I have a black thought on this. I would be happy if someone corrected me. When something breaks, sometimes we repair it, sometimes we throw it out. The more valuable the item, the more we will spend to fix it. However even with the most valuable items, we sometimes reluctantly decide that it is broken beyond repair. Are people like this? Are some simply too broken to fix? I feel awful thinking this, but I wonder if there is some truth to it.
“Many that live deserve death. And some that die deserve life. Can you give it to them? Then do not be too eager to deal out death in judgement.”
What is a broken person? since we're all fallible beings ourselves, who could possibly decide that someone is broken beyond repair? It doesn't matter if there's truth to it.
There's a big difference between judging someone unworthy of life and acting to kill them, and judging that someone is not worth the energy and struggle to fight against their own drive to throw themselves off a cliff.
We're not collectively strong enough to save everyone. Getting strong enough is a goal to aspire to, but the dark reality is that in our state of weakness, we need to prioritize what we struggle to hold onto.
Not acting and letting them destroy themselves can be worse in many ways to them and others around them rather than "acting to kill them".
This is a hard truth, I am not advocated mercy killings but doing nothing to help them can be worse in many than doing something for all involved, which is why most advocate for doing something to help even is it seem futile, sometimes its as much for everyone else than the person receiving help.
Ultimately there's a never ending ethical conversation of when or if one ever has a duty to act to help others. I'm inclined to be believe there's a lot of cases where you ethically do have a duty to act, but we're not going to resolve the debate of where that line is here.
But there does exist a practical limitations to what you can do to save someone. A key rule of any kind of emergency response is to always prioritize your own safety first, because if you don't you risk creating an additional victim and making the situation worse for everyone. That can be an incredibly hard thing to accept when you see someone suffering and dying, but it's the truth.
If you jump in the water to save a drowning person, there's a high chance in their panic, they drag you down and you both drown.
I always remember this phrase, from Harry Potter, when thinking about death:
"You are the true master of death, because the true master does not seek to run away from Death. He accepts that he must die, and understands that there are far, far worse things in the living world than dying.”
A little bit pessimistic, but lifelong suffering might be worser than dying outright.
I think societies had a simple curve for this. They help, help a bit more.. but after some time they drop the ball. Most average people have no clue anyway so they are powerless about the whole thing. People who know more may be able to go further in their efforts, but even then you're never sure you can carry someone like that for long. Even though .. I dearly think that most suicidal people only need a root deep emotional connection. Way too often people respond to shared pain, real empathy, understanding, trust ..
There are, certainly, medical situations where we cannot fix it, and we let them go. In fact, most of us will meet our end in such a way, eventually. The difficult thing about mental illness, is that we know so little about how it works (and much of what we think we know is incorrect), so that the solution might be really close at hand, but we haven't found it yet.
We know when someone's physical health, for example a rapidly spreading cancer, has passed the point of no return. We don't understand mental health well enough to know that. In rare cases, of course, like brain damage from trauma that leaves the person in a vegetative state, we know that it will never get better, but in cases like this article I don't think we ever know one way or the other.
Objectively, it's possible to be "too broken" to be fixed (e.g. acute blunt force trauma, malignant tumor, etc.) where the only "fix" is palliative care. Although, I think technically we would say: "too broken to fix based on our CURRENT tools, knowledge and resources". It's an interesting thought experiment to think about how advanced can we become where anything is fixable?
In addition, this gets complicated VERY quickly; it's relatively easy to say "This leg is broken; it is not right; it needs to be fixed and changed for better".
With mental illnesses though, it's difficult to comprehensively, objectively, universally define "right/correct/well" and "broken/incorrect".
We all perceive the external world through a faulty set of sensors and interpretations which trigger some mental processes and reactions. It's difficult to mark some such perception/processing as "broken, not worth living". My gut feel is that it's more about finding appropriate environment.
Additionally, non-living items are frequently judged based on their utility; "too broken to fix" is related to "cheaper to replace than to fix". With human beings and mental care - not only is it hard to define "Broken" let alone "too broken", it's far harder to define "not feasible to repair" - though of course, when it comes to public policy, such choices are made daily, by necessity. Only so much money to be invested into so many programs.
And while I'm rambling, note that myself, and many others, there is an inherent double-standard: my threshold for myself being too broken to fix is far far lower (and I'm a massive proponent of voluntary euthanasia, for myself) than for others (I don't want anybody in my life to leave ever)
There's a decent Stargate Atlantis episode along these lines called Miller's Crossing. The chief scientist McKay gets kidnapped along with his sister (herself a brilliant scientist) by a billionaire trying to use alien nanite technology to cure his daughter of leukemia. In order to incentivize McKay to cooperate and fix the nanite coding, the guy injects McKay's sister with the nanites.
McKay figures it out but the daughter ends up dying because, although the nanites cure her leukemia, they also cure an undiagnosed heart murmur by stopping her heart and repairing it thus depriving her brain of oxygen and leaving her braindead.
They didn't have much time to explore the philosophical implications (sadly far too common for these scifi shows) but the rest of the episode is a race to disable the nanites before they try to "fix" the sister's epilepsy, including breaking her bones to create work for the nanites.
The only type of nanites in the SG universe that could repair a human being without causing crippling unintended consequences were hyper-intelligent replicator nanites that were hell bent on destroying humanity because they had abandonment issues.
Mental illness is not contagious and it is not entirely learned either. By fixing it, you are changing the physical substrate of the mind. Did you fix anything at all? Or did you destroy one mind and create a new one in its place.
Ignorance is not contagious and it is not entirely learned either. By teaching anyone anything, you are changing the physical substrate of the mind. Did you fix anything at all? Or did you destroy one mind and create a new one in its place.
That's not how it works in real life. Family (and maybe generous government healthcare) will take care of "too broke" to give any yield, in the future, people. Anyone else who isn't lucky to have that kind of support will find himself in the streets.
And that's fine. Societies can only function if the yield from the people it invested in is higher than the investment. This is why socialized healthcare is tricky. If you invest too much, you might be wasting resources and endangering all of your society. If you invest too little, you might be leaving people who would otherwise be productive once the investment is made.
> Are some simply too broken to fix?
There is no one too broken to fix but how compatible people are with their environments. A duck will leave its baby if it thinks it can't cross the river. Its brothers did cross, and thus it has to go forward, carry on and leave the weak behind. On the other hand, if the duck was living in your backyard and eating from your food; it would not have to do such a difficult choice. Its baby will not need to cross any river and thus it'll keep taking care of it.
> I feel awful thinking this, but I wonder if there is some truth to it.
It's life. Netflix has great series (Planet Earth) that you can watch. We are not really different from animals, we just happen to live in a different environment.
> And that's fine. Societies can only function if the yield from the people it invested in is higher than the investment. This is why socialized healthcare is tricky. If you invest too much, you might be wasting resources and endangering all of your society. If you invest too little, you might be leaving people who would otherwise be productive once the investment is made.
This is quite evidently not how most socialized healthcare systems work. Thankfully so, because you paint a nightmarish picture of people being left to die or suffer if there is no hope of them recouping an investment in their health. In fact, taken to the logical conclusion it would mean killing retirees instead of paying them pensions (imagine what society could spend all that money on, right?).
> In fact, taken to the logical conclusion it would mean killing retirees instead of paying them pensions (imagine what society could spend all that money on, right?).
only a logical conclusion in a very simplistic sense. if you kill all the retirees, it will be hard to persuade the working population to produce any surplus.
>> This is quite evidently not how most socialized healthcare systems work.
This is how socialized healthcare systems work. In an ideal world, everyone would get the healthcare they needed whatever the cost. We live in a world with finite resources. A single payer healthcare system is not free from these constraints.
The British socialized healthcare system for example will allocate up to $25K-$40K to buy a year of healthy life.
> [National Institute for Health and Care Excellence] uses a unit of measurement called the "Qaly" - the "quality-adjusted life year". It gauges drug effectiveness in terms of how much it would cost to give you a year of healthy life.
>[National Institute for Health and Care Excellence] aims to spend less than £20,000 to £30,000 per Qaly. That is not a hard limit; it will go almost twice as high for end-of-life drugs [1]
> The British socialized healthcare system for example will allocate up to $25K-$40K to buy a year of healthy life.
"a year of healthy life" != "a productive member of society"
GP talks about "yield" from people as a measure for whether to help someone, which is decidedly different from Qaly. Yes, healthcare puts a price on life (it has to). No, that price does not primarily derive from the productivity of that individual.
You could """optimize""" society by spending more on healthcare for able-bodied than for "unproductive" people, but walk too far along that road and you get euthanasia.
> In fact, taken to the logical conclusion it would mean killing retirees instead of paying them pensions (imagine what society could spend all that money on, right?).
