Conservatorship: Inside California’s System of Coercion and Care for Mental Illness 0231210256, 9780231210256

Is involuntary psychiatric treatment the solution to the intertwined crises of untreated mental illness, homelessness, a

129 40 3MB

English Pages 416 [413] Year 2023

Report DMCA / Copyright

DOWNLOAD PDF FILE

Table of contents :
Table of Contents
Preface
Introduction: The Other Magna Carta
Part I. The Conservatorship Continuum
1. Outpatient
2. Crisis
3. Emergency Room
4. Inpatient
5. Public Guardian
6. Court
Part II. Care and Coercion Under Conservatorship
7. Locked In
8. Stepped Down
9. Neglect and Abuse
10. Stabilization and Recovery
Part III. Reform
11. Paving a New Pathway
12. Asylum for the Dying
13. Sharing Authority, Restoring Autonomy
Conclusion: Beyond Miracles
Methodological Appendix
Chronology of “Abdicated Authority”
Glossary of Terms, Procedures, and Facilities
Acknowledgments
Notes
Index
Recommend Papers

Conservatorship: Inside California’s System of Coercion and Care for Mental Illness
 0231210256, 9780231210256

  • 0 0 0
  • Like this paper and download? You can publish your own PDF file online for free in a few minutes! Sign Up
File loading please wait...
Citation preview

Conservatorship Inside California’s System of Coercion and Care for Mental Illness

Alex V. Barnard

CONSERVATORSHIP

CONSERVATORSHIP Inside California’s System of #˃ɐ̅Ʉɷ˃ʯ‫ף‬ȡʯɊ‫ף‬#ȡ̅ɐ‫ף‬ɩ˃̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎

alex v. barnard

Columbia University Press New York

Columbia University Press Publishers Since 1893 ‡ʇ͸੮Ě˺̼ˌ੥#ʩʮɻʩʇ͐ͅʇ̼ੴ੮Ĕʇ͐ͅ੮ä͙ͅͅʇͽ ɻ͙̹ੳɻ˺ˑ͙˚ɺʮɘੳʇʁ͙ #˺̹;̼ʮʡʩ͐੮ૢ੮৲ৰ৲৳੮#˺ˑ͙˚ɺʮɘ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅ ˑˑ੮̼ʮʡʩ͐ͅ੮̼ʇͅʇ̼ͷʇʁ rʮɺ̼ɘ̼;੮˺ʠ੮#˺˦ʡ̼ʇͅͅ੮#ɘ͐ɘˑ˺ʡʮ˦ʡચʮ˦ચØ͙ɺˑʮɻɘ͐ʮ˺˦੮)ɘ͐ɘ ‡ɘ˚ʇͅੵ੮"ɘ̼˦ɘ̼ʁੴ੮ˑʇͽ੮ēੳੴ੮ৱ৹৸৷જ੮ɘ͙͐ʩ˺̼ੳ੮ îʮ͐ˑʇੵ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ੵ੮ʮ˦ͅʮʁʇ੮#ɘˑʮʠ˺̼˦ʮɘ૊ͅ੮ͅ;͐ͅʇ˚੮˺ʠ੮ɻ˺ʇ̼ɻʮ˺˦੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʠ˺̼੮ ੥˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ઃ੮ˑʇͽ੮ēੳ੮"ɘ̼˦ɘ̼ʁੴ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ä˺ɻʮ˺ˑ˺ʡ;ੴ੮‡ʇ͸੮Ě˺̼ˌ੮õ˦ʮͷʇ̼ͅʮ͐;ੳ੮ )ʇͅɻ̼ʮ̹͐ʮ˺˦ੵ੮ৱੳ੮૩੮‡ʇ͸੮Ě˺̼ˌ੮ੵ੮#˺ˑ͙˚ɺʮɘ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰ৲৳ੳ੮૩੮U˦ɻˑ͙ʁʇͅ੮ʮ˦ʁʇͽੳ Uʁʇ˦͐ʮϲʮʇ̼ͅੵ੮r##‡੮৲ৰ৲৳ৰৰৰ৸৸ৱ੮ફ̹̼ʮ˦͐બ੮૩੮r##‡੮৲ৰ৲৳ৰৰৰ৸৸৲੮ફʇɺ˺˺ˌબ੮૩੮ ੥Uä"‡੮৹৷৸ৰ৲৳ৱ৲ৱৰ৲৴৹੮ફʩɘ̼ʁɺɘɻˌબ੮૩੮Uä"‡੮৹৷৸ৰ৲৳ৱ৲ৱৰ৲৵৶੮ફ̼͐ɘʁʇ੮̹ɘ̹ʇ̼ɺɘɻˌબ੮૩੮ ੥Uä"‡੮৹৷৸ৰ৲৳ৱ৵৵৸৳৲৷੮ફʇɺ˺˺ˌબ੮ ä͙ɺˈʇɻ͐ͅੵ੮r#äPੵ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ઝ#ɘˑʮʠ˺̼˦ʮɘੳ੮૩੮I͙ɘ̼ʁʮɘ˦੮ɘ˦ʁ੮͸ɘ̼ʁઝ#ɘˑʮʠ˺̼˦ʮɘੳ੮૩੮ ੥{ʇ˦͐ɘˑˑ;੮ʮˑˑઝ#ɘ̼ʇઝ#ɘˑʮʠ˺̼˦ʮɘੳ੮૩੮{ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ˑɘ͸ͅઝ#ɘˑʮʠ˺̼˦ʮɘੳ #ˑɘͅͅʮϲʮɻɘ͐ʮ˺˦ੵ੮r##੮nH#ৱৱ৲੮ੳ"৳৷੮৲ৰ৲৳੮੮ફ̹̼ʮ˦͐બ੮૩੮r##੮nH#ৱৱ৲੮੮ફʇɺ˺˺ˌબ੮૩੮ ੥))#੮৳৴৴ੳৰ৴ઃ৴ৰ৹৷৹৴ઝʁɻ৲৳ઃʇ˦ʡઃ৲ৰ৲৳ৰ৷ৱ৲ r#੮̼ʇɻ˺̼ʁ੮ɘͷɘʮˑɘɺˑʇ੮ɘ͐੮ʩ̹͐͐ͅੵઃઃˑɻɻ˦ੳˑ˺ɻੳʡ˺ͷઃ৲ৰ৲৳ৰৰৰ৸৸ৱ r#੮ʇɺ˺˺ˌ੮̼ʇɻ˺̼ʁ੮ɘͷɘʮˑɘɺˑʇ੮ɘ͐੮ʩ̹͐͐ͅੵઃઃˑɻɻ˦ੳˑ˺ɻੳʡ˺ͷઃ৲ৰ৲৳ৰৰৰ৸৸৲ Ø̼ʮ˦͐ʇʁ੮ʮ˦੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮˺ʠ੮˚ʇ̼ʮɻɘ #˺ͷʇ̼੮ʁʇͅʮʡ˦ੵ੮‡˺ɘʩ੮̼ˑ˺͸ #˺ͷʇ̼੮ʮ˚ɘʡʇੵ੮Iʇ͐͐;੮U˚ɘʡʇͅ

“The pressing problem with regard to the future of the insane in this country is: how can the chronic insane pauper be most cheaply cared for, consistently with a ̂̅˃̂ɐ̅‫̅ף‬ɐɪȡ̅Ɋ‫ף˃̙ף‬ɲ̢ʣȡʯɷ̙͇‫ףׯ‬ʯɊ‫ף‬ʣ̢̙̎‫̙ף‬ɲɷ̎‫̅˃́ף‬ʕ‫ף‬Ƀɐ‫ף‬Ɋ˃ʯɐ‫ף‬Ƀ͇‫̙ף‬ɲɐ‫͗̎ף‬ȡ̙ɐ‫̙ף̅˃ף‬ɲɐ‫̎ף‬ɐ̀ɐ̅ȡʚ‫ף‬ counties?” ઝH̼ʇʁʇ̼ʮɻˌ੮Ĕʮ˦ʇͅੴ੮äʇɻ̼ʇ͐ɘ̼;ੴ੮Uˑˑʮ˦˺ʮͅ੮"˺ɘ̼ʁ੮˺ʠ੮ ä͐ɘ͐ʇ੮#˺˚˚ʮͅͅʮ˺˦ʇ̼ͅ੮˺ʠ੮Ø͙ɺˑʮɻ੮#ʩɘ̼ʮ͐ʮʇͅ੮ફৱ৸৷৹બ

For the moms, especially my own

\

CONTENTS

Ø̅ɐ͖ȡɄɐ‫͆ך‬ɷ

U˦̼͐˺ʁ͙ɻ͐ʮ˺˦ੵ੮îʩʇ੮š͐ʩʇ̼੮{ɘʡ˦ɘ੮#ɘ̼͐ɘ੥ৱ PART I: THE CONSERVATORSHIP CONTINUUM

੮ ৱ੮ š͙̹͐ɘ͐ʮʇ˦͐੥৲৷ ੮ ৲੮ #̼ʮͅʮͅ੥৴৸ ੮ ৳੮ /˚ʇ̼ʡʇ˦ɻ;੮Û˺˺˚੥৷ৰ ੮ ৴੮ U˦̹ɘ͐ʮʇ˦͐੥৸৵ ੮ ৵੮ Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੥ৱৰ৲ ੮ ৶੮ #˺͙̼͐੥ৱ৲ৰ PART II: CARE AND COERCION UNDER CONSERVATORSHIP

੮ ৷੮ r˺ɻˌʇʁ੮U˦੥ৱ৴ৱ ੮ ৸੮ ä͐ʇ̹̹ʇʁ੮)˺͸˦੥ৱ৵৷ ੮ ৹੮ ‡ʇʡˑʇɻ͐੮ɘ˦ʁ੮ɺ͙ͅʇ੥ৱ৷৲ ੮ ৱৰ੮ ä͐ɘɺʮˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮Ûʇɻ˺ͷʇ̼;੥ৱ৹ৱ

X

CONTENTS

PART III: REFORM

੮ ৱৱ੮ Øɘͷʮ˦ʡ੮ɘ੮‡ʇ͸੮Øɘ͐ʩ͸ɘ;੥৲ৱৱ ੮ ৱ৲੮ ͅ;ˑ͙˚੮ʠ˺̼੮͐ʩʇ੮);ʮ˦ʡ੥৲৲৶ ੮ ৱ৳੮ äʩɘ̼ʮ˦ʡ੮͙͐ʩ˺̼ʮ͐;ੴ੮Ûʇ͐ͅ˺̼ʮ˦ʡ੮͙͐˺˦˺˚;੥৲৴৶ ੮ ੮ #˺˦ɻˑ͙ͅʮ˺˦ੵ੮"ʇ;˺˦ʁ੮{ʮ̼ɘɻˑʇͅ੥৲৷৳ {ɐ̙ɲ˃Ɋ˃ʚ˃ɪɷɄȡʚ‫̂̂ף‬ɐʯɊɷ͆‫ך‬թհլ #ɲ̅˃ʯ˃ʚ˃ɪ͇‫˃ף‬ɩ‫آף‬ɃɊɷɄȡ̙ɐɊ‫̢̙ף‬ɲ˃̅ɷ̙͇‫ךأ‬ժէլ Iʚ˃̎̎ȡ͇̅‫˃ף‬ɩ‫ף‬îɐ̅ʣ̎‫ףש‬Ø̅˃ɄɐɊ̢̅ɐ̎‫ףש‬ȡʯɊ‫ף‬HȡɄɷʚɷ̙ɷɐ̎‫ך‬ժէհ Ʉʕʯ˃́ʚɐɊɪʣɐʯ̙̎‫ך‬ժըլ ‡˃̙ɐ̎‫ך‬ժըծ UʯɊɐ͆‫ך‬ժկը

PREFACE

I

˦੮৲ৰৱ৵ੴ੮U੮̹ͅʇ˦͐੮ɘ੮;ʇɘ̼੮ʮ˦੮H̼ɘ˦ɻʇ੮̼ʇͅʇɘ̼ɻʩʮ˦ʡ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͐ʩʇ̼ʇ੮ ʠ˺̼੮˚;੮Øʩ)੮ʁʮͅͅʇ̼͐ɘ͐ʮ˺˦੮ɘ͐੮͐ʩʇ੮õ˦ʮͷʇ̼ͅʮ͐;੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘੴ੮"ʇ̼ˌʇˑʇ;ੳ੮U੮ɘ̼̼ʮͷʇʁ੮ ʁ͙̼ʮ˦ʡ੮ ɘ੮ ʁ̼ɘ˚ɘ͐ʮɻ੮ ̼ʮͅʇ੮ ʮ˦੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮ ફɘˑͅ˺੮ ˌ˦˺͸˦੮ɘͅ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅબ੮͐ʩɘ͐੮ɻ˺˚˚ʇ˦͐ɘ͐˺̼ͅ੮ͅɘ͸੮ɘͅ੮ɘ੮ͅ;˚̹͐˺˚੮˺ʠ੮ɘ੮ʠ̼ɘɻ͙̼͐ચ ʮ˦ʡ੮ͅ˺ɻʮʇ͐;੮ɘ˦ʁ੮͸ʮ͐ʩʇ̼ʮ˦ʡ੮ͅ˺ɻʮɘˑ੮ͅɘʠʇ͐;੮˦ʇ͐ੳ੮îʩʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮ʠ̼ʇή͙ʇ˦ɻ;੮͸ʮ͐ʩ੮͸ʩʮɻʩ੮ ɻʮ͐ʮΈʇ˦ͅૄ੮ ɻʮͷʮˑ੮ ̼ʮʡʩ͐ͅ੮ ͸ʇ̼ʇ੮ ɺʇʮ˦ʡ੮ ̼ʇ̼͐ͅʮɻ͐ʇʁ੮ ʮ˦੮ ͐ʩʇ੮ ˦ɘ˚ʇ੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ̹̼˺ͷ˺ˌʇʁ੮̹ɘ̼ˑʮɘ˚ʇ˦͐ɘ̼;੮ʮ˦ή͙ʮ̼ʮʇͅ੮ɘ˦ʁ੮͸ɘͅ੮̼͐ʇɘ͐ʇʁ੮ɘͅ੮/ͽʩʮɺʮ͐੮੮ʠ˺̼੮ɘ੮̹͙ɺˑʮɻ੮̹ͅ;ચ ɻʩʮɘ̼͐ʮɻ੮ͅ;͐ͅʇ˚੮ʮ˦੮ʁʇʇ̹੮ɻ̼ʮͅʮͅੳৼ U੮̼ʇ͙̼͐˦ʇʁ੮͐˺੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮͸˺˦ʁʇ̼ʮ˦ʡ੮ʮʠ੮͐ʩʇ੮͐ͅ˺̼;੮͸ɘͅ੮͐ʩʇ੮ͅɘ˚ʇ੮ɺɘɻˌ੮ʩ˺˚ʇੳ੮ ˦ʇɻʁ˺͐ɘˑˑ;ੴ੮ U੮ ʩʇɘ̼ʁ੮ ͐ʩɘ͐੮ ̼ɘ͐ʇͅ੮ ˺ʠ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ͸ʇ̼ʇ੮ ʮ˦ɻ̼ʇɘͅʮ˦ʡੴ੮ ɺ͙͐੮U੮ɻ˺͙ˑʁ੮˦˺͐੮ϲʮ˦ʁ੮ʇͷʇ˦੮͐ʩʇ੮˚˺͐ͅ੮ɺɘͅʮɻ੮ʁɘ͐ɘ੮˺˦੮͐ʩʇ੮ʠ̼ʇή͙ʇ˦ɻ;੮˺ʠ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐ચ ˚ʇ˦͐੮ʮ˦੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮˺̼੮ʮ˦੮‡ʇ͸੮Ě˺̼ˌੴ੮͸ʩʇ̼ʇ੮U੮͸ɘͅ੮ˑʮͷʮ˦ʡੳ੮U˦੮ʠɘɻ͐ੴ੮U੮͸ɘͅ੮ʁʮͅચ ɻ˺͙̼ɘʡʇʁ੮ʠ̼˺˚੮ʇͷʇ˦੮ˑ˺˺ˌʮ˦ʡੳ੮U੮̹ͅ˺ˌʇ੮͐˺੮ɘ੮̹̼˺˚ʮ˦ʇ˦͐੮ɘɻɘʁʇ˚ʮɻ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʩ˺੮ ͐˺ˑʁ੮˚ʇੴ੮˦˺੮ʁ˺͙ɺ͐੮ɻ˺˦ɻʇ̼˦ʇʁ੮ɘɺ˺͙͐੮˚;੮ʠ͙͙̼͐ʇ੮̹̼˺̹ͅʇɻ͐ͅ੮ɘͅ੮ɘ੮̼ʇͅʇɘ̼ɻʩʇ̼ੴ੮͐ʩɘ͐੮ુʮ˦੮ ͐ʩʇ੮ৱ৹৷ৰͅੴ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮͸ʇ̼ʇ੮ɘ੮ʩ˺͐੮͐˺̹ʮɻੴ੮ɘ˦ʁ੮͐ʩɘ͐੮̹ͅɘ͸˦ʇʁ੮ɘ੮ˑɘ̼ʡʇ੮˦͙˚ɺʇ̼੮ ˺ʠ੮͙͐ͅʁʮʇͅੳ੯ੳ੯ੳ੯ੳ੮ય"͙͐ર੮͸ʇૄ̼ʇ੮˺˦੮͐˺੮˦ʇ͸੮ή͙ʇ͐ͅʮ˺˦ͅ੮˦˺͸ੳૂ੮Pʇ੮͸ɘͅ੮̼ʮʡʩ͐ੳ੮H˺̼੮ʁʇɻɘʁʇͅੴ੮ ̹ˑɘ˦˦ʮ˦ʡ੮ɘ˦ʁ੮˺ͷʇ̼ͅʮʡʩ͐੮ʠ˺̼੮͐ʩʇ੮˚ʇ̼ʮɻɘ˦੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ͅ;͐ͅʇ˚੮ʩɘͷʇ੮̼͐ʇɘ͐ʇʁ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ɘͅ੮ɘ˦੮ɘʠ͐ʇ̼͐ʩ˺͙ʡʩ͐ੳ )ʇ̹ͅʮ͐ʇ੮ ʩɘͷʮ˦ʡ੮ ɺʇʇ˦੮ ͸ɘ̼˦ʇʁ੮ ɘ͸ɘ;੮ ʠ̼˺˚੮ ͐ʩʇ੮ ͙ͅɺˈʇɻ͐ੴ੮ U੮ ɺʇʡɘ˦੮ ɻ˺˦ʁ͙ɻ͐ʮ˦ʡ੮ ˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮ ʮ˦੮ ɻ˺͙̼̼͐˺˺˚ͅ੮ ͙͐ɻˌʇʁ੮ ɘ͸ɘ;੮ ʮ˦੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ʮ˦੮ ‡ʇ͸੮ Ě˺̼ˌ੮ #ʮ͐;ੳ੮ îʩʇ̼ʇੴ੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ʩɘʁ੮ ɺʇʇ˦੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ ɘʡɘʮ˦͐ͅ੮ ͐ʩʇʮ̼੮ ͸ʮˑˑ੮ ̼ʇή͙ʇ͐ͅʇʁ੮ ͐˺੮ ɺʇ੮ ̼ʇˑʇɘͅʇʁ੮ ɺ;੮ ɘ੮ ˈ͙ʁʡʇੳ੮ U੮ ή͙ʮɻˌˑ;੮ ̼ʇɘˑʮΈʇʁ੮ ͐ʩɘ͐ੴ੮ ͙˦̼ʇ˚ɘ̼ˌʇʁ੮ ͐ʩ˺͙ʡʩ੮ ʮ͐੮ ˚ɘ;੮ ɺʇੴ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮̼ʇ˚ɘʮ˦ͅ੮͐ʩʇ੮ɺɘɻˌɺ˺˦ʇ੮˺ʠ੮˺͙̼੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮͐ʩʇ੮˚˺͐ͅ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅʇͅੳ੮U੮ͅɘ͸੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘ˦ʁ੮ʁʮͅɻʩɘ̼ʡʇʁ੮˚˺̼ʇ੮͐ʩɘ˦੮˺˦ʇ੮ ʩ͙˦ʁ̼ʇʁ੮͐ʮ˚ʇͅੳ੮š͐ʩʇ̼ͅ੮ʩɘʁ੮ɺʇʇ˦੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇʁ੮ʠ˺̼੮ʁʇɻɘʁʇͅੳ੮š͙̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮

XII

P R E FAC E

ͅ;͐ͅʇ˚੮̹ͅʇ˦ʁͅ੮˚˺̼ʇ੮˺˦੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐ʩɘ˦੮ʮ͐੮ʁ˺ʇͅ੮ʠ˺̼੮ɻˑʮ˦ʮɻͅ੮˺̼੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ɘ˦ʁ੮ɘɺ˺͙͐੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮ʮ͐੮̹ͅʇ˦ʁͅ੮˺˦੮˚ʇʁʮɻɘ͐ʮ˺˦ͅੳ৽੮੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʮ˦੮˚ʇ̼ચ ʮɻɘૄͅ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ̼ʇ੮͐ʩʇ̼ʇ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ৾੮ͅ੮U੮ͅɘ͸੮ʮ˦੮͐ʩʇ੮ɻ˺͙̼̼͐˺˺˚ͅੴ੮ ˚ɘ˦;੮ʁʇ̹ͅʇ̼ɘ͐ʇˑ;੮͸ɘ˦͐੮͐˺੮ʡʇ͐੮ɘͅ੮ʠɘ̼੮ɘ͸ɘ;੮ʠ̼˺˚੮͐ʩʇ˚੮ɘͅ੮̹˺ͅͅʮɺˑʇੳ U੮̼ʇ͙̼͐˦ʇʁ੮͐˺੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮ˦੮৲ৰৱ৷ੳ੮ʠ͐ʇ̼੮͐͸˺੮;ʇɘ̼ͅૄ੮ɘɺͅʇ˦ɻʇੴ੮͐ʩʇ੮ɘ˚ɘˑʡɘ˚੮˺ʠ੮ʁʮͅચ ̼͙̹͐ʮͷʇ੮ɺʇʩɘͷʮ˺̼ੴ੮ʁ̼͙ʡ੮͙ͅʇੴ੮ɘ˦ʁ੮͙˦̼͐ʇɘ͐ʇʁ੮͙ͅʠʠʇ̼ʮ˦ʡ੮ɘ˚˺˦ʡ੮͙˦ʩ˺͙ͅʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ ͸ʩʮɻʩ੮ʩɘʁ੮ɺʇʇ˦੮ͷʮͅʮɺˑʇ੮ͅʮ˦ɻʇ੮U੮ϲʮ̼͐ͅ੮˚˺ͷʇʁ੮͐˺੮͐ʩʇ੮"ɘ;੮̼ʇɘ੮ʮ˦੮৲ৰৱৱੴ੮ͅʇʇ˚ʇʁ੮͐˺੮ʩɘͷʇ੮ ̼ʇɘɻʩʇʁ੮ɘ੮˦ʇ͸੮ˑʇͷʇˑ੮˺ʠ੮ɘɻ͙͐ʇ˦ʇͅͅੳ੮ͅ੮ʮ˦੮H̼ɘ˦ɻʇੴ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮͸ɘͅ੮˺˦੮͐ʩʇ੮ ɘʡʇ˦ʁɘ੶੮͙˦ˑʮˌʇ੮ʮ˦੮H̼ɘ˦ɻʇੴ੮͐ʩʇ੮ʠ˺ɻ͙ͅ੮͸ɘͅ੮˺˦੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮ʮ͐ͅ੮͙ͅʇੳ੮rʇʡʮͅˑɘ͐˺̼ͅ੮ʠ̼˺˚੮äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺੮͸ʇ̼ʇ੮̹͙ͅʩʮ˦ʡ੮͐˺੮̼ɘ˚̹੮͙̹੮͐ʩʇ੮͙ͅʇ੮˺ʠ੮ુɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴૂ੮ɘ੮ˑʇʡɘˑ੮͐˺˺ˑ੮͐ʩɘ͐੮ ɘˑˑ˺͸ͅ੮ɘ੮͐ʩʮ̼ʁ੮̹ɘ̼͐;੮͐˺੮ʠ˺̼ɻʇ੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮͐˺੮̹ˑɘɻʇ੮͐ʩʇ˚੮ʮ˦੮ɘ੮ ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʠ˺̼੮;ʇɘ̼ͅ੮ɘ͐੮ɘ੮͐ʮ˚ʇੳ îʩʮͅ੮͸ɘͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮ʁʇ̹ͅʮ͐ʇ੮͐ʩʇ੮ˑɘɻˌ੮˺ʠ੮ɘ˦;੮̼ʇɘˑ੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ʠ̼˺˚੮͐ʩʇ੮ˑʇʡચ ʮͅˑɘ͙̼͐ʇ੮˺̼੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʮ˦͐˺੮͸ʩɘ͐੮͸ɘͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮͐˺੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸ʇ̼ʇ੮ ɘˑ̼ʇɘʁ;੮ ɻ˺˦ͅʇ̼ͷʇʁੳ੮ ੮ ή͙ʮɻˌ੮ ʮ˦͐ʇ̼˦ʇ͐੮ ͅʇɘ̼ɻʩ੮ ̼ʇͷʇɘˑʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇ̼ʇ੮ ͸ɘͅ੮ ɘˑ˚˺͐ͅ੮ ˦˺੮ ̼ʇɻʇ˦͐੮ɘɻɘʁʇ˚ʮɻ੮̼ʇͅʇɘ̼ɻʩ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʇʮ͐ʩʇ̼ੳ੮U੮ʇ˚ɺɘ̼ˌʇʁ੮˺˦੮ɘ੮ͅ˚ɘˑˑ੮ͅʮʁʇ੮ ̹̼˺ˈʇɻ͐੮˺˦੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੳ੮ä͐ʮˑˑੴ੮U੮ʠʇɘ̼ʇʁ੮͐ʩʇ੮͐˺̹ʮɻ੮͸ɘͅ੮͐˺˺੮ ˦ʮɻʩʇ੮͐˺੮ɘ̹̹ʇɘˑ੮͐˺੮̼ʇɘʁʇ̼ͅ੮ɺʇ;˺˦ʁ੮ͅ˺ɻʮɘˑ੮ͅʇ̼ͷʮɻʇ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮˺̼੮͐ʩʇ੮̹ɘ̼ʇ˦͐ͅ੮˺ʠ੮ ɻʩʮˑʁ̼ʇ˦੮͐ɘ˦ʡˑʇʁ੮͙̹੮ʮ˦੮͐ʩʇ੮ͅ;͐ͅʇ˚ੳ /˦͐ʇ̼੮ "̼ʮ͐˦ʇ;੮ ä̹ʇɘ̼ͅੳ੮ îʩʇ੮ ʇͽ̹ˑ˺ͅʮͷʇ੮ ৲ৰ৲ৱ੮ ̼ʇͷʇˑɘ͐ʮ˺˦ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ͸ʮʁʇ੮ ̼ɘ˦ʡʇ੮ ˺ʠ੮ ɘɺ͙ͅʇͅ੮͐ʩʇ੮̹˺̹੮͐ͅɘ̼੮ʩɘʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇʁ੮ʁ͙̼ʮ˦ʡ੮ɘ੮͐ʩʮ̼͐ʇʇ˦ચ;ʇɘ̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮˚ʇɘ˦͐੮͐ʩɘ͐੮͙ͅʁʁʇ˦ˑ;੮U੮͸ɘͅ੮͙͐ͅʁ;ʮ˦ʡ੮ɘ੮ʩ˺͐੮͐˺̹ʮɻੳ੮U੮ɻʮ̼ɻ͙ˑɘ͐ʇʁ੮ɘ੮ʁ̼ɘʠ͐੮ ˺ʠ੮ͅ˺˚ʇ੮˺ʠ੮˚;੮ϲʮ˦ʁʮ˦ʡͅ੮͐˺੮ɘʁͷ˺ɻɘ͐ʇͅ੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮͐ʩʇ੮̹˺ˑʮɻ;੮ɘ̼ʇ˦ɘੳ੮îʩʇʮ̼੮̹˺ͅʮ͐ʮͷʇ੮ ̼ʇ̹ͅ˺˦ͅʇ੮ɻ˺˦ͷʮ˦ɻʇʁ੮˚ʇ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮͸ɘͅ੮̼ʇɘˑ੮ʩ͙˦ʡʇ̼੮ʠ˺̼੮ɘ੮ɻ˺˚̹̼ʇʩʇ˦ͅʮͷʇ੮ˑ˺˺ˌ੮ɘ͐੮ ͐ʩʇ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮˚ɘ˦;੮̹ʇ˺̹ˑʇੴ੮͙̹੮͐˺੮I˺ͷʇ̼˦˺̼੮Iɘͷʮ˦੮‡ʇ͸ͅ˺˚ੴ੮͸ʇ̼ʇ੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮ ʇͽ̹ɘ˦ʁʮ˦ʡ੮ɘ˦ʁ੮͐ʩɘ͐੮˺͐ʩʇ̼ͅੴ੮ˑʮˌʇ੮͐ʩʇ੮H̼ʇʇ੮"̼ʮ͐˦ʇ;੮˚˺ͷʇ˚ʇ˦͐ੴ੮͸ʇ̼ʇ੮̼͐;ʮ˦ʡ੮͐˺੮͐ʇɘ̼੮ ʁ˺͸˦ੳ੮Ĕʩʇ˦੮U੮͐˺ˑʁ੮/̼ʮɻ੮äɻʩ͸ɘ̼͐Έੴ੮͐ʩʇ੮ʇʁʮ͐˺̼੮ɘ͐੮#˺ˑ͙˚ɺʮɘ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮͐˺੮ ͸ʩ˺˚੮ U੮ ˺͸ʇʁ੮ ɘ˦੮ ɘɻɘʁʇ˚ʮɻ੮ ͐˺˚ʇ੮ ɻ˺˚̹ɘ̼ʮ˦ʡ੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ͅ੮ ʮ˦੮ ͐ʩʇ੮ õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮ɘ˦ʁ੮H̼ɘ˦ɻʇੴ੮͐ʩɘ͐੮U੮͸ɘ˦͐ʇʁ੮͐˺੮͸̼ʮ͐ʇ੮ɘ੮˚˺̼ʇ੮ɘɻɻʇͅͅʮɺˑʇ੮ɺ˺˺ˌ੮ʠ˺ɻ͙ͅʇʁ੮ ˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮̹ͅʇɻʮϲʮɻɘˑˑ;ੴ੮ʩʇ੮͐˺ˑʁ੮˚ʇ੮͐˺੮ʡ˺੮ʠ˺̼੮ʮ͐ੳ੮ä˺੮͐ʩɘ͐ૄͅ੮ ʩ˺͸੮͸ʇ੮ʡ˺͐੮ʩʇ̼ʇੳ U˦੮ͅ˺˚ʇ੮͸ɘ;ͅੴ੮U੮ʩɘͷʇ੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮ʠ˺͙̼੮;ʇɘ̼ͅ੮˺ʠ੮̼ʇͅʇɘ̼ɻʩ੮ɘ˦ʁ੮ʩ͙˦ʁ̼ʇʁͅ੮˺ʠ੮ʮ˦͐ʇ̼ચ ͷʮʇ͸ͅ੮˺˦ˑ;੮͐˺੮ɻ˺˦ϲʮ̼˚੮˚;੮ʮ˦ʮ͐ʮɘˑ੮ʮ˦͙͐ʮ͐ʮ˺˦ͅੳ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ɺʇʮ˦ʡ੮͙ͅʇʁ੮͐˺੮ ʠ˺̼ɻʮɺˑ;੮̼͐ʇɘ͐੮ɘ˦ʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇ੮͐ʩ˺͙ͅɘ˦ʁͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮̹ʇ̼੮;ʇɘ̼੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੳ੮Ěʇ͐੮ U੮ϲʮ˦ʁ੮ɘ˦੮ɘ͐ͅ˺˦ʮͅʩʮ˦ʡ੮ˑɘɻˌ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮˺ͷʇ̼ͅʮʡʩ͐੮ɘ˦ʁ੮ˑʇɘʁʇ̼ͅʩʮ̹ੴ੮͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͅ;͐ͅʇ˚੮ ɻ˺˦͐ʮ˦͙ʇͅ੮ ͐˺੮ ʠɘʮˑ੮ ͐ʩʇ੮ ˚˺͐ͅ੮ ͷʮͅʮɺˑ;੮ ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮

P R E FAC E

XIII

̹ʇ˺̹ˑʇ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮îʩʮͅ੮ɺ˺˺ˌ੮ʁ˺ɻ͙˚ʇ˦͐ͅ੮͐ʩʇ੮˚;̼ʮɘʁ੮͸ɘ;ͅ੮͐ʩɘ͐੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʩɘͅ੮ ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;ੴ੮ʁʇɻˑʮ˦ʮ˦ʡ੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩʇ੮ɘɻɻ˺͙˦͐ɘɺˑʇ੮ɘ˦ʁ੮ɻ˺ʩʇ̼ʇ˦͐੮ʇͽʇ̼ɻʮͅʇ੮ ˺ʠ੮ʮ͐ͅ੮˺͸˦੮̹˺͸ʇ̼ੳ੮îʩʮͅ੮˚ɘˌʇͅ੮ɻ˺ʇ̼ɻʮͷʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ʩɘ̹ʩɘΈɘ̼ʁੴ੮ʮ˦ɻ˺˦ͅʮ͐ͅʇ˦͐ੴ੮ɘ˦ʁ੮ ̼ɘ̼ʇˑ;੮͙ͅɻɻʇͅͅʠ͙ˑ੮ʮ˦੮̼͐ɘ˦ͅʠ˺̼˚ʮ˦ʡ੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑૄͅ੮ɻɘ̼ʇʇ˦ʮ˦ʡ੮̼͐ɘˈʇɻ͐˺̼;੮ɺʇ͐͸ʇʇ˦੮ ʩ˺̹ͅʮ͐ɘˑͅੴ੮ ˈɘʮˑͅੴ੮ ͅʩʇˑ͐ʇ̼ͅੴ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ̼͐ͅʇʇ͐ੳ੮ {˺̼ʇ੮ ɺ̼˺ɘʁˑ;ੴ੮ ͐ʩʇ੮ ɺ˺˺ˌ੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʇͅ੮ ͸ʩɘ͐੮ ʩɘ̹̹ʇ˦ͅ੮ ͸ʩʇ˦੮ ુʩ;̹ʇ̼˚ɘ̼ʡʮ˦ɘˑʮΈʇʁૂ੮ ̹ʇ˺̹ˑʇ੮ ɺʇɻ˺˚ʇ੮ ͐ʩʇ੮ ͐ɘ̼ʡʇ͐ͅ੮ ˺ʠ੮ ʮ˦͐ʇ̼ચ ͷʇ˦͐ʮ˺˦੮ ʠ̼˺˚੮ ɘ੮ ˚ɘͅͅ੮ ˺ʠ੮ ʁʮͅˈ˺ʮ˦͐ʇʁੴ੮ ̹̼ʮͷɘ͐ʮΈʇʁੴ੮ ɘ˦ʁ੮ ɻ˺˦ϲˑʮɻ͐ʮ˦ʡ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ ˺ʠ੮ ɻɘ̼ʇ੮ɘ˦ʁ੮ɻ˺˦̼͐˺ˑੳ৿ /ͷʇ˦੮ɘ੮ˑ˺˦ʡ੮ɺ˺˺ˌ੮ɻɘ˦˦˺͐੮ʁ˺੮ʇͷʇ̼;͐ʩʮ˦ʡੳ੮H˺̼੮˺˦ʇ੮͐ʩʮ˦ʡੴ੮͐ʩʮͅ੮ɺ˺˺ˌ੮ʮͅ੮˦˺͐੮ɘ˦੮ ɘ͐͐ʇ˚̹͐੮ ͐˺੮ ɘ˦ͅ͸ʇ̼੮ ͐ʩʇ੮ ̹ʇ̼ʇ˦˦ʮɘˑ੮ ή͙ʇ͐ͅʮ˺˦੮ ˺ʠ੮ ͸ʩʇ͐ʩʇ̼੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ુ͸˺̼ˌͅੳૂ੮Ø̼˺̹˺˦ʇ˦͐ͅ੮ʮ˦ͅʮ͐ͅ੮ʠ˺̼ɻʇʁ੮ɻɘ̼ʇ੮ʮͅ੮ɘ˦੮ʮ˦ʁʮ̹ͅʇ˦ͅɘɺˑʇ੮ુˑʮʠʇͅɘͷʮ˦ʡૂ੮ʮ˦͐ʇ̼ͷʇ˦ચ ͐ʮ˺˦ੳ਀੮š̹̹˺˦ʇ˦͐ͅ੮ɻ˺͙˦͐ʇ̼੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ʮͅ੮ુˑʮ͐͐ˑʇ੮ʇͷʮʁʇ˦ɻʇૂ੮͐ʩɘ͐੮ɻ˺ʇ̼ɻʮ˺˦੮ુɻ˺˦ʠʇ̼યͅર੮ ɘ˦;੮ɻˑʮ˦ʮɻɘˑ੮ɺʇ˦ʇϲʮ͐ੳૂਁ੮îʩʇ੮̼͙͐͐ʩ੮ͅʇʇ˚ͅ੮˚͙̼ˌʮʇ̼ੳ੮{ɘ˦;੮͙͐ͅʁʮʇͅ੮ͅʩ˺͸੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮ ͙ͅɺˈʇɻ͐੮͐˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ʁʇ˚˺˦̼͐ͅɘ͐ʇ੮ʮ˚̹̼˺ͷʇ˚ʇ˦͐ͅ੮ʮ˦੮ͅ;˚̹͐˺˚ͅੳਂ ੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮˚ʮ˦˺̼ʮ͐;੮˺ʠ੮͐ʩʇ˚੮͸ʮˑˑ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮͐ʇˑˑ੮̼ʇͅʇɘ̼ɻʩʇ̼ͅ੮͐ʩɘ͐੮͐ʩʇʮ̼੮ʩ˺̹ͅʮચ ͐ɘˑʮΈɘ͐ʮ˺˦੮͸ɘͅ੮ˈ͙͐ͅʮϲʮʇʁੳਃ੮Ěʇ͐੮˺͐ʩʇ̼ͅ੮ϲʮ˦ʁͅ੮͐ʩɘ͐੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ˑʇɘʁͅ੮͐˺੮ͅ;˚̹ચ ͐˺˚ͅ੮˺ʠ੮̹˺͐ͅચ̼͐ɘ͙˚ɘ͐ʮɻ੮̼͐ͅʇͅͅ਄੮ɘ˦ʁ੮ʮ˦ɻ̼ʇɘͅʇʁ੮̼ʮͅˌ੮˺ʠ੮͙ͅʮɻʮʁʇੳৼ৻੮îʩʇ̼ʇ੮ʮͅ੮ɘ੮͸ʇɘˑ͐ʩ੮ ˺ʠ੮ɻ˺˦̼͐ɘʁʮɻ͐˺̼;੮͙͐ͅʁʮʇͅ੮ɘɺ˺͙͐੮͸ʩʇ͐ʩʇ̼੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ʁʇɻ̼ʇɘͅʇͅ੮̹ʇ˺̹ˑʇૄͅ੮ ͙ͅɺͅʇή͙ʇ˦͐੮ ͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮ ͐˺੮ ʇ˦ʡɘʡʇ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚੮ ʮ˦੮ ͐ʩʇ੮ ˑ˺˦ʡʇ̼੮ ͐ʇ̼˚ੳৼৼ੮Ěʇ͐੮͐ʩʇͅʇ੮͙͐ͅʁʮʇͅ੮ɘ̼ʇ੮̹ˑɘʡ͙ʇʁ੮͸ʮ͐ʩ੮˚ʇ͐ʩ˺ʁ˺ˑ˺ʡʮɻɘˑ੮̹̼˺ɺˑʇ˚ͅੴ੮ɘ˦ʁ੮˦ʇɘ̼ˑ;੮ ɘˑˑ੮˺ʠ੮͐ʩʇ˚੮ʁʇɘˑ੮͸ʮ͐ʩ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮͐ʩɘ͐੮ˑɘ͐ͅ੮ʁɘ;ͅ੮˺̼੮͸ʇʇˌͅੳ੮îʩʇ̼ʇ੮ʮͅ੮ɘˑ˚˺͐ͅ੮˦˺੮ ̼ʇɻʇ˦͐੮ʇͷʮʁʇ˦ɻʇ੮ͅʩ˺͸ʮ˦ʡ੮͐ʩʇ੮ʇϲϲʮɻɘɻ;੮˺ʠ੮ˑ˺˦ʡʇ̼ચ͐ʇ̼˚੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮˺̼੮ɻ˺˦ચ ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͸ʩʮɻʩ੮ʮͅ੮͸ʩɘ͐੮̹˺ˑʮɻ;੮˚ɘˌʇ̼ͅ੮ɘ̼ʇ੮̹̼˺̹˺ͅʮ˦ʡ੮͐˺੮ʇͽ̹ɘ˦ʁੳৼ৽੮îʩʮͅ੮ɺ˺˺ˌ੮ ʁ˺ʇͅ੮˦˺͐੮ͅʇʇˌ੮͐˺੮̼ʇͅ˺ˑͷʇ੮͐ʩʮͅ੮ˑ˺˦ʡચ̼͙˦˦ʮ˦ʡ੮ʁʇɺɘ͐ʇੳ੮Ûɘ͐ʩʇ̼ੴ੮ʮ͐੮ͅʩ˺͸ͅ੮ʩ˺͸੮ɘɺʁʮચ ɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮˚ɘˌʇͅ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇ੮ɻ̼͙ʇˑʇ̼੮͐ʩɘ˦੮ʮ͐੮˦ʇʇʁͅ੮͐˺੮ɺʇ੮ɘ˦ʁ੮ͷ˺ˑ͙˦͐ɘ̼;੮ ͅʇ̼ͷʮɻʇͅ੮ˑʇͅͅ੮ʇʠʠʇɻ͐ʮͷʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮͐ʩɘ˦੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ɺʇੳ îʩʮͅ੮ɺ˺˺ˌ੮ʮͅ੮ɘˑͅ˺੮˦˺͐੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮͐ʩʇ੮ͷʮ͐ɘˑˑ;੮ʮ˚̹˺̼͐ɘ˦͐੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮͸ʩʇ͐ʩʇ̼੮ ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮͅ੮ʮ˚̹˺ͅʇʁ੮ʇή͙ʮ͐ɘɺˑ;੮˺˦੮ʁʮʠʠʇ̼ʇ˦͐੮ͅ˺ɻʮɘˑ੮ʡ̼˺͙̹ͅੳ੮U͐੮ɘˑ˚˺͐ͅ੮ɻʇ̼ચ ͐ɘʮ˦ˑ;੮ʮͅ੮˦˺͐ੳ੮੮ʩ˺͐ͅ੮˺ʠ੮͙͐ͅʁʮʇͅ੮ʁ˺ɻ͙˚ʇ˦͐੮͐ʩɘ͐੮"ˑɘɻˌ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ ɺʇ੮˚ʮͅʁʮɘʡ˦˺ͅʇʁ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴৼ৾੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮͙ͅɺˈʇɻ͐ʇʁ੮͐˺੮ɻ˺ʇ̼ɻʮͷʇ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴৼ৿੮ɘ˦ʁ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮̹ˑɘɻʇʁ੮ʮ˦੮ˑ˺͸ચή͙ɘˑʮ͐;੮ʠɘɻʮˑʮ͐ʮʇͅੴৼ਀੮͸ʩʇ̼ʇ੮ ͐ʩʇ;੮ɘ̼ʇ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮ʠ˺̼ɻʮɺˑ;੮ʡʮͷʇ˦੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮̹ʩ;ͅʮɻɘˑˑ;੮̼ʇ̼͐ͅɘʮ˦ʇʁੳৼਁ "̼ʮ͐˦ʇ;੮ä̹ʇɘ̼ͅૄͅ੮͐ͅʮϲˑʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ͐੮͐ʩʇ੮ʩɘ˦ʁͅ੮˺ʠ੮ʩʇ̼੮ʠɘ͐ʩʇ̼੮̼ʇ˚ʮ˦ʁʇʁ੮͙ͅ੮ ͐ʩɘ͐੮ɻˑɘʮ˚ͅ੮ɘ̼˺͙˦ʁ੮͸ʩ˺੮ʮͅ੮ુɻ̼ɘΈ;ૂ੮ʩɘͷʇ੮ɘˑˑ੮͐˺˺੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̼ʇʮ˦ʠ˺̼ɻʇʁ੮̹ɘ̼͐ʮɘ̼ɻʩɘˑ੮ ʁ˺˚ʮ˦ɘ͐ʮ˺˦ੳৼਂ੮ ˦ʁ੮ ʮ˦੮ ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮ ͸ʮ͐ʩ੮ rI"îÚ੮ ̹ʇ˺̹ˑʇ੮ ͙ͅɺˈʇɻ͐੮ ͐˺੮ ʠ˺̼ɻʇʁ੮ ʩ˺ͅચ ̹ʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮U੮ʩʇɘ̼ʁ੮˚͙ˑ͐ʮ̹ˑʇ੮͐ʮ˚ʇͅ੮˺ʠ੮͐ʩʇ੮ʠɘʮˑ͙̼ʇ੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮

XIV

P R E FAC E

͐˺੮ʇ˦͙̼ͅʇ੮͐ʩʇ੮ɺɘͅʮɻ੮ʁʮʡ˦ʮ͐;੮͐ʩɘ͐੮ɻ˺˚ʇͅ੮ʠ̼˺˚੮ɻɘˑˑʮ˦ʡ੮ɘ੮̹ɘ͐ʮʇ˦͐੮ɺ;੮͐ʩʇʮ̼੮ɻʩ˺ͅʇ˦੮ ʡʇ˦ʁʇ̼੮̹̼˺˦˺͙˦ͅੳ Ĕʩʮˑʇ੮͐ʩʮͅ੮ɺ˺˺ˌ੮˦˺ʁͅ੮͐˺੮͐ʩʇͅʇ੮ʁʮ̹ͅɘ̼ʮ͐ʮʇͅੴ੮ʮ͐੮ʁ˺ʇͅ੮˦˺͐੮ɻʇ˦͐ʇ̼੮˺˦੮͐ʩʇ˚ੳ੮U͐੮ʩʮʡʩચ ˑʮʡʩ͐ͅੴ੮ʮ˦͐ͅʇɘʁੴ੮ʮ˦ʇή͙ʮ͐ʮʇͅ੮͐ʩɘ͐੮ʇ˚ʇ̼ʡʇ੮ʠ̼˺˚੮ɘ˦੮͙˦ʁʇ̼̼ʇʡ͙ˑɘ͐ʇʁ੮ɘ˦ʁ੮ʠ̼ɘʡ˚ʇ˦͐ʇʁ੮ ͅ;͐ͅʇ˚ੳ੮U͐੮̼ʇͷʇɘˑͅ੮ʩ˺͸੮ͅ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɘ̼ʇ੮ɘɺɘ˦ʁ˺˦ʇʁ੮͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮˺͐ʩʇ̼ͅ੮ ̼ʇˑʇʡɘ͐ʇʁ੮͐˺੮ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐ʮʇͅ੮˦˺͐੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇʮ̼੮ɻˑʮ˦ʮɻɘˑ੮˦ʇʇʁͅ੮ɺ͙͐੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮ ͸ʩʮɻʩ੮ͅʮʁʇ੮˺ʠ੮ɘ੮ɻ˺͙˦͐;ૄͅ੮ɺ˺̼ʁʇ̼੮͐ʩʇ;੮ˑʮͷʇ੮˺˦ੴ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ;੮ͅʇʇ੮ɘ੮ɻ˺̹੮˺̼੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦੮ ͸ʩʇ˦੮ʮ˦੮ɻ̼ʮͅʮͅੴ੮ɘ˦ʁ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ;੮͸ʮ˦ʁ੮͙̹੮ʮ˦੮ɘ੮̹̼ʮͷɘ͐ʇ੮˺̼੮ɘ੮̹͙ɺˑʮɻ੮ʩ˺̹ͅʮ͐ɘˑੳ "ʇʠ˺̼ʇ੮͐ͅɘ̼͐ʮ˦ʡੴ੮ɘ੮ϲʮ˦ɘˑ੮˦˺͐ʇ੮˺˦੮͐ʇ̼˚ʮ˦˺ˑ˺ʡ;ੳ੮îʩʇ੮ɻʩ˺ʮɻʇ੮˺ʠ੮͸˺̼ʁͅ੮͐˺੮ʁʇͅɻ̼ʮɺʇ੮ ͐ʩʇ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʮͅ੮ʠ̼ɘ͙ʡʩ͐ੳ੮š˦੮͐ʩʇ੮˺˦ʇ੮ʩɘ˦ʁੴ੮ͅ˺˚ʇ੮ɘʁͷ˺ચ ɻɘ͐ʇͅ੮ʠ˺̼੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ફ˺ʠ͐ʇ˦੮̹ɘ̼ʇ˦͐ͅબ੮ʩɘͷʇ੮ɻɘˑˑʇʁ੮ʠ˺̼੮̼ʇˑɘɺʇˑʮ˦ʡ੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ ˑʮˌʇ੮ ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ ɘͅ੮ ુ˦ʇ͙̼˺ɺʮ˺ˑ˺ʡʮɻɘˑ੮ ʁʮͅ˺̼ʁʇ̼ͅੳૂ੮ îʩʇ;੮ ɘ̼ʇ੮ ͐ɘˌʮ˦ʡ੮ ͐ʩʇʮ̼੮ɻ͙ʇ੮ʠ̼˺˚੮ͅ˺˚ʇ੮̼ʇʠ˺̼˚ʇ̼ͅ੮ʮ˦੮͐ʩʇ੮‡ɘ͐ʮ˺˦ɘˑ੮U˦͐ͅʮ͙͐͐ʇ੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮ ʩɘͷʇ੮͸˺˦੮˺ͷʇ̼੮̹˺ˑʮ͐ʮɻʮɘ˦ͅ੮͙ͅɻʩ੮ɘͅ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚ੴ੮͸ʩ˺੮͐ɘˑˌͅ੮ɘɺ˺͙͐੮ુͅʇ̼ʮ˺͙ͅ੮ ɺ̼ɘʮ˦੮ʮˑˑ˦ʇͅͅʇͅੳૂৼਃ੮îʩʇ੮ɘ͙ͅͅ˚̹͐ʮ˺˦੮ʮͅ੮͐ʩɘ͐੮͐ʩʇͅʇ੮ˑɘɺʇˑͅ੮̼ʇʁ͙ɻʇ੮͐ͅʮʡ˚ɘ੮ફ˦˺੮˺˦ʇ੮ɻɘ˦੮ ɺʇ੮ʩʇˑʁ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮͐ʩʇʮ̼੮ʠɘ͙ˑ͐;੮ʡʇ˦ʇͅ੮˺̼੮ɺ̼˺ˌʇ˦੮˚ʇ˦͐ɘˑ੮ɻʮ̼ɻ͙ʮ̼͐;બੳ੮îʩʇ;੮ɘˑͅ˺੮ ʮ˚̹ˑ;੮ ͐ʩɘ͐੮ ˚ʇʁʮɻɘˑ੮ ˦ʇʇʁ੮ ͅʩ˺͙ˑʁ੮ ̼͙͐˚̹੮ ɻʮͷʮˑ੮ ˑʮɺʇ̼͐ʮʇͅ੮ ફુ;˺͙੮ ʁ˺˦ૄ͐੮ ʩɘͷʇ੮ ͐˺੮ ʩɘͷʇ੮ ͐ʩʇ੮̹ʇ̼˚ʮͅͅʮ˺˦੮˺ʠ੮ɘ੮ˈ͙ʁʡʇ੮͐˺੮̼͐ʇɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ʠ˺̼੮ɘ੮ɺ̼ɘʮ˦੮ʁʮͅʇɘͅʇ੮ˑʮˌʇ੮ˑΈʩʇʮ˚ʇ̼ૄͅੴૂ੮ U੮ʩɘͷʇ੮˺ʠ͐ʇ˦੮ɺʇʇ˦੮͐˺ˑʁબੳ U˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮U੮ʇͅɻʩʇ͸੮͐ʇ̼˚ͅ੮ˑʮˌʇ੮brain disease or neurobiological disorderੳ੮H˺̼੮˺˦ʇ੮ ͐ʩʮ˦ʡੴ੮͐ʩʇ;੮ɘ̼ʇ੮̹˺͐ʇ˦͐ʮɘˑˑ;੮ʩɘ̼˚ʠ͙ˑੳ੮)ʇͅɻ̼ʮɺʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɘͅ੮ʩɘͷʮ˦ʡ੮ ʁɘ˚ɘʡʇʁ੮ɺ̼ɘʮ˦ͅ੮ɘɻ͙͐ɘˑˑ;੮ͅʇʇ˚ͅ੮͐˺੮ʮ˦ɻ̼ʇɘͅʇ੮͐ͅʮʡ˚ɘ੮ɘ˦ʁ੮ʠʇɘ̼ੳৼ਄੮îʩʇ;੮ɘ̼ʇ੮ɘˑͅ˺੮˚ʮͅˑʇɘʁચ ʮ˦ʡੳ੮U੮ɘ˚੮ͅ;˚̹ɘ͐ʩʇ͐ʮɻ੮͐˺੮ɘʁͷ˺ɻɘ͐ʇͅૄ੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ɘ̼ʡ͙ʇ੮͐ʩɘ͐੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ˑʮˌʇ੮ͅɻʩʮΈ˺ચ ̹ʩ̼ʇ˦ʮɘ੮ɘ̼ʇ੮ɘͅ੮ુ̼ʇɘˑૂ੮ɘͅ੮ʁʮɘɺʇ͐ʇͅ੮˺̼੮ʁʇ˚ʇ˦͐ʮɘੳ੮"͙͐੮͐ʩʇ੮ʠɘɻ͐੮͐ʩɘ͐੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̼͐ʇɘ͐˚ʇ˦͐੮ ɻɘ˦੮ɺʇ੮ʮ˚̹˺ͅʇʁ੮˺˦੮̹ʇ˺̹ˑʇ੮ʇͽ̹ˑʮɻʮ͐ˑ;੮̼ʇʠ͙ͅʮ˦ʡ੮ʮ͐੮ɘˑͅ˺੮˚ɘˌʇͅ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ˑʮˌʇ੮ͅɻʩʮΈ˺ચ ̹ʩ̼ʇ˦ʮɘ੮͙˦ʮή͙ʇ੮ʮ˦੮ɘ੮͸ɘ;੮͐ʩɘ͐੮͐ʇ̼˚ͅ੮ˑʮˌʇ੮brain illness੮ʁʇˑʮɺʇ̼ɘ͐ʇˑ;੮ͅʇʇˌ੮͐˺੮ʇˑʮʁʇੳ š˦੮ ͐ʩʇ੮ ˺͐ʩʇ̼੮ ʇ˦ʁ੮ ˺ʠ੮ ͐ʩʇ੮ ̹ͅʇɻ̼͙͐˚੮ ɘ̼ʇ੮ ͐ʇ̼˚ͅ੮ ˑʮˌʇ੮ consumerੴ੮ survivorੴ੮ ˺̼੮ ɐ͆؅̂ȡ̙ɷɐʯ̙ੴ੮ ͸ʩʮɻʩ੮ ɘ̼ʇ੮ ͙ͅʇʁ੮ ɺ;੮ ̹ʇ˺̹ˑʇ੮ ˺˦੮ ͐ʩʇ੮ ̼ʇɻʇʮͷʮ˦ʡ੮ ʇ˦ʁ੮ ˺ʠ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ɻɘ̼ʇੳ੮ Survivor or ɐ͆؅̂ȡ̙ɷɐʯ̙੮ɻɘ̹͙̼͐ʇͅ੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇૄͅ੮ˑʮͷʇʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮˺ʠ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ ɺ͙͐੮ɘ̼ʇ੮̼ɘ̼ʇˑ;੮͙ͅʇʁ੮ɘ˚˺˦ʡ੮̼ʇɻʮ̹ʮʇ˦͐ͅ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮˚˺̼ʇ੮ʡʇ˦ʇ̼ɘˑˑ;ੳ৽৻ Consumer੮ʩɘ̼ˌʇ˦ͅ੮͐˺˺੮˚͙ɻʩ੮͐˺੮͐ʩʇ੮̹̼ʮͷɘ͐ʮΈɘ͐ʮ˺˦੮˺ʠ੮ɻɘ̼ʇ੮͐ʩɘ͐੮͐ʩʮͅ੮ɺ˺˺ˌ੮ɻ̼ʮ͐ʮή͙ʇͅੳ੮ U੮ʁ˺੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮ˈ˺ʮ˦੮ɘɻ͐ʮͷʮ͐ͅͅ੮ɘ˦ʁ੮ͅɻʩ˺ˑɘ̼ͅ੮͸ʩ˺੮ʩɘͷʇ੮̼ʇɻˑɘʮ˚ʇʁ੮͐ʩʇ੮˺͐ʩʇ̼͸ʮͅʇ੮ ̹ʇˈ˺̼ɘ͐ʮͷʇ੮͐ʇ̼˚੮mad੮ફ˚͙ɻʩ੮ɘͅ੮rI"îÚ੮ɘɻ͐ʮͷʮ͐ͅͅ੮ʩɘͷʇ੮ʁ˺˦ʇ੮ʠ˺̼੮queerબੳ੮U੮ɘˑͅ˺੮͐ɘˑˌ੮ about clients੮ʮ˦੮ɻˑʮ˦ʮɻͅੴ੮patients੮ʮ˦੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ɘ˦ʁ੮residents੮ʮ˦੮ɺ˺ɘ̼ʁચɘ˦ʁચɻɘ̼ʇ੮ʩ˺˚ʇͅ੮ ɺʇɻɘ͙ͅʇ੮͐ʩ˺ͅʇ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮͷʇ੮ˑɘɺʇˑͅ੮ɘ̼ʇ੮ɘɻɻ͙̼ɘ͐ʇ੮ͅʩ˺̼͐ʩɘ˦ʁ੮ʠ˺̼੮͸ʩʇ̼ʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮͅ੮ ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੳ

P R E FAC E

XV

U˦੮͐ʩʇ੮ʇ˦ʁੴ੮U੮ʩɘͷʇ੮ˑɘ̼ʡʇˑ;੮ɻʩ˺ͅʇ˦੮͐ʩʇ੮˚˺͐ͅ੮ɺɘ˦ɘˑ੮̼˺͙͐ʇੳ੮U˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮U੮̹ͅʇɘˌ੮˺ʠ੮ ુ̹ʇ˺̹ˑʇ੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅૂ੮͐˺੮ʁʇͅɻ̼ʮɺʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮ɘ̼ʇ੮ʁʮɘʡચ ˦˺ͅʇʁ੮͸ʮ͐ʩ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͙ͅɻʩ੮ɘͅ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ੮ɺʮ̹˺ˑɘ̼੮ʁʮͅ˺̼ʁʇ̼ੴ੮˺̼੮˚ɘˈ˺̼੮ʁʇ̹̼ʇͅચ ͅʮ˺˦ੳ৽ৼ੮ä͙͐ʁʮʇͅ੮ʩɘͷʇ੮ͅʩ˺͸˦੮͐ʩɘ͐੮͙ͅɻʩ੮ુ̹ʇ̼ͅ˺˦ચϲʮ̼͐ͅૂ੮ˑɘ˦ʡ͙ɘʡʇ੮ʮ˦ɻ̼ʇɘͅʇͅ੮ʇ˚̹ɘ͐ʩ;੮ ͐˺͸ɘ̼ʁ੮͐ʩ˺ͅʇ੮ͅ˺੮ˑɘɺʇˑʇʁੳ৽৽੮îʩɘ͐੮ͅɘʮʁੴ੮͐ʩʮͅੴ੮͐˺˺ੴ੮ʮͅ੮ɘ˦੮ʮ˚̹ʇ̼ʠʇɻ͐੮˚˺˦ʮˌʇ̼ੳ੮Ĕʩʮˑʇ੮৴ੳ৵੮ ̹ʇ̼ɻʇ˦͐੮˺ʠ੮˚ʇ̼ʮɻɘ˦੮ɘʁ͙ˑ͐ͅ੮ʩɘʁ੮ɘ੮ુͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅૂ੮ʮ˦੮͐ʩʇ੮̹ɘ͐ͅ੮;ʇɘ̼ੴ৽৾੮͐ʩʮͅ੮ ɺ˺˺ˌ੮ʮͅ੮˺˦ˑ;੮ɘɺ˺͙͐੮ɘ੮͐ʮ˦;੮ͅˑʮͷʇ̼੮˺ʠ੮͐ʩʇ˚ੳ੮/ͷʇ˦੮ɘ˚˺˦ʡ੮͐ʩʇ੮ৰੳ৴੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɘʁ͙ˑ͐ͅ੮ ͸ʩ˺੮ˑʮͷʇ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ৽৿੮˚ɘ˦;੮̼ʇͅʮʁʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮͸ʮ͐ʩ˺͙͐੮ʇͷʇ̼੮ɺʇʮ˦ʡ੮ ɻ˺˦ͅʮʁʇ̼ʇʁ੮ ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ îʩʮͅ੮ ɺ˺˺ˌૄͅ੮ ʠ˺ɻ͙ͅ੮ ʮͅ੮ ˺˦੮ ͐ʩ˺ͅʇ੮ ͸ʩ˺੮ ʩɘͷʇ੮ ʠɘˑˑʇ˦੮ ͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ɻ̼ɘɻˌͅ੮˺ʠ੮͐ʩʇ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮U͐੮˺ʠʠʇ̼ͅ੮ˑʇͅͅ੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮ ͐ʩ˺ͅʇ੮͸ʩ˺੮ʩɘͷʇ੮ɺʇʇ˦੮͸ʇˑˑ੮ͅʇ̼ͷʇʁ੮ɘ˦ʁ੮ʩɘͷʇ੮͐ʩ̼ʮͷʇʁ੮͸ʮ͐ʩ੮ʮ͐ͅ੮ʩʇˑ̹ੳ ˦˺͐ʩʇ̼੮ ʁ̼ɘ͸ɺɘɻˌ੮ ˺ʠ੮ ͐ɘˑˌʮ˦ʡ੮ ɘɺ˺͙͐੮ ુ̹ʇ˺̹ˑʇ੮ ˑʮͷʮ˦ʡ੮ ͸ʮ͐ʩ੮ ͅʇ̼ʮ˺͙ͅ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑચ ˦ʇͅͅૂ੮ʮͅ੮͐ʩɘ͐੮͐ʩʇ੮ˑɘɺʇˑ੮ʣɐʯ͗ȡʚʚ͇‫ף‬ɷʚʚ੮ʮͅ੮̹̼ʇɻʮͅʇˑ;੮͸ʩɘ͐੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ɘ̼ʇ੮ ɻ˺˦͐ʇ͐ͅʮ˦ʡੳ੮ Uૄ˚੮ ͐ʮ̹̹ʮ˦ʡ੮ ˚;੮ ʩɘ˦ʁ੮ ʩʇ̼ʇੳ੮ ͅ੮ ʮ˦˦͙˚ʇ̼ɘɺˑʇ੮ ɘ˦͐ʩ̼˺ચ ̹˺ˑ˺ʡʮ͐ͅͅ੮ʩɘͷʇ੮ͅʩ˺͸˦ੴ੮ુ˚ɘͅͅʮͷʇ੮ɘ˦ʁ੮ˑɘ͐ͅʮ˦ʡ੮ʁʮ͙̼͐ͅɺɘ˦ɻʇͅ੮˺ʠ੮̼ʇɘͅ˺˦ੴ੮ʮ˦͐ʇˑˑʇɻ͙͐ɘˑੴ੮ ɘ˦ʁ੮ʇ˚˺͐ʮ˺˦ͅૂ੮ɘ̼ʇ੮ુ͐˺੮ɺʇ੮ʠ˺͙˦ʁ੮ʮ˦੮ɘˑˑ੮ˌ˦˺͸˦੮ͅ˺ɻʮʇ͐ʮʇͅੳૂ৽਀੮Ĕʩʇ͐ʩʇ̼੮ɘ˦ʁ੮ʩ˺͸੮͸ʇ੮ ɻɘ̼ͷʇ੮͙̹੮͐ʩ˺ͅʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ʮ˦͐˺੮˚ʇʁʮɻɘˑ੮ʁʮɘʡ˦˺ͅʇͅ੮ͷɘ̼ʮʇͅ੮ʇ˦˺̼˚˺͙ͅˑ;੮ɺ;੮ͅ˺ɻʮɘˑ੮ ɘ˦ʁ੮ɻ͙ˑ͙̼͐ɘˑ੮ɻ˺˦͐ʇͽ͐ੳ৽ਁ੮Øɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮̼ʮʡʩ͐੮͐ʩɘ͐੮͐ʩʇͅʇ੮ʁʮɘʡ˦˺ͅʇͅ੮ɘ̼ʇ੮˺ʠ͐ʇ˦੮ɘ̹̹ˑʮʇʁ੮ ʮ˦੮͙˦ʠɘʮ̼੮ɘ˦ʁ੮͙˦ʩʇˑ̹ʠ͙ˑ੮͸ɘ;ͅੳ੮"͙͐੮͐ʩʇ੮̹˺ʮ˦͐੮ʮͅ੮͐ʩɘ͐੮ુͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅૂ੮ɻɘ̹ચ ͙̼͐ʇͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮͐ʩɘ͐੮ɘ̼ʇੴ੮ʮ˦੮ɘ˦੮ʮ˚̹˺̼͐ɘ˦͐੮ͅʇ˦ͅʇੴ੮ુ̼ʇɘˑੳૂ੮H˺̼੮ͅ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ ͐ʩʇ੮͙ͅʠʠʇ̼ʮ˦ʡ੮͐ʩʇͅʇ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ɻɘ͙ͅʇ੮ɻɘ˦੮ɺʇ੮ɘˑˑʇͷʮɘ͐ʇʁ੮ɺ;੮ɺʮ˺˚ʇʁʮɻɘˑ੮̼͐ʇɘ͐˚ʇ˦͐ͅ੮ ˑʮˌʇ੮ ̹ʩɘ̼˚ɘɻʇ͙͐ʮɻɘˑͅੴ੮ ͐ʩ˺͙ʡʩ੮ ͐˺˺੮ ˺ʠ͐ʇ˦੮ ˺͙̼੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ઝɘ˦ʁ੮ ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮̹ɘ̼͐ʮɻ͙ˑɘ̼ઝʇͽɘɻʇ̼ɺɘ͐ʇͅ੮ʮ͐ੳ šʠ੮ɻ˺͙̼ͅʇੴ੮͐ʩʇ੮ɺʇ͐ͅ੮˺̹͐ʮ˺˦੮ʮͅ੮͐˺੮͐ɘˑˌ੮ɘɺ˺͙͐੮̹ʇ˺̹ˑʇ੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅʇͅ੮ ɘͅੴ੮ͅʮ˚̹ˑ;ੴ੮̹ʇ˺̹ˑʇੳ੮îʩ̼˺͙ʡʩ˺͙͐੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮ɘ˦;੮̹ʇ̼ͅ˺˦੮U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮͸ʩ˺੮ʮͅ੮ʮ˦̼͐˺ચ ʁ͙ɻʇʁ੮͸ʮ͐ʩ੮ɘ੮ϲʮ̼͐ͅ੮ɘ˦ʁ੮ˑɘ͐ͅ੮˦ɘ˚ʇ੮ʩɘͅ੮ʡʮͷʇ˦੮ɻ˺˦ͅʇ˦͐੮ʠ˺̼੮͐ʩʇʮ̼੮̼ʇɘˑ੮˦ɘ˚ʇ੮͐˺੮ɺʇ੮͙ͅʇʁੳ੮ š͐ʩʇ̼੮˦ɘ˚ʇͅ੮ɘ̼ʇ੮̹ͅʇ͙ʁ˺˦;˚ͅੳ੮U੮ʩɘͷʇ੮ˑʇ͐੮̹ɘ̼͐ʮɻʮ̹ɘ˦͐ͅ੮ɻʩ˺˺ͅʇ੮͐ʩʇʮ̼੮̹̼ʇʠʇ̼̼ʇʁ੮ˑʇͷʇˑ੮ ˺ʠ੮ɘ˦˺˦;˚ʮ͐;ੴ੮͸ʩʮɻʩ੮ʮͅ੮͸ʩ;੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮͸ʮ͐ʩ੮ɘ੮̹̼ʇɻʮͅʇ੮ˑ˺ɻɘ͐ʮ˺˦੮ ɘ˦ʁ੮ˈ˺ɺ੮͐ʮ͐ˑʇ੮͸ʩʮˑʇ੮˺͐ʩʇ̼ͅ੮ɘ̼ʇ੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮ʮ˦੮ͷɘʡ͙ʇ੮͐ʇ̼˚ͅੳ੮U͐੮ʮͅ੮˚;੮ʩ˺̹ʇ੮͐ʩɘ͐੮ɘˑˑ੮ ͐ʩʇͅʇ੮ʮ˦ͷɘˑ͙ɘɺˑʇ੮ɻ˺˦̼͐ʮɺ͙͐˺̼ͅ੮͐˺੮͐ʩʮͅ੮͙͐ͅʁ;ੴ੮͸ʩʇ͐ʩʇ̼੮˺̼੮˦˺͐੮͐ʩʇ;੮ɘʡ̼ʇʇ੮͸ʮ͐ʩ੮˚;੮ ɻ˺˦ɻˑ͙ͅʮ˺˦ͅੴ੮ϲʮ˦ʁ੮͐ʩɘ͐੮U੮ʩɘͷʇ੮ɘɻɻ͙̼ɘ͐ʇˑ;੮ͅʩʇʁ੮ˑʮʡʩ͐੮˺˦੮͐ʩʇʮ̼੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ɘ˦ʁ੮ʡʮͷʇ˦੮ ͷ˺ʮɻʇ੮͐˺੮͐ʩʇʮ̼੮̹ʇ̼̹ͅʇɻ͐ʮͷʇͅੳ

CONSERVATORSHIP

INTRODUCTION The Other Magna Carta

W

ally sits alone while California’s mental health system swirls around him. In July 2021, I drive to central Los Angles alongside Dr. Susan Partovi, the media-styled “Renegade Doctor of Skid Row.”ৼ We’re on an outreach mission to one of her “super-dupers”—individuals who, as a result of a seri˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ɘ̼ʇ੮͙̹ͅʇ̼ʠ̼ʇή͙ʇ˦͐੮͙ͅʇ̼ͅ੮˺ʠ੮̹͙ɺˑʮɻ੮ͅʇ̼ͷʮɻʇͅੴ੮ bouncing endlessly among emergency rooms, jails, shelters, and the street—and, for all that excess utilization, are at risk of imminent death. As we pull into a gas station parking lot, Dr. Partovi points out Wally to me. He’s easy to overlook. In a city where homelessness is visible not just in unhoused ɺ˺ʁʮʇͅ੮ɺ͙͐੮ʮ˦੮˚ɘˌʇͅʩʮʠ͐੮ͅʩɘɻˌͅ੮ɘ˦ʁ੮˺ͷʇ̼ϲˑ˺͸ʮ˦ʡ੮ͅʩ˺̹̹ʮ˦ʡ੮ɻɘ̼͐ͅੴ੮Ĕɘˑˑ;੮ʮͅ੮ͅʮ͐͐ʮ˦ʡ੮ in a bus shelter without so much as a backpack. ‘He’s been there for weeks with absolutely nothing. That’s the biggest sign to me that someone’s really not doing well, really gravely disabled,’৽ Dr. Partovi tells me. Hold on to that term, gravely disabledੳ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮Ĕʇˑʠɘ̼ʇ੮ɘ˦ʁ੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮#˺ʁʇ੮ʁʇϲʮ˦ʇͅ੮ʮ͐੮ɘͅ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅੴ੮ “as a result of a mental disorder, unable to provide for his or her basic personal needs for food, clothing, or shelter.”৾ It’s key to Wally’s story. Ĕɘˑˑ;੮ˑ˺˺ˌͅ੮͐˺੮ɺʇ੮͸ʩʮ͐ʇ੮ɘ˦ʁ੮ʮ˦੮ʩʮͅ੮ʠ˺̼͐ʮʇͅ੮˺̼੮ϲʮʠ͐ʮʇͅੴ੮ɘˑ͐ʩ˺͙ʡʩ੮ʮ͐ૄͅ੮ʩɘ̼ʁ੮͐˺੮͐ʇˑˑੳ੮ His face is grimy, and his gnarled hands are covered in sores. He’s wearing a red heavy winter jacket, even though the temperature will soon plateau at one hundred degrees. ૃPʮੴ੮ʁ˺੮;˺͙੮̼ʇ˚ʇ˚ɺʇ̼੮˚ʇ੺ૄ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ή͙ʇ̼ʮʇͅ੮ ɻʩʇʇ̼ʮˑ;ੳ੮ äʩʇૄͅ੮ ɺʇʇ˦੮ͷʮͅʮ͐ʮ˦ʡ੮ him regularly for a year. Wally smiles, baring his two remaining teeth, but doesn’t ɘ˦ͅ͸ʇ̼੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦ੳ ‘Have you been eating?’

2

INTRODUCTION

He responds slowly: ‘Not really.’ ‘Are you drinking any water?’ He says ‘yes.’ But there are no bottles around him, so we have doubts about how recently. ‘Can you take that jacket off if it keeps getting hot?’ she asks. He stares back. Partovi proposes getting him a burrito, and we start crossing the street toward ɘ੮˦ʇɘ̼ɺ;੮͐ɘή͙ʇ̼ʮɘੴ੮ɘˑ͐ʩ˺͙ʡʩ੮U੮ɻʮ̼ɻˑʇ੮ɺɘɻˌ੮͐˺੮ɘͅˌ੮ʩʮ˚੮͸ʩɘ͐੮ˌʮ˦ʁੳ Now he lights up: ‘Carne asada.’ Ĕʩʮˑʇ੮͸ʇૄ̼ʇ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮ɺ͙̼̼ʮ͐˺ੴ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ϲʮˑˑͅ੮˚ʇ੮ʮ˦੮˺˦੮ɘ੮ɺʮ͐੮˺ϲ੮Ĕɘˑˑ;ૄͅ੮ back story. He had been in a shelter in Hollywood, where he was ‘pretty happy’ until it closed down. But the COVID-19 pandemic offered a potential upgrade: Project Roomkey, which gave him and thousands of “high-risk” homeless individuals converted hotel rooms. He left his room after one day, with no explanation. Shortly thereafter, he was hit by a car while inebriated and spent ten days in an intensive care unit. They released him to a nursing home, where Partovi hoped he would stay. But Wally walked out, cast still on his leg. Back to his bus stop. Ĕʇ੮ɻ˺˚ʇ੮ɺɘɻˌ੮͸ʮ͐ʩ੮͐ʩʇ੮ɺ͙̼̼ʮ͐˺ੴ੮ɘ˦ʁ੮Øɘ̼͐˺ͷʮ੮ɻ˺˦͐ʮ˦͙ʇͅ੮ή͙ʮΈΈʮ˦ʡ੮ʩʮ˚ੵ੮ૃĔʩʇ̼ʇ੮ have you been sleeping?’ ‘Here,’ he tells us. ‘You were at the hotel, why did you leave?’ He shrugs. ‘We’ve been trying really hard to keep you indoors, you know.’ Wally smiles and nods. Right then, I get a better sense of who ‘we’ is. Wally’s case manager from his Full-Service Partnership team—the most intensive level of public outpatient mental health care in California—pulls up in a sedan. Dr. Partovi walks up to the ɻɘ̼੮͸ʮ˦ʁ˺͸੮ɘ˦ʁ੮ʡʮͷʇͅ੮ɘ੮ή͙ʮɻˌ੮̼͙˦ʁ˺͸˦੮˺ʠ੮˺͙̼੮ʮ˦͐ʇ̼ɘɻ͐ʮ˺˦੮ͅ˺੮ʠɘ̼ੳ੮îʩʇ੮ɻɘͅʇ͸˺̼ˌʇ̼੮ starts ticking off the various shelters and supported housing programs she’s been applying to on his behalf. ‘We’re just going to try everything and see if it sticks,’ she announces. They’ve had some successes. With Wally’s agreement, one of Partovi’s team members donned a hazmat suit and shaved off his lice-ridden hair. His case manager visited him daily until she convinced him to go onto a monthly antipsychotic injection. ‘Do you see how he’s making eye contact?’ Partovi tells me, ‘That’s because we got him on Abilify [an antipsychotic].’ Nonetheless, we presume he is

INTRODUCTION

3

still so delusional that we can stand right next to him talking about him, without expecting much of a response. We leave Wally with his caseworker, but when we’re pulling out of the parking lot, we hear ‘Hey!’ and see a staff member from his previous homeless shelter, who is driving up to check on him. Dr. Partovi will have a phone call this afternoon with a clinician from the LA Department of Mental Health’s Homeless Outreach and Mobile Engagement team. They’ve picked Wally out of Los Angeles’s 69,144 homeless individuals as one of a few dozen most “unable to live safely in the community.”৿ With all those interventions swirling around him, he’s still unhoused, barely fed, and wearing a winter jacket at a bus stop during a heat wave. Partovi’s credentials as someone who not only cares for but listens to and respects the poor and dispossessed are impeccable. Later that week, I join her at the Skid Row clinic where she treats homeless heroin users and sends them to pick up injection supplies at the needle exchange on the way out. She once took in a homeless woman’s nine cats to get her to go into treatment. She tells me that, back when public insurance didn’t cover the cost of antipsychotics, she’d buy them herself. But when it comes to Wally, she’s doesn’t think we should be deferring to his decisions anymore. I ask her what she thinks you’d have to offer Wally to get him ͐˺੮ɘʡ̼ʇʇ੮͐˺੮ɻ˺˚ʇ੮˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮äʩʇ੮ϲʮ̼ʇͅ੮ɺɘɻˌੵ੮ુ‡˺͐ʩʮ˦ʡੳ੮Pʇૄͅ੮ͅ˺੮̹ɘ̼ɘ˦˺ʮʁ੮͐ʩɘ͐੮ he doesn’t want to go anywhere other than the bus stop that he’s used to. And so you need to treat him.” Wally is already on medication. “Treat” means forcing him into an institution where, in Partovi’s words, he can “marinate” on his antipsychotic until he’s capable of realizing he wants to stay indoors, properly fed and clothed. In order to force him into an institution, Wally needs a conservatorship—a legal status under which a judge gives a third party the power to decide where a person lives, how to spend their money, and whether to consent to medical treatment on their behalf. And in order to get a conservatorship, not just a ˈ͙ʁʡʇ੮ɺ͙͐੮ɘ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ੴ੮ɘ˦੮ʇ˚ʇ̼ʡʇ˦ɻ;੮̼˺˺˚੮ɻˑʮ˦ʮɻʮɘ˦ੴ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴ੮ a county investigator, and the person deciding on admissions for a locked treatment facility all need to agree over the course of a months-long process that he is gravely disabled. Every time one of the many and varied actors serving Wally has tried to get him conserved, someone along that continuum has said, against all apparent indications, that Wally is not gravely disabled. And so he goes back to his bus stop.

