to exercise, many of whom will die at younger ages than William.

Using psychiatrists as gatekeepers does not resolve the matter. Their own diagnostic criteria are often equally vague and subjectively applied. Abuses of commitment procedures are one of the reasons laws were passed scaling them back. I believe that helping build support networks for such at-risk patients is a better solution than a big-brother, therapeutic state.

NICK MCNAUGHTON

Los Angeles

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The word "anasognosia" means impaired insight into one's illness. The part of the brain that has awareness of one's mental illness is not functioning well. This is the problem that Partovi describes so well. Maintaining laws that protect the right to refuse psychiatric treatment is important when free will does not cause harm to others or to oneself. It's time the laws were modified once again so that our hands are not tied when we try to assist people who are not totally aware they need help.

EVELYN GOODMAN

Culver City

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