I'm strictly talking about people who are getting support but didn't chip in. Most retirees have saved up for their pension in the past, in the expectation that they'll get it in the future.
Yes. It's well known that someone with, say, Down's syndrome may need a full time handler and is extremely unlikely to be a productive member of society (they'd need to be twice as productive, to make up for their handler).
Many couples when informed of Down's risk choose to abort.
We're not talking, in these instances, of someone who is mentally able but with a mobility issue, we are talking about people who will never contribute to society. That's money taken away from you, not some billionaire.
That said -- rounding up people and killing them is insane. But failing to test for birth defects and not working to prevent them is also insane.
Some ways this thread is going are kind of concerning, like, we don't know why people are depressed, so doing something like selecting against people who are liable to be depressed is probably a huge mistake. We could end up with generations that are poorly equipped to solve problems under pressure, etc, or whatever depression may naturally exist to help the host do.
Could caring for these kind of people have a utility in helping us think about compassion, and our values in a more broad way, that enables not making sub optimal decisions in cases that would have negative returns.. To use this thread as an example .. if we were in a society that was black and white utilitarian about one type of disability, it might lead to that thinking being applied directly and 'naturally' to this mental health issue also.
Maybe? But there are cases where the answer is either "no" or "it's too expensive." I've interacted with people with very serious mental disabilities and while it's not necessarily a negative experience you can usually tell the parents are lying to themselves when they say they enjoy their life.
If you create a hypothetical where the outcome is bad then I am not surprised the outcome is bad. You need to find something more concrete. I actually gave one: selecting against something nebulous like depression may have deleterious effects on the human germline leading to our own extinction. There's evidence that depression aids in avoiding potentially deadly stressors and increases problem solving ability.
It is not that we are too broken to fix, people are just afraid of us because we reveal the fragility of the mental state. And people are just greedy as well.
I do not ask for much help, all I need a simple place to live. A studio or something that is clean. That would help me so much. But all they build now are luxury studio apartments. Most of us would be fine with some stability. For the more serious cases we should bring back the institutions that they dismantled in the 70's.
I don't think your example works - when a valuable item is broken beyond repair that is a fact (based on known physics / science). If I snap a ruler into two pieces I know there is no way to bring it back to the state it was originally in - a single piece. We can glue it back and use other mechanisms but it won't be exactly the same - we know this definitively. The same cannot be said about mental illness.
We do not have the knowledge and science to make such a statement about mental illness. In fact, medical science and research shows the opposite, that we are learning more and getting better at treating mental illness.
Mental illness is usually not a downhill spiral to death, but a roller coaster that you can jump out of. Your perception of being beyond repair depends where on the roller coaster you are.
I don't think there is such a thing as broken beyond repair. How would you even begin defining that? If you're thinking in economic terms then sure, we can try to optimize a limited budget to save/improve the maximum number of lives. It would still be beneficial to have at least a few people look into whether new methods can be developed to increase the amount of "good life" you get per dollar. Giving up and deciding something is beyond repair can be one course of action in this optimization, but it seems counter productive, and perhaps a bit unethical, to try and generalize this position. Having the thought, and the discussion, is obviously totally fine.
A burnt match is broken beyond repair. And certainly there are human medical conditions which presently elude our technical ability to "repair" them. Rabies is a good example; if we didn't have the vaccine for it, then I think it would be pretty clear that an infected person is broken beyond repair.
Well, there's the estimated work to fix and then there's how ... "valauble" someone is. It's an invisible measure: a little bit of celebrity (or how many people know you), some kind of reputational Whuffie (will they be missed?), a dash of disregard for age("he was so young" versus "it was his time"), some men versus women as kind of a global score, then you have individual removal. As an example, were Taylor Swift were pursued by the black dog, wallets would open up for suicide prevention, but some loathed yet similarly known figure not so much.
Whatever it is, the never-to-be-acknowledged issue that for many, people "care" to an extent that is materially indistinguishable from not caring one bit. Most people give advice with no skin in the game and no penalties for being wrong. Who wants to face the question, "What if it didn't get better?" What if you convince some miserable twenty-something that it gets better, as the platitude goes, and some fifty years later, no, it didn't, that their life was one terrible slog through stone-faced despair, lest we "affect loved ones" via the taboo of picking the time we board the train to Endsville? Whoops, sorry about that, we guilted you into suffering for half a century so we wouldn't have to look at you. Someone who would have done a Richard Cory instead ends up like Giles Corey, and it was just one more weight on the plank crushing them down, but gosh we feel good about saying the right thing.