4

INTRODUCTION

îʩʮͅ੮ ɺ˺˺ˌ੮ ʠ˺ˑˑ˺͸ͅ੮ ͐ʩʇ੮ ʇʠʠ˺̼͐ͅ੮ ˺ʠ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ˺ϲϲʮɻʮɘˑͅੴ੮ ʠɘ˚ʮˑʮʇͅੴ੮ ɘ˦ʁ੮ ˚ʇʁʮcal professionals to get people like Wally onto conservatorship in California. It charts the simultaneous battles of civil liberties campaigners, survivors of forced treatment, and clinicians committed to voluntary care to keep people off of conservatorships. Everyone agrees it’s a life-or-death struggle. Governor Gavin Newsom claims that the state’s strict laws governing conservatorship have “sentenced people” like Wally “to death.”਀ In response, Newsom has supported a host of reforms to ramp up conservatorships to address disruptive behavior and substance abuse among people who are homeless. Many families of people with mental illness see conservatorship as their last hope to stabilize loved ones ricocheting among jails, hospitals, and the street. These efforts have been opposed by groups like the American Civil Liberties Union, which assert that conservatorships are “the greatest deprivation of civil rights aside from the death penalty.”ਁ There’s no doubt where Dr. Partovi stands: “The idea that people ‘just like being homeless, that’s their choice, if they want to die, it’s their right to die’—it’s just bullshit,” she tells me. Most portrayals of this debate depict a titanic clash between people’s civil rights and their well-being, between mental health clients who see conservatorship as coercion and family members who see it as compassionate care. Social scientists, too, have looked at debates over civil commitment as a battle between two powerful professions: law and medicine. This book tells the story of conservatorship from a different angle. It focuses ˺˦੮ʩ˺͸ੴ੮ʠ˺̼੮ϲʮʠ͐;੮;ʇɘ̼ͅੴ੮͐ʩʇ੮͐ͅɘ͐ʇ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩɘͅ੮abdicated authority for the use of its own power. Government, which has the prerogative to organize, regulate, and direct the conservatorship system, doesn’t. It has instead delegated responsibility ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐˺੮ɘ੮͸ʇˑ͐ʇ̼੮˺ʠ੮̹̼ʮͷɘ͐ʇ੮ɘ˦ʁ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ɘʡʇ˦ɻʮʇͅ੮ɘ˦ʁ੮ʡʮͷʇ˦੮͐ʩʇ˚੮ enormous discretion੮ʮ˦੮͙ͅʮ˦ʡ੮ʮ͐ੳ੮ͅ੮ɘ੮̼ʇ͙ͅˑ͐ੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮ɺʇʮ˦ʡ੮ʁʇϲʮ˦ʇʁ੮˦˺͐੮ by the courts or legislators but by the market forces that shape the availability of psychiatric hospital beds and the resources, constraints, and preferences of “street-level bureaucrats.”ਂ îʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ɘɺʁʮɻɘ͐ʮ˺˦੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮ɘ੮̹ɘ̼ɘʁ˺ͽʮɻɘˑ੮̼͐ɘʡedy. People like Wally can be subjected to repeated, ineffectual bouts of coercive ɻɘ̼ʇੳ੮ îʩʇ;੮ ɘ̼ʇ੮ ˺ʠ͐ʇ˦੮ ͐ʩʇ੮ ˺ɺˈʇɻ͐ͅ੮ ˺ʠ੮ ʇͽʩɘ͙͐ͅʮͷʇ੮ ʇʠʠ˺̼͐ͅ੮ ˺ʠ੮ ͅʇˑϲˑʇͅͅ੮ ɻˑʮ˦ʮɻʮɘ˦ͅੳ੮ Ěʇ͐੮ their basic needs for shelter, dignity, and care are still unmet. When someone winds up conserved, it’s more likely thanks to what one mother described as “luck

INTRODUCTION

5

and heroics”ਃ—or what conservatees might think of as misfortune and abusive paternalism—than any coherent policy. The result is a triumph for neither law nor medicine but for privatization, fragmentation, and bureaucratization. People under conservatorship in California and those potentially affected by the expansions of conservatorship number in the tens of thousands.਄ But this book is a broader cautionary tale. Nationwide, politicians want to address problems ranging from the overdose crisis to the mass incarceration of people living with severe mental illness by ramping up involuntary mental health care. But new laws will leave individuals like Wally at their bus stops until government assumes real authority over the mental health system and accountability to the people it serves.

A NEW BILL OF RIGHTS To understand how Wally wound up at that bus stop, you need to go back to a landmark piece of legislation: the 1967 Lanterman-Petris-Short (LPS) Act. It is remembered as a “Bill of Rights” for people with mental illness that aimed to strictly limit involuntary psychiatric treatment.ৼ৻ Less visibly, it laid the groundwork for the state’s departure from responsibility for providing care to people with the most serious mental illnesses. By the mid-twentieth century, California’s Department of Mental Hygiene was the second-largest agency in the state (after only the University of California).ৼৼ It managed fourteen state psychiatric hospitals that, at their height, ʮ˦͐ʇ̼˦ʇʁ੮৳৷ੴৰৰৰ੮̹ʇ˺̹ˑʇੳ੮U˦੮ৱ৹৶৳ੴ੮ʮ˦ͷʇ͐ͅʮʡɘ͐˺̼ͅ੮ʁʮͅɻ˺ͷʇ̼ʇʁ੮ુͅʩ˺ɻˌʮ˦ʡ੯ੳ੯ੳ੯ੳ੮ɺ̼͙͐ɘˑʮ͐;੮ and neglect” at Fairview hospital, the state’s newest facility.ৼ৽ Patients were shackled and left naked in unheated seclusion rooms for days on end.ৼ৾ The state hospital system was thus just the kind of bloated, underperforming government bureaucracy that was a ripe target for the likes of Frank Lanterman, an archconservative Republican state assembly member from Pasadena. So he, Nicholas Petris (a Democrat from Oakland), and a handful of other legislators launched ɘ˦੮ʮ˦ή͙ʮ̼;ੴ੮̼͐;ʮ˦ʡ੮͐˺੮ુɘͅɻʇ̼͐ɘʮ˦੮͸ʩʇ͐ʩʇ̼੮͸ʇ੮͸ʇ̼ʇ੮ʡʇ͐͐ʮ˦ʡ੮˺͙̼੮˚˺˦ʇ;ૄͅ੮͸˺̼͐ʩੳૂৼ৿ They were not. State-run asylums had been set up in the nineteenth century on psychiatrists’ promise that giving the “mad” a calm place cut off from society would restore them to sanity and productivity.ৼ਀ These institutions had become, in the words of these legislators, “a bin marked ‘miscellaneous’ to receive every

6

INTRODUCTION

personnel problem facing society.”ৼਁ Those abandoned inside included people diagnosed with schizophrenia as well as chronic alcoholism, dementia, and developmental disabilities. Few received anything resembling treatment. The legislators’ survey found that 2 percent of “patients” went to individual or group therapy, 12 percent received drugs, 41 percent were getting “milieu therapy” (that is, “treatment” that comes from the mere fact of being in a hospital), and 40 percent had only custodial care (why they weren’t even getting “milieu therapy” is unclear).ৼਂ Perhaps most alarming, though, was how people got there.ৼਃ Petris recalled in ɘ੮ˑɘ͐ʇ̼੮ʮ˦͐ʇ̼ͷʮʇ͸ੵ੮ુ੮ʡ͙;੮͸ɘˑˌʮ˦ʡ੮ʁ˺͸˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ʩʮ˚ͅʇˑʠ੯ੳ੯ੳ੯ੳ੮ɘ੮̹˺ˑʮɻʇman could pick him up, take him to the emergency hospital, and a judge would ̼ɘʮˑ̼˺ɘʁ੮ʩʮ˚੮ʮ˦͐˺੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੯ੳ੯ੳ੯ੳ੮äʇ˦ʮ˺̼੮ɻʮ͐ʮΈʇ˦ͅ੮͸ʇ̼ʇ੮ɺʇʮ˦ʡ੮ͅʩ˺ͷʇˑʇʁ੮ʮ˦͐˺੮ hospitals by many thousands a year.”ৼ਄ The people in state hospitals seemed to “suffer not from mental illness, but from contingencies”—the bad luck of lacking a family willing to keep them or the resources to go somewhere else.৽৻ They were subject to civil commitments: a very particular form of government power that allows the state to intern people deemed mentally ill, even when they are accused ˺ʠ੮˦˺੮ɻ̼ʮ˚ʇੳ੮îʩʇ੮ʮ˦ή͙ʮ̼;੮ʠ˺͙˦ʁ੮͐ʩɘ͐ੴ੮ʮ˦੮ৱ৹৶৶ੴ੮͐ʩʇ੮ɻ˺͙̼͐੮ʩʇɘ̼ʮ˦ʡͅ੮ɘ̹̹̼˺ͷʮ˦ʡ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮ˑɘ͐ͅʇʁ੮ɘ˦੮ɘͷʇ̼ɘʡʇ੮˺ʠ੮ϲʮͷʇ੮˚ʮ˦͙͐ʇͅੳ৽ৼ Commitment could be permanent. In 1967, the legislature announced its intention to end the “inappropriate, ʮ˦ʁʇϲʮ˦ʮ͐ʇੴ੮ ɘ˦ʁ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ɻ˺˚˚ʮ͐˚ʇ˦͐੮ ˺ʠ੮ ˚ʇ˦͐ɘˑˑ;੮ ʁʮͅ˺̼ʁʇ̼ʇʁ੮ ̹ʇ̼ͅ˺˦ͅੳૂ੮ Lanterman and Petris characterized the bill that ultimately bore their names (and that of Senator Alan Short, a Democrat from Stockton) as the “Magna Carta” of the mentally ill.৽৽ There’s a grain of grandiosity but also of truth to the analogy between the Lanterman-Petris-Short Act and the original Magna Carta, from 1215 CE: both protected people from unjust imprisonment at the hands of the state. îʩʇ੮ ϲʮ̼͐ͅ੮ ̹̼˺˦ʡ੮ ˺ʠ੮ ͐ʩʇ੮ ɺʮˑˑ੮ ˑʮ˚ʮ͐ʇʁ੮ ɻʮͷʮˑ੮ ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮ ͐˺੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ͸ʇ̼ʇ੮ deemed a danger to themselves or others or were gravely disabled as a result of a mental disorder. It replaced a single, never-ending court-ordered commitment with a series of time-limited hospitalization procedures subject to intensifying judicial scrutiny. It included a host of new legal protections, from guaranteed access to personal possessions or visitors to the right to refuse electroshocks or lobotomy. And, in the vein of the original Magna Carta, it extended to psyɻʩʮɘ̼͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ϲʮˑʇ੮ɘ੮͸̼ʮ͐੮˺ʠ੮ʩɘɺʇɘͅ੮ɻ˺̼̹͙ͅ੮ɘͅˌʮ˦ʡ੮͐˺੮ɺʇ੮̼ʇˑʇɘͅʇʁ੮ ʠ̼˺˚੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ੮îʩʇ੮ʮʁʇɘੴ੮͐˺੮ή͙˺͐ʇ੮̼͐੮"˺ˑ͐˺˦ੴ੮ɘ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ɘʮʁ੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮

INTRODUCTION

7

drafting the bill, was that “if we could lodge a huge boulder in the center of that over-used road to the [state] mental hospital, the patients would have to be sent somewhere else, to more appropriate facilities.”৽৾ A second prong of the bill would ensure those more appropriate facilities existed. The state pledged to pay for 90 percent of new county mental health programs.৽৿ The approach, the Los Angeles Times observed, was in line with the philosophy of “modern psychiatry” that “treating the mentally ill early and in the community environment is often more effective [than institutionalizing them].”৽਀ Indeed, Governor Ronald Reagan used the passage of LPS to announce that local mental health services “offer the most feasible and enlightened way to achieve the best results” and, as a result, “we can continue to reduce the size of our mental hospitals.”৽ਁ He delivered. By 1973, the state had already shuttered three of its ʩ˺̹ͅʮ͐ɘˑͅઝ͐ʩʇ੮ϲʮ̼͐ͅ੮ʮ˦੮͐ʩʇ੮˦ɘ͐ʮ˺˦੮͐˺੮ʁ˺੮ͅ˺ੳ৽ਂ The LPS Act put California at the leading edge of a movement to deinstitutionalize care for people with mental illness. U͐੮ʮͅ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮˺ͷʇ̼͐ͅɘ͐ʇ੮͐ʩʇ੮͸ʮʁʇ̹̼ͅʇɘʁ੮ʇ˦͐ʩ͙ͅʮɘͅ˚੮ʠ˺̼੮rØä੮͸ʩʇ˦੮ʮ͐੮͸ʇ˦͐੮ into effect. The San Diego Union celebrated in 1969 that it had already “advanced ɘ˦ʁ੮ʮ˚̹̼˺ͷʇʁ੮͐ʩʇ੮̼͐ʇɘ͐˚ʇ˦͐੮˺ʠ੮˚ʇ˦͐ɘˑ੮̹ɘ͐ʮʇ˦͐ͅ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ʩɘͅ੮̼ʇ͐ͅ˺̼ʇʁ੮͐ʩʇʮ̼੮ɺɘͅʮɻੴ੮ civil rights as human beings.”৽ਃ Academics described California as a “trendsetter,”৽਄ the exemplar of how a “civil libertarian, legalistic approach”৾৻ could replace the abusive medical paternalism of the old commitment system. LPS became the “prototype for mental health laws” in many states and other Western countries.৾ৼ Hɘ͐ͅચʠ˺̼͸ɘ̼ʁ੮ϲʮͷʇ੮ʁʇɻɘʁʇͅੴ੮ɘ˦ʁ੮͐ʩʇ੮rØä੮ɻ͐੮̼ʇ˚ɘʮ˦ͅ੮ˑɘ̼ʡʇˑ;੮͙˦ɻʩɘ˦ʡʇʁੳ੮"͙͐੮ depictions of it have been turned on their head. Heather Knight, a columnist for the San Francisco Chronicle, asserted in 2017 that LPS “lets the mentally ill choose to live on the streets”৾৽—offering them not genuine freedom but the right to ʠʇ͐ͅʇ̼ੴ੮͙˦̼͐ʇɘ͐ʇʁੴ੮ʮ˦੮ϲʮˑ͐ʩ੮ɘ˦ʁ੮ʠʇɻʇͅੳ੮Ø˺ˑʮ͐ʮɻʮɘ˦ͅ੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɺˑɘ˚ʇ੮rØä੮ for homelessness, mass incarceration, homicides, and deaths from overdoses and untreated diseases.৾৾ Before he died in 1981, even Frank Lanterman purportedly confessed, “I wanted the LPS Act to help the mentally ill. I never meant for it to prevent those who need care from receiving it. The law has to be changed.”৾৿ Governor Newsom declared in 2020 that “California’s behavioral health laws may have been ahead of their time but today call out for reform.”৾਀ He has backed ɘ੮ ϲˑ͙̼̼;੮ ˺ʠ੮ ɺʮˑˑͅ੮ ͐˺੮ ˑ˺˺ͅʇ˦੮ ˑʇʡɘˑ੮ ̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ ɘʡɘʮ˦͐ͅ੮ ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐ੳ੮ îʩʇ;੮ ɘ̼ʇ੮ a particularly visible manifestation of a nationwide push to use coercive care to manage homelessness, curb substance abuse, and divert people from prisons and jails.৾ਁ Prominent psychiatrists are calling for rebuilding the long-term care

8

INTRODUCTION

institutions LPS was intended to empty.৾ਂ The Magna Carta is eight hundred years old. It’s not clear if the Magna Carta of the mentally ill will make it to sixty.

THE “GRAVE DISABILITY” LOOPHOLE These debates over expanding involuntary treatment overlook an inconvenient reality: forced treatment never went away. LPS’s original boosters৾ਃ as well as contemporary critics৾਄ seem to agree that the law made it nearly impossible to subject people to extended psychiatric internment. Social scientists, too, have depicted a system in which protracted institutionalization through civil commitments has largely disappeared.৿৻ Instead, researchers suggest, people with serious mental illness are either living in the community (where they are sometimes informally pressured into accepting treatment, but legally free to refuse it) or incarcerated in prisons and jails, not hospitals.৿ৼ But LPS, like most civil commitment laws around the United States, con͐ɘʮ˦ͅ੮ɘ੮ˑ˺˺̹ʩ˺ˑʇੳ੮"ʇʠ˺̼ʇ੮rØäੴ੮͐ʩʇ੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮͸ɘͅ੮parens patriae, or the state’s obligation to serve as a substitute parent for subjects who are vulnerable and incapable of caring for themselves. LPS shifted the basis of commitments. Today, hospitalizations for danger to self or danger to others are based on the state’s police power, its prerogative to protect citizens from physical harm.৿৽ Yet the law also contains a third criterion: grave disability, or an inability to provide for basic needs of food, clothing, or shelter as a result of a mental disorder.৿৾ Grave disability, psychiatrists observed after LPS went into effect, ̹̼˺ͷʮʁʇʁ੮ɘ੮ʠ͙ΈΈ;੮ુɻɘ͐ɻʩચɘˑˑ੮ʠ˺̼੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ʁʮʁ੮˦˺͐੮˚ʇʇ͐੮̹ͅʇɻʮϲʮɻ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ɺ͙͐੮ for whom hospitalization appeared to be warranted on clinical grounds.”৿৿ It was the escape clause that kept the spirit of parens patriae alive in the shadows of a reformed mental health system. In California, someone who is a danger to themself or others can stay in the hospital for a few weeks (which can feel like an incredibly long time if you don’t want to be there). But someone who is deemed gravely disabled by a court can be placed in a conservatorship, which lasts one year and can be renewed indefinitely.৿਀ A court-appointed conservator can be a family member or a private ̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ɺ͙͐੮ʮͅ੮˚˺͐ͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɘ੮ɻ˺͙˦͐;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੳ੮îʩʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ becomes a heavy-handed parent in control of nearly every aspect of a person’s ˑʮʠʇੴ੮ʠ̼˺˚੮ϲʮ˦ɘ˦ɻʇͅ੮͐˺੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇੳ

INTRODUCTION

9

Conservatorship was designed to be the backstop that would catch people like Wally and keep them interned, in treatment, and alive.৿ਁ Academics and policy makers have focused on how laws like LPS contributed to the deinstitutionalization of people with mental illness from hospitals onto the streets or their transinstitutionalization into prisons.৿ਂ Conservatees are the ones stuck in the locked institutions that were supposed to have disappeared, the invisible population that stayed behind.৿ਃ They are so invisible, in fact, that it took a pop star with a hundred million record sales to bring conservatorship to light. In 2021, thanks to a New York Times documentary and the burgeoning “Free Britney Spears” movement, California’s hidden conservatorship system burst into public view. Ms. Spears’s father had been her conservator since 2008, when she suffered a breakdown exhaustively documented (and probably exacerbated) by the paparazzi, which spiraled into two psychiatric hospitalizations. Spears alleged that in the ensuing thirteen years, she faced a range of startling abuses, including being denied access to a phone, forced to perform, and de facto sterilized by an involuntarily implanted IUD. All this happened based on a ten-minute hearing during her hospitalization, which included a somewhat implausible allegation that the then twenty-six-year-old ʩɘʁ੮ʁʇ˚ʇ˦͐ʮɘੳ੮îʩʇ੮ˈ͙ʁʡʇ੮ʩʇɘ̼ʁ੮˦˺੮͐ʇ͐ͅʮ˚˺˦;ੳ੮rɘ͸;ʇ̼ͅ੮ɘͅˌʇʁ੮˦˺੮ή͙ʇ͐ͅʮ˺˦ͅੳ৿਄ It seemed California did it again: the parallels with the pre-LPS era—short sham ʩʇɘ̼ʮ˦ʡͅ੮ˑʇɘʁʮ˦ʡ੮͐˺੮ʮ˦ʁʇϲʮ˦ʮ͐ʇ੮̼ʮʡʩ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮ˺˦ͅ੮ɺ;੮ͅʇʇ˚ʮ˦ʡˑ;੮˚ɘˑʇͷ˺ˑʇ˦͐੮ʠɘ˚ʮˑ;੮ members (usually men)—are striking. Even if it brought conservatorship to the public’s attention, Spears’s case is not relevant to this book in an important sense. Although she was originally hospitalized through the procedures of the LPS Act, she was ultimately placed on a probate conservatorship, which is a separate legal tool (usually reserved for people with developmental disabilities or the elderly). LPS conservatorships are more potent: they grant the conservator the power not only to manage someone’s money and personal affairs but also to place them in a locked facility and force them to take psychiatric medications. They are also harder to get. (It’s almost ʮ˦ɻ˺˦ɻʇʮͷɘɺˑʇ੮͐ʩɘ͐੮ä̹ʇɘ̼ͅ੮͸˺͙ˑʁ੮ή͙ɘˑʮʠ;੮ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳબ Spears’s case is relevant, though, because civil liberties advocates seized on it to argue that, despite her stature and resources, it was “no exception.”਀৻ Accordʮ˦ʡ੮ ͐˺੮ )ʮͅɘɺʮˑʮ͐;੮ Ûʮʡʩ͐ͅ੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ુĔʩʮˑʇ੮ "̼ʮ͐˦ʇ;ૄͅ੮ ʠɘ˚ʇ੮ ˚ɘ;੮ ɺʇ੮ ͙˦ʮή͙ʇੴ੮ ʩʇ̼੮ experience in the current conservatorship system is not.”਀ৼ In the eyes of movements representing consumers, survivors, or ex-patients, conservatorships (usually

10

INTRODUCTION

referred to as guardianships in other states) are similarly toxic nationwide. In 2022, legislators suddenly began considering laws to get more people out of conservatorships rather than into them.਀৽ So did LPS not go far enough in restoring the fundamental civil rights of people living with psychiatric disabilities?਀৾ Or have the restrictions imposed by LPS left people like Wally to die on the streets, by making lifesaving conserva͐˺̼ͅʩʮ̹ͅ੮ʇͽɻʇͅͅʮͷʇˑ;੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ʮ˚̹˺ͅʇ੺੮U͐ૄͅ੮ʩɘ̼ʁ੮͐˺੮ˌ˦˺͸੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ̼ʇ੮ʩɘͅ੮ɺʇʇ˦੮ barely any published research on conservatorship for decades.਀৿ The California state government provides no reliable data on conservatorships and conducts no regular evaluation of how the system is functioning.਀਀ This dearth of transparency is true of civil commitments around the United States, a situation that led Senator Elizabeth Warren to write the Departments of Justice and Health and Human Services to demand updated data on conservatorships after the Spears story broke.਀ਁ îʩʮͅ੮ɺ˺˺ˌ੮ɘ̼ʡ͙ʇͅ੮͐ʩɘ͐੮͐ʩʇ੮ɘ˦ͅ͸ʇ̼੮͐˺੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮͸ʩʇ͐ʩʇ̼੮rØä੮͸ʇ˦͐੮͐˺˺੮ far or not far enough in protecting people from forced treatment and institutionalization is “both.” People who need intensive care are turned down for conservatorships and left to die in neglect. Others on conservatorship are locked in institutions despite having the potential to survive—and, in some cases, thrive— outside of them, if only society invested in the right supports. The culprit, I argue, is a joint failure of government authority and accountability over the conservatorship system.

LAW AND MEDICINE, CONFLICT AND COLLABORATION Even for readers not riveted by the Spears case, debates about conservatorships ̹ͅʇɘˌ੮͐˺੮ɘ੮ɺʮʡʡʇ̼੮ͅʇ͐੮˺ʠ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ɘɺ˺͙͐੮˺͙̼੮ɻ˺ˑˑʇɻ͐ʮͷʇ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ɘʁʁ̼ʇͅͅ੮ʮ˦͐ʇ̼linked crises of homelessness, drug addiction, and untreated mental illness. Before getting to my own explanation, let’s consider two existing diagnoses of the problem and the solutions each proposes. One framing of laws like LPS is that they pit the professions of law and medicine against each other in ʣɐɊɷɄ˃ʚɐɪȡʚ‫ף‬Ʉ˃ʯͷʚɷɄ̙. Lawyers and doctors have fought for centuries over who has primary jurisdiction over mad people.਀ਂ When states ɺʇʡɘ˦੮̼ʇʠ˺̼˚ʮ˦ʡ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ˑɘ͸ͅ੮ʮ˦੮͐ʩʇ੮ৱ৹৶ৰͅ੮ɘ˦ʁ੮ర৷ৰͅੴ੮ͅ˺ɻʮɘˑ੮ͅɻʮʇ˦͐ʮ͐ͅͅ੮ ̹˺̼̼͐ɘ;ʇʁ੮͐ʩʇ˚੮ɘͅ੮̹̼˺ͷ˺ˌʮ˦ʡ੮ɘ੮ુ˦ʇ͸੮ɻ˺ˑˑʮͅʮ˺˦੮ɺʇ͐͸ʇʇ˦੮˚ʇʁʮɻɘˑ੮યɘ˦ʁર੮ˑʇʡɘˑ੯ੳ੯ੳ੯ੳ੮

INTRODUCTION

11

concerns.”਀ਃ What was once “viewed as a basically psychiatric problem (the presence of mental illness and need for hospitalization)” would now have “superim̹˺ͅʇʁ੮͙̹˺˦੮ʮ͐੮ɘ੮ˑʇʡɘˑ੮ή͙ɘˑʮϲʮɻɘ͐ʮ˺˦੮ફɻ˺˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮ˑʮɺʇ̼͐ʮʇͅੴ੮ɘ੮̼͐ʮɘˑ੮ɺ;੮ˈ͙̼;ੴ੮ʇ͐ɻੳબੳૂ਀਄ Battles between law and medicine are not just about competing professional prerogatives but about internal ethical conundrums.ਁ৻ As ethnographers embedded with clinical teams show, many providers today are torn between a desire to provide compassionate care and respect for their client’s right to refuse it.ਁৼ This image of an intractable clash between law (as in “rights”) and medicine (as in “care”) has become the dominant popular lens for depicting disputes over LPS. To critics, the law is the paragon of civil liberties taken to excess, a power grab by disability rights advocates who have “succeeded in having the courts place so many roadblocks between patients and treatment that families ͸ɘ˦͐ʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ɘ̼ʇ੮ʠ˺̼ɻʇʁ੮͐˺੮ϲʮ˦ʁ੮ɘ੮ˑɘ͸;ʇ̼੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘ੮ʁ˺ɻ͐˺̼ੳૂਁ৽ As a 2012 proposal for reforming the law put it, California’s system is “lengthy, multiˑɘ;ʇ̼ʇʁੴ੮ ˦˺˦ચ͐ʩʇ̼ɘ̹ʇ͙͐ʮɻੴ੮ ɻ͙˚ɺʇ̼ͅ˺˚ʇ੯ ੳ੯ ੳ੯ ੳ੮ ɻ˺͐ͅˑ;੯ ੳ੯ ੳ੯ ੳ੮ ɻ˺˚̹ˑʮɻɘ͐ʇʁ੮ ɘ˦ʁ੮ ૃ";Έɘ˦tine.’”ਁ৾ This book proves that this description is absolutely true. But if you believe that conservatorship is one step shy of the death penalty, you should want putting one into place to be as cumbersome and costly as possible.ਁ৿ From ͐ʩʮͅ੮ɻ˺˦ϲˑʮɻ͐੮̹ʇ̼̹ͅʇɻ͐ʮͷʇੴ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇͷʇ̼ʇ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮ʮ͐ૄͅ੮̼ʮʡʩ͐ͅ੮˺̼੮ɻɘ̼ʇੵ੮ you can’t have both. From the vantage point of a person subject to involuntary treatment (as well as many scholars studying the topic), a second perspective is probably more conͷʮ˦ɻʮ˦ʡੳ੮rɘ͸੮ɘ˦ʁ੮˚ʇʁʮɻʮ˦ʇ੮ɘ̼ʇ੮˦˺͐੮ʮ˦੮ɻ˺˦ϲˑʮɻ͐੮ɺ͙͐੮ʮ˦͐ͅʇɘʁ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʇ੮ʮ˦੮ʮ˚̹˺ͅing forced treatment. The famed social theorist Michel Foucault examined how, in nineteenth-century France, the nascent discipline of psychiatry conspired ͸ʮ͐ʩ੮ˑɘ͸੮ʮ˦੮ɘ੮ુʡɘ˚ʇ੮˺ʠ੮ʁ͙ɘˑ੮˚ʇʁʮɻɘˑ੮ɘ˦ʁ੮ˈ͙ʁʮɻʮɘˑ੮ή͙ɘˑʮϲʮɻɘ͐ʮ˺˦ૂ੮͐˺੮ˑɘɺʇˑ੮ʁʇͷʮɘ˦͐ͅ੮ ɘͅ੮ʁɘ˦ʡʇ̼˺͙ͅˑ;੮˚ɘʁ੮ɘ˦ʁ੮̼ʇή͙ʮ̼ʮ˦ʡ੮ʮ˦͐ʇ̼˦˚ʇ˦͐੮ʮ˦੮ɘͅ;ˑ͙˚ͅੳਁ਀ His insight was that law and medicine, acting in concert, have powers they do not have on their own. Doctors can typically treat people only with their consent.ਁਁ Judges can normally imprison people only if they are accused of a crime. Together, though, law and medicine could declare someone to be insane and incarcerate them preemptively. The authors of LPS imagined the legislation as an enormous break from the past, but theorists of what I’ll call medicolegal control see surprising continuities. Foucault, for example, documented how a whole range of disadvantaged peo̹ˑʇ੮ ͸ʇ̼ʇ੮ ͅ͸ʇ̹͐੮ ʮ˦͐˺੮ ɘͅ;ˑ͙˚ͅ੮ ʮ˦੮ ɘ੮ ુI̼ʇɘ͐੮ #˺˦ϲʮ˦ʇ˚ʇ˦͐ૂ੮ ͐ͅɘ̼͐ʮ˦ʡ੮ ʮ˦੮ ͐ʩʇ੮ ͅʇͷʇ˦teenth century.ਁਂ But according to the disability scholar Chris Chapman, “If one

12

INTRODUCTION

considers homeless shelters, group homes, supportive living centres [sic], retirement homes, jails, halfway houses, hospitals of various kinds, certain kinds of ̼ʇ˚ʇʁʮɘˑ੮ͅɻʩ˺˺ˑͅੴ੮ɘ˦ʁ੮ͅ˺੮ʠ˺̼͐ʩ੯ੳ੯ੳ੯ੳ੮ય͐ʩʇ˦੮͐ʩʇર੮ૃʡ̼ʇɘ͐੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐ૄૂ੮˺ʠ੮͐ʩ˺ͅʇ੮ͅɘ˚ʇ੮ populations “lives on.”ਁਃ Deinstitutionalization from state hospitals did not end control of the mad; it simply dispersed (and, in many cases, privatized) it.ਁ਄ Consistent with this perspective, there are myriad examples of how medicine and law in contemporary California intertwine to manage disadvantaged populations. On Skid Row, law enforcement engages in “therapeutic policing,” writing an avalanche of citations to homeless people and offering participation in drug-recovery programs as a way out of paying them.ਂ৻ Police rely on ambulance crews to help clear out-of-place people without the hassle of arresting them.ਂৼ Hospitals, for their part, depend on the police to cull overcrowded and unruly emergency department waiting rooms.ਂ৽ In drug or mental health courts, where people are mandated to accept services as an alternative to going to jail, the lines between punishment and treatment blur so much as to make the two indistinguishable.ਂ৾ “Care and control,” according to the social theorist Nikolas Rose, “have become inextricably linked” in a common project of disciplining the mad.ਂ৿ This is far from abstract theorizing. These perspectives prescribe distinctive ͅ˺ˑ͙͐ʮ˺˦ͅੳ੮H̼˺˚੮͐ʩʇ੮ͷɘ˦͐ɘʡʇ੮̹˺ʮ˦͐੮˺ʠ੮˚ʇʁʮɻ˺ˑʇʡɘˑ੮ɻ˺˦ϲˑʮɻ͐ੴ੮rØä੮̼ʇ̹̼ʇͅʇ˦͐ʇʁ੮ɘ˦੮ attempt to use law to curb the excesses of medicine. The crisis on California’s streets shows the need for the pendulum to swing back toward more forced treatment.ਂ਀ Those viewing the system through the lens of medicolegal control, on the other hand, see a never-ending excess of coercion that robs people with mental illness of autonomy and choice. The solution is a ramp-up of voluntary outpatient services and independent supported housing, with care offered not just by clinicians but by peers with lived experience of surviving psychiatric abuse.ਂਁ The problem with these perspectives is that, in contemporary California, neither law (in the sense of rights) nor medicine (as in care) nor medicolegal control (as in discipline of the disruptive or deviant) seems to be winning. For all the complaints that LPS created a system of civil libertarian excess, people living with mental illnesses in California are subjected to extensive restrictions of their rights—and not just in jails and prisons. The state’s rate of seventy-two-hour emerʡʇ˦ɻ;੮ʁʇ͐ʇ˦͐ʮ˺˦ͅ੮ફʮ˦੮͸ʩʮɻʩ੮ɘ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼੮˺̼੮ɻˑʮ˦ʮɻʮɘ˦੮̼͐ɘ˦̹ͅ˺̼͐ͅ੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦બ੮ʮͅ੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮ʩʮʡʩʇ̼੮͐ʩɘ˦੮͐ʩʇ੮õੳäੳ੮ɘͷʇ̼ɘʡʇ੮ફϲʮʡ͙̼ʇ੮ৰੳৱબੳਂਂ The rate of people admitted for up to fourteen days in a hospital without their ɻ˺˦ͅʇ˦͐੮ʮͅ੮ɘɺ˺ͷʇ੮͐ʩɘ͐੮˺ʠ੮˚˺͐ͅ੮/͙̼˺̹ʇɘ˦੮ɻ˺͙˦̼͐ʮʇͅ੮ફϲʮʡ͙̼ʇ੮ৰੳ৲બੳਂਃ

0

Source: Sheridan Rains et al. (2019); California involuntary detention reports

0.2 Involuntary hospitalizations in select countries and California, 2016

Italy

Portugal

Ireland

Denmark

Belgium

New Zealand

Greece

United Kingdom

Sweden

Spain

California (5250s)

Switzerland

France

Norway

Finland

Netherlands

Germany

Australia

Austria

Rate per 10,000

Rate per 10,000

Florida Massachusetts Colorado South Dakota California (“5150s”) Alaska Nevada Idaho Virginia U.S. Average Missouri Indiana Oregon New Jersey (2018) New Hampshire Wisconsin Nebraska (2018) North Dakota Texas Michigan Montana Washington (2014) Arkansas Kansas (2018) Vermont Delaware Oklahoma Utah Wyoming (2018) Connecticut

100 90 80 70 60 50 40 30 20 10 0

0.1 Involuntary holds and initial commitments in select states, 2016

Sourceੵ੮rʇʇ੮ɘ˦ʁ੮#˺ʩʇ˦੮ફ৲ৰ৲ৱબ੶੮͐ͅɘ͐ʇ੮H̼ʇʇʁ˺˚੮˺ʠ੮U˦ʠ˺̼˚ɘ͐ʮ˺˦੮ɻ͐੮̼ʇή͙ʇ͐ͅͅ੮ફɺ;੮ɘ͙͐ʩ˺̼બ

30

25

20

15

10

5

14

INTRODUCTION

Far from serving as an insidiously effective tool of medicolegal control, though, this profusion of coercive interventions in California appears arbitrary, unpredictable, and ineffectual in calming crises and maintaining public order. Meanwhile, the state’s expanding investment in community-based care and housing—the alternatives for which critics of medicolegal control are clamoring—has not kept up with rising overdose deaths, stemmed the rates of mental illness among homeless people, or answered the unheeded pleas for help by suffering individuals and families. It’s a situation that no one should want— whether they believe LPS gave too much power to law over medicine or that it didn’t go far enough in protecting citizens from both.

POWER OVER CONSERVATEES, AUTHORITY OVER CONSERVATORSHIP To really understand the failings of California’s conservatorship system, then, we need to move away from analyzing the clash (or collaboration) of two powerful forces, law and medicine. We should instead ask why both seem so impotent to effect real, enduring change in the lives of many people with serious mental illness. To do that, the reader will need to bear with me as we make three shifts: ϲʮ̼͐ͅੴ੮ɘʁʁʮ˦ʡ੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘˑ˺˦ʡͅʮʁʇ੮ˑɘ͸੮ɘ˦ʁ੮˚ʇʁʮɻʮ˦ʇ੶੮ͅʇɻ˺˦ʁੴ੮˚˺ͷʮ˦ʡ੮ ʠ̼˺˚੮ɘ˦ɘˑ;Έʮ˦ʡ੮̹˺͸ʇ̼੮ʮ˦੮ʡʇ˦ʇ̼ɘˑ੮͐˺੮ʇͽɘ˚ʮ˦ʮ˦ʡ੮ɘ੮̹ͅʇɻʮϲʮɻ੮͐;̹ʇ੮˺ʠ੮̹˺͸ʇ̼ੴ੮ɘ͙͐ʩ˺̼ʮ͐;੶੮ and third, looking at how authority is exercised not over conservatees but over the conservatorship system. Together, these shifts give us a clearer framework for explaining what’s going wrong with conservatorship in California. #˺˦ͅʇ̼ͷʮ˦ʡ੮ ͅ˺˚ʇ˺˦ʇ੮ ̼ʇή͙ʮ̼ʇͅ੮ ͐ʩʇ੮ ɻ˺˺̹ʇ̼ɘ͐ʮ˺˦੮ ˺ʠ੮ ɘ੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ ફ˚ʇʁʮɻʮ˦ʇબ੮ and a judge (law), but also a third party: a county public guardian (government), ͸ʩ˺੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʇͅ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮ʠ̼˺˚੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘ˦ʁ੮ϲʮˑʇͅ੮ɘ੮̹ʇ͐ʮtion with the courts. As you’ll see, to go onto conservatorship, people often need to be on the edge of dying—so sick as to be unable to feed themselves or keep a roof over their head. It is not an exaggeration to say that LPS grants public ʡ͙ɘ̼ʁʮɘ˦ͅ੮ુͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼ૂੵ੮͸ʩɘ͐੮H˺͙ɻɘ͙ˑ͐੮ʁʇϲʮ˦ʇͅ੮ɘͅ੮͐ʩʇ੮ુ͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ʁʇɻʮʁʇ੮ life and death.”ਂ਄ Yet a lifesaving conservatorship also imposes a kind of “social death” on conservatees. They are “expelled from normal participation in the community,” potentially losing, for example, the right to vote, to make contracts, or to choose

INTRODUCTION

15

where they reside.ਃ৻ Although a conservatorship can be imposed without the use of force, the potential for violence lurks behind sovereign power. A conservatee lives with the threat of being cuffed by police, strapped to a bed, forcibly injected ͸ʮ͐ʩ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ ɘ˦ʁ੮ ɻ˺˦ϲʮ˦ʇʁ੮ ɺʇʩʮ˦ʁ੮ ˑ˺ɻˌʇʁ੮ ʁ˺˺̼ͅ੮ ʠ˺̼੮ ;ʇɘ̼ͅ੮ ɘ͐੮ ɘ੮ ͐ʮ˚ʇੳ੮ š˦ʇ੮ public guardian described his role in 1972 as “tak[ing] over most of the conservatee’s civil rights. They [conservatees] have no powers, really, except to live and breathe.”ਃৼ Since public guardians can (and do) sign do-not-resuscitate orders for their wards, they can even take away that power to live and breathe.ਃ৽ The second key to understanding the conservatorship system is to ask how ʡ˺ͷʇ̼˦˚ʇ˦͐੮͙ͅʇͅ੮ɘ੮̹ͅʇɻʮϲʮɻ੮ˌʮ˦ʁ੮˺ʠ੮̹˺͸ʇ̼ੵ੮authorityੳ੮{ɘͽ੮Ĕʇɺʇ̼੮ʁʇϲʮ˦ʇʁ੮ɘ͙͐ʩ˺̼ity as the combination of a “power to command and duty to obey.”ਃ৾ The political scientist Hannah Arendt went further, distinguishing authority from both “coercion by force” (like the sovereign power described above) and “persuasion through arguments.”ਃ৿ Studies of physicians often describe their authority in this way: as power that cannot be physically imposed, but is not open to debate either. Doctors have authority because of their social prestige, claims to expertise grounded in science (symbolized by their white coats), and role as gatekeepers to ͐ʩʮ˦ʡͅ੮ˑʮˌʇ੮ɺɘʁˑ;੮˦ʇʇʁʇʁ੮̹̼ʇͅɻ̼ʮ̹͐ʮ˺˦ͅ੮˺̼੮ή͙ɘˑʮϲʮɻɘ͐ʮ˺˦੮ʠ˺̼੮̼ʇɻʇʮͷʮ˦ʡ੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙̼ʮ͐;੮ʁʮͅɘɺʮˑʮ͐;੮ɺʇ˦ʇϲʮ͐ͅੳ੮Øʇ˺̹ˑʇ੮ʠʇʇˑ੮ɻ˺˚̹ʇˑˑʇʁ੮͐˺੮ʠ˺ˑˑ˺͸੮͐ʩʇʮ̼੮ɘ͙͐ʩ˺̼ʮ͐;੮͸ʮ͐ʩ˺͙͐੮ being forced to.ਃ਀ This brings us to the third shift I make in this book: from analyzing coercion over conservatees to examining government authority over the conservatorship system.ਃਁ Obviously, no one in the conservatorship system (be it a judge, police ˺ϲϲʮɻʇ̼ੴ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴ੮˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦બ੮ʩɘͅ੮ͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼ઝ͐ʩʇ੮̹˺͸ʇ̼੮˺ʠ੮ˑʮʠʇ੮ or death—over other professionals. But in order to get such a diverse range of actors to work together, someone does need to have authority over them. Here, I am using the clunky but useful elaboration of authority by legal theorist Joseph Raz. A person has authority when they are able to give “exclusionary reasons”: commands that override whatever other reasons the person being commanded might have for acting or not acting a certain way.ਃਂ Authority, in this sense, is the ɘɺʮˑʮ͐;੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩɘ͐੮ɘɻ͐˺̼ͅ੮ʮ˦੮ɘ੮ͅ;͐ͅʇ˚੮ુʇ˦ʡɘʡʇ੮ʮ˦੮ͅ˺˚ʇ੮ɻ˺˚˚˺˦੮ɘɻ͐ʮͷʮ͐;੮̼ʇή͙ʮ̼ing a certain degree of coordinated action,” even in the face of disagreements among them.ਃਃ Competing sides of debates over forced treatment would like to see law or medicine alone have this kind of authority over the conservatorship system. One mother who has tirelessly advocated for reforming LPS to make it easier to place

16

INTRODUCTION

̹ʇ˺̹ˑʇ੮ʮ˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐˺ˑʁ੮˚ʇੴ੮ુU͐੮યͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘર੮ʮͅ੮ɘ੮˚ʇʁʮɻɘˑ੮ʮˑˑ˦ʇͅͅੳ੯ੳ੯ੳ੯ੳ੮Ě˺͙੮ shouldn’t have to go to lawyers, attorneys, jailors to get treatment for a medical disease.” She was in effect arguing that medicine’s diagnosis of a serious mental illness should be an exclusionary reason for law to help get someone conserved. But when Thatcher, a person who has been subjected to civil commitments, ʁʇͅɻ̼ʮɺʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮ɘ˦੮ʮ˦͐ʇ̼ͷʮʇ͸੮ɘͅ੮ɘ੮ુʩ͙˚ɘ˦੮̼ʮʡʩ͐ͅ੮ͷʮ˺ˑɘ͐ʮ˺˦੮ɘ˦ʁ੯ੳ੯ੳ੯ੳ੮ɘ੮ form of torture,” they were giving an exclusionary reason for abolishing it. This logic is also endorsed by the UN Convention on the Rights of People with Disabilities: that law should have authority to block medicine, because autonomy and freedom trump health and welfare.ਃ਄ But neither law nor medicine has this authority in the conservatorship system created by LPS. Instead, the law reserved the authority to coordinate coercive care to government itself, in the guise of public guardians.਄৻ Consider an early account from just after LPS went into effect: public guardians could “apprehend the person at his home by force; commit him to a mental hospital for up to one ;ʇɘ̼੯ੳ੯ੳ੯ੳ੮ɘ͙͐ʩ˺̼ʮΈʇ੮˺̼੮͸ʮ͐ʩʩ˺ˑʁ੮ʇˑʇɻ̼͐ʮɻ੮ͅʩ˺ɻˌ੮̼͐ʇɘ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ɘ˦ʁੴ੮ϲʮ˦ɘˑˑ;ੴ੮ɘ͙͐ʩ˺̼ʮΈʇ੮ or withhold release from the institution.”਄ৼ The guardian was not directly exercising this sovereign power. Instead, guardians had the state-sanctioned authority to mobilize others to do so. This book will paint a starkly different portrait of authority in the conserͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚੮͐˺ʁɘ;ੳ੮îʩʇ੮ʇ˦͙ͅʮ˦ʡ੮ɻʩɘ̹͐ʇ̼ͅ੮ɘ̼ʇ੮ϲʮˑˑʇʁ੮͸ʮ͐ʩ੮ʇͽ̼͐ʇ˚ʇ੮ʇͽɘ˚̹ˑʇͅ੮ ˺ʠ੮ʩ˺͸੮˦ɘ̼̼˺͸ˑ;੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮ɺʇʮ˦ʡ੮ɻʮ̼ɻ͙˚ͅɻ̼ʮɺʇʁੴ੮ʮ˦੮͸ɘ;ͅ੮͐ʩɘ͐੮ʁʮͅή͙ɘˑify from conservatorship people who appear to need it.਄৽ The explanation for this is not that LPS law has become stricter, since the law has largely stayed the same. Instead, the conservatorship system is facing a crisis of authority. At multiple levels, government fails to provide exclusionary reasons that would compel professionals to apply grave disability in a coherent and consistent way. Police ˺ϲϲʮɻʇ̼ͅ੮ɻɘ˦˦˺͐੮ɻ˺˦ͷʮ˦ɻʇ੮/Û੮ʁ˺ɻ͐˺̼ͅ੮͐˺੮ɘʁ˚ʮ͐੮̹ʇ˺̹ˑʇ੮ʮ˦੮ɻ̼ʮͅʮͅ੮ʮ˦͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮ Public guardians cannot make inpatient psychiatrists apply for conservatorship ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮˚ʮʡʩ͐੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ʮ͐ੳ੮k͙ʁʡʇͅ੮̼͙͐ͅʡʡˑʇ੮͐˺੮ʡʇ͐੮ɺɘͅʮɻ੮ʮ˦ʠ˺̼˚ɘtion out of doctors necessary to rule on whether someone is gravely disabled. And county mental health departments are overruled by private providers of long-term care. In short, while many people can (and do) exert sovereign power over clients of the mental health system, government does not exercise authority to make law and medicine use that power in a concerted way. It is failing to coordinate

INTRODUCTION

17

interventions that would keep people from becoming gravely disabled and neglecting people when they do.

ABDICATION THROUGH DELEGATION AND DISCRETION How did this happen? Government in California not only lacks authority over the conservatorship system. It has abdicated authority; that is, through active policy choices and passive neglect, government has given up authority that it could potentially wield. As you will see throughout this book, abdication has been a convenient way of escaping two dilemmas facing the state’s system of invol͙˦͐ɘ̼;੮ɻɘ̼ʇੳ੮Hʮ̼͐ͅੴ੮ˑɘ͸ͅ੮ˑʮˌʇ੮rØä੮ͅ˺͙ʡʩ͐੮͐˺੮ʇ˦ʁ੮͐ʩʇ੮˺˦ʇચͅʮΈʇચϲʮ͐ͅચɘˑˑ੮ɘ̹̹̼˺ɘɻʩ੮˺ʠ੮ interning everyone in state hospitals, creating a new challenge of organizing and funding the range of services that conservatees need. Second, legal standards like ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɘ̼ʇ੮ͷɘʡ͙ʇੴ੮ˑʇɘͷʮ˦ʡ੮˺̹ʇ˦੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮͸ʩ˺ੴ੮ʇͽɘɻ͐ˑ;ੴ੮ͅʩ˺͙ˑʁ੮ɺʇ੮ subject to forced hospitalization or conservatorship. Government has never comprehensively addressed either of these conundrums. The California legislature has hosted ferocious battles over reforming LPS, including two large, unsuccessful initiatives to expand grave disability in 1987 and 2000 (as well as in recent years). Yet you would be hard-pressed to ϲʮ˦ʁ੮ ɘ˦;͐ʩʮ˦ʡ੮ ̼ʇͅʇ˚ɺˑʮ˦ʡ੮ ɘ੮ ̼͐ͅɘ͐ʇʡ;੮ ʠ˺̼੮ ʩ˺͸੮ ˈ͙ʁʡʇͅੴ੮ ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ ˺̼੮ ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮ should be using the law as written. Two major task forces on California’s public mental health system in 2000 and 2003, for example, included hundreds of pages of recommendations without a single one on conservatorship.਄৾ For all the more recent attention to conservatorship, a 2021 “Vision for All Californians’ Behavioral Health,” put together by just about every imaginable stakeholder, mentions conservatees only once as a “special population that should be considered by policymakers.”਄৿ Instead of acting as an authority engaged in assuring the implementation of LPS, the state has delegated the organization of services to counties and private entities and granted them discretion to apply grave disability in inconsistent, and at times seemingly inexplicable, ways. First, delegation: The United States is distinctive among developed countries in the degree to which essential state functions, ranging from health and welfare to incarceration, are farmed out to nonstate actors. It relies on charities to care for domestic violence victims, commercial insurance companies to ʁʮͅɺ͙̼ͅʇ੮ ̹͙ɺˑʮɻˑ;੮ ʠ͙˦ʁʇʁ੮ ̹̼ʇͅɻ̼ʮ̹͐ʮ˺˦੮ ʁ̼͙ʡ੮ ɺʇ˦ʇϲʮ͐ͅ੮ ͐˺੮ ͅʇ˦ʮ˺̼ͅੴ੮ ɘ˦ʁ੮ ̹̼ʮͷɘ͐ʇˑ;੮

18

INTRODUCTION

run charter schools to replace failing public ones.਄਀ Mental health was once the great exception. States built enormous asylums long before they started paying ʠ˺̼੮ʩʮʡʩʇ̼੮ʇʁ͙ɻɘ͐ʮ˺˦੮˺̼੮͙˦ʇ˚̹ˑ˺;˚ʇ˦͐੮ɺʇ˦ʇϲʮ͐ͅੳ੮";੮͐ʩʇ੮˚ʮʁચ͐͸ʇ˦͐ʮʇ͐ʩ੮ɻʇ˦͙̼͐;ੴ੮ psychiatry was an almost entirely public affair: nearly 90 percent of psychiatric treatment happened in state hospitals, which at their peak housed more than a half-million people. States spent an average of 8 percent of their budgets on these institutions.਄ਁ Deinstitutionalization—the closure of 90 percent of state psychiatric hospital beds in just a few decades਄ਂ—was not just an exodus of patients (and before them ˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੴ੮͸ʩ˺੮ʮ˦੮͐ʩʇ੮ৱ৹৵ৰͅ੮ή͙ʮ͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʇ˦੮˚ɘͅͅʇ੮ʠ˺̼੮̹̼ʮͷɘ͐ʇ੮̹̼ɘɻtice). It also meant that the state almost entirely ceased being a direct provider of services. Frank and Glied argue that the shift was “as dramatic as those in Eastern European nations after the Soviet Union’s disintegration. In a matter of twenty ;ʇɘ̼ͅ੯ੳ੯ੳ੯ੳ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮˚˺ͷʇʁ੮ˑɘ̼ʡʇˑ;੮ʠ̼˺˚੮ɘ੮ɻʇ˦̼͐ɘˑˑ;੮̹ˑɘ˦˦ʇʁੴ੮͐ͅɘ͐ʇચ˺͸˦ʇʁ੮ and operated enterprise to a system dominated by market forces.”਄ਃ LPS delegated responsibility for organizing local mental health services to counties. Then counties, following the pattern of other antipoverty programs ˺ʠ੮͐ʩʇ੮I̼ʇɘ͐੮ä˺ɻʮʇ͐;੮ʮ˦੮͐ʩʇ੮ৱ৹৶ৰͅੴ੮ɻ˺˦̼͐ɘɻ͐ʇʁ੮˺͙͐੮ͅʇ̼ͷʮɻʇ੮̹̼˺ͷʮͅʮ˺˦੮͐˺੮˦˺˦̹̼˺ϲʮ͐੮ organizations.਄਄ While counties paid for medical treatment for at least some people leaving state hospitals, they did almost nothing to meet these individuals’ ɺɘͅʮɻ੮˦ʇʇʁͅ੮ʠ˺̼੮ʮ˦ɻ˺˚ʇੴ੮ʠ˺˺ʁੴ੮˺̼੮ͅʩʇˑ͐ʇ̼ੳ੮੮ͅʩɘʁ˺͸;੮͸˺̼ˑʁ੮˺ʠ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ɘ˦ʁ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇͅ੮ʇ˚ʇ̼ʡʇʁ੮͐˺੮ϲʮˑˑ੮͐ʩʇ੮ʡɘ̹ੴ੮ʩɘ̼ͷʇ͐ͅing the disability checks of deinstitutionalized ex-patients eking out survival on the margins of society.ৼ৻৻੮îʩʇ੮͐ͅɘ͐ʇૄͅ੮̼ʇˑʮ˦ή͙ʮͅʩ˚ʇ˦͐੮˺ʠ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ˑʇʠ͐੮ʠɘ˚ʮˑʮʇͅ੮ to try to stitch together these fragmented programs into a threadbare safety net for their loved ones.ৼ৻ৼ Delegation has a clear economic logic. It has allowed the state to shift costs onto others (as in the case of board and care homes, operating on federal social security checks). Yet the abdication of authority provides a way to avoid the challenge of organizing an effective conservatorship system even in moments of government largesse. Today, California state government pumps ten billion dollars per year into the mental health system. Yet while this money gives the state leverage to make the jumble of county and private providers it feeds fully serve people on or needing conservatorship, it largely has not used that authorʮ͐;ੳ੮U˦੮ʠɘɻ͐ੴ੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ʁɘ͐ɘ੮ɘ̼ʇ੮ͅ˺੮̹˺˺̼੮ʮ˦੮ή͙ɘˑʮ͐;ੴ੮ʮ˦ɻ˺˦ͅʮ͐ͅʇ˦͐ੴ੮ɘ˦ʁ੮ʮ˦ɻ˺˚̹ˑʇ͐ʇ੮ that it does not even know how many LPS conservatees there are, where they

INTRODUCTION

19

ɘ̼ʇੴ੮˺̼੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ͅ੮͐˺੮͐ʩʇ˚ੳ੮îʩʮͅ੮ʮͅ੮͐ʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ʁʇˑʇʡɘ͐ʮ˺˦ੵ੮ɘ੮ુɻ˺˚̹ˑʇͽ੮ hybrid of public and private actors” with such “convoluted lines of authority and accountability” that it seems as though no one has any authority or accountability at all.ৼ৻৽ Delegation crisscrosses with another way the state has abdicated authority for conservatorship: granting extensive, underregulated, and privatized discretion. Øͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੴ੮ˑɘ͸;ʇ̼ͅੴ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮ɘ˦ʁ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅ੮ɺ̼ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇ˚੮̼ɘʁically different philosophies about the merits of involuntary treatment and tools for intervention. But they all face the classic dilemma of street-level bureaucrats. As theorized by political scientist Michael Lipsky, these are “public service workʇ̼ͅ੮͸ʩ˺੮ʮ˦͐ʇ̼ɘɻ͐੮ʁʮ̼ʇɻ͐ˑ;੮͸ʮ͐ʩ੮ɻʮ͐ʮΈʇ˦ͅ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͸ʩ˺੮ʩɘͷʇ੮͙ͅɺ͐ͅɘ˦͐ʮɘˑ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ in the execution of their work.”ৼ৻৾ That discretion comes from scarcity: bureaucrats invariably face more demand from people legally entitled to their services than they have resources to provide those services. This bind obligates them to informally triage based on their own preferences, professional identities, and organizational constraints. Lipsky’s classic insight is that “when taken together, ͐ʩʇ੮ʁʇɻʮͅʮ˺˦ͅ੮˺ʠ੮͐ʩʇͅʇ੮͸˺̼ˌʇ̼ͅ੯ੳ੯ੳ੯ੳ੮ɘʁʁ੮͙̹੮͐˺੮ɘʡʇ˦ɻ;੮̹˺ˑʮɻ;ੳૂৼ৻৿ Discretion is an endemic feature of public services. But there are two distinctive aspects of discretion in the conservatorship system. In some government agencies, street-level bureaucrats can grant access to services on their own: ɘ੮ ͅ˺ɻʮɘˑ੮ ͅʇɻ͙̼ʮ͐;੮ ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼੮ ή͙ɘˑʮʠ;ʮ˦ʡ੮ ͅ˺˚ʇ˺˦ʇ੮ ʠ˺̼੮ ʁʮͅɘɺʮˑʮ͐;੮ ɺʇ˦ʇϲʮ͐ͅੴ੮ ʠ˺̼੮ example, or a prosecutor choosing whether to charge someone with a crime. In ɻ˺˦̼͐ɘ͐ͅੴ੮̹͙͐͐ʮ˦ʡ੮ʮ˦͐˺੮̹ˑɘɻʇ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇή͙ʮ̼ʇͅ੮͐ʩɘ͐੮ɘ੮ɻ˺˚̹ˑʇͽ੮ɻʩɘʮ˦੮˺ʠ੮ bureaucrats exercise their individual discretion in a consistent way. All must agree that a person remains gravely disabled over the course of weeks or months, even as that person moves among institutions and receives treatment intended to change their state. As a result, the conservatorship system has myriad “veto points”ৼ৻਀ where police, ER physicians, or public guardians can stop someone ʠ̼˺˚੮ɘʁͷɘ˦ɻʮ˦ʡ੮͐˺͸ɘ̼ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ફʮ˦͐ͅʇɘʁ੮ͅʩ͙ϲϲˑʮ˦ʡ੮͐ʩʇ˚੮˺˦͐˺੮˺͐ʩʇ̼੮ɘʡʇ˦cies or abandoning them entirely).ৼ৻ਁ Veto points are a crucial protection against the overuse of sovereign power (indeed, multiple veto points are a key feature of the separation of powers among the legislature, the executive, and the judiciary in the federal government). Still, it is striking that while the legislature created criteria for when someone can be ̹ˑɘɻʇʁ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ʮ͐੮˦ʇͷʇ̼੮ʮʁʇ˦͐ʮϲʮʇʁ੮͐ʩʇ੮ͅʮ͙͐ɘ͐ʮ˺˦ͅ੮ʮ˦੮͸ʩʮɻʩ੮̹̼˺ʠʇͅͅʮ˺˦als should do so. The LPS Act expressly granted the California Department of

20

INTRODUCTION

Mental Health, later merged into the Department of Health Care Services, the power to adopt “rules, regulations, and standards as necessary” for its implementation (such as offering guidance about best practices for applying grave disability).ৼ৻ਂ੮"͙͐੮͐ʩɘ͐੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮ʡ˺ʮ˦ʡ੮͙˦͙ͅʇʁੳ੮îʩʇ੮ϲʮ̼͐ͅ੮ɻ̼ʮ͐ʮɻɘˑ੮ʠʇɘ͙̼͐ʇ੮˺ʠ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ in the conservatorship system is that each actor exercises only negative discretion. Many people can say “no” to conservatorship, but no one exerts authority to make these actors, collectively, get to “yes.” The second key aspect of discretion in the conservatorship system is how ˚ɘ˦;੮ͷʇ͐˺੮̹˺ʮ˦͐ͅ੮ͅʮ͐੮ʮ˦ͅʮʁʇ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʇ˦͐ʮ͐ʮʇͅੳ੮#̼ʮ͐ʮɻͅ੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʁʇ̼ʮʁʇ੮ɘ੮ુ˦˺˦ચ̹̼˺ϲʮ͐੮ʮ˦ʁ͙̼͐ͅʮɘˑ੮ɻ˺˚̹ˑʇͽૂ੮˺ʠ੮ʮ˦ʇϲϲʮɻʮʇ˦͐੮ɻ˺˚˚͙˦ʮ͐;੮˺̼ʡɘ˦ʮzations and hapless homeless service providers.ৼ৻ਃ But the most restrictive end ˺ʠ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ʮͅ੮ʁ˺˚ʮ˦ɘ͐ʇʁ੮ɺ;੮͙˦ɘɺɘͅʩʇʁˑ;੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʇ˦͐ʇ̼̹̼ʮͅʇͅੳ੮˦੮ɘ˦ɘˑ˺ʡ;੮ ͐˺੮ʠ˺̼ચ̹̼˺ϲʮ͐੮̹̼ʮͅ˺˦ͅ੮ʮͅ੮͙˦ɻ˺˚ʠ˺̼͐ɘɺˑʇ੮ɺ͙͐੮͸ɘ̼̼ɘ˦͐ʇʁੵ੮ʮ˦੮ɺ˺͐ʩ੮ɻɘͅʇͅੴ੮͐ͅɘ͐ʇ੮ʠ͙˦ʁͅ੮ are used to pay for beds in private facilities, and state power is used to keep those beds full. But the comparison is also imperfect. Because of the risk that ʠ˺̼ચ̹̼˺ϲʮ͐੮ʇ˦͐ʮ͐ʮʇͅ੮˚ʮʡʩ͐੮̼͐;੮͐˺੮˚ɘͽʮ˚ʮΈʇ੮̹̼˺ϲʮ͐ͅ੮ɺ;੮ͅʇ̼ͷʮ˦ʡ੮͐ʩʇ੮ˑʇɘ͐ͅ੮˦ʇʇʁ;੮ફɘ˦ʁ੮ therefore least costly) cases, government often tightly curtail their discretion, obligating them to “surrender” the prerogatives of “private judgment.”ৼ৻਄ For̹̼˺ϲʮ͐੮̹̼ʮͅ˺˦ͅ੮ɻɘ˦੮ɻ͙͐੮ɻ˺͐ͅͅ੮ʮ˦੮ɘˑˑ੮ͅ˺̼͐ͅ੮˺ʠ੮̹̼˺ɺˑʇ˚ɘ͐ʮɻ੮͸ɘ;ͅੴ੮ɺ͙͐੮˺˦ʇ੮͐ʩʮ˦ʡ੮͐ʩʇ;੮ cannot usually do is screen every person sentenced by the courts to weed out the ˚˺͐ͅ੮ʁʮϲϲʮɻ͙ˑ͐੮ʮ˦˚ɘ͐ʇͅੳ Yet the unwillingness of government in California to provide care directly ʩɘͅ੮ˑʇʁ੮ʮ͐੮͐˺੮ͅʩ˺͸੮˚ɘ̼ˌʇʁ੮ʁʇʠʇ̼ʇ˦ɻʇ੮͐˺੮͐ʩʇ੮̹̼˺ϲʮ͐ચʁ̼ʮͷʇ˦੮̹̼ʇʠʇ̼ʇ˦ɻʇͅ੮˺ʠ੮͐ʩʇ੮̹̼ʮvate hospitals, subacute facilities, or board and care homes that are willing to ̹̼˺ͷʮʁʇ੮͐ʩɘ͐੮ɻɘ̼ʇੳ੮ͅ੮;˺͙੮͸ʮˑˑ੮ͅʇʇੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʇͽ̹ɘ˦ʁͅ੮˺̼੮ɻ˺˦̼͐ɘɻ͐ͅ੮͐˺੮ϲʮˑˑ੮ the beds those entities make available. Those beds, in turn, depend on market forces, which are shrinking and shuttering these institutions across the state. Street-level bureaucrats in the conservatorship system have adapted their use of discretion to this new reality. They veto conservatorship for the people with the most complex and expensive problems, who could clog up those scarce beds for months or years. These factors, not an imagined cadre of die-hard civil libertarian lawyers and nihilistic disability rights activists, are driving grave disability to ɺʇ੮ʁʇϲʮ˦ʇʁ੮ʮ˦੮ʇͷʇ̼੮˦ɘ̼̼˺͸ʇ̼੮͸ɘ;ͅੳ U˦੮ͅʩ˺̼͐ੴ੮ɘͅ੮;˺͙੮͸ʮˑˑ੮ͅʇʇ੮ʮ˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ϲʮ͐ͅ੮ with scholars’ image of a “many-handed” state.ৼৼ৻ People facing conservatorship ɻ˺͙ˑʁ੮ ʇɘͅʮˑ;੮ ʩɘͷʇ੮ ɘ੮ ʩɘˑʠચʁ˺Έʇ˦੮ ɘʡʇ˦ɻʮʇͅઝʠ̼˺˚੮ ϲʮ̼ʇ੮ ɘ˦ʁ੮ ̹˺ˑʮɻʇ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ ͐˺੮

INTRODUCTION

21

̹ɘ̼˺ˑʇ੮˺ϲϲʮɻʇ̼ͅ੮͐˺੮͙ͅɺ͐ͅɘ˦ɻʇ੮ɘɺ͙ͅʇ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮ˦ʮɻʮɘ˦ͅઝ̹̼˺ͷʮʁʮ˦ʡ੮ɻɘ̼ʇ੮ and imposing coercion in their lives. But that state is hollow: many hands, but no brain telling them what to do.ৼৼৼ As these public and private entities exercise negative discretion in incompatible and disconnected ways, the aggregation of discretion that is supposed to “add up to agency policy” adds up to no coherent policy at all. For better or worse, attempts to rewrite LPS law to make it easier to ɻ˺˦ͅʇ̼ͷʇ੮̹ʇ˺̹ˑʇ੮͸ʮˑˑ੮ʠɘʮˑੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮͸ʮˑˑ੮˦˺͐੮̼ʇ͸̼ʮ͐ʇ੮͐ʩʇ੮ʮ˦ʠ˺̼˚ɘˑ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ grave disability that has been created by delegation and discretion and government’s abdication of authority over them.

COVERING THE CONTINUUM I conducted the research for Conservatorship between 2018 and 2022. This book is based primarily on 268 interviews with professionals, policy makers, advocates, family members, and people subject to forced treatment. These interviewees ɻ˺˚ʇ੮ʠ̼˺˚੮͐ʩʮ̼͐;ચʠ˺͙̼੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅੴ੮̹ͅɘ˦˦ʮ˦ʡ੮ʩɘ˚ˑʇ͐ͅ੮ʮ˦੮ the High Sierras to Southern California beach towns. While jumping between counties might be jarring for the reader, showing disparities between them ̼ʇͷʇɘˑͅ੮ɘ੮ɻ˺˚˚˺˦੮ˑɘɻˌ੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮U੮ɘˑͅ˺੮ʮˑˑ͙̼͐ͅɘ͐ʇ੮˚;੮ϲʮ˦ʁʮ˦ʡͅ੮ by drawing on dozens of site visits to hospitals, ERs, board and care homes, and conservatorship courts, as well as days spent shadowing professional outreach workers, outpatient clinical teams, and law enforcement. U੮͙̹̹ͅˑʇ˚ʇ˦͐ʇʁ੮˚;੮ϲʮʇˑʁ੮̼ʇͅʇɘ̼ɻʩ੮͸ʮ͐ʩ੮ɘ˦੮ɘ˦ɘˑ;ͅʮͅ੮˺ʠ੮˚˺̼ʇ੮͐ʩɘ˦੮ৱੴ৵ৰৰ੮˦ʇ͸ͅpaper articles on conservatorship, LPS, and the public mental health system published in California newspapers from the 1950s to the present, plus virtually every piece of academic literature, hearing transcript, or government report on rØä੮U੮ɻ˺͙ˑʁ੮ϲʮ˦ʁੳ੮{;੮ɻ˺˦ɻˑ͙ͅʮ˺˦ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ͅʩɘ̹ʇʁ੮ɺ;੮˚;੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʮ˺˦੮ʮ˦੮͸˺̼ˌ੮ groups and policy discussions on conservatorship, as well as numerous preliminary presentations of this work where I received sharp and critical feedback from stakeholders (see the methodological appendix for more details). Part 1 of this book traces each step in the “conservatorship continuum”: the chain of street-level bureaucracies a person encounters on their way to a conservatorship. Chapter 1 starts with the voluntary outpatient services that too often fail to keep people out of crisis. Chapter 2 moves to how police and clinicians respond to those crises with 5150 “holds,” a legal mechanism created by LPS

22

INTRODUCTION

that allows them to transport a person involuntarily to an ER for evaluation. Chapter 3 looks at the strict screening those ERs exercise before, in chapter 4, ʡ˺ʮ˦ʡ੮˺˦͐˺੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐੮͐˺੮ͅʇʇ੮ʩ˺͸੮ϲʮ˦ɘ˦ɻʮɘˑ੮̹̼ʇ͙̼ͅͅʇͅ੮ͅʩɘ̹ʇ੮ʁʇɻʮͅʮ˺˦ͅ੮͐˺੮ apply for conservatorship. Once an application is made, it is “investigated” by a public guardian (covered in chapter 5) and ultimately ruled on by a court (the subject of chapter 6). Across part 1, negative discretion, exercised in inconsistent ways, is king. It keeps the vast majority of people whom at least some professionals see as gravely disabled out of conservatorship—often leaving them deserted, not diverted into a less coercive alternative. Part 2 focuses on the trajectories of those people who are in fact placed in conservatorship. Chapter 7 examines locked facilities, both state hospitals and largely private, subacute “institutions for mental disease” (more on that later). Chapter 8 brings us inside unlocked board and care homes. In both cases, the delegation of services for chronically ill conservatees to private entities allows those entities to decide who gets a bed and, indirectly, who gets conserved in ͐ʩʇ੮ϲʮ̼͐ͅ੮̹ˑɘɻʇੳ੮#ʩɘ̹͐ʇ̼੮৹੮ɻ˺˦ͅʮʁʇ̼ͅ੮ɘɺ͙ͅʇͅੴ੮ɺ˺͐ʩ੮ɘɻ͐ʮͷʇ੮ʩɘ̼˚੮ɘ˦ʁ੮̹ɘͅͅʮͷʇ੮ʮ˦ʁʮʠference, that happen throughout the system. Chapter 10 analyzes, in contrast, the mechanisms through which conservatorship can achieve positive outcomes like stabilization, independence, and recovery. Abdicated authority means a lack of clear accountability for protecting conservatees from the worst possible outcomes or for the coordinated pursuit of the best possible ones. Part 3 analyzes proposals for reform. In chapter 11, we delve into a pilot program in San Francisco to conserve homeless substance users who were generating high costs and citizen complaints. Chapter 12 looks at proposals to expand grave disability to capture people dying on the streets in Los Angeles. The impacts of both reforms, I will show, are limited by an absence of government authority to get hospitals to implement the new conservatorship pathway (in San Francisco) ˺̼੮͐˺੮˚ɘˌʇ੮͐ʩʇ੮̹̼ʮͷɘ͐ʇ੮ͅʇɻ͐˺̼੮ɺ͙ʮˑʁ੮͙ͅϲϲʮɻʮʇ˦͐੮ɺʇʁͅ੮͐˺੮ʩ˺͙ͅʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸˺͙ˑʁ੮ ɺʇ੮˦ʇ͸ˑ;੮ɻ˺˦ͅʇ̼ͷʇʁ੮ફʮ˦੮r˺ͅ੮˦ʡʇˑʇͅੴ੮ɘ˦ʁ੮͐ͅɘ͐ʇ͸ʮʁʇબੳ੮#ʩɘ̹͐ʇ̼੮ৱ৳੮̹̼˺ϲʮˑʇͅ੮ɘ੮ʁʮͷʇ̼ͅʇ੮ range of alternatives to forced treatment, helping us envision what giving authority to people with mental illnesses themselves would look like. Such a system would not force potential conservatees to accept services they do not want but would instead compel providers to offer services their clients do want. In the conclusion, I revisit my core argument: an absence of government leadership, coordination, and regulation creates the readily apparent failings of California’s mental health system. Delegating care to private providers has been a

INTRODUCTION

23

convenient way to elide the challenge of designing a public system capable of meeting conservatees’ complex needs. Granting discretion to myriad street-level bureaucrats has been easier than writing guidelines for when to use conservatorship that weigh the delicate balance between care and coercion, compassion and constraint. It is the abdication of authority over the conservatorship system, rather than an absence of power and coercion over the people it serves, that explains why people like Wally are dying on California’s streets—despite all the frantic efforts to help them.

