But there is nothing natural about these practices. There is nothing necessary about these practices. And there is nothing historically and culturally to suggest that human beings must be protected from themselves and from each other in the ways bureaucracies in the United States have found to be most expedient. Involuntary commitment, forced treatment, and psychiatric control over decision-making are really not complicated issues, despite the efforts to make them seem so. I believe that until we frame this question properly, as a human rights question, we will continue to make the simple complicated.
Paternalism is the core justification.
The patient's sphere of self-determination has been made very small. The history of our civilization is, in part, the struggle against paternalism and for self-determination. People in power are always saying that they know what is best for those they rule over, even if those poor unfortunate individuals think they know best what they want. The powerful seldom cast their own motives in anything but benevolent terms. The struggle for freedom has always been seen by the powerful as a denial of the obvious truth of the superiority of the rulers.