I have grown very close to a woman I met online. She is extremely intelligent, but I could tell she had issues. I did not know how severe until we finally met, at my insistence.
I knew she had depression and anxiety. ADHD. That she had trouble getting things done, trouble making decisions, overall trouble functioning but on top of this, she cannot take care of herself hygienically, has a severe problem with hoarding and basically spends much of her waking moments crying or feeling scared/panicked.
She also is clearly autistic though she insists she is not.
At the same time, she is extremely sweet and has a strong sense of justice. She is truly a good person, I have never met anyone so honest. It's sad that we cannot make space for people like this in our society. She asks for so little to survive.
I know I will take care of her for the rest of my life, but of course I know there are other people like her -- if she exists, there have to be others.
She cannot work. She can barely function to take care of herself, and in some ways she cannot even meet that standard. She also lives in another country, so what I can do is limited and sending money helps but it doesn't help enough.
I think she cannot be fixed but I would like to hope there is still a chance. She (and I) are relatively young, in our 30s.
If you think about it coldly, that's probably true - there are a bunch of different human-mental states, why would all of them be reparable? It's more likely that some are and some aren't. But all of this is difficult to measure so regardless of what state you're in, you do the best you can with what you have.
You’re not a bad person for thinking it, there’s a surprising about of nuance in the handling of life, things like “mom’s suffering brings us no comfort” and then mom’s long term hospital stay is reduced when she dies quietly in her sleep.
I, for one, would like to normalize what is often called "dying with dignity" but could also be described simply as "intentionally dying." It's not suicide in the traditional sense, it's choosing your end of life with the same sort of assertiveness that most of us wish to have in all the other aspects of our lives. I understand why it's difficult. I still think we should be able to be in control of our own termination sequence when many of our subsystems are already doing so of their own accord.
Are humans the way they are due to their inherent 'nature'? Are they genetically set in stone, programmed and minimally changing from a set point(like an object)?
Or are human's the way they are by 'nurture' and does their environment influence their essence and with a changed external environment they can change as well?
Science seems to believe it's a bit of both. Look at twin studies and epigenetic expression of schizophrenia for examples.
The issue I see with your argument is that it assumes that human's are like objects and therefore heavily 'nature' based.
I think science leans towards more of a balance of nature and nurture.
"Broken" is always with respect to some function that we're expecting an object to perform. We expect a hammer to be able to drive nails into wood; if it can't do that, we say it's broken. A person has no intrinsic function, so we can't say that they're broken. It would be more accurate to say the system placing that expectation on them is broken, or at least in need of improvement.
The example of socialized healthcare is given elsewhere in this thread. The line of thinking is, well, some people are just too much of a burden on the healthcare system, so we (sadly) have to let them suffer or die in order to keep the system working for everyone else. But the broken object in this case is not the people, but the healthcare system itself. The system is too weak to care for everyone. Maybe it's not possible to build a system that's strong enough, but the blame should rest on the system (which actually has the potential to be fixed), not on the people (who should not need "fixing" in order to be cared for).
> A person has no intrinsic function, so we can't say that they're broken.
I disagree. When you see people whose brains are so fried they spend their entire waking state walking in and out of traffic screaming incoherently at everyone and no one, and their mind exists in a different reality with no connection to the actual, and there's no medical treatment (or, any way to administer) to overcome the mental disease compounded by extreme drug use... I find it hard to argue that such a person is not "broken."
I do definitely believe people can be too broken to fix in certain ways. I feel like this about some parts of myself. But the thing is, that we can't say someone is too broken to fix as a whole, because the paths to be are virtually infinite. So that's why most people intuitively lean towards "you can't never lose hope". I'd say they are intuitively right this time, and yet people can also be too broken to fix in some ways. They are not mutually exclusive.
Now, that doesn't say much about whether one should try to overcome trauma or try to bury it. That depends a lot on the context, the direction you would like to move towards and the support you have to do it.
In my town was a single mother who lived with her adult son that struggled with mental issues. She probably had very little help through the years, but somehow managed. One day, her son murdered her with a knife.
It's very sad, but I think we generally leave people to fend for themselves when they have dependents with mental issues. I worry about disturbed individuals that target, stalk, or kill other innocent people.