PART I

THE CONSERVATORSHIP CONTINUUM

CHAPTER 1

OUTPATIENT

U

rban Mental Health (UMH), a public outpatient clinic in Northern California where I attended weekly team meetings in 2018 and 2019, is laser-focused on people with serious mental illnesses. Most ˺ʠ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮ʩɘͷʇ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮˺̼੮ɺʮ̹˺ˑɘ̼੮ʁʮͅ˺̼ʁʇ̼ੴ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɻ˺͙̹ˑʇʁ੮͸ʮ͐ʩ੮ substance use, trauma, homelessness, and a history of criminal-legal contact. UMH confronts these challenging cases with the best tools at the disposal of California’s public mental health system. One team, called a Full-Service Partnership (FSP), sends clinicians in pairs multiple times a week to engage clients under freeway underpasses, in homeless encampments, or in the supported housing units their $24,000-a-year-per-client budget helps pay for. The evidence for the effectiveness of FSPs is robust: according to UMH data, participants show an 86 percent reduction in hospitalization, 90 percent reduction in incarceration, ɘ˦ʁ੮ ৶৸੮ ̹ʇ̼ɻʇ˦͐੮ ̼ʇʁ͙ɻ͐ʮ˺˦੮ ʮ˦੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ʮ˦੮ ͐ʩʇʮ̼੮ ϲʮ̼͐ͅ੮ ;ʇɘ̼੮ ʮ˦੮ ͐ʩʇ੮ ̹̼˺ʡ̼ɘ˚ੳৼ "͙͐੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ͅʩ˺͸ͅ੮͸ʩ;੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮̹̼˺˚ʮͅʇ੮͐˺੮̹̼˺ͷʮʁʇ੮ʩʮʡʩચή͙ɘˑʮ͐;ੴ੮ͷ˺ˑ͙˦tary services through programs like FSPs nonetheless sometimes falls short—thus hurling some of the neediest individuals toward conservatorship. At one meeting, the staff discusses a twenty-six-year-old Asian man diagnosed with bipolar disorder. Stu, a thirty-year-veteran social worker who has watched UMH transform from a clinic offering psychotherapy to the “worried well” (people with psychologic troubles but not serious illnesses) to one focused on keeping people with psychosis and meth use out of ERs, handled his intake. Pʇ੮ʇͽ̹ˑɘʮ˦ͅ੮͐ʩɘ͐੮͐ʩʇ੮˚ɘ˦੮ʩɘʁ੮ʩʮͅ੮ϲʮ̼͐ͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻ˺˦͐ɘɻ͐ͅ੮ɘ੮ʠʇ͸੮;ʇɘ̼ͅ੮ɘʡ˺੮ ͐ʩ̼˺͙ʡʩ੮nɘʮͅʇ̼੮Øʇ̼˚ɘ˦ʇ˦͐ʇੴ੮ɘ˦੮ʇ˦˺̼˚˺͙ͅ੮ɘ˦ʁ੮͸ʇɘˑ͐ʩ;੮˦˺˦̹̼˺ϲʮ͐੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮ They prescribed him medication but failed to give him the whole range of social supports crucial for someone experiencing a psychotic break. In the past year, he

28

T H E C O N S E RVATO R S H I P C O N T I N U U M

has been seen by UMH’s mobile crisis team on nine occasions when community ˚ʇ˚ɺʇ̼ͅ੮ ʩɘͷʇ੮ ɻɘˑˑʇʁ੮ ৹ৱৱ੮ ͐˺੮ ʇͽ̹̼ʇͅͅ੮ ɻ˺˦ɻʇ̼˦੮ ɘɺ˺͙͐੮ ʩʮͅ੮ ϲʮʡʩ͐ʮ˦ʡ੮ ͸ʮ͐ʩ੮ ʮ˦ͷʮͅʮɺˑʇ੮ antagonists on the street. In one recent hospitalization, he was referred to UMH for ongoing care. ‘We tried to swoop in,’ says Avril, a psychologist with mobile crisis, ‘because it was ɻˑʇɘ̼੮ʮʠ੮͐ʩʇ;੮ʁʮͅɻʩɘ̼ʡʇʁ੮ʩʮ˚੮͐˺˺੮ή͙ʮɻˌˑ;ੴ੮ʩʇૄʁ੮͸ʮ˦ʁ੮͙̹੮ɺʇʮ˦ʡ੮̼ʇɘʁ˚ʮ͐͐ʇʁੳૄ੮"͙͐੮ʩʇ੮ refused treatment and left the hospital without follow-up care. Now, as they predicted, he’s back in the hospital, where Stu carried out the assessment and found him paranoid, refusing food, and borderline catatonic (that is, nonresponsive). ä͙͐੮͐ʩʮ˦ˌͅ੮ʩʇૄʁ੮ɺʇ੮ɘ੮ʡ˺˺ʁ੮ϲʮ͐੮ʠ˺̼੮HäØੴ੮͸ʩʮɻʩ੮ɻɘ˦੮ʡʮͷʇ੮ʩʮ˚੮͐ʩʇ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮˺͙̼͐ʇɘɻʩ੮ he thinks is necessary to engage him. But Blair, who oversees adult programs at the clinic, thinks it’s too late: ‘he needs to be a “captive audience” [i.e., in a locked unit] to get him on meds longer term. We should focus on getting him into an IMD.’ To get into an IMD (Institution for Mental Diseases, a subacute facility ͸ʩʇ̼ʇ੮ͅ˺˚ʇ੮͸ʮˑˑ੮͐ͅɘ;੮ʠ˺̼੮˚˺˦͐ʩͅ੮˺̼੮;ʇɘ̼ͅબੴ੮ʩʇ੮ʩɘͅ੮͐˺੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੮ϲʮ̼͐ͅੳ੮‡ʇʮ͐ʩʇ̼੮ UMH nor Kaiser was able to get him into high-intensity voluntary services, like an FSP, fast enough to keep him from declining to the point where he was considered gravely disabled and a conservatorship seemed the only option. At other times, UMH struggled to catch people coming out of conservatorͅʩʮ̹ੳ੮ š˦ʇ੮ ˚˺̼˦ʮ˦ʡੴ੮ ͐ʩʇ੮ ˦ʇ͸੮ ʮ˦͐ɘˌʇ੮ ʮͅ੮ ɘ੮ ϲʮʠ͐;ચʠ˺͙̼ચ;ʇɘ̼ચ˺ˑʁ੮ ʠ̼ʮɻɘ˦੮ ˚ʇ̼ʮɻɘ˦੮ who was brought to his appointment by his wife. He was, Stu said, ‘cooperative for two minutes’ before coming across as ‘suicidal,’ ‘having no insight’ into his illness, and ‘aggressive.’ He had spent nineteen years in a state hospital after ɺʇʮ˦ʡ੮ʠ˺͙˦ʁ੮˦˺͐੮ʡ͙ʮˑ͐;੮ɺ;੮̼ʇɘͅ˺˦੮˺ʠ੮ʮ˦ͅɘ˦ʮ͐;੮ʠ˺̼੮ͅʇ͐͐ʮ˦ʡ੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦੮˺˦੮ϲʮ̼ʇ੮ (who, thankfully, survived). The hospital released him to a board and care home, where he stayed for ten years before leaving to get his own apartment. Now, he and his wife are on the verge of eviction. ‘He has a long history of nonadherence to treatment and refusing follow-up,’ Stu adds. Stu is recommending that he go onto Intensive Case Management (ICM). It is a level of care one step below FSP but still involves meeting with a clinician once per week. ‘I don’t think so,’ replies Mary, the social worker at the head of ICM. ‘This is a lot of scary stuff, he’s not stable and it sounds like he doesn’t want to come in on his own.’ She thinks he should go onto FSP. Charlie, the head of the FSP team, counters, ‘Our responsibility is to people who have a high use of services and are highly visible in the community. He doesn’t meet a single one of our criteria.’ The man might have a severe mental

O U T PAT I E N T

29

ʮˑˑ˦ʇͅͅੴ੮ɺ͙͐੮HäØ੮̼ʇή͙ʮ̼ʇͅ੮ɘ੮ɻʇ̼͐ɘʮ˦੮˦͙˚ɺʇ̼੮˺ʠ੮̼ʇɻʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮/Û੮ͷʮͅʮ͐ͅੴ੮ or incarcerations, plus risk factors like current homelessness or violence. Nonetheless, Charlie agrees to go visit him at his apartment. Charlie reports back to the group the next week: ‘We started introducing ourselves and he just said, “Stop.” He was very clear about refusing services. He said, “Never come back.” He made that motion where you zip up your mouth.’ Kevin, the clinic director, summarizes, ‘So now we have someone with a lengthy state hospitalization, a long period in residential care, now he’s home ɘ˦ʁ੮͐ʩʇ̼ʇૄͅ੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ͅ˺˚ʇ੮ͅɻɘ̼;੮͙͐ͅʠʠ੯ੳ੯ੳ੯ੳૄ Blair adds, ‘And he is not taking any meds whatsoever.’ Charlie insists there’s nothing more FSP can do: ‘The fact is he doesn’t want services.’ {ɘ;ɺʇ੮ ˦˺͐੮ ή͙ʮ͐ʇੳ੮ ä͙͐੮ ɻ˺˚ʇͅ੮ ʮ˦͐˺੮ ͐ʩʇ੮ ̼˺˺˚੮ ɘ˦ʁ੮ ̼ʇ̹˺̼͐ͅੴ੮ ૃU੮ ˈ͙͐ͅ੮ ʩʇɘ̼ʁ੮ ʠ̼˺˚੮ Angela’—a woman who used to be a client of UMH, and now works there—‘that ʩʇ੮ɻɘ˚ʇ੮͐˺੮˺͙̼੮̹ʇʇ̼ચˑʇʁ੮͸ʇˑˑ˦ʇͅͅ੮ʡ̼˺͙̹੮ɘ˦ʁ੮͸ɘͅੴ੮ή͙˺͐ʇੴ੮ુʁʇˑʮʡʩ͐ʠ͙ˑੳૄૄੰૄ Kevin tells me these kinds of cases (minus the nineteen-year hospitalization) are typical: ‘All those people you see out on the street, they’re not people that are looking for [UMH]. You have to be motivated to be treated here. And, as a result, we wind up cutting loose clients who can be very ill, but whose mother brought them in [rather than choosing to come themselves].’ Therein lies the paradox. With some exceptions, California reserves its best services (like FSPs) for people who have already been repeatedly hospitalized and incarcerated or are homeless. But even then, they still have to actively consent to services. By that time, they might be too sick to do so. Or they’ve been burned too many times by the mental health system to want to try again. This chapter is not about the people who stabilize and recover thanks to the tireless efforts of clinicians at places like UMH. It’s about the clients for whom those efforts fail. There’s no single explanation for why, but this chapter ʠ˺ɻ͙ͅʇͅ੮˺˦੮ʠ˺͙̼੮̹˺ͅͅʮɺʮˑʮ͐ʮʇͅੳ੮Hʮ̼͐ͅੴ੮̹̼ʮͷɘ͐ʇ੮ʮ˦͙̼ͅɘ˦ɻʇ੮̼ɘ̼ʇˑ;੮̹̼˺ͷʮʁʇͅ੮͙ͅϲϲʮɻʮʇ˦͐ˑ;੮ intensive services, pawning people off onto the public sector only once their ɻ˺˦ʁʮ͐ʮ˺˦੮ʩɘͅ੮ʁʇ͐ʇ̼ʮ˺̼ɘ͐ʇʁ੮ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;ੳ੮îʩʇ੮ɺ͙̼ʁʇ˦੮˺ʠ੮˦ɘͷʮʡɘ͐ʮ˦ʡ੮ɺ˺͐ʩ੮ʠɘˑˑͅ੮˺˦੮ family members. Second, the public system has seesawed between expansion and austerity, creating extraordinary fragmentation and an unclear demarcation of responsibilities that leaves people to bounce endlessly between disconnected levels of care. Third, voluntary outpatient services allow people with anosognosia— a lack of awareness of their need for care—to decline services (a source of

30

T H E C O N S E RVATO R S H I P C O N T I N U U M

desperation for parents in particular). Finally, people refuse to engage with the ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮̹ʇ̼ɻʇʮͷʇ੮ʮ͐ͅ੮˺ʠʠʇ̼ʮ˦ʡͅ੮ɘͅ੮͙̹ͅʇ̼ϲʮɻʮɘˑੴ੮ʮ˦ɻ˺˚̹ʇtent, unwelcoming, and unable to meet their primary needs (often community and help with housing and income, not just medication and therapy). This chapter points to a common thread of abdicated authority. There are ˚ɘ˦;੮ʁ˺˺̼ͅ੮ʮ˦͐˺੮͐ʩʇ੮ͅ;͐ͅʇ˚ੴ੮ɺ͙͐੮˦˺͐ʩʮ˦ʡ੮̼ʇή͙ʮ̼ʮ˦ʡ੮˚˺͐ͅˑ;੮̹̼ʮͷɘ͐ʇ੮̹̼˺ͷʮʁʇ̼ͅ੮͐˺੮ keep those doors open. No single entity is clearly accountable for serving the citizens of the state with the most serious mental health challenges, come what may.

PRIVATE AND PUBLIC FAILURES, FAMILY RESPONSIBILITIES California’s mental health system, which sharply divides between services ϲʮ˦ɘ˦ɻʇʁ੮͸ʮ͐ʩ੮̹͙ɺˑʮɻ੮ʁ˺ˑˑɘ̼ͅ੮ɘ˦ʁ੮͐ʩ˺ͅʇ੮̹ɘʮʁ੮ʠ˺̼੮ɺ;੮̹̼ʮͷɘ͐ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˺̼੮ɻ˺˚mercial insurance, is a microcosm of the American welfare state. Public services are reserved for those too poor and too sick to go anywhere else. Parents can try to help navigate the chasm between the two systems, but as Kiley, the mother of a daughter diagnosed with bipolar and borderline personality disorder, put it, it’s hard when the pathways into care are “clear as mud.” ુÛʇϲˑʇɻ͐ʮ˦ʡ੮ɺɘɻˌੴૂ੮ͅʩʇ੮͐˺ˑʁ੮˚ʇੴ੮ુ͸ʇ੮ɻ˺͙ˑʁ੮ͅʇʇ੮͐ʩʇ੮ͅʮʡ˦ͅ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ͐੮ɘ੮ very young age.” When her daughter Clarissa was twelve, she cut herself after seeing the movie Thirteen (which depicts self-harm among teenage girls). Kiley thought, “She’s copying this stupid movie, it’s frustrating.” Her husband was ˚˺̼ʇ੮͸˺̼̼ʮʇʁੴ੮ʠ̼ʇ͐͐ʮ˦ʡ੮͐ʩɘ͐੮ુɘ੮˦˺̼˚ɘˑ੮ɺ̼ɘʮ˦੮ʁ˺ʇͅ˦ૄ͐੮ɻ˺̹;੮ɘ੮˚˺ͷʮʇੳૂ੮";੮ϲʮʠ͐ʇʇ˦ੴ੮ Clarissa “wasn’t able to control her emotions anymore,” and Kiley called the ̹˺ˑʮɻʇ੮˺˦੮ʩʇ̼੮ʁɘ͙ʡʩ͐ʇ̼ੴ੮͐ʩʇ੮ϲʮ̼͐ͅ੮˺ʠ੮˚ɘ˦;੮͐ʮ˚ʇͅੳ Kiley, like 55 percent of Californians, had commercial health insurance,৽ but ͅʩʇ੮ ή͙ʮɻˌˑ;੮ ʠ˺͙˦ʁ੮ ͐ʩɘ͐੮ ͐˺˺ˌ੮ ʩʇ̼੮ ˺˦ˑ;੮ ͅ˺੮ ʠɘ̼ੳ੮ Øͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ ɘ̼ʇ੮ ͐ʩʇ੮ ˑʇɘ͐ͅ੮ ˑʮˌʇˑ;੮ of any specialists to take insurance.৾੮îʩʇ੮̹̼˺ͷʮʁʇ̼ͅ੮ͅʩʇ੮ɻ˺͙ˑʁ੮ϲʮ˦ʁ੮ͅʇʇ˚ʇʁ੮ʮˑˑચ ʇή͙ʮ̹̹ʇʁ੮͐˺੮ʩɘ˦ʁˑʇ੮ʩʇ̼੮ʁɘ͙ʡʩ͐ʇ̼ૄͅ੮̹̼˺ɺˑʇ˚ͅੳ੮Pʇ̼੮ʠɘ˚ʮˑ;੮ʁ˺ɻ͐˺̼ੴ੮ͅʩʇ੮ͅɘʮʁੴ੮͸ɘͅ੮ reluctant to diagnose her, telling Kiley, “I don’t want to diagnose someone, because they’re just labels. The reality is that she is very sensitive.” She got her daughter in to see a rotating series of psychologists and psychiatrists. Clarissa ͸˺͙ˑʁ੮ુ˚ɘ˦ʮ̹͙ˑɘ͐ʇ੮͸ʩɘ͐੮͐ʩʇ;੮͸ɘ˦͐੮͐˺੮ʩʇɘ̼ૂ੮ʠ˺̼੮͐ʩʇ੮ϲʮ̼͐ͅ੮ʠʇ͸੮ͅʇͅͅʮ˺˦ͅ੮ɘ˦ʁ੮ુɘͅ੮ soon as they started pushing back, she’d be on to the next one.” Private providers are under no obligation to treat a patient if they don’t want to.৿ Most private

O U T PAT I E N T

31

therapists are in the business of treating anxiety and depression, not psychosis and personality disorders. ä͐ʮˑˑੴ੮nʮˑʇ;੮͸ɘͅ੮ˑ͙ɻˌ;੮͐˺੮ɺʇ੮ʮ˦੮ɘ੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸ʩʇ̼ʇ੮ͅʩʇ੮ɻ˺͙ˑʁ੮ϲʮ˦ʁ੮ɘ੮˚ʇ˦͐ɘˑ੮ health provider at all. There are three to four times as many psychologists and psychiatrists per capita in the Bay Area as in the Sierras, the Inland Empire, or ͐ʩʇ੮ äɘ˦੮ k˺ɘή͙ʮ˦੮ ēɘˑˑʇ;ੳ਀ Seven rural counties have no psychiatrist whatsoever. A lawyer who worked with families struggling to connect to mental health care in rural Northern California lamented, “The rural situation is the worst when it ɻ˺˚ʇͅ੮͐˺੮ɘɻɻʇͅͅੳ੯ੳ੯ੳ੯ੳ੮˦;͐ʩʮ˦ʡ੮˚˺̼ʇ੮͐ʩɘ˦੮̹̼ʮ˚ɘ̼;੮ɻɘ̼ʇ੮ʮͅ੮˦˺͐੮ɘͷɘʮˑɘɺˑʇੳ੮੮ˑ˺͐੮˺ʠ੮ poor folks can’t afford the transport” to the coastal cities where specialists choose to congregate. Having been failed by more conventional outpatient services, Kiley—who works as an interior designer—paid out of pocket for her daughter to go to a private clinic in Southern California. The clinic promised that, with “a brain scan and a physical,” they could “tell what’s wrong with the brain.” She recounted, “All these places supposedly know mental illness and you slap down your $5,000 and they’re going to put her where she needs to go.” The clinic gave Clarissa a regimen of medication and vitamins and recommended she go to a wilderness-based rehab center in Colorado.ਁ੮äʩʇ੮ˑɘ͐ͅʇʁ੮ɘ੮͸ʇʇˌ੮ɺʇʠ˺̼ʇ੮ͅʩʇ੮ϲˑʇʁ੮ɘ˦ʁ੮ɻɘ˚ʇ੮ɺɘɻˌ੮ʩ˺˚ʇੳ੮ Kiley showed me a timeline cataloging Clarissa’s stints in more than a dozen priͷɘ͐ʇ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮͐ʩɘ͐੮ή͙ʮɻˌˑ;੮ʁʮͅɻʩɘ̼ʡʇʁ੮ʩʇ̼ઝͅ˺˚ʇ੮͸ʮ͐ʩʮ˦੮ˑʇͅͅ੮͐ʩɘ˦੮ɘ੮ day—saying she needed a higher level of care. They don’t give refunds. Over time, Kiley realized that the providers that take private insurance often don’t offer the suite of services, like case management or a multidisciplinary ͐ʇɘ˚ੴ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮˺ʠ͐ʇ˦੮̼ʇή͙ʮ̼ʇ੮ʮ˦੮ɘʁʁʮ͐ʮ˺˦੮͐˺੮˚ʇʁʮcation or talk therapy. Kaiser Permanente has 40 percent of the insurance market share in California,ਂ and a particularly abysmal record. In 2013, the state Depart˚ʇ˦͐੮ ˺ʠ੮ Pʇɘˑ͐ʩ੮ #ɘ̼ʇ੮ äʇ̼ͷʮɻʇͅ੮ ϲʮ˦ʇʁ੮ nɘʮͅʇ̼੮ ʠ˺̼੮ ͷʮ˺ˑɘ͐ʮ˦ʡ੮ ુ̹ɘ̼ʮ͐;ૂ੮ ˑɘ͸ͅ੮ ɺ;੮ ̹̼˺viding slower and less comprehensive access to mental health services than to physical ones.ਃ Kaiser mental health workers went on strike in 2022. They alleged ͐ʩɘ͐੮͐ʩʇ੮ɻ˺˚̹ɘ˦;੮ʩɘʁ੮ˑʇ͐੮͸ɘʮ͐ˑʮ͐ͅͅ੮ʠ˺̼੮ɘ੮ϲʮ̼͐ͅ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐੮ʡ̼˺͸੮͐˺੮ʇʮʡʩ͐੮͸ʇʇˌͅ੮ and underfunded psychiatric care so grossly that some Kaiser ERs had no mental health staff at night.਄ Among Kaiser’s many shocking practices—especially given that it made ଏ৸੮ ɺʮˑˑʮ˺˦੮ ʮ˦੮ ̹̼˺ϲʮ͐ͅ੮ ʮ˦੮ ৲ৰ৲ৱઝʮͅ੮ ɘɺʁʮɻɘ͐ʮ˦ʡ੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ʠ˺̼੮ ʮ͐ͅ੮ ˺͸˦੮ ɻˑʮʇ˦͐ͅੳৼ৻ A 2014 lawsuit alleged that Kaiser sought to disenroll people from coverage so

32

T H E C O N S E RVATO R S H I P C O N T I N U U M

that the public sector would pay for them to go into a locked residential facility.ৼৼ Dr. Fazio, a doctor in one of those facilities, insisted, “If you’re a young person ͸ʮ͐ʩ੮̹ͅ;ɻʩ˺ͅʮͅ੮;˺͙ૄ̼ʇ੮ɺʇ͐͐ʇ̼੮˺ʠʠ੮˦˺͐੮ʩɘͷʮ˦ʡ੮̹̼ʮͷɘ͐ʇ੮ʮ˦͙̼ͅɘ˦ɻʇੳ੯ੳ੯ੳ੯ੳ੮îʩʇ੮ʁɘ͐ɘ੮˺˦੮ϲʮ̼͐ͅ੮ break episodes [that is, the early stages of schizophrenia, when hallucinations or delusions begin] for privately insured patients is horrible,” he told me, citing a ͙͐ͅʁ;੮͐ʩɘ͐੮ʠ˺͙˦ʁ੮;˺͙˦ʡ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮̹ͅ;ɻʩ˺ͅʮͅ੮ʩɘʁ੮͐͸ʇ˦͐;ચϲʮͷʇ੮͐ʮ˚ʇͅ੮͐ʩʇ੮˚˺̼͐ɘˑity rate in the year after diagnosis as those without psychosis.ৼ৽ Family members like Kiley sometimes do the dirty work for insurance companies themselves. She had been writing letters to her county supervisors—she called them, “Oh shit” letters, of the genre “Oh shit, Clarissa is back in jail!”— and realized that “the county wasn’t going to help her unless she was completely reliant on them.” She promised herself she would stop taking her daughter home when the hospital called, instead letting them dump her onto the street. She disenrolled Clarissa from her family insurance plan, which was “unfortunate” because her daughter had a serious physical condition for which she lost access to her existing specialist. There’s no estimate of the number of people who drop private insurance to get public mental health services, but it’s enough to be a vexing problem for county governments.ৼ৾ Michelle Cabrera from the County Behavioral Health Directors ͅͅ˺ɻʮɘ͐ʮ˺˦੮ʠ͙˚ʇʁੴ੮ુîʩʇ੮ʠɘʮˑ͙̼ʇ੮˺ʠ੮ɻ˺˚˚ʇ̼ɻʮɘˑ੮યʮ˦͙̼ͅɘ˦ɻʇર੮̹ˑɘ˦ͅ੯ੳ੯ੳ੯ੳ੮͐˺੮̼ʇɘˑˑ;੮͐ɘˌʇ੮ ͅʇ̼ʮ˺͙ͅˑ;੮͐ʩʇ੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮˦ʇʇʁͅ੮˺ʠ੮͐ʩʇʮ̼੮ɺʇ˦ʇϲʮɻʮɘ̼ʮʇͅ੮̼ʇ͙ͅˑ͐ͅ੮ʮ˦੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ ɘ̼ʇ੮ɘˑˑ˺͸ʇʁ੮͐˺੮ɺʇɻ˺˚ʇ੮ʁʮͅɘɺˑʇʁੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮͐ʩʮͅ੮̹͙͐ͅ੮ɘʁʁʮ͐ʮ˺˦ɘˑ੮̹̼ʇ͙̼ͅͅʇ੮˺˦੮˺͙̼੮̹͙ɺlic system.” By the time they reach the county mental health department, a crucial window of opportunity has closed: “it’s unconscionable because if you do catch ̹ʇ˺̹ˑʇ੮ɘ͐੮ૃϲʮ̼͐ͅ੮ɺ̼ʇɘˌૄ੯ੳ੯ੳ੯ੳ੮;˺͙੮ɻɘ˦੮̼ʇɘˑˑ;੮ʩʇˑ̹੮̹ʇ˺̹ˑʇ੮ˑʮͷʇ੮ɘ੮ɻ˺˚̹ˑʇ͐ʇˑ;੮ʁʮʠʠʇ̼ʇ˦͐੮ˑʮʠʇ੮ ͐ʩɘ͐੮ʮͅ˦ૄ͐੮ϲʮˑˑʇʁ੮͸ʮ͐ʩ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮ˈ͙͐ͅʮɻʇચʮ˦ͷ˺ˑͷʇ˚ʇ˦͐ੴ੮ɘ˦ʁ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳૂ By the time Clarissa went off private insurance, she was in free fall. She totaled her car by leaving it on a train track. When she got on social security disability ɺʇ˦ʇϲʮ͐ͅੴ੮ͅʩʇ੮ɺ˺͙ʡʩ͐੮ɘ˦˺͐ʩʇ̼੮˺˦ʇ੮ફ̼ʇɻʮ̹ʮʇ˦͐ͅ੮˺ʠ͐ʇ˦੮̼ʇɻʇʮͷʇ੮ɘ੮͙ͅɺ͐ͅɘ˦͐ʮɘˑ੮ɺɘɻˌ੮̹ɘ;ment for the period between when they apply for disability and are approved). Clarissa was convinced she needed to help “save a pregnant dog” in Tijuana, and drove to Mexico. Kiley recounted, “She called me [from Tijuana] and said, ‘Mom, I’m in a police car, something happened to me.’” The county put Clarissa in its Assisted Outpatient Treatment (AOT) program, a form of court-ordered outpatient care in which a judge mandates that a person accept treatment. But the AOT team couldn’t convince the county’s own

O U T PAT I E N T

33

hospital to keep her the ten times in the previous year police dropped her off for an emergency psychiatric evaluation. When Clarissa stabbed someone and ended up in jail, Kiley was hoping the AOT team would “swoop in” and ensure she got treatment while incarcerated. But after one of her infamous email blasts to county supervisors, the district attorney called her to let her know they wouldn’t press charges. Clarissa would go back to the streets. “I call people in county government and they say, ‘Oh, have you tried this, have you heard of AOT?’ and U੮ͅɘ;ੴ੮ૃĚʇɘʩੴ੮ͅʩʇૄͅ੮ɘˑ̼ʇɘʁ;੮̹ɘ̼͐੮˺ʠ੮ʮ͐ੳૄ੯ੳ੯ੳ੯ੳ੮îʩʇ੮̼ʮʡʩ͐੮ʩɘ˦ʁ੮ʁ˺ʇͅ˦ૄ͐੮ˌ˦˺͸੮͸ʩɘ͐੮͐ʩʇ੮ ˑʇʠ͐੮ʩɘ˦ʁ੮ʮͅ੮ʁ˺ʮ˦ʡੳ੯ੳ੯ੳ੯ੳ੮#˺˚˚͙˦ʮɻɘ͐ʮ˺˦੮ɺʇ͐͸ʇʇ˦੮͐ʩʇ੮̹˺ˑʮɻʇੴ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮šîઝʮ͐ૄͅ੮ a shitshow,” she raged. Kiley thought that after the private sector had thoroughly failed her daughter, the county would take charge of halting her decline. But becoming a client of the county was no panacea either, partly because “the county” is actually a host of disparate agencies touching on the lives of people with serious mental illness and following their own discretion in doing so. Parents like Kiley are the glue that holds this nonsystem together. They cart their children’s medical records between providers who don’t share them. Their frantic emails connect agencies that usually don’t talk. They’re the burned-out care coordinators who can never ή͙ʮ͐੮˺̼੮͐ɘˌʇ੮ɘ੮ͷɘɻɘ͐ʮ˺˦ੳৼ৿ As a result, Kiley sighed, “It’s just trial and error while my daughter is drowning.”

FISCAL FEAST AND FAMINE IN A FRAGMENTED SYSTEM For Kiley, California’s public mental health system was a last resort. For Ashley, it was a new hope. I spoke to her and her sister Meredith over Zoom in 2022, both of them sitting on a couch in a bare apartment in Stanislaus County. Ashley is not sure when her hallucinations started: “When I was young, 14 or 15, I saw these men out the window, following a little girl dressed in green. It could have been psychosis, it could have been real, but I freaked out.” She told her parents, who called the police to check on her. Like so many I talked to, law enforcement—not ɻˑʮ˦ʮɻʮɘ˦ͅઝ͸ʇ̼ʇ੮ʩʇ̼੮ϲʮ̼͐ͅ੮ɻ˺˦͐ɘɻ͐੮ʮ˦੮ɘ੮ɻ̼ʮͅʮͅੳৼ਀ She didn’t get treatment until she was arrested for drug possession and diverted to a residential substance use program at eighteen. While there, she was diagnosed with bipolar disorder and put on lithium. She stopped it when she became pregnant.

34

T H E C O N S E RVATO R S H I P C O N T I N U U M

The next decade was a blur of aimless short-term psychiatric coercion. Ashley grew up in Florida, where the 1971 Baker Act mirrored LPS: it gave legal authority to law enforcement to place people on involuntary “holds” and transport ͐ʩʇ˚੮͐˺੮ɘ˦੮/Û੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੳ੮U͐੮ʮͅ੮͙ͅʇʁ੮ʇͷʇ˦੮˚˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;ੳৼਁ She recalls being “Baker Act’ed” when she was “completely erratic” and fought with a friend over a burrito. Another time, police found her outside her house, naked, fearful her whole family was dead inside. Ashley’s sister chimed in to remind her of when she was held for throwing herself in front of a car. Sometimes the ER would say her psychosis was from drug use and let her go immediately; other times, they’d attribute it to schizophrenia and keep her a few days. Ashley’s care was constricted by Florida’s decision to leave adults living in poverty, like Ashley, uninsured (Florida chose not to expand public health insurance through Medicaid under the 2010 Affordable Care Act, better known as Obamacare). The hospital would not be reimbursed for Ashley’s stay ɘ˦ʁ੮͐ʩ͙ͅ੮ʁʮͅɻʩɘ̼ʡʇʁ੮ʩʇ̼੮ʮ˦੮ɘ੮ϲˑɘͅʩੳ੮Ĕ˺̼ͅʇੴ੮ʩʇ̼੮ͅʮ͐ͅʇ̼੮{ʇ̼ʇʁʮ͐ʩ੮̼ʇɻɘˑˑʇʁੴ੮ુîʩʇ;੮ય͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑર੮͸˺͙ˑʁ੮ͅʇ˦ʁ੮ʩʇ̼੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮ͅɻ̼ʮ̹͐ͅ੮ʠ˺̼੮äʇ̼˺ή͙ʇˑ੮યɘ੮ુͅʇɻ˺˦ʁચʡʇ˦ʇ̼ɘ͐ʮ˺˦ૂ੮ anti-psychotic with fewer side effects] that were $2,000 or 3,000 [a month].” So they switched her to Haldol, an older drug. Ashley hated it, but it was “one of the cheapest drugs. We could pay cash for it.”ৼਂ Ashley encouraged me to go online to read her arrest record, which I did: it’s a litany of drug possession and disorderly conduct charges. But in 2019, Ashley, now in her thirties, off medication and on methamphetamine, told her mother ͐ʩɘ͐੮ ͅʩʇ੮ ͸ɘͅ੮ ɘ੮ ʁʇ˚˺˦੮ ɘ˦ʁ੮ ̼͐ʮʇʁ੮ ͐˺੮ ̼͐ͅɘ˦ʡˑʇ੮ ʩʇ̼ੳ੮ ˦੮ ˺ϲϲʮɻʇ̼੮ ʩɘ͙ˑʇʁ੮ ʩʇ̼੮ ˺͙͐੮ ˺ʠ੮ the bathroom and declared she would be Baker Act’ed. When she spit on him, he arrested her for battery instead. Things, improbably, turned around from there. Ashley went to the jail medical unit, which was “basically like solitary યɻ˺˦ϲʮ˦ʇ˚ʇ˦͐રੳૂ੮U͐੮͸ɘͅ੮ͅ˺੮ɺɘʁ੮͐ʩɘ͐੮ͅʩˑʇ;੮ɘʡ̼ʇʇʁ੮͐˺੮͐ɘˌʇ੮˚ʇʁͅ੮ˈ͙͐ͅ੮͐˺੮ʡ˺੮ɺɘɻˌ੮͐˺੮ her cell block. There, Meredith tells me, “the girls in the pod were aware she was sick, and they’d all tell her to take her medicine every day.” Meredith had learned about AOT and was convinced Ashley needed it. Florida has an AOT statute on the books, but the program was unfunded and inactive.ৼਃ Meredith lived in California, which has AOT (the program that Clarissa was on). Meredith asked the judge to let her take Ashley home, telling the court, “It’s a liberal paradise over here, there are systems to help her, they have better healthcare.” Ashley pledged to take her Haldol. The judge let her go on the condi͐ʮ˺˦੮ͅʩʇ੮͸˺͙ˑʁ੮ુϲʮ˦ʁ੮ɘ੮ʁ˺ɻ͐˺̼੮ɘ˦ʁ੮ͅʇ˦ʁ੮ɘ੮ˑʇ͐͐ʇ̼ੳૂ੮ͅ੮ͅʩˑʇ;੮̼ʇɻɘˑˑʇʁ੮ʮ͐ੴ੮ુîʩʇ੮ˈ͙ʁʡʇ੮

O U T PAT I E N T

35

was like, ‘get out of here,’ so I walked out of jail, my sister was standing there by a car, I had nothing”—not even a day’s supply of meds. This all might sound implausible, but it’s what her court records show. Meredith had reason to be optimistic. In 2015, California spent the fourteenth most per capita on mental health care among states; Florida was dead last.ৼ਄ But that headline number misses the way California’s public system has been alternately stuffed by new initiatives and starved by budget cuts, creating layers of delegated services—all of which have the discretion to say “no.” Alongside granting new civil liberties and creating the legal framework for conservatorship, the LPS Act took an existing program (Short-Doyle, enacted in 1955) that provided matching funds for local mental health programs and upped the state’s contribution from 50 to 90 percent (leaving counties to pay the other 10 percent). Some counties ignored the opportunity; others ran their own programs; still others took the money and contracted with private organizations to provide services.৽৻ Who actually got served varied. Many community clinics appeared more interested in providing psychotherapy to people with less severe conditions (“pretty co-eds with interesting sex lives”৽ৼ) than people whose only stories were of spending the last ten years in a state institution. There’s a well-worn tale about what happened next. As Nicolas Petris recalled in an oral history in 1988, “When we started keeping people out of state hospitals, it was under the intention that the state dollar for mental health was going ͐˺੮ʠ˺ˑˑ˺͸੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮îʩɘ͐੮˦ʇͷʇ̼੮ʩɘ̹̹ʇ˦ʇʁੳ੯ੳ੯ੳ੯ੳ੮યÛʇɘʡɘ˦ર੮͐˺˺ˌ੮͐ʩʇ੮ʡ͙͐ͅ੮̼ʮʡʩ͐੮ out of this state money for local treatment.”৽৽ This is accurate, but incomplete: in the ensuing decades, every governor—not just Reagan—subjected county mental health programs to brutal cuts.৽৾ As the Los Angeles Times observed, once care for the severely mentally ill went from “wholly a state responsibility” to one delegated to the local level, “Sacramento’s interest seemed to fade.”৽৿ The original bargain of LPS was that those concerned about civil rights would get new legal protections and those concerned about providing care would get new treatment programs. The deal was almost immediately broken. The late 1980s were particularly pitiless. Governor Deukmejian cut one-third of the mental health budget from 1985 to 1990.৽਀ The austerity was so bad that San Diego developed a triage plan that would withdraw care from half of its existing clients.৽ਁ In 1991, legislators responded by further delegating mental health care through a process called “realignment.” Counties would assume full responsibility not just for operating outpatient clinics but also for paying for

36

T H E C O N S E RVATO R S H I P C O N T I N U U M

expensive long-term residential treatment. Each county’s mental health program would get a dedicated if inconsistent funding stream from a 1.25 percent sales tax increase and a hike in vehicle registration fees. The bill also established a clear set of objectives: “To the extent resources are available, public mental health services ʮ˦੮͐ʩʮͅ੮͐ͅɘ͐ʇ੮ͅʩ˺͙ˑʁ੮ɺʇ੮̹̼˺ͷʮʁʇʁ੮͐˺੯ੳ੯ੳ੯ੳ੮̹ʇ̼ͅ˺˦ͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮ͅʇͷʇ̼ʇ੮ɘ˦ʁ੮ʁʮͅɘɺˑʮ˦ʡ੮ mental illnesses.”৽ਂ Realignment successfully refocused public mental health services on people who were poorer, less educated, and more impaired.৽ਃ It expanded county bureaucracies to act much like insurance companies: managing contracts with providers, evaluating people for services, and authorizing (and withholding) continued treatment. Realignment also entrenched huge disparities in the services available across counties: some spent much of their realignment money on locked facilities while others went all in for outpatient care.৽਄ The Legislative Analyst šϲϲʮɻʇ੮ ɻ˺˦ɻˑ͙ʁʇʁ੮ ʮ˦੮ ৲ৰৰৱ੮ ͐ʩɘ͐੮ ͸ʩʮˑʇ੮ ̼ʇɘˑʮʡ˦˚ʇ˦͐੮ ʩɘʁ੮ ͙ͅɻɻʇͅͅʠ͙ˑˑ;੮ ુ͐ͅɘɺʮˑʮΈʇયʁર੮ mental health funding,” it did little to expand care to an estimated six hundred thousand “seriously mentally ill persons” in the state going without treatment.৾৻ An attempt to reach that unserved population came with California’s Mental Health Services Act (MHSA), which is second only to LPS in the amount of initial hope it sparked and later derision it received. The MHSA, approved by voters in 2004, imposes a 1 percent surcharge on incomes above one million dollars. Half its funds go to FSPs—outpatient teams assigned to do “whatever it takes” to keep people who have been cycling through jails and hospitals stable in the community (by tracking down clients in homeless encampments to give them antipsychotic injections, for example, or intervening with landlords to keep clients from getting evicted from supported housing). The rest of the ʠ͙˦ʁͅ੮ʡ˺੮͐˺੮̹̼ʇͷʇ˦͐ʮ˺˦ੴ੮ʇɘ̼ˑ;੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ੴ੮ɘ˦ʁ੮ʮ˦˦˺ͷɘ͐ʮ˺˦ੳ੮U˦੮ʮ͐ͅ੮ϲʮ̼͐ͅ੮ʠ͙ˑˑ੮;ʇɘ̼੮ʮ˦੮ effect, MHSA brought $1.3 billion new dollars into the system; within a decade, it ͸ɘͅ੮̹̼˺ͷʮʁʮ˦ʡ੮৲৴੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ϲʮ˦ɘ˦ɻʮ˦ʡ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇੳ৾ৼ You might think that Ashley, with her history of hospitalizations and incarcera͐ʮ˺˦ੴ੮͸˺͙ˑʁ੮ή͙ɘˑʮʠ;੮ʠ˺̼੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮৶৵ੴৰৰৰ੮HäØ੮̹ͅ˺͐ͅ੮{Pä੮˚ɘʁʇ੮ɘͷɘʮˑɘɺˑʇੳ৾৽ She even posted on social media that there was one nearby that she thought would “bring me meds every three days” and that her sister could contact instead of the police in a crisis. But when Meredith called the county access line, which evaluates new cases ɘ˦ʁ੮˺̼ʮʇ˦͐ͅ੮͐ʩʇ˚੮͐˺੮ͅʇ̼ͷʮɻʇͅੴ੮ͅʩˑʇ;੮ʁʮʁ˦ૄ͐੮ή͙ɘˑʮʠ;੮ɺʇɻɘ͙ͅʇੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐੮ explained, she was “too stable.” Meredith went to a public outreach event for the county clinic where they told her, “if it’s not a crisis, we don’t have anything.”৾৾

O U T PAT I E N T

37

Meredith and Ashley were running up against the limits of what MHSA could do to plug the gaps in California’s mental health system. Even as MHSA ʁ˺ˑˑɘ̼ͅ੮͸ʇ̼ʇ੮ϲˑ˺͸ʮ˦ʡ੮ʮ˦ੴ੮̼ʇɘˑʮʡ˦˚ʇ˦͐੮ʠ͙˦ʁͅ੮͐ɘ˦ˌʇʁ੮ʮ˦੮͐ʩʇ੮I̼ʇɘ͐੮Ûʇɻʇͅͅʮ˺˦ੳ੮îʩʇ੮ public mental health caseload dropped from 658,314 in 2007 to 442,691 in 2009.৾৿ A decade later, the basic infrastructure of care—clinics with case managers and psychiatrists—that counties are supposed to provide for people who don’t meet strict FSP criteria were, at least in Stanislaus (where Ashley lived), just not there.৾਀ The county mental health bureaucracy’s determination that Ashley was “too stable” threw her into an entirely different, parallel public system. (If all of these layers of services and funding streams are confusing, imagine what it’s like to try to navigate them in a crisis.) The 2010 Affordable Care Act ushered in a new expansion of care in California.৾ਁ It also added another set of actors to an already convoluted system. In this regime, private care insurance companies would take public Medicaid dollars (in California, called Medi-Cal) to pay private mental health providers to care for people with “mild-to-moderate” conditions. Counties ͸˺͙ˑʁ੮̼ʇʠ˺ɻ͙ͅ੮˺˦ˑ;੮˺˦੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮ુͅʮʡ˦ʮϲʮɻɘ˦͐ૂ੮ʮ˚̹ɘʮ̼˚ʇ˦͐੮ફͅʇʇ੮ϲʮʡ͙̼ʇ੮ৱੳৱબੳ৾ਂ This deepening privatization is visible nationwide: for example, since 2016, private

County “ACCESS” Line “Significant” impairment

“Mild” or “moderate” impairment

County “Mental Health Plan” Referral

Referral

No longer meets strict criteria Contracted or county-run FSP or Early Psychosis Teams MHSA and Medi-Cal Funded

Private “Managed Care” Plan t en ” ri m ant pa ic m if s i sign m ai t “ Cl no is

Referral Cla act ims im ua lly pairm “sig nif ent is ica nt”

Contracted or county-run clinics and case management Realignment and Medi-Cal Funded

1.1 Access to services for Californians on Medi-Cal

Private clinics or professionals Medi-Cal Funded (Expanded by Affordable Care Act)

38

T H E C O N S E RVATO R S H I P C O N T I N U U M

ʇή͙ʮ͐;੮ϲʮ̼˚ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ͅ˦ɘ̹̹ʮ˦ʡ੮͙̹੮ɻ˺˚˚͙˦ʮ͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮ˦ʮɻͅ੮˺˦ɻʇ੮̼͙˦੮ ɺ;੮˦˺˦̹̼˺ϲʮ͐ͅੳ৾ਃ According to Kevin, the director of the UMH clinic, the expansion of Medi#ɘˑ੮ ͸ɘͅ੮ ˑʮˌʇ੮ ɘ੮ ુϲʮ̼ʇʩ˺͙ͅʇૂ੮ ˺ʠ੮ ˦ʇ͸ˑ;੮ ʮ˦͙̼ͅʇʁ੮ ̹ʇ˺̹ˑʇ੮ ʁʇ˚ɘ˦ʁʮ˦ʡ੮ ɻɘ̼ʇੳ੮ ɺ˺͙͐੮ ͐ʩ̼ʇʇચή͙ɘ̼͐ʇ̼ͅ੮˺ʠ੮͐ʩ˺ͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʁ˺੮˦˺͐੮ή͙ɘˑʮʠ;੮ʠ˺̼੮ɻ˺͙˦͐;੮ͅʇ̼ͷʮɻʇͅ੮ˑʮˌʇ੮õ{P੮ and are thrown back out to this privatized Medi-Cal managed care system. Dr. Stevens, the clinic’s psychiatrist, was not optimistic about what happens next: ‘They [the insurance company] will refer you to a therapist network, but they [the therapists] don’t return calls, they cap the number of people on Medi-Cal [they will serve] because it doesn’t pay well, they’re too busy, or they’re dead. Those lists are really horrendous. If someone is high functioning, they can connect, but I don’t know what percentage makes it.’ The head of one county’s mental health department did know the percentage: 50 percent of the people they referred to ͐ʩʇ੮{ʇʁʮચ#ɘˑ੮˚ɘ˦ɘʡʇʁ੮ɻɘ̼ʇ੮˦ʇ͐͸˺̼ˌ੮˦ʇͷʇ̼੮˚ɘʁʇ੮ʮ͐੮͐˺੮ɘ੮ϲʮ̼͐ͅ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ੳ Meredith called the clinics on the Medi-Cal managed care company’s list, desperate to get care for her sister. “I get violent,” Ashley cuts in, explaining the urgency. But if the county thought Ashely was too stable, the publicly paid private providers that took Medi-Cal thought she was too severe. Given her criminal justice history, some programs wanted a “special letter [from a psychiatrist] ͅɘ;ʮ˦ʡ੮ Uૄ˚੮ ͅɘʠʇ੮ ʠ˺̼੮ ɻ˺˚˚͙˦ʮ͐;੮ ɻɘ̼ʇੴૂ੮ ɺ͙͐੮ ͅʮ˦ɻʇ੮ ͅʩˑʇ;੮ ɻ˺͙ˑʁ˦ૄ͐੮ ϲʮ˦ʁ੮ ɘ੮ ̹ͅ;ɻʩʮatrist, that was a dead end. Drug programs (which have a separate Medi-Cal funding stream) said they didn’t take people with serious mental illness and that she should return to the county system. This is exactly the situation some government watchdogs feared when California further subdivided its system: gaps in services as clients are referred back and forth between counties and private managed care plans.৾਄ Meredith eventually found a psychiatrist who took Medi-Cal. She agreed to ʁ˺੮ ͐ʇˑʇʩʇɘˑ͐ʩ੮ ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅ੮ ͐˺੮ ʡʮͷʇ੮ ͅʩˑʇ;੮ ̼ʇϲʮˑˑͅੴ੮ ɺ͙͐੮ ˺˦ˑ;੮ ʠ˺̼੮ ͐ʩ̼ʇʇ੮ ˚˺˦͐ʩͅੳ੮ îʩ̼ʇʇ੮;ʇɘ̼ͅ੮ˑɘ͐ʇ̼ੴ੮͐ʩɘ͐੮ʁ˺ɻ͐˺̼੮ʮͅ੮͐ͅʮˑˑ੮͸̼ʮ͐ʮ˦ʡ੮̼ʇϲʮˑˑͅੴ੮ͅʮ˦ɻʇ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮ϲʮ˦ʁ੮ɘ˦;˺˦ʇ੮ else who will. Ashley wrote me after her interview to describe the “tactile and auditory hallucinations, messages from the gods making me suffer.” She’s conͷʮ˦ɻʇʁ੮ͅʩʇ੮˦ʇʇʁͅ੮ɘ੮˚˺̼ʇ੮̹˺͸ʇ̼ʠ͙ˑ੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻੴ੮#ˑ˺Έɘ̼ʮˑੴ੮͐˺੮ή͙ʮʇ͐੮͐ʩʇ੮ͷ˺ʮɻʇͅ੮˦ʮ̹ping at her. The doctor won’t do a complex medication change over the phone. A few days after we spoke, she posted a despairing message online: “Literally ɺʇʡʡʮ˦ʡ੮ʠ˺̼੮˚;੮ˑʮʠʇੳ੯ੳ੯ੳ੯ੳ੮Ø͙͐੮˚ʇ੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮͐ʩɘ͐੮͸ʮˑˑ੮͙˦ʁʇ̼͐ͅɘ˦ʁੳ੮Ûʇ˚˺ͷʇ੮ my barriers to care.”

O U T PAT I E N T

39

In an odd way, for Ashley, that barrier was not an absence of providers, but a surfeit of them. On the ground, the multiplication of funding streams and programs in California makes it so every point in the nominally public system can say “no” to someone like Ashley, who seems too impaired for privately run services and not impaired enough for county-run ones. After all, there’s always a different level of care more appropriate for her—except, in her case, there isn’t.

DELUSIONAL REFUSAL? Ashley couldn’t get care when she wanted it. Some people can get it, but don’t. Multiple parents insisted that, to understand why, I needed to read either D. J. Jaffe’s Insane Consequences or Xavier Amador’s I’m Not Sick, I Don’t Need Help.৿৻ What these books share is their unswerving emphasis on anosognosia. According to Jaffe, anosognosia is the “clinical term for lack of awareness of being ill” (sometimes also called a lack of insight). He asserts it has “major policy implications”: namely, that the law should not allow people with anosognosia—supposedly 50 percent of people with schizophrenia—to refuse treatment, since that refusal is itself a psychotic symptom.৿ৼ From this perspective, because the communitybased programs that LPS envisioned as an alternative to institutionalization were voluntary, they were guaranteed to fail people living with the most serious conditions.৿৽ I can see why Michael and Julie would turn to anosognosia as an explanation for the seemingly inexplicable unwillingness of their son, Adam, to accept help. He was an Eagle Scout with a 4.0 GPA when, early in college, he started failing his courses. Over time, Julie recounts, “It turned into paranoia, blockading himself in his room, refusing to eat the food we served, stories about freemasons, etcetera. He took these spontaneous trips across the country in his car, we’d have ͐˺੮ϲˑ;੮˺͙͐੮͐˺੮ϲʮ˦ʁ੮ʩʮ˚ੴ੮ʮ˚̹˺͙˦ʁ੮͐ʩʇ੮ɻɘ̼ੳૂ੮îʩʇ;੮̼͐ʮʇʁ੮͐˺੮ʡʇ͐੮ʩʮ˚੮͐˺੮ɘ੮̹̼ʮͷɘ͐ʇ੮̹ͅ;chiatrist, but Adam refused to go. Instead, he installed locks on his bedroom door, blocked it with furniture, and began accusing Julie of putting benzodiazepines in the tuna sandwiches she would drop off for him. Michael and Julie mentioned this accelerating catastrophe to a friend at church who recommended they go to meetings of the National Alliance for Mental Illness (NAMI), an advocacy organization that provides support for parents. NAMI counseled reading Amador’s book (where they learned about anosognosia)

40

T H E C O N S E RVATO R S H I P C O N T I N U U M

ɘ˦ʁ੮̼ʇɘɻʩʮ˦ʡ੮˺͙͐੮͐˺੮rî/Ûੴ੮ɘ੮̹̼˺ʡ̼ɘ˚੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮ɘ੮ϲʮ̼͐ͅ੮̹ͅ;ɻʩ˺͐ʮɻ੮ break. Both federal and state lawmakers have been funneling money into such early intervention programs.৿৾੮îʩʇ̼ʇ੮ʮͅ੮ɻ˺˚̹ʇˑˑʮ˦ʡ੮ʇͷʮʁʇ˦ɻʇ੮͐ʩɘ͐੮ή͙ʮɻˌˑ;੮̹͙͐͐ʮ˦ʡ੮ a young person on a low dose of an antipsychotic and providing a host of psychosocial supports to keep them in school, working, and connected with family can prevent a life of chronic illness.৿৿ They only managed to get Adam to take a single phone call from the ALTER team. As Julie recounted, “He said, ‘I’m not sick, do not call here, I will not go to your program,’ and hung up.” The ALTER social worker told Julie, “He’s over 18, our hands are tied”: he needed to consent to care. Without his agreement, ALTER also couldn’t share information with his parents. Michael read me a letter he wrote to the program expressing his frustration: “First of all, your program is great, we wanted our son to be involved, but the whole approach that you ͐ɘˌʇ੯ੳ੯ੳ੯ੳ੮ʮͅ੮ɘ੮ͷʮ˺ˑɘ͐ʮ˺˦੮˺ʠ੮͸ʩɘ͐੮;˺͙੮ɘ˦ʁ੮ɘˑˑ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ˌ˦˺͸੮ʮͅ੮ૃɘ˦˺ͅ˺ʡ˦˺ͅʮɘੳૄૂ੮ I get their exasperation. Michael and Julie had been going to NAMI webinars where they heard the claim that “with every episode there’s more brain damɘʡʇੴૂ੮ɘ˦੮ʮ˚ɘʡʇ੮͐ʩɘ͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ʩɘͷʇ੮ɺʇʇ˦੮̹˺̹͙ˑɘ̼ʮΈʮ˦ʡ੮͐˺੮ɘ̼ʡ͙ʇ੮͐ʩɘ͐੮ϲʮ̼͐ͅ੮ɺ̼ʇɘˌͅ੮ should be treated with the urgency of a heart attack.৿਀ For them, letting Adam refuse care was as much medical malpractice as deciding not to revive someone ͙˦ɻ˺˦ͅɻʮ˺͙ͅ੮ʠ̼˺˚੮ɻɘ̼ʁʮɘɻ੮ɘ̼̼ʇ͐ͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ʁʮʁ੮˦˺͐੮ɻ˺˦ͅʇ˦͐੮͐˺੮ʁʇϲʮɺ̼ʮˑˑɘ͐ʮ˺˦ੳ੮ “It’s just tragic,” Julie added. At home, Adam was becoming more hostile. Michael and Julie called the sheriff, but every time they’d come to evaluate him for an involuntary psychiatric ʩ˺ˑʁੴ੮ ુʩʇૄʁ੮ ̼ɘˑˑ;ૂ੮ ɘ˦ʁ੮ ˺ϲϲʮɻʇ̼ͅ੮ ͸˺͙ˑʁ੮ ʁʇɻˑɘ̼ʇ੮ ͐ʩɘ͐੮ ʩʇ੮ ʁʮʁ˦ૄ͐੮ ˚ʇʇ͐੮ ɻ̼ʮ͐ʇ̼ʮɘ੮ ફʮੳʇੳੴ੮ ʩʇ੮͸ɘͅ੮˦ʇʮ͐ʩʇ̼੮ʁɘ˦ʡʇ̼˺͙ͅ੮˦˺̼੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁબੳ੮/ͷʇ˦͙͐ɘˑˑ;ੴ੮͐ʩʇ੮˺ϲϲʮɻʇ̼ͅ੮̼ʇɻ˺˚mended that Michael and Julie evict him; a social worker at ALTER gave the same advice, suggesting, “Throw him out, and he’ll be back in a week, he’ll be hungry, and maybe you can get him into care then.” They weren’t ready to make such a wrenching decision, but Adam ran away on his own. Michael and Julie tracked him to a motel and convinced a county mental health team to outreach him. “They went to the motel and he wouldn’t open the door, he was just screaming at them, and [the team] told us, ‘He really isn’t cooperative, so when he’s back home ɘ˦ʁ੮˚˺̼ʇ੮͐ͅɘɺˑʇੴ੮͸ʇૄʁ੮ɺʇ੮ʩɘ̹̹;੮͐˺੮ɻ˺˚ʇ੮˺͙͐ੴૄ੮ɘ˦ʁ੮͸ʇૄ̼ʇ੮ˑʮˌʇੴ੮ૃ̼ʇ੮;˺͙੮ʇϲϲʮ˦ʡ੮ʮʁʮ˺͐ͅ੺੮ If he were home and stable, we wouldn’t need you,’” she seethed. It’s not easy to watch a beloved child’s life fall apart and to be continuously told the mental health system can’t do anything about it. But there are both

O U T PAT I E N T

41

ϲʮ˦ɘ˦ɻʮɘˑ੮ɘ˦ʁ੮̹̼ɘʡ˚ɘ͐ʮɻ੮̼ʇɘͅ˺˦ͅ੮͸ʩ;੮˺͙̹͐ɘ͐ʮʇ˦͐੮͐ʇɘ˚ͅ੮͸ʇ̼ʇ੮˦˺͐੮ɺʇ̼ɘ͐ʮ˦ʡ੮ʁɘ˚੮ ʮ˦͐˺੮ɻɘ̼ʇੵ੮ϲʮ˦ɘ˦ɻʮɘˑੴ੮ɺʇɻɘ͙ͅʇ੮{ʇʁʮɻɘʮʁ੮͸˺˦ૄ͐੮̼ʇʮ˚ɺ͙̼ͅʇ੮ɻˑʮ˦ʮɻɘˑ੮͐ʇɘ˚ͅ੮ʠ˺̼੮ʡ˺ʮ˦ʡ੮͐˺੮ motels to be yelled at by people whom they can’t diagnose and can’t treat; pragmatic, because the whole effectiveness of models like ALTER is to engage young people by enticing them with things they want—help with school and work, for example—and minimizing the imposition of things they don’t, like heavy doses of antipsychotics.৿ਁ Then again, even top-shelf early-intervention programs have “disengagement” rates ranging from 12 to more than 50 percent.৿ਂ {ɘ˦;੮ɻ̼ʮ͐ʮή͙ʇͅ੮˺ʠ੮ˑɘ͸ͅ੮ˑʮˌʇ੮rØä੮ɘ̼ʡ͙ʇ੮͐ʩɘ͐੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮͸˺˦ૄ͐੮ coerce people into care funnels them into institutions that will coerce them: prisons and jails.৿ਃ੮îʩʇ੮ͅʩʇ̼ʮϲϲૄͅ੮ʁʇ̹͙͐ʮʇͅ੮͸˺͙ˑʁ˦ૄ͐੮ɺ̼ʮ˦ʡ੮ʁɘ˚੮͐˺੮ɘ˦੮/Û੮͸ʩʇ˦੮ Julie and Michael asked them to, but they did pick him up when he hit a woman with a rock. Julie and Michael begged the jail to give him a psychiatric evalua͐ʮ˺˦ੳ੮Ĕʩʮˑʇ੮͸ɘʮ͐ʮ˦ʡੴ੮ʩʇ੮̹͙˦ɻʩʇʁ੮ɘ੮ʡ͙ɘ̼ʁ੮ɘ˦ʁ੮͐ʩʇ;੮̹͙͐੮ʩʮ˚੮ʮ˦੮ͅ˺ˑʮ͐ɘ̼;੮ɻ˺˦ϲʮ˦ʇment. Eventually, though, Adam made it to the jail psychiatric unit and received court-ordered involuntary medication. Julie and Michael hounded the county mental health director until he agreed to pressure the jail to release their son to a hospital and have him conserved. He stayed four months, stabilized to the point where that the public guardian released him from conservatorship, and he went to live in a board and care home. The home was run by Jehovah’s Witnesses and was pretty strict, but to his parents, the monthly injection and structured environment worked wonders. Julie told me, “It was like a miracle, honest-to-goodness. He went back to school, he had a car again, he was doing really well.” But, to their horror, he convinced his county psychiatrist to titrate his medication downward. The psychiatrist, in their eyes, allowed Adam’s disease—namely, his anosognosia—to drive his treatment. The resulting spiral ended when Adam committed a serious violent crime. When I interviewed his parents, Adam was in jail awaiting trial but, Julie ˦˺͐ʇʁੴ੮ુPʇૄͅ੮ɺɘɻˌ੮˺˦੮˚ʇʁʮɻɘ͐ʮ˺˦੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ʩʇૄͅ੮̹̼ʇ͐͐;੮˦˺̼˚ɘˑੳ੮îʩʇ੮ɻ̼ɘΈ;੮̹ɘ̼͐੮˺ʠ੮ this is because he has anosognosia, he still doesn’t think he’s ill, he’s only taking the medication because he thinks it’s better for his case [to show the judge he’s complying with treatment].” Michael and Julie were tireless advocates for getting their son the best voluntary services their insurance company and the county ʩɘʁ੮͐˺੮˺ʠʠʇ̼ੳ੮ʁɘ˚੮̼ʇʠ͙ͅʇʁ੮ʮ͐੮ɘˑˑੴ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮͸ʩʇ˦੮ʩʇ੮͸ɘͅ੮̼ʇή͙ʮ̼ʇʁ੮͐˺੮͐ɘˌʇ੮˚ʇʁication, he did really well by all accounts (except maybe his own).

42

T H E C O N S E RVATO R S H I P C O N T I N U U M

Anosognosia is such a powerful framework not only because it helps make ͅʇ˦ͅʇ੮˺ʠ੮͐ʩʇͅʇ੮ɻɘͅʇͅ੮ɺ͙͐੮ɘˑͅ˺੮ɺʇɻɘ͙ͅʇ੮ʮ͐੮ͅʇʇ˚ͅ੮͐˺੮ʁʇϲʮ˦ʮ͐ʮͷʇˑ;੮̼ʇͅ˺ˑͷʇ੮͐ʩʇ੮ʮ˦̼͐ɘɻ͐ɘble tension between medical care and civil rights they present. The psychiatrists who have popularized anosognosia argue that heavy-handed medical intervention can restore not just someone like Adam’s sanity, but his very capacity for rational choice.৿਄ Indeed, you’ll hear in this book from people who turned down treatment, were forced to receive it, and ultimately came to see their past refusals as a disordered symptom of anosognosia, leaving them grateful for the involuntary help in overcoming it. Medicine, it seems, can do great things when Law gets out of its way.

ACCESS TO SERVICES, QUALITY OF SERVICES Cases like Adam’s are like a Rorschach test, in which a psychoanalyst asks what images a patient sees in blobs of ink. If you look at treatment refusal and see anosognosia, you’re likely to conclude that forced treatment is the solution. Critics, however, argue that there has been a “striking function creep” as anosognosia (a condition that neuroscientists use primarily for people who have had strokes or Alzheimer’s, not schizophrenia) has come to “account for just about everything that goes wrong in community mental health care.”਀৻ When you ask erstwhile clients themselves, you hear about a different set of barriers to care: social ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͐ʩɘ͐੮˚ɘˌʇ੮ɻ˺˚̹ˑʮɘ˦ɻʇ੮ʁʮϲϲʮɻ͙ˑ͐ੴ੮͙̹ͅʇ̼ϲʮɻʮɘˑ੮ɘ˦ʁ੮ˑ˺͸ચή͙ɘˑʮ͐;੮ͅʇ̼ͷʮɻʇͅੴ੮ɘ੮ lack of professional competence, and a failure of the mental health system to proͷʮʁʇ੮͸ʩɘ͐੮͐ʩʇ;੮ɘɻ͙͐ɘˑˑ;੮͸ɘ˦͐ੳ੮Uʠ੮;˺͙੮ͅή͙ʮ˦͐੮ɘ͐੮̹ʇ˺̹ˑʇ੮ʁʮͅɻ˺˦˦ʇɻ͐ʇʁ੮ʠ̼˺˚੮ͅʇ̼ͷʮɻʇͅ੮ and see these alternative explanations, then expanding conservatorship—versus ϲʮͽʮ˦ʡ੮͐ʩʇ੮ʠɘʮˑʮ˦ʡͅ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̼͐ʇɘ͐˚ʇ˦͐੮ͅ;͐ͅʇ˚੮͸ʩʮˑʇ੮ˌʇʇ̹ʮ˦ʡ੮ʮ͐੮ voluntary—starts to make a lot less sense. Thatcher had nine involuntary hospitalizations throughout the Bay Area starting in 2016 during a series of manic episodes (which I will describe further in a later chapter). What’s important here, though, is what happened when Thatcher’s legally imposed inpatient treatment ended and they (Thatcher uses they/ them pronouns) were discharged to voluntary outpatient care. As they recounted, ુîʩʇ;੮͸˺͙ˑʁ੮ʡʮͷʇ੮˚ʇ੮ɘ੮ɻ˺͙̹ˑʇ੮ʁɘ;ͅ੮˺ʠ੮ય˚ʇʁʮɻɘ͐ʮ˺˦રੴ੮ɘ˦ʁ੮ɺʇ੮ˑʮˌʇੴ੮ૃĚ˺͙੮ʩɘͷʇ੮͐˺੮̼ʇϲʮˑˑ੮ it at San Francisco General Hospital.’ And I just wouldn’t have my shit together to do it, you know?” Thatcher “remember[s] trying to take meds,” but without

O U T PAT I E N T

43

stable housing or income, getting to the hospital in the right timeframe was a challenge. /ͷʇ˦੮ʮϲ੮îʩɘ͐ɻʩʇ̼੮ʁʮʁ੮ʡʇ͐੮͐ʩʇ੮̼ʇϲʮˑˑੴ੮˦ɘͷʮʡɘ͐ʮ˦ʡ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮͐˺੮̼ʇɻʇʮͷʇ੮ʠ˺ˑˑ˺͸ચ͙̹੮ care was frustrating: “I was on a waiting list for over a year to try to see a psychiatrist. They’ll give you medication once you get arrested and 5150ed, but access ͐˺੮˚ʇʁʮɻɘ͐ʮ˺˦੮ʮͅ੮ɘɻ͙͐ɘˑˑ;੮̼ʇɘˑˑ;੮ʩɘ̼ʁ੮͐˺੮ϲʮʡ͙̼ʇ੮˺͙͐੮ʮʠ੮;˺͙੮ɘ̼ʇ੮˦˺͐੮̼ʮɻʩੳૂ੮ͅ੮ɘ੮̼ʇ̹˺̼͐੮ from the LA Department of Mental Health in 2020 observed, medication nonadherence from someone who might be unhoused or lack regular access to a phone ʮͅ੮ુ˚͙ˑ͐ʮચʠɘɻ͐˺̼ʮɘˑૂੵ੮ુɻʩ˺ʮɻʇ੮˺̼੮યˑɘɻˌ੮˺ϲર੮ʮ˦ͅʮʡʩ͐ૂ੮˚ʮʡʩ͐੮ɺʇ੮̹ɘ̼͐੮˺ʠ੮ʮ͐ੴ੮ɺ͙͐੮ͅ˺੮͐˺˺੮ are a “lack of transportation to clinics or pharmacies, lack of safe places to store medications, [and] concerns that medication side effects may place them at risk for violent victimization [on the streets].”਀ৼ Depending on who you ask, the single-minded focus on medications may itself be the problem. Gail, the mother of a thirty-year-old son with schizophrenia in Los Angeles, told me she is a fervent believer in “recovery,” which she understands to be the ability of people with serious mental illness to “get a job, ʡʇ͐੮˚ɘ̼̼ʮʇʁੴ੮યɘ˦ʁર੮ʠ͙ˑϲʮˑˑ੮͐ʩʇʮ̼੮ʁ̼ʇɘ˚ͅੴ੮ˈ͙͐ͅ੮ɘͅ੮͐ʩʇ;੮ʁʮʁ੮ɺʇʠ˺̼ʇ੮͐ʩʇ;੮ʡ˺͐੮ʮˑˑੳૂ੮˦ʁ੮ she believes that the key to achieving recovery is medication. To her, because schizophrenia is a “lifetime illness for which relapse is real,” people should be ̼ʇή͙ʮ̼ʇʁ੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ુʠ˺̼੮ˑʮʠʇੳૂ Her son Alexander sees things differently. He claims his mom dragged him to see a clinician at age seventeen when he got caught at school with a bottle of ͐ʇή͙ʮˑɘ੮ʮ˦੮ɘ੮ʡ;˚੮ɺɘʡ੮ફͅʩʇ੮ͅɘ;ͅ੮ʩʇ੮͸ɘͅ੮ͅʩ˺͸ʮ˦ʡ੮ͅʮʡ˦ͅ੮˺ʠ੮̹ɘ̼ɘ˦˺ʮɘ੮ɘ˦ʁ੮ʁʇˑ͙ͅʮ˺˦ͅબੳ੮ His prior image of mental health treatment was similar to what many educated and middle-class people probably imagine: “I thought I could be open and talk to them and I would get a non-judgmental ear to listen.” What he got instead was ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮̹˺ʮ˦͐ʇʁ੮ή͙ʇ͐ͅʮ˺˦ͅੴ੮ˑʮˌʇ੮ુ)˺੮;˺͙੮͐ʩʮ˦ˌ੮͐ʩʇ̼ʇૄͅ੮ɘ˦੮˺̼ʡɘ˦ʮΈʇʁ੮ʡ̼˺͙̹੮͐ɘ̼geting you?” He was being evaluated for schizophrenia, not getting therapy. This unwelcoming entrée isn’t helped by the fact that mental health services act as if their clients are potential criminals: to get into a public clinic in LA, you might have to pass through a metal detector or receive a pat down. ˑʇͽɘ˦ʁʇ̼੮ʁʇͅɻ̼ʮɺʇʁ੮͐ʩʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ʩʇ੮̼ʇɻʇʮͷʇʁ੮ɘͅ੮͙̹ͅʇ̼ϲʮɻʮɘˑ੮ʮ˦੮ʇͽɘɻ͐ˑ;੮͐ʩʇ੮ way you would expect if your psychiatrist had an active caseload of three hundred clients.਀৽ “They like to hear that you can identify your symptoms,” he expounded. But when his doctor told him, “You have disorganized thinking,” Alexander ϲʮʡ͙̼ʇʁ੮ ͐ʩʇ;ૄʁ੮ ુɻˑʇɘ̼੮ ʮ͐੮ ˺͙͐ੴ੮ ͸̼ʮ͐ʇ੮ ʁ˺͸˦੮ ͐ʩ˺ͅʇ੮ ͐ʩ˺͙ʡʩ͐ͅੴ੮ ɘ˦ʁ੮ ˺̼ʡɘ˦ʮΈʇ੮ ͐ʩʇ˚ੳૂ੮

44

T H E C O N S E RVATO R S H I P C O N T I N U U M

He expected an ongoing, multifaceted partnership. Instead, he received a neverending medical monologue about complying with his antipsychotic medication.਀৾ His doctors were the ones who ultimately applied to place him on conservatorship. This didn’t exactly deepen the connection: “They’ll always tell you that they want to help you, but I felt like any contact I had with them was risky.” So he decided to go into his appointments “and think about the image they want to see, and try to get them to believe that everything is going well. I tell them that their solution”—that is, medication—“is working.” Then, he laughed, “Every few months I’d get the spirit back and run away, totally avoid everything [treatment].” For him, “recovery” meant escaping the mental health system, not being permanently enmeshed with it. š͐ʩʇ̼੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮͐ʮʡʩ͐ˑ;੮ˑʮ˦ˌʇʁ੮͐ʩʇ੮ή͙ɘˑʮ͐;੮˺ʠ੮̼͐ʇɘ͐˚ʇ˦͐੮͸ʮ͐ʩ੮͸ʩ˺੮͸ɘͅ੮̹̼˺viding it. Advocates have increasingly called for “culturally competent” services ͐ʩɘ͐੮ɘɻɻ˺͙˦͐੮ʠ˺̼੮͐ʩʇ੮͙˦ʮή͙ʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ɘ˦ʁ੮ɺʇˑʮʇʠͅ੮˺ʠ੮ʁʮʠʠʇ̼ʇ˦͐੮ͅ˺ɻʮɘˑ੮ʡ̼˺͙̹ͅੳ਀৿ Lola, who is Latina, lamented the dearth of professionals who understood the distinctive forms of stigma she faced. She wished more could understand Spanish: she’s bilingual, but some feelings just didn’t translate. (Four percent of psychiatrists in the state are Hispanic/Latinx, even though 39 percent of state residents are.਀਀) But Lola’s care didn’t just lack cultural competence; sometimes, it lacked competence, full stop.਀ਁ After one involuntary hospitalization, she was discharged to the care of a county psychiatrist who was “very validating” and open to talking about Lola’s depression and self-injury as well as her challenges with her weight. One day, the psychiatrist told Lola she had to see her urgently. Lola drove eighty miles to learn that her psychiatrist was leaving for private practice. We often chastise mental health clients who don’t stick with care, but underworked and underpaid public-sector professionals also don’t stick with providing that care. Every one of a rotating cast of clinicians wanted Lola to recount the same checklist of traumas and failed treatments; every one piled on more medications for symptoms and those medications’ side effects. Then a new psychiatrist, straight out of med school, proposed taking her off all ten at once. She crashed and ended up in an ER. Lola was happy to see that psychiatrist go. The next one was skeptical of big pharma’s pills and encouraged her to deal with her anxiety by “just taking a breath, breathe your problems away.” Lola found this clueless: “I was like, ‘What

O U T PAT I E N T

45

are you talking about? I have asthma! How do you want me to take a deep breath ʮʠ੮U੮ɻɘ˦ૄ͐੮ʇͷʇ˦੮ɺ̼ʇɘ͐ʩʇ੮͸ʮ͐ʩ˺͙͐੮ɘ˦੮ʮ˦ʩɘˑʇ̼੺ૄૂ੮Øͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ή͙ʮɻˌˑ;੮ʁʮͅ˚ʮͅͅʇʁ੮ʩʇ̼੮ back to her primary care provider for any physical complaint; those primary care providers usually told Lola her problems were psychosomatic. Inattention ͐˺੮̹ʩ;ͅʮɻɘˑ੮̹̼˺ɺˑʇ˚ͅ੮ɺ;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ʮͅ੮ɘ੮ʠ̼ʇή͙ʇ˦͐੮̼ʇ˚˺˦̼͐ͅɘ˦ɻʇੳ੮ Meredith told me her sister Ashley once reported excruciating abdominal pain while in a psychiatric ward. Her doctor assumed it was a hallucination. It was appendicitis, and she needed emergency surgery. Sometimes, people who supposedly lack the insight to accept mental health services suddenly gain it when the services offered change. Thatcher readily admitted that they had a mental illness and that the long-acting injectable Abilify they were getting helped them enormously (including making them well enough to participate in advocacy groups looking to abolish forced treatment). "͙͐੮ ͐ʩʇ;੮ ˺˦ˑ;੮ ʡ˺͐੮ ˺˦੮ ͐ʩɘ͐੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮ ɘʠ͐ʇ̼੮ ϲʮ˦ʁʮ˦ʡ੮ ɘ੮ ɻˑʮ˦ʮɻ੮ ͐ʩɘ͐੮ ̹̼˺ͷʮʁʇʁ੮ ˦˺͐੮ just medication management but also peer supports, psychotherapy, information ɘɺ˺͙͐੮ ʡʇ˦ʁʇ̼੮ ɻ˺˦ϲʮ̼˚ɘ͐ʮ˺˦੮ ̼͐ʇɘ͐˚ʇ˦͐ੴ੮ ɘ˦ʁ੮ ʩʇˑ̹੮ ɘ̹̹ˑ;ʮ˦ʡ੮ ʠ˺̼੮ ʁʮͅɘɺʮˑʮ͐;੮ ɺʇ˦ʇϲʮ͐ͅੳ਀ਂ In the new intakes I observed at Urban Mental Health, one-third of people ͅɘʮʁ੮͐ʩɘ͐੮͐ʩʇʮ̼੮̹̼ʮ˚ɘ̼;੮ʁʇͅʮ̼ʇ੮͸ɘͅ੮ʡʇ͐͐ʮ˦ʡ੮ʩʇˑ̹੮͸ʮ͐ʩ੮ʩ˺͙ͅʮ˦ʡ੮˺̼੮ɺʇ˦ʇϲʮ͐ͅੳ੮š˦ˑ;੮ ৱ৳੮ ̹ʇ̼ɻʇ˦͐੮ ͅɘʮʁ੮ ͐ʩʇ;੮ ͸ɘ˦͐ʇʁ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ #ˑʮ˦ʮɻʮɘ˦ͅ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮ ɘ̼͐͐ʮɺ͙͐ʇ੮ ɻˑʮʇ˦͐੮ disengagement to stigma or a lack of insight. But in a survey of clients, “the ̼ʇɘͅ˺˦੮˚˺͐ͅ੮ɻ˺˚˚˺˦ˑ;੮̼ʇ̹˺̼͐ʇʁ੯ੳ੯ੳ੯ੳ੮͸ɘͅ੮͐ʩɘ͐੮ͅʇ̼ͷʮɻʇͅ੮͸ʇ̼ʇ੮˦˺͐੮̼ʇˑʇͷɘ˦͐੮͐˺੮͐ʩʇʮ̼੮ needs.”਀ਃ Almost all agreed they could use help, just not the help the mental health system was offering. Kate has a history of forced hospitalization that made her oppose involuntary treatment in all but the most extreme circumstances. (“Like, if I saw a child ̼͙˦˦ʮ˦ʡ੮ʮ˦͐˺੮̼͐ɘϲϲʮɻੴ੮͸˺͙ˑʁ੮U੮ʠ˺̼ɻʮɺˑ;੮ʡ̼ɘɺ੮͐ʩʇ˚੺੮Ěʇͅੳૂબ੮"͙͐੮ͅʩʇ੮ɘˑͅ˺੮ή͙ʇ͐ͅʮ˺˦ʇʁ੮ the idea that the solution to involuntary, medicalized inpatient treatment is voluntary, medicalized outpatient treatment. As an advocate, she explained, ુU੮ ʡ˺੮ ͐˺੮ ɘ੮ ˑ˺͐੮ ˺ʠ੮ ˚ʇʇ͐ʮ˦ʡͅ੮ ͸ʩʇ̼ʇ੮ ͐ʩʇ;੮ ͐ɘˑˌ੮ ɘɺ˺͙͐੮ ૃɘɻɻʇͅͅ੮ ͐˺੮ ͅʇ̼ͷʮɻʇͅੳૄ੯ ੳ੯ ੳ੯ ੳ੮ ˦ʁ੮ thinking back, all through my life, these were not services that I wanted to ɘɻɻʇͅͅੳૂ੮U˦͐ͅʇɘʁੴ੮ͅʩʇ੮͸ʮͅʩʇͅ੮ʠ˺̼੮ુʇʁ͙ɻɘ͐ʮ˺˦ੴ੮ʇ˚̹ˑ˺;˚ʇ˦͐੮̼͐ɘʮ˦ʮ˦ʡ੯ੳ੯ੳ੯ੳ੮͸ʮˑʁʇ̼˦ʇͅͅੴ੮ camping experience, working with animals, creative arts.” It may seem obvious, but any conversation about whether people are accepting “services” needs ͐˺੮ɻ˺˦ͅʮʁʇ̼੮͸ʩɘ͐੮͐ʩ˺ͅʇ੮ͅʇ̼ͷʮɻʇͅ੮ɘ̼ʇੴ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ;੮ɘ̼ʇ੮ʩʮʡʩ੮ή͙ɘˑʮ͐;ੴ੮ɘ˦ʁ੮ʮʠ੮͐ʩʇ;੮ match what people want.

46

T H E C O N S E RVATO R S H I P C O N T I N U U M

CONCLUSION: THE RIGHTS ROAD NOT TAKEN California’s public mental health system provides care “to the extent resources are available.” Even in its more generous moments, the state legislature never created an entitlement program, whereby funding would expand to match the needs of all people with serious mental illnesses in the state. As Michelle Cabrera, from the association representing county behavioral health directors, put it, the ˑʇʡʮͅˑɘ͙̼͐ʇ੮ʁʇϲʮ˦ʇʁ੮ɘ੮ɻ˺˚̹̼ʇʩʇ˦ͅʮͷʇ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ɘͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ that would be “‘nice to have,’ not a ‘must have.’”਀਄ A “must have” system would not just establish an abstract right to care. /˦ʡɘʡʇʁ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ͸˺͙ˑʁ੮ ʇ˦͙̼ͅʇ੮ ͐ʩɘ͐੮ ͐ʩʇ̼ʇ੮ ͸ʇ̼ʇ੮ ̹ͅʇɻʮϲʮɻ੮ ɻˑʮ˦ʮɻͅੴ੮ professionals, or teams with an obligation to provide that care, even to individ͙ɘˑͅ੮ ͐ʩʇ;੮ ̹ʇ̼ɻʇʮͷʇ੮ ɘͅ੮ ʁʮϲϲʮɻ͙ˑ͐੮ ˺̼੮ ̼ʇͅʮ͐ͅɘ˦͐ੳ੮ îʩʮͅ੮ ʮ˦͙͐ʮ͐ʮͷʇ੮ ʁʇϲʮ˦ʮ͐ʮ˺˦੮ ˺ʠ੮ ુ̹͙ɺˑʮɻ੮ ͅʇ̼ͷʮɻʇૂ੮ɘͅ੮ુʠ˺̼੮ɘ˦;˺˦ʇ੮ʮ˦੮͐ʩʇ੮̹͙ɺˑʮɻ੮͸ʩ˺੮ή͙ɘˑʮϲʮʇͅૂ੮ʮͅ੮͐ʩʇ੮ɺɘͅʮͅ੮˺ʠ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ health services in countries like France, but jarringly absent in California.ਁ৻ The limits of even the most intensive outpatient services were visible at the ʇ˦ʁ੮˺ʠ੮õ{P੮˚ʇʇ͐ʮ˦ʡͅੴ੮͸ʩʇ˦੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ʁʮͅɻ͙ͅͅʇʁ੮ɻˑʮʇ˦͐ͅ੮͸ʩ˺ͅʇ੮ϲʮˑʇͅ੮͐ʩʇ;ૄʁ੮ɺʇ੮ closing. Sometimes clients moved to another county or state. Mostly, though, they disappeared or made it clear they no longer wanted care. I almost never saw anyone progress out of the public system into the less intensive treatment ˺̼ʡɘ˦ʮΈʇʁ੮ ɺ;੮ ̹̼ʮͷɘ͐ʇ੮ {ʇʁʮચ#ɘˑ੮ ˚ɘ˦ɘʡʇʁ੮ ɻɘ̼ʇ੮ ̹ˑɘ˦ͅੴ੮ ɘͅ੮ ɻ˺˦͙ͅˑ͐ɘ˦͐ͅૄ੮ ϲˑ˺͸ɻʩɘ̼͐ͅ੮ had envisioned. At one meeting in 2018, Charlie (the head of the FSP team) mentions a forty-six-year-old white man with schizoaffective disorder (a combination of psychosis and mood disorder symptoms): ‘Basically he’s been disengaged since he ˑʇʠ͐੮ʩʮͅ੮ʩ˺͙ͅʮ˦ʡ੮યɘ˦੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ɘ̹ɘ̼͐˚ʇ˦͐੮õ{P੮ʩʇˑ̹ʇʁ੮ϲʮ˦ʁ੮ʠ˺̼੮ʩʮ˚ર੮ʮ˦੮৲ৰৱ৶ੳ੮ He was talking about ‘wanting to teach the Star Trek opera.’ My only contact is that I saw him at [local park] at 6 ӣੳՖੳ taking a walk in his bathrobe.’ Avril, a clinician from the mobile crisis team, declares in response, ‘Well, ͸ʇૄͷʇ੮ʡ˺͐੮͐˺੮ɻˑ˺ͅʇ੮ʩʮ˚ੳ੮U੮ɘˑ͸ɘ;ͅ੮ͅɘ;੮ુɘ˦੮˺̹ʇ˦੮ɻʩɘ̼͐੮ʮͅ੮˦˺͐੮̼͐ʇɘ͐˚ʇ˦͐ੳૄૄੰૄ੮Pʇ੮ʁʮʁ˦ૄ͐੮ want care, so UMH’s responsibility to him had concluded. Stu, the social worker who would handle his intake if he came back, adds, ‘We can always catch him the next time he’s hospitalized.’ That “next time”—the very much not-voluntary, not-outpatient part of the ͅ;͐ͅʇ˚ઝʮͅ੮͸ʩʇ̼ʇ੮͸ʇ੮˦˺͸੮͙̼͐˦੮ફϲʮʡ͙̼ʇ੮ৱੳ৲બੳ

Stages toward conservatorship 5150 Evaluation (by Police, Clinician)

ER Evaluation

Inpatient Hospitalization (5250)

Key factors in discretion

Focus on disruptive behavior over grave disability Exclusion of “addicts,” “frequent flyers,” and “malingerers”.

Exits from continuum

Not held (or arrested)

Hold “dropped”

Financial incentives towards short-term care Discharged

Probable Cause / Writ Hearing

Low bar for showing acceptable “survival plan”

Temporary Conservatorship (30 days)

Conservatorship Investigation (by Public Guardian)

Released at hearing

Denial of referrals for people with other supports (e.g. families) Referral denied

Conservatorship Hearing

Permanent Conservatorship (1 year)

1.2 The conservatorship continuum

Limitations on admissable evidence of grave disability

Petition denied

CHAPTER 2

CRISIS

‘H

omeless or hipster?’ I’m driving with Dani, a licensed clinical social worker, and ͅʩʇૄͅ੮ ʮ˦̼͐˺ʁ͙ɻʮ˦ʡ੮ ˚ʇ੮ ͐˺੮ ɘ੮ ͐ʮ˚ʇˑʇͅͅ੮ ή͙ʮΈ੮ ʡɘ˚ʇ੮ ̹ˑɘ;ʇʁ੮ ɺ;੮ ʩ˺˚ʇˑʇͅͅ੮˺͙̼͐ʇɘɻʩ੮͐ʇɘ˚ͅ੮ʮ˦੮ʩʇ̼੮ä˺͙͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɺʇɘɻʩ੮͐˺͸˦ੳ੮äʩʇૄͅ੮̼ʇʠʇ̼̼ʮ˦ʡ੮͐˺੮ɘ੮ ͸ʩʮ͐ʇ੮˚ɘ˦੮͸ʩ˺੮ˑ˺˺ˌͅ੮͐˺੮ɺʇ੮ʮ˦੮ʩʮͅ੮ˑɘ͐ʇ੮͐͸ʇ˦͐ʮʇͅ੮ɘ˦ʁ੮ʮͅ੮͸ɘˑˌʮ˦ʡ੮ͅʩʮ̼͐ˑʇͅͅ੮ʁ˺͸˦੮͐ʩʇ੮ ̼͐ͅʇʇ͐੮͸ʮ͐ʩ੮ɘ੮̹ɘʮ̼੮˺ʠ੮ɺ˺ɘ̼ʁ੮ͅʩ˺̼͐ͅੴ੮ɻ˺͸ɺ˺;੮ɺ˺˺͐ͅੴ੮ɘ੮ʩɘ͐ੴ੮ɘ˦ʁ੮ɘ੮ʠʇ͸੮ʁ͙ʠʠʇˑ੮ɺɘʡͅੳ੮ But whether he’s homeless or a hipster, he’s not the kind of individual Dani is ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼ੳ äʩʇૄͅ੮̹ɘ̼͐੮˺ʠ੮ɘ੮ͅ˚ɘˑˑ੮͐ʇɘ˚੮ϲʮ˦ɘ˦ɻʇʁ੮ɺ;੮͐ʩʇ੮ɻʮ͐;੮͐˺੮ϲʮʡ͙̼ʇ੮˺͙͐੮ɻ̼ʇɘ͐ʮͷʇ੮͸ɘ;ͅ੮͐˺੮ ̼͐ɘ˦ͅʠ˺̼˚੮͐ʩʮ̼͐;੮͙ˑ̼͐ɘʩʮʡʩ੮͙ͅʇ̼ͅ੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ˈɘʮˑͅੴ੮ɘ˦ʁ੮/Ûͅ੮ʮ˦͐˺੮ˈ͙͐ͅ੮̼ʇʡ͙ˑɘ̼੮ʩʮʡʩ੮ ͙ͅʇ̼ͅੳ੮)ɘ˦ʮ੮ɻɘ˚ʇ੮ʩʇ̼ʇ੮͐͸˺੮;ʇɘ̼ͅ੮ɘʡ˺੮ɘʠ͐ʇ̼੮ɺ͙̼˦ʮ˦ʡ੮˺͙͐੮˚ɘˌʮ˦ʡ੮ଏ৳৵ੴৰৰৰ੮ɘ੮;ʇɘ̼੮ɘͅ੮ɘ੮ ʁʮͅɻʩɘ̼ʡʇ੮̹ˑɘ˦˦ʇ̼੮ʮ˦੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮͐ʩʇ੮ä˺͙͐ʩੴ੮͸ʩʇ̼ʇ੮ͅʩʇ੮ʡ̼ʇ͸੮͙̹ੳ੮‡˺͸੮ ͅʩʇ੮̼ɘʮˑͅ੮ɘʡɘʮ˦͐ͅ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ɘ˦ʁ੮̹ͅʇ˦ʁͅ੮ʩʇ̼੮ʁɘ;ͅ੮ʠ̼ɘ˦͐ʮɻɘˑˑ;੮̼͐;ʮ˦ʡ੮͐˺੮ ˚ʇʇ͐੮ʩʇ̼੮ɻˑʮʇ˦͐ͅ੮͸ʩʇ̼ʇͷʇ̼੮͐ʩʇ;ૄ̼ʇ੮ɘ͐੮ɘ˦ʁ੮ˌʇʇ̹੮͐ʩʇ˚੮͐ʩʇ̼ʇੳ੮îʩɘ͐੮˚ʇɘ˦ͅ੮ɻ˺˦ͷʮ˦ɻʮ˦ʡ੮ ͐ʩʇ˚੮͐˺੮ͅ͸ʮ͐ɻʩ੮ʠ̼˺˚੮ͷ˺ʁˌɘ੮͐˺੮ɺʇʇ̼ੴ੮̹̼˺ͷʮʁʮ˦ʡ੮͐ʩʇ˚੮͸ʮ͐ʩ੮ͅ˺ɻˌͅ੮ɘ˦ʁ੮ʩ;ʡʮʇ˦ʇ੮ˌʮ͐ͅੴ੮ keeping them from getting evicted from their supported housing, and sometimes ʇͷʇ˦੮ʡʇ͐͐ʮ˦ʡ੮͐ʩʇ˚੮ͅ˺˚ʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐ੳ îʩʇ੮͐ʇɘ˚੮ɘˑͅ˺੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮͙ͅɺˈʇɻ͐ͅ੮̹ʇ˺̹ˑʇ੮͐˺੮৵ৱ৵ৰͅੳ੮੮৵ৱ৵ৰ੮̼ʇʠʇ̼ͅ੮͐˺੮͐ʩʇ੮ͅʇɻ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮rØä੮ɻ͐੮͐ʩɘ͐੮ɘˑˑ˺͸ͅ੮ુ̹ʇɘɻʇ੮˺ϲϲʮɻʇ̼ͅૂ੮ɘ˦ʁ੮ɻʇ̼͐ɘʮ˦੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮ ɺ;੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮̹ˑɘɻʇ੮̹ʇ˺̹ˑʇ੮˺˦੮ɘ੮ુʩ˺ˑʁૂ੮ɘ˦ʁ੮̼͐ɘ˦̹ͅ˺̼͐੮͐ʩʇ˚੮͐˺੮ɘ˦੮/Û੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੳ੮îʩʇͅʇ੮ʩ˺ˑʁͅ੮ɘ̼ʇ੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ͅʇ̹੮˺˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮ͅ੮;˺͙ૄˑˑ੮ ͅʇʇ੮ʮ˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੴ੮৵ৱ৵ৰͅ੮ɘ̼ʇ੮ʩɘ̹ʩɘΈɘ̼ʁੴ੮ʇ˚˺͐ʮ˺˦ɘˑˑ;੮ʠ̼ɘ͙ʡʩ͐ੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ͷʮ˺ˑʇ˦͐ੴ੮ ɘ˦ʁ੮˺ʠ͐ʇ˦੮ʁʮͅɻ˺˦˦ʇɻ͐ʇʁ੮ʠ̼˺˚੮ɘ˦;੮ɻ˺ʩʇ̼ʇ˦͐੮̹̼˺ˈʇɻ͐੮͐˺੮ʡʇ͐੮ͅ˺˚ʇ˺˦ʇ੮ɺʇ͐͐ʇ̼ੳ੮Ĕʩ˺੮ ʡʇ͐ͅ੮৵ৱ৵ৰʇʁ੮ʁʇ̹ʇ˦ʁͅ੮ˑʇͅͅ੮˺˦੮͸ʩʇ͐ʩʇ̼੮ͅ˺˚ʇ˺˦ʇ੮˚ʇʇ͐ͅ੮͐ʩʇ੮ʠ˺̼˚ɘˑ੮ɻ̼ʮ͐ʇ̼ʮɘ੮˺ʠ੮ʁɘ˦ʡʇ̼੮ ͐˺੮ͅʇˑʠੴ੮ʁɘ˦ʡʇ̼੮͐˺੮˺͐ʩʇ̼ͅੴ੮˺̼੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ɘ˦ʁ੮˚˺̼ʇ੮˺˦੮ʩ˺͸੮ɘ੮̹ʇ̼ͅ˺˦੮ϲʮ͐ͅ੮ʮ˦͐˺੮

CRISIS

49

ʠ˺͙̼੮ɘ̼ɻʩʇ͐;̹ʇͅ੮˺ʠ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮˚ʮʡʩ͐੮̼ʇɻʇʮͷʇ੮ɘ੮৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੵ੮̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮ on the streets, in the wrong state of mind at the wrong place and time, in crisis ʮ˦੮̹͙ɺˑʮɻੴ੮ɘ˦ʁ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˦ʡ੮ɘ͐੮ʩ˺˚ʇੳ kʇ̼̼;੮ʮͅ੮ʮ˦੮͐ʩɘ͐੮ϲʮ̼͐ͅ੮ɻɘ͐ʇʡ˺̼;ੳ੮Pʇૄͅ੮͐ʩʇ੮˚ɘʮ˦੮͐˺̹ʮɻ੮˺ʠ੮͐ʩʇ੮˚˺̼˦ʮ˦ʡ੮͐ͅɘʠʠ੮˚ʇʇ͐ʮ˦ʡੴ੮ɺʇʠ˺̼ʇ੮̹ʇ˺̹ˑʇ੮ʩʮ͐੮͐ʩʇ੮̼˺ɘʁ੮ફ˺̼ੴ੮ʮ˦੮ͅ˺˚ʇ੮ɻɘͅʇͅੴ੮͐ʩʇ੮ɺ˺ɘ̼ʁ͸ɘˑˌબੳ੮ˑ͐ʩ˺͙ʡʩ੮ʩʇૄͅ੮ ͅʮͽ͐;ચ˺˦ʇੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮)ɘ˦ʮੴ੮ʩʇ੮ૃˑ˺˺ˌͅ੮ˑʮˌʇ੮ʩʇૄͅ੮ʇʮʡʩ͐;ੳૄ੮੮ɻ˺˚ɺʮ˦ɘ͐ʮ˺˦੮˺ʠ੮ɘˑɻ˺ʩ˺ˑʮͅ˚੮ɘ˦ʁ੮ʁʇ̹̼ʇͅͅʮ˺˦੮ʩɘͅ੮ͅʩ̼ʮͷʇˑʇʁ੮ʩʮ˚੮͐˺੮˦ʮ˦ʇ͐;ચϲʮͷʇ੮̹˺͙˦ʁͅ੮ɘ˦ʁ੮ɻ˺˦ϲʮ˦ʇʁ੮ʩʮ˚੮ ͐˺੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼ੳ੮U˦੮ʩʮͅ੮˚˺͐ͅ੮̼ʇɻʇ˦͐੮͐ͅʮ˦͐੮ʮ˦੮ʁʇ͐˺ͽੴ੮ʩʇ੮ˑʇʠ͐੮ફ͐ʩʇ੮̹̼˺ʡ̼ɘ˚ੴ੮ˑʮˌʇ੮˦ʇɘ̼ˑ;੮ ɘˑˑ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ɘɺ͙ͅʇ੮̹̼˺ʡ̼ɘ˚ͅੴ੮͸ɘͅ੮͙˦ˑ˺ɻˌʇʁ੮ɘ˦ʁ੮ͷ˺ˑ͙˦͐ɘ̼;બ੮ɘ˦ʁ੮͸ʇ˦͐੮ɺɘɻˌ੮͐˺੮ʩʮͅ੮ ͅʩʇˑ͐ʇ̼੮ɘʠ͐ʇ̼੮͐͸˺੮ʁɘ;ͅੳ੮‡˺͸੮͐ʩʇ੮ͅʩʇˑ͐ʇ̼੮ʮͅ੮ˌʮɻˌʮ˦ʡ੮ʩʮ˚੮˺͙͐੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ˌʇʇ̹ͅ੮ʠɘˑˑʮ˦ʡ੮ ˺͙͐੮˺ʠ੮ɺʇʁ੮ɘ˦ʁ੮ϲʮʡʩ͐ʮ˦ʡ੮͸ʮ͐ʩ੮͐ͅɘʠʠ੮͸ʩʮˑʇ੮ʁ̼͙˦ˌੳ੮#˺͙̼͐˦ʇ;ੴ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʩ˺੮ʮͅ੮ ʡ˺ʮ˦ʡ੮˺˦੮ʩʇ̼੮͐ʩʮ̼ʁ੮;ʇɘ̼੮͸ʮ͐ʩ੮͐ʩʇ੮͐ʇɘ˚ੴ੮ɘʁʁͅੴ੮ૃU͐ૄͅ੮ͷʇ̼;੮ͅɘʁ੮ɘ˦ʁ੮ʇ˚˺͐ʮ˺˦ɘˑ੮ʠ˺̼੮͙ͅੳ੮ Ĕʇ੮ˌ˦˺͸੮͐ʩʇ੮͐ͅɘ˦ʁɘ̼ʁ੮યʠ˺̼੮ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁર੮ʮͅ੮͐ʩɘ͐੮ʮ͐੮ʩɘͅ੮͐˺੮ɺʇ੮ɘ੮˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼ੳ੮"͙͐੮ ʩʇ੮ʩɘͅ੮ɘ੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʁʮͅ˺̼ʁʇ̼੮ʠ̼˺˚੮ɘ੮˚˺͐˺̼ɻ;ɻˑʇ੮ɘɻɻʮʁʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮U͐ૄͅ੮̼ʇˑɘ͐ʇʁ੮͐˺੮ ͐ʩʇ੮ɺ̼ɘʮ˦ੴ੮ɺ͙͐੮ʮ͐੮ʁ˺ʇͅ˦ૄ͐੮ɻ˺͙˦͐ੳ੮ä˺੮͸ʇૄ̼ʇ੮ˈ͙͐ͅ੮͸ɘ͐ɻʩʮ˦ʡ੮ʩʮ˚੮ʁʮʇੳૄ );ˑɘ˦੮ʮͅ੮͐ʩʇ੮͐ʇɘ˚ૄͅ੮͙̹ͅʇ̼ͷʮͅ˺̼੮ɘ˦ʁ੮͐ʩʇ੮˺˦ˑ;੮˺˦ʇ੮ɘ͙͐ʩ˺̼ʮΈʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮ ̹ˑɘɻʇ੮৵ৱ৵ৰ੮ʩ˺ˑʁͅੳ੮ૃîʩʮͅ੮ʮͅ੮˦˺͐੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮U੮͙ͅʇ੮ˑʮʡʩ͐ˑ;ੴૄ੮ʩʇ੮̼ʇ˚ʮ˦ʁͅ੮͐ʩʇ੮͐ʇɘ˚ੳ੮U˦੮ kʇ̼̼;ૄͅ੮ɻɘͅʇੴ੮ʮ͐ૄͅ੮˦˺͐੮ˈ͙͐ͅ੮ɘ੮˚ɘ͐͐ʇ̼੮˺ʠ੮ˑʇʡɘˑ੮ɻ̼ʮ͐ʇ̼ʮɘੳ੮"ʇɻɘ͙ͅʇ੮kʇ̼̼;੮ʩɘͅ੮˚ʇʁʮɻɘˑੴ੮̹ͅ;ɻʩʮɘ̼͐ʮɻੴ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ʮ͙ͅͅʇͅੴ੮ૃUʠ੮͸ʇ੮̹͙͐੮ʩʮ˚੮˺˦੮ɘ੮ʩ˺ˑʁੴ੮ʩʇૄˑˑ੮ɺʇ੮ͅʩ͙ϲϲˑʇʁ੮ɺʇ͐͸ʇʇ˦੮ ̹ͅ;ɻʩ੮ɘ˦ʁ੮˚ʇʁ੮યʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑરੳ੮ä˺˚ʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʮˑˑ੮ͅɻ̼ʇɘ˚੮ɘ͐੮˚ʇ੮ʮʠ੮U੮ɺ̼ʮ˦ʡ੮ ʩʮ˚੮͐˺੮ɘ੮̹ͅ;ɻʩ੮/Ûੴૄ੮ͅɘ;ʮ˦ʡ੮ʩʇ੮ɺʇˑ˺˦ʡͅ੮ʮ˦੮ɘ੮˚ʇʁʮɻɘˑ੮͙˦ʮ͐੮ɺʇ͐͐ʇ̼੮ɘɺˑʇ੮͐˺੮ʩɘ˦ʁˑʇ੮ ͐ʩʇ੮̹ʩ;ͅʮɻɘˑ੮ʇʠʠʇɻ͐ͅ੮˺ʠ੮ɘˑɻ˺ʩ˺ˑ੮͸ʮ͐ʩʁ̼ɘ͸ɘˑੳ੮ä͐ʮˑˑੴ੮);ˑɘ˦੮ͅɘ;ͅੴ੮ૃɺɘͅʇʁ੮˺˦੮͸ʩɘ͐੮Uૄ˚੮ ʩʇɘ̼ʮ˦ʡ੮͐˺ʁɘ;ੴ੮U੮˚ʮʡʩ͐੮ˈ͙͐ͅ੮̼͐;੮ʮ͐ੳ੮U੮ɻɘ˦ૄ͐੮͙ͅʇ੮ɻʩ̼˺˦ʮɻ੮ɘˑɻ˺ʩ˺ˑʮͅ˚੮˺̼੮î"U੮ય̼͐ɘ͙˚ɘ͐ʮɻ੮ ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼;રੴ੮Uૄˑˑ੮ʩɘͷʇ੮͐˺੮ˑʇɘ˦੮˺˦੮͐ʩʇ੮ʁʇ̹̼ʇͅͅʮ˺˦ੴૄ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮ʇͷʇ̼;˺˦ʇ੮ɘʡ̼ʇʇͅ੮ʮ͐ૄͅ੮ ˦˺͐੮ʁʇ̹̼ʇͅͅʮ˺˦੮͐ʩɘ͐੮ʮͅ੮ˌʮˑˑʮ˦ʡ੮ʩʮ˚ੳ੮ૃUʠ੮ʩʇ੮ͅɘʮʁ੮ɘˑˑ੮˺ʠ੮͐ʩʮͅ੮͸ɘͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ ʁʇ˚˺˦ͅ੮͐˺ˑʁ੮ʩʮ˚੮͐˺ੴૄ੮)ɘ˦ʮ੮˺ʠʠʇ̼ͅੴ੮ૃ͐ʩʮͅ੮͸˺͙ˑʁ੮ɺʇ੮ʇɘͅʮʇ̼੮ય͐˺੮ʁ˺੮ɘ੮৵ৱ৵ৰરੴૄ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ ͸˺͙ˑʁ੮ɺʇ੮˚˺̼ʇ੮˺ɺͷʮ˺͙ͅˑ;੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑੳ U੮ʩɘʁ੮ʮ˚ɘʡʮ˦ʇʁ੮ɘ੮৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮͐˺੮ɺʇ੮ɘ੮ʩʮʡʩચʁ̼ɘ˚ɘ੮ɘʠʠɘʮ̼ੴ੮ɺ͙͐੮);ˑɘ˦ૄͅ੮˺˦ɻʇચ ˺ͷʇ̼੮˺ʠ੮kʇ̼̼;੮ʮͅ੮ˑ˺͸੮ˌʇ;ੳ੮Ĕʇ੮͸ɘˑˌ੮͐˺੮͐ʩʇ੮ɺɘɻˌ੮ʡɘ̼ʁʇ˦੮˺ʠ੮͐ʩʇ੮ʩ˺˚ʇˑʇͅͅ੮ͅʩʇˑ͐ʇ̼ੳ੮kʇ̼̼;੮ ʮͅ੮ͅʮ͐͐ʮ˦ʡ੮ʮ˦੮ɘ੮ʠ˺ˑʁʮ˦ʡ੮ɻʩɘʮ̼ੴ੮̼ɘʮˑ੮͐ʩʮ˦੮͸ʮ͐ʩ੮ɘ੮ɻʩʇɻˌʇ̼ʇʁ੮ͅʩʮ̼͐੮ɘ˦ʁ੮ˈʇɘ˦ͅ੮ʩɘ˦ʡʮ˦ʡ੮ ˑ˺˺ͅʇˑ;੮ʠ̼˺˚੮ʩʮͅ੮ʠ̼ɘ˚ʇੳ ૃUૄ˚੮ʮ˦੮ɺɘʁ੮ͅʩɘ̹ʇੴૄ੮kʇ̼̼;੮ʁʇɻˑɘ̼ʇͅੴ੮ˑɘ˚ʇ˦͐ʮ˦ʡ੮ૃͅ˺˚ʇ˺˦ʇ੮͐ͅ˺ˑʇ੮˚;੮͸ʩʇʇˑɻʩɘʮ̼ੳ੮"͙͐੮ Uૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮ʡ˺੮͐˺੮̼ʇʩɘɺ੮˺˦੮H̼ʮʁɘ;ੳ੮Uૄ˚੮˦˺͐੮ʁ̼ʮ˦ˌʮ˦ʡ੮ɘ˦;˚˺̼ʇੳ੮Uૄ˚੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʡ˺੮ ˺͙͐੮͙˦͐ʮˑ੮͐ʩʇ˦ੴ੮ʮ͐ૄͅ੮ˈ͙͐ͅ੮͐˺˺੮ʁɘ˦ʡʇ̼˺͙ͅੳૄ੮ફU͐ૄͅ੮î͙ʇͅʁɘ;ੳબ ૃU͐ૄͅ੮˦ʮɻʇ੮͐˺੮ͅʇʇ੮;˺͙̼੮̼ʇͅ˺ˑͷʇੴૄ੮)ɘ˦ʮ੮˺ʠʠʇ̼ͅੳ ૃPɘͷʇ੮;˺͙੮ɺʇʇ˦੮ʇɘ͐ʮ˦ʡ੺ૄ੮);ˑɘ˦੮ɘͅˌͅੴ੮ͅʮ̹̹ʮ˦ʡ੮ʠ̼˺˚੮ɘ੮ɻ˺ʠʠʇʇ੮ɻ͙̹ੳ

50

T H E C O N S E RVATO R S H I P C O N T I N U U M

ૃU੮ʩɘʁ˦ૄ͐੮ʇɘ͐ʇ˦੮ʮ˦੮͐ʩ̼ʇʇ੮ʁɘ;ͅੴ੮ɺ͙͐੮͐ʩʮͅ੮˚˺̼˦ʮ˦ʡੴ੮U੮ʩɘʁ੮͐͸˺੮ɺʮ͐ʇͅੴ੮ɘ˦ʁ੮U੮ʩɘͷʇ੮ ͐ʩʮͅੴૄ੮kʇ̼̼;੮͐ͅɘ͐ʇͅੴ੮ʩ˺ˑʁʮ˦ʡ੮͙̹੮ɘ˦੮ʇ˚̹͐;੮ɺ˺͐͐ˑʇ੮˺ʠ੮/˦͙̼ͅʇੳ੮ૃU੮ɘˑͅ˺੮ͅʩɘͷʇʁ੮ɘ˦ʁ੮͐˺˺ˌ੮ɘ੮ ͅʩ˺͸ʇ̼ੴૄ੮ʩʇ੮ɘʁʁͅੴ੮̹̼˺͙ʁˑ;ੳ );ˑɘ˦੮̼˺ˑˑͅ੮ʩʮͅ੮ʇ;ʇͅੴ੮ɘ˦ʁ੮ɻˑ˺ͅʇͅੴ੮ૃU੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɺʇ੮ʩɘ̼ͅʩੴ੮kʇ̼̼;ੴ੮ɺ͙͐੮͐ʩʮͅ੮ʮͅ੮ɘ੮ ˑʮʠʇચ˺̼ચʁʇɘ͐ʩ੮ͅʮ͙͐ɘ͐ʮ˺˦੮ʠ˺̼੮;˺͙ੴ੮ͅ˺੮U੮͸ɘ˦͐੮;˺͙੮͐˺੮ʡ˺੮˺˦੮H̼ʮʁɘ;ੳૄ੮kʇ̼̼;੮ʩɘͅ੮ɻˑʇɘ˦ʇʁ੮ ͙̹ੳ੮Pʇ੮͸˺˦ૄ͐੮ɺʇ੮৵ৱ৵ৰʇʁੳ੮îʩʮͅ੮ʮͅ੮͐ʩʇ੮̹ɘ͐͐ʇ̼˦ੵ੮kʇ̼̼;੮ʩɘͅ੮ɺʇʇ˦੮ͅʇʇ˦੮ɺ;੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐ment paramedics ten times in the past two months while passed out on the street, ɺ͙͐੮ʩɘͅ੮˦ʇͷʇ̼੮ɺʇʇ˦੮͐ɘˌʇ˦੮ʮ˦੮ɘʡɘʮ˦͐ͅ੮ʩʮͅ੮͸ʮˑˑੳ੮Ĕʩʇ˦੮)ɘ˦ʮ੮̼͙˦ͅ੮ʮ˦͐˺੮#˺͙̼͐˦ʇ;੮ˑɘ͐ʇ̼੮ ͐ʩɘ͐੮ʁɘ;ੴ੮ͅʩʇ੮̼ʇ̹˺̼͐ͅੴ੮ૃPʇ੮ˑ˺˺ˌʇʁ੮ɺʇ͐͐ʇ̼ੴ੮ɺ͙͐੮͐ͅʮˑˑ੮ͅ˺੮͐ʇ̼̼ʮɺˑʇੳ੮Pʇ੮ͅʩɘͷʇʁ੮ɘ˦ʁ੮͐ʩʇ̼ʇ੮ ͸ɘͅ੮˦˺੮ʁʮ̼͐੮˺˦੮ʩʮͅ੮˦ʇɻˌੳ੮U͐੮˚ɘʁʇ੮ɘ੮ʁʮʠʠʇ̼ʇ˦ɻʇੳ੮"͙͐੮͐ʩɘ͐ૄͅ੮͐ʩʇ੮̹̼˺ɺˑʇ˚ੳ੮Pʇ੮ʡʇ͐ͅ੮ʮ͐੮ ͐˺ʡʇ͐ʩʇ̼ੴ੮ɘ˦ʁ੮͐ʩʇ̼ʇૄͅ੮˦˺͐ʩʮ˦ʡ੮͸ʇ੮ɻɘ˦੮ʁ˺ੳૄ Ĕʇ੮˦ʇͽ͐੮ʩʇɘʁ੮͐˺੮͐ʩʇ੮ɺʇɘɻʩ੮͐˺੮ͅʇʇ੮ɘ੮ϲʮʠ͐;ચ;ʇɘ̼ચ˺ˑʁ੮ɻˑʮʇ˦͐੮˦ʮɻˌ˦ɘ˚ʇʁ੮Ø̼˺ʠʇͅͅ˺̼੮ k˺ˑʮʇੳ੮)ɘ˦ʮ੮ͅɘ;ͅ੮ͅʩʇ੮˺˦ɻʇ੮͸ɘͅ੮ૃʩ˺͙ͅʇʁ੮ɘ˦ʁ੮˺˦੮˚ʇʁͅૄ੮ɺ͙͐੮͸ɘͅ੮ʇͷʮɻ͐ʇʁ੮ʠ˺̼੮ͅɻ̼ʇɘ˚ʮ˦ʡ੮ ̼ɘɻʮɘˑ੮ʇ̹ʮ͐ʩʇ͐ͅ੮ɘ͐੮ʩʇ̼੮"ˑɘɻˌ੮˦ʇʮʡʩɺ˺̼ͅੳ੮ફäʩʇ੮ɘˑͅ˺੮ʮͅ੮"ˑɘɻˌੳબ੮äʩʇૄͅ੮˦˺͸੮ɺʇʇ˦੮˺˦੮͐ʩʇ੮ ̼͐ͅʇʇ͐ͅ੮ʠ˺̼੮͐ʇ˦੮;ʇɘ̼ͅੴ੮ɘ˦ʁ੮˦ʇʮ͐ʩʇ̼੮͐ʩʮͅ੮͐ʇɘ˚੮˦˺̼੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮šî੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ʩɘͷʇ੮ ɺʇʇ˦੮ɘɺˑʇ੮͐˺੮ʁʮͅˑ˺ʁʡʇ੮ʩʇ̼ੴ੮ʁʇ̹ͅʮ͐ʇ੮ʠ˺͙̼੮৵ৱ৵ৰͅ੮ʮ˦੮͐ʩʇ੮̹ɘ͐ͅ੮ʠʇ͸੮˚˺˦͐ʩͅੳ੮ૃäʩʇ੮ʁ˺ʇͅ੮ ͸ʇˑˑ੮˺˦੮˚ʇʁͅੴ੮͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮ͅʩʇ੮ʡʇ͐ͅ੮˺͙͐੮ય˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑરૄ੮ɘ˦ʁੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮͐ͅ˺̹ͅ੮ ͐ɘˌʮ˦ʡ੮͐ʩʇ˚ੳ੮äʩʇ੮ʮͅੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮)ɘ˦ʮੴ੮రৱৰৰ੮̹ʇ̼ɻʇ˦͐੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɻੳૄ੮äʩʇ੮ʮͅ੮ɘˑͅ˺੮ )ɘ˦ʮૄͅ੮ૃʠɘͷ˺̼ʮ͐ʇੳૄ U੮ ή͙ʮɻˌˑ;੮ ʡʇ͐੮ ͸ʩ;ੳ੮ Ø̼˺ʠʇͅͅ˺̼੮ k˺ˑʮʇૄͅ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐੮ ʮͅ੮ ɘ੮ ϲʮͷʇચɺ;ચϲʮͷʇચ;ɘ̼ʁ੮ ̹ˑ˺͐੮ ˺ʠ੮ɺ˺ɘ̼ʁ͸ɘˑˌ੮ɘʁ˺̼˦ʇʁ੮͸ʮ͐ʩ੮ɘ̼͐͸˺̼ˌੴ੮˺̼˦ɘ͐ʇ੮˚ʇ͐ɘˑ੮ˑɘ͸˦੮ʠ͙̼˦ʮ͙̼͐ʇ੮ફʮ˦ɻˑ͙ʁʮ˦ʡ੮ɘ੮ ͐ɘɺˑʇ੮͸ʮ͐ʩ੮ɘ੮ʠʇ͸੮ϲʮ˦ʮͅʩʇʁ੮ɺ˺͐͐ˑʇͅ੮˺ʠ੮ˑʮή͙˺̼੮ɘ͐˺̹੮ʮ͐બੴ੮ɘ˦ʁ੮ɘ੮ͅˑʇʇ̹ʮ˦ʡ੮ɘ̼ʇɘ੮ɻ˺ͷʇ̼ʇʁ੮ɺ;੮ ɻ˺ˑ˺̼ʠ͙ˑੴ੮ϲˑ˺͸ʮ˦ʡ੮ʠɘɺ̼ʮɻੳ੮ૃU͐ૄͅ੮ɘ੮ʡ̼ʇɘ͐੮ͅʇ͐੮͙̹ੴ੮Uૄʁ੮ˑʮˌʇ੮͐˺੮ˑʮͷʇ੮͐ʩʇ̼ʇੴૄ੮#˺͙̼͐˦ʇ;੮͐˺ˑʁ੮ ˚ʇੳ੮îʩʇ̼ʇૄͅ੮ɘˑͅ˺੮ɘ੮ͅʮʡ˦੮͐ͅɘ͐ʮ˦ʡ੮ૃ#šēU)ચৱ৹ੵ੮ä͸ʇʇ̹ͅ੮nʮˑˑੴૄ੮͸ʩʮɻʩ੮ʮͅ੮ɘ੮̼ʇ˚ʮ˦ʁʇ̼੮˺ʠ੮ ͐ʩʇ੮͙̼ʡʇ˦ɻ;੮˺ʠ੮˺͙̼੮ͷʮͅʮ͐ੵ੮͐ʩʇ੮ɻʮ͐;੮ʩɘͅ੮̹͙͐੮ʩʇ̼੮˺˦੮˦˺͐ʮɻʇ੮͐ʩɘ͐੮ͅʩʇૄˑˑ੮ɺʇ੮ʇͷʮɻ͐ʇʁ੮˦ʇͽ͐੮ ͸ʇʇˌੳ੮k˺ˑʮʇ੮ʇ˚ʇ̼ʡʇͅ੮ʠ̼˺˚੮ʩʇ̼੮ɺʇʁ̼˺˺˚ੴ੮͸ʇɘ̼ʮ˦ʡ੮ɘ੮͙ͅ˦੮ʩɘ͐ੴ੮ɘ੮ɻ˺ˑ˺̼ʠ͙ˑ੮ʁ̼ʇͅͅੴ੮ɘ˦ʁ੮ɘ˦੮ ɘ̼̼ɘ;੮˺ʠ੮ɺ̼ɘɻʇˑʇ͐ͅੴ੮ʩʇ̼੮ɻ͙̼ˑ;ੴ੮ͅˑʮʡʩ͐ˑ;੮ʡ̼ʇ;ʮ˦ʡ੮ʩɘʮ̼੮̹ʇ̼ʠʇɻ͐ˑ;੮ɻ˺ʮʠʠʇʁੳ Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੮ͅʇʇ˚ͅ੮ʩɘ̹̹;੮ʇ˦˺͙ʡʩ੮͐˺੮ͅʇʇ੮͙ͅੵ੮͐ʩʇ੮͐ʇɘ˚੮ʩɘͅ੮ɺʇʇ˦੮ʡʮͷʮ˦ʡ੮ʩʇ̼੮ ˚ʇʁʮɻɘˑ੮ ͙̹̹ͅˑʮʇͅ੮ ʠ˺̼੮ ɘ੮ ˑʇʡ੮ ͸˺͙˦ʁ੮ ͅʩʇ੮ ͙ͅʠʠʇ̼ʇʁ੮ ʮ˦੮ ɘ੮ ɺʮˌʇ੮ ɘɻɻʮʁʇ˦͐ੳ੮ äʩʇ੮ ̼˺ˑˑͅ੮ ͙̹੮ ʩʇ̼੮ɺɘ˦ʁɘʡʇ੮͐˺੮ͅʩ˺͸੮͙ͅ੮͐ʩɘ͐੮ʮ͐ૄͅ੮ʩʇɘˑʮ˦ʡ੮˦ʮɻʇˑ;ੳ੮Ĕʩʇ˦੮)ɘ˦ʮ੮ʮ˦̼͐˺ʁ͙ɻʇͅ੮˚ʇ੮ɘͅ੮ɘ੮ ̼ʇͅʇɘ̼ɻʩʇ̼ੴ੮k˺ˑʮʇ੮̼ʇ̹ˑʮʇͅੴ੮ૃU੮ɘ˚੮ɘ੮̹̼˺ʠʇͅͅ˺̼੮͐˺˺ੴ੮;˺͙੮ˌ˦˺͸ੳૄ੮äʩʇ੮ʩ˺ˑʁͅ੮͙̹੮ɘ੮ͅ˚ɘˑˑ੮ ɻɘ˦ͷɘͅ੮͸ʮ͐ʩ੮ɘ੮̹ɘʮ˦͐ʮ˦ʡ੮͐ʩɘ͐੮ˑ˺˺ˌͅ੮ˑʮˌʇ੮ä͐ɘ̼̼;੮‡ʮʡʩ͐ੳ੮ૃU͐੮ય̹ͅɘɻʇર੮̼ʇɘˑˑ;੮ˑ˺˺ˌͅ੮ˑʮˌʇ੮ ͐ʩʮͅੴૄ੮ͅʩʇ੮͐ʇˑˑͅ੮˚ʇੳ੮îʩʇ੮˦ɘ̼̼ɘ͐ʮͷʇ੮͐ʩɘ͐੮ʠ˺ˑˑ˺͸ʇʁ੮͸ɘͅ੮͸ʇˑˑ੮̹͙͐੮͐˺ʡʇ͐ʩʇ̼੮ɘ˦ʁ੮ʇ˚̹ʩɘ͐ʮɻɘˑˑ;੮͐ͅɘ͐ʇʁઝɘ˦ʁ੮ʩɘ̼ʁ੮˦˺͐੮͐˺੮ͅʇʇ੮ɘͅ੮ʁʇˑ͙ͅʮ˺˦ɘˑੳ੮ͅ੮ͅʩʇ੮ʇͽ̹ˑɘʮ˦ͅ੮ʮ͐ੴ੮͸ʩʇ˦੮ͅʩʇ੮͸ɘͅ੮ ϲʮͷʇੴ੮ ͅʩʇ੮ ͸̼˺͐ʇ੮ ɘ੮ ɺ˺˺ˌ੮ ʠ˺̼੮ Pɘ̼ͷɘ̼ʁ੮ rɘ͸੮ äɻʩ˺˺ˑੴ੮ ͸ʩʮɻʩ੮ ̼ʇ̹ɘʮʁ੮ ʩʇ̼੮ ɺ;੮ ͅʇ˦ʁʮ˦ʡ੮ ʩʇ̼੮͐˺੮͐ʩʇ੮˚˺˺˦੮͸ʮ͐ʩ੮‡ʇʮˑ੮̼˚̼͐ͅ˺˦ʡੴ੮͸ʩ˺੮͐ʩʇ˦੮ɘʁ˺̹͐ʇʁ੮ʩʇ̼ੴ੮͸ʩʮɻʩ੮˚ɘʁʇ੮ʩʇ̼੮

CRISIS

51

ɘ੮ ˚ʇ˚ɺʇ̼੮ ˺ʠ੮ ͐ʩʇ੮ ä͸ʇʁʮͅʩ੮ ̼˺;ɘˑ੮ ʠɘ˚ʮˑ;੮ ɘ˦ʁ੮ ɺʇή͙ʇɘ͐ʩʇʁ੮ ʩʇ̼੮ ͐͸˺ચ͐ʩʮ̼ʁͅ੮ ˺ʠ੮ ͐ʩʇ੮ ͸˺̼ˑʁૄͅ੮͸ʇɘˑ͐ʩੳ ͐੮ ͐ʩʮͅ੮ ˚˺˚ʇ˦͐ੴ੮ )ɘ˦ʮ੮ ʮ˦͐ʇ̼ˈʇɻ͐ͅੴ੮ ૃĚ˺͙੮ ˌ˦˺͸ੴ੮ ͐ʩʇ;ૄ̼ʇ੮ ɻˑʇɘ̼ʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮ ˺͙͐੮ ʩʇ̼ʇઝ͸˺͙ˑʁ੮;˺͙੮ɺʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ʮ˦੮ʩ˺͙ͅʮ˦ʡ੺ૄ Iʮͷʇ˦੮͸ʩɘ͐੮ͅʩʇૄͅ੮ˈ͙͐ͅ੮͐˺ˑʁ੮͙ͅੴ੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇૄͅ੮˦ʇͽ͐੮̼ʇ̹ͅ˺˦ͅʇ੮ʮͅ੮˦˺͐੮͙̼̹̼ͅʮͅʮ˦ʡੵ੮ ૃ‡˺ੳ੮U੮ɘɻ͙͐ɘˑˑ;੮˺͸˦੮ʩ˺͙ͅʇͅ੮͙̹੮ɘ˦ʁ੮ʁ˺͸˦੮ʩʇ̼ʇੳ੮Uૄ˚੮ˈ͙͐ͅ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮ ʁ̼˺̹੮˺ʠʠ੮͐ʩʇ੮ˌʇ;ͅੳૄ š͙̼੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮ʡ˺ʇͅ੮ʁ˺͸˦ʩʮˑˑ੮ʠɘ͐ͅੳ੮ૃĔ˺͙ˑʁ੮;˺͙੮ɺʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ʮ˦੮͐ɘˑˌʮ˦ʡ੮͐˺੮ ˺͙̼੮ʁ˺ɻ͐˺̼੮ɘɺ˺͙͐੮͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦੺ૄ੮)ɘ˦ʮ੮˺ʠʠʇ̼ͅੳ Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੮͐ͅʮʠʠʇ˦ͅੴ੮ૃ‡˺ੴ੮Uૄ˚੮ϲʮ˦ʇੴ੮U੮ʁ˺˦ૄ͐੮˦ʇʇʁ੮͐ʩɘ͐ੳ੮Uૄ˚੮ɘɻ͙͐ɘˑˑ;੮ɘ੮̹̼˺ʠʇͅͅ˺̼੮ ˺ʠ੮̹ʩ;ͅʮ˺ચ̹ͅ;ɻʩʮɘ̼͐;ੳ੮U੮ʁ˺੮˦˺͐੮͐ʇɘɻʩ੮ɻɘˑʮ͐ͅʩʇ˦ʮɻͅੳૄ੮äʩʇ੮ͅʇʇ˚ͅ੮˚˺̼ʇ੮ɘʡʮ͐ɘ͐ʇʁੴ੮ɘ˦ʁ੮ )ɘ˦ʮ੮˚˺ͷʇͅ੮͐˺੮ˑʇɘͷʇੳ Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੮͐ɘˌʇͅ੮ɘ੮ʠʇ͸੮͐ͅʇ̹ͅ੮͸ʮ͐ʩ੮͙ͅੴ੮ɘ˦ʁ੮͐ʩʇ˦੮̹ͅʮ˦ͅ੮ɘ˦ʁ੮ͅʩ˺͙͐ͅੴ੮ૃ"ʮ͐ɻʩੴ੮ ˑʇɘͷʇ੮˚ʇ੮ɘˑ˺˦ʇੳૄ îʩʇ̼ʇૄͅ੮˦˺੮˺˦ʇ੮͐ʩʇ̼ʇੴ੮ɺ͙͐੮)ɘ˦ʮ੮ɘͅˌͅ੮ͅ;˚̹ɘ͐ʩʇ͐ʮɻɘˑˑ;ੴ੮ૃ)˺੮͐ʩ˺ͅʇ੮̹ʇ˺̹ˑʇ੮ɺ˺͐ʩʇ̼੮ ;˺͙੺ૄ੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੮˦˺ʁͅੳ੮)ɘ˦ʮ੮ɻˑ˺ͅʇͅੴ੮ૃšˌɘ;ੴ੮͸ʇˑˑੴ੮͸ʇૄˑˑ੮ͅʇʇ੮;˺͙੮ͅ˺˺˦ੳૄ äʩʇ੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐ੴ੮ʮ˦੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇૄͅ੮̼ʇɻʇ˦͐੮৵ৱ৵ৰͅੴ੮ૃ͐ʩʇ੮̹˺ˑʮɻʇ੮ʩɘͷʇ੮ʩɘʁ੮͐˺੮ ʡ˺੮ુʩɘ˦ʁͅ੮˺˦ૂ੮ɺʇɻɘ͙ͅʇ੮ͅʩʇૄͅ੮ɘʡʡ̼ʇͅͅʮͷʇ੮ɘ˦ʁ੮ͷ˺ˑɘ͐ʮˑʇੳૄ੮îʩʇ੮̼ʮͅˌ੮˺ʠ੮ͷʮ˺ˑʇ˦ɻʇ੮ʠ̼˺˚੮ ̹˺ˑʮɻʇઝɘ˦ʁ੮͐ʩʇ੮ˑɘɻˌ੮˺ʠ੮͙ͅɻɻʇͅͅ੮˺˦੮̹̼ʇͷʮ˺͙ͅ੮ʩ˺ˑʁͅઝ˚ʇɘ˦ͅ੮͐ʩɘ͐੮͐ʩʇ̼ʇૄͅ੮˦˺੮̹ˑɘ˦੮ ͐˺੮ ͅʇ˦ʁ੮ );ˑɘ˦੮ ʁ˺͸˦੮ ͐˺੮ ʇͷɘˑ͙ɘ͐ʇ੮ ʩʇ̼ੳ੮ Ø̼˺ʠʇͅͅ˺̼੮ k˺ˑʮʇ੮ ̼ʇ̹̼ʇͅʇ˦͐ͅ੮ ɘ੮ ʁʮʠʠʇ̼ʇ˦͐੮ ͐;̹ʇ੮ ˺ʠ੮ ͅʮ͙͐ɘ͐ʮ˺˦੮ ͸ʩʇ̼ʇ੮ ɘ੮ ৵ৱ৵ৰ੮ ɺʇɻ˺˚ʇͅ੮ ɘ੮ ̹˺͐ʇ˦͐ʮɘˑ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ੵ੮ ɘ੮ ͷʮͅʮɺˑʇ੮ ɻ̼ʮͅʮͅ੮ʮ˦੮̹͙ɺˑʮɻੳ š͙̼੮͐ʩʮ̼ʁ੮ͷʮͅʮ͐੮ʮͅ੮͐˺੮I͙ɘʁɘˑ͙̹ʇੴ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˦ʡ੮ɘ͐੮ʩ˺˚ʇੳ੮ૃäʩʇ੮̼ʇɘˑˑ;੮˦ʇʇʁͅ੮ ͐˺੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁੴૄ੮)ɘ˦ʮ੮͐ʇˑˑͅ੮˚ʇੴ੮ɘ੮̹̼˺ɻʇͅͅ੮͐ʩɘ͐੮͸ʮˑˑ੮ʩɘͷʇ੮͐˺੮͐ͅɘ̼͐੮͸ʮ͐ʩ੮ɘ੮৵ৱ৵ৰੳ੮äʩʇ੮ ʩɘͅ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ੮ʮͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮˚͙͐ʇੴ੮ɘ˦ʁ੮ʩɘͅ੮ʁʇ̼͐ͅ˺;ʇʁ੮ʩʇ̼੮ɘ̹ɘ̼͐˚ʇ˦͐੮ɺɘͅʇʁ੮˺˦੮ ̹ɘ̼ɘ˦˺ʮɘ੮͐ʩɘ͐੮ʇͽ̼͐ɘ͐ʇ̼̼ʇ̼͐ͅʮɘˑͅ੮ʩɘͷʇ੮ʮ˦͐ͅɘˑˑʇʁ੮ɻɘ˚ʇ̼ɘͅ੮ʮ˦ͅʮʁʇੳ੮îʩʇ੮͐ʇɘ˚੮ʩɘͅ੮ʩɘʁ੮͐˺੮ ͙ͅʇ੮ʮ͐ͅ੮ϲʮ˦ʮ͐ʇ੮ʠ͙˦ʁͅ੮͐˺੮̹ɘ;੮͐ʩʇ੮˦˺˦̹̼˺ϲʮ͐੮̼͙˦˦ʮ˦ʡ੮ʩʇ̼੮ɺ͙ʮˑʁʮ˦ʡ੮ʠ˺̼੮̼ʇ̹ɘʮ̼ͅੳ੮äʩʇૄͅ੮ ̼ʮͅˌʮ˦ʡ੮ʇͷʮɻ͐ʮ˺˦ੴ੮͸ʩʮɻʩ੮ʮͅ੮͙̼̹̼ͅʮͅʮ˦ʡˑ;੮ɻ˺˚˚˺˦੮ʇͷʇ˦੮ʮ˦੮ુ̹ʇ̼˚ɘ˦ʇ˦͐ૂ੮͙̹̹ͅ˺̼͐ʇʁ੮ ʩ˺͙ͅʮ˦ʡੳৼ੮U˦੮ɘ˦;੮ɻɘͅʇੴ੮ͅʩʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʁ˺ʇͅ˦ૄ͐੮ͅˑʇʇ̹੮͐ʩʇ̼ʇੴ੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮ɺʇˑʮʇͷʇͅ੮ͅʩʇ੮ ʮͅ੮ɺʇʮ˦ʡ੮ͅʇͽ͙ɘˑˑ;੮ɘͅͅɘ͙ˑ͐ʇʁ੮ɺ;੮͐ʩʇ੮ɘˑʮʇ˦ͅੳ੮Ĕʩɘ͐ʇͷʇ̼੮;˺͙੮͐ʩʮ˦ˌ੮ɘɺ˺͙͐੮͐ʩʇ੮ɻ̼ʇʁʮɺʮˑʮ͐;੮ ˺ʠ੮͐ʩɘ͐੮ʠʇɘ̼ੴ੮)ɘ˦ʮ੮̹ͅʇɻ͙ˑɘ͐ʇͅ੮͐ʩɘ͐੮͐ʩʇͅʇ੮ʁʇˑ͙ͅʮ˺˦ͅ੮ˑʮˌʇˑ;੮ɻ˺˚ʇ੮ʠ̼˺˚੮ɘ੮ˑʮʠʇ੮˺ʠ੮̹̼ʇ͐͐;੮ ͙˦̼ʇˑʇ˦͐ʮ˦ʡ੮̼͐ɘ͙˚ɘੳ Ĕʇ੮̼ɘ̹੮˺˦੮ʩʇ̼੮ʁ˺˺̼ੳ੮äʩʇૄͅ੮͸ʇɘ̼ʮ˦ʡ੮ɘ੮ʁʮ̼͐;੮îચͅʩʮ̼͐੮ɘ˦ʁ੮ˑ˺˺ˌͅ੮ˑʮˌʇ੮ͅʩʇ੮ʩɘͅ˦ૄ͐੮ ɺʇʇ˦੮ ͅˑʇʇ̹ʮ˦ʡੳ੮ )ɘ˦ʮૄͅ੮ ̹̼ʇ͐ʇͽ͐੮ ʠ˺̼੮ ɻʩʇɻˌʮ˦ʡ੮ ͙̹੮ ˺˦੮ ʩʇ̼੮ ʮͅ੮ ɘ˦੮ ͙̹ɻ˺˚ʮ˦ʡ੮ ˺̹͐˺˚ʇ̼͐;੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ੳ੮Ĕʩʇ˦੮ͅʩʇ੮ɘͅˌͅ੮I͙ɘʁɘˑ͙̹ʇ੮ʮʠ੮ͅʩʇ੮̼ʇ˚ʇ˚ɺʇ̼ͅ੮͐ʩʇ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ੴ੮ I͙ɘʁɘˑ͙̹ʇ੮ʩ˺ˑʁͅ੮͙̹੮ɘ੮ϲʮ˦ʡʇ̼ੴ੮̼ʇ̼͐ʇɘ͐ͅ੮ɺɘɻˌ੮ʮ˦͐˺੮ʩʇ̼੮ɘ̹ɘ̼͐˚ʇ˦͐ੴ੮ɘ˦ʁ੮ɻ˺˚ʇͅ੮ɺɘɻˌ੮

52

T H E C O N S E RVATO R S H I P C O N T I N U U M

͸ʮ͐ʩ੮ɘ੮˦˺͐ʇɺ˺˺ˌੴ੮͸ʩʇ̼ʇ੮ͅʩʇ੮͸̼ʮ͐ʇͅ੮͐ʩɘ͐੮ͅʩʇ੮ʁʮʁ˦ૄ͐ੳ੮ૃUͅ੮͐ʩʇ̼ʇ੮ɘ˦;͐ʩʮ˦ʡ੮͸ʇ੮ɻɘ˦੮ʁ˺੮ ʠ˺̼੮;˺͙੺ૄ੮äʩʇ੮͸̼ʮ͐ʇͅ੮ૃ˦˺ૄ੮ɘ˦ʁ੮ɘɺ̼͙̹͐ˑ;੮ɻˑ˺ͅʇͅ੮͐ʩʇ੮ʁ˺˺̼ੳ š͙͐ͅʮʁʇੴ੮͸ʇ੮̼͙˦੮ʮ˦͐˺੮#˺͙̼͐˦ʇ;੮ɘ˦ʁ੮k˺̼ʁɘ˦ੴ੮͐ʩʇ੮͐ʇɘ˚ૄͅ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ɻ˺͙˦ͅʇˑ˺̼ੴ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ʩʇ̼ʇ੮ ͐˺੮ ͷʮͅʮ͐੮ ɘ˦˺͐ʩʇ̼੮ ɻˑʮʇ˦͐ੳ੮ ૃ);ˑɘ˦੮ ͅɘ;ͅ੮ ͸ʇ੮ ͅʩ˺͙ˑʁ੮ ɺʇ੮ ͐ʩʮ˦ˌʮ˦ʡ੮ ɘˑˑ੮͐ʩʇ੮͐ʮ˚ʇ੮ɘɺ˺͙͐੮͸ʩʇ͐ʩʇ̼੮ͅʩʇ੮˚ʇʇ͐ͅ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮͙ͅ੮͐˺੮̹͙͐੮ʩʇ̼੮˺˦੮ɘ੮৵ৱ৵ৰੴૄ੮ #˺͙̼͐˦ʇ;੮ʇͽ̹ˑɘʮ˦ͅੴ੮ૃɺ͙͐੮ͅʩʇૄͅ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ͅ˺੮˚ɘ˦;੮͐ʮ˚ʇͅ੮͐ʩɘ͐੮ͅʩʇૄͅ੮ુʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇʁੳૄૄੰૄ੮U˦੮͐ʩʇ੮ৱ৹৶ৰͅੴ੮ુʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇʁૂ੮˚ʇɘ˦͐੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ʩɘʁ੮̹ͅʇ˦͐੮ ͅ˺੮ˑ˺˦ʡ੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩʇ;੮ʁʮʁ˦ૄ͐੮ˌ˦˺͸੮ʩ˺͸੮͐˺੮ˑʮͷʇ੮˺͙͐ͅʮʁʇ੮ʮ͐੶੮ʠ˺̼੮I͙ɘʁɘˑ͙̹ʇੴ੮ʮ͐੮ ˚ʇɘ˦ͅ੮ͅʩʇૄͅ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ͅ˺੮˚ɘ˦;੮͐ʮ˚ʇͅ੮ͅʩʇ੮ˌ˦˺͸ͅ੮͸ʩɘ͐੮͐˺੮ͅɘ;੮͐˺੮͐ʩʇ੮ˈ͙ʁʡʇ੮ ફ͸ʩ˺੮͸ʮˑˑ੮̼ʇͷʮʇ͸੮ʩʇ̼੮ɻɘͅʇ੮͸ʮ͐ʩʮ˦੮ɘ੮͸ʇʇˌ੮ʮʠ੮ʩʇ̼੮৵ৱ৵ৰ੮ˑʇɘʁͅ੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮͅͅʮ˺˦બ੮ ͐˺੮ʡʇ͐੮˺͙͐ੳ Ĕʩʇ˦੮U੮ɻ˺˚ʇ੮ɺɘɻˌ੮͐ʩʇ੮ʠ˺ˑˑ˺͸ʮ˦ʡ੮͸ʇʇˌੴ੮ʇͷʇ̼;˺˦ʇ੮ʮͅ੮ʁ˺ʮ˦ʡ੮͸˺̼ͅʇੳ੮Ĕʇ੮ʡ˺੮͐˺੮͐ʩʇ੮ ͅʩʇˑ͐ʇ̼੮͐˺੮ʡʮͷʇ੮ɘ੮ɻˑʮʇ˦͐੮ʩʮͅ੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻ੮ʮ˦ˈʇɻ͐ʮ˺˦੮ɘ˦ʁ੮̼͙˦੮ʮ˦͐˺੮kʇ̼̼;ੳ੮Pʇૄͅ੮ή͙ʮͷʇ̼ʮ˦ʡੴ੮ૃU͐ૄͅ੮̼ʇɘˑ੮ɺɘʁ੯ੳ੯ੳ੯ੳ੮Ě˺͙੮ˌ˦˺͸੯ੳ੯ੳ੯ੳ੮U੮ʩɘʁ੮ɘ੮ʠ˺͙̼ચʁɘ;੮ʩɘ˦ʡ˺ͷʇ̼੮ɘ˦ʁ੮;ʇ͐ͅʇ̼ʁɘ;੯ੳ੯ੳ੯ੳ੮ U੮ˈ͙͐ͅ੮ɻ˺͙ˑʁ˦ૄ͐੮ʁ˺੮ʮ͐ੴ੮U੮ʁ̼ɘ˦ˌੳૄ੮îʩʇ੮͐ʇɘ˚੮ʮͅ੮ɻ˺˦ͷʮ˦ɻʇʁ੮ʮ͐ૄͅ੮ͅ˺੮ɻˑʇɘ̼੮ʩʮͅ੮̹̼˺ɺˑʇ˚੮ʮͅ੮ ɘˑɻ˺ʩ˺ˑʮͅ˚ੴ੮ɘ˦ʁ੮˦˺͐੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮͐ʩɘ͐੮˦˺੮̹ͅ;ɻʩ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʮˑˑ੮ɘʁ˚ʮ͐੮ʩʮ˚ੳ੮Pʮͅ੮ ˑɘ͐ͅੴ੮ɺʇ͐ͅ੮ʩ˺̹ʇ੮ʮͅ੮ɘ੮ʁʇ͐˺ͽ੮̹̼˺ʡ̼ɘ˚ੴ੮͸ʩʮɻʩ੮ʩʇૄˑˑ੮ʩɘͷʇ੮͐˺੮ʡ˺੮͐˺੮ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ੮Ĕʇૄ̼ʇ੮ʮ˦੮ ɘ੮̼͙ͅʩ੮ɘ˦ʁ੮˚˺ͷʇ੮˺˦੮ή͙ʮɻˌˑ;੮͐˺੮͐ʩʇ੮ɺ˺ɘ̼ʁ͸ɘˑˌੳ੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੮ʮͅ੮˚͙ɻʩ੮ʩɘ̼ʁʇ̼੮͐˺੮ ʠ˺ˑˑ˺͸ੳ੮äʩʇ੮ʮͅ੮ͅʩʮʠ͐ʮ˦ʡ੮ɺʇ͐͸ʇʇ˦੮ɘ੮#ɘ̼ʮɺɺʇɘ˦੮ɘ˦ʁ੮ɘ˦੮˚ʇ̼ʮɻɘ˦੮ɘɻɻʇ˦͐ੴ੮ʇͽ̹ˑɘʮ˦ʮ˦ʡੴ੮ ૃU੮ɘ˚੮˦˺͐੮˦˺ʁʇ੮͐ʩ̼ʇʇੴ੮U੮ɘ˚੮˦˺ʁʇ੮ϲʮͷʇੳૄ੮Ĕʇ੮̼͐;੮͐˺੮͐ʇˑˑ੮ʩʇ̼੮͐ʩɘ͐੮ʩʇ̼੮ʇͷʮɻ͐ʮ˺˦੮ʮͅ੮ʮ˚˚ʮ˦ʇ˦͐ੴ੮ɘ˦ʁ੮ͅʩʇ੮ʁʇɻˑɘ̼ʇͅੴ੮ૃ";ʇૄ੮ɘ˦ʁ੮͐ͅɘ̼͐ͅ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅ੮ͅʮ͐͐ʮ˦ʡ੮ɘ͐੮ʩʇ̼੮ ʇ˦ɻɘ˚̹˚ʇ˦͐ૄͅ੮͐ɘɺˑʇੴ੮ɘˑ͐ʩ˺͙ʡʩ੮͸ʇ੮ɻɘ˦˦˺͐੮ͅʇʇ੮͐ʩʇ˚ੳ "͙͐੮ʮ͐ૄͅ੮I͙ɘʁɘˑ͙̹ʇ੮͸ʩ˺੮ʮͅ੮͐ʩʇ੮̼ʇɘˑ੮ɻ˺˦ɻʇ̼˦ੳ੮îʩʇ੮͐ʇɘ˚੮̼ʇɻʇʮͷʇʁ੮ɘ੮ɻɘˑˑ੮ʠ̼˺˚੮ʩʇ̼੮ ɺ͙ʮˑʁʮ˦ʡ੮˚ɘ˦ɘʡʇ̼੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮ͅɻ̼ʇɘ˚ʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ʩɘˑˑ͸ɘ;ੳ੮#˺͙̼͐˦ʇ;੮͸ʇ˦͐੮͐˺੮ͅʇʇ੮ ʩʇ̼ੵ੮ૃäʩʇ੮͸ɘͅ੮̹˺ʮ˦͐ʮ˦ʡ੮͐˺੮͐ͅɘʮ˦ͅ੮˺˦੮ʩʇ̼੮̹ɘ˦͐ͅ੮ɘ˦ʁ੮ͅɘʮʁੴ੮ુ)˺੮;˺͙੮ͅʇʇ੮ɘˑˑ੮͐ʩʮͅ੮ͅʇ˚ʇ˦੺੮ îʩʇ;੮ɘ̼ʇ੮̼ɘ̹ʮ˦ʡ੮˚ʇੳૂ੮"͙͐੮͐ʩʇ̼ʇ੮͸ɘͅ੮˦˺͐ʩʮ˦ʡ੮͐ʩʇ̼ʇੳૄ੮Ĕ˺̼ͅʇੴ੮ૃäʩʇ੮ʩɘʁ੮ɘ੮ʡ˺ˑʠચɺɘˑˑ੮ ͅʮΈʇʁ੮ͅ͸˺ˑˑʇ˦੮ɻʩʇʇˌੴ੮ɘ˦ʁ੮ɘ੮ʡɘͅʩ੮ʮ˦੮ʩʇ̼੮ʩʇɘʁੳ੮äʩʇૄͅ੮̹̼˺ɺɘɺˑ;੮ʁ˺ʮ˦ʡ੮͐ʩʮͅ੮͐˺੮ʩʇ̼ͅʇˑʠੳૄ š˦੮Ĕʇʁ˦ʇͅʁɘ;ͅੴ੮͐ʩʇ੮͐ʇɘ˚੮ʮͅ੮ˈ˺ʮ˦ʇʁ੮ɘ͐੮ʮ͐ͅ੮˚˺̼˦ʮ˦ʡ੮˚ʇʇ͐ʮ˦ʡ੮ɺ;੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴ੮ ͸ʩ˺੮ʩʇˑ̹ͅ੮̼ʇϲʮˑˑ੮ɻˑʮʇ˦͐ͅૄ੮˚ʇʁͅੵ੮ૃĔʩ;੮ʮͅ˦ૄ͐੮ͅʩʇ੮ɻ˺˦ͅʮʁʇ̼ʇʁ੮ʩ˺ˑʁɘɺˑʇ੮ય˺˦੮ɘ੮৵ৱ৵ৰર੺ૄ੮ ʩʇ੮ɘͅˌͅੳ #˺͙̼͐˦ʇ;੮̼ʇ̹ˑʮʇͅੴ੮ૃ"ʇɻɘ͙ͅʇ੮ɘʠ͐ʇ̼੮U੮͐ɘˑˌʇʁ੮͐˺੮ʩʇ̼ੴ੮ͅʩʇ੮ʡ˺͐੮ʮ˦੮͐ʩʇ੮ͷɘ˦੮ɘ˦ʁ੮͸ʇ੮͸ʇ˦͐੮ ͐˺੮ʩʇ̼੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ੳ੮äʩʇ੮͸ɘͅ੮ʠ͙˦ɻ͐ʮ˺˦ɘˑੴ੮ͅʩʇ੮͸ɘͅ੮˺̼ʮʇ˦͐ʇʁੳૄ U੮ˈ˺ʮ˦੮#˺͙̼͐˦ʇ;੮˺˦੮ɘ੮ͷʮͅʮ͐੮͐˺੮I͙ɘʁɘˑ͙̹ʇૄͅ੮ɘ̹ɘ̼͐˚ʇ˦͐ੳ੮U͐੮͐ɘˌʇͅ੮ɘ੮ˑ˺˦ʡ੮͐ʮ˚ʇ੮ʠ˺̼੮ ʩʇ̼੮͐˺੮˺̹ʇ˦੮ʩʇ̼੮ʁ˺˺̼ੴ੮ɘ˦ʁ੮U੮ɻɘ˦੮ͅʇʇ੮ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮ɺ˺ɘ̼ʁͅ੮͐ͅɘɻˌʇʁ੮ɻʩɘ˺͐ʮɻɘˑˑ;੮ɘʡɘʮ˦͐ͅ੮ ʮ͐ੳ੮îʩʇ੮͸ɘˑˑͅ੮˺ʠ੮ʩʇ̼੮ɘ̹ɘ̼͐˚ʇ˦͐੮ɘ̼ʇ੮ˑʮ˦ʇʁ੮͸ʮ͐ʩ੮̹ˑɘ͐ͅʮɻ੮ɺɘʡͅੳ੮ૃ#ɘ˦੮;˺͙੮͐ʇˑˑ੮˚ʇ੮ʩ˺͸੮ ;˺͙੮ʡ˺͐੮͐ʩɘ͐੺ૄ੮#˺͙̼͐˦ʇ;੮ɘͅˌͅੴ੮̹˺ʮ˦͐ʮ˦ʡ੮͐˺੮ɘ੮ʡɘͅʩ੮˺˦੮ʩʇ̼੮͐ʇ˚̹ˑʇੳ੮I͙ɘʁɘˑ͙̹ʇ੮ͅʩɘˌʇͅ੮