Maybe some day we might have a more humane treatment for these 'unfixable' individuals. Maybe even a virtual/persistent metaverse where they can live out a satisfying life without putting others in danger.
There is always an end for all of us where we can't be repaired. The harder questions come from those who are seemingly far from that end. All of those people are morally worth fixing, but they aren't going to fix themselves, and the resources needed to fix them are more often than not unavailable or unwilling (either by the provider or the person needed fixing).
I think that is a fine question to ask in this forum. Maybe not a question that people in the situation described can handle of course!
Related may be "Too broken to imagine (myself) being fixed." Which is probably more of a failure of imagination (and possibly of support) than a reality.
And then you get into what does "fixed" mean, vs "good", in a _person_ ...
Many people say this of those who have borderline personality disorder. BPD is the top result when you google "most painful mental illness," and some therapists either refuse to treat or limit their exposure to these patients. And so their imagined fear of abandonment becomes real, and their illness worsens.
> Are people like this? Are some simply too broken to fix? I feel awful thinking this, but I wonder if there is some truth to it.
In the criminal justice system, this is essentially what pleading insanity recognizes. Many of these people are placed in long term mental-health institutions.
The man in this article was broken, what would it have cost to fix him?
We don't have the information you're assuming we do, whether the costs are monetary or otherwise there is no estimate for what it would have cost to fix the daddy in this story.
The problem is that we know how to fix anything we make and/or can see. We can't make or see the human mind just yet, so we definitely struggle to fix it.
in a perfect world, i believe there is a happy and fulfilling lifestyle we can carve out for anyone in a well-functioning society, no matter where they come from or where they're going
we just need the space / time / resources to supply all those different lifestyles that swing outside the mean, and a moral code that allows for them all to exist on the same planet
When you say "fixed", I assume you mean that the traumatized brain is returned to a state where a person can learn and experience positive emotions. In most cases, I would argue that it's probable, yes, but I'm not an expert in this area, though I spend a lot of time trying to understand abuse (to remove it from my own language and actions) and trauma (so that I can help my children recover from it).
It is my very slightly educated opinion that given a place of psychological, emotional, and physical safety, it is possible to train a person to gain resilience. I will also say that places that meet these criteria are rare in the United States, at a minimum. Our society is highly competitive and attacks people who do poorly, even though that's largely assigned at random, or is based on already existing/trained resilience, which is not well taught in most schools in the US, at least not to the extent that it needs to be. Emotional intelligence is the primary toolkit for dealing with these kinds of issues, and it can't just be taught as a one-and-done. It is something that requires constant practice, similar to sports or music preparation.
I would even go as far as to suggest that the entire media system, for all that it does well, strongly encourages reductions in emotional intelligence. Advertising is designed to get us to relate to emotions like pride (buy a brand new vehicle to be your own person!) or fear. Facebook pushes anger at us regularly. The fundamental attribution error is so rife and abusive in our society that now we identify ourselves almost completely via the categories and labels that are tossed around so lazily, inducing category error, outgroup bias, and a whole slew of cognitive errors that reduce emotional regulation and empathy, key tools in maintaining a healthy mental state.
Given all this working against us, on the other side there needs to be understanding that safety isn't enough. Abusive language is incredibly common in the US (I don't have insight to what the media really looks like in most of Europe, or Asia). There are positive actions that can be taken to help people around you to heal, and to heal your own mind if you are concerned about hieghtened anxiety or depression, but they probably require counseling (hard to access and expensive), meditation and or pharmacology.
I would recommend understanding NVC (Non-violent communication) as a strictly non-abusive method of communicating with others, understanding abusive language patterns (name-calling, dismissing, condescension, etc.) which are easily found online, and also reading books like "Trauma and young children: Teaching Strategies to support and empower" by the NAEYC. The understanding of trauma, how subjective it is, and how often it is associated with thinking patterns and how to modify them, is key in helping people recover from trauma.
As a side note: I have had to do a lot of counseling because the 750k dead in the US from Covid caused me a lot of secondary trauma. I have a tendency to think in the empathetic, and updating from empathy to compassion freed up a lot of room for new ways of thinking. However, I have access to the necessary health care. People who are under intense pressure (month-to-month pay, homelessness, bullying, etc.) will not be experiencing what is called "toxic stress", which alters the brain and practically eliminates the ability to build good connections in the prefrontal cortex.
I guess what I'm saying is it can be done, if we reorganize society for mental health, or if you have the money.