CRISIS

53

ʩʇ̼੮ʩʇɘʁੳ੮ૃ#ɘ˦੮;˺͙੮͸̼ʮ͐ʇ੮ʮ͐੺ૄ੮äʩʇ੮ͅʩɘˌʇͅ੮ʩʇ̼੮ʩʇɘʁ੮ɘʡɘʮ˦ੳ੮ૃUͅ੮͐ʩʇ̼ʇ੮ɘ˦;͐ʩʮ˦ʡ੮ʇˑͅʇ੮;˺͙੮ ˦ʇʇʁ੮ʠ̼˺˚੮͙ͅ੺ૄ੮äʩʇ੮͐ͅɘ̼͐ͅ੮ɻˑ˺ͅʮ˦ʡ੮͐ʩʇ੮ʁ˺˺̼ੳ੮ૃîʩʇ੮ʁ˺ɻ͐˺̼੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ʁ̼˺̹੮ɺ;੮͐˺੮ͅʇʇ੮ ;˺͙ੳૄ੮I͙ɘʁɘˑ͙̹ʇ੮˚ɘˌʇͅ੮ɘ੮ͅ˚ɘˑˑ੮ૃɺ;ʇચɺ;ʇૄ੮͸ɘͷʇ੮͸ʮ͐ʩ੮ʩʇ̼੮ʩɘ˦ʁ੮ɘ˦ʁ੮ͅʩ͙͐ͅ੮͐ʩʇ੮ʁ˺˺̼ੳ š͙͐ͅʮʁʇੴ੮U੮ɻɘ˦੮͐ʇˑˑ੮͐ʩʇ੮ɻɘͅʇ੮ʮͅ੮͸ʇʮʡʩʮ˦ʡ੮˺˦੮#˺͙̼͐˦ʇ;ੳ੮Ĕʇ੮ɻ˺˦ʠɘɺ੮͸ʮ͐ʩ੮)ɘ˦ʮੴ੮ ͸ʩ˺੮ʁʇɻˑɘ̼ʇͅੴ੮ૃUૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮ʡʇ͐੮rØä੮ʁʇͅʮʡ˦ɘ͐ʇʁੴ੮ͅ˺੮U੮ɻɘ˦੮ʁʇ̹̼ʮͷʇ੮̹ʇ˺̹ˑʇ੮˺ʠ੮͐ʩʇʮ̼੮ ɺɘͅʮɻ੮ʩ͙˚ɘ˦੮̼ʮʡʩ͐ͅ੸ૄ #˺͙̼͐˦ʇ;੮˺ʠʠʇ̼ͅੴ੮ʮ˦੮̼ʇ̹ͅ˺˦ͅʇੴ੮ૃU͐ૄͅ੮ʠ˺̼੮ɘ੮ʡ˺˺ʁ੮ɻɘ͙ͅʇੳૄ )ɘ˦ʮ੮̼ʇ̹ˑʮʇͅੴ੮ૃä͙̼ʇੴ੮ɺ͙͐੮U੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ੮ˑ˺͐੮˺ʠ੮˺̹͐ʮ˚ʮͅ˚੮ɘ੮ʩ˺ˑʁ੮͸ʮˑˑ੮͐ͅʮɻˌੳૄ H˺̼੮)ɘ˦ʮ੮ɘ˦ʁ੮ʩʇ̼੮ɻ˺ˑˑʇɘʡ͙ʇͅੴ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ɘ˦੮ɘˑ˚˺͐ͅ੮˚;͐ͅʮɻɘˑ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦੮͐ʩɘ͐੮ʇͷʇ̼;˺˦ʇ੮˦ʇʇʁͅ੮ɺ͙͐੮˦˺੮˺˦ʇ੮ʡʇ͐ͅੳ੮îʩʇ੮͐ʇɘ˚੮ʩɘͅ੮ͅ˺˚ʇ੮ʮ˦ɻ̼ʇʁʮɺˑʇ੮͙ͅɻɻʇͅͅ੮ ͐ͅ˺̼ʮʇͅੳ੮"͙͐੮˚ɘ˦;੮ɻˑʮʇ˦͐ͅ੮ʇʮ͐ʩʇ̼੮ʁʮʇ੮ફ˺˦ʇ੮̹ʇ̼ͅ˺˦੮͸ɘͅ੮ʩʮ͐੮ɺ;੮ɘ੮ɻɘ̼੮͸ʩʮˑʇ੮ʮ˦ʇɺ̼ʮɘ͐ʇʁ੮ ɘ˦ʁ੮̹ɘͅͅʇʁ੮ɘ͸ɘ;੮ɘ੮͸ʇʇˌ੮ɺʇʠ˺̼ʇ੮U੮ˈ˺ʮ˦ʇʁ੮͐ʩʇ˚બੴ੮ɺ˺͙˦ɻʇ੮ʇ˦ʁˑʇͅͅˑ;੮ʮ˦੮ɘ˦ʁ੮˺͙͐੮˺ʠ੮ ˈɘʮˑੴ੮˺̼੮ɘˑ͐ʇ̼˦ɘ͐ʇ੮ɺʇ͐͸ʇʇ˦੮ˑʮͷʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮͐ͅɘ;ʮ˦ʡ੮͐ʇ˚̹˺̼ɘ̼ʮˑ;੮ʮ˦੮ુ̹ʇ̼˚ɘ˦ʇ˦͐ૂ੮ʩ˺͙ͅʮ˦ʡ੮͙˦͐ʮˑ੮͐ʩʇ;੮ʡʇ͐੮ʇͷʮɻ͐ʇʁੳ੮ુ‡˺͐੮ɺʇʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷʇʁૂ੮ʮͅ੮͐ʩ͙ͅ੮ʠɘ̼੮ʠ̼˺˚੮ ુʩɘͷʮ˦ʡ੮˺˦ʇૄͅ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮̼ʇ̹ͅʇɻ͐ʇʁੳૂ ͅ੮;˺͙ૄˑˑ੮ͅʇʇ੮ʮ˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੴ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺ˑʁͅ੮ɻɘ˦੮ʠʇʇˑ੮ˑʮˌʇ੮ɘ੮̹˺͐ʇ˦͐੮ɘ˦ʁ੮͐ʇ̼̼ʮʠ;ʮ˦ʡ੮͐ͅɘ͐ʇ੮̹˺͸ʇ̼੮͐˺੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮͐ʩʇ˚ੳ੮Ěʇ͐੮͐ʩʇ;੮ɘ̼ʇ੮˦˺͐੮̼ʇɘˑˑ;੮ɻ˺˺̼ʁʮ˦ɘ͐ʇʁ੮ɺ;੮ɘ˦;੮̹͙ɺˑʮɻ੮ɘ͙͐ʩ˺̼ʮ͐;ੳ੮Ĕʇૄˑˑ੮͐ͅɘ̼͐੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ɺ;੮ʇͽɘ˚ʮ˦ʮ˦ʡ੮ʩ˺͸੮̹˺ˑʮɻʇ੮ ͙ͅʇ੮͐ʩʇʮ̼੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ʮ˦੮͸ɘ;ͅ੮͐ʩɘ͐੮ɻ˺˦ɻʇ˦̼͐ɘ͐ʇ੮ɻ˺ʇ̼ɻʮ˺˦੮˺˦੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ͷʮͅʮɺˑ;੮ ʁʮ̼͙̹͐ͅʮͷʇੴ੮͸ʩʮˑʇ੮ɘˑͅ˺੮ͅ͸ʇʇ̹ʮ˦ʡ੮͙̹੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ͅʇʇ˚੮͐˺੮ʩɘͷʇ੮ˈ͙͐ͅ੮ɺʇʇ˦੮ʮ˦੮ ͐ʩʇ੮͸̼˺˦ʡ੮͐ͅɘ͐ʇ੮˺ʠ੮˚ʮ˦ʁ੮ɘ͐੮͐ʩʇ੮͸̼˺˦ʡ੮̹ˑɘɻʇ੮ɘ͐੮͐ʩʇ੮͸̼˺˦ʡ੮͐ʮ˚ʇੳ੮îʩʇ˦੮͸ʇૄˑˑ੮ͅʇʇ੮ ʩ˺͸੮͐ʩʇ੮ͅ;͐ͅʇ˚੮˺ͷʇ̼ˑ˺˺ˌͅ੮̹ʇ˺̹ˑʇ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˦ʡ੮ɘ͐੮ʩ˺˚ʇ੮ɘ˦ʁ੮ʡʮͷʇͅ੮͙̹੮˺˦੮͐ʩ˺ͅʇ੮ ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ

CRISIS IN PUBLIC ˑɘ˚ʇʁɘ੮#˺͙˦͐;ੴ੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮"ɘ;੮ʠ̼˺˚੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɘ˦ʁ੮ʩ˺˚ʇ੮͐˺੮šɘˌˑɘ˦ʁ੮ɘ˦ʁ੮ "ʇ̼ˌʇˑʇ;ੴ੮ʮͅ੮͐ʩʇ੮৵ৱ৵ৰ੮ɻɘ̹ʮ͐ɘˑ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘੳ੮Ĕʮ͐ʩ੮ৱ৷ੴ৶ৰৰ੮ʩ˺ˑʁͅ੮̹ˑɘɻʇʁ੮ʮ˦੮৲ৰৱ৷ੴ੮ʮ͐ͅ੮ ̼ɘ͐ʇ੮ʮͅ੮˦ʇɘ̼ˑ;੮ʠ˺͙̼੮͐ʮ˚ʇͅ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘͷʇ̼ɘʡʇੳ৽੮î˺੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͸ʩɘ͐੮ʁ̼ʮͷʇͅ੮ʩʮʡʩ੮̼ɘ͐ʇͅ੮ ˺ʠ੮৵ৱ৵ৰͅੴ੮͸ʇ੮˦ʇʇʁ੮͐˺੮ʇͽɘ˚ʮ˦ʇ੮ʩ˺͸੮̹˺ˑʮɻʇ੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɻ̼ʮͅʇͅ੮ʮ˦੮̹͙ɺˑʮɻੴ੮ ͸ʩʮɻʩ੮ ɘ̼ʇ੮ ͐ʩʇ˚ͅʇˑͷʇͅ੮ ʇͽɘɻʇ̼ɺɘ͐ʇʁ੮ ɺ;੮ ͐ʩʇ੮ ɻ˺ˑˑʇɻ͐ʮͷʇ੮ ɻ̼ʮͅʇͅ੮ ˺ʠ੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ɘ˦ʁ੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੳ Uૄͷʇ੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ɘ੮ʁ˺Έʇ˦੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮˺ϲϲʮɻʇ̼ͅ੮ͅʮ˦ɻʇ੮৲ৰ৲ৱੳ੮îʩʇ;੮ɘˑˑ੮ɻ˺˦ɻ͙̼̼ʇʁ੮ ͐ʩɘ͐੮ ͅ˺˚ʇ੮ ৵ৱ৵ৰ੮ ʩ˺ˑʁͅ੮ ɘ̼ʇ੮ ̼͐ͅɘʮʡʩ͐ʠ˺̼͸ɘ̼ʁ੮ ɘ˦ʁ੮ ͙˦ɘͷ˺ʮʁɘɺˑʇੳ੮ rʮʇ͙͐ʇ˦ɘ˦͐੮ Ûʇʮʁੴ੮ ʩʇɘʁ੮ ˺ʠ੮ ͐ʩʇ੮ r˺ͅ੮ ˦ʡʇˑʇͅ੮ Ø˺ˑʮɻʇ੮ )ʇ̹ɘ̼͐˚ʇ˦͐ૄͅ੮ {˺ɺʮˑʇ੮ /ͷɘˑ͙ɘ͐ʮ˺˦੮ õ˦ʮ͐੮

54

T H E C O N S E RVATO R S H I P C O N T I N U U M

ફ{/õબੴ੮͸ʩʮɻʩ੮̹ͅʇɻʮɘˑʮΈʇͅ੮ʮ˦੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮͐˺੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅજ̼ʇˑɘ͐ʇʁ੮ɻɘˑˑͅੴ੮ʡʮͷʇͅ੮˚ʇ੮ ͐͸˺੮ ɻˑɘͅͅʮɻ੮ ɻɘͅʇͅੵ੮ ͐ʩʇ੮ ુ̹ʇ̼ͅ˺˦੮ ˺˦੮ ͐ʩʇ੮ ɺ̼ʮʁʡʇ੮ ͸ɘ˦͐ʮ˦ʡ੮ ͐˺੮ ˈ͙˚̹੮ ˺ʠʠ੮ ˺˦͐˺੮ ͐ʩʇ੮ ৱৰৱ੮ ʠ̼ʇʇ͸ɘ;ૂ੮ɘ˦ʁ੮͐ʩʇ੮ુ˦ɘˌʇʁ੮˚ɘ˦੮͸ʮ͐ʩ੮ɘ੮˚ɘɻʩʇ͐ʇ੮̼͙˦˦ʮ˦ʡ੮ʁ˺͸˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳૂ੮{/õ੮ ͅʇ˦ʁͅ੮ä;͐ͅʇ˚͸ʮʁʇ੮{ʇ˦͐ɘˑ੮ͅͅʇͅͅ˚ʇ˦͐੮Ûʇ̹ͅ˺˦ͅʇ੮îʇɘ˚ͅ੮ફä{Ûîબੴ੮͸ʩʮɻʩ੮̹ɘʮ̼੮ɘ˦੮ ˺ϲϲʮɻʇ̼੮͸ʮ͐ʩ੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦ੴ੮͐˺੮ͅ˺˚ʇ੮ɻɘˑˑͅੳ੮"͙͐੮ͅʩʇ੮ͅɘ;ͅ੮ʮ˦ɻʮʁʇ˦͐ͅ੮ˑʮˌʇ੮͐ʩʇͅʇ੮ɘ̼ʇ੮͙̼ʡʇ˦͐੮ ʇ˦˺͙ʡʩ੮͐˺੮ʡʇ͐੮ɘ੮ુ̹ɘ̼͐˺ˑ੮̼ʇ̹ͅ˺˦ͅʇૂઝ͐ʩɘ͐੮ʮͅ੮͐˺੮ͅɘ;ੴ੮ɘ੮̼ʇʡ͙ˑɘ̼੮ɺʇɘ͐੮˺ϲϲʮɻʇ̼ੳ੮îʩʇ;ૄˑˑ੮ ͙͙ͅɘˑˑ;੮͸̼ʮ͐ʇ੮ɘ੮৵ৱ৵ৰ੮˺˦੮͐ʩʇʮ̼੮˺͸˦ੳ {˺͐ͅ੮ ৵ৱ৵ৰͅ੮ ɘ̼ʇ˦ૄ͐੮ ͅ˺੮ ɻˑʇɘ̼ચɻ͙͐ੳ੮ š˦ʇ੮ ʇ͐ʩ˦˺ʡ̼ɘ̹ʩ;੮ ˺ʠ੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ʮ˦੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺੮ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ʩ˺͸੮̹˺ˑʮɻʮ˦ʡ੮˺ʠ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ʮͅ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ુɻ˺˚̹ˑɘʮ˦͐ચ ˺̼ʮʇ˦͐ʇʁੳૂ৾੮šϲϲʮɻʇ̼ͅ੮̹ͅʇ˦ʁ੮͐ʩʇʮ̼੮͐ʮ˚ʇ੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮͐˺੮ɻʮ͐ʮΈʇ˦ͅ੮͸ʩ˺੮ɘ̼ʇ੮ɻɘˑˑʮ˦ʡ੮ʮ˦੮ ફ˺̼੮ ̼ʇ̹˺̼͐ʮ˦ʡ੮ ˺˦੮ ɘ੮ ɻʮ͐;੮ ͅ˚ɘ̼̹͐ʩ˺˦ʇ੮ ɘ̹̹બ੮ ̹ʇ˺̹ˑʇ੮ ɺˑ˺ɻˌʮ˦ʡ੮ ʁ˺˺̼͸ɘ;ͅੴ੮ ɘɻɻ˺͐ͅʮ˦ʡ੮ ̹ɘͅͅʇ̼ͅચɺ;ੴ੮ ɘɻ͐ʮ˦ʡ੮ ɺʮΈɘ̼̼ʇˑ;ੴ੮ ˺̼੮ ɺ˺͐ʩʇ̼ʮ˦ʡ੮ ɻɘˑˑʇ̼ͅ੮ ɺ;੮ ͐ʩʇʮ̼੮ ͷʇ̼;੮ ̹̼ʇͅʇ˦ɻʇੳ੮ rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩɘ͐੮ʠ˺̼੮{/õੴ੮ુʮ͐ૄͅ੮ɘˑˑ੮ɻʮ͐ʮΈʇ˦੮ʡʇ˦ʇ̼ɘ͐ʇʁੳ੮/ͷʇ˦੮͐ʩʇ੮ä{Ûî੮ ͐ʇɘ˚ͅ੮ʁ˺˦ૄ͐੮ʡ˺੮˺͙͐੮ɘ˦ʁ੮̹̼˺ɘɻ͐ʮͷʇˑ;੮ˑ˺˺ˌ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͐˺੮ͅɘ;ੴ੮ૃPʇ;ੴ੮͸ʇૄ̼ʇ੮˺ɺͅʇ̼ͷʮ˦ʡ੮ ;˺͙੮̼ʮʡʩ͐੮˦˺͸ੴ੮ɘ˦ʁ੮;˺͙ૄ̼ʇ੮͙˦ɘɺˑʇ੮͐˺੮ɻɘ̼ʇ੮ʠ˺̼੮;˺͙̼ͅʇˑʠੳૄૂ৿੮šϲϲʮɻʇ̼੮Pʇ̼˚ɘ˦ੴ੮͸ʩ˺੮ ʩɘ˦ʁˑʇͅ੮ɻ˺˚˚͙˦ʮ͐;੮˺͙̼͐ʇɘɻʩ੮͸ʮ͐ʩ੮{/õੴ੮ͅɘʮʁ੮ͅʩʇ੮˚˺˦ʮ͐˺̼ͅ੮ɻ˺˚˚͙˦ʮ͐;੮̹ɘʡʇͅ੮˺˦੮ Hɘɻʇɺ˺˺ˌ੮ɘ˦ʁ੮‡ʇͽ͐)˺˺̼ੳɻ˺˚੮͐˺੮ʮʁʇ˦͐ʮʠ;੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʮ̼̼ʮ͐ɘ͐ʮ˦ʡ੮˦ʇʮʡʩɺ˺̼ͅੴ੮ɺ͙ͅʮ˦ʇͅͅ੮˺͸˦ʇ̼ͅੴ੮˺̼੮̹ʇʁʇ̼͐ͅʮɘ˦ͅੳ îʩʇ̼ʇ੮ɘ̼ʇ੮˚˺̼ʇ੮̹ʇ˺̹ˑʇ੮͐ʩɘ˦੮ʇͷʇ̼੮ʩɘͷʮ˦ʡ੮ɻ̼ʮͅʇͅ੮ʮ˦੮̹͙ɺˑʮɻ੮͐˺੮ɻ˺˚̹ˑɘʮ˦੮ɘɺ˺͙͐ੳ੮ ä͐ɘ̼͐ʮ˦ʡ੮ʮ˦੮৲ৰৱ৴ੴ੮ɘ੮ʁʇɻɘʁʇચˑ˺˦ʡ੮ʁʇɻˑʮ˦ʇ੮ʮ˦੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮̼ʇͷʇ̼ͅʇʁੳ੮ P˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ʮ˦ɻ̼ʇɘͅʇʁ੮ ৴৲੮ ̹ʇ̼ɻʇ˦͐੮ ɺ;੮ ৲ৰ৲ৰੳ਀੮ îʩʇ੮ ͙˦ͅʩʇˑ͐ʇ̼ʇʁ੮ ɘ̼ʇ੮ ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ ʮ˦੮͙ͅɺ͙̼ɺɘ˦੮ɘ˦ʁ੮̼͙̼ɘˑ੮ɘ̼ʇɘͅ੮ɘɻɻ͙͐ͅ˺˚ʇʁ੮͐˺੮ͷʮʇ͸ʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ɘͅ੮ɘ˦੮͙̼ɺɘ˦ੴ੮ ɻ˺ɘ͐ͅɘˑ੮̹̼˺ɺˑʇ˚ੳ੮U˦੮ˑɘ˚ʇʁɘ੮#˺͙˦͐;ੴ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮˦ʇɘ̼ˑ;੮ʁ˺͙ɺˑʇʁ੮ʠ̼˺˚੮৲ৰৱ৷੮͐˺੮ ৲ৰ৲ৱੳ੮îʩʇ੮ͷɘ͐ͅ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮͐ʩʇ੮͙˦ʩ˺͙ͅʇʁ੮͸ʇ̼ʇ੮ˑ˺˦ʡ͐ʮ˚ʇ੮ɻ˺͙˦͐;੮̼ʇͅʮʁʇ˦͐ͅੳਁ Calls to ̹˺ˑʮɻʇ੮ʠ˺̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʩ˺ˑʁͅ੮ʡ̼ʇ͸੮ʮ˦੮͐ɘ˦ʁʇ˚ੳਂ Øʇ̼ʩɘ̹ͅ੮ ɘ੮ ˚˺̼ʇ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ʠɘɻ͐˺̼੮ ʮͅ੮ ˦˺͐੮ ͐ʩʇ੮ ή͙ɘ˦͐ʮ͐;੮ ˺ʠ੮ ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇ੮ ɺ͙͐੮ɘ੮ʁʇʡ̼ɘʁɘ͐ʮ˺˦੮ʮ˦੮͐ʩʇ੮ɺʇʩɘͷʮ˺̼੮˺ʠ੮ɘ੮ͷʮͅʮɺˑʇ੮˚ʮ˦˺̼ʮ͐;੮˺ʠ੮͐ʩʇ˚ੳ੮Ø˺ˑʮ͐ʮɻʮɘ˦ͅ੮ɘ˦ʁ੮ ͐ʩʇ੮ ʡʇ˦ʇ̼ɘˑ੮ ̹͙ɺˑʮɻ੮ ͷʮʇ͸੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ɘͅ੮ ͙ɺʮή͙ʮ͐˺͙ͅ੮ ɘ˚˺˦ʡ੮ ͙˦ʩ˺͙ͅʇʁ੮ ̹ʇ˺̹ˑʇੴ੮ ɘˑ͐ʩ˺͙ʡʩ੮ ɺ˺͐ʩ੮ ͅ˺ɻʮɘˑ੮ ͅɻʮʇ˦͐ʮ͐ͅͅ੮ ɘ˦ʁ੮ ʠʇʁʇ̼ɘˑ੮ ʁɘ͐ɘ੮ ʁʮ̹͙͐ͅʇ੮ ͐ʩʮͅ੮ ɻˑɘʮ˚ੳਃ But cliniɻʮɘ˦ͅ੮ɘ˦ʁ੮ϲʮ̼͐ͅ੮̼ʇ̹ͅ˺˦ʁʇ̼ͅ੮˺˦੮͐ʩʇ੮ʡ̼˺͙˦ʁ੮ͅɘ͸੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ʇˑͅʇ੮ɺʇʩʮ˦ʁ੮͐ʩʇ੮ɻʩɘ˺ͅ੮ ʡʇ˦ʇ̼ɘ͐ʮ˦ʡ੮ ɻ˺˚̹ˑɘʮ˦͐ͅੵ੮ ˚ʇ͐ʩɘ˚̹ʩʇ͐ɘ˚ʮ˦ʇੳ਄ In the shadow of the more mediɘ͐ʮΈʇʁ੮ ˺̹ʮ˺ʮʁ੮ ʇ̹ʮʁʇ˚ʮɻੴ੮ ˚ʇ͐ʩ੮ ˺ͷʇ̼ʁ˺ͅʇ੮ ʁʇɘ͐ʩͅ੮ ʮ˦੮ ͐ʩʇ੮ õ˦ʮ͐ʇʁ੮ ä͐ɘ͐ʇͅ੮ ͸ʇ˦͐੮ ͙̹੮ ৱ৸ৰ੮ ̹ʇ̼ɻʇ˦͐੮ ʠ̼˺˚੮ ৲ৰৱ৵੮ ͐˺੮ ৲ৰৱ৹ੳৼ৻੮ U˦੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ੴ੮ /Û੮ ͷʮͅʮ͐ͅ੮ ̼ʇˑɘ͐ʇʁ੮ ͐˺੮ ˚ʇ͐ʩ੮ ʮ˦ɻ̼ʇɘͅʇʁ੮৶ৰৰ੮̹ʇ̼ɻʇ˦͐੮ɺʇ͐͸ʇʇ˦੮৲ৰৱৱ੮ɘ˦ʁ੮৲ৰৱ৶ੳৼৼ {ʇ͐ʩચʮ˦ʁ͙ɻʇʁ੮ ̹ͅ;ɻʩ˺ͅʮͅ੮ ˑ˺˺ˌͅ੮ ɘ੮ ˑ˺͐੮ ˑʮˌʇ੮ ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘચʮ˦ʁ͙ɻʇʁ੮ ̹ͅ;ɻʩ˺ͅʮͅੳ੮ )̼ੳ੮Ĥʇˑʁʇͅੴ੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮̹̼ɘɻ͐ʮɻʮ˦ʡ੮̼͐ͅʇʇ͐੮˚ʇʁʮɻʮ˦ʇ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʠ˺̼੮ʁʇɻɘʁʇͅੴ੮

CRISIS

55

̼ʇϲˑʇɻ͐ʇʁ੮˺˦੮͐ʩʇ੮ʡ̼˺͸ʮ˦ʡ੮ɻɘˑˑͅ੮ʠ˺̼੮ʩʮͅ੮͐ʇɘ˚੮͐˺੮ુʁ˺੮ͅ˺˚ʇ͐ʩʮ˦ʡૂ੮ɘɺ˺͙͐੮ʁʮ̼͙̹͐ͅʮͷʇ੮ ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇੵ੮ ુîʩʇ੮ ˦ɘ̼̼ɘ͐ʮͷʇ੮ ʮͅੴ੮ ૃĔʇ੮ ʩɘͷʇ੮ ɘˑˑ੮ ͐ʩʇͅʇ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ય˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅરੳૄ੮îʩʇ੮̼ʇɘˑʮ͐;੮ʮͅੴ੮͸ʩɘ͐੮̹ʇ˺̹ˑʇ੮યɻ˺˚̹ˑɘʮ˦ʇ̼ͅર੮ɘ̼ʇ੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮ ͐˺੮ʮͅ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮˚ʇ͐ʩɘ˚̹ʩʇ͐ɘ˚ʮ˦ʇ੮͙ͅʇ̼ͅੴ੮ɘ˦ʁ੮͸ʩ˺੮ɘ̼ʇ੮ɘɻ͐ʮ˦ʡ੮ɺʮΈɘ̼̼ʇˑ;੮ɘ˦ʁ੮ ɺʇʩɘͷʮ˺̼ɘˑˑ;੮ʩʮʡʩˑ;੮ʁ;̼ͅʇʡ͙ˑɘ͐ʇʁੳૂ੮Ĕʩʮˑʇ੮̹ͅ;ɻʩ˺͐ʮɻ੮ͅ;˚̹͐˺˚ͅ੮ʁ͙ʇ੮͐˺੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɘ̼ʇ੮ɻʩɘˑˑʇ˦ʡʮ˦ʡ੮͐˺੮̼͐ʇɘ͐ੴ੮͐ʩ˺ͅʇ੮ʠ̼˺˚੮˚ʇ͐ʩ੮ͅʇʇ˚ʇʁ੮ʮ˦͙̼ͅ˚˺͙˦͐ɘɺˑʇੵ੮ુU͐ૄͅ੮̼ʇɘˑˑ;੮ ʩɘ̼ʁੳ੯ੳ੯ੳ੯ੳ੮Ĕʩɘ͐੮ɻ˺͙ˑʁ੮ɺʇ੮˚˺̼ʇ੮ɻ˺˚̹ʇˑˑʮ˦ʡ੮͐ʩɘ˦੮ɘ੮ɺˑɘ͐ͅ੮˺ʠ੮˚ʇ͐ʩɘ˚̹ʩʇ͐ɘ˚ʮ˦ʇ੺ૂ੮ ʩʇ੮˚͙ͅʇʁੳ੮˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻͅ੮ɻɘ˦੮ɺˑ͙˦͐੮͐ʩʇ੮ɘɻ͙͐ʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮˚ʇ͐ʩ੮̹ͅ;ɻʩ˺ͅʮͅੴ੮ɺ͙͐੮ ɻʩ̼˺˦ʮɻ੮˚ʇ͐ʩ੮͙ͅʇ੮ɻɘ˦੮ɻ̼ʇɘ͐ʇ੮̹ʇ̼˚ɘ˦ʇ˦͐੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅੳ Ø˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅૄ੮˺̹͐ʮ˺˦ͅ੮ʠ˺̼੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮͐˺੮ʁ̼͙ʡચ̼ʇˑɘ͐ʇʁ੮ɻ˺˚̹ˑɘʮ˦͐ͅ੮ʩɘͷʇ੮ʁ͸ʮ˦ʁˑʇʁੳ੮Ø̼˺̹˺ͅʮ͐ʮ˺˦੮৴৷ੴ੮ɘ̹̹̼˺ͷʇʁ੮ɺ;੮#ɘˑʮʠ˺̼˦ʮɘ˦੮ͷ˺͐ʇ̼ͅ੮ʮ˦੮৲ৰৱ৴੮͐˺੮ˑʮ˚ʮ͐੮˚ɘͅͅ੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦ੴ੮ ˚ʇɘ˦ͅ੮ ɘ˦੮ ɘ̼̼ʇ͐ͅ੮ ʠ˺̼੮ ̹˺ͅͅʇͅͅʮ˺˦੮ ʮͅ੮ ͙˦ˑʮˌʇˑ;੮ ͐˺੮ ˑʇɘʁ੮ ͐˺੮ ˈɘʮˑ੮ ͐ʮ˚ʇੳৼ৽੮ îʩʮͅ੮ ͅʇʇ˚ͅ੮͐˺੮̼ʇϲˑʇɻ͐੮ɘ੮ɺ̼˺ɘʁʇ̼੮ɻ͙ˑ͙̼͐ɘˑ੮ͅʩʮʠ͐ੳ੮ͅ੮šϲϲʮɻʇ̼੮Pʇ̼˚ɘ˦੮̼ʇɻ˺͙˦͐ʇʁੴ੮ુĔʩʇ˦੮ U੮ɻɘ˚ʇ੮˺˦੮ʮ˦੮৲ৰৰৰੴ੮U੮͸˺͙ˑʁ˦ૄ͐੮ʡʇ͐੮˚ɘ˦;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘˑˑͅੳ੮U˦͐ͅʇɘʁੴ੮̹ʇ˺̹ˑʇ੮͸˺͙ˑʁ੮ ɻɘˑˑ੮৹ৱৱ੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃU੮ʩɘͷʇ੮ɘ੮̹ʇ̼ͅ˺˦੮˺˦੮ʁ̼͙ʡͅ੮ɘɻ͐ʮ˦ʡ੮ʇ̼̼ɘ͐ʮɻੴ੮ɻɘ͙ͅʮ˦ʡ੮ɘ੮ʁʮ͙̼͐ͅɺɘ˦ɻʇੴ੮ ͐ʩʇ;ૄ̼ʇ੮ ɘ੮ ɻ̼ʮ˚ʮ˦ɘˑੴ੮ U੮ ͸ɘ˦͐੮ ͐ʩʇ˚੮ ɘ̼̼ʇ͐ͅʇʁੳૄૂ੮ î˺ʁɘ;ੴ੮ ͐ʩ˺͙ʡʩੴ੮ ુ͐ʩʇ;੮ ય͐ʩʇ੮ ̹͙ɺˑʮɻર੮ ɻʩɘ˦ʡʇʁ੮͐ʩʇʮ̼੮˚ʮ˦ʁͅʇ͐੮˺ʠ੮͸ʩɘ͐੮͐ʩʇ;੮͸ɘ˦͐ʇʁ੮͐˺੮ɻɘˑˑ੮ૃɻ̼ʮ˚ʇૄ੮ɻ˺˚̹ɘ̼ʇʁ੮͐˺੮ૃ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩੴૄ੮ɘ˦ʁ੮͐ʩʇ;ૄͷʇ੮ɺ˺͙ʡʩ͐੮͐ʩʇ੮ʮʁʇɘ੯ੳ੯ੳ੯ੳ੮͐ʩɘ͐੮ʁ̼͙ʡ੮͙ͅʇ੮ʮͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩੳૂ੮îʩʇ੮̹͙ɺˑʮɻ੮˦˺͸੮ʇͽ̹ʇɻ͐ͅ੮˺ϲϲʮɻʇ̼ͅ੮͐˺੮̼͐;੮͐˺੮ʡʇ͐੮ʁ̼͙ʡ੮͙ͅʇ̼ͅ੮ʮ˦͐˺੮ͅʇ̼ͷʮɻʇͅੳ "͙͐੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ͅʇ̼ͷʮɻʇͅ੮ɘ̼ʇ੮ͅ˺̼ʇˑ;੮ˑɘɻˌʮ˦ʡ੮ɘ˦ʁ੮ʮ˦ɘɻɻʇͅͅʮɺˑʇੳৼ৾੮U˦੮ʇɘ̼ˑ;੮৲ৰ৲৲ੴ੮ U੮͸ʇ˦͐੮˺˦੮ɘ੮̼ʮʁʇચɘˑ˺˦ʡ੮ʮ˦੮ˑɘ˚ʇʁɘ੮#˺͙˦͐;੮͸ʮ͐ʩ੮šϲϲʮɻʇ̼੮Pɘ̼ʁʇ˦ੴ੮ɘ੮̼ʇɘˑ੮ʇ͐ͅɘ͐ʇ੮ ɘʡʇ˦͐੮ ͙̼͐˦ʇʁ੮ ɻ˺̹੮ ͸ʩ˺੮ ʮͅ੮ ɘˑͅ˺੮ ɘ੮ ɺˑɘɻˌ੮ ɺʇˑ͐੮ ʮ˦੮ ˈ͙ˈʮ͙͐ͅ੮ ɘ˦ʁ੮ ʡʮͷʇͅ੮ ˚ʇ੮ ɻ˺˚̹ʇˑˑʮ˦ʡ੮ ɘ̼ʡ͙˚ʇ˦͐ͅ੮ ʠ˺̼੮ ͅ͸ʮ͐ɻʩʮ˦ʡ੮ ͐˺੮ ɘ੮ nʇ͐˺੮ ʁʮʇ͐ੳ੮ Ĕʇ੮ ͐ͅɘ̼͐੮ ˺͙̼੮ ʁɘ;੮ ͸ɘ͐ɻʩʮ˦ʡ੮ ɘ੮ ͸ʇɺʮ˦ɘ̼੮ ʠ̼˺˚੮͐ʩʇ੮Pʇɘˑ͐ʩ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺˦੮͐ʩʇ੮ુ̹̼ʇɻʮ̹ʮ͐˺͙ͅ੮̼ʮͅʇ੮ʮ˦੮͐ͅʮ˚͙ˑɘ˦͐੮˺ͷʇ̼ʁ˺ͅʇͅૂ੮ʮ˦੮ ͐ʩʇ੮̹ɘ͐ͅ੮ʠʇ͸੮;ʇɘ̼ͅੳ੮Pɘ̼ʁʇ˦੮ʮͅ੮ʡʇ˦͙ʮ˦ʇˑ;੮ʇͽɻʮ͐ʇʁ੮ɘɺ˺͙͐੮͐ʩʇ੮˦ʇ͸੮ɻ˺͙˦͐;੮#Û/ä੮ ફ#˺˚˚͙˦ʮ͐;੮ͅͅʇͅͅ˚ʇ˦͐ੴ੮Ûʇʠʇ̼̼ɘˑੴ੮ɘ˦ʁ੮/˦ʡɘʡʇ˚ʇ˦͐੮äʇ̼ͷʮɻʇͅબ੮#ʇ˦͐ʇ̼ੴ੮͸ʩʮɻʩ੮ʮͅ੮ ɘ੮ˌʮ˦ʁ੮˺ʠ੮˺˦ʇચ͐ͅ˺̹੮ͅʩ˺̹੮ʠ˺̼੮ͅʮʡ˦ʮ˦ʡ੮͙̹੮ʠ˺̼੮ʩ˺͙ͅʮ˦ʡ੮ɘ˦ʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮šϲϲʮɻʇ̼ͅ੮ɻɘ˦੮ ʁ̼˺̹੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮ɘͅ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ɘ̼̼ʇ͐ͅʮ˦ʡ੮͐ʩʇ˚੮ʠ˺̼੮ɘ੮˚ʮͅʁʇ˚ʇɘ˦˺̼ੳ U੮ɘɻɻ˺˚̹ɘ˦;੮ɘ੮#Û/ä੮ͅɘˑʇͅ੮͐ʇɘ˚੮˺ʠ੮ʠ˺͙̼੮ɘ̼˚ʇʁ੮˺ϲϲʮɻʇ̼ͅ੮͐˺੮ɘ੮ͅ˚ɘˑˑ੮ʇ˦ɻɘ˚̹˚ʇ˦͐੮ɺ;੮͐ʩʇ੮ͅʮʁʇ੮˺ʠ੮ɘ੮ʠ̼ʇʇ͸ɘ;੮ʮ˦੮ˑɘ˚ʇʁɘੳ੮U͐ૄͅ੮ɘ੮͸ʇˑˑચ˚ɘʮ˦͐ɘʮ˦ʇʁ੮̹ͅɘɻʇੴ੮͸ʮ͐ʩ੮ɘ੮ ʩɘ̹ʩɘΈɘ̼ʁ੮̹ˑ;͸˺˺ʁ੮͸ɘˑˑ੮͙̼̼ͅ˺͙˦ʁʮ˦ʡ੮͐ʩ̼ʇʇ੮͐ʇ˦͐ͅੴ੮̹̼˺̹ɘ˦ʇ੮͐ͅ˺ͷʇੴ੮ɘ˦ʁ੮ɘ੮ɺɘ͐ʩʮ˦ʡ੮ ɘ̼ʇɘ੮ʮ˦੮ɘ˦੮ɘʁˈɘɻʇ˦͐੮ɻʮ͐ͅʇ̼˦ੳ੮šϲϲʮɻʇ̼੮Pɘ̼ʁʇ˦ૄͅ੮̹ɘ̼͐˦ʇ̼ੴ੮äʇ̼ʡʇɘ˦͐੮"̼ʮʡʡͅੴ੮̼ɘ̹ͅ੮˺˦੮ɘ੮ ͐ʇ˦͐ੴ੮ʁʇɻˑɘ̼ʮ˦ʡੴ੮ૃä˺ϲʮɘੴ੮͸ʇ੮ˌ˦˺͸੮;˺͙ૄ̼ʇ੮ʮ˦੮͐ʩʇ̼ʇੴ੮ɻ˺͙ˑʁ੮;˺͙੮ɻ˺˚ʇ੮͐ɘˑˌ੮͐˺੮͙ͅ੮ʠ˺̼੮ɘ੮ ʠʇ͸੮˚ʮ˦͙͐ʇͅ੺ૄ੮੮rɘ͐ʮ˦ɘ੮͸ʩ˺੮ɘ̹̹ʇɘ̼ͅ੮͐˺੮ɺʇ੮ʮ˦੮ʩʇ̼੮͐ʩʮ̼͐ʮʇͅ੮ʇ˚ʇ̼ʡʇͅੴ੮ˑ˺˺ˌʮ˦ʡ੮ʡ̼˺ʡʡ;ੳ੮ äʩʇ੮ʩɘͅ੮ɘ੮ɺˑɘɻˌ੮ʇ;ʇੳ ૃĔʩɘ͐੮ʩɘ̹̹ʇ˦ʇʁ੮͐˺੮;˺͙̼੮ʇ;ʇ੺ૄ੮Pɘ̼ʁʇ˦੮ɘͅˌͅੳ

56

T H E C O N S E RVATO R S H I P C O N T I N U U M

Pʇ̼੮̹ͅʇʇɻʩ੮ʮͅ੮ͅˑ͙̼̼ʇʁੳ੮ફPɘ̼ʁʇ˦੮ɺʇˑʮʇͷʇͅ੮ͅʩʇ੮ʩɘͅ੮ͅʇ̼ʮ˺͙ͅ੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʁɘ˚ɘʡʇ੮ʠ̼˺˚੮ ˚ʇ͐ʩ੮͙ͅʇੳબ੮U੮ʩʇɘ̼੮ૃʠʇˑˑੴૄ੮ɘ˦ʁ੮͐ʩʇ˦੮ૃϲʮʡʩ͐ੳૄ ૃr˺˺ˌͅ੮ˑʮˌʇ੮;˺͙੮ʩɘʁ੮ɘ੮̼˺͙ʡʩ੮˦ʮʡʩ͐ੳ੮Ĕ˺͙ˑʁ੮;˺͙੮ɺʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ʮ˦੮ɻʩʇɻˌʮ˦ʡ੮˺͙͐੮ ͐ʩɘ͐੮ #Û/ä੮ ̹̼˺ʡ̼ɘ˚੮ U੮ ͐˺ˑʁ੮ ;˺͙੮ ɘɺ˺͙͐ૄઝʩʇ੮ ˚ɘˌʇͅ੮ ͐ʩʮͅ੮ ̹ʮ͐ɻʩ੮ ɘ੮ ʠʇ͸੮ ͐ʮ˚ʇͅ੮ ɘ੮ ˚˺˦͐ʩઝૃʡʇ͐੮;˺͙੮ͅ˺˚ʇ੮̼ʇͅ˺͙̼ɻʇͅੴ੮ͅʩʇˑ͐ʇ̼ੴ੮˚ɘ;ɺʇ੮ɘ੮ˈ˺ɺ੺ૄ੮îʩʇ੮͸˺˚ɘ˦੮˦˺ʁͅੳ ૃĚ˺͙੮͸ɘ˦͐੮͐˺੮ɺʇ੮̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮͙̹੮͐ʩʇ̼ʇ੮͐˺ʁɘ;੺ૄ੮ʩʇ੮ɘͅˌͅੴ੮ɻˑʇɘ̼ˑ;੮͙̼̹̼ͅʮͅʇʁੳ੮äʩʇ੮ ˦˺ʁͅ੮ɘʡɘʮ˦ੳ ૃšˌɘ;ੴ੮ˑʇ͐੮˚ʇ੮˚ɘˌʇ੮ɘ੮̹ʩ˺˦ʇ੮ɻɘˑˑ੮ય͐˺੮#Û/äરੴૄ੮Pɘ̼ʁʇ˦੮ʁʇɻˑɘ̼ʇͅੴ੮ʇͽ͙ɺʇ̼ɘ˦͐ˑ;ੳ îʩʇ੮ ͸˺˚ɘ˦੮ ͐ͅɘ̼͐ͅ੮ ͐ʩ̼˺͸ʮ˦ʡ੮ ɘ੮ ʠʇ͸੮ ʮ͐ʇ˚ͅ੮ ʮ˦੮ ɘ੮ ɺɘɻˌ̹ɘɻˌੳ੮ "̼ʮʡʡͅ੮ ͐ͅʇ̹ͅ੮ ʮ˦੮ ͐˺੮ ʇͽ̹ˑɘʮ˦ੴ੮ૃU͐ૄͅ੮˦˺͐੮͐˺੮͐ɘˌʇ੮;˺͙੮ʁʮ̼ʇɻ͐ˑ;੮͐˺੮ʩ˺͙ͅʮ˦ʡੴ੮ˈ͙͐ͅ੮ʩʇˑ̹ʮ˦ʡ੮;˺͙੮˚ɘˌʇ੮ɻ˺˦˦ʇɻ͐ʮ˺˦ͅੳ੮Ě˺͙੮ɻɘ˦੮ˑʇɘͷʇ੮;˺͙̼੮͙͐ͅʠʠੳૄ Ĕʩʮˑʇ੮šϲϲʮɻʇ̼੮Pɘ̼ʁʇ˦੮ʮͅ੮˺˦੮͐ʩʇ੮̹ʩ˺˦ʇੴ੮ɘ˦˺͐ʩʇ̼੮˺ϲϲʮɻʇ̼੮ʮͅ੮̹ɘ͐͐ʮ˦ʡ੮ʁ˺͸˦੮ɘ੮̼ɘʮˑચ ͐ʩʮ˦ੴ੮ͅʩʮ̼͐ˑʇͅͅ੮˚ɘ˦ੴ੮͸ʩ˺੮ʩɘʁ੮ʇ˚ʇ̼ʡʇʁ੮ʠ̼˺˚੮ɘ˦˺͐ʩʇ̼੮͐ʇ˦͐ੳ੮îʩʇ੮˺ϲϲʮɻʇ̼੮ɻ˺˚ʇͅ੮˺ͷʇ̼੮ ͐˺੮"̼ʮʡʡͅੴ੮̼ʇ̹˺̼͐ʮ˦ʡੴ੮ૃUʠ੮ͅʩʇ੮યä˺ϲʮɘર੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮#Û/äੴ੮ʩʇૄˑˑ੮ʡ˺੮͐˺˺ੳૄ "͙͐੮ɘ͐੮͐ʩʮͅ੮̹˺ʮ˦͐ੴ੮šϲϲʮɻʇ̼੮Pɘ̼ʁʇ˦੮ʩɘͅ੮ͅ˺˚ʇ੮ɺɘʁ੮˦ʇ͸ͅੵ੮ૃ#Û/ä੮ͅɘʮʁ੮͐ʩʇʮ̼੮ɻˑʮ˦ʮɻʮɘ˦੮ʮͅ੮˺˦੮ͷɘɻɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮͐ʩʇ੮̼ʇ̹ˑɘɻʇ˚ʇ˦͐੮ʁʮʁ˦ૄ͐੮ɻ˺˚ʇ੮ʮ˦ੳ੮"͙͐੮͐ʩʇ;੮ͅɘ;ੴ੮ৱৰৰ੮̹ʇ̼ɻʇ˦͐ੴ੮͸ʇ੮ɻɘ˦੮ɺ̼ʮ˦ʡ੮͐ʩʇ˚੮͐˺˚˺̼̼˺͸ੳૄ äʇ̼ʡʇɘ˦͐੮"̼ʮʡʡͅ੮ʇͽɻˑɘʮ˚ͅੴ੮ૃîʩʇ̼ʇૄͅ੮ɘ੮ৱৰৰ੮̹ʇ̼ɻʇ˦͐੮ɻʩɘ˦ɻʇ੮͐ʩɘ͐੮˚ʇ͐ʩ੮͸ʮˑˑ੮˚ɘˌʇ੮ ʮ͐੮ ͐˺੮ ͐ʩʮͅ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐੮ ͐˺˦ʮʡʩ͐੮ ɘ˦ʁ੮ ͐ʩʇ;੮ ͸˺˦ૄ͐੮ ʡ˺੮ ͐˺˚˺̼̼˺͸੸ૄ੮ îʩʇ;੮ ͸ʇ̼ʇ੮ ʇɘɻʩ੮ ৵ৰ੮̹ʇ̼ɻʇ˦͐੮̼ʮʡʩ͐ੵ੮͐ʩʇ੮˦ʇͽ͐੮ʁɘ;ੴ੮ä˺ϲʮɘ੮͐ͅʮˑˑ੮͸ɘ˦͐ʇʁ੮͐˺੮ʡ˺ੴ੮͐ʩʇ੮˺͐ʩʇ̼੮˚ɘ˦੮ʁʮʁ˦ૄ͐ੳ੮ͅ੮ ɺ˺͐ʩ੮ɻ˺̹ͅ੮ɘ˦ʁ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮͸ʮˑˑ੮͐ʇˑˑ੮;˺͙ੴ੮̹ʇ˺̹ˑʇૄͅ੮˺̹ʇ˦˦ʇͅͅ੮͐˺੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮̼͐ʇɘ͐˚ʇ˦͐੮˚ʮʡʩ͐੮ˑɘ͐ͅ੮ˈ͙͐ͅ੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅ੮ɘʠ͐ʇ̼੮ɘ੮ɺɘʁ੮̼͐ʮ̹੮˺̼੮ɘ੮̼ʇͷʇ̼ͅʇʁ੮˺ͷʇ̼ʁ˺ͅʇੳ੮"͙͐੮˚˺͐ͅ੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ͅʇ̼ͷʮɻʇͅ੮ɘ̼ʇ੮˦ʮ˦ʇચ͐˺ચϲʮͷʇ੮˺̹ʇ̼ɘ͐ʮ˺˦ͅੳৼ৿ /ͷʇ˦੮ʮ˦੮ɻ˺͙˦͐ʮʇͅ੮͐ʩɘ͐੮ʩɘͷʇ੮৲৴ઃ৷੮ʁʇ͐˺ͽ੮˺̼੮ʁ̼˺̹ચʮ˦੮ɻʇ˦͐ʇ̼ͅੴ੮̹ʇ˺̹ˑʇ੮ʩɘͷʇ੮͐˺੮ʡ˺੮ ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ੮ä˺੮͸ʩʇ˦੮˺ϲϲʮɻʇ̼ͅ੮ɘ̼ʇ੮ʠɘɻʇʁ੮͸ʮ͐ʩ੮ɻ˺˚̹ˑɘʮ˦͐ચʡʇ˦ʇ̼ɘ͐ʮ˦ʡ੮ɺʇʩɘͷʮ˺̼੮͐ʩʇ;੮ ɻɘ˦ૄ͐੮ʮʡ˦˺̼ʇ੮ɺ͙͐੮ʠ˺̼੮͸ʩʮɻʩ੮ɘ˦੮ɘ̼̼ʇ͐ͅ੮ͅʇʇ˚ͅ੮ʠ͙͐ʮˑʇੴ੮͐ʩʇ;੮ʠʇʇˑ੮͐ʩʇ;੮ʩɘͷʇ੮˺˦ˑ;੮˺˦ʇ੮ ˺̹͐ʮ˺˦ੵ੮ ͸̼ʮ͐ʮ˦ʡ੮ ɘ੮ ৵ৱ৵ৰੳ੮ ˑɘ˚ʇʁɘ੮ ʮͅ੮ ɘ੮ ͐ͅɘ˦ʁચ˺͙͐੮ ɘ˚˺˦ʡ੮ ˑɘ̼ʡʇ੮ ɻ˺͙˦͐ʮʇͅ੮ ʠ˺̼੮ ʩ˺͸੮ ˑʮ͐͐ˑʇ੮ʮ͐੮ʩɘͅ੮ʮ˦ͷʇ͐ͅʇʁ੮ʮ˦੮˦˺˦ચ̹˺ˑʮɻʇ੮ɻ̼ʮͅʮͅ੮̼ʇ̹ͅ˺˦ͅʇ੮͐ʇɘ˚ͅੵ੮ʮ͐੮ʩɘͅ੮˺˦ˑ;੮ϲʮͷʇ੮˚˺ɺʮˑʇ੮ ɻ̼ʮͅʮͅ੮͐ʇɘ˚ͅ੶੮ʇή͙ʮͷɘˑʇ˦͐ˑ;ચͅʮΈʇʁ੮äɘ˦͐ɘ੮#ˑɘ̼ɘ੮ʩɘͅ੮͐͸ʮɻʇ੮ɘͅ੮˚ɘ˦;ੳৼ਀ So it is no sur̹̼ʮͅʇ੮͐ʩɘ͐੮ɘ͐੮ˑɘ˚ʇʁɘ૊ͅ੮˚ɘʮ˦੮ͅɘʠʇ͐;ચ˦ʇ͐੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑੴ੮k˺ʩ˦੮Iʇ˺̼ʡʇੴ੮ͷʮ̼͙͐ɘˑˑ;੮ʇͷʇ̼;˺˦ʇ੮ʮͅ੮˺̼ʮʡʮ˦ɘˑˑ;੮ʁʇ͐ɘʮ˦ʇʁ੮ɺ;੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੳৼਁ੮"͙͐੮ɘͅ੮;˺͙ૄˑˑ੮ͅʇʇ੮ʮ˦੮ ͐ʩʇ੮˦ʇͽ͐੮ɻʩɘ̹͐ʇ̼ੴ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮ɺʇʩɘͷʮ˺̼੮͸ʇૄ̼ʇ੮ʁʮͅɻ͙ͅͅʮ˦ʡઝɘ͐੮͐ʩʇ੮ɺ˺̼ʁʇ̼੮ɺʇ͐͸ʇʇ˦੮ ʮˑˑʇʡɘˑચɘ˦ʁચʁɘ˦ʡʇ̼˺͙ͅ੮ɘ˦ʁ੮ˑʇʡɘˑચɺ͙͐ચʁʮ̼͙̹͐ͅʮͷʇੴ੮ɘ˦ʁ੮˚ɘ;ɺʇ੮ɻɘ͙ͅʇʁ੮ɺ;੮˚ʇ͐ʩ੮͙ͅʇ੮ ̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘ੮ુ̼ʇɘˑૂ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅઝʮͅ੮ˑʮˌʇˑ;੮͐˺੮ˑʇɘʁ੮͐˺੮ɘ੮ή͙ʮɻˌ੮ʁʮͅɻʩɘ̼ʡʇੳ š˦ʇ੮˦͙̼ͅʇ੮͸˺̼ˌʮ˦ʡ੮ɘ͐੮k˺ʩ˦੮Iʇ˺̼ʡʇ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩʇ੮ɘɺ͙̼ͅʁ੮ɺɘɻˌચɘ˦ʁચʠ˺̼͐ʩ੮ɻ̼ʇɘ͐ʇʁ੮ɺ;੮̹˺ˑʮɻʇ੮̹͙ͅʩʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͙˦͸ɘ˦͐ʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮˺˦͐˺੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐ʩɘ͐੮

CRISIS

57

ɘˑͅ˺੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐ʩʇ˚ੵ੮ુĔʇૄͷʇ੮ʩɘʁ੮ͅ˺˚ʇ੮͙͐ʡચ˺ʠચ͸ɘ̼ͅ੮͸ʮ͐ʩ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ ʡʇ͐੮̹ʇ˺̹ˑʇ੮͐ʩɘ͐੮͸ʇ੮ʁʮͅɻʩɘ̼ʡʇ੮ɘ˦ʁ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ˑʇɘͷʇੴ੮ͅ˺੮͸ʇ੮ʩɘͷʇ੮͐˺੮ɻɘˑˑ੮ˑɘ͸੮ ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮͐˺੮̼ʇ˚˺ͷʇ੮͐ʩʇ˚ੳ੮îʩʇ;੮ɘ̹̹̼˺ɘɻʩ੮͐ʩʇ੮ʡ͙;ੴ੮͸ʩ˺੮͐ʇˑˑͅ੮͐ʩʇ˚੮ʩʇ੮͸ɘ˦͐ͅ੮͐˺੮ ʩ͙̼͐੮ʩʮ˚ͅʇˑʠੳ੮îʩʇ˦੮͐ʩʇ੮˺ϲϲʮɻʇ̼੮͸ʮˑˑ੮ͅɘ;ੴ੮ૃU੮ʩɘͷʇ੮͐˺੮̹͙͐੮ʩʮ˚੮ɺɘɻˌ੮˺˦੮ɘ੮ʩ˺ˑʁੳૄ੮Ĕʇ੮ͅɘ;ੴ੮ ૃĔʇ੮͸ʮˑˑ੮ˈ͙͐ͅ੮ʁ̼˺̹੮͐ʩʇ੮ʩ˺ˑʁੳૄ੮˦ʁ੮͸ʇ੮ɻ˺͙ˑʁ੮ʁ˺੮͐ʩʮͅ੮ɘˑˑ੮ʁɘ;ੳૂ੮îʩʮͅ੮ͅʇʇ˚ʇʁ੮ʮ˚̹ˑɘ͙ͅʮɺˑʇ੮͐˺੮˚ʇੴ੮͙˦͐ʮˑ੮ͅʇͷʇ̼ɘˑ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮˺ϲϲʮɻʇ̼ͅ੮ʁʇͅɻ̼ʮɺʇʁ੮̹̼ʇɻʮͅʇˑ;੮͐ʩʮͅ੮̹̼˺ɻʇͅͅ੮ ̹ˑɘ;ʮ˦ʡ੮˺͙͐੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̹ɘ̼ˌʮ˦ʡ੮ˑ˺͐ੳ š˦ʇ੮ɻˑʮ˦ʮɻ੮ʁʮ̼ʇɻ͐˺̼੮ʮ˦੮ˑɘ˚ʇʁɘ੮#˺͙˦͐;੮͙ͅ˚˚ɘ̼ʮΈʇʁ੮͐ʩʇ੮ͅʮ͙͐ɘ͐ʮ˺˦ੵ੮ૃîʩʇ੮̹˺ˑʮɻʇ੮ ͅʇʇ੮ʠ˺ˑˌͅ੮͸ʩ˺੮ɘ̼ʇ੮ʩʮʡʩੳ੮੮৵ৱ৵ৰ੮ʮͅ੮͐ʩʇ੮ʇɘͅʮʇ͐ͅ੮͸ɘ;੮͐˺੮ʡʇ͐੮͐ʩʇ˚੮˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮îʩʇ੮ /Û੮ʮͅ੮˦˺͐੮ɘʁ˚ʮ͐͐ʮ˦ʡ੮͐ʩʇ˚ੴ੮ɘ˦ʁ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ʮͅ੮ͅ˺̼͐੮˺ʠ੮ʠ͙˦ɻ͐ʮ˺˦ɘˑˑ;੮ʁ;ͅʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮ ͐ʩʇ੮͸ɘ;੮ʮ͐੮ʮͅ੮͙̹̹ͅ˺ͅʇʁ੮͐˺ੳૄ੮îʩʮͅ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮ʁ;ͅʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮˚ʇɘ˦ͅ੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ ͸̼ɘɻˌ੮͙̹੮ʇͽ̼͐ɘ˺̼ʁʮ˦ɘ̼;੮˦͙˚ɺʇ̼ͅ੮˺ʠ੮৵ৱ৵ৰͅੳ੮š˦ʇ੮͙͐ͅʁ;੮ʠ̼˺˚੮ˑɘ˚ʇʁɘ੮ʠ˺͙˦ʁ੮͐ʩɘ͐੮ ɘ੮ͅ˚ɘˑˑ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ϲʮͷʇ੮˺̼੮˚˺̼ʇ੮৵ৱ৵ৰͅ੮ɘɻɻ˺͙˦͐ʇʁ੮ʠ˺̼੮৹੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɘˑˑ੮ ɘ˚ɺ͙ˑɘ˦ɻʇ੮ʇ˦ɻ˺͙˦͐ʇ̼ͅ੮ɘ˦ʁ੮৳৹੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɘˑˑ੮ʩ˺ˑʁͅ੮ʮ˦੮͐ʩʇ੮ɻ˺͙˦͐;ੳৼਂ îʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ɘ੮ɻ˺˦ϲʮʁʇ˦͐ʮɘˑ੮ʮ˦ʠ˺̼˚ɘ˦͐੮͸ʮ͐ʩ੮ɘɻɻʇͅͅ੮͐˺੮ɻ˺͙˦͐;੮ʁɘ͐ɘ੮͐˺ˑʁ੮ ˚ʇੴ੮ɘ̼ʇ੮˦˺͐੮͐ʩʇ੮ͅʮɻˌʇ͐ͅ੮˺ʠ੮͐ʩʇ੮ͅʮɻˌ੮ɺ͙͐ੴ੮ʮ˦͐ͅʇɘʁੴ੮̹ʇ˺̹ˑʇ੮˺˦੮͐ʩʇ੮ʇʁʡʇ੮ɺʇ͐͸ʇʇ˦੮˚͙ˑ͐ʮ̹ˑʇ੮ͅ;͐ͅʇ˚ͅ੮˺ʠ੮ɻɘ̼ʇ੮ɘ˦ʁ੮ɻ˺˦̼͐˺ˑੳৼਃ Police have the power to put them on a hold, ɺ͙͐੮ ˦˺͐੮ ͐ʩʇ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ͐˺੮ ˚ɘˌʇ੮ ͐ʩʇ੮ ɻ̼ʮ˚ʮ˦ɘˑ੮ ˈ͙͐ͅʮɻʇ੮ ˺̼੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ͅ੮ ʮ˦͐ʇ̼ͷʇ˦ʇ੮ʮ˦੮ɘ˦;੮ʇ˦ʁ͙̼ʮ˦ʡ੮͸ɘ;ઝ͸ʩʇ͐ʩʇ̼੮ɺ;੮̹̼˺ͷʮʁʮ˦ʡ੮ͷ˺ˑ͙˦͐ɘ̼;੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮ ˺̼੮̹͙ͅʩʮ˦ʡ੮͐ʩʇ˚੮͐˺͸ɘ̼ʁ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ

CONFUSION AND MISUNDERSTANDINGS IN THE “STATE OF EXCEPTION” "ʇʮ˦ʡ੮৵ৱ৵ৰʇʁ੮˚ʮʡʩ͐੮ɺʇ੮ʮ˦੮ͅ˺˚ʇ˺˦ʇૄͅ੮ɺʇ͐ͅ੮ʮ˦͐ʇ̼ʇ͐ͅ੮ɘ˦ʁ੮ɺʇ͐͐ʇ̼੮͐ʩɘ˦੮ɺʇʮ˦ʡ੮ɘ̼̼ʇ͐ͅʇʁੴ੮ ɺ͙͐੮ʮ͐ૄͅ੮˦˺͐੮ɘ੮ɺʇ˦ʮʡ˦੮͸ɘ;੮͐˺੮˚˺ͷʇ੮ɘ੮̹ʇ̼ͅ˺˦੮˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐੮ʠ˺̼੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅੳ੮Øʇ˺̹ˑʇ੮ ͸ʩ˺੮ɘ̼ʇ੮৵ৱ৵ৰʇʁ੮ɘ̼ʇ੮ʩɘ˦ʁɻ͙ʠʠʇʁ੮ɺʇʠ˺̼ʇ੮ɺʇʮ˦ʡ੮̹͙͐੮ʮ˦੮ɘ੮ͅή͙ɘʁ੮ɻɘ̼੮˺̼੮͐ʮʇʁ੮ʁ˺͸˦੮ʠ˺̼੮ ̼͐ɘ˦̹ͅ˺̼͐੮ʮ˦੮ɘ˦੮ɘ˚ɺ͙ˑɘ˦ɻʇੳ੮#ɘ̹͐ɘʮ˦੮"̼ʮɘ˦੮"ʮͽˑʇ̼ੴ੮ʩʇɘʁ੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮͙˦ʮ͐੮ ɘ͐੮rØ)ੴ੮͐˺ˑʁ੮˚ʇ੮̹̼˺͙ʁˑ;੮͐ʩɘ͐੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮ʁɘ͐ɘੴ੮˺˦ˑ;੮ৱੳ৲੮̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮৵ৱ৵ৰͅ੮ʮ˦੮৲ৰ৲ৰ੮ʮ˦ͷ˺ˑͷʇʁ੮ɘ੮ુ͙ͅʇ੮˺ʠ੮ʠ˺̼ɻʇੴૂ੮͸ʩʮɻʩ੮͸˺͙ˑʁ੮ʮ˦ɻˑ͙ʁʇ੮ુɘ˦;͐ʩʮ˦ʡ੮ʠ̼˺˚੮ ɘ੮ ϲʮ̼˚੮ ʡ̼ʮ̹੯ ੳ੯ ੳ੯ ੳ੮ ͐˺੮ ɻ˺˦̼͐˺ˑ੮ ʁʇͷʮɻʇͅੴ੮ ʮੳʇੳ੶੮ îä/Ûੴ੮ ɺɘ͐˺˦ੴ੮ ̹ʇ̹̹ʇ̼੮ ̹̼ͅɘ;ੴ੮ ʇ͐ɻੳૂ੮ Pʇ੮ ʇ˦ɻ˺͙̼ɘʡʇʁ੮˚ʇ੮͐˺੮̹͙ɺˑʮɻʮΈʇ੮͐ʩʮͅ੮͐ͅɘ͐ʮ͐ͅʮɻ੮͐˺੮ͅʩ˺͸੮͐ʩʇ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ɘ˦ʁ੮ɻ˺˚̹ʇ͐ʇ˦͐੮͸ɘ;੮˺ϲϲʮɻʇ̼ͅ੮ʩɘ˦ʁˑʇ੮˚˺͐ͅ੮ɻɘˑˑͅੳ੮U੮ʩʇɘ̼ʁ੮ɘɺ˺͙͐੮̹ˑʇ˦͐;੮˺ʠ੮ʮ˦ɻʮʁʇ˦͐ͅ੮͸ʩʇ̼ʇ੮ ͐ʩʮͅ੮ͅʇʇ˚ʇʁ੮͐˺੮ɺʇ੮̼͙͐ʇੳ੮ä͐ʮˑˑੴ੮͸ʩʇ˦੮;˺͙੮͐ͅɘ̼͐੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮˚ɘ˦;ੴ੮˚ɘ˦;੮৵ৱ৵ৰͅ੮ʠ˺̼੮ ɘ੮ͅʮ˦ʡˑʇ੮̹ʇ̼ͅ˺˦ઝʮ˦੮r˺ͅ੮˦ʡʇˑʇͅੴ੮ϲʮͷʇ੮ʩ͙˦ʁ̼ʇʁ੮̹ʇ˺̹ˑʇ੮ʩɘͷʇ੮ʩɘʁ੮ɘ͐੮ˑʇɘ͐ͅ੮ϲʮʠ͐;੮ફ੸બ੮

58

T H E C O N S E RVATO R S H I P C O N T I N U U M

৵ৱ৵ৰͅઝ͐ʩ˺ͅʇ੮̼ʮͅˌͅ੮ɘʁʁ੮͙̹ੳৼ਄੮˦ʁ੮ͅʮ˦ɻʇ੮"ˑɘɻˌ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ʩ͙ʡʇˑ;੮˺ͷʇ̼̼ʇ̹̼ʇͅʇ˦͐ʇʁ੮ ɘ˚˺˦ʡ੮͐ʩ˺ͅʇ੮͸ʮ͐ʩ੮˚ɘ˦;੮৵ৱ৵ৰ੮ʩ˺ˑʁͅੴ੮͐ʩʇ੮̹˺͐ʇ˦͐ʮɘˑ੮ʠ˺̼੮ʩɘ̼˚੮ʮͅ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮͐ͅɘ̼ˌੳ৽৻ ৵ৱ৵ৰͅ੮ʩɘͷʇ੮ʇ˦˺͙ʡʩ੮̼ʇɘɻʩ੮͐˺੮ɻ̼˺̹੮͙̹੮ʮ˦੮ͅ˺˦ʡ੮ˑ;̼ʮɻͅੵ੮ɺ;੮̼ɘ̹੮ʁ͙˺੮r͙˦ʮΈੴ੮̹͙˦ˌ੮ ɺɘ˦ʁ੮î͙ͅ˦ɘ˚ʮ੮"˺˚ɺੴ੮˺̼੮̼ɘ̹̹ʇ̼੮͙̼͐˦ʇʁ੮̹˺̹੮̹͙˦ˌ੮{ɘɻʩʮ˦ʇ੮I͙˦੮nʇˑˑ;ੳ੮îʩʮͅ੮ʮͅ˦ૄ͐੮ ̹̼˺˺ʠ੮͐ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮͙ɺʮή͙ʮ͐˺͙ͅੴ੮ɘʠʠʇɻ͐ʮ˦ʡ੮ʇͷʇ̼;˺˦ʇ੮̼ʇʡɘ̼ʁˑʇͅͅ੮˺ʠ੮ʠɘ˚ʇੴ੮̹̼ʮͷʮˑʇʡʇੴ੮ ˺̼੮˚͙ͅʮɻɘˑ੮ʡʇ˦̼ʇ੶੮̼ɘ͐ʩʇ̼ੴ੮ʮ͐ૄͅ੮ɘ੮ͅʮʡ˦੮͐ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮ɘ੮ˑʮ͐͐ˑʇ੮ɺʮ͐੮̼ɘ˦ʁ˺˚ੳ੮r˺ˑɘ੮̼͙͐ͅʡʡˑʇʁ੮͸ʮ͐ʩ੮ɺ˺͐ʩ੮ʩʇ̼੮˚ʇ˦͐ɘˑ੮ɘ˦ʁ੮̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩ੮ʠ̼˺˚੮ɘ੮;˺͙˦ʡ੮ɘʡʇੴ੮ɺ͙͐੮ɺ˺͐ʩ੮ʁʇ͐ʇ̼ʮ˺̼ɘ͐ʇʁ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;੮ ͸ʩʇ˦੮ ͅʩʇ੮ ͅˑʮ̹̹ʇʁੴ੮ ʮ˦ˈ͙̼ʇʁ੮ ʩʇ̼੮ ɺɘɻˌੴ੮ ɘ˦ʁ੮ ͸ɘͅ੮ ɺʇʁɺ˺͙˦ʁ੮ ˚͙ɻʩ੮ ˺ʠ੮ ͐ʩʇ੮ ͐ʮ˚ʇੳ੮ äʩʇ੮ ͸ʇ˦͐੮ ̼ʇ̹ʇɘ͐ʇʁˑ;੮ ͐˺੮ ͐ʩʇ੮ /Û੮ ʠ˺̼੮ ̹ɘʮ˦੮ ˚ʇʁʮɻɘ͐ʮ˺˦ͅੴ੮ ɺ͙͐੮ ͸ɘͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮͙̼͐˦ʇʁ੮ɘ͸ɘ;੮ʠ˺̼੮ુʁ̼͙ʡચͅʇʇˌʮ˦ʡੳૂ੮š˦ɻʇੴ੮͐ʩ˺͙ʡʩੴ੮ͅʩʇ੮ɻ˺˦ϲʮʁʇʁ੮͐˺੮ ɘ੮̼ʇͅʮʁʇ˦͐੮͐ʩɘ͐੮ુ˚;੮ɻ˺˚̹ˑɘʮ˦͐ͅ੮યɘɺ˺͙͐੮̹ɘʮ˦ર੮ɘ̼ʇ੮̼͙͐ʇੴ੮ɺ͙͐੮͐ʩʇ̼ʇૄͅ੮ɘ˦˺͐ʩʇ̼੮ͅʮʁʇ੮ ͐˺੮ ͸ʩ;੮ Uૄ˚੮ ʩʇ̼ʇੳ੮ U੮ ʁ˺˦ૄ͐੮ ʠʇʇˑ੮ ͅɘʠʇੴ੮ U੮ ˦ʇʇʁ੮ ͙̹̹ͅ˺̼͐ੴ੮ U੮ ˦ʇʇʁ੮ ʩʇˑ̹ੳૂ੮ îʩʇ੮ ̼ʇͅʮʁʇ˦͐੮ ͐˺ˑʁ੮r˺ˑɘ੮͐ʩɘ͐੮ͅʩʇ੮ʁʮʁ˦ૄ͐੮͐ʩʮ˦ˌ੮ʮ͐੮͸ɘͅ੮ɘ੮ʡ˺˺ʁ੮ʮʁʇɘ੮͐˺੮ʡ˺੮ʩ˺˚ʇੳ੮äʩʇૄʁ੮ɺʇ੮ɺʇ͐͐ʇ̼੮ ͙̹͐ͅɘʮ̼ͅੴ੮͸ʩʇ̼ʇ੮͐ʩʇ੮͐ͅɘʠʠ੮͸ʇ̼ʇ੮ɻɘ̼ʮ˦ʡ੮ɘ˦ʁ੮͸˺͙ˑʁ੮ˑʮ͐ͅʇ˦੮͐˺੮ʩʇ̼ੳ੮U͐੮͸ɘͅ˦ૄ͐੮͙˦͐ʮˑ੮͐ʩʇ;੮ ͸ʩʇʇˑʇʁ੮ʩʇ̼੮ʮ˦͐˺੮͐ʩʇ੮͙˦ʮ͐੮ɘ˦ʁ੮ͅʩʇ੮ʩʇɘ̼ʁ੮͐ʩʇ੮ɻˑʮɻˌ੮˺ʠ੮͐ʩʇ੮ʁ˺˺̼੮ɺʇʩʮ˦ʁ੮ʩʇ̼੮͐ʩɘ͐੮ ͅʩʇ੮̼ʇɘˑʮΈʇʁ੮ɘ੮৷৲ચʩ˺͙̼੮ʩ˺ˑʁ੮˚ʇɘ˦͐੮ʡ˺ʮ˦ʡ੮͐˺੮ɘ੮ˑ˺ɻˌʇʁ੮͸ɘ̼ʁੵ੮ુU੮͸ɘͅ੮ʠ̼ʇɘˌʮ˦ʡ੮˺͙͐ੴ੮ ૃäʩʮ͐ੴ੮͐ʩʮͅ੮ʮͅ੮̼ʇɘˑੳૄૂ îʩʇ੮ ͅʇɻ˺˦ʁ੮ ͐ʮ˚ʇ੮ ͅʩʇ੮ ͸ɘͅ੮ ৵ৱ৵ৰʇʁੴ੮ ͅʩʇ੮ ʩɘʁ੮ ɻɘˑˑʇʁ੮ ɘ੮ ͙ͅʮɻʮʁʇ੮ ʩ˺͐ˑʮ˦ʇ੮ ɘ˦ʁ੮ ͐˺ˑʁ੮ ͐ʩʇ˚੮ͅʩʇ੮͐˺˺ˌ੮ʇˑʇͷʇ˦੮î;ˑʇ˦˺ˑ੮Ø{ͅ੮ફɘ੮ɻ˺˚ɺʮ˦ɘ͐ʮ˺˦੮ͅʇʁɘ͐ʮͷʇ੮ɘ˦ʁ੮̹ɘʮ˦ˌʮˑˑʇ̼બઝ͐˺੮ ͅˑʇʇ̹ੳ੮îʩʇ੮˦ʇͽ͐੮˚˺̼˦ʮ˦ʡੴ੮ͅʩʇ੮͸˺ˌʇ੮͙̹੮͐˺੮ɘ੮ɻɘˑˑ੮ʠ̼˺˚੮ʩʇ̼੮˚˺͐ʩʇ̼ੴ੮͸ʩ˺੮̼ʇ̹˺̼͐ʇʁ੮ ͐ʩɘ͐੮͐͸˺੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅ੮͸ʇ̼ʇ੮ɺɘ˦ʡʮ˦ʡ੮˺˦੮ʩʇ̼੮ʁ˺˺̼੮ɘͅˌʮ˦ʡ੮͸ʩʇ̼ʇ੮r˺ˑɘ੮͸ɘͅੳ੮r˺ˑɘ੮ ˑʇ͐੮ʩʇ̼੮˚˺˚੮ʡʮͷʇ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ʩʇ̼੮ɘʁʁ̼ʇͅͅੳ৽ৼ੮Ĕʮ͐ʩʮ˦੮ɘ੮ʠʇ͸੮˚ʮ˦͙͐ʇͅੴ੮͐ʩʇ;੮ͅʩ˺͸ʇʁ੮͙̹ੳ੮ ુîʩʇ̼ʇ੮͸ʇ̼ʇ੮͐͸˺੮˺ϲϲʮɻʇ̼ͅੴ੮˺˦ʇ੮˚ɘˑʇੴ੮˺˦ʇ੮ʠʇ˚ɘˑʇੳ੮˦ʁ੮͐ʩʇ;੮͸ʇ̼ʇ੮˦ʮɻʇੴ੮˦˺͐੮͐ʩ̼ʇɘ͐ʇ˦ʮ˦ʡ੮ʮ˦੮ɘ˦;੮͸ɘ;ੳૂ੮"͙͐੮͐ʩʇ;੮ʁʮʁ੮͐ʇˑˑ੮ʩʇ̼੮͐ʩʇ;੮͸˺͙ˑʁ੮ɺʇ੮͐ɘˌʮ˦ʡ੮ʩʇ̼੮ɘ͸ɘ;੮ʮ˦੮ɘ੮ͅή͙ɘʁ੮ ɻɘ̼ੳ੮ુU੮͸ɘͅ੮ˑʮˌʇੴ੮ૃ̼ʇ੮;˺͙੮ˌʮʁʁʮ˦ʡ੮˚ʇ੺੮Ĕʩɘ͐੮ɘ˚੮Uੴ੮ɘ੮ɻ̼ʮ˚ʮ˦ɘˑ੺ૄૂ੮äʩʇ੮ɻˑɘʮ˚ʇʁ੮͐ʩʇ;੮ ̼ʇ̹ͅ˺˦ʁʇʁੴ੮ુĔʇˑˑੴ੮͸ʇ੮ˈ͙͐ͅ੮ʁ˺˦ૄ͐੮ˌ˦˺͸੮ʮʠ੮;˺͙ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ʩɘ̼˚੮;˺͙̼ͅʇˑʠੳ੮ä˺੮ʮ͐ૄͅ੮ͅɘʠʇ͐ͅ੮ʮʠ੮͸ʇ੮͐ɘˌʇ੮;˺͙ੳૂ੮äʩʇ੮ɺʇʡʡʇʁ੮͐ʩʇ˚੮͐˺੮ɻɘˑˑ੮ɘ˦੮ɘ˚ɺ͙ˑɘ˦ɻʇ੮ʮ˦͐ͅʇɘʁੳ੮îʩʇ;੮ʮ˦ͅʮ͐ͅʇʁ੮ ʮ͐੮͸ɘͅ˦ૄ͐੮ɘ˦੮˺̹͐ʮ˺˦੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮͸ɘͅ੮ɘ͐੮̼ʮͅˌ੮˺ʠ੮ʩɘ̼˚ੳ੮îʩʇ੮͸ʩ˺ˑʇ੮ુʇͷɘˑ͙ɘ͐ʮ˺˦ૂ੮ˑɘ͐ͅʇʁ੮ ˈ͙͐ͅ੮ɘ੮ʠʇ͸੮˚ʮ˦͙͐ʇͅ੮ɘ˦ʁ੮ʡɘͷʇ੮ʩʇ̼੮ɘˑ˚˺͐ͅ੮˦˺੮˺̹̹˺̼͙͐˦ʮ͐;੮͐˺੮ʇͽ̹ˑɘʮ˦੮ʩʇ̼੮ͅʮ͙͐ɘ͐ʮ˺˦ੳ੮ r˺ˑɘ੮ʮ˦ͅʮ͐ͅʇʁੴ੮ુU੮͸ɘͅ੮ͷʇ̼;੮ɻ˺˚̹ˑʮɘ˦͐੮ɘ˦ʁ੮U੮ʠ˺ˑˑ˺͸ʇʁ੮͐ʩʇʮ̼੮˺̼ʁʇ̼ͅੳ੮"͙͐੮ʮ͐੮͸ɘͅ੮ͅ˺੮ ʁʇʡ̼ɘʁʮ˦ʡૂ੮ ͐˺੮ ɺʇ੮ ɻɘ̼͐ʇʁ੮ ˺ʠʠ੮ ʮ˦੮ ʠ̼˺˦͐੮ ˺ʠ੮ ʩʇ̼੮ ˦ʇʮʡʩɺ˺̼ͅઝɘ˦ʁੴ੮ ʮ˦੮ ʩʇ̼੮ ʇ;ʇͅੴ੮ ɻ˺˚̹ˑʇ͐ʇˑ;੮͙˦˦ʇɻʇͅͅɘ̼;ੴ੮ʡʮͷʇ˦੮͐ʩɘ͐੮ͅʩʇ੮ʩɘʁ੮ɺʇʇ˦੮͐ʩʇ੮˺˦ʇ੮͸ʩ˺੮̼ʇɘɻʩʇʁ੮˺͙͐੮ʠ˺̼੮ʩʇˑ̹ੳ৽৽ /ͷʇ˦੮͸ʮ͐ʩ˺͙͐੮̹ʩ;ͅʮɻɘˑ੮ʠ˺̼ɻʇੴ੮͐ʩʇ̼ʇૄͅ੮ɘ˦੮ʮ˦ʩʇ̼ʇ˦͐੮ͷʮ˺ˑʇ˦ɻʇ੮͐˺੮৵ৱ৵ৰͅੳ੮P˺ˑʁͅ੮͐ʇɘ̼੮ ̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮͐ʩʇʮ̼੮ʇͷʇ̼;ʁɘ;੮ˑʮͷʇͅ੮ɘ˦ʁ੮͐ʩ̼˺͸੮͐ʩʇ˚੮ʮ˦͐˺੮ɘ੮ʠɘ͐ͅચ˚˺ͷʮ˦ʡ੮˚ɘɻʩʮ˦ʇ੮ ͸ʩʇ̼ʇ੮ ̼ʇ̼͐ͅɘʮ˦͐ͅੴ੮ ʠ˺̼ɻʇʁ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ ɘ˦ʁ੮ ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮ ɘ̼ʇ੮ ɻ˺˦͐ͅɘ˦͐੮ ̹˺ͅͅʮɺʮˑʮ͐ʮʇͅੳ੮k˺ʩ˦੮"ˑɘɻˌ੮ʮͅ੮ɘ੮ϲʮͽ͙̼͐ʇ੮˺ʠ੮͐ʩʇ੮ä͐ɘ˦ʮͅˑɘ͙ͅ੮#˺͙˦͐;੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅɻʇ˦ʇੴ੮

CRISIS

59

͸ʩʇ̼ʇ੮ʩʇ੮̼͙˦ͅ੮ɘ੮ʁ̼˺̹ચʮ˦੮̹ͅɘɻʇ੮ɘ˦ʁ੮ʡɘˑˑʇ̼;੮͐ʩɘ͐੮ͅʩ˺͸ɻɘͅʇͅ੮ɘ̼͐੮ɻ̼ʇɘ͐ʇʁ੮ɺ;੮̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅʇͅੳ੮Pʇૄͅ੮ɘˑͅ˺੮ɘ੮˚ʇ˚ɺʇ̼੮˺ʠ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮ Øˑɘ˦˦ʮ˦ʡ੮ #˺͙˦ɻʮˑੳ੮ Ĕʩʇ˦੮ U੮ ̹̼ʇͅʇ˦͐ʇʁ੮ ˚;੮ ͸˺̼ˌ੮ ͐ʩʇ̼ʇੴ੮ ʩʇ੮ ʮ˦ͷʇʮʡʩʇʁ੮ ɘʡɘʮ˦͐ͅ੮ ͐ʩʇ੮ idea of expanding conservatorships and insisted on peer-run programs as the ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੳ੮Pʇ੮͸̼˺͐ʇ੮ɘ੮ʠʇ͸੮˚˺˦͐ʩͅ੮ˑɘ͐ʇ̼੮͐˺੮͙̹ʁɘ͐ʇ੮˚ʇ੮͐ʩɘ͐੮ʩʇ੮͸ɘͅ੮ુ̹ʇ̼ͅ˺˦ɘˑˑ;੯ੳ੯ੳ੯ੳ੮ ʠ˺̼ɻʇ੮̼͐ʇɘ͐ʇʁૂ੮͐ʩ̼˺͙ʡʩ੮ɘ˦੮ુ͙˦ɺʇˑʮʇͷɘɺˑʇ੯ੳ੯ੳ੯ੳ੮˚ʮͽ੮˺ʠ੮ʮˑˑʇʡɘˑ੮˚ʇ͐ʩ˺ʁͅੳૂ੮Pʇ੮͸ɘͅ੮ʩ˺̹ʮ˦ʡ੮ ʩʮͅ੮ ͐ͅ˺̼;੮ ͸˺͙ˑʁ੮ ુʮ˦ɻ̼ʇɘͅʇ੮ ;˺͙̼੮ ʮ˦ͅʮʡʩ͐੮ ʮ˦͐˺੮ ͐ʩʇ੮ ͙˦ɻʇ̼͐ɘʮ˦͐;੮ ˺ʠ੮ #੮ ৵ৱ৵ৰ੮ ʮ˦੮ ̼ʇɘˑʮ͐;੮͐ͅ;ˑʇ੮ʠ˺̼˚ɘ͐ੳૂ ä˺˚ʇ˺˦ʇ੮ˑʮˌʇ੮k˺ʩ˦ੴ੮͸ʩ˺੮̼ʇɘʁʮˑ;੮͐ͅɘ͐ʇͅ੮͐ʩɘ͐੮ʩʇ੮ˑʮͷʇͅ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੴ੮ ͐ͅɘ̼͐ͅ੮ ɘ͐੮ ɘ੮ ʁʮͅɘʁͷɘ˦͐ɘʡʇੴ੮ ɺʇɻɘ͙ͅʇ੮ ɘ੮ ɻ˺˦ʁʮ͐ʮ˺˦੮ ͐ʩɘ͐੮ ɻɘ˦੮ ʇ˦͐ɘʮˑ੮ ʩɘˑˑ͙ɻʮ˦ɘ͐ʮ˺˦ͅੴ੮ʁʇˑ͙ͅʮ˺˦ͅੴ੮˺̼੮̹ɘ̼ɘ˦˺ʮɘ੮˚ɘˌʇͅ੮ʩʮͅ੮ɘɻɻ˺͙˦͐੮͙˦ʠɘʮ̼ˑ;੮͙̹ͅͅʇɻ͐ੳ৽৾੮Ěʇ͐੮k˺ʩ˦ૄͅ੮͐ͅ˺̼;੮ ɻɘ̹͙̼͐ʇͅ੮͐ʩʇ੮ʇ˦ʁ͙̼ʮ˦ʡ੮ʁʮ̼͐ͅʇͅͅ੮͐ʩɘ͐੮ɻɘ˦੮ɺʇ੮ɻɘ͙ͅʇʁ੮ɺ;੮ɘ੮৵ৱ৵ৰੳ੮Pʇ੮̼ʇɻ˺͙˦͐ʇʁ੮ʩ˺͸੮ ʩʮͅ੮ˑʮʠʇ੮͐ͅɘ̼͐ʇʁ੮̹ͅʮ̼ɘˑʮ˦ʡੵ੮ʩʇ੮ɘ˦ʁ੮ʩʮͅ੮ʡʮ̼ˑʠ̼ʮʇ˦ʁ੮͸ʇ̼ʇ੮ͅʇ̹ɘ̼ɘ͐ʮ˦ʡੴ੮͐͸˺੮ʡ˺˺ʁ੮ʠ̼ʮʇ˦ʁͅ੮ ʁʮʇʁੴ੮ɘ˦ʁ੮ʩʇ੮͸ɘͅ੮ͅɻɘ˚˚ʇʁ੮ɺ;੮ʩʮͅ੮̹ɘ̼͐˦ʇ̼੮ʮ˦੮ʩʮͅ੮ͅʮʁʇ੮ɺ͙ͅʮ˦ʇͅͅ੮ͅʇˑˑʮ˦ʡ੮ϲʮ̼ʇ͸˺̼ˌͅੳ੮ Pʇ੮͸ɘͅ੮͐ͅɘ;ʮ˦ʡ੮͸ʮ͐ʩ੮ʩʮͅ੮ɺ̼˺͐ʩʇ̼੮ɘ˦ʁੴ੮ɘ͐੮ͅ˺˚ʇ੮̹˺ʮ˦͐ੴ੮ુʁʮʁ˦ૄ͐੮ˌ˦˺͸੮͸ʩɘ͐੮͸ɘͅ੮̼ʇɘˑ੮ ɘ˦ʁ੮͸ʩɘ͐੮͸ɘͅ˦ૄ͐ૂ੮ɘ˦ʁ੮͐˺˺ˌ੮˺ʠʠ੮̼͙˦˦ʮ˦ʡੴ੮͸ʇɘ̼ʮ˦ʡ੮˺˦ˑ;੮ɘ੮̹ɘʮ̼੮˺ʠ੮ϲˑʮ̹ચϲˑ˺̹ͅੳ੮/ͷʇ˦͙͐ɘˑˑ;ੴ੮ʩʇ੮ˑ˺͐ͅ੮ʇͷʇ˦੮͐ʩ˺ͅʇ੮ɘ˦ʁ੮ʁʇɻʮʁʇʁ੮͐˺੮͸ɘˑˌ੮ɺɘɻˌੳ੮U͐੮͸ɘͅ੮৳੮ӣੳՖੳ Uૄˑˑ੮ ˺ʠʠʇ̼੮ ͐ʩʇ੮ ˦ʇͽ͐੮ ̹ɘ̼͐੮ ˺ʠ੮ k˺ʩ˦ૄͅ੮ ͐ͅ˺̼;੮ ˦ʇɘ̼ˑ;੮ ͷʇ̼ɺɘ͐ʮ˚ੵ੮ ુĔʩʇ˦੮ U੮ ʡʇ͐੮ ʩ˺˚ʇੴ੮ ͐ʩʇ̼ʇૄͅ੮ɘ੮ϲʮ̼ʇ੮ʮ˦੮͐ʩʇ੮ɺɘ̼˦ੴ੮͐ʩʇ̼ʇૄͅ੮̹˺ˑʮɻʇੴ੮͐ʩʇ̼ʇૄͅ੮ɘ˚ɺ͙ˑɘ˦ɻʇͅੴ੮ɘ˦ʁ੮U੮͸ɘˑˌ੮͙̹ੴ੮ɘ˦ʁ੮ U੮ˌ˦˺͸੮͐ʩʇ;ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ͅʩ˺˺͐੮˚ʇੴ੮ɺʇɻɘ͙ͅʇ੮̹˺ˑʮɻʇ੮ͅʩ˺˺͐੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮʇ˦͐ͅੳ੮ U੮ʁ̼˺̹̹ʇʁ੮͐˺੮͐ʩʇ੮ʡ̼˺͙˦ʁੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮˚;੮ɺ̼˺͐ʩʇ̼੮ʩɘʁ੮ɘˑˑ੮˚;੮˚ʇʁʮɻʮ˦ʇͅੴ੮ɘ˦ʁ੮U੮ͅɘʮʁੴ੮ ૃk͙͐ͅ੮˺̹ʇ˦੮͐ʩʇ੮ʁ˺˺̼੮ɘ˦ʁ੮ʡʮͷʇ੮͐ʩʇ˚੮͐˺੮˚ʇੳૄ੮îʩʇ;੮͸˺͙ˑʁ˦ૄ͐੮ʁ˺੮ʮ͐ੳ੮U੮ʩɘʁ੮˺˦ʇ੮˺ʠ੮˚;੮ ɻɘ̼ͅ੮͐ʩʇ̼ʇੴ੮ɘ˦ʁ੮U੮˺̹ʇ˦ʇʁ੮˚;੮̼͙͐˦ˌੴ੮ɘ˦ʁ੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮ɘ˦੮˺ˑʁ੮̹ɘʮ̼੮˺ʠ੮ˈ͙˚̹ʇ̼੮ɻɘɺˑʇͅੳ੮ îʩʇ੮ͅʩʇ̼ʮʠʠͅੴ੮͐ʩʇ੮ϲʮ̼ʇ˚ʇ˦ੴ੮͐ʩʇ੮̹˺ˑʮɻʇ੮͸ʇ̼ʇ੮̼͐;ʮ˦ʡ੮͐˺੮ʡʇ͐੮ɘ̼˺͙˦ʁ੮˚ʇ੮͐˺੮͐ɘɻˌˑʇ੮˚ʇੴ੮ U੮ ˈ͙͐ͅ੮ ʡ̼ɘɺɺʇʁ੮ ͐ʩʇ੮ ˈ͙˚̹ʇ̼੮ ɻɘɺˑʇͅ੯ ੳ੯ ੳ੯ ੳ੮ યɘ˦ʁર੮ ̹͙͐੮ ͐ʩʇ੮ ˈ͙˚̹ʇ̼੮ ɻɘɺˑʇͅ੮ ɘ̼˺͙˦ʁ੮ ˚;੮ ʩʇɘʁੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ͅɘʮʁ੮˺˦੮˚;੮৵ৱ৵ৰ੮̹ɘ̹ʇ̼͸˺̼ˌ੮͐ʩɘ͐੮U੮͸ɘͅ੮̼͐;ʮ˦ʡ੮͐˺੮ʩɘ˦ʡ੮˚;ͅʇˑʠ੮͸ʮ͐ʩ੮ ˈ͙˚̹ʇ̼੮ɻɘɺˑʇͅੳૂ îʩʇ੮ ̹˺ˑʮ͐ʮɻɘˑ੮ ͐ʩʇ˺̼ʮ͐ͅ੮ Iʮ˺̼ʡʮ˺੮ ʡɘ˚ɺʇ˦੮ ɘ̼ʡ͙ʇͅ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ̹ʮ˦˦ɘɻˑʇ੮ ˺ʠ੮ ͐ͅɘ͐ʇ੮ ̹˺͸ʇ̼੮ʮͅ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮ʁʇɻˑɘ̼ʇ੮ɘ੮̎͗ȡ̙ɐ‫˃ף‬ɩ‫ף‬ɐ͆Ʉɐ̙̂ɷ˃ʯੴ੮͙̹ͅͅʇ˦ʁʮ˦ʡ੮͐ʩʇ੮ͷʇ̼;੮ˑʇʡɘˑ੮˺̼ʁʇ̼੮ ͐ʩʇ੮͐ͅɘ͐ʇ੮ʮͅ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮̹̼˺͐ʇɻ͐ੳ৽৿੮H˺̼੮˚ɘ˦;ੴ੮͐ʩʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮˺ʠ੮ɺʇʮ˦ʡ੮৵ৱ৵ৰʇʁ੮ʮͅ੮ ̹̼ʇɻʮͅʇˑ;੮͐ʩɘ͐ੵ੮ɺʇʮ˦ʡ੮̼ʮ̹̹ʇʁ੮ʠ̼˺˚੮ɘ੮͸˺̼ˑʁ੮ʮ˦੮͸ʩʮɻʩ੮͐ʩʇ;੮ɘ̼ʇ੮˺̼ʁʮ˦ɘ̼;੮ɻʮ͐ʮΈʇ˦ͅ੮͐˺੮ ˺˦ʇ੮͸ʩʇ̼ʇ੮͐ʩʇ੮˦˺̼˚ɘˑ੮̼ʮʡʩ͐ͅ੮ʮ˦੮ɘ੮ʁʇ˚˺ɻ̼ɘ͐ʮɻ੮ͅ˺ɻʮʇ͐;੮ɘ̼ʇ੮ʩʇˑʁ੮ʮ˦੮ɘɺʇ;ɘ˦ɻʇੳ੮H˺̼੮ ʇͽɘ˚̹ˑʇੴ੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮ɘ͙ͅͅ˚ʇ੮͐ʩɘ͐੮̹˺ˑʮɻʇ੮ɻɘ˦੮ʁʇ͐ɘʮ˦੮͐ʩʇ˚੮˺˦ˑ;੮ʮʠ੮͐ʩʇ;ૄ̼ʇ੮ɘɻɻ͙ͅʇʁ੮ ˺ʠ੮ ɺ̼ʇɘˌʮ˦ʡ੮ ͐ʩʇ੮ ˑɘ͸ੳ੮ {ɘ˦;੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ ʇͽ̹̼ʇͅͅʇʁ੮ ͐ʩʇʮ̼੮ ͅʩ˺ɻˌ੮ ͙̹˺˦੮ ˑʇɘ̼˦ʮ˦ʡ੮ ͐ʩ̼˺͙ʡʩ੮͐ʩʇʮ̼੮ϲʮ̼͐ͅ੮৵ৱ৵ৰ੮͐ʩɘ͐੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ɺʇ੮ʩʇˑʁ੮ɘʡɘʮ˦͐ͅ੮͐ʩʇʮ̼੮͸ʮˑˑ੮ɺɘͅʇʁ੮˺˦ˑ;੮˺˦੮ɘ੮ ̹̼ʇʁʮɻ͐ʮ˺˦੮͐ʩɘ͐੮͐ʩʇ;੮͸ʮˑˑ੮ɻɘ͙ͅʇ੮ʩɘ̼˚ੳ

60

T H E C O N S E RVATO R S H I P C O N T I N U U M

In this state of exception, police do not read {ɷ̅ȡʯɊȡ੮ ̼ʮʡʩ͐ͅ੮ ફ͸ʩʮɻʩ੮ ͐ʇˑˑ੮ ɘ੮ ɻ̼ʮ˚ʮ˦ɘˑ੮͙̹ͅͅʇɻ͐੮͐ʩɘ͐੮͐ʩʇ;੮ʩɘͷʇ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮̼ʇ˚ɘʮ˦੮ͅʮˑʇ˦͐બੳ੮Øʇ˺̹ˑʇ੮͙˦ʁʇ̼ʡ˺ʮ˦ʡ੮ɘ੮ ৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮͐ʩɘ͐੮̼ʮʡʩ͐ੴ੮ͅʮ˦ɻʇ੮ͅʮˑʇ˦ɻʇ੮ɻ˺͙ˑʁ੮ɺʇ੮ɘ੮ͅʮʡ˦੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮ ુʮ˦͐ʇ̼˦ɘˑˑ;੮̹̼ʇ˺ɻɻ͙̹ʮʇʁૂ੮ફʁʮ̼͐ͅɘɻ͐ʇʁ੮ɺ;੮ʮ˦͐ʇ̼˦ɘˑ੮ͷ˺ʮɻʇͅબ੮ɘ˦ʁ੮̼ʇή͙ʮ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ੮U˦੮šɘˌˑɘ˦ʁੴ੮̹˺ˑʮɻʇ੮ʡʮͷʇ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮ɘ੮৵ৱ৵ৰ੮ɘ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Ûʇͅ˺͙̼ɻʇ੮ #ɘ̼ʁ੮ ફϲʮʡ͙̼ʇ੮ ৲ੳৱબੳ੮ U͐੮ ʇͽ̹ˑɘʮ˦ͅ੮ ͐ʩɘ͐੮ ુ;˺͙੮ ͸ʮˑˑ੮ ɺʇ੮ ͐˺ˑʁ੮ ;˺͙̼੮ ̼ʮʡʩ͐ͅ੮ ɺ;੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮͐ͅɘϲϲૂ੮ˑɘ͐ʇ̼੮˺˦ੳ੮îʩ˺ͅʇ੮̼ʮʡʩ͐ͅ੮͸˺͙ˑʁ੮˦˺͐੮ʮ˦ɻˑ͙ʁʇ੮ɘɻɻʇͅͅ੮͐˺੮ɘ˦੮ɘ͐͐˺̼˦ʇ;੮˺̼੮ɘ੮

2.1 ৵ৱ৵ৰ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ɻɘ̼ʁ ä˃̢̅Ʉɐੵ੮šɘˌˑɘ˦ʁ੮Ø˺ˑʮɻʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐

CRISIS

61

̼ʮʡʩ͐੮͐˺੮ɻ˺˦͐ʇ͐ͅ੮͐ʩʇ੮ʩ˺ˑʁੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮rØä੮ͅ;͐ͅʇ˚੮ɘɻ͙͐ɘˑˑ;੮͙̹ͅͅʇ˦ʁͅ੮͐ʩ˺ͅʇ੮̼ʮʡʩ͐ͅ੮ ʁ͙̼ʮ˦ʡ੮͐ʩʇ੮ͅʇͷʇ˦͐;ચ͐͸˺ચʩ˺͙̼੮৵ৱ৵ৰ੮ɘ˦ʁ੮̼ʇ͐ͅ˺̼ʇͅ੮͐ʩʇ˚੮˺˦ˑ;੮˺˦ɻʇ੮ɘ੮ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮ ৵৲৵ৰ੮ɺʇʡʮ˦ͅੳ৽਀੮îʩɘ͐੮ɻɘ̼ʁ੮ɘˑͅ˺੮˦˺͐ʮϲʮʇͅ੮̹ʇ˺̹ˑʇ੮͐ʩɘ͐੮͐ʩʇ;੮˚ɘ;੮ુ˚ɘˌʇ੮ɘ੮̹ʩ˺˦ʇ੮ɻɘˑˑ੮ ɘ˦ʁઃ˺̼੮ˑʇɘͷʇ੮ɘ੮˦˺͐ʇ੮͐˺੮͐ʇˑˑ੮;˺͙̼੮ʠ̼ʮʇ˦ʁͅ੮˺̼੮ʠɘ˚ʮˑ;੮͸ʩʇ̼ʇ੮;˺͙੮ʩɘͷʇ੮ɺʇʇ˦੮͐ɘˌʇ˦ੳૂ੮ îʩʮͅ੮̹ʩ̼ɘͅʮ˦ʡੴ੮/ͅ˚ʋ੮Ĕʇʮˈ͙˦੮Ĕɘ˦ʡ੮̹˺ʮ˦͐ͅ੮˺͙͐੮ʮ˦੮ʩʇ̼੮ɺ˺˺ˌ੮˺˦੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੴ੮ુʇɻʩ˺ʇͅ੮͐ʩʇ੮͸˺̼ʁʮ˦ʡ੮˺ʠ੮ˌʮʁ˦ɘ̹̹ʮ˦ʡ੮˦ɘ̼̼ɘ͐ʮͷʇͅੳૂ৽ਁ੮îʩʮͅ੮ɻɘ̼ʁ੮ ʮͅ੮ɘˑͅ˺੮˚ʮͅˑʇɘʁʮ˦ʡੳ੮੮̹ʇ̼ͅ˺˦੮ɻɘ˦੮ɺ˺͙˦ɻʇ੮ʠ̼˺˚੮ɘ˦੮/Û੮͐˺੮ɘ˦;੮˦͙˚ɺʇ̼੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ ɺɘͅʇʁ੮˺˦੮ɺʇʁ੮ɘͷɘʮˑɘɺʮˑʮ͐;ੳ੮˦;੮˦˺͐ʇ੮ʮͅ੮ˑʮɘɺˑʇ੮͐˺੮ɺʇ੮ɻ˺˚̹ˑʇ͐ʇˑ;੮ʮ˦ɘɻɻ͙̼ɘ͐ʇੳ U˦੮k˺ʩ˦ૄͅ੮ɻɘͅʇੴ੮͐ʩʇ੮͐ͅɘ̼͐੮˺ʠ੮ʩʮͅ੮৵ৱ৵ৰ੮̼ʇɘˑˑ;੮ʁʮʁ੮ʠʇʇˑ੮ˑʮˌʇ੮ʇ˦͐ʇ̼ʮ˦ʡ੮ɘ੮͐ͅɘ͐ʇ੮˺ʠ੮ʇͽɻʇ̹͐ʮ˺˦ੴ੮˺˦ʇ੮͐ʩɘ͐੮ͅʩɘ̼ʇʁ੮ʠʇɘ͙̼͐ʇͅ੮˺ʠ੮ɘ˦੮ɘ̼̼ʇ͐ͅ੮ɘ˦ʁ੮ͅʇʇ˚ʇʁ੮͐˺੮ʡ˺੮ɺʇ;˺˦ʁ੮ʮ͐ੳ੮Pʇ੮ʇˑɘɺ˺̼ɘ͐ʇʁੵ੮ ુîʩʇ;੮ ɘ̼̼ʇ͐ͅʇʁ੮ ˚ʇੳ੮ îʩʇ;੮ ɻ͙͐੮ ˚;੮ ͸̼ʮ͐ͅͅ੮ ͅ˺੮ ʁʇʇ̹੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ɻ͙ʠʠͅੳ੮ U੮ ʩɘͷʇ੮ ʡɘͅʩʇͅੳ੮îʩʇ;੮ʁ̼ɘʡʡʇʁ੮˚ʇ੮͐˺੮ય͐ʩʇ੮ͅή͙ɘʁ੮ɻɘ̼રੴ੮ɺ͙͐੮U੮͸˺͙ˑʁ˦ૄ͐੮ϲʮ͐ੳ੯ੳ੯ੳ੯ੳ੮ä˺੮͐ʩʇ;੮̹͙͐੮˚ʇ੮ ˺˦੮ɘ੮ʡ͙̼˦ʇ;੮ɘ˦ʁ੮͐˺̼˚ʇ˦͐ʇʁ੮˚ʇ੮ɘˑˑ੮͐ʩʇ੮͸ɘ;੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૂ੮Pʇ੮ɻ˺˦͐ʮ˦͙ʇʁੴ੮ુ/ͷʇ˦੮ ʮʠ੮U੮͸ɘͅ੮৵ৱ৵ৰʇʁੴ੮͐ʩʇ;੮ʩɘʁ੮˦˺੮̼ʮʡʩ͐੮͐˺੮ʠ˺̼ɻʇ੮̼͐ʇɘ͐੮˚ʇੴ੮̼͐ͅɘ̹੮˚ʇ੮ʁ˺͸˦੮͐˺੮ɘ੮ʡ͙̼˦ʇ;ੴ੮ ˑʇɘͷʮ˦ʡ੮˚ʇ੮ʮ˦੮˚;੮˺͸˦੮̹͙ˌʇ੮ʠ˺̼੮͐͸ʇˑͷʇ੮ʩ˺͙̼ͅ੮યɘ͐੮͐ʩʇ੮/Ûરੴ੮̹͙͐੮˚ʇ੮ʮ˦੮ɘ੮ʩɘˑˑ͸ɘ;੮͸ʮ͐ʩ੮ ɺ̼ʮʡʩ͐੮ˑʮʡʩ͐ͅ੮ͅʩʮ˦ʮ˦ʡ੮ʮ˦੮˚;੮ʠɘɻʇੳ੮îʩɘ͐੮͐ʩʇ;੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ʁ˺ੳૂ੮îʩʇ੮̹˺ʮ˦͐੮ ˺ʠ੮ɘ੮͐ͅɘ͐ʇ੮˺ʠ੮ʇͽɻʇ̹͐ʮ˺˦੮ʮͅ੮͐ʩɘ͐੮͸ʩʇ͐ʩʇ̼੮˺̼੮˦˺͐੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʩɘͅ੮͐ʩʇ੮ુ̼ʮʡʩ͐ੴૂ੮ʮ͐੮ ɻɘ˦੮ʁ˺੮ʮ͐੮ɘ˦;͸ɘ;ੳ U੮͸ɘͅ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ɘ̹̹̼ʇɻʮɘ͐ʮͷʇ੮˺ʠ੮k˺ʩ˦ૄͅ੮͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮͐˺੮ͅʩɘ̼ʇ੮ʩʮͅ੮͐ͅ˺̼;ੴ੮͐ʩ˺͙ʡʩੴ੮ ɺʇɻɘ͙ͅʇ੮ʮ͐੮͙ͅʡʡʇ͐ͅͅ੮ʩ˺͸੮ɘ˚ɺʮͷɘˑʇ˦͐੮ͅ˺˚ʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮˺ʠ੮৵ৱ৵ৰͅ੮ɻɘ˦੮ɺʇੳ੮î˺੮˚;੮͙̼̹̼ͅʮͅʇੴ੮ˑɘ͐ʇ̼੮ʮ˦੮˺͙̼੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦ੴ੮k˺ʩ˦੮͐˺ˑʁ੮˚ʇੴ੮ુä˺੮͐ʩʇ੮৵ৱ৵ৰ੮͸ɘͅ੮ɘˑ̼ʮʡʩ͐ੴ੮ɺʇɻɘ͙ͅʇ੮ U੮ʩɘʁ੮ɺʇʇ˦੮ʡ˺ʮ˦ʡ੮˦͙͐ͅੴ੮̼͐;ʮ˦ʡ੮͐˺੮ϲʮʡ͙̼ʇ੮˺͙͐੮ʩ˺͸੮ɘˑˑ੮͐ʩʮͅ੮ʩɘ̹̹ʇ˦ʇʁ੮͐˺੮˚ʇੳ੮U੮ʩɘͷʇ੮ ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੴ੮ɘ˦ʁ੮U੮ɺ̼˺ˌʇੳૂ੮Øʇ˺̹ˑʇ੮ˑʮˌʇ੮k˺ʩ˦੮ɘ̼ʇ੮͐;̹ʮɻɘˑˑ;੮ʁʇʇ˚ʇʁ੮ɘͅ੮ ˦ʇʇʁʮ˦ʡ੮ɘ੮৵ৱ৵ৰ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ˑɘɻˌ੮͐ʩʇ੮ʮ˦ͅʮʡʩ͐੮˦ʇɻʇͅͅɘ̼;੮͐˺੮ͅʇʇˌ੮̼͐ʇɘ͐˚ʇ˦͐੮˺˦੮͐ʩʇʮ̼੮ ˺͸˦ੳ੮"͙͐੮k˺ʩ˦੮ɻˑɘʮ˚ͅ੮ʩʇ੮͸ɘͅ੮ɘˑ̼ʇɘʁ;੮͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮ˌ˦ʇ͸੮͐ʩɘ͐੮ʩʇ੮ɻ˺͙ˑʁ੮ ͙ͅʇ੮ʩʇˑ̹ੳ੮Iʮͷʇ˦੮͐ʩɘ͐੮k˺ʩ˦੮ʮͅ੮ɘͷʮʁˑ;੮ʁʇʁʮɻɘ͐ʇʁ੮͐˺੮ͅʇˑʠચɘʁͷ˺ɻɘɻ;੮ɘ˦ʁ੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐ͅੴ੮ I wonder how he would have responded if a clinician and a person with lived ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ʩɘʁ੮ͅʩ˺͸ʇʁ੮͙̹੮ɘ͐੮ʩʮͅ੮ɺ̼˺͐ʩʇ̼ૄͅ੮ʩ˺͙ͅʇੴ੮˦˺͐੮ɘ੮ʡɘʡʡˑʇ੮˺ʠ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅੳ

DECOMPENSATING AT HOME îʩʇ੮ϲʮ̼͐ͅ੮͐͸˺੮̹ɘ̼͐ͅ੮˺ʠ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ʠ˺ɻ͙ͅ੮˺˦੮͐ʩʇ੮ͅʮ͙͐ɘ͐ʮ˺˦ͅઝʠ̼˺˚੮ͷʮͅʮɺˑʇ੮ɻ̼ʮͅʇͅ੮͐˺੮ ͅʇ̼ʮ˺͙ͅ੮˚ʮ͙ͅ˦ʁʇ̼͐ͅɘ˦ʁʮ˦ʡͅઝ͐ʩɘ͐੮ˑʇɘʁ੮̹ʇ˺̹ˑʇ੮͐˺੮ʡʇ͐੮৵ৱ৵ৰʇʁੳ੮îʩʮͅ੮͐ʩʮ̼ʁ੮̹ɘ̼͐੮ˑ˺˺ˌͅ੮ at the contexts in which people who might seem to meet criteria for an involun͐ɘ̼;੮ʩ˺ˑʁ੮ʁ˺੮˦˺͐੮ʡʇ͐੮̹ˑɘɻʇʁ੮˺˦੮˺˦ʇੳ

62

T H E C O N S E RVATO R S H I P C O N T I N U U M

Ĕʇૄˑˑ੮͐ͅɘ̼͐੮ɘ͐੮ɘˑ˚˺͐ͅ੮͐ʩʇ੮̹˺ˑɘ̼੮˺̹̹˺ͅʮ͐ʇ੮ʠ̼˺˚੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ʮ˦੮ͷʮͅʮɺˑʇ੮ɻ̼ʮͅʮͅ੮ʮ˦੮ ̹͙ɺˑʮɻੵ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ˑʮˌʇ੮I͙ɘʁɘˑ͙̹ʇ੮ફ͸ʩ˺੮͸ɘͅ੮ʮ˦ˈ͙̼ʮ˦ʡ੮ʩʇ̼ͅʇˑʠ੮ɘ˦ʁ੮ʮͅ˺ˑɘ͐ʮ˦ʡ੮ʮ˦੮ʩʇ̼੮ ɘ̹ɘ̼͐˚ʇ˦͐બ੮ ͸ʩ˺ͅʇ੮ ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˺˦੮ ɘ͐੮ ʩ˺˚ʇ੮ ʮͅ੮ ʮ˦ͷʮͅʮɺˑʇ੮ ͐˺੮ ʇͷʇ̼;˺˦ʇ੮ ɺ͙͐੮ ͐ʩ˺ͅʇ੮ ɻˑ˺ͅʇ͐ͅ੮͐˺੮͐ʩʇ˚ੳ੮U˦੮͐ʩʇ੮̹̼ʇચrØä੮ʇ̼ɘੴ੮ʠɘ˚ʮˑʮʇͅ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʇʁ੮͸ʮ͐ʩ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ɘ˦ʁ੮ ˈ͙ʁʡʇͅ੮͐˺੮ɻ˺˦̼͙͐ͅɻ͐੮͸ʩɘ͐੮/̼ͷʮ˦ʡ੮I˺ʠʠ˚ɘ˦੮ɻɘˑˑʇʁ੮ɘ੮ુɺʇ̼͐ɘ;ɘˑ੮͙͐˦˦ʇˑૂ੮͐˺੮̼͐ͅʮ̹੮̼ʇˑɘ͐ʮͷʇͅ੮˺ʠ੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅ੮ɘ˦ʁ੮ʠ͙˦˦ʇˑ੮͐ʩʇ˚੮͐˺੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳ৽ਂ੮îʩʇ੮ɘ͙͐ʩ˺̼ͅ੮˺ʠ੮rØä੮ ɻ̼ɘʠ͐ʇʁ੮ɘ੮ˑɘ͸੮͐ʩɘ͐੮ͷʮ̼͙͐ɘˑˑ;੮ʇˑʮ˚ʮ˦ɘ͐ʇʁ੮ʠɘ˚ʮˑʮʇͅૄ੮ɘɺʮˑʮ͐;੮͐˺੮ʁʮ̼ʇɻ͐ˑ;੮̹ʇ͐ʮ͐ʮ˺˦੮ɻ˺͙̼͐ͅ੮ ͐˺੮˺̼ʁʇ̼੮ɘ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ੳ৽ਃ੮‡˺͸੮͸ʩɘ͐੮ʠɘ˚ʮˑʮʇͅઝ˺̼੮ʩ˺͙ͅʮ˦ʡ੮̹̼˺ͷʮʁʇ̼ͅ੮˺̼੮˺͙̹͐ɘ͐ʮʇ˦͐੮ ͐ʇɘ˚ͅઝɻɘ˦੮ ʁ˺੮ ʮͅ੮ ɻɘˑˑ੮ ৹ৱৱੴ੮ ˺ͷʇ̼੮ ɘ˦ʁ੮ ˺ͷʇ̼੮ ɘʡɘʮ˦ੴ੮ ͐˺੮ ̹ˑʇɘʁ੮ ʠ˺̼੮ ɘ੮ ৵ৱ৵ৰੳ੮ îʩʇ੮ ɺʇ̼͐ɘ;ɘˑ੮͙͐˦˦ʇˑ੮ʩɘͅ੮͙̼͐˦ʇʁ੮ʮ˦͐˺੮ɘ੮ɺʇ̼͐ɘ;ɘˑ੮˚ʇ̼̼;ચʡ˺ચ̼˺͙˦ʁੳ )˺̼˺͐ʩ;ੴ੮ ͅʇͷʇ˦͐;ચ˺˦ʇ੮ ɘ˦ʁ੮ ˑʮͷʮ˦ʡ੮ ʮ˦੮ ‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ͸ɘͅ੮ ɺʇʮ˦ʡ੮ ͙˦ʁʇ̼͐ͅɘ͐ʇʁ੮͸ʩʇ˦੮ͅʩʇ੮ͅɘʮʁ੮ʩʇ̼੮ʠɘ˚ʮˑ;੮ʩɘͅ੮ʩɘʁ੮ʮ͐ͅ੮ુʠɘʮ̼੮ͅʩɘ̼ʇੴ੮˺̼੮˚ɘ;ɺʇ੮˚˺̼ʇૂ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ੮äʩʇ੮͐ʮɻˌͅ੮˺ʠʠ੮ʩʇ̼੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅ੮͸ʩ˺੮ʩɘͷʇ੮ɺʇʇ˦੮͐˺͙ɻʩʇʁ੮ɺ;੮ʮ͐ੵ੮ɘ˦੮͙˦ɻˑʇ੮ ͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮͸ʩ˺੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ʁʮʇʁ੮ɺ;੮͙ͅʮɻʮʁʇੴ੮ɘ੮ͅʮ͐ͅʇ̼੮͸ʮ͐ʩ੮ɺʮ̹˺ˑɘ̼੮ʁʮͅ˺̼ʁʇ̼੮ ͸ʩ˺੮ˑʮͷʇͅ੮ɘ˦ʁ੮͸˺̼ˌͅ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ɺ͙͐੮ʮͅ੮˺ʠ͐ʇ˦੮ુ˺˦੮͐ʩʇ੮ʇʁʡʇૂ੮˺ʠ੮ɘ੮ɺ̼ʇɘˌʁ˺͸˦ੴ੮ ɘ˦ʁ੮ɘ੮ʁɘ͙ʡʩ͐ʇ̼੮͸ʮ͐ʩ੮ʁʇ̹̼ʇͅͅʮ˺˦੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮˺͙͐੮˺ʠ੮ɻ˺˦͐ɘɻ͐੮ʠ˺̼੮ɘ੮ʠʇ͸੮˚˺˦͐ʩͅੳ੮ )˺̼˺͐ʩ;੮ͅʇ˦ʁͅ੮͐ʩʇ੮˺ɻɻɘͅʮ˺˦ɘˑ੮˦˺͐ʇ੮ʇ˦ɻ˺͙̼ɘʡʮ˦ʡ੮ʩʇ̼੮͐˺੮̼ʇɘɻʩ੮˺͙͐ੴ੮ɺ͙͐੮˚͙ɻʩ੮˺ʠ੮ʩʇ̼੮ ͸˺̼̼ʮʇʁ੮ʇ˦ʇ̼ʡ;੮͐ͅɘ;ͅ੮ɻˑ˺ͅʇ̼੮͐˺੮ʩ˺˚ʇੳ /ʮʡʩ͐੮˺̼੮˦ʮ˦ʇ੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮ʩʇ̼੮ͅ˺˦੮̼˦˺ˑʁઝ˦˺͸੮ʠ˺̼͐;ઝ͐ͅɘ̼͐ʇʁ੮ͅˑʇʇ̹ʮ˦ʡ੮ˑʇͅͅ੮ɘ˦ʁ੮ ˑʇͅͅੳ੮äʩʇ੮̼ʇɻɘˑˑʇʁੴ੮ુPʇ੮͸ɘͅ੮ʩɘͷʮ˦ʡ੮ɘ੮ͅɻʩʮͅ˚੮ʠ̼˺˚੮ʩʮͅ੮˺͸˦੮˚ʇ˚˺̼ʮʇͅੴ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ ɻ˺˦͙ͅ˚ʇʁ੮ɺ;੮ʡ͙ʮˑ͐੮ɘɺ˺͙͐੮͐ʩʮ˦ʡͅ੮͐ʩɘ͐੮ʩɘ̹̹ʇ˦ʇʁ੮ʮ˦੮ʩʮͅ੮ˑʮʠʇੳૂ੮Pʇ੮͸ɘ˦͐ʇʁ੮͐˺੮ɻ˺˦ʠʇͅͅ੮ ʩʮͅ੮ ͅʩɘ˚ʇ੮ ͐˺੮ ͐ʩʇ੮ ̹˺ˑʮɻʇੴ੮ ͸ʩʮɻʩ੮ )˺̼˺͐ʩ;੮ ʁʮͅɻ˺͙̼ɘʡʇʁੳ੮ Pʇ੮ ͸ɘˑˌʇʁ੮ ͐˺੮ ͐ʩʇ੮ ̹˺ˑʮɻʇ੮ ͐ͅɘ͐ʮ˺˦੮ ɘ੮ ʠʇ͸੮ ˚ʮˑʇͅ੮ ɘ͸ɘ;੮ ɘ˦;͸ɘ;ੴ੮ ɺ͙͐੮ ુ͐ʩʇ;੮ ͸ʇ̼ʇ˦ૄ͐੮ ˺̹ʇ˦੮ ˺̼੮ ͸˺͙ˑʁ˦ૄ͐੮ ˑʇ͐੮ ʩʮ˚੮ ʮ˦ੳૂ੮ä˺˺˦ੴ੮͐ʩʇ੮̹ɘ͐͐ʇ̼˦੮ɻʩɘ˦ʡʇʁੳ੮Pʇ੮͐ͅ˺̹̹ʇʁ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ʩʮͅ੮ʠ̼ʮʇ˦ʁͅ੮ɘ˦ʁੴ੮͐ʩʇ˦ੴ੮ʩʮͅ੮ ˚˺͐ʩʇ̼ੵ੮ુPʇ੮͐ʩ˺͙ʡʩ͐੮ʩʇ੮͸ɘͅ੮ɺʇʮ˦ʡ੮̹˺ʮͅ˺˦ʇʁ੮ɘ˦ʁ੮͐ʩɘ͐੮U੮˚ɘ;੮ʩɘͷʇ੮ˑ˺˺ˌʇʁ੮ˑʮˌʇ੮ʩʮͅ੮ ˚˺͐ʩʇ̼ੴ੮ ɺ͙͐੮ U੮ ͸ɘͅ੮ ɘɻ͙͐ɘˑˑ;੮ ɘ੮ ̹̼ʮͅ˺˦੮ ʡ͙ɘ̼ʁ੮ ̹ͅ;ʮ˦ʡ੮ ˺˦੮ ʩʮ˚ੳૂ੮ Pʮͅ੮ ͸ʇʮʡʩ͐੮ ͐ͅɘ̼͐ʇʁ੮ ̹ˑ͙˚˚ʇ͐ʮ˦ʡੴ੮ɘ˦ʁ੮ʩʇ੮ɺʇɻɘ˚ʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ʮ˚˚˺ɺʮˑʇ੮˺˦੮ʩʇ̼੮ɻ˺͙ɻʩੳ )˺̼˺͐ʩ;੮̼ʇɘɻʩʇʁ੮˺͙͐੮ʠ˺̼੮ʩʇˑ̹ੳ੮̼˦˺ˑʁ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ͅʇʇ੮ɘ੮͐ʩʇ̼ɘ̹ʮ͐ͅੴ੮ɘ˦ʁ੮ͅʩʇ੮ ɻ˺͙ˑʁ˦ૄ͐੮ ɻ˺˦ͷʮ˦ɻʇ੮ ʩʮ˚੮ ͐˺੮ ʡ˺੮ ͐˺੮ ͐ʩʇ੮ /Ûੳ੮ ä˺੮ ͅʩʇ੮ ɻɘˑˑʇʁ੮ ৹ৱৱੳ੮ {˺͐ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ʠɘ˚ʮˑ;੮ ˚ʇ˚ɺʇ̼ͅ੮U੮͐ɘˑˌʇʁ੮͐˺੮̹ͅʇɻʮϲʮʇʁ੮͐ʩʇ;੮͸ɘ˦͐ʇʁ੮˚ʇʁʮɻɘˑ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ˑɘ͸੮ ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮͐˺੮ɻ˺˚ʇ੮˺͙͐ੳ੮H˺̼੮ɘ੮ͷɘ̼ʮʇ͐;੮˺ʠ੮̼ʇɘͅ˺˦ͅੴ੮ʮ͐ૄͅ੮˺ʠ͐ʇ˦੮͐ʩʇ੮̹˺ˑʮɻʇ੮ɘ˦;͸ɘ;ੳ੮ {˺ɺʮˑʇ੮ɻ̼ʮͅʮͅ੮͐ʇɘ˚ͅ੮ʁ˺˦ૄ͐੮ʇͽʮ͐ͅ੮ʮ˦੮ͅ˺˚ʇ੮ɻ˺͙˦͐ʮʇͅੴ੮˺̹ʇ̼ɘ͐ʇ੮˺˦ˑ;੮ʮ˦੮ɘ੮˦ɘ̼̼˺͸੮ʡʇ˺ʡ̼ɘ̹ʩʮɻ੮ɘ̼ʇɘੴ੮˺̼੮ɘ̼ʇ˦ૄ͐੮ɘͷɘʮˑɘɺˑʇ੮ɘ͐੮˦ʮʡʩ͐ੳ৽਄੮/ͷʇ˦੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅੴ੮͸ʩʮɻʩ੮ʩɘͅ੮ϲʮʠ͐;੮ ˚˺ɺʮˑʇ੮ ͐ʇɘ˚ͅ੮ ͐ʩɘ͐੮ ̹ɘ̼͐˺ˑ੮ ɘ̼˺͙˦ʁ੮ ͐ʩʇ੮ ɻˑ˺ɻˌੴ੮ ͅ˺˚ʇ੮ ʁʮ̹ͅɘ͐ɻʩʇ̼ͅ੮ ̼ʇɻ˺˚˚ʇ˦ʁ੮ ͐ʩʇ੮ ̹˺ˑʮɻʇ੮ɘ˦;͸ɘ;ੳ৾৻੮/Û੮͐ͅɘʠʠ੮ɻɘ˦੮̼ʇʠ͙ͅʇ੮͐˺੮ʇͷɘˑ͙ɘ͐ʇ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʮͅ੮ɺ̼˺͙ʡʩ͐੮͐˺੮͐ʩʇ˚੮ ɺ;੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦ੳ੮îʩʇ;੮ɻɘ˦ૄ͐੮ʮʠ੮͐ʩʇ;੮ɘ̼̼ʮͷʇ੮͸ʮ͐ʩ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੳ৾ৼ

CRISIS

63

#ˑʮ˦ʮɻʮɘ˦ચˑʇʁ੮͐ʇɘ˚ͅ੮˚ʮʡʩ͐੮ɘˑͅ˺੮ʁʇɻˑɘ̼ʇ੮ɘ੮ɻɘͅʇ੮͐˺˺੮̼ʮͅˌ;੮ʠ˺̼੮͐ʩʇ˚੮͐˺੮ʩɘ˦ʁˑʇੳ੮U˦੮ )˺̼˺͐ʩ;ૄͅ੮ɻɘͅʇੴ੮ુ͐ʩʇ;੮͐˺ˑʁ੮˚ʇ੮͐ʩʇ;੮͸˺͙ˑʁ˦ૄ͐੮ɻ˺˚ʇ੮͸ʮ͐ʩ˺͙͐੮͐ʩʇ੮̹˺ˑʮɻʇ੮ɻ˺˚ʮ˦ʡ੮ϲʮ̼͐ͅੳ੮ ä˺੮U੮ɻɘˑˑʇʁ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ʠ˺̼੮͸ʇˑʠɘ̼ʇ੮ɻʩʇɻˌͅ੮ɘ੮˦͙˚ɺʇ̼੮˺ʠ੮͐ʮ˚ʇͅੴ੮͸ʮ͐ʩ੮˦˺͐੮ͷʇ̼;੮˚͙ɻʩ੮ ͙ͅɻɻʇͅͅੳૂ੮U੮̹̼ʇͅͅʇʁ੮ʩʇ̼੮˺˦੮͸ʩɘ͐੮͐ʩɘ͐੮˚ʇɘ˦͐ੴ੮ɘ˦ʁ੮ͅʩʇ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩɘ͐ઝ˚͙ɻʩ੮ɘͅ੮͐ʩʇ੮ rØä੮ɻ͐੮ʮ˦͐ʇ˦ʁʇʁઝ̹˺ˑʮɻʇ੮ˑ˺˺ˌʇʁ੮ʠ˺̼੮ͷʮͅʮɺˑʇ੮ɺʇʩɘͷʮ˺̼ͅ੮ɘ˦ʁ੮˦˺͐੮ʮ˦˦ʇ̼੮͙ͅʠʠʇ̼ʮ˦ʡ੮ɘͅ੮ ͐ʩʇ੮ɺɘͅʮͅ੮ʠ˺̼੮ɘ੮৵ৱ৵ৰੳ৾৽੮ુîʩʇ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ͅ੮͸ʇ̼ʇ੮ˈ͙͐ͅ੮ɘ੮ϲˑɘͅʩੳ੮U੮ʩɘͷʇ੮ɘ੮ʁʇ͐ɘɻʩʇʁ੮ʡɘ̼ɘʡʇੴ੮ ɘ˦ʁ੮ʩʇ੮ય̼˦˺ˑʁર੮͸˺͙ˑʁ੮ˈ͙͐ͅ੮ˑ˺ɻˌ੮ʩʮ˚ͅʇˑʠ੮ʮ˦੮͐ʩʇ̼ʇੳ੮ä˺੮͐ʩʇ੮˺ϲϲʮɻʇ̼ͅ੮͸˺͙ˑʁ੮ͅɘ;ੴ੮ૃĔʇ੮ ɻɘ˦੮͐ʇˑˑ੮ʩʇૄͅ੮˦˺͐੮̼ʮʡʩ͐ੴ੮ɺ͙͐੮͐ʩʇ̼ʇૄͅ੮˦˺͐ʩʮ˦ʡ੮͸ʇ੮ɻɘ˦੮ʁ˺ੳૄૂ )˺̼˺͐ʩ;੮͸ɘͅ੮̼͙˦˦ʮ˦ʡ੮͙̹੮ɘʡɘʮ˦͐ͅ੮ɘ˦੮˺ʁʁ੮ɻ˺˦̼͐ɘʁʮɻ͐ʮ˺˦ੵ੮̹ʇ˺̹ˑʇ੮ɻɘ˦੮ɻʩ˺˺ͅʇ੮˦˺͐੮ ͐˺੮ɺʇ੮ʇͷɘˑ͙ɘ͐ʇʁ੮ʠ˺̼੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ʮʠ੮͐ʩʇ;੮ʩɘͷʇ੮ɘ੮ʁ˺˺̼੮͐˺੮ʩʮʁʇ੮ɺʇʩʮ˦ʁੳ੮š˦ʇ੮ ͸ʇʇˌੴ੮͐ʩʇ੮͐ʇɘ˚੮ɘ͐੮õ̼ɺɘ˦੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ʁʮͅɻ͙ͅͅʇʁ੮ɘ˦੮ʇˑʁʇ̼ˑ;੮͸ʩʮ͐ʇ੮͸˺˚ɘ˦੮͸ʮ͐ʩ੮ ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ ʁʮͅ˺̼ʁʇ̼ੳ੮ äʩʇ੮ ʩɘʁ੮ ˚˺̼ʇ੮ ͐ʩɘ˦੮ ɘ੮ ʁ˺Έʇ˦੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮ ɘ˦ʁ੮ ͐͸˺੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ɺʇʩʮ˦ʁ੮ ʩʇ̼੮ ɺ͙͐੮ ʩɘʁ੮ ɺʇʇ˦੮ ͐ͅɘɺˑ;੮ ʩ˺͙ͅʇʁ੮ ʠ˺̼੮ ;ʇɘ̼ͅੳ੮ ɻɻ˺̼ʁʮ˦ʡ੮ ͐˺੮ ʩʇ̼੮ ɻɘͅʇ͸˺̼ˌʇ̼ੴ੮ ͐ʩ˺͙ʡʩੴ੮ ૃͅʩʇ੮ ͐ͅ˺̹̹ʇʁ੮ ʩʇ̼੮ ˚ʇʁͅ੮ ɘ˦ʁ੮ ʮͅ੮ ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˦ʡੳ੮ äʩʇ੮ ̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮Iɘͷʮ˦੮‡ʇ͸ͅ˺˚੮͸ɘͅ੮ʁʇɘʁ੮ʮ˦੮ʩʇ̼੮ɘ̹ɘ̼͐˚ʇ˦͐੮ɘ˦ʁ੮͐ʩɘ͐੮)˺˦ɘˑʁ੮î̼͙˚̹੮ ͸ɘ˦͐ʇʁ੮͐˺੮ʩɘͷʇ੮ͅʇͽ੮͸ʮ͐ʩ੮ʩʇ̼ੳ੮äʩʇ੮ʮͅ੮˦˺੮ˑ˺˦ʡʇ̼੮̹ɘ;ʮ˦ʡ੮̼ʇ˦͐੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮ɻˑɘʮ˚ͅ੮ͅʩʇ੮ ˺͸˦ͅ੮͐ʩʇ੮ɺ͙ʮˑʁʮ˦ʡੳૄ੮îʩʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮ɘʁ͙ˑ͐੮̹̼˺ʡ̼ɘ˚ͅੴ੮"ˑɘʮ̼ੴ੮ʮͅ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩʇ̼ʇૄͅ੮ ˺˦ˑ;੮˺˦ʇ੮̼˺͙͐ʇ੮ʠ˺̼͸ɘ̼ʁੵ੮ૃ੮৵ৱ৵ৰ੮ʮͅ੮ˌʇ;੮ʩʇ̼ʇੳ੮äʩʇ੮˦ʇʇʁͅ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮͐˺੮ʡʇ͐੮ʩʇ̼੮ ɺɘɻˌ੮˺˦੮˚ʇʁͅੳૄ îʩʇ੮ ˺˦ˑ;੮ ̹̼˺ɺˑʇ˚੮ ʮͅ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ɻˑʮ˦ʮɻૄͅ੮ ˚˺ɺʮˑʇ੮ ɻ̼ʮͅʮͅ੮ ͐ʇɘ˚੮ ͷʮͅʮ͐ʇʁ੮ ʩʇ̼੮ ɘ੮ ͸ʇʇˌ੮ ago, spoke with her through the screen door, and determined she didn’t meet ৵ৱ৵ৰ੮ɻ̼ʮ͐ʇ̼ʮɘੳ੮ૃ‡˺͸੮Uૄ˚੮ɻ˺˦ͷʮ˦ɻʇʁ੮ͅʩʇ੮ʁ˺ʇͅੴૄ੮͐ʩʇ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼੮̼ʇ̹˺̼͐ͅੴ੮ૃɺ͙͐੮ͅʩʇ੮ ͸˺˦ૄ͐੮˺̹ʇ˦੮͐ʩʇ੮ʁ˺˺̼ੳૄ੮îʩʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮˺˦੮˚˺ɺʮˑʇ੮ɻ̼ʮͅʮͅ੮ʩɘͷʇ੮˦˺੮ˑʇʡɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮ ͐˺੮ɺ̼ʇɘˌ੮ʮ͐੮ʁ˺͸˦ੳ੮îʩʇ੮̹˺ˑʮɻʇ੮ɻ˺͙ˑʁੴ੮ɺ͙͐੮ɘͅ੮ͷ̼ʮˑ੮ફʠ̼˺˚੮˚˺ɺʮˑʇ੮ɻ̼ʮͅʮͅબ੮ɻ˺˚˚ʇ˦͐ͅੴ੮ ૃ͐ʩʇ;ૄ̼ʇ੮̼ʇɘˑˑ;੮͙˦ˑʮˌʇˑ;੮͐˺੮ʁ˺੮͐ʩɘ͐੮͙˦ˑʇͅͅ੮͸ʇ੮ɻɘ˦੮ͅʩ˺͸੮͐ʩʇ̼ʇૄͅ੮ɘ˦੮ʮ˚˚ʮ˦ʇ˦͐੮ʩʇɘˑ͐ʩ੮ ɘ˦ʁ੮ͅɘʠʇ͐;੮̼ʮͅˌੳૄ੮"̼ʮɘ˦੮ɘͅˌͅ੮ʩ˺̹ʇʠ͙ˑˑ;ੴ੮ૃUͅ੮ͅʩʇ੮˚ɘ;ɺʇ੮ʁʮɘɺʇ͐ʮɻ੺ੴૄ੮ˌ˦˺͸ʮ˦ʡ੮͐ʩʮͅ੮ɻ˺͙ˑʁ੮ ˑʇɘʁ੮͐˺੮ɘ੮ˑʮʠʇચ͐ʩ̼ʇɘ͐ʇ˦ʮ˦ʡ੮ɻ̼ʮͅʮͅੳ੮ૃ‡˺ੴૄ੮ͷ̼ʮˑ੮̼ʇ̹ˑʮʇͅੳ੮H˺̼੮͐ʩʇ੮˚˺˚ʇ˦͐ੴ੮͐ʩʇ;੮ϲʮʡ͙̼ʇੴ੮ ͐ʩʇʮ̼੮ɺʇ͐ͅ੮ʩ˺̹ʇ੮ʮͅ੮͐ʩɘ͐੮ͅʩʇ੮͸ʮˑˑ੮̼͙˦੮˺͙͐੮˺ʠ੮ʠ˺˺ʁ੮ɘ˦ʁ੮ʩɘͷʇ੮͐˺੮ɻ˺˚ʇ੮˺͙͐ੳ੮ɺͅʇ˦͐੮͐ʩɘ͐ੴ੮ ͐ʩʇ;ૄˑˑ੮ͅʇʇ੮ʩʇ̼੮͸ʩʇ˦੮ͅʩʇ੮ʡʇ͐ͅ੮ʇͷʮɻ͐ʇʁੳ U੮̼ɘʮͅʇʁ੮͐ʩʮͅ੮ˌʮ˦ʁ੮˺ʠ੮ͅɻʇ˦ɘ̼ʮ˺੮͸ʮ͐ʩ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮ʠ̼˺˚੮rØ)੮ɘ˦ʁ੮ɘͅˌʇʁੴ੮ ુĔʩʇ˦੮͸ʮˑˑ੮˺ϲϲʮɻʇ̼ͅ੮ʠ˺̼ɻʇ੮ɘ˦੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ʠ˺̼੮ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁ੮˺˦੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅ੮̼ʇʠ͙ͅʮ˦ʡ੮ ʮ͐੺੮Ĕʩʇ˦੮͸ʮˑˑ੮;˺͙੮ɺ̼ʇɘˌ੮ʁ˺͸˦੮͐ʩʇ੮ʁ˺˺̼੺ૂ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮̹ɘ͙ͅʇʁੴ੮͐ʩʇ˦੮ˑɘ͙ʡʩʇʁੵ੮ ુĔʇ੮͸˺˦ૄ͐ੳ੮Ĕʇ੮ˈ͙͐ͅ੮͸˺˦ૄ͐ੳ੮Ĕʇૄˑˑ੮͸ɘˑˌ੮ɘ͸ɘ;੮ʠ̼˺˚੮ʮ͐ੳ੮îʩʇ੮ˑɘ͐ͅ੮͐ʩʮ˦ʡ੮͸ʇ੮͸ɘ˦͐੮͐˺੮ʁ˺੮ ʮͅ੮̼ʮ̹੮ʁ˺͸˦੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʁ˺˺̼੮͐˺੮ʁ˺੮ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁੳૂ੮äʩʇ੮ʇˑɘɺ˺̼ɘ͐ʇʁੵ੮ુ/ͷʇ˦੮ʮʠ੮͐ʩʇ̼ʇૄͅ੮ ɘ੮ ͸ʇɘ̹˺˦ੴ੮ ͸ʇૄˑˑ੮ ͐ɘˌʇ੮ ͐ʩʇ੮ ʠɘ˚ʮˑ;੮ ˺͙͐ੴ੮ ɘ˦ʁ੮ ͸ɘˑˌ੮ ɘ͸ɘ;ੳ੮ Ĕʇ੮ ɻɘˑˑ੮ ʮ͐੮ ૃ͐ɘɻ͐ʮɻɘˑ੮ ʁʮͅʇ˦ʡɘʡʇ˚ʇ˦͐ੳૄ੮š͐ʩʇ̼͸ʮͅʇੴ੮͸ʇ੮͸ʮ˦ʁ੮͙̹੮ͅʩ˺˺͐ʮ˦ʡ੮̹ʇ˺̹ˑʇੴ੮ʮ˦ˈ͙̼ʮ˦ʡ੮͐ʩʇ˚ੴ੮˺̼੮ʁɘ˚ɘʡʮ˦ʡ੮

64

T H E C O N S E RVATO R S H I P C O N T I N U U M

͐ʩʇ੮ʩ˺͙ͅʇੳૂ৾৾੮äʩʇ੮ɻˑɘ̼ʮϲʮʇʁ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʮ˦ɻʮʁʇ˦͐ͅੴ੮͙ͅɻʩ੮ɘͅ੮ɘ੮͙ͅʮɻʮʁʇ੮ʮ˦੮̹̼˺ʡ̼ʇͅͅੴ੮ ͸ʩʇ̼ʇ੮̹˺ˑʮɻʇ੮͸ʮˑˑ੮ʇ˦ʡɘʡʇੳ੮ફ˦ʁੴ੮ʠ͙ˑˑ੮ʁʮͅɻˑ˺͙̼ͅʇੴ੮U੮˺˦ɻʇ੮˺ɺͅʇ̼ͷʇʁ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ɺ̼ʇɘˌ੮ ʁ˺͸˦੮ɘ੮ʁ˺˺̼੮͸ʮ͐ʩ੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ૄͅ੮ʩʇˑ̹੮͐˺੮ʁ˺੮ɘ੮৵ৱ৵ৰ੮ɘ͐੮ɘ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮ ɻ˺˚̹ˑʇͽੳબ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁૄͅ੮ʠʇɘ̼ͅ੮˺ʠ੮ɺ˺͐ʩ੮ɺɘʁ੮˺͙͐ɻ˺˚ʇͅ੮ɘ˦ʁ੮ɺɘʁ੮̹͙ɺˑʮɻʮ͐;੮ʠ̼˺˚੮ ʮ˚̹˺ͅʮ˦ʡ੮ɘ੮৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ɘ̼ʇ੮ˈ͙͐ͅʮϲʮʇʁੳ੮Pɘˑʠ੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ˌʮˑˑʇʁ੮ ɺ;੮̹˺ˑʮɻʇ੮ʁʮʇ੮ʮ˦੮͐ʩʇʮ̼੮˺͸˦੮ʩ˺˚ʇੳ৾৿ )˺̼˺͐ʩ;੮ˌʇ̹͐੮̼͐;ʮ˦ʡੳ੮š˦੮͐ʩʇ੮ϲʮʠ͐ʩ੮˺̼੮ͅʮͽ͐ʩ੮ɻɘˑˑੴ੮ͅʩʇ੮ʩɘʁ੮ɘ੮ɺ̼ʇɘˌ͐ʩ̼˺͙ʡʩੳ੮̼˦˺ˑʁ੮ ͸ɘͅ੮ ˑ;ʮ˦ʡ੮ ˺˦੮ ͐ʩʇ੮ ɻ˺͙ɻʩੳ੮ U˦੮ ɻɘ˚ʇ੮ ɘ˦੮ ʇͽ̹ʇ̼ʮʇ˦ɻʇʁ੮ ɘ˦ʁ੮ ͅ;˚̹ɘ͐ʩʇ͐ʮɻ੮ ˺ϲϲʮɻʇ̼ੳ੮ äʩʇ੮ ુͅʩ˺͸ʇʁ੮ʩʮ˚੮ɘ੮̹ʮɻ͙̼͐ʇ੮ʠ̼˺˚੮ʩʮͅ੮ય̼˦˺ˑʁૄͅર੮ʁ̼ʮͷʇ̼ૄͅ੮ˑʮɻʇ˦ͅʇੴ੮ɘ˦ʁ੮͐ʩʇ੮˺ϲϲʮɻʇ̼੮ˑ˺˺ˌʇʁ੮ ɘ͐੮ʩʮ˚ੴ੮ͅˌʮ˦੮ɘ˦ʁ੮ɺ˺˦ʇͅੴ੮ɘ˦ʁ੮ͅɘʮʁੴ੮ૃUૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮ɻɘˑˑ੮ʩʮ˚੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳૄૂ੮"͙͐ੴ੮ ͅʩʇ੮ͅʮʡʩʇʁੴ੮ુʮ͐੮͐˺˺ˌ੮͐ʩɘ͐੮˚͙ɻʩઝ͸ʇૄ̼ʇ੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮ʇʮʡʩ͐;੮̹˺͙˦ʁͅੴ੮˺˦ʇ੮ʩ͙˦ʁ̼ʇʁ੮ ̹˺͙˦ʁͅ੮͸ʇʮʡʩ͐੮ˑ˺ͅͅ੮ʠ˺̼੮ʮ͐੮͐˺੮ɺʇ੮ɘʁʁ̼ʇͅͅʇʁੳૂ੮îʩʇ੮˺ϲϲʮɻʇ̼੮˺ʠʠʇ̼ʇʁ੮ʩʇ̼੮ͅ˺˦੮͐ʩʇ੮˺̹͐ʮ˺˦੮ ˺ʠ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ʩʇ੮/Û੮ʮ˦੮͐ʩʇ੮ɺɘɻˌ੮˺ʠ੮ɘ੮ɻ̼͙ʮͅʇ̼੮ʮ˦੮ʩɘ˦ʁɻ͙ʠʠͅ੮˺̼੮ʮ˦੮ɘ˦੮ɘ˚ɺ͙ˑɘ˦ɻʇ੮˺˦੮ɘ੮ ʡ͙̼˦ʇ;ੳ੮î˺੮ʇͷʇ̼;˺˦ʇૄͅ੮̼ʇˑʮʇʠੴ੮ʩʇ੮ɻʩ˺ͅʇ੮͐ʩʇ੮ˑɘ͐͐ʇ̼ੳ Pʇ੮͐ͅɘ;ʇʁ੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮͐͸˺੮͸ʇʇˌͅੴ੮ɻɘ˚ʇ੮˺͙͐੮˺˦੮ɘ˦੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻੴ੮ɘ˦ʁੴ੮ ʮ˦੮)˺̼˺͐ʩ;ૄͅ੮ͷʮʇ͸ੴ੮͸ɘͅ੮ʁ˺ʮ˦ʡ੮ુ˚͙ɻʩ੮ɺʇ͐͐ʇ̼ੳૂ੮Pʇ੮͐ʩʇ˦੮͐ͅ˺̹̹ʇʁ੮͐ɘˌʮ˦ʡ੮ʩʮͅ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ુ‡˺͸ੴ੮͸ʇ੮ͅʩɘ̼ʇ੮ɘ੮ʩ˺͙ͅʇੴ੮ɺ͙͐੮ʩʇ੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮˚ʇ੮͐˺੮̹ͅʇɘˌ੮͐˺੮ʩʮ˚ੴ੮ʩʇ੮͐ʇ˦ʁͅ੮ to avoid me and spends most of his time around the house at night, when I’ve ʡ˺˦ʇ੮͐˺੮ɺʇʁੳ੯ੳ੯ੳ੯ੳ੮Pʇૄͅ੮ɻˑʇɘ̼ˑ;੮˦˺͐੮ɘ੮ʁɘ˦ʡʇ̼੮͐˺੮ʩʮ˚ͅʇˑʠ੮˺̼੮˺͐ʩʇ̼ͅੴ੮ͅ˺੮Uૄ˚੮ˈ͙͐ͅ੮ˌʮ˦ʁ੮˺ʠ੮ ɻ˺ʇͽʮ͐ͅʮ˦ʡ੮͸ʮ͐ʩ੮ʩʮ˚ੳ੮Uૄ˚੮ʇ˦ɘɺˑʮ˦ʡ੮ʩʮ˚੮ɺ;੮ˑʇ͐͐ʮ˦ʡ੮ʩʮ˚੮ˑʮͷʇ੮ʩʇ̼ʇੴ੮યɺ͙͐ર੮U੮ɻɘ˦ૄ͐੮˦˺͐੮ ʁ˺੮͐ʩʮͅੳ੮îʩɘ͐ૄͅ੮˚;੮̹ʇ̼ͅ˺˦ɘˑ੮ʠʇʇˑʮ˦ʡੳૂ੮ુîʩɘ͐ૄͅ੮͐˺͙ʡʩੴૂ੮U੮˺ʠʠʇ̼ੳ੮Ĕʇ੮ɺ˺͐ʩ੮ˌ˦˺͸੮͐ʩɘ͐੮ the police sometimes advise parents to throw their children out to render them ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮äʩʇ੮ɻɘ˦ૄ͐੮ɺ̼ʮ˦ʡ੮ʩʇ̼ͅʇˑʠ੮͐˺੮ʁ˺੮ʮ͐ੵ੮ુîʩʇ̼ʇ੮ɘ̼ʇ੮ˈ͙͐ͅ੮͐˺˺੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ ˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ͅɻ̼ʇɘ˚ʮ˦ʡ੮ɘ˦ʁ੮͐˺˺੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ʡʇ͐͐ʮ˦ʡ੮ͅʩ˺͐੮ ɺ;੮͐ʩʇ੮̹˺ˑʮɻʇੳૂ ˦੮˺͙̹͐ɘ͐ʮʇ˦͐੮͐ʇɘ˚੮ɻɘˑˑͅ੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮͐˺੮˺ʠʠʇ̼੮ʩʇ̼੮ͅ˺˦੮ͅʇ̼ͷʮɻʇͅੴ੮ɺ͙͐੮ͅʩʇ੮ɻɘ˦ૄ͐੮ ʇͷʇ˦੮ʡʇ͐੮̼˦˺ˑʁ੮͐˺੮ˑʮ͐ͅʇ˦੮͐˺੮͐ʩʇʮ̼੮ͷ˺ʮɻʇ੮˚ʇͅͅɘʡʇͅੳ੮îʩʇ੮ɻ˺͙˦͐;੮˦˺͸੮ʩɘͅ੮ɘ੮ˈ˺ʮ˦͐੮ ̹˺ˑʮɻʇચɻˑʮ˦ʮɻʮɘ˦੮̼ʇ̹ͅ˺˦ͅʇ੮͐ʇɘ˚ੳ੮äʩʇ੮ɻ˺˦͐ɘɻ͐ʇʁ੮͐ʩʇ˚੮͸ʩʇ˦੮ʩʇ̼੮ͅ˺˦੮ͅ˚ɘͅʩʇʁ੮͐ʩʇʮ̼੮ ̼ʇʠ̼ʮʡʇ̼ɘ͐˺̼੮ʮ˦੮ɘ੮˚˺˚ʇ˦͐੮˺ʠ੮ʩʇʮʡʩ͐ʇ˦ʇʁ੮̹ɘ̼ɘ˦˺ʮɘੳ੮îʩʇ;੮ɘ̼̼ʮͷʇʁ੮͐ʩ̼ʇʇ੮ʁɘ;ͅ੮ˑɘ͐ʇ̼ੳ੮ Pʇ੮͸ɘͅ੮ɻɘˑ˚ʇ̼੮ɺ;੮͐ʩʇ˦ੳ੮ä˺੮͸ʩʮˑʇ੮ͅʩʇૄͅ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ʩʇ̼੮ͅ˺˦੮͐˺੮ʁʇ͐ʇ̼ʮ˺̼ɘ͐ʇ੮ʇ˦˺͙ʡʩ੮ ͐˺੮ɺʇ੮̹ˑɘɻʇʁ੮˺˦੮ɘ˦˺͐ʩʇ̼੮ʩ˺ˑʁੴ੮)˺̼˺͐ʩ;੮ʮͅ੮ʩʇˑ̹ʮ˦ʡ੮͐ͅɘʠʠ੮͐ʩʇ੮ˑ˺ɻɘˑ੮ɻʩɘ̹͐ʇ̼੮˺ʠ੮͐ʩʇ੮ ‡ɘ͐ʮ˺˦ɘˑ੮ˑˑʮɘ˦ɻʇ੮ʠ˺̼੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅ੮͙̹̹ͅ˺̼͐੮ˑʮ˦ʇੳ੮äʩʇ੮ʇ˦ɻ˺͙̼ɘʡʇͅ੮̹ɘ̼ʇ˦͐ͅ੮ɘ˦ʁ੮ ͅʮɺˑʮ˦ʡͅ੮͐˺੮͐ɘˌʇ੮ɻɘ̼ʇ੮˺ʠ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮ʠ͐ʇ̼੮ɘˑˑੴ੮͐ʩʇ̼ʇ੮ʮͅ੮˺ʠ͐ʇ˦੮˦˺͐੮ɘ੮ˑ˺͐੮͐ʩʇ;੮ɻɘ˦੮ʁ˺੮ ʠ˺̼੮͐ʩʇʮ̼੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅੳ )˺̼˺͐ʩ;੮ɘ˦ʁ੮̼˦˺ˑʁૄͅ੮ɻɘͅʇ੮ʮͅ੮ɘ˦੮ʇ͐ʩʮɻɘˑ੮˚˺̼ɘͅͅੳ੮ુĔʇˑʠɘ̼ʇ੮ɻʩʇɻˌͅૂ੮ɘ̼ʇ੮ɘ੮͸ɘ̼̼ɘ˦͐ˑʇͅͅ੮̹˺ˑʮɻʇ੮ʇ˦̼͐;੮ʮ˦͐˺੮ɘ੮̹̼ʮͷɘ͐ʇ੮̹ͅɘɻʇੳ੮/ͷʇ˦੮ʮʠ੮̹ɘ̼ʇ˦͐ͅ੮ɘ̼ʇ੮ʮ˦ͷʮ͐ʮ˦ʡ੮͐ʩʇ੮̹˺ˑʮɻʇ੮

CRISIS

65

ʮ˦͐˺੮͐ʩʇʮ̼੮ʩ˺˚ʇͅੴ੮͐ʩʇͅʇ੮ɘ̼ʇ੮͐ʩʇʮ̼੮ɻʩʮˑʁ̼ʇ˦ૄͅ੮ʩ˺˚ʇͅੴ੮͐˺˺ੳ੮ˑ͐ʩ˺͙ʡʩ੮)˺̼˺͐ʩ;ૄͅ੮ͅ˺˦੮ ɻ˺͙ˑʁ੮ɺʇ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ʁʇ̹ͅʮ͐ʇ੮ɺʇʮ˦ʡ੮ʩ˺͙ͅʇʁੴ੮ʮ˦ͅ˺ʠɘ̼੮ɘͅ੮ʩʇ੮ʩɘʁ੮͐ͅ˺̹̹ʇʁ੮ʇɘ͐ʮ˦ʡੴ੮ ʮ͐ૄͅ੮˦˺͐੮ɻˑʇɘ̼ચɻ͙͐੮ɘ͐੮͸ʩɘ͐੮˚˺˚ʇ˦͐੮͐ʩʮͅ੮ɺʇɻ˺˚ʇͅ੮͙ͅɻʩ੮ɘ੮ɻ̼ʮͅʮͅ੮͐ʩɘ͐੮ʮ͐੮˚ʇ̼ʮ͐ͅ੮ɺ̼ʇɘˌʮ˦ʡ੮ʁ˺͸˦੮ɘ੮ʁ˺˺̼ੳ੮š˦੮͐ʩʇ੮˺͐ʩʇ̼੮ʩɘ˦ʁੴ੮ɘͅ੮)˺̼˺͐ʩ;੮ɻˑ˺ͅʇʁ੮˺͙̼੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦ੴ੮ુUૄ˚੮ ɻ˺˦ɻʇ̼˦ʇʁ੮ɘɺ˺͙͐੮̹ʇ˺̹ˑʇૄͅ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੴ੮ɺ͙͐੮͸ʩɘ͐੮ɘɺ˺͙͐੮˚;੮̼ʮʡʩ͐ͅ੺੮Uૄ˚੮ɘ˦੮ɘˑ˚˺͐ͅ੮ ͅʇͷʇ˦͐;ચ͐͸˺ચ;ʇɘ̼ચ˺ˑʁ੮͸˺˚ɘ˦੮͸ʩ˺੮ʮͅ੮˦˺੮ˑ˺˦ʡʇ̼੮̼͐ɘͷʇˑʮ˦ʡੴ੮ɻɘ˦ૄ͐੮ʩɘͷʇ੮ʡ͙ʇ͐ͅͅ੮˺ͷʇ̼ੳ੮ {;੮̼ʮʡʩ͐ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ʮ˦ͷɘʁʇʁ੮ɺʇɻɘ͙ͅʇ੮Uૄ˚੮͐ʩʇ੮˺˦ˑ;੮ͅɘˑͷɘ͐ʮ˺˦੮͐ʩɘ͐੮ʩʇ੮ʩɘͅ੮ʮ˦੮ʩɘͷʮ˦ʡ੮ ɘ੮ͅɘʠʇ੮ʩ˺˚ʇੳૂ

DYING ON THE STREETS {ɘ˦;੮ʠɘ˚ʮˑʮʇͅ੮͸˺͙ˑʁ੮̹̼ʇʠʇ̼੮͐ʩɘ͐੮ʮ͐੮˦˺͐੮ɺʇ੮̹˺ˑʮɻʇ੮͸ʩ˺੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮͐ʩʇʮ̼੮̹ˑʇɘͅ੮ʠ˺̼੮ ʩʇˑ̹ੳ੮{˺͐ͅ੮˺ϲϲʮɻʇ̼ͅ੮͸˺͙ˑʁ੮̹̼ʇʠʇ̼੮˦˺͐੮͐˺੮ɺʇ੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮͐˺੮͐ʩʇ˚ੳ੮H˺̼੮ɻ˺̹ͅੴ੮ɘ੮৵ৱ৵ৰ੮ ˚ʮʡʩ͐੮˚ʇɘ˦੮͸ɘʮ͐ʮ˦ʡ੮ʩ˺͙̼ͅ੮ʮ˦੮ɘ˦੮/Û੮ʠ˺̼੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦੮͐˺੮ʠ˺̼˚ɘˑˑ;੮ɘɻɻʇ̹͐੮ɘ੮ʩɘ˦ʁ˺ʠʠ੮˺ʠ੮ ɘ੮̹ɘ͐ʮʇ˦͐੮ફɘʠ͐ʇ̼੮͸ʩʮɻʩ੮͐ʩʇ;੮ɘ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮͐˺ˑʁ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ɻɘ˦˦˺͐੮ɺʇ੮ɘʁ˚ʮ͐͐ʇʁબੳ੮ Ĕʩʮˑʇ੮͐ʩʇ;ૄ̼ʇ੮ɺ͙ͅ;੮̹̼˺ɻʇͅͅʮ˦ʡ੮͐ʩʇ੮˚˺͙˦ʁ੮˺ʠ੮ɺʇˑ˺˦ʡʮ˦ʡͅ੮ˑʇʠ͐੮ɺʇʩʮ˦ʁ੮ʮ˦੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ̼ͅ˺˦ૄͅ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐ੴ੮ ͐ʩʇ;੮ ɻ˺͙ˑʁ੮ ɺʇ੮ ͸ɘ͐ɻʩʮ˦ʡ੮ ɻɘˑˑͅ੮ ʠ˺̼੮ ɻ̼ʮ˚ʇͅ੮ ʮ˦੮ ̹̼˺ʡ̼ʇͅͅ੮ ʡ˺੮ ͙˦ɘ˦ͅ͸ʇ̼ʇʁੳ੮îʩʇ̼ʇૄͅ੮ɘ੮̼ʇɘͅ˺˦੮͐ʩɘ͐੮)ɘ˦ʮੴ੮͐ʩʇ੮˺͙̼͐ʇɘɻʩ੮ɻˑʮ˦ʮɻʮɘ˦੮ɘ͐੮͐ʩʇ੮͐ͅɘ̼͐੮˺ʠ੮͐ʩʮͅ੮ ɻʩɘ̹͐ʇ̼ੴ੮ʁʇͅɻ̼ʮɺʇʁ੮ɻɘ̼ʮ˦ʡ੮ʠ˺̼੮ʩʮʡʩ੮͙͐ʮˑʮΈʇ̼ͅ੮˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ͅʇ̼ͷʮɻʇͅ੮͸ʩ˺੮ɘ̼ʇ੮ુʁ;ʮ˦ʡ੮ ˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅૂ੮ɘͅ੮ɘ੮ુʡɘ˚ʇ੮˺ʠ੮ʩ˺͐੮̹˺͐ɘ͐˺੮͸ʩʇ̼ʇ੮͸ʇૄ̼ʇ੮͐ʩʇ੮˺˦ˑ;੮˺˦ʇͅ੮͐ͅʮˑˑ੮̹ˑɘ;ʮ˦ʡੳૂ ä˺˚ʇ੮˺ϲϲʮɻʇ̼ͅੴ੮͐ʩ˺͙ʡʩੴ੮ɘ̼ʇ੮͐ͅʮˑˑ੮ʮ˦੮͐ʩʇ੮ʡɘ˚ʇੳ੮)ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺੮̼ʇ̹ͅ˺˦ʁʇʁ੮͐˺੮ ˚;੮ϲʮ̼͐ͅ੮ή͙ʇ͐ͅʮ˺˦ੴ੮ɘɺ˺͙͐੮ʩ˺͸੮ͅʩʇ੮͸˺͙˦ʁ੮͙̹੮͸˺̼ˌʮ˦ʡ੮ʠ˺̼੮rØ)ૄͅ੮#ɘͅʇ੮ͅͅʇͅͅ˚ʇ˦͐੮ {ɘ˦ɘʡʇ˚ʇ˦͐੮Ø̼˺ʡ̼ɘ˚੮ફ#{Øબੴ੮͸ʮ͐ʩ੮ɘ੮͐ͅɘ˦ʁɘ̼ʁ੮ʁʮͅɻˑɘʮ˚ʇ̼ੵ੮ુĔʩʇ˦੮U੮͐ͅɘ̼͐ʇʁ੮ɘͅ੮ ɘ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼੮͐͸ʇ˦͐;ચͅʮͽ੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮U੮˦ʇͷʇ̼੮͐ʩ˺͙ʡʩ͐੮͐ʩɘ͐੮U੮͸˺͙ˑʁ੮ɺʇ੮͸˺̼ˌʮ˦ʡ੮˺˦੮ ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮͙˦ʮ͐ੳૂ੮ͅ੮ͅʩʇ੮̼ʇɻɘˑˑʇʁੴ੮ɺɘɻˌ੮ʮ˦੮ৱ৹৹৵ੴ੮rØ)ૄͅ੮{/õ੮ɻ˺˦ͅʮ͐ͅʇʁ੮˺ʠ੮ ͐ʩ̼ʇʇ੮˺ϲϲʮɻʇ̼ͅ੮͐ͅɘ͐ʮ˺˦ʇʁ੮ુʮ˦੮ɘ੮ɺɘͅʇ˚ʇ˦͐੮ɘ͐੮ʩʇɘʁή͙ɘ̼͐ʇ̼ͅ੮ʁ˺͸˦͐˺͸˦ੴ੮ˌʮ˦ʁ੮˺ʠ੮ɘ੮ˑʮ͐͐ˑʇ੮ʁ͙˦ʡʇ˺˦ੳૂ੮"͙͐੮ͅʩʇ੮ʇͷʇ˦͙͐ɘˑˑ;੮͸˺̼ˌʇʁ੮ʩʇ̼੮͸ɘ;੮ʮ˦͐˺੮îʩ̼ʇɘ͐੮{ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮͸ʩʮɻʩ੮ ʩɘ˦ʁˑʇͅ੮ ʩʮʡʩચ̹̼˺ϲʮˑʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ ˚ʮʡʩ͐੮ ુʩɘͷʇ੮ ɘ੮ ʁʇˑ͙ͅʮ˺˦੮ ɘɺ˺͙͐੮ ɺʇʮ˦ʡ੮ ʮ˦੮ ɘ੮ ̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮͸ʮ͐ʩ੮"̼ɘʁ੮Øʮ͐͐ૂ੮ɘ˦ʁ੮͸ʮ˦ʁ੮͙̹੮ɺ̼ʇɘˌʮ˦ʡ੮ʮ˦͐˺੮ʩʮͅ੮ʩ˺˚ʇੳ੮"ʇɻɘ͙ͅʇ੮ͅ˺˚ʇ੮ ˺ʠ੮͐ʩ˺ͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ુ˦ʇʇʁʇʁ੮͐˺੮ɺʇ੮ˑʮ˦ˌʇʁ੮͐˺੮ͅʇ̼ͷʮɻʇͅ੯ੳ੯ੳ੯ੳ੮͐˺੮ʡʇ͐੮͐ʩʇ˚੮͐ͅɘɺʮˑʮΈʇʁੴૂ੮ ͅʩʇ੮ɻɘ˚ʇ੮ʮ˦͐˺੮ɻˑ˺ͅʇ̼੮ɻ˺˦͐ɘɻ͐੮͸ʮ͐ʩ੮ɘ੮͐ʩʇ˦੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮{/õੳ੮/ͷʇ˦͙͐ɘˑˑ;ੴ੮)ʇ͐ʇɻ͐ʮͷʇ੮ #ɘ˚ɘɻʩ˺ઝ͸ʩ˺੮͸ʇ˦͐੮ʮ˦͐˺੮͐ʩʇ੮ʠ˺̼ɻʇ੮͸ʮ͐ʩ੮ɘ˦੮ʮ˚ɘʡʇ੮˺ʠ੮ુU੮͸ɘ˦͐੮͐˺੮ʩ˺˺ˌ੮ɘ˦ʁ੮ɺ˺˺ˌੴ੮ ̹͙͐੮ɺɘʁ੮ʡ͙;ͅ੮ʮ˦੮ˈɘʮˑૂઝɘ̹̹ˑʮʇʁ੮ʠ˺̼੮ɘ੮ˈ˺ɺ੮ɘ͐੮{/õੴ੮͸ʩʮɻʩ੮̹͙͐ͅ੮ͅʮɻˌ੮ʡ͙;ͅ੮ʮ˦੮ʩ˺̹ͅʮ͐ɘˑͅੳ rØ)ૄͅ੮ä{Ûî੮˺ϲϲʮɻʇ̼ચɻˑʮ˦ʮɻʮɘ˦੮ɻ̼ʮͅʮͅ੮͐ʇɘ˚ͅ੮ɘ̼ʇ੮̼ʇɻ˺ʡ˦ʮΈʇʁ੮˦ɘ͐ʮ˺˦ɘˑˑ;੮ɘͅ੮ɘ˦੮ ʮ˦͐ʇˑˑʮʡʇ˦͐੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ৾਀੮"͙͐੮)ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺੮ͅɘ͸੮͐ʩʇʮ̼੮ˑʮ˚ʮ͐ͅੵ੮

66

T H E C O N S E RVATO R S H I P C O N T I N U U M

ુU੮ˑʇɘ̼˦ʇʁ੮͐ʩɘ͐੮͸ʇ੮͸ʇ̼ʇ੮̹͙͐͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮ʡʇ͐੮͐ʩʇ੮ʩʇˑ̹੮͐ʩʇ;੮˦ʇʇʁʇʁ੮ ɘ͐੮͐ʩɘ͐੮˚˺˚ʇ˦͐੮˺ʠ੮ɻ̼ʮͅʮͅੴ੮ɺ͙͐੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ;੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁ੮˦˺͐੮ˑ˺˦ʡ੮ɘʠ͐ʇ̼ੴ੮ɘ˦ʁ੮ ͸ʇ੮ɻ˺˦͐ʮ˦͙ʇʁ੮͐˺੮ͅʇʇ੮͐ʩʇ੮ͅɘ˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɻ˺˚ʮ˦ʡ੮͐ʩ̼˺͙ʡʩੳૂ੮îʩɘ͐ૄͅ੮͸ʩʇ̼ʇ੮#{Ø੮ ɻ˺˚ʇͅ੮ ʮ˦ੳ੮ U͐ૄͅ੮ ͐ʩʇ੮ ુʁʇ͐ʇɻ͐ʮͷʇ੮ ɻ˺˚̹˺˦ʇ˦͐ૂ੮ ˺ʠ੮ ͐ʩʇ੮ ɻʮ͐;ૄͅ੮ ̼ʇ̹ͅ˺˦ͅʇ੮ ͐˺੮ ુʩʮʡʩચ̼ʮͅˌੴ੮ ʩʮʡʩચ͙͐ʮˑʮΈʮ˦ʡ੮ ͙ͅɺˈʇɻ͐ͅੳૂ੮ äʮ˦ɻʇ੮ ͅʩʇ੮ ˈ˺ʮ˦ʇʁੴ੮ ͅʩʇૄͅ੮ ɺʇʇ˦੮ ʩʇˑ̹ʮ˦ʡ੮ ͅˑʇ͙͐ʩ੮ ˺͙͐੮ ʇˑ͙ͅʮͷʇ੮ ͅ˺ˑ͙͐ʮ˺˦ͅ੮ʠ˺̼੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ʩɘ̼ʁʇ͐ͅચ͐˺ચɻ̼ɘɻˌ੮ɻɘͅʇͅੳ੮š˦ʇ੮ͅ˺ˑ͙͐ʮ˺˦੮ʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ îʩʇ੮ϲʮ̼͐ͅ੮͐ͅʇ̹੮͐˺੮ʡʇ͐͐ʮ˦ʡ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘ੮৵ৱ৵ৰ੮͐ʩɘ͐੮ˑɘ͐ͅͅ੮˚˺̼ʇ੮͐ʩɘ˦੮ˈ͙͐ͅ੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅੳ U੮̹ͅ˺ˌʇ੮͐˺੮)ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺੮ɘ͐੮ˑʇ˦ʡ͐ʩ੮ɘɺ˺͙͐੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮͸ʩ˺੮͸ɘͅ੮̹ʇ̼̹ˑʇͽʮ˦ʡ੮ʇ˦˺͙ʡʩ੮͐ʩɘ͐ੴ੮͸ʩʇ˦੮U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮˺͐ʩʇ̼ͅ੮ʮ˦੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩੴ੮ ͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇੴ੮ɘ˦ʁ੮{/õ੮ʁ͙̼ʮ˦ʡ੮৲ৰ৲ৱੴ੮͐ʩʇ;੮ɘˑˑ੮ʮ˚˚ʇʁʮɘ͐ʇˑ;੮˚ʇ˦͐ʮ˺˦ʇʁ੮ʩʮ˚ੳ੮îʩʇ੮͙ͅɺˈʇɻ͐ੴ੮{̼ੳ੮Ûੴ੮͸ɘͅ੮ʮ˦੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼੮͸ʮ͐ʩ੮ͅʇͷʇ̼ʇ੮ɘɺͅɻʇͅͅʇͅ੮ɘ˦ʁ੮ɘ੮ ɻ˺ˑ˺͐ͅ˺˚;੮ɺɘʡੳ੮{̼ੳ੮Û੮͸˺͙ˑʁ੮ɻɘˑˑ੮৹ৱৱ੮ુ˚ɘ;ɺʇ੮ʇͷʇ̼;੮˺͐ʩʇ̼੮ʁɘ;ੴ੮ɘ˦ʁ੮͐ʩɘ͐ૄͅ੮˦˺੮ˈ˺ˌʇૂ੮ ͐˺੮ʩɘͷʇ੮ʩʮͅ੮͸˺͙˦ʁͅ੮ʁ̼ʇͅͅʇʁ੮ɘ˦ʁ੮ʩʮͅ੮ɺɘʡ੮ɻʩɘ˦ʡʇʁੳ੮Pʇ੮ʩɘʁ੮ৱ৷ৰ੮̼͐ɘ˦̹ͅ˺̼͐ͅ੮͐˺੮ɘ˦੮/Û੮ ͐ʩʇ੮;ʇɘ̼੮̹̼ʮ˺̼ੳ੮Pʇ੮ʩɘʁ੮˺˦ʇ੮ˑʇʡ੮ɘ˚̹͙͐ɘ͐ʇʁ੮ɘʠ͐ʇ̼੮ɘ੮ɻ˺͙̼͐੮˺̼ʁʇ̼੮ͅɘ;ʮ˦ʡ੮ʮ͐੮͸ɘͅ੮˦ʇɻʇͅͅɘ̼;੮͐˺੮ͅɘͷʇ੮ʩʮͅ੮ˑʮʠʇੴ੮ɘ˦ʁ੮ʩʇ੮͸ɘͅ੮˺˦੮ʩʮͅ੮͸ɘ;੮͐˺੮ˑ˺ͅʮ˦ʡ੮͐ʩʇ੮˺͐ʩʇ̼ੳ੮U˦੮৲ৰৰ৶ੴ੮{ɘˑɻ˺ˑ˚੮ Iˑɘʁ͸ʇˑˑ੮̹͙ɺˑʮͅʩʇʁ੮ɘ˦੮˺ʠ͐ચɻʮ͐ʇʁ੮͐ͅ˺̼;੮ɘɺ˺͙͐੮{ʮˑˑʮ˺˦੮)˺ˑˑɘ̼੮{͙̼̼ɘ;ੴ੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮ ɘˑɻ˺ʩ˺ˑʮɻ੮͸ʩ˺੮ɻ˺͐ͅ੮͐ʩʇ੮ɻʮ͐;੮˺ʠ੮Ûʇ˦˺ੴ੮‡ʇͷɘʁɘੴ੮ɘ੮˚ʮˑˑʮ˺˦੮ʁ˺ˑˑɘ̼ͅ੮ʮ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮ ɘ˦ʁ੮ˈɘʮˑ੮ͷʮͅʮ͐ͅ੮˺ͷʇ̼੮͐ʇ˦੮;ʇɘ̼ͅੳ৾ਁ੮#ʩ͙˚̹੮ɻʩɘ˦ʡʇੳ੮ɻɻ˺̼ʁʮ˦ʡ੮͐˺੮#ɘ̹͐ɘʮ˦੮"ʮͽˑʇ̼ੴ੮͐ʩʇ੮ ɻʮ͐;੮̹ͅʇ˦͐੮͐͸˺੮˚ʮˑˑʮ˺˦੮ʁ˺ˑˑɘ̼ͅ੮˺˦੮{̼ੳ੮Û੮ʮ˦੮৲ৰ৲ৱੳ Ûʇʡ͙ˑɘ̼੮ ͷʮͅʮ͐ͅ੮ ͐˺੮ ͐ʩʇ੮ /Û੮ ɘʠʠ˺̼ʁ੮ ̹ˑʇ˦͐;੮ ˺ʠ੮ ˺̹̹˺̼͙͐˦ʮ͐ʮʇͅ੮ ʠ˺̼੮ /Û੮ ʁ˺ɻ͐˺̼ͅ੮ ͐˺੮ ɘʁ˚ʮ͐੮ʩʮ˚੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੴ੮ɺ͙͐੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮)ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺ੴ੮ુ͐ʩʇ੮̹̼˺ɺˑʇ˚੮ʮͅ੮ ͐ʩɘ͐੮ʩʇ੮̹̼ʇͅʇ˦͐ͅ੮ͷʇ̼;੮͸ʇˑˑੳ੯ੳ੯ੳ੯ੳ੮Pʇ੮ͅɘ;ͅੴ੮ૃU੮ɻɘ˦੮͐ɘˌʇ੮ɻɘ̼ʇ੮˺ʠ੮ʮ͐ੴ੮ʮ͐ૄͅ੮˚;੮͸˺͙˦ʁੴ੮ʮ͐ૄͅ੮˚;੮ ɺ˺ʁ;ੳૄ੮Ě˺͙੮ɻɘ˦੮͐ɘˑˌ੮͐˺੮ʩʮ˚ੴ੮ʩʇૄͅ੮˦˺͐੮ʁʇˑ͙ͅʮ˺˦ɘˑੳૂ੮U੮ɘͅˌʇʁ੮ʩʇ̼੮ʮʠ੮{̼ੳ੮Û੮ʩɘʁ੮ɘ੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ʁʮɘʡ˦˺ͅʮͅੳ੮äʩʇ੮ɻʩ͙ɻˌˑʇʁੴ੮ુU੮ʁ˺˦ૄ͐੮ˌ˦˺͸ੴ੮͐ʩʇ;੮ͅɘʮʁ੮ʮ͐੮͸ɘͅ੮ૃͅ˺ɻʮɘˑ੮ͅ˺˚ʇ͐ʩʮ˦ʡੳૄ੮ U͐ૄͅ੮ˑʮˌʇ੮ɺʇʮ˦ʡ੮ɘ੮ʡ̼˺͙ɻʩ੮͸ʮ͐ʩ੮̹ʇ˺̹ˑʇੳૂ੮U͐੮ͅ˺͙˦ʁͅ੮ˑʮˌʇ੮ɘ˦͐ʮͅ˺ɻʮɘˑ੮̹ʇ̼ͅ˺˦ɘˑʮ͐;੮ʁʮͅ˺̼ʁʇ̼ੳ੮/Û੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુPʇ੮ʮͅ੮ɘɺˑʇ੮͐˺੮˚ɘˌʇ੮ʁʇɻʮͅʮ˺˦ͅੴ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮͐ʩʇ;ૄ̼ʇ੮ɺɘʁ੮ ˺˦ʇͅ੮ɘ˦ʁ੮ʡ˺ʮ˦ʡ੮͐˺੮ˌʮˑˑ੮ʩʮ˚ੳૂ੮#̼ʮ͐ʮɻͅ੮˺ʠ੮͐ʩʇ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ɘʡɘʮ˦͐ͅ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ ʮ˦੮ˑɘ͸ͅ੮ˑʮˌʇ੮rØä੮ɘ̼ʡ͙ʇ੮͐ʩɘ͐੮͐ʩʇ;੮ˑʇɘͷʇ੮̹ʇ˺̹ˑʇ੮͐˺੮ુ̼˺͐੮͸ʮ͐ʩ੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅ੮˺˦ੳૂ৾ਂ੮H˺̼੮ {̼ੳ੮Ûੴ੮͐ʩʮͅ੮ͅʇʇ˚ʇʁ੮ή͙ʮ͐ʇ੮ˑʮ͐ʇ̼ɘˑˑ;੮̼͙͐ʇੳ {̼ੳ੮Û੮͸ɘͅ੮˺ɺͷʮ˺͙ͅˑ;੮ͅʩ˺͸ʮ˦ʡ੮͙̹੮˺˦੮ˈ͙͐ͅ੮ɘɺ˺͙͐੮ʇͷʇ̼;੮ɻʮ͐;੮ɘʡʇ˦ɻ;ૄͅ੮̼ɘʁɘ̼੮ͅɻ̼ʇʇ˦ੳ੮ #ɘ˚ɘɻʩ˺੮˦˺͐ʇʁੴ੮ુĔʇ੮ʡ˺͐੮͐ʩʇ੮ɻɘͅʇ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮ʮͅ੮ͅʇʇʮ˦ʡ੮ʩʮ˚੮ʇͷʇ̼;੮ ʁɘ;ੳ੮ૃPʇૄͅ੮ɻ˺͐ͅʮ˦ʡ੮͙ͅ੮̼ʇͅ˺͙̼ɻʇͅ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮ɺʇ੮ʡ˺ʮ˦ʡ੮͐˺੮˺͐ʩʇ̼੮ɻɘͅʇͅੳૄ੮"͙͐੮ɘˑˑ੮͐ʩʇ;੮ ɻ˺͙ˑʁ੮ʁ˺੮͸ɘͅ੮ͅɘ;ੴ੮ૃĚʇɘʩੴ੮;˺͙੮ɻɘ˦ૄ͐੮ɻɘˑˑ੮৹ৱৱ੮ʇͷʇ̼;੮͐ʮ˚ʇ੮;˺͙੮˦ʇʇʁ੮;˺͙̼੮ɻ˺ˑ˺͐ͅ˺˚;੮ɺɘʡ੮ ɻʩɘ˦ʡʇʁ੮ɘ˦ʁ੮;˺͙੮˦ʇʇʁ੮͐˺੮ɺʇ੮ɻˑʇɘ˦ʇʁ੮͙̹ੳૄૂ੮#{Øૄͅ੮̼˺ˑʇ੮͸ɘͅ੮͐˺੮ɺ̼ʮ˦ʡ੮͐˺ʡʇ͐ʩʇ̼੮͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ੴ੮ ){Pੴ੮ P˺˚ʇˑʇͅͅ੮ äʇ̼ͷʮɻʇͅੴ੮ ʁ͙ˑ͐੮ Ø̼˺͐ʇɻ͐ʮͷʇ੮ äʇ̼ͷʮɻʇͅੴ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮˺˦੮ɘ੮̼ʇʡ͙ˑɘ̼੮ɺɘͅʮͅ੮͐˺੮ʁʮͅɻ͙ͅͅ੮͐ʩʇ੮ɻɘͅʇੳ੮"͙͐੮͸ʩ˺ͅʇ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮

CRISIS

67

͸ɘͅ੮ʩʇ੺੮U͐ૄͅ੮˦˺͐੮){Pૄͅ੮ˈ˺ɺ੮͐˺੮ʁʇɘˑ੮͸ʮ͐ʩ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˦˺੮ɻˑʇɘ̼੮ʁʮɘʡ˦˺ͅʮͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ ˺ͷʇ̼͙ͅʮ˦ʡ੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ɺ͙͐੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮ʁ˺ʇͅ˦ૄ͐੮̼ʇɘˑˑ;੮ʩɘͷʇ੮ુɻˑʮʇ˦͐ͅૂ੮ɘ˦ʁ੮ɻʇ̼͐ɘʮ˦ˑ;੮ʁ˺ʇͅ˦ૄ͐੮˺̼ʡɘ˦ʮΈʇ੮ˑ˺ɻˌʇʁ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ʠ˺̼੮͐ʩʇ˚ੳ੮Ø˺ˑʮɻʇੴ੮˺˦੮͐ʩʇ੮ ˺͐ʩʇ̼੮ʩɘ˦ʁੴ੮ɘ̼ʇ੮ફʮ˦੮͐ʩʇ੮͸˺̼ʁͅ੮˺ʠ੮˺˦ʇ੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅબ੮ુ͐ʩʇ੮͐ʇ̼˚ʮ˦ɘˑੴ੮ɘˑˑચ̹͙̼̹˺ͅʇ੮̼ʇ˚ʇʁʮɘˑ੮ɘʡʇ˦͐ૂ੮͐ʩɘ͐੮ɻɘ˦ૄ͐੮͸ɘˑˌ੮ɘ͸ɘ;ੳ৾ਃ )ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺੮͐˺ˑʁ੮˚ʇ੮͐ʩʇ;੮͸˺̼ˌʇʁ੮͙̹੮ɘ੮ɻ˺˦ͅʇ˦͙ͅͅ੮͐ʩɘ͐੮{̼ੳ੮Û੮ͅʩ˺͙ˑʁ੮ɺʇ੮ ɻ˺˦ͅʇ̼ͷʇʁ੮ɘ˦ʁ੮ʇͷʇ˦੮ʩɘʁ੮͐ʩʇ੮ɻ˺͙̼͐ͅ੮ુ˺˦੮ɺ˺ɘ̼ʁૂ੮͐˺੮ʁ˺੮ͅ˺ੵ੮ુ͐੮͐ʩʮͅ੮̹˺ʮ˦͐ੴ੮͸ʇૄͷʇ੮ʡ˺͐੮ ͐ʩʇ੮˚˺˦ʇ;੮ͅʮ͙͐ɘ͐ʇʁੴ੮˦˺͸੮ʮ͐ૄͅ੮ˈ͙͐ͅ੮ϲʮ˦ʁʮ˦ʡ੮ʩʮ˚੮ɘ੮ˑ˺ɻɘ͐ʮ˺˦ੳૂ੮îʩɘ͐੮͸ɘͅੴ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮ ͐ʩʇ੮͐ͅʮɻˌʮ˦ʡ੮̹˺ʮ˦͐ੳ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁੴ੮˺˦ʇ੮˺ʠ੮#ɘ˚ɘɻʩ˺ૄͅ੮͙̹ͅʇ̼ͷʮͅ˺̼ͅੴ੮ͅɘʮʁ੮͐ʩʮͅ੮̹̼˺ϲʮˑʇ੮͸ɘͅ੮ɻɘ͐ɘ̼͐ͅ˺̹ʩʮɻɘˑˑ;੮ʩɘ̼ʁ੮͐˺੮̹ˑɘɻʇੵ੮ુØʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘͷʇ੮ͅʇͷʇ̼ʇ੮˚ʇʁʮɻɘˑ੮ʩʇɘˑ͐ʩ੮ ʮ͙ͅͅʇͅੴ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʮ͙ͅͅʇͅੴ੮ɘ˦ʁ੮ʁ̼͙ʡ੮ʮ͙ͅͅʇͅੴ੮˦˺ɺ˺ʁ;੮͸ɘ˦͐ͅ੮͐ʩʇ˚ੳ੮îʩʇ੮˚ʇʁʮɻɘˑ੮ ͅʮʁʇ੮ͅɘ;ͅੴ੮ૃîʩʇ;ૄ̼ʇ੮͐˺˺੮ɘʡʮ͐ɘ͐ʇʁ੮͐˺੮̼͐ʇɘ͐੮˚ʇʁʮɻɘˑˑ;ੴૄ੮ɘ˦ʁ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʮʁʇ੮ʮͅ੮ ˑʮˌʇੴ੮ૃĚʇɘʩੴ੮U੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐ʩʇ੮ʡ͙;੮͸ʮ͐ʩ੮ɘɺͅɻʇͅͅʇͅ੮ɘ˦ʁ੮ɘ੮ɻ˺ˑ˺͐ͅ˺˚;੮ɺɘʡ੮͐ʩɘ͐ૄͅ੮ʮ˦੮ɘ੮ ͸ʩʇʇˑɻʩɘʮ̼੮˚ʮͅͅʮ˦ʡ੮ɘ੮ˑʇʡੳૄ੮ä˺੮͸ʩʇ̼ʇ੮ɘ̼ʇ੮͸ʇ੺੮Ĕʇ੮̹ʮɻˌ੮ʩʮ˚੮͙̹੮ɘ˦ʁ੮ˑʇɘͷʇ੮ʩʮ˚੮ɘ͐੮͐ʩʇ੮ ̼͐ɘʮ˦੮͐ͅɘ͐ʮ˺˦ੳૂ੮){Pੴ੮ͅʩʇ੮˦˺͐ʇʁੴ੮͸˺͙ˑʁ˦ૄ͐੮̹͙ͅʩ੮ʠ˺̼੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͙˦͐ʮˑ੮͐ʩʇ;੮ ˌ˦ʇ͸੮͐ʩʇ̼ʇ੮͸ɘͅ੮ɘ੮ɺʇʁੴ੮ɘ˦ʁ੮͐ʩ˺ͅʇ੮ɺʇʁͅ੮͸ʇ̼ʇ˦ૄ͐੮͙˦ʁʇ̼੮͐ʩʇʮ̼੮ɻ˺˦̼͐˺ˑੳ੮îʩʇ;੮͸ʇ̼ʇ੮ʮ˦੮ private facilities that had the discretion to refuse unwanted and expensive indiͷʮʁ͙ɘˑͅੴ੮ˑʮˌʇ੮{̼ੳ੮Ûੳ Both Camacho and some clinicians I spoke to evoked a similar set of chalˑʇ˦ʡʇͅ੮ʮ˦੮̼ʇˑɘ͐ʮ˺˦੮͐˺੮ɘ˦੮ʮ˦ɻ̼ʇɘͅʇ੮ʮ˦੮̹ʇ˺̹ˑʇ੮ͅʇʇˌʮ˦ʡ੮͐˺੮ɻ˺˚˚ʮ͐੮ુ͙ͅʮɻʮʁʇ੮ɺ;੮ɻ˺̹ੳૂ੮ š˦ʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮ #{Ø੮ ͸ɘͅ੮ ʠ˺ˑˑ˺͸ʮ˦ʡ੮ ʩɘʁ੮ ɺʇʇ˦੮ ʡ˺ʮ˦ʡ੮ ʠ̼˺˚੮ ͐ͅɘ͐ʮ˺˦੮ ͐˺੮ ͐ͅɘ͐ʮ˺˦੮ ʁʇ˚ɘ˦ʁʮ˦ʡ੮͐˺੮ɺʇ੮ͅʩ˺͐ੴ੮ɺʇʠ˺̼ʇ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ɻˑʮ˚ɺʮ˦ʡ੮˺ͷʇ̼੮ɘ੮͸ɘˑˑ੮͐˺੮ʡʇ͐੮ʮ˦ੳ੮#ɘ˚ɘɻʩ˺੮ ʇͽ̹ˑɘʮ˦ʇʁੴ੮ુPʇ੮͸ɘͅ੮ϲʮͽɘ͐ʇʁ੮˺˦੮ʁ;ʮ˦ʡ੮ɺ;੮͐ʩʇ੮ʩɘ˦ʁͅ੮˺ʠ੮ɘ˦੮˺ϲϲʮɻʇ̼ੴ੮ʩʇ੮͸ɘͅ˦ૄ͐੮ʡʇ͐͐ʮ˦ʡ੮ ʮ͐੮˺͙͐੮˺ʠ੮ʩʮͅ੮ʩʇɘʁ੯ੳ੯ੳ੯ੳ੮ʩʇ੮͸ɘͅ੮̼ʇʠ͙ͅʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ˈ͙͐ͅ੮ͅɘ;ʮ˦ʡੴ੮ૃU੮ʁ˺˦ૄ͐੮˦ʇʇʁ੮ͅʇ̼ͷʮɻʇͅੴ੮ U੮ˈ͙͐ͅ੮͸ɘ˦͐੮͐˺੮ʁʮʇੳૄૂ õ˦ɘɺˑʇ੮͐˺੮˚ɘˌʇ੮͐ʩʇʮ̼੮৵ৱ৵ৰͅ੮͐ͅʮɻˌ੮ˑ˺˦ʡ੮ʇ˦˺͙ʡʩ੮͐˺੮ʇͷʇ˦੮ɻ˺˦͐ʇ˚̹ˑɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ʁʮʁ੮͸ʩɘ͐੮͐ʩʇ;੮ʁ˺੮ɺʇ͐ͅੵ੮͐ʩʇ;੮ɘ̼̼ʇ͐ͅʇʁ੮ʩʮ˚ੳ੮îʩʇ;੮ʁʮʁ੮ͅ˺੮ɘʠ͐ʇ̼੮ ɻ˺˦͙ͅˑ͐ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇ੮ʁʮ̼͐ͅʮɻ͐੮ɘ͐͐˺̼˦ʇ;੮͐˺੮˚ɘˌʇ੮͙̼ͅʇ੮ʩʇ੮͸˺͙ˑʁ੮ɺʇ੮˺ʠʠʇ̼ʇʁ੮ɘ੮ુʁʮͷʇ̼ͅʮ˺˦ૂ੮̹̼˺ʡ̼ɘ˚ੴ੮͸ʩʇ̼ʇɺ;੮ʩʇ੮ɻ˺͙ˑʁ੮ɘɻɻʇ̹͐੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮ʡʇ͐੮͐ʩʇ੮ɻʩɘ̼ʡʇͅ੮ʁ̼˺̹̹ʇʁੳ੮ )ʇ͐ʇɻ͐ʮͷʇ੮#ɘ˚ɘɻʩ˺੮ˌ˦˺͸ͅ੮ʩ˺͸੮͐ʩʮͅ੮ͅ˺͙˦ʁͅੵ੮ુʮ͐ૄͅ੮͐ʩʇ੮ˑɘ͐ͅ੮̼ʇͅ˺̼͐ੴ੮͸ʇ੮ˌ˦˺͸੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੮ʮͅ˦ૄ͐੮ɘ੮ɻ̼ʮ˚ʮ˦ɘˑੴ੮͸ʇ੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮͐ͅʮʡ˚ɘ͐ʮΈʇ੮͸ʩɘ͐੮ʩʇૄͅ੮ʡ˺ʮ˦ʡ੮͐ʩ̼˺͙ʡʩੳ੮͐੮͐ʩʇ੮ ͅɘ˚ʇ੮͐ʮ˚ʇੴ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮͸ɘͅ˦ૄ͐੮ɻ˺˚̹ˑʮɘ˦͐੮ɘ˦ʁ੮ʩʇ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʡʇ͐੮ʩʇˑ̹ੴ੮͸ʇ੮͸ʇ̼ʇ੮ ɘɺˑʇ੮͐˺੮͙ͅʇ੮͐ʩɘ͐੮ɻ̼ʮ˚ʮ˦ɘˑ੮ɻɘͅʇ੮͐˺੮ʩɘͷʇ੮͐ʩʇ੮ɻ˺͙̼͐੮˚ɘ˦ʁɘ͐ʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐੮ ʠ˺̼੮ʩʮ˚ੳૂ੮Ĕʩʇ˦੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͸˺˦ૄ͐੮ɻ˺ʇ̼ɻʮͷʇˑ;੮ɘʁʁ̼ʇͅͅ੮ɺʇʩɘͷʮ˺̼ͅ੮͐ʩɘ͐੮ ͅ˺ɻʮʇ͐;੮ʁʇʇ˚ͅ੮ફ̼ʮʡʩ͐ˑ;੮˺̼੮͸̼˺˦ʡˑ;બ੮͙˦ɘɻɻʇ̹͐ɘɺˑʇੴ੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ˈ͙͐ͅʮɻʇ੮ͅ;͐ͅʇ˚੮ɻɘ˦੮ ͐ͅʇ̹੮ʮ˦ੳ੮U͐੮͙ͅʇͅ੮͐ʩʇ੮̹˺͸ʇ̼ͅ੮˺ʠ੮ˑɘ͸੮͐˺੮˺ͷʇ̼ɻ˺˚ʇ੮͐ʩʇ੮̼ʇɻɘˑɻʮ̼͐ɘ˦ɻʇ੮˺ʠ੮˚ʇʁʮɻʮ˦ʇੳ

68

T H E C O N S E RVATO R S H I P C O N T I N U U M

Ě˺͙੮ͅʩ˺͙ˑʁ੮˦˺͐ʇ੮˺˦ʇ੮ʠʇɘ͙̼͐ʇ੮˺ʠ੮ɺ˺͐ʩ੮˺ʠ੮͐ʩʇͅʇ੮ુʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅૂ੮ɻɘͅʇͅੵ੮ʮ˦੮ ʇɘɻʩੴ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮͸ɘͅ੮ɻɘˑˑʮ˦ʡ੮ʇ˦˺̼˚˺͙ͅ੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮ફ˺̼੮ʇͷʇ˦੮ͅ˺ˑʮɻʮ͐ʮ˦ʡબ੮͐ʩʇʮ̼੮˺͸˦੮ ʁʇɘ͐ʩੳ੮{˺͐ͅ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ˦ૄ͐ੳ੮੮){P੮ɻˑʮ˦ʮɻʮɘ˦੮̹˺ʮ˦͐ʇʁ੮˺͙͐ੴ੮ુĔʩʇ˦੮͸ʇ੮͐ɘˑˌʇʁ੮ɘɺ˺͙͐੮ ͐ʩɘ͐੮ ય{̼ੳ੮ Ûરੴ੮ ͸ʇ੮ ɘˑˑ੮ ɘʡ̼ʇʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇ̼ʇૄͅ੮ ɘ੮ ͐ʩ˺͙ͅɘ˦ʁ੮ ˚˺̼ʇ੮ ˑʮˌʇ੮ ʩʮ˚੮ ͐ʩɘ͐੮ ɘ̼ʇ˦ૄ͐੮ ʡ˺ʮ˦ʡ੮ય͐˺੮͐ʩʇ੮/Ûરੴ੮ɘ̼ʇ˦ૄ͐੮ɘ̼͐͐ɘɻ͐ʮ˦ʡ੮͐ʩʇ੮ɘ͐͐ʇ˦͐ʮ˺˦੮˺ʠ੮˚ʇʁʮɻɘˑ੮ͅʇ̼ͷʮɻʇͅੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮ ʩ͙˚ɘ˦੮ɺʇʮ˦ʡͅੴ੮ɻˑ͙˚̹ʇʁ੮ʮ˦੮ɺˑɘ˦ˌʇ͐ͅੴ੮ʇͷʇ̼;͸ʩʇ̼ʇ੮ʮ˦੮͐ʩʇ੮ɻʮ͐;ੴ੮͸ʮ͐ʩ੮̹̼ʇ͐͐;੮ʩʇʮ˦˺͙ͅ੮ ˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅੴ੮˦˺͐੮ɺʇʮ˦ʡ੮̼͐ʇɘ͐ʇʁੳૂ੮"͙͐੮͐ʩʇ;੮͸ʇ̼ʇ˦ૄ͐੮ɘ˦˦˺;ʮ˦ʡ੮͐ʩʇ੮˦ʇʮʡʩɺ˺̼ͅੴ੮ soliciting the police, facing eviction from their housing, or causing fear in their ʠɘ˚ʮˑʮʇͅੳ੮˦ʁ੮ͅ˺ੴ੮ɺ;੮ɘ˦ʁ੮ˑɘ̼ʡʇੴ੮͐ʩʇ;੮͸ʇ̼ʇ˦ૄ͐੮ʡʇ͐͐ʮ˦ʡ੮৵ৱ৵ৰʇʁੳ

CONCLUSION: DISORDER-DRIVEN DISCRETION îʩʇ੮rØä੮ɻ͐੮ʁʇ̹͙͐ʮΈʇʁ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɘ˦ʁ੮̹˺ˑʮɻʇ੮͐˺੮͸̼ʮ͐ʇ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ʠ˺̼੮৵ৱ৵ৰ੮ʩ˺ˑʁͅ੮ ɘ˦ʁ੮̼͐ɘ˦̹ͅ˺̼͐੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͐˺੮ɘ˦੮/Û੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੳ੮Ě˺͙ૄʁ੮ɺʇ੮ʩɘ̼ʁ੮̹̼ʇͅͅʇʁ੮͐˺੮ϲʮ˦ʁ੮ ɘ˦;੮ɻˑʇɘ̼੮ʡ͙ʮʁʇˑʮ˦ʇͅ੮ʠ˺̼੮͸ʩʇ˦੮͐ʩʇ;੮ͅʩ˺͙ˑʁ੮ɘɻ͙͐ɘˑˑ;੮ʁ˺੮ͅ˺ੳ੮੮͐ͅɘ͐ʇ੮˺ϲϲʮɻʮɘˑ੮ɘʁ˚ʮ͐͐ʇʁ੮ ͐ʩɘ͐੮͐ʩʇ;੮ʩɘʁ੮ુʠɘʮˑʇʁ੮ɻ˺˦͙ͅ˚ʇ̼ͅ੮ɘ˦ʁ੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅ੮ʮ˦੮͐ʩʮͅ੮̹ͅɘɻʇ੮યʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐રੳૂ੮"͙͐੮͐˺੮͐ʩʇ˚ੴ੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ˑʇͷʇ̼ͅ੮˺ʠ੮ɘɻ͐ʮ˺˦੮͸ʇ̼ʇ੮͙˦ɻˑʇɘ̼ੵ੮ુયš͙̼੮ˑʇͷʇ̼ɘʡʇર੮ ʮͅ੮ ̹̼ʇ͐͐;੮ ˑʮ˚ʮ͐ʇʁੳ੮ U͐ૄͅ੮ ͐ʩʮͅ੮ ʁɘ˦ɻʇ੮ ɺʇ͐͸ʇʇ˦੮ ͐ʩʇ੮ ˑʇʡɘˑ੮ ͅ;͐ͅʇ˚੮ ɘ˦ʁ੮ ͐ʩʇ˦੮ ˑ˺ɻɘˑ੮ ˈ͙̼ʮͅʁʮɻ͐ʮ˺˦ͅੳ੯ੳ੯ੳ੯ੳ੮ä͐ɘ͐ʇ੮ˑɘ͸੮ʁʮɻ͐ɘ͐ʇͅ੮͸ʩ˺੮ɻɘ˦੮̹ˑɘɻʇ੮ͅ˺˚ʇ˺˦ʇ੮˺˦੮ɘ੮ʩ˺ˑʁੴ੮ɺ͙͐੮͐ʩʇ̼ʇૄͅ੮ ɘ੮ˑ˺͐੮˺ʠ੮˦͙ɘ˦ɻʇͅ੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠ੮̹ʇ˺̹ˑʇૄͅ੮ʮ˦͐ʇ̼̹̼ʇ͐ɘ͐ʮ˺˦੮˺ʠ੮͸ʩɘ͐੮˚ʇʇ͐ͅ੮͐ʩʇ੮͐ʩ̼ʇͅʩ˺ˑʁੳૂ੮ äʩʇ੮˚͙ͅʇʁੴ੮ુ)˺੮͸ʇ੮ʡ˺੮ʮ˦੮ɘ˦ʁ੮ʁ˺੮ɘ੮ˑ˺͐੮˺ʠ੮ɘ͙ʁʮ͐ʮ˦ʡ੮͐˺੮ͅʇʇ੮͐ʩʇ੮ή͙ɘˑʮ͐;੮˺ʠ੮͐ʩɘ͐੺੮‡˺ੳ੮ îʇɻʩ˦ʮɻɘˑˑ;ੴ੮ʁ˺੮͸ʇ੮ʩɘͷʇ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮ʁ˺੮ͅ˺˚ʇ੮˺ʠ੮͐ʩɘ͐੺੮Ø̼˺ɺɘɺˑ;ੳ੮"͙͐੮Uૄ˚੮˦˺͐੮͙̼ͅʇ੮ ͐ʩɘ͐੮ʮ͐ૄͅ੮ɺʇʇ˦੮̼ʇͅ˺͙̼ɻʇʁ੮ʮ˦੮͐ʩɘ͐੮ʠɘͅʩʮ˺˦ੳૂ îʩʮͅ੮ ɘɺʁʮɻɘ͐ʇʁ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ˑʇɘͷʇͅ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ʮ˦੮ ͐ʩʇ੮ ʩɘ˦ʁͅ੮ ˺ʠ੮ ͐ʩʇ੮ ̹˺ˑʮɻʇੳ੮ ੮ ৵ৱ৵ৰ੮ ʩ˺ˑʁ੮ ʮͅ੮ ˺˦ʇ੮ ͐˺˺ˑ੮ ʮ˦੮ ˑɘ͸੮ ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ૄͅ੮ ͅ˺ͷʇ̼ʇʮʡ˦੮ ̹˺͸ʇ̼੮ ͐˺˺ˑˌʮ͐ੴ੮ ɘ˦ʁ੮͐ʩʇ;੮͙ͅʇ੮ʮ͐ੴ੮̹̼ʇʁʮɻ͐ɘɺˑ;ੴ੮̹̼ʮ˚ɘ̼ʮˑ;੮˺˦੮͐ʩʇ੮ɘ͙ʁʮɺˑ;੮ɘʁʁʮɻ͐ʇʁ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮͐ʩʇ੮ ͅʮˑʇ˦͐ˑ;੮͙ͅʠʠʇ̼ʮ˦ʡੴ੮͐ʩʇ੮ͷʮͅʮɺˑ;੮ʁʮ̼͙̹͐ͅʮͷʇ੮ɘ˦ʁ੮˦˺͐੮͐ʩʇ੮ʮ˦ͷʮͅʮɺˑ;੮ʁ;ʮ˦ʡੳ৾਄੮/ͷʇ˦੮˺ϲϲʮɻʇ̼ͅ੮ɻ˺˚˚ʮ͐͐ʇʁ੮͐˺੮ʩʇˑ̹ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʡʇ͐੮̼͐ʇɘ͐˚ʇ˦͐੮ʠʇʇˑ੮ɘ੮ͅʇ˦ͅʇ੮˺ʠ੮ʠ͙͐ʮˑʮ͐;੮ɘɺ˺͙͐੮͸ʩɘ͐੮ ͸ʮˑˑ੮ʩɘ̹̹ʇ˦੮͐˺੮̹ʇ˺̹ˑʇ੮ˑʮˌʇ੮{̼ੳ੮Û੮˺̼੮kʇ̼̼;੮ʠ͙̼͐ʩʇ̼੮ɘˑ˺˦ʡ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮îʩʇ;੮ɘ̼ʇ੮ ͐ʩ͙ͅ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ˑʇɘ˦੮˺˦੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮˺ʠ੮ʁɘ˦ʡʇ̼੮͐˺੮ͅʇˑʠ੮ɘ˦ʁ੮ʁɘ˦ʡʇ̼੮͐˺੮˺͐ʩʇ̼ͅ੮ ͐ʩɘ˦੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ৿৻੮ͅ੮ɘ੮̼ʇ͙ͅˑ͐ੴ੮̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ̼ʇ੮̼͙ˑʇʁ੮˺͙͐੮˺ʠ੮ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ͐੮͐ͅʇ̹੮˺˦ʇੳ Iʮͷʇ˦੮ɘˑˑ੮͐ʩɘ͐ੴ੮͸ʩ˺੮ʮ˦੮˺͙̼੮ä˺͙͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɺʇɘɻʩ੮͐˺͸˦੮ʡ˺͐੮৵ৱ৵ৰʇʁ੮ʮ˦੮͐ʩʇ੮ ʇ˦ʁੵ੮I͙ɘʁɘˑ͙̹ʇੴ੮kʇ̼̼;ੴ੮˺̼੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇ੺੮Uʠ੮;˺͙ૄͷʇ੮ʡ˺͐੮͐ʩʇ੮ʡʮ͐ͅੴ੮;˺͙੮˚ʮʡʩ͐੮ʩɘͷʇ੮ ʡ͙ʇͅͅʇʁ੮Ø̼˺ʠʇͅͅ˺̼੮k˺ˑʮʇੳ੮îʩʇ੮͸ʇʇˌ੮ɘʠ͐ʇ̼੮U੮͸ʇ˦͐੮˺͙͐੮͸ʮ͐ʩ੮͐ʩʇ੮˺͙̼͐ʇɘɻʩ੮͐ʇɘ˚ੴ੮k˺̼ʁɘ˦੮

CRISIS

69

sent me a video of what happened when police showed up at Jolie’s campsite for ͐ʩʇ੮ ͅ͸ʇʇ̹ੳ੮ äʩʇ੮ ʮͅ੮ ʮ˦੮ ɘ੮ ʁ̼ʇͅͅ੮ ɘ˦ʁ੮ ͙ͅ˦ʩɘ͐ੴ੮ ʠ˺ˑʁʮ˦ʡ੮ ʩʇ̼੮ ɻˑ˺͐ʩʇͅੴ੮ ͸ʩʮˑʇ੮ ͅʮͽ੮ ˺ϲϲʮɻʇ̼ͅ੮ ɻˑ͙͐ͅʇ̼੮˦ʇɘ̼ɺ;ੳ੮Ě˺͙੮ɻɘ˦੮ͅʇʇ੮ɘ˦੮˺ϲϲʮɻʇ̼੮ɘ̹̹̼˺ɘɻʩ੮ʩʇ̼ੳ äʩʇ੮͐ʇˑˑͅ੮ʩʮ˚ੴ੮ુUૄ˚੮˦˺͐੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦ੴ੮Uૄ˚੮ɘˑˑ˺͸ʇʁ੮͐˺੮ɺʇ੮ɘ੮ͷʇ˦ʁ˺̼ੴ੮ɘ˦ʁ੮ U੮ʩɘͷʇ੮˦˺͐੮ʠ͙ɻˌʇʁ੮͙̹੮ɘ˦;͐ʩʮ˦ʡੳૂ੮îʩʇ੮˺ϲϲʮɻʇ̼੮˦˺ʁͅੴ੮ɺ͙͐੮͙ͅʁʁʇ˦ˑ;੮͐͸˺੮˺ϲϲʮɻʇ̼ͅ੮ʡ̼ɘɺ੮ ʩʇ̼੮ʠ̼˺˚੮ɺʇʩʮ˦ʁੳ ુĔʩɘ͐ૄͅ੮ʡ˺ʮ˦ʡ੮˺˦੺ૂ੮ͅʩʇ੮ɘͅˌͅੳ੮îʩʇ੮˺ϲϲʮɻʇ̼੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮ʩʇ̼੮͐ͅʮˑˑ੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮ˑʮ͐ͅʇ˦ʮ˦ʡ੮͸ʩʇ˦੮ͅʩʇ੮ɘ˦˦˺͙˦ɻʇͅੴ੮ુU੮ʩɘͷʇ੮ɘ੮̼ʇ̼͐ͅɘʮ˦ʮ˦ʡ੮˺̼ʁʇ̼੮ɘʡɘʮ˦͐ͅ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮ ય˺ʠ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩરੳૂ îʩʇ੮˺ϲϲʮɻʇ̼ͅ੮͐ͅɘ̼͐੮ˑʇɘʁʮ˦ʡ੮ʩʇ̼੮˺ʠʠੴ੮ɘ˦ʁ੮ʩʇ̼੮ͷ˺ʮɻʇ੮̼ɘʮͅʇͅੴ੮ુU੮ʁ˺˦ૄ͐੮˦ʇʇʁ੮͐˺੮ʡ˺੮͐˺੮ ͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੸ૂ ‡ʇɘ̼ɺ;ੴ੮ɘ੮ɺ;͐ͅɘ˦ʁʇ̼੮̹̼˺͐ʇ͐ͅͅੴ੮ુîʩʇ̼ʇૄͅ੮͐͸ʇ˦͐;੮̹ʇ˺̹ˑʇ੮ʠ˺̼੮˺˦ʇ੮͸˺˚ɘ˦੸ૂ k˺ˑʮʇ੮ʮͅ੮˦˺͸੮ͅʩ˺͙͐ʮ˦ʡੴ੮ુĔʩɘ͐੮ʮͅ੮͸̼˺˦ʡ੮͸ʮ͐ʩ੮;˺͙ੴ੮Uૄ˚੮ɘ੮õੳäੳ੮ʠʇʁʇ̼ɘˑ੮˚ɘ̼ͅʩɘˑੴ੮˚;੮ ɻ̼ʇʁʇ˦͐ʮɘˑͅ੮ɘ̼ʇ੮̼ʇɘˑੴ੮͸ʩɘ͐੮ʮͅ੮͸̼˺˦ʡ੮͸ʮ͐ʩ੮;˺͙੮̹ʇ˺̹ˑʇੴ੮U੮ʩɘͷʇ੮˦˺͐੮ɺ̼˺ˌʇ˦੮͐ʩʇ੮ˑɘ͸ੴ੮ U੮ɘ˚੮͐ʩʇ੮͐ʮ͐ˑʇ੮˺͸˦ʇ̼ੳ੮Ě˺͙੮ɻɘ˦ૄ͐੮ʁʇ͐ɘʮ˦੮˚ʇ੮ʠ˺̼੮˦˺੮̼ʇɘͅ˺˦ੳૂ ‡˺੮˺˦ʇ੮̼ʇ̹ˑʮʇͅੳ ‡˺͸੮ͅʩʇ੮ʮͅ੮ͅɻ̼ʇɘ˚ʮ˦ʡੴ੮ુĚ˺͙੮ɘ̼ʇ੮‡ɘΈʮͅੴ੮;˺͙੮ɘ̼ʇ੮ʠ͙ɻˌʮ˦ʡ੮‡ɘΈʮͅੳ੮Ĕʩɘ͐੮ɘ̼ʇ੮͐ʩʇ੮ ɻʩɘ̼ʡʇͅ੺ૂ੮îʩʇ;੮ˑʮʠ͐੮ʩʇ̼੮ʮ˦͐˺੮͐ʩʇ੮ɘ˚ɺ͙ˑɘ˦ɻʇ੮ɘ˦ʁ੮ɻˑ˺ͅʇ੮͐ʩʇ੮ʁ˺˺̼ੳ U੮ʡʇ͐੮ɘ੮͐ʇͽ͐੮ʠ̼˺˚੮k˺̼ʁɘ˦੮ɘ੮ʠʇ͸੮ʁɘ;ͅ੮ˑɘ͐ʇ̼ੴ੮ુš͙̼੮ʡʮ̼ˑ੮ʡ˺͐੮˺͙͐੮˺˦੮{˺˦ʁɘ;ੳૂ੮äʩʇ੮ ʁʮʁ˦ૄ͐੮ʇͷʇ˦੮˚ɘˌʇ੮ʮ͐੮͐˺੮͐ʩʇ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇ੮ͅʇͷʇ˦͐;ચ͐͸˺੮ʩ˺͙̼ͅੴ੮ɺʇɻɘ͙ͅʇ੮ુ͸ʇ੮͐ʩʮ˦ˌ੮͐ʩʇ੮ ̹˺ˑʮɻʇ੮ʁʮʁ੮ɘ੮ͅʩʮ͐͐;੮ˈ˺ɺ੮˺˦੮͐ʩʇ੮ʩ˺ˑʁੳૂ੮îʩɘ͐੮ʮͅ੮͐˺੮ͅɘ;ੴ੮͐ʩʇ;੮ɻ˺͙ˑʁ˦ૄ͐੮ફ˺̼੮ʁʮʁ˦ૄ͐੮̼͐;੮ ͐˺બ੮ɻ˺˦ͷʮ˦ɻʇ੮͐ʩʇ੮/Û੮ɻˑʮ˦ʮɻʮɘ˦੮͐˺੮ˌʇʇ̹੮ʩʇ̼ੳ੮îʩʇ੮˦ʇͽ͐੮ɻʩɘ̹͐ʇ̼੮ɘͅˌͅ੮͸ʩ;੮ɻ˺˦ͷʮ˦ɻʮ˦ʡ੮ ͐ʩʇ˚੮ʮͅ੮ͅ˺੮ʩɘ̼ʁੴ੮ɘ˦ʁ੮͸ʩ;੮ʮ͐ૄͅ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮˦˺͐੮͸˺̼͐ʩ੮ʮ͐੮͐˺੮̼͐;ੳ

CHAPTER 3

EMERGENCY ROOM

T

hankfully, the videos of Serge Obolensky are now gone, but you used to be able to search for “No Hands,” “Crazy,” and “Hollywood” on Ě˺͙î͙ɺʇ੮ɘ˦ʁ੮ϲʮ˦ʁ੮ʩʮ˚ੳ੮U˦੮˺˦ʇ੮͐ʩɘ͐੮ͅʇʇ˚ͅ੮͐˺˺੮P˺ˑˑ;͸˺˺ʁ੮͐˺੮ɺʇ੮̼͙͐ʇੴ੮ ͐ʩʇ੮ɻɘ˚ʇ̼ɘ̹ʇ̼ͅ˺˦੮ʮͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ɘ˦੮rØ)੮˺ϲϲʮɻʇ̼੮͸ʩ˺੮ʮͅ੮ˑɘ;ʮ˦ʡ੮˺͙͐੮ɘ੮̹ͅʮˌʇ੮̼͐ɘ̹੮ ʮ˦੮͐ʩʇ੮̼˺ɘʁੴ੮̹̼ʇ͙ͅ˚ɘɺˑ;੮͐˺੮̹͙͐੮ɘ˦੮ʇ˦ʁ੮͐˺੮ɘ੮ɻɘ̼੮ɻʩɘͅʇ੮ʮ˦੮̹̼˺ʡ̼ʇͅͅੳ੮îʩʇ੮ͷʮʁʇ˺੮̹ɘ˦ͅ੮ ˺ͷʇ̼੮͐˺੮ɘ੮˚ɘ˦੮͸ʮ͐ʩ੮˦˺੮ʩɘ˦ʁͅੴ੮ɘ੮ʡ̼ʮΈΈˑʇʁ੮ɺʇɘ̼ʁੴ੮ɘ˦ʁ੮ɻɘˌʇʁ੮ɘ˦ʁ੮ʁʮ̼͐;੮ʩɘʮ̼ੳ੮Pʇ੮ʮͅ੮ ͅʩ˺͙͐ʮ˦ʡ੮ɘ͐੮͐ʩʇ੮ͅˌ;੮ɘ˦ʁ੮ɻˑɘ̹̹ʮ˦ʡ੮ʩʮͅ੮͐͸˺੮͸̼ʮ͐ͅͅ੮͐˺ʡʇ͐ʩʇ̼੮ɘͅ੮ʩʮͅ੮̹ɘ˦͐ͅ੮ʠɘˑˑ੮͐˺੮ʩʮͅ੮ ˌ˦ʇʇͅੳ੮U˦੮ɘ˦˺͐ʩʇ̼ੴ੮äʇ̼ʡʇ੮ʮͅ੮̹̼ʇ͐ʇ˦ʁʮ˦ʡ੮͐˺੮ͅʩ˺˺͐੮̹ʇʁʇ̼͐ͅʮɘ˦ͅ੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮̼͐ͅʇʇ͐੮͙ͅʮ˦ʡ੮ ʩʮͅ੮ɘ̼˚੮ɘͅ੮ɘ੮˚ɘɻʩʮ˦ʇ੮ʡ͙˦ੳ੮Pʇ੮͐ʩʇ˦੮̹ͅʮ˦ͅ੮ɘ˦ʁ੮ͅ˚ɘɻˌͅ੮͐ʩʇ੮ɻɘ˚ʇ̼ɘੳ îʩʇͅʇ੮ͷʮʁʇ˺ͅ੮ɻɘ̹͙̼͐ʇ੮äʇ̼ʡʇૄͅ੮ʇͽ͐ʇ̼˦ɘˑ੮̹ͅ;ɻʩ˺͐ʮɻ੮ɺʇʩɘͷʮ˺̼ੴ੮˦˺͐੮ʩʮͅ੮ʮ˦͐ʇ̼˦ɘˑ੮͙ͅʠʠʇ̼ʮ˦ʡੳ੮Pʇ੮ʁ˺ʇͅ˦ૄ͐੮ʡʮͷʇ੮˚ʇ੮ɘ੮ˑ˺͐੮˺ʠ੮ʁʇ͐ɘʮˑͅ੮ɘɺ˺͙͐੮ʩʮͅ੮ɺɘɻˌʡ̼˺͙˦ʁ੮ɺ͙͐੮ͅɘ;ͅ੮͐ʩɘ͐੮ʩʇ੮ ͙ͅʠʠʇ̼ʇʁ੮ɘ˦੮ɘɻɻʮʁʇ˦͐੮͸ʮ͐ʩ੮ɘ੮ϲʮ̼ʇɻ̼ɘɻˌʇ̼੮ʮ˦੮ʩʮͅ੮ˑɘ͐ʇ੮͐ʇʇ˦ͅੳ੮Pʇ੮ˑ˺͐ͅ੮ɺ˺͐ʩ੮ʩʮͅ੮ʩɘ˦ʁͅ੮ ɘ˦ʁ੮˺˦ʇ੮ʇ;ʇੳ੮Pʮͅ੮̹ɘ̼ʇ˦͐ͅ੮͸ʇ̼ʇ੮äɻʮʇ˦͐˺ˑ˺ʡʮ͐ͅͅ੮ɘ˦ʁ੮͐ͅɘ͙˦ɻʩˑ;੮˺̹̹˺ͅʇʁ੮͐˺੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮ʩʇ੮ͅʩ˺͸ʇʁ੮ͅʮʡ˦ͅ੮˺ʠ੮ʁʇͷʇˑ˺̹ʮ˦ʡ੮̹ͅ;ɻʩ˺ͅʮͅੳ੮îʩʇ;੮ʁʮʁ੮ ̹ɘ;੮ʠ˺̼੮ɘ˦੮ɘ̹ɘ̼͐˚ʇ˦͐ੴ੮ʠ̼˺˚੮͸ʩʮɻʩ੮ʩʇ੮͸ɘͅ੮ʇͷʮɻ͐ʇʁ੮ʮ˦੮৲ৰৰৱੳ੮Pʇ੮̹ͅʇ˦͐੮˚˺̼ʇ੮͐ʩɘ˦੮ ɘ੮ʁʇɻɘʁʇ੮ʩ˺˚ʇˑʇͅͅ੮ʮ˦੮P˺ˑˑ;͸˺˺ʁੳ੮ુU͐੮͸ɘͅ੮ͷʇ̼;੮ʩɘ̼ʁੳ੮ēʇ̼;੮̹ɘʮ˦ʠ͙ˑੴૂ੮ʩʇ੮͐˺ˑʁ੮˚ʇੴ੮ ુU੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮ͅʩ˺ʇͅੴ੮˚;੮ʩɘʮ̼੮͸ɘͅ੮ɘˑˑ੮ʁʮ̼͐;ੴ੮U੮͸ɘͅ੮ʩ͙˦ʡ̼;੮ɘˑˑ੮͐ʩʇ੮͐ʮ˚ʇੳ੮U੮͸ɘͅ੮ʠ̼ʇʇΈʮ˦ʡ੮ ɻ˺ˑʁ੮ɘˑˑ੮˦ʮʡʩ͐ੴ੮U੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮ɘ੮ɺˑɘ˦ˌʇ͐੮˺̼੮ɘ˦;͐ʩʮ˦ʡੳ੮U͐੮͸ɘͅ੮̼ʇɘˑˑ;੮ɺɘʁੳૂ šɻɻɘͅʮ˺˦ɘˑˑ;ੴ੮ ɘ˦੮ ˺͙̼͐ʇɘɻʩ੮ ͸˺̼ˌʇ̼੮ ʠ̼˺˚੮ ɘ੮ ɻʩ͙̼ɻʩ੮ ͸˺͙ˑʁ੮ ʡʮͷʇ੮ ʩʮ˚੮ ɘ੮ ̹ɘʮ̼੮ ˺ʠ੮ ͅ˺ɻˌͅੴ੮ ɺ͙͐੮ äʇ̼ʡʇ੮ ɻɘ˦ૄ͐੮ ̼ʇɻɘˑˑ੮ ɘ˦;੮ ɻ˺˦ɻʇ̼͐ʇʁ੮ ʇʠʠ˺̼͐੮ ͐˺੮ ʡʇ͐੮ ʩʮ˚੮ ʩ˺͙ͅʮ˦ʡ੮ ˺̼੮ ̼͐ʇɘ͐˚ʇ˦͐ੳৼ੮ Ĕʩɘ͐੮ ʩʇ੮ ʁ˺ʇͅ੮ ̼ʇ˚ʇ˚ɺʇ̼੮ ɘ̼ʇ੮ ˚ɘ˦;ੴ੮ ˚ɘ˦;੮ ৵ৱ৵ৰͅੳ੮ îʩʇ੮ ͷ˺ʮɻʇͅ੮ ʮ˦੮ ʩʮͅ੮ ʩʇɘʁ੮ ͸˺͙ˑʁ੮͐ʇˑˑ੮ʩʮ˚੮͐˺੮̼͙˦੮ʮ˦͐˺੮̼͐ɘϲϲʮɻੴ੮̹˺ˑʮɻʇ੮͸˺͙ˑʁ੮̹ʮɻˌ੮ʩʮ˚੮͙̹੮ɘ˦ʁ੮͐ɘˌʇ੮ʩʮ˚੮͐˺੮ɘ੮ ʩ˺̹ͅʮ͐ɘˑੴ੮ɘ˦ʁ੮ʩʇૄʁ੮ɺʇ੮̼ʇˑʇɘͅʇʁ੮͸ʮ͐ʩʮ˦੮ʠ˺̼͐;ચʇʮʡʩ͐੮ʩ˺͙̼ͅੳ੮ä˺˚ʇ͐ʮ˚ʇͅੴ੮ʮʠ੮ʩʇ੮ʩɘʁ੮ɺʇʇ˦੮ ̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮ɘ˦˺͐ʩʇ̼੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁੴ੮͐ʩʇ;੮͸˺͙ˑʁ੮ʇͷʇ˦੮̹̼˺ͷʮʁʇ੮ʩʮ˚੮ ɘ੮͐ɘͽʮ੮ɺɘɻˌ੮͐˺੮P˺ˑˑ;͸˺˺ʁੳ੮Pʇ੮ɘˑͅ˺੮͐˺˺ˌ੮ʩʮ˚ͅʇˑʠ੮͐˺੮͐ʩʇ੮/Û੮ɘ੮ʠʇ͸੮͐ʮ˚ʇͅੳ੮"ɘɻˌ੮ʮ˦੮

EMERGENCY ROOM

71

৲ৰৱ৳ੴ੮ુU੮ˌʇ̹͐੮͐ʩʮ˦ˌʮ˦ʡ੮U੮ʩɘʁ੮ʩ;̹˺͐ʩʇ̼˚ʮɘ੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮˺͙͐੮ʮ˦੮͐ʩʇ੮ɻ˺ˑʁੳ੮U੮͸˺͙ˑʁ੮ɻɘˑˑ੮ ৹ৱৱੴ੮ɘ˦ʁ੮U੮͸˺͙ˑʁ੮ʡ˺੮͐˺੮͐ʩʇ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮̼˺˺˚ੳ੮U੮͸ɘͅ੮̼ʇɘˑˑ;੮ɻ̼ɘɻˌʮ˦ʡ੮͙̹ੳૂ੮îʩʇ੮/Û੮ ͸˺͙ˑʁ੮ુʡʮͷʇ੮˚ʇ੮̼ʇɘˑˑ;੮͸ɘ̼˚੮ɺˑɘ˦ˌʇ͐ͅ੮͐˺੮̹͙͐੮˺˦੮˚ʇ੮͐˺੮̼͐;੮͐˺੮͸ɘ̼˚੮˚ʇ੮͙̹ੳૂ੮š˦ʇ੮ ͐ʮ˚ʇ੮͐ʩʇ;੮ʇͷʇ˦੮ુʩ˺˺ˌʇʁ੮˚ʇ੮͙̹੮͸ʮ͐ʩ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ੴૂ੮͸ʩ˺੮ͅʇ˦͐੮ʩʮ˚੮͐˺੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮ ͅʩʇˑ͐ʇ̼ੴ੮ɺ͙͐੮ુʮ͐੮ʁʮʁ˦ૄ͐੮͸˺̼ˌ੮˺͙͐ੳૂ੮äʇ̼ʡʇ੮ʁʮʁ˦ૄ͐੮ʇˑɘɺ˺̼ɘ͐ʇ੮͸ʩ;ੳ Serge was a source of constant consternation to Kerry Morrison, who was ͐ʩʇ˦੮ʩʇɘʁ੮˺ʠ੮P˺ˑˑ;͸˺˺ʁૄͅ੮"͙ͅʮ˦ʇͅͅ੮U˚̹̼˺ͷʇ˚ʇ˦͐੮)ʮ̼͐ͅʮɻ͐੮ફ"U)બੳ੮H˺̼੮ʩʇ̼੮˚ʇ˚ɺʇ̼ͅੴ੮ äʇ̼ʡʇ੮ ͸ɘͅ੮ ɘ੮ ɺʮ͐੮ ˑʮˌʇ੮ P˺ˑˑ;͸˺˺ʁૄͅ੮ ુʠʇ̼ɘˑ੮ ɻɘ͐ੴૂ੮ ͸ʩ˺˚੮ ͐ʩʇ;੮ ͸ʇ̼ʇ੮ ˌʇʇ̹ʮ˦ʡ੮ ɘˑʮͷʇ੮͸ʮ͐ʩ੮ʁ˺˦ɘ͐ʮ˺˦ͅ੮˺ʠ੮ʠ˺˺ʁ੮ɘ˦ʁ੮͸ɘ͐ʇ̼ੳ੮"U)ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮̼˺͙˦ʁˑ;੮ɻ̼ʮ͐ʮɻʮΈʇʁ੮ʠ˺̼੮ ɘʁͷ˺ɻɘ͐ʮ˦ʡ੮ ͐ʩʇ੮ ɻ̼ʮ˚ʮ˦ɘˑʮΈɘ͐ʮ˺˦੮ ˺ʠ੮ ͙˦ͅʮʡʩ͐ˑ;੮ ʩ˺˚ʇˑʇͅͅ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅੳ৽੮ "͙͐੮ {˺̼̼ʮͅ˺˦੮ʁʮʁ੮˚͙ɻʩ੮˚˺̼ʇ੮͐ʩɘ˦੮ʁʇ˚ɘ˦ʁ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ɘ̼̼ʇ͐ͅ੮˺̼੮৵ৱ৵ৰ੮ʩʮ˚ੳ੮ʠ͐ʇ̼੮ɘˑˑੴ੮äʇ̼ʡʇ੮ ͸ɘͅ੮ɘˑ̼ʇɘʁ;੮ɺʇʮ˦ʡ੮̼ʇʡ͙ˑɘ̼ˑ;੮ʁʇ͐ɘʮ˦ʇʁੳ੮Ĕʩɘ͐੮ͅʩʇ੮̼ʇɘˑʮΈʇʁ੮͸ɘͅ੮͐ʩɘ͐੮ુ͐ʩʇ̼ʇ੮͸ɘͅ੮˦˺੮ ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;ૂ੮ ʠ˺̼੮ ʇ˦͙̼ͅʮ˦ʡ੮ ͐ʩ˺ͅʇ੮ ʁʇ͐ʇ˦͐ʮ˺˦ͅ੮ ɘɻ͙͐ɘˑˑ;੮ ɘɻɻ˺˚̹ˑʮͅʩʇʁ੮ ɘ˦;͐ʩʮ˦ʡੳ੮ äʩʇ੮ɻ˺˦ɻˑ͙ʁʇʁ੮͐ʩɘ͐੮äʇ̼ʡʇ੮ɘ˦ʁ੮˺͐ʩʇ̼ͅ੮ˑʮˌʇ੮ʩʮ˚੮͸ʇ̼ʇ੮˚ʮͅͅʮ˦ʡ੮ɘ˦੮ુɘʮ̼੮̼͐ɘϲϲʮɻ੮ɻ˺˦̼͐˺ˑˑʇ̼ૂ੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩɘ͐੮͐ʩʇ;੮ɘɻ͙͐ɘˑˑ;੮̹̼˺ʡ̼ʇͅͅʇʁ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ ̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ˈ͙͐ͅ੮ɻ;ɻˑʇʁ੮ʮ˦੮ɘ˦ʁ੮˺͙͐੮˺ʠ੮ʮ͐ੳ Ĕʩɘ͐ૄͅ੮̼͐ͅʮˌʮ˦ʡ੮ʮͅ੮͐ʩɘ͐੮nʇ̼̼;੮{˺̼̼ʮͅ˺˦੮ͅɘ͸੮˦˺੮˺˦ʇ੮͸ʮ͐ʩʮ˦੮ɘ˦;੮˺ʠ੮͐ʩʇ੮˚ɘ˦;੮ ɘʡʇ˦ɻʮʇͅ੮͐˺͙ɻʩʮ˦ʡ੮äʇ̼ʡʇૄͅ੮ɻɘͅʇઝ͐ʩʇ੮̹˺ˑʮɻʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩੴ੮͐ʩʇ੮P˺˚ʇˑʇͅͅ੮äʇ̼ͷʮɻʇͅ੮͙͐ʩ˺̼ʮ͐;ੴ੮ʩ˺̹ͅʮ͐ɘˑ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮̼˺˺˚ͅઝ͐ɘˌʮ˦ʡ੮ ˺˦੮͐ʩɘ͐੮̼˺ˑʇੳ੮ä˺੮ͅʩʇ੮ʁʇɻʮʁʇʁ੮͐˺੮ʁ˺੮ʮ͐੮ʩʇ̼ͅʇˑʠੳ੮äʩʇ੮ɻ˺˦ͷʇ˦ʇʁ੮ɘ੮ʡ̼˺͙̹੮˺ʠ੮ͷ˺ˑ͙˦͐ʇʇ̼ͅ੮ ʠ̼˺˚੮ ˦˺˦̹̼˺ϲʮ͐ͅ੮ ɘ˦ʁ੮ ˑ˺ɻɘˑ੮ ɻʩ͙̼ɻʩʇͅੴ੮ ͸ʩ˺੮ ͅʇ͐੮ ˺͙͐੮ ͐˺੮ ϲʮ˦ʁ੮ ˺͙͐੮ ʇͷʇ̼;͐ʩʮ˦ʡ੮ ͐ʩʇ;੮ ɻ˺͙ˑʁ੮ɘɺ˺͙͐੮͐ʩʇ੮ુP˺ˑˑ;͸˺˺ʁ੮î˺̹੮ৱ৴ੳૂ੮îʩʇͅʇ੮͸ʇ̼ʇ੮͐ʩʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʮ˦੮͐ʩʇ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁ੮͐ʩʇ;੮ʮʁʇ˦͐ʮϲʮʇʁ੮ɘͅ੮͐ʩʇ੮˚˺͐ͅ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇੴ੮˚˺͐ͅ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ʩ˺͙ͅʇੴ੮ɘ˦ʁ੮˚˺͐ͅ੮ ˑʮˌʇˑ;੮͐˺੮ʁʮʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ îʩʇ;੮͐ͅɘ̼͐ʇʁ੮ɺ;੮ϲʮʡ͙̼ʮ˦ʡ੮˺͙͐੮äʇ̼ʡʇૄͅ੮˦ɘ˚ʇ੮ɘ˦ʁ੮ɺɘɻˌʡ̼˺͙˦ʁੳ੮îʩʮͅ੮͐˺˺ˌ੮͐ʩʇ˚੮ ˺˦ˑ;੮ͅ˺੮ʠɘ̼ੴ੮ɺʇɻɘ͙ͅʇ੮rØ)੮͸˺͙ˑʁ˦ૄ͐੮ͅʩɘ̼ʇ੮ʩʮͅ੮̼ʇɻ˺̼ʁͅ੮͸ʮ͐ʩ੮͐ʩʇ˚ੳ੮੮̼˺ʡ͙ʇ੮){P੮ ʇ˚̹ˑ˺;ʇʇ੮͐ʮ̹̹ʇʁ੮͐ʩʇ˚੮˺ʠʠ੮͐ʩɘ͐੮ʩʇ੮ʩɘʁ੮͐͸ʇ˦͐;ચʇʮʡʩ͐੮৵ৱ৵ৰͅੳ੮੮ɺ̼ʇɘˌ͐ʩ̼˺͙ʡʩ੮ɻɘ˚ʇ੮ ͸ʮ͐ʩ੮͐ʩʇ੮äɘ˦͐ɘ੮{˺˦ʮɻɘ੮Ø˺ˑʮɻʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐ੴ੮͸ʩ˺ͅʇ੮ˈ͙̼ʮͅʁʮɻ͐ʮ˺˦੮äʇ̼ʡʇ੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮ ͷʮͅʮ͐ʇʁ੮ફુU੮ˈ͙͐ͅ੮ˑʮˌʇʁ੮͐ʩʇ੮˺ɻʇɘ˦ૂબ੮ɘ˦ʁ੮͸ʩʮɻʩ੮ʩɘʁ੮ɘ੮̼˺ɺ͙͐ͅ੮ʩ˺˚ʇˑʇͅͅ੮˺͙̼͐ʇɘɻʩ੮̹̼˺ʡ̼ɘ˚ੳ੮îʩʇ;੮ʡɘͷʇ੮͐ʩʇ੮͐ʇɘ˚ੴ੮ʮ˦੮ɺ͙ˑˑʇ͐੮ʠ˺̼˚ੴ੮ɘ੮ˑʮ͐ͅ੮˺ʠ੮ɘˑˑ੮ʩʮͅ੮ɘ̼̼ʇ͐ͅͅ੮ʠ˺̼੮̼͐ʇ̹ͅɘͅͅʮ˦ʡ੮ ɘ˦ʁ੮ͷɘ̼ʮ˺͙ͅ੮˚ʮͅʁʇ˚ʇɘ˦˺̼ͅੳ îʩʇ;੮ ɘͅͅʇ˚ɺˑʇʁ੮ ɘˑˑ੮ ˺ʠ੮ ͐ʩʮͅ੮ ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ ʮ˦͐˺੮ ɘ੮ ʁ˺ͅͅʮʇ̼੮ ɘ˦ʁ੮ ʩɘ͐ɻʩʇʁ੮ ɘ੮ ̹ˑɘ˦ੳ੮ õ͙ͅɘˑˑ;੮ɘ˦੮/Û੮ʁ˺ɻ͐˺̼੮͸˺͙ˑʁ੮˚ɘˌʇ੮ɘ੮ʁʇɻʮͅʮ˺˦੮ɺɘͅʇʁ੮˺˦੮ɘ੮ͅ˦ɘ̹ͅʩ˺͐੮˺ʠ੮äʇ̼ʡʇ੮ɘ͐੮͐ʩʇ੮ ̹̼ʇɻʮͅʇ੮˚˺˚ʇ˦͐੮ʩʇ੮͸ɘͅ੮ͅʮ͐͐ʮ˦ʡ੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮͐ʩʇ˚ੴ੮͸ʮ͐ʩ˺͙͐੮ɻ˺˦ͅʮʁʇ̼ʮ˦ʡ੮͐ʩʇ੮;ʇɘ̼ͅ੮˺ʠ੮ ͙ͅʠʠʇ̼ʮ˦ʡ੮͐ʩɘ͐੮ʩɘʁ੮̹̼ʇɻʇʁʇʁ੮ʩʮͅ੮ɘ̼̼ʮͷɘˑੳ੮îʩʇ੮̹˺ʮ˦͐੮˺ʠ੮͐ʩʇ੮ʁ˺ͅͅʮʇ̼੮͸ɘͅ੮͐˺੮˚ɘˌʇ੮͐ʩʇ੮ ɻɘͅʇ੮͐ʩɘ͐ੴ੮ʁʇ̹ͅʮ͐ʇ੮͐ʩʮͅ੮ˑ˺˦ʡ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ʠɘʮˑʇʁ੮ʮ˦͐ʇ̼ɘɻ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮

72

T H E C O N S E RVATO R S H I P C O N T I N U U M

ͅ;͐ͅʇ˚ੴ੮äʇ̼ʡʇ੮˦˺˦ʇ͐ʩʇˑʇͅͅ੮ʁʇ̹ͅʇ̼ɘ͐ʇˑ;੮˦ʇʇʁʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮îʩʇ੮ʡ̼˺͙̹੮͸˺͙ˑʁ੮͸ɘʮ͐੮ ʠ˺̼੮ɘ੮ʁɘ;੮͸ʩʇ˦੮ɘ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ͅ;˚̹ɘ͐ʩʇ͐ʮɻ੮ʁ˺ɻ͐˺̼੮͸ɘͅ੮˺˦੮ɻɘˑˑ੮ɘ͐੮ɘ੮ˑ˺ɻɘˑ੮ʩ˺̹ͅʮ͐ɘˑੳ੮ )͙̼ʮ˦ʡ੮͐ʩɘ͐੮̹ʩ;ͅʮɻʮɘ˦ૄͅ੮ͅʩʮʠ͐ੴ੮͐ʩʇ੮"U)ૄͅ੮ʠ˺˺͐੮̹ɘ̼͐˺ˑ੮͸˺͙ˑʁ੮͸ɘ͐ɻʩ੮ʠ˺̼੮äʇ̼ʡʇ੮͐˺੮̼͙˦੮ ʮ˦͐˺੮̼͐ɘϲϲʮɻ੮ɘ˦ʁ੮͐ʩʇ˦੮ɻɘˑˑ੮rØ)ૄͅ੮{˺ɺʮˑʇ੮/ͷɘˑ͙ɘ͐ʮ˺˦੮õ˦ʮ͐ੳ੮{ʇɘ˦͸ʩʮˑʇੴ੮ͅ˺˚ʇ˺˦ʇ੮ ʠ̼˺˚੮͐ʩʇ੮P˺ˑˑ;͸˺˺ʁ੮î˺̹੮ৱ৴੮͐ʇɘ˚੮͸˺͙ˑʁ੮ુɻɘ˚̹੮˺͙͐੮ʮ˦੮͐ʩʇ੮/Û੮ͅ˺੮͐ʩɘ͐ੴ੮ɺʇʠ˺̼ʇ੮ʩʇ੮ ͸ɘͅ੮̼ʇˑʇɘͅʇʁੴ੮͐ʩʇ;੮͸˺͙ˑʁ੮ͅʩ˺͸੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮͐ʩʇ੮ʁ˺ͅͅʮʇ̼ੴ੮͐˺੮ͅɘ;ੴ੮ૃUʠ੮;˺͙੮ˑʇ͐੮ʩʮ˚੮ʡ˺ੴ੮ ͐ʩʮͅ੮ʩɘͅ੮ɺʇʇ˦੮͐ʩʇ੮̹ɘ͐͐ʇ̼˦ੴ੮ɘ˦ʁ੮ʩʇૄͅ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇੳૄૂ /ͷʇ̼;͐ʩʮ˦ʡ੮͸˺̼ˌʇʁ੮ુˑʮˌʇ੮ɻˑ˺ɻˌ͸˺̼ˌੴૂ੮ͅʩʇ੮͐˺ˑʁ੮˚ʇੳ੮îʩɘ͐੮ʁʮʁ˦ૄ͐੮˚ɘˌʇ੮ʠ˺̼੮ɘ˦;੮ ˑʇͅͅ੮˺ʠ੮ɘ੮̼͐ɘʡʮɻ੮ͅɻʇ˦ʇੵ੮ુ͐ʩʇ੮̹˺ˑʮɻʇ੮ʩɘʁ੮͐˺੮ʩɘ˦ʁɻ͙ʠʠ੮ʩʮ˚ੴ੮ɺ͙͐੮ʩʇ੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮ʩɘ˦ʁͅੴ੮ ͅ˺੮͐ʩʇ;੮͙ͅʇʁ੮͐ʩ˺ͅʇ੮Έʮ̹੮͐ʮʇͅੴ੮ɘ˦ʁ੮ʩʇ੮͸ɘͅ੮ˌ˦ʇʇˑʮ˦ʡ੮˺˦੮͐ʩʇ੮ʡ̼˺͙˦ʁੴ੮͐ʩʇ̼ʇૄͅ੮ɘˑˑ੮ͅ˺̼͐ͅ੮˺ʠ੮ ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮ɘˑˑ੮ɘ̼˺͙˦ʁ੮ʩʮ˚ੳૂ੮Ĕʩʇ˦੮{˺̼̼ʮͅ˺˦੮͐ɘˑˌͅ੮ɘɺ˺͙͐੮ʩʇ̼੮͸˺̼ˌੴ੮ુU੮ͅɘ;ੴ੮ ૃäɘʁˑ;ੴ੮͐ʩʮͅ੮ʮͅ੮ʩ˺͸੮͸ʇ੮ʩʇˑ̹੮̹ʇ˺̹ˑʇ੮ʮ˦੮˚ʇ̼ʮɻɘੳૄૂ äʇ̼ʡʇ੮ʇͽ̹ʇɻ͐ʇʁ੮͐ʩɘ͐੮ʩʇ੮͸˺͙ˑʁ੮ˈ͙͐ͅ੮͸ɘʮ͐੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅ੮ɺʇʠ˺̼ʇ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮̼ʇˑʇɘͅʇʁ੮ ʩʮ˚੮͐˺੮͐ʩʇ੮ͅʮʁʇ͸ɘˑˌੳ੮"͙͐੮͐ʩʇ੮ʁ˺ͅͅʮʇ̼੮ʠ˺ˑˑ˺͸ʇʁ੮äʇ̼ʡʇ੮͐ʩ̼˺͙ʡʩ੮ɘ੮ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮৵৲৵ৰ੮ ɘʠ͐ʇ̼੮ʩʮͅ੮ͅʇͷʇ˦͐;ચ͐͸˺ચʩ˺͙̼੮৵ৱ৵ৰ੮͸ɘͅ੮ϲʮ˦ʮͅʩʇʁੳ੮U͐੮ʇͷʇ˦͙͐ɘˑˑ;੮̼ʇɘɻʩʇʁ੮ɘ੮ˈ͙ʁʡʇੴ੮͸ʩ˺੮ ̹͙͐੮ʩʮ˚੮͙˦ʁʇ̼੮ɘ੮˺˦ʇચ;ʇɘ̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮Ĕʇૄˑˑ੮̼ʇͷʮͅʮ͐੮ʮ˦੮ɘ੮ˑɘ͐ʇ̼੮ɻʩɘ̹͐ʇ̼੮͸ʩɘ͐੮ ˑʮʠʇ੮ʮ˦੮ɘ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡ੮ˑ˺˺ˌʇʁ੮ˑʮˌʇ੮ʠ˺̼੮äʇ̼ʡʇ੮ફʮ͐੮͸ɘͅ੮ʡ̼ʮ˚બੴ੮ɺ͙͐੮ʮ˦੮̼ʇ̼͐˺̹ͅʇɻ͐ੴ੮ɺ˺͐ʩ੮ nʇ̼̼;੮ɘ˦ʁ੮äʇ̼ʡʇ੮͐ʩʮ˦ˌ੮͐ʩʇ੮̼ʇ͙ͅˑ͐ͅ੮͸ʇ̼ʇ੮͸˺̼͐ʩ੮ʮ͐ੳ੮Ĕʩʇ˦੮ͅʩʇ੮ͷʮͅʮ͐ʇʁ੮ʩʮ˚੮ɘʠ͐ʇ̼੮ʠ˺͙̼੮ ˚˺˦͐ʩͅ੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ͅʩʇ੮̼ʇɻɘˑˑʇʁੴ੮ુ{;੮ˈɘ͸੮͸ɘͅ੮ˈ͙͐ͅ੮ʮ˦੮˚;੮ˑɘ̹ੳૂ੮Pʇ੮ʩɘʁ੮ɺʇʇ˦੮ ુɻ˺˚̹ˑʇ͐ʇˑ;੮̼͐ɘ˦ͅʠ˺̼˚ʇʁ੮ɘͅ੮ɘ੮ʩ͙˚ɘ˦੮ɺʇʮ˦ʡੴ੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮˺˦੮͐ʩʇ੮"˺͙ˑʇͷɘ̼ʁੴ੮ʮ˦੮ʩʮͅ੮ ʠʇɻʇͅੴ੮ʩɘʁ˦ૄ͐੮͸ɘͅʩʇʁ੮ʮ˦੮˚˺˦͐ʩͅੴ੮ͷʇ̼;੮ʮ˦͐ʮ˚ʮʁɘ͐ʮ˦ʡੴ੮͐˺੮ɺʇʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮͐ʩɘ͐੮;˺͙੮ ͸˺͙ˑʁ੮͸ɘ˦͐੮͐˺੮ʩ͙ʡੳૂ੮Ĕʩʇ˦੮͸ʇ੮̹ͅ˺ˌʇੴ੮äʇ̼ʡʇ੮͸ɘͅ੮ˑʮͷʮ˦ʡ੮ʮ˦੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੳ੮nʇ̼̼;੮ ʩɘʁ੮ɺʇʇ˦੮͐ʇɘɻʩʮ˦ʡ੮ʩʮ˚੮ʩ˺͸੮͐˺੮͙ͅʇ੮ʩʮͅ੮˦ʇ͸੮ʮØʩ˺˦ʇੴ੮ʁ˺˦ɘ͐ʇʁ੮ɺ;੮ɘ੮̹ʩʮˑɘ˦͐ʩ̼˺̹ʮɻ੮ ˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦ੴ੮ ̼ʮʡʩ͐੮ ɺʇʠ˺̼ʇ੮ ͸ʇ੮ ͐ɘˑˌʇʁੳ੮ ુUૄ˚੮ ̼͐;ʮ˦ʡ੮ ͐˺੮ ʡʇ͐੮ ˚;੮ I/)੮ ય͐ʩʇ੮ ʇή͙ʮͷɘˑʇ˦͐੮˺ʠ੮ɘ੮ʩʮʡʩ੮ͅɻʩ˺˺ˑ੮ʁʮ̹ˑ˺˚ɘરੴૂ੮ʩʇ੮͐˺ˑʁ੮˚ʇ੮ʇ˦͐ʩ͙ͅʮɘ͐ͅʮɻɘˑˑ;ੳ੮U੮ɘͅˌʇʁ੮ʩʮ˚੮͸ʩɘ͐੮ ʩʇ੮͸ʮͅʩʇʁ੮͸˺̼ˌʇʁ੮ʁʮʠʠʇ̼ʇ˦͐ˑ;੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮Pʮͅ੮ɘ˦ͅ͸ʇ̼ੵ੮ ુU੮͸ʮͅʩ੮͐ʩʇ;੮ʩɘʁ੮ɻ˺˦ͅʇ̼ͷʇʁ੮˚ʇ੮ͅ˺˺˦ʇ̼ੳૂ Ûʇʡɘ̼ʁˑʇͅͅ੮ ˺ʠ੮ ͸ʩʇ͐ʩʇ̼੮ ;˺͙੮ ɺʇˑʮʇͷʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͸ɘͅ੮ ͐ʩʇ੮ ˺˦ˑ;੮ ˺̹͐ʮ˺˦੮ ʠ˺̼੮ äʇ̼ʡʇੴ੮͐ʩʇ̼ʇૄͅ੮˦˺੮ʁ˺͙ɺ͐੮͐ʩɘ͐੮ʩʇ੮ʮͅ੮ɘ˦੮ʮ˦ɻ̼ʇʁʮɺˑʇ੮͙̼ͅͷʮͷ˺̼੮ɘ˦ʁ੮͙ͅɻɻʇͅͅ੮͐ͅ˺̼;ੳ੮"͙͐੮ ʩʮͅ੮ͅɘʡɘ੮͸ɘͅ੮ͅʩɘ̹ʇʁ੮ʮ˦੮͐ͅɘ̼ˌ੮͸ɘ;ͅ੮ɺ;੮ʡ˺ͷʇ̼˦˚ʇ˦͐ૄͅ੮ɘɺʁʮɻɘ͐ʮ˺˦੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;ੳ੮äʇ̼ʡʇ੮ ͸ɘͅ੮ʠɘ̼੮ʠ̼˺˚੮ɘɺɘ˦ʁ˺˦ʇʁ੮ʮ˦੮P˺ˑˑ;͸˺˺ʁੵ੮ʮ˦͐ͅʇɘʁੴ੮ʩʇ੮ʠɘɻʇʁ੮ɘ˦੮˺˦ʡ˺ʮ˦ʡ੮ɺɘ̼̼ɘʡʇ੮˺ʠ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺ˑʁͅ੮ɘ˦ʁ੮ɘ̼̼ʇ͐ͅͅੳ੮rɘ͸੮ɘ˦ʁ੮{ʇʁʮɻʮ˦ʇ੮͸ʇ̼ʇ੮˦ʇʮ͐ʩʇ̼੮ʮ˦੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦੮ ˦˺̼੮ʮ˦੮ɻ˺˦ϲˑʮɻ͐੶੮͐ʩʇ;੮͸ʇ̼ʇ੮ˈ͙͐ͅ੮͸˺̼ˌʮ˦ʡ੮ɘ͐੮ɻ̼˺ͅͅ੮̹͙̼̹˺ͅʇͅੳ੮îʩʇ̼ʇ੮͸ɘͅ੮˦˺੮̹ˑɘ˦੮͐˺੮ ɘˑʮʡ˦੮͐ʩʇ੮̹˺ˑʮɻʇૄͅ੮ʁʇɻʮͅʮ˺˦੮͐˺੮̹ˑɘɻʇ੮ɘ੮ʩ˺ˑʁ੮͸ʮ͐ʩ੮͐ʩʇ੮/Ûૄͅ੮ʁʇɻʮͅʮ˺˦੮͐˺੮ɘʁ˚ʮ͐੮ʩʮ˚ੳ੮U͐੮ ͐˺˺ˌ੮ɘ੮̹ɘͅͅʮ˺˦ɘ͐ʇ੮ɘ˦ʁ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮̹̼ʮͷɘ͐ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ˑʮˌʇ੮nʇ̼̼;੮{˺̼̼ʮͅ˺˦੮͐˺੮ ͐ͅʇ̹੮͙̹੮ɘ˦ʁ੮ɻ˺˺̼ʁʮ˦ɘ͐ʇ੮ʩ˺͸੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸˺͙ˑʁ੮ʇͽʇ̼ɻʮͅʇ੮ʮ͐ͅ੮˺͸˦੮̹˺͸ʇ̼ੳ

EMERGENCY ROOM

73

/Ûͅ੮ɘ̼ʇ੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮̼͐ͅʮɻ͐ʇ͐ͅ੮ͷʇ͐˺੮̹˺ʮ˦͐ͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ɻʇͅͅੳ੮#ˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺˦ɻʇ˦̼͐ɘ͐ʇ੮̼ʇͅ˺͙̼ɻʇͅ੮˺˦੮͐ʩ˺ͅʇ੮ɘɻ͐ʮ˦ʡ੮ʁɘ˦ʡʇ̼˺͙ͅˑ;੮˺̼੮ʁʮ̼͙̹͐ͅʮͷʇˑ;੮˺ͷʇ̼੮ ͐ʩ˺ͅʇ੮͸ʩ˺੮ɘ̼ʇ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮îʩʇ;੮ϲʮˑ͐ʇ̼੮˺͙͐੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ɻ˺˚ʮ˦ʡ੮ʮ˦੮˺˦੮৵ৱ৵ৰͅ੮ ͸ʩ˺ͅʇ੮̹̼˺ɺˑʇ˚ͅ੮͐ʩʇ;੮ɘ̼͐͐ʮɺ͙͐ʇ੮͐˺੮ɻ̼ʮ˚ʮ˦ɘˑʮ͐;ੴ੮ɘʁʁʮɻ͐ʮ˺˦ੴ੮˺̼੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੳ੮š͙͐ͅʮʁʇ̼ͅ੮˚ɘ;੮ͅʇʇ੮͐ʩʇͅʇ੮ʁʇɻʮͅʮ˺˦ͅ੮ɘͅ੮ɻɘˑˑ˺͙ͅੴ੮ɺ͙͐੮͐ʩʇ;੮ɘ̼ʇ੮˦˺͐੮ɘ̼ɺʮ̼͐ɘ̼;ੳ੮îʩʇ;੮̼ʇϲˑʇɻ͐੮ ͐ʩʇ੮ ˑʇʡɘˑ੮ ɻ˺˦̼͐ͅɘʮ˦͐ͅੴ੮ ̼ʇͅ˺͙̼ɻʇ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅੴ੮ ɘ˦ʁ੮ ̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ ˺ɺˑʮʡɘ͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ /Û੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ɘɻ͐ʮ˦ʡ੮ɘͅ੮ή͙ʮ˦͐ʇͅͅʇ˦͐ʮɘˑ੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੴ੮˚͙͐ͅ੮ˈ͙ʡʡˑʇ੮˺˦੮ ʇͷʇ̼;੮ͅʩʮʠ͐ੳ

PEOPLE PROCESSING IN THE EMERGENCY DEPARTMENT äʇ̼ʡʇ੮ɻ˺͙ˑʁ˦ૄ͐੮ʡʇ͐੮͐ʩ̼˺͙ʡʩ੮ɘ˦੮/Û੮͐˺੮ɺʇɻ˺˚ʇ੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦͐ʮˑ੮͐ʩʇ̼ʇ੮͸ɘͅ੮ુ˦˺͐ʩʮ˦ʡ੮ˑʇʠ͐੮ɺʇ͐͸ʇʇ˦੮ʁʇɘ͐ʩ੮ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮ɘͅ੮nʇ̼̼;੮{˺̼̼ʮͅ˺˦੮̹͙͐੮ʮ͐ੳ੮î˺੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͸ʩ;ੴ੮;˺͙੮˦ʇʇʁ੮͐˺੮ɻ˺˦ͅʮʁʇ̼੮͐ʩʇ੮˺˦ͅˑɘ͙ʡʩ͐੮˺ʠ੮ͅ˺ɻʮɘˑ੮ɘ˦ʁ੮˚ʇʁʮɻɘˑ੮̹̼˺ɺˑʇ˚ͅ੮ ˑɘ˦ʁʮ˦ʡ੮ ˺˦੮ /Û੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ˑʮˌʇ੮ )̼ੳ੮ Ûɘ˦ʁੳ੮ Pʇૄͅ੮ ͐ʩʇ੮ ʁʮ̼ʇɻ͐˺̼੮ ˺ʠ੮ ͐ʩʇ੮ ʇ˚ʇ̼ʡʇ˦ɻ;੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ɘ੮̹͙ɺˑʮɻ੮ͅɘʠʇ͐;ચ˦ʇ͐੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮ɘ੮ˑɘ̼ʡʇੴ੮͙̼ɺɘ˦੮‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ ɻ˺͙˦͐;ੴ੮͸ʩʇ̼ʇ੮ʩʇ੮͐ͅɘ̼͐ʇʁ੮̹̼ɘɻ͐ʮɻʮ˦ʡ੮͐͸ʇ˦͐;ચʇʮʡʩ͐੮;ʇɘ̼ͅ੮ɘʡ˺ੳ੮Pʇૄͅ੮ɘ੮ુͅʮ˦ʡˑʇચ̹ɘ;ʇ̼ੴ੮ ɘɻɻʇͅͅ੮͐˺੮ɻɘ̼ʇੴ੮ɺˑʇʇʁʮ˦ʡ੮ʩʇɘ̼͐੮ˑʮɺʇ̼ɘˑੳૂ੮Ĕʇ੮ɺ˺˦ʁ੮˺ͷʇ̼੮˺͙̼੮˚͙͙͐ɘˑ੮ɘϲϲʮ˦ʮ͐;੮ʠ˺̼੮͐ʩʇ੮ H̼ʇ˦ɻʩ੮˚ʇʁʮɻɘˑ੮ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮ͅ;͐ͅʇ˚੮ફʩʇ੮͸˺̼ˌʇʁ੮ʮ˦੮les urgences੮˺ʠ੮ɘ੮Øɘ̼ʮͅʮɘ˦੮ʩ˺̹ͅʮ͐ɘˑ੮ ʠ˺̼੮ɘ੮;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ʩɘˑϲબੵ੮ુU੮͐ʩʮ˦ˌ੮͐ʩʇ̼ʇ੮યʮ˦੮H̼ɘ˦ɻʇરੴ੮͐ʩʇ̼ʇૄͅ੮ɘ੮ϲˑ˺˺̼੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ ͅʇ̼ͷʮɻʇͅੳ੯ੳ੯ੳ੯ੳ੮Ě˺͙੮ɻɘ˦੮ɺʇ੮ɘ˦੮͙˦ʇ˚̹ˑ˺;ʇʁ੮ɻʩ̼˺˦ʮɻ੮ɘˑɻ˺ʩ˺ˑʮɻੴ੮ɘ˦ʁ੮ɘˑ˚˺͐ͅ੮ʮ˦ͷɘ̼ʮɘɺˑ;੮ ʩɘͷʇ੮ɘ੮̹ˑɘɻʇ੮͐˺੮ˑʮͷʇੳૂ੮îʩɘ͐ੴ੮ʩʇ੮͐ʩʮ˦ˌͅੴ੮ʮͅ੮͸ʩɘ͐ૄͅ੮˚ʮͅͅʮ˦ʡ੮ʠ˺̼੮˚ɘ˦;੮˺ʠ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ʩʇ੮ͅʇʇͅੵ੮ુH˺̼੮˺͙̼੮̹ʇ˺̹ˑʇੴ੮͸ʩɘ͐੮ɘ̼ʇ੮͐ʩʇ੮˺̼ʮʡʮ˦ͅ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੺੮îʩʇ;ૄ̼ʇ੮ ˑɘɻˌ੮˺ʠ੮ʩ˺͙ͅʮ˦ʡੴ੮ˑɘɻˌ੮˺ʠ੮ʠ˺˺ʁੴ੮ˑɘɻˌ੮˺ʠ੮ɘɻɻʇͅͅ੮͐˺੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮ɘʠʠ˺̼ʁɘɺˑʇ੮ʩʇɘˑ͐ʩ੮ ɻɘ̼ʇ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͐ʩɘ͐੮ͅ˺ɻʮɘˑ੮̹ɘ̼͐੮ʮͅ੮ɘ̼ʡ͙ɘɺˑ;੮˚˺̼ʇ੮ʁʇ͐ʇ̼˚ʮ˦ɘ˦͐੮͐ʩɘ˦੮͐ʩʇ੮ɘɻ͙͐ɘˑ੮ʮˑˑ˦ʇͅͅੳૂ Pʇ੮ɘ˦ʁ੮ુʇͅͅʇ˦͐ʮɘˑˑ;੮ɘ˦੮ɘ̼˚;ૂ੮˺ʠ੮˦͙̼ͅʇͅੴ੮̼ʇͅʮʁʇ˦͐ͅੴ੮͐ʇɻʩͅੴ੮ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮ ɘ̼ʇ੮͐ʩʇ੮̼ʮɻˌʇ͐;੮ϲˑ˺˺̼੮˺ʠ੮ͅ˺ɻʮɘˑ੮ͅʇ̼ͷʮɻʇͅ੮ʠ˺̼੮ʩʮͅ੮̹ɘ͐ʮʇ˦͐ͅੴ੮ɺ;੮ʁʇͅʮʡ˦੮ɘ˦ʁ੮ɺ;੮ʁʇʠɘ͙ˑ͐ੳ੮ U˦੮ ৱ৹৸৶ੴ੮ #˺˦ʡ̼ʇͅͅ੮ ̹ɘͅͅʇʁ੮ ͐ʩʇ੮ /˚ʇ̼ʡʇ˦ɻ;੮ {ʇʁʮɻɘˑ੮ î̼ʇɘ͐˚ʇ˦͐੮ ɘ˦ʁ੮ rɘɺ˺̼੮ ɻ͐੮ ફ/{îrબੴ੮͸ʩʮɻʩ੮̼ʇή͙ʮ̼ʇͅ੮/Ûͅ੮͐˺੮̹̼˺ͷʮʁʇ੮ͅɻ̼ʇʇ˦ʮ˦ʡ੮ɘ˦ʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʠ˺̼੮ɘ˦;˺˦ʇ੮ ͸ʮ͐ʩ੮ɘ˦੮ુʇ˚ʇ̼ʡʇ˦ɻ;੮˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ૂ੮͸ɘˑˌʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇʮ̼੮ʁ˺˺̼ͅ੮ફ˺̼੮ɺʇʮ˦ʡ੮ ʁʇ̹˺ͅʮ͐ʇʁ੮ɺ;੮̹˺ˑʮɻʇੴ੮ɘͅ੮ʮ˦੮͐ʩʇ੮ɻɘͅʇ੮˺ʠ੮˚ɘ˦;੮৵ৱ৵ৰͅબੴ੮̼ʇʡɘ̼ʁˑʇͅͅ੮˺ʠ੮ɘɺʮˑʮ͐;੮͐˺੮̹ɘ;ੳ৾ îʩʇ੮ɻ͐੮ʩʇˑ̹ʇʁ੮͙̼͐˦੮/Ûͅ੮ʮ˦͐˺੮ɘ੮ુ˚˺ʁʇ̼˦੮ʁɘ;੮ɘˑ˚ͅʩ˺͙ͅʇૂ੮ʠ˺̼੮͐ʩʇ੮̹˺˺̼ੴ੮ϲʮˑˑʮ˦ʡ੮ ʮ˦੮ʠ˺̼੮͐ʩʇ੮ͅɘʠʇ͐;੮˦ʇ͐੮͐ʩɘ͐੮Ø̼ʇͅʮʁʇ˦͐੮Ûʇɘʡɘ˦੮͸ɘͅ੮ʇͷʮͅɻʇ̼ɘ͐ʮ˦ʡ੮ɘ͐੮͐ʩʇ੮ͅɘ˚ʇ੮͐ʮ˚ʇੳ৿ î̼ɘ˦ͅʠ˺̼˚ɘ͐ʮ˺˦ͅ੮ʮ˦੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʮ˦ɘʁͷʇ̼͐ʇ˦͐ˑ;੮ʮ˦ɻ̼ʇɘͅʇʁ੮͐ʩʇ੮̹̼ʇ͙̼ͅͅʇੳ੮)͙̼ʮ˦ʡ੮͐ʩʇ੮৲ৰৰ৸੮I̼ʇɘ͐੮Ûʇɻʇͅͅʮ˺˦੮ɘ˦ʁ੮͙ͅɺͅʇή͙ʇ˦͐੮ɺ͙ʁʡʇ͐੮ɻ͙͐ͅੴ੮ɘ੮̼ɘ˦ʡʇ੮˺ʠ੮

74

T H E C O N S E RVATO R S H I P C O N T I N U U M

˦˺˦ʩ˺̹ͅʮ͐ɘˑ੮ɻ̼ʮͅʮͅ੮̼ʇͅ˺͙̼ɻʇͅઝˑʮˌʇ੮ʁ̼˺̹ચʮ˦੮ɻˑʮ˦ʮɻͅ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮̹̼˺ͷʮʁʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ ̼ʇϲʮˑˑͅ੮˺̼੮̼ʇ̹ͅʮ͐ʇ੮ɺʇʁͅ੮ʠ˺̼੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮˦ʇʇʁʮ˦ʡ੮ɘ੮˦ʮʡʩ͐੮ʮ˦ͅʮʁʇઝɻˑ˺ͅʇʁੳ਀੮Øʇ˺̹ˑʇ੮ ʮ˦੮ʁʮ̼͐ͅʇͅͅ੮ʩɘʁ੮͐˺੮ʡ˺੮ͅ˺˚ʇ͸ʩʇ̼ʇੳ੮îʩʇ੮̹ͅʮˌʇ੮͸ɘͅ੮ʁ̼ɘ˚ɘ͐ʮɻੵ੮ʠ̼˺˚੮৲ৰৰ৶੮͐˺੮৲ৰৱৱੴ੮͐ʩʇ੮ ˦͙˚ɺʇ̼੮˺ʠ੮ͷʮͅʮ͐ͅ੮͐˺੮#ɘˑʮʠ˺̼˦ʮɘ੮/Ûͅ੮ɺ;੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɘ੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʮɘʡ˦˺ͅʮͅ੮ ͸ʇ˦͐੮͙̹੮৴৷੮̹ʇ̼ɻʇ˦͐ੳਁ H˺̼੮ϲˑɘʡ̼ɘ˦͐ˑ;੮̹ͅ;ɻʩ˺͐ʮɻ੮̹ʇ˺̹ˑʇ੮ɺ̼˺͙ʡʩ͐੮ʮ˦੮˺˦੮ɘ੮৵ৱ৵ৰੴ੮͐ʩʇ੮˚ɘ̼ɻʩʮ˦ʡ੮˺̼ʁʇ̼ͅ੮ ʠ˺̼੮)̼ੳ੮Ûɘ˦ʁૄͅ੮˚ʇʁʮɻɘˑ੮ɘ̼˚;੮ɘ̼ʇ੮ɻˑʇɘ̼ੵ੮ુš͙̼੮ɻ˺ʡ੮ʮ˦੮͐ʩʇ੮˚ɘɻʩʮ˦ʇ੮ʮͅ੮͐ʩɘ͐੮͸ʇ੮̹̼˺ͷʮʁʇ੮͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮˚ʇʁʮɻɘˑ੮ɻˑʇɘ̼ɘ˦ɻʇ੮ʠ˺̼੮̹ɘ͐ʮʇ˦͐ͅ੮ʡ˺ʮ˦ʡ੮˺˦੮͐˺੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʩ˺̹ͅʮ͐ɘˑੳૂ੮Pʮͅ੮˺͸˦੮ʩ˺̹ͅʮ͐ɘˑ੮ʁ˺ʇͅ੮˦˺͐੮ʩɘͷʇ੮ʮ͐ͅ੮˺͸˦੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͙˦ʮ͐ੴ੮ɺ͙͐੮ʮ͐੮ʁ˺ʇͅ੮ ʩɘͷʇ੮͐ʩ̼ʇʇ੮˺˦ચͅʮ͐ʇ੮ͅʩʇ̼ʮϲϲૄͅ੮ʁʇ̹͙͐ʮʇͅੴ੮ͅ˺੮ʮ͐੮͐ʇ˦ʁͅ੮͐˺੮ʡʇ͐੮͐ʩʇ੮ુͷʇ̼;੮ͷʮ˺ˑʇ˦͐ੴ੮̹ʩ;ͅʮɻɘˑˑ;੮ ʮ˚̹˺ͅʮ˦ʡ੮ ̹ɘ͐ʮʇ˦͐ͅੳૂ੮ Pʇ੮ ʇˑɘɺ˺̼ɘ͐ʇͅੵ੮ ુUʠ੮ ͐ʩʇ;ૄ̼ʇ੮ ̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ ɘʡʡ̼ʇͅͅʮͷʇ੮ ˺̼੮ ɘʡʮ͐ɘ͐ʇʁੴ੮͐ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮̹͙͐੮ʮ˦͐˺੮ɘ੮ʩʮʡʩચͷʮΈੴ੮ɘɻ͙͐ʇ੮ɻɘ̼ʇ੮̼˺˺˚੮ʠ˺̼੮ʮ˚˚ʇʁʮɘ͐ʇ੮͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦ੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮͐ʩ̼ʇʇ੮˺̼੮ʠ˺͙̼੮ʁʮʠʠʇ̼ʇ˦͐੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮͸ʇૄˑˑ੮͙ͅʇੴ੮͙͙ͅɘˑˑ;੮ɘͅ੮ɘ੮ ͅʩ˺͐੮ ˺̼੮ Uēੴ੮ ͐˺੮ ɺ̼ʮ˦ʡ੮ ͐ʩʇ˚੮ ʁ˺͸˦ੳૂ੮ ̼ˈ͙˦ੴ੮ ɘ˦˺͐ʩʇ̼੮ /Û੮ ̹ʩ;ͅʮɻʮɘ˦ੴ੮ ̼˺͙˦ʁʇʁ੮ ˺͙͐੮ ͐ʩʇ੮̹ʮɻ͙̼͐ʇੵ੮ુîʩʇ੮͸ɘʮ͐ʮ˦ʡ੮͐ʮ˚ʇ੮ʠ˺̼੮ͅʇͷʇ̼ʇˑ;੮̹ͅ;ɻʩ˺͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅ੮ʮͅ੮Έʇ̼˺ੳ੮îʩʇ;ૄ̼ʇ੮ ˌʮɻˌʮ˦ʡੴ੮ͅɻ̼ʇɘ˚ʮ˦ʡੴ੮ɘ˦ʁ੮ͅ˺੮͸ʇ੮˚ʇʁʮɻɘ͐ʇ੮ɘ˦ʁ੮ʁʇɘˑ੮͸ʮ͐ʩ੮͐ʩʇ˚੮̼ʮʡʩ͐੮ɘ͸ɘ;ੳૂ੮š˦ɻʇ੮ ͅʇʁɘ͐ʇʁੴ੮͐ʩʇ;੮ʡ˺੮͐˺੮ɘ˦੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦੮̼˺˺˚ੴ੮͸ʩʇ̼ʇ੮͐ʩʇ;੮ɻ˺͙ˑʁ੮͸ɘʮ͐ઝͅ˺˚ʇ͐ʮ˚ʇͅ੮ʠ˺̼੮ ʁɘ;ͅઝʠ˺̼੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɺʇʁੳ Pɘͷʮ˦ʡ੮ ʇ˦˺͙ʡʩ੮ ͐ͅɘʠʠ੮ ɘ˦ʁ੮ ɺʇʁͅ੮ ͐˺੮ ʩɘ˦ʁˑʇ੮ ͐ʩʇͅʇ੮ ɻ̼ʮͅʇͅ੮ ̼ʇή͙ʮ̼ʇͅ੮ ʁʇɘˑʮ˦ʡ੮ ʇͽ̹ʇʁʮ͐ʮ˺͙ͅˑ;੮͸ʮ͐ʩ੮˺͐ʩʇ̼ੴ੮ˑʇͅͅ੮ˑʇʡʮ͐ʮ˚ɘ͐ʇ੮̹͙ˑˑͅ੮˺˦੮͐ʩʇ੮/Ûૄͅ੮̼ʇͅ˺͙̼ɻʇͅੳ੮š˦ʇ੮͙ͅɻʩ੮ʁ̼ɘʮ˦੮ ͐ͅʇ˚ͅ੮ʠ̼˺˚੮̹˺ˑʮɻʇ੮Ƀ̢̅Ɋɐʯ‫̎ף‬ɲ̢ɩͷʚɷʯɪ੮͙˦͸ɘ˦͐ʇʁ੮ɘ˦ʁ੮͙˦̼͙ˑ;੮̹ʇ̼ͅ˺˦ͅ੮˺˦͐˺੮͐ʩʇ੮ʩʇɘˑ͐ʩ੮ ɻɘ̼ʇ੮ͅ;͐ͅʇ˚੮ફ͸ʩʮɻʩੴ੮ɘͅ੮;˺͙੮ͅɘ͸੮ʮ˦੮͐ʩʇ੮̹̼ʇͷʮ˺͙ͅ੮ɻʩɘ̹͐ʇ̼ੴ੮ʮͅ੮̹ɘ̼͐ˑ;੮ʁ̼ʮͷʇ˦੮ɺ;੮ͅ˺ɻʮʇ͐ɘˑ੮ ʁʇ˚ɘ˦ʁͅ੮͐ʩɘ͐੮͐ʩʇ;੮ˑʮ˚ʮ͐੮ɘ̼̼ʇ͐ͅͅબੳਂ੮îʩʇ੮/Û੮͐ͅɘʠʠ੮U੮̹ͅ˺ˌʇ੮͐˺੮͸ʇ̼ʇ੮˦˺͐੮˺˦੮ɺ˺ɘ̼ʁ੮͸ʮ͐ʩ੮ ͐ʩʮͅ੮̼͐ͅɘ͐ʇʡ;੮˺ʠ੮ʁʮͅ˺̼ʁʇ̼੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੳ੮‡͙̼ͅʇ੮)͸;ʇ̼ੴ੮͸ʩ˺੮͸˺̼ˌͅ੮͸ʮ͐ʩ੮)̼ੳ੮Ûɘ˦ʁੴ੮ ̼ʇɻ˺͙˦͐ʇʁੴ੮ ૃš˦ʇ੮ ͐ʮ˚ʇੴ੮ ͐ʩʇ੮ ɻ˺̹ૄͅ੮ ય৵ৱ৵ৰ੮ ̹ɘ̹ʇ̼͸˺̼ˌર੮ ͸ɘͅ੮ ˑʮ͐ʇ̼ɘˑˑ;੮ ˈ͙͐ͅ੮ ɘ੮ ʁʇͅɻ̼ʮ̹͐ʮ˺˦੮˺ʠ੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦ੵ੮ુîʩʮͅ੮̹ʇ̼ͅ˺˦੮ʮͅ੮ˑʮͷʮ˦ʡ੮ɺʇʩʮ˦ʁ੮#ēä੮યɘ੮̹ʩɘ̼˚ɘɻ;રੴ੮͐ʩʇʮ̼੮ ɻˑ˺͐ʩʇͅ੮ɘ̼ʇ੮ʁʮ̼͐;ੳૄૄੰૄ੮îʩʇ੮/Û੮̹̼˺ͷʮʁʇʁ੮ɘ੮ͷɘˑ͙ɘɺˑʇ੮ͅʇ̼ͷʮɻʇੵ੮ʁ̼˺̹̹ʮ˦ʡ੮͐ʩʇ੮ʩ˺ˑʁ੮ɘ˦ʁ੮ ̹̼˺͐ʇɻ͐ʮ˦ʡ੮ɘ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮̹ʇ̼ͅ˺˦੮ʠ̼˺˚੮ɻ˺˦͐ʮ˦͙ʇʁੴ੮͙˦ˈ͙͐ͅʮϲʮʇʁ੮ʁʇ͐ʇ˦͐ʮ˺˦ੳ ˦˺͐ʩʇ̼੮ͅʇ͐੮˺ʠ੮̹ɘ͐ʮʇ˦͐ͅ੮˺˦੮৵ৱ৵ৰͅ੮͙ͅʠʠʇ̼੮ʠ̼˺˚੮ુʮ˦ɻɘ̼ɻʇ̼ʮ͐ʮͅૂઝɘ੮͙ͅʁʁʇ˦੮ʩʇɘˑ͐ʩ੮ ɻ˺˚̹ˑɘʮ˦͐੮ફ͐ʩʮ˦ˌ੮ુɻʩʇ͐ͅ੮̹ɘʮ˦ૂ੮˺̼ੴ੮˚˺̼ʇ੮ʮ˚̹˺̼͐ɘ˦͐ˑ;੮ʠ˺̼੮˺͙̼੮̹͙̼̹˺ͅʇͅੴ੮ુ͙ͅʮɻʮʁɘˑ੮ ʮʁʇɘ͐ʮ˺˦ૂબ੮͐ʩɘ͐੮ʠ˺̼ɻʇͅ੮ɘ˦੮˺ϲϲʮɻʇ̼੮͐˺੮͐ɘˌʇ੮ɘ੮̹ʇ̼ͅ˺˦੮͙˦ʁʇ̼੮ɘ̼̼ʇ͐ͅ੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ ɘ੮ͅɻ̼ʇʇ˦ʮ˦ʡੳਃ੮Ûʇ̹ͅ˺˦ͅʇͅ੮͐˺੮͐ʩʇͅʇ੮ɻɘͅʇͅ੮ɘ̼ʇ੮ͅ͸ʮʠ͐ੳ੮)̼ੳ੮Ûɘ˦ʁ੮ʡ̼͙˚ɺˑʇʁੴ੮ુU͐ૄͅ੮ͷʇ̼;੮ ɻ˺˚˚˺˦੮͐˺੮ʩɘͷʇ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ɘ̼ʇ੮ɘ̼̼ʇ͐ͅʇʁੴ੮ɘ˦ʁ੮͐ʩʇ;ૄˑˑ੮ɻ˺˚̹ˑɘʮ˦੮͐ʩʇ;ૄ̼ʇ੮͙ͅʮɻʮʁɘˑੴ੮ ˌ˦˺͸ʮ˦ʡ੮͐ʩʮͅ੮͸ʮˑˑ੮ɻ̼ʇɘ͐ʇ੮ɘ੮ʁʇ͐˺͙̼ੳ੯ੳ੯ੳ੯ੳ੮U͐ૄͅ੮ˈ͙͐ͅ੮͙̹ͅͅʇɻ͐੮˺˦੮ʮ͐ͅ੮ʠɘɻʇੴ੮ɘ˦ʁ੮͸ʇ੮ˌ˦˺͸੮ ͐ʩʇ;ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ˈɘʮˑੴ੮ͅ˺੮͸ʩɘ͐ૄͅ੮͐ʩʇ੮͸˺̼͐ͅ੮ɻɘͅʇ੮ͅɻʇ˦ɘ̼ʮ˺੺੯ੳ੯ੳ੯ੳ੮îʩʇ;ૄ̼ʇ੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ ʩɘͷʇ੮ɘɻɻʇͅͅ੮͐˺੮ɘ੮ʡ͙˦ੴ੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʩɘͷʇ੮ɘ੮ˌ˦ʮʠʇੴ੮͐ʩʮͅ੮ʮͅ੮̹͙̼ʇˑ;੮˚ɘ˦ʮ̹͙ˑɘ͐ʮͷʇ੮

EMERGENCY ROOM

75

ɺʇʩɘͷʮ˺̼ੳ੯ੳ੯ੳ੯ੳ੮Uૄˑˑ੮ɻ˺˦͙ͅˑ͐੮͸ʮ͐ʩ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃ͙ͅʮɻʮʁɘˑ੮ʮʁʇɘ͐ʮ˺˦੮ʮ˦੮͐ʩʇ੮ ɺɘɻˌ੮˺ʠ੮ɘ੮̹˺ˑʮɻʇ੮ɻ̼͙ʮͅʇ̼ૄ੮ɘ˦ʁ੮͐ʩʇ;ૄˑˑ੮ˈ͙͐ͅ੮ͅɘ;ੴ੮ૃɻˑʇɘ̼੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ય˺ʠ੮ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁર੮ɘ˦ʁ੮ ͅʇ˦ʁ੮͐ʩʇ˚੮͐˺੮ˈɘʮˑੳૄૂ਄੮ફH˺̼੮͐ʩʇ੮̼ʇɻ˺̼ʁੴ੮ʠ˺͙̼͐ʇʇ˦੮̹ʇ˺̹ˑʇ੮ʁʮʇʁ੮ɺ;੮͙ͅʮɻʮʁʇ੮ʮ˦੮ˑɘ˚ʇʁɘ੮ #˺͙˦͐;ૄͅ੮ˈɘʮˑ੮ʠ̼˺˚੮৲ৰৱ৵੮͐˺੮৲ৰৱ৹ੴ੮͸ʩʮˑʇ੮äɘ˦੮)ʮʇʡ˺੮#˺͙˦͐;੮ͅɘ͸੮͐ʩʮ̼͐;੮ɺʇ͐͸ʇʇ˦੮৲ৰৱৰ੮ ɘ˦ʁ੮৲ৰৱ৸ੳৼ৻બ îʩʇ˦੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ɻɘ˦੮̹ˑɘ͙ͅʮɺˑ;੮ɺʇ੮ͅʇ̼ͷʇʁ੮ʇˑͅʇ͸ʩʇ̼ʇੳ੮੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʩ˺੮͐˺ˑʁ੮˚ʇ੮ʩʇ੮ʩɘʁ੮ʇͷɘˑ͙ɘ͐ʇʁ੮˚˺̼ʇ੮͐ʩɘ˦੮৹ৰੴৰৰৰ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘɻ̼˺ͅͅ੮ʩʮͅ੮ɻɘ̼ʇʇ̼੮ ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩɘ͐੮ʩʮͅ੮ʡ˺ɘˑ੮͸ɘͅ੮͐˺੮ુ̼ʇˑʮʇͷʇ੮͙ͅʠʠʇ̼ʮ˦ʡૂઝ˚ɘ;ɺʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ή͙ʮɻˌ੮ʁʇˑʮͷʇ̼;੮˺ʠ੮ɘ˦੮ɘ˦͐ʮɘ˦ͽʮʇ͐;੮˚ʇʁʮɻɘ͐ʮ˺˦ઝɘ˦ʁ੮ુʡʇ͐੮͐ʩʇ˚੮͐˺੮͐ʩʇ੮ˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ˑʇͷʇˑ੮˺ʠ੮ ɻɘ̼ʇੳૂ੮îʩʇ੮ʡ˺ɘˑ੮˺ʠ੮ɘ˦੮/Û੮ʮͅ੮ુɘˑ͸ɘ;ͅ੮˦˺͐੮͐˺੮ʩ˺̹ͅʮ͐ɘˑʮΈʇੴ੮ɺ͙͐੮͐˺੮͙̼͐˦੮ɘ˦੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ ̹ɘ͐ʮʇ˦͐੮ʮ˦͐˺੮ɘ˦੮˺͙̹͐ɘ͐ʮʇ˦͐ੳૂ੮)̼ੳ੮Ûɘ˦ʁੴ੮ɘ͸ɘ̼ʇ੮˺ʠ੮˚ɘ˦;੮˺ʠ੮ʩʮͅ੮̹ɘ͐ʮʇ˦͐ͅૄ੮ͅ˺ɻʮɘˑ੮ɻʮ̼ɻ͙˚͐ͅɘ˦ɻʇͅੴ੮͸ɘͅ੮ˑʇͅͅ੮ͅɘ˦ʡ͙ʮ˦ʇ੮ɘɺ˺͙͐੮ͅʇ˦ʁʮ˦ʡ੮̹ʇ˺̹ˑʇ੮˺͙͐੮͸ʮ͐ʩ੮ɘ੮ˑʮ͐ͅ੮˺ʠ੮̼ʇʠʇ̼̼ɘˑͅੵ੮ ુ{ɘ˦;੮˺ʠ੮˺͙̼੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮ɻ˺˚ʮ˦ʡ੮˺͙͐੮˺ʠ੮͐ʩʇͅʇ੮͐ʇ˦͐੮ɻʮ͐;੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐ͅ੮ɘ˦ʁ੮͐ʩʇ;ૄ̼ʇ੮ ˈ͙͐ͅ੮̹ʇ͐ͅʮˑʇ˦͐ੴ੮ʩ˺̼̼ʮɺˑʇੴ੮ɘ͸ʠ͙ˑ੮̹ˑɘɻʇͅੳ੯ੳ੯ੳ੯ੳ੮Ě˺͙੮ˑ˺˺ˌ੮ʮ˦੮͐ʩʇ੮˚ʇʁʮɻɘˑ੮̼ʇɻ˺̼ʁੴ੮ɘ˦ʁ੮ʮ͐੮ ͅɘ;ͅੴ੮ ˚ɘ˦;੮ ͐ʮ˚ʇͅੴ੮ ૃÛʇʠʇ̼̼ʇʁ੮ ͐˺੮ #˺͙˦͐;੮ ##/ää੮ ˑʮ˦ʇૄૂઝ͐ʩʇ੮ ʡɘ͐ʇ͸ɘ;੮ ͐˺੮ ̹͙ɺˑʮɻ੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅઝુɘ˦ʁ੮͐ʩʇ;੮ʡʇ͐੮ɘͅͅʮʡ˦ʇʁ੮ɘ੮ɻˑʮ˦ʮɻੴ੮ɘ˦ʁ੮˚ɘ;ɺʇ੮͐ʩʇ;੮ʡ˺੮˺˦ɻʇੴ੮ ɺ͙͐੮͐ʩʇ;੮ʩɘͷʇ੮˦˺੮ɘɺʮˑʮ͐;੮͐˺੮ʡʇ͐੮͐˺੮͐ʩʇ੮˦ʇͽ͐੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ੴ੮˦˺੮ɻʇˑˑ੮̹ʩ˺˦ʇ੮͐˺੮ʇͷʇ˦੮ ɺʇ੮ɻ˺˦͐ɘɻ͐ʇʁੳૂৼৼ îʩʇͅʇ੮͐;̹˺ˑ˺ʡʮʇͅ੮ʩʇˑ̹੮ɻˑɘ̼ʮʠ;੮͐ʩʇ੮̼˺ˑʇ੮/Ûͅ੮ɘɻ͙͐ɘˑˑ;੮̹ˑɘ;੮ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮äɻʩ˺ˑɘ̼ͅ੮˺ʠ੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘɻ;੮ʩɘͷʇ੮ʁʮʠʠʇ̼ʇ˦͐ʮɘ͐ʇʁ੮ɺʇ͐͸ʇʇ˦੮ ̂ɐ˃̂ʚɐ؅Ʉɲȡʯɪɷʯɪ agencies and ̂ɐ˃̂ʚɐ؅̂̅˃Ʉɐ̎̎ɷʯɪ੮ ˺˦ʇͅੳৼ৽੮ îʩʇ੮ ͅ˺ɻʮɘˑ੮ ͅʇɻ͙̼ʮ͐;੮ ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦੮ʮͅ੮ɘ˦੮ʮɻ˺˦ʮɻ੮̹ʇ˺̹ˑʇચ̹̼˺ɻʇͅͅʮ˦ʡ੮ɺ͙̼ʇɘ͙ɻ̼ɘɻ;ੵ੮ʮ͐ͅ੮ʡ˺ɘˑ੮ʮͅ੮͐˺੮ɻʩʇɻˌ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʇˑʮʡʮɺʮˑʮ͐;੮ɘ˦ʁ੮͐ʩʇ˦੮ͅʇ˦ʁ੮͐ʩʇ˚੮˺˦੮͐ʩʇʮ̼੮͸ɘ;੮͸ʮ͐ʩ੮ɘ੮ɻʩʇɻˌੳ੮{˺͐ͅ੮˺ʠ੮͙ͅ੮͸˺͙ˑʁ੮ ˑʮˌʇ੮͐˺੮͐ʩʮ˦ˌ੮˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚੮ɘͅ੮˚ɘʁʇ੮͙̹੮˺ʠ੮̹ʇ˺̹ˑʇચɻʩɘ˦ʡʮ˦ʡ੮ ɺ͙̼ʇɘ͙ɻ̼ɘɻʮʇͅੳ੮‡˺੮˺˦ʇ੮͸ɘ˦͐ͅ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʮͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮͐˺੮͐ͅɘ;੮͐ʩɘ͐੮͸ɘ;ੳ੮ "͙͐੮̹ʇ˺̹ˑʇ੮ɻʩɘ˦ʡʮ˦ʡ੮͐ɘˌʇͅ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦ੴ੮̼ʇͅ˺͙̼ɻʇͅੴ੮ɘ˦ʁ੮͐ʮ˚ʇੴ੮ɘˑˑ੮˺ʠ੮͸ʩʮɻʩ੮ɘ̼ʇ੮ʮ˦੮ ͅʩ˺̼͐੮͙̹̹ͅˑ;੮ʮ˦੮ɘ˦੮/Û੮ɺ˺˚ɺɘ̼ʁʇʁ੮͸ʮ͐ʩ੮ɘˑˑ੮͐ʩʇ੮˚ʮͅʇ̼;੮ˑʇʠ͐੮͙˦ɘʁʁ̼ʇͅͅʇʁ੮ɺ;੮͐ʩʇ੮̼ʇ͐ͅ੮ ˺ʠ੮˚ʇ̼ʮɻɘૄͅ੮˚ʮͅʇ̼ˑ;੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇੳ੮˦ʁ੮̹ʇ˺̹ˑʇ੮ɻʩɘ˦ʡʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ̼ʇή͙ʮ̼ʇͅ੮ɺʇʁͅੴ੮˺ʠ੮͸ʩʮɻʩ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʠʇ͸ʇ̼੮ɘ˦ʁ੮ʠʇ͸ʇ̼੮ફϲʮʡ͙̼ʇ੮৳ੳৱબੳৼ৾੮/ͷʇ˦੮͸ʩʇ˦੮͐ʩʇ;੮ ɘ̼ʇ੮ɻˑʇɘ̼ʇʁ੮ʠ˺̼੮ɘʁ˚ʮͅͅʮ˺˦ੴ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ɘʮ͐੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮͐ʩ̼ʇʇ੮͐ʮ˚ʇͅ੮ˑ˺˦ʡʇ̼੮͐ʩɘ˦੮˦˺˦̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅ੮͐˺੮ɺʇ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ɻ̼ɘ˚̹ʇʁੴ੮ɻʩɘ˺͐ʮɻ੮ ̹ͅɘɻʇ੮˺ʠ੮ɘ˦੮/)੮ʮ˦͐˺੮ɘ੮̹̼˺̹ʇ̼੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐ੳৼ৿੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ੮ʩ͙˚ɘ˦ʇ੮͐ʩʮ˦ʡ੮ʮͅ੮͐˺੮ ̹̼˺ɻʇͅͅ੮ɘ˦ʁ੮̼ʇˑʇɘͅʇੴ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘ͐͐ʇ˚̹͐੮͐˺੮ˌʇʇ̹੮ɘ˦ʁ੮ɻʩɘ˦ʡʇ੮ફɘ˦ʁ੮ͅʇʇ੮͐ʩɘ͐੮̹ʇ̼ͅ˺˦੮ ̼ʇˑʇɘͅʇʁ੮ɺ;੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘ੮ʠʇ͸੮ʁɘ;ͅ੮ˑɘ͐ʇ̼੮ɘ˦;͸ɘ;બੳ õ˦͙̼̹̼ͅʮͅʮ˦ʡˑ;ੴ੮ ͐ʩʇ˦ੴ੮ ͐ʩʇ੮ ̹̼˺̹˺̼͐ʮ˺˦੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ʮ˦੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ɻ̼ʮͅʮͅ੮ ͐ʩɘ͐੮ )̼ੳ੮Ûɘ˦ʁ੮ͅʇʇͅ੮͸ʩ˺੮ɘ̼ʇ੮ɘɻ͙͐ɘˑˑ;੮ɘʁ˚ʮ͐͐ʇʁ੮ʮ˦͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮͅ੮ˑ˺͸ੳ੮ˑ͐ʩ˺͙ʡʩ੮͐ʩʇ̼ʇૄͅ੮

76

T H E C O N S E RVATO R S H I P C O N T I N U U M

30,000 State hospital (Patients) State hospital - Forensic State hospital - LPS Acute hospital (Beds)

25,000

Beds/patients

20,000

15,000

10,000

5,000

2022

2019

2016

2013

2010

2007

2004

2001

1998

1995

1992

1989

1986

1983

1980

1977

1974

1971

1968

1965

0

3.1 Øͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮ɺʇʁͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ৱ৹৶৵જ৲ৰ৲৲ Sourceੵ੮#ɘˑʮʠ˺̼˦ʮɘ੮P˺̹ͅʮ͐ɘˑ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੶੮Û‡)੮ફ৲ৰ৲৲બ੶੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑͅ

˦˺੮˺ϲϲʮɻʮɘˑ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ϲʮʡ͙̼ʇੴ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮P˺̹ͅʮ͐ɘˑ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮ʇ͐ͅʮ˚ɘ͐ʇͅ੮͐ʩɘ͐੮ ˺˦ˑ;੮ɘɺ˺͙͐੮৲৵੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ʁʇʇ˚ʇʁ੮ͅ˺੮ʁɘ˦ʡʇ̼˺͙ͅ੮˺̼੮ʁʮͅɘɺˑʇʁ੮ ͐ʩʇ;੮ʩɘʁ੮͐˺੮ɺʇ੮ʠ˺̼ɻʮɺˑ;੮̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮͐˺੮ɘ˦੮/Û੮˺˦੮ɘ੮৵ৱ৵ৰ੮ɘ̼ʇ੮ʁɘ˦ʡʇ̼˺͙ͅ੮˺̼੮ʁʮͅɘɺˑʇʁ੮ ʇ˦˺͙ʡʩ੮͐˺੮ˌʇʇ̹੮̹ɘ͐ͅ੮͐͸ʇ˦͐;ચʠ˺͙̼੮ʩ˺͙̼ͅੳৼ਀੮Ĕʩʇ͐ʩʇ̼੮ɺ;੮ɻ˺˦˦ʇɻ͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͐˺੮˺͙̹͐ɘ͐ʮʇ˦͐੮ ɻɘ̼ʇੴ੮ ̹̼˺͐ʇɻ͐ʮ˦ʡ੮ ͐ʩʇʮ̼੮ ɻʮͷʮˑ੮ ˑʮɺʇ̼͐ʮʇͅੴ੮ ɻɘˑˑʮ˦ʡ੮ ˺͙͐੮ ˚ɘˑʮ˦ʡʇ̼ʮ˦ʡੴ੮ ˺̼੮ ͅɘͷʮ˦ʡ੮ ͅɻɘ̼ɻʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɺʇʁͅ੮ʠ˺̼੮͐ʩʇ੮˚˺͐ͅ੮ʁʮ̼͙̹͐ͅʮͷʇ੮̹ɘ͐ʮʇ˦͐ͅੴ੮/Ûͅ੮̹ʇ˺̹ˑʇ੮̹̼˺ɻʇͅͅ੮˚˺͐ͅ੮ ̹ɘ͐ʮʇ˦͐ͅ੮˺ʠʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ

THE FRUSTRATION OF “FREQUENT FLYERS” "͙͐੮ ͸ʩɘ͐੮ ʩɘ̹̹ʇ˦ͅ੮ ʮʠ੮ ͐ʩʇ੮ ̹ʇ˺̹ˑʇ੮ ɺʇʮ˦ʡ੮ ̹̼˺ɻʇͅͅʇʁ੮ ˌʇʇ̹੮ ɻ˺˚ʮ˦ʡ੮ ɺɘɻˌ੺੮ /ͷʇ̼;੮ /Û੮ ɻˑʮ˦ʮɻʮɘ˦੮ ʩɘͅ੮ ͐ɘˑʇͅ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͷʮͅʮ͐ʮ˦ʡ੮ ʁɘʮˑ;੮ ͐˺੮ ʩɘͷʇ੮ ͸˺͙˦ʁͅ੮ ʁ̼ʇͅͅʇʁੴ੮ ͸ʇʇˌˑ;੮ ͐˺੮ ʩʇˑ̹੮˚ɘ˦ɘʡʇ੮ʁʮɘɺʇ͐ʇͅੴ੮˚˺˦͐ʩˑ;੮͐˺੮ʡʇ͐੮˚ʇʁʮɻɘ͐ʮ˺˦੮̼ʇϲʮˑˑͅੴ੮˺̼੮ͅʇɘͅ˺˦ɘˑˑ;੮͐˺੮ʩɘͷʇ੮ɘ੮ ʩ˺͐੮˚ʇɘˑ੮ɘ˦ʁ੮ɘ੮ɻ˺͐੮͸ʩʇ˦੮͐ʩʇ੮͸ʇɘ͐ʩʇ̼੮͙̼͐˦ͅੳ੮Ûʇͅʇɘ̼ɻʩ੮ʠ̼˺˚੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʠ˺͙˦ʁ੮ ͐ʩɘ͐ੴ੮ɘ˚˺˦ʡ੮ુ͙̹ͅʇ̼ચʠ̼ʇή͙ʇ˦͐ૂ੮͙͐ʮˑʮΈʇ̼ͅ੮˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ફ̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ ɘ͐੮ ˑʇɘ͐ͅ੮ ʇʮʡʩ͐ʇʇ˦੮ ͷʮͅʮ͐ͅ੮ ɘ੮ ;ʇɘ̼બੴ੮ ৸৷੮ ̹ʇ̼ɻʇ˦͐੮ ʩɘʁ੮ ͅ˺˚ʇ੮ ˌʮ˦ʁ੮ ˺ʠ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ˺̼੮

EMERGENCY ROOM

77

͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ʁʮͅ˺̼ʁʇ̼ੳৼਁ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮ͅ;˚̹͐˺˚ͅ੮˚ʮʡʩ͐੮ɺʇ੮͐ʩʇ੮ʁʮ̼ʇɻ͐੮̼ʇɘͅ˺˦੮ʠ˺̼੮ɘ੮ ɻ˺˦͙ͅˑ͐ɘ͐ʮ˺˦ੴ੮ɺ͙͐੮˚˺̼ʇ੮˺ʠ͐ʇ˦੮͐ʩʇ;੮ɘ̼ʇ੮˺˦ʇ੮̹ɘ̼͐੮˺ʠ੮ɘ੮ɻ˺˚̹ˑʇͽ੮˺ʠ੮ͅ˺ɻʮɘˑੴ੮˚ʇʁʮɻɘˑੴ੮ ɘ˦ʁ੮ ̹ͅ;ɻʩ˺ˑ˺ʡʮɻɘˑ੮ ʠɘɻ͐˺̼ͅ੮ ͐ʩɘ͐੮ ˚ɘˌʇ੮ ̹ʇ˺̹ˑʇ੮ ͙˦ɘɺˑʇ੮ ͐˺੮ ˚ɘʮ˦͐ɘʮ˦੮ ͐ʩʇʮ̼੮ ʩ˺͙ͅʮ˦ʡੴ੮ ɘ͐͐ʇ˦ʁ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅੴ੮˺̼੮˚˺˦ʮ͐˺̼੮͐ʩʇʮ̼੮ɺˑ˺˺ʁ੮͙ͅʡɘ̼ੳ /˚ʮˑ;ૄͅ੮ͅ˺˦੮kʇ̼ɘʁ੮ʮͅੴ੮ɺ;੮ʩʇ̼੮˺͸˦੮ɘʁ˚ʮͅͅʮ˺˦ੴ੮ુʁʇϲʮ˦ʮ͐ʇˑ;੮ɘ੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ੳૂ੮ˑ˚˺͐ͅ੮ ͐͸˺੮ʁʇɻɘʁʇͅ੮ɘʡ˺ੴ੮ʩʇ੮˚ɘ˦ɘʡʇʁ੮͐˺੮ʡʇ͐੮˺˦੮˚ʇʁʮɻɘ͐ʮ˺˦੮͐ʩɘ͐੮͐ͅɘɺʮˑʮΈʇʁ੮ʩʮͅ੮̹ͅ;ɻʩ˺ͅʮͅੳ੮ Pʇ੮͸ʇ˦͐੮˺ʠʠ੮ʮ͐੮ʮ˦੮৲ৰৰ৴੮ફુ͐ʩʇ੮ͅʮʁʇ੮ʇʠʠʇɻ͐ͅ੮͸ʇ̼ʇ੮ʩ˺̼̼ʮɺˑʇૂબ੮ɘ˦ʁ੮ͅʮ˦ɻʇ੮͐ʩʇ˦੮ʩʇૄͅ੮ɺʇʇ˦੮ ͐ʩʇ੮ή͙ʮ˦͐ʇͅͅʇ˦͐ʮɘˑ੮̼ʇͷ˺ˑͷʮ˦ʡચʁ˺˺̼੮̹ɘ͐ʮʇ˦͐ੳ੮îʩʮ˦ʡͅ੮ʡ˺͐੮͸˺̼ͅʇ੮ʁ͙̼ʮ˦ʡ੮͐ʩʇ੮#šēU)੮ ̹ɘ˦ʁʇ˚ʮɻੳ੮Pʇ੮ʩɘͅ੮ɘ˦੮HäØ੮͐ʇɘ˚ੴ੮ɺ͙͐੮͐ʩʇ;੮͸˺͙ˑʁ˦ૄ͐੮ɻ˺˚ʇ੮͐˺੮ʩʮ˚ੵ੮ʩʇ੮ʇʮ͐ʩʇ̼੮ʡʇ͐ͅ੮ ͷʮʁʇ˺ɻ˺˦ʠʇ̼ʇ˦ɻʇ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅੴ੮͸ʩʮɻʩ੮ʩʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮˚ʮͅͅʇͅੴ੮˺̼੮ʩɘͅ੮͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮ ɻˑʮ˦ʮɻੴ੮͸ʩʮɻʩ੮ʮͅ੮ɘ˦੮ʩ˺͙̼ચɘ˦ʁચɘચʩɘˑʠ੮͸ɘˑˌ੮ʠ̼˺˚੮͐ʩʇ੮ɘ̹ɘ̼͐˚ʇ˦͐੮/˚ʮˑ;੮̼ʇ˦͐ͅ੮ʠ˺̼੮ʩʮ˚ੳ੮ Pʇ੮ʮͅ੮ɘʠ̼ɘʮʁ੮˺ʠ੮ʡ˺ʮ˦ʡ੮ɺʇɻɘ͙ͅʇ੮̹ʇ˺̹ˑʇ੮ʁ˺˦ૄ͐੮͸ʇɘ̼੮˚ɘͅˌͅੳ੮ͅ੮/˚ʮˑ;੮ʁʇͅɻ̼ʮɺʇʁ੮ʮ͐ੴ੮ʩʇ੮ ʮͅ੮ુʮͅ˺ˑɘ͐ʇʁ੮ɘ˦ʁ੮ɘˑ˺˦ʇૂ੮ɘ˦ʁ੮ʡ˺ʇͅ੮͐˺੮͐ʩʇ੮˺˦ʇ੮̹ˑɘɻʇ੮͸ʩʇ̼ʇ੮ʩʇ੮ʠʇʇˑͅ੮ͅɘʠʇ੮ɘ˦ʁ੮ɻɘ˦੮ʡʇ͐੮ ͅ˺˚ʇ੮ɘ͐͐ʇ˦͐ʮ˺˦ੵ੮ɘ˦੮/Ûੳ îʩʇ੮͐;̹ʮɻɘˑ੮ͅɻʇ˦ɘ̼ʮ˺ੴ੮ͅʩʇ੮ͅɘʮʁੴ੮ʮͅ੮͐ʩɘ͐੮ʩʇ੮ɻɘˑˑͅ੮ɘ੮͙ͅʮɻʮʁʇ੮ɻ̼ʮͅʮͅ੮ˑʮ˦ʇ੮ʇͷʇ̼;੮ʠʇ͸੮ ʩ˺͙̼ͅ੮ɘ˦ʁ੮͐ʩʇ˦ੴ੮ɘ͐੮˦ʮʡʩ͐ੴ੮ʩʮ͐ͅ੮͙̹੮/Ûͅ੮ɘ̼˺͙˦ʁ੮͐ʩʇ੮"ɘ;੮̼ʇɘੳ੮îʩʇ੮ʁ˺˺̼ͅ੮̼ʇͷ˺ˑͷʇ੮ ή͙ʮɻˌˑ;ੳ੮Pʇ̼ʇૄͅ੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ʇʁ੮͐ʩʇ੮͸ʇʇˌ੮ɺʇʠ˺̼ʇ੮U੮̹ͅ˺ˌʇ੮͐˺੮ʩʇ̼੮ʮ˦੮͐ʩʇ੮ʠɘˑˑ੮˺ʠ੮৲ৰ৲ৰੳ੮ kʇ̼ɘʁ੮ʁ̼ɘ˦ˌઝુʠ˺̼੮ͅ˺˚ʇ੮̼ʇɘͅ˺˦੮ʩʇ੮͐ʩʮ˦ˌͅ੮ʩʇ੮ʩɘͅ੮͐˺੮ʁ̼ʮ˦ˌ੮͐˺੮ʡ˺੮͐ʩʇ̼ʇ੮ય͐˺੮ɘ˦੮/Ûરૂઝ ɘ˦ʁ੮͸ʇ˦͐੮͐˺੮ɘ੮͙˦ʮͷʇ̼ͅʮ͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ʩʇ̼ʇ੮ʩʇ੮͐ͅɘ;ʇʁ੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅੳ੮îʩʇ;੮ʁʮͅɻʩɘ̼ʡʇʁ੮ ʩʮ˚੮ɘ͐੮ৱੵৰৰ੮ӣੳՖੳੴ੮ુ͸ʩʇ˦੮ʩʇ੮ʩɘʁ੮˦˺੮͸ɘ;੮˺ʠ੮ʡʇ͐͐ʮ˦ʡ੮ʩ˺˚ʇੳૂ੮Pʇ੮͐ʩʇ˦੮͸ʇ˦͐੮͐˺੮ɘ੮˦ʇɘ̼ɺ;੮ ˦˺˦̹̼˺ϲʮ͐੮ʩ˺̹ͅʮ͐ɘˑੴ੮̹ɘ̼͐੮˺ʠ੮ʩʮͅ੮̹̼ʇʁʮɻ͐ɘɺˑʇ੮ɻʮ̼ɻ͙ʮ͐ੳ੮Ĕʩʇ˦੮/˚ʮˑ;੮ɻɘˑˑʇʁੴ੮͐ʩʇ;੮ͅɘʮʁ੮ ʩʇ੮͐ͅɘ;ʇʁ੮ʠ̼˺˚੮৴੮ӣੳՖੳ੮͐˺੮৷੮ӣੳՖੳ੮‡ʇͽ͐੮͐ͅ˺̹੮͸ɘͅ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ʩʮɻʩ੮ ʠ˺͙˦ʁ੮ʩʮ˚੮ɘ੮ɺʇʁ੮ʮ˦੮ɘ੮˦ʇʮʡʩɺ˺̼ʮ˦ʡ੮ɻ˺͙˦͐;ੴ੮͸ʩʇ̼ʇ੮͐ʩʇ;੮ˌʇ̹͐੮ʩʮ˚੮ʠ̼˺˚੮Ĕʇʁ˦ʇͅʁɘ;੮ ͐˺੮{˺˦ʁɘ;੮ɘ˦ʁ੮͐ʩʇ˦੮ʁʮͅɻʩɘ̼ʡʇʁ੮ʩʮ˚ੳ੮îʩɘ͐੮˦ʮʡʩ͐ੴ੮ʩʇ੮͸ʇ˦͐੮͐˺੮͐ʩ̼ʇʇ੮ʁʮʠʠʇ̼ʇ˦͐੮/Ûͅੳ੮ îʩʇ੮̹͙ɺˑʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮ˌʇ̹͐੮ʩʮ˚੮˺ͷʇ̼˦ʮʡʩ͐੮ɘ˦ʁ੮ɻɘˑˑʇʁ੮/˚ʮˑ;੮͐˺੮̹ʮɻˌ੮ʩʮ˚੮͙̹੮͐ʩɘ͐੮ î͙ʇͅʁɘ;ੳ੮Pʇ੮̼ʇ͙̼͐˦ʇʁ੮͐ʩɘ͐੮˦ʮʡʩ͐ੳ੮Pʇ੮ʩɘʁ੮ͷʮͅʮ͐ʇʁ੮/Ûͅ੮ɘ͐੮ˑʇɘ͐ͅ੮ৱ৲ৰ੮͐ʮ˚ʇͅ੮ͅʮ˦ɻʇ੮͐ʩʇ੮ ͐ͅɘ̼͐੮˺ʠ੮͐ʩʇ੮̹ɘ˦ʁʇ˚ʮɻੴ੮͸ʮ͐ʩ੮ʇʮʡʩ͐੮ͷʇ̼;੮ͅʩ˺̼͐ચ͐ʇ̼˚੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮ʁ͙̼ʮ˦ʡ੮͸ʩʮɻʩ੮ʩʇ੮ ̼ʇʠ͙ͅʇʁ੮ɘˑˑ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ U͐੮ͅɘ;ͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ʩ˺̼̼ʮɺˑʇ੮ɘɺ˺͙͐੮͐ʩʇ੮͸˺̼ˑʁ੮˺͙͐ͅʮʁʇ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮͸˺͙ˑʁ੮͸ɘ˦͐੮͐˺੮ ʡ˺੮͐˺੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮/Û੮̼ʇ̹ʇɘ͐ʇʁˑ;ੳ੮‡͙̼ͅʇ੮k˺˦ʇͅ੮͸˺̼ˌʇʁ੮ʮ˦੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ ͅʇ̼ͷʮɻʇͅ੮ફØ/äબ੮ɘ͐੮äH੮Iʇ˦ʇ̼ɘˑੴ੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮˚ɘʮ˦੮̹͙ɺˑʮɻ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʠ˺̼੮͐ʩʇ੮ɺʇ͐͐ʇ̼੮ ̹ɘ̼͐੮˺ʠ੮ɘ੮ʁʇɻɘʁʇੳ੮U੮ɘͅˌʇʁ੮ʩʇ̼੮͸ʩɘ͐੮Ø/ä੮ˑ˺˺ˌʇʁ੮ˑʮˌʇੴ੮ɘ˦ʁ੮ͅʩʇ੮̼ʇ̹ͅ˺˦ʁʇʁੴ੮ુîʩʇ੮͸˺̼ʁ੮ ૃˑ˺˺ˌͅૄ੮ʮͅ੮ʮ˦ɻ˺˚̹ˑʇ͐ʇੴ੮ɺʇɻɘ͙ͅʇ੮ʮ͐ૄͅ੮ɘ੮ʠ͙ˑˑચ˺˦੮ͅʇ˦ͅ˺̼;੮ʇͽ̹ʇ̼ʮʇ˦ɻʇੳ੮îʩʇ̼ʇૄͅ੮ɘ੮ˑ˺͐੮˺ʠ੮ ˦˺ʮͅʇੴ੮ɘ੮ˑ˺͐੮˺ʠ੮ͅ˚ʇˑˑͅੴ੮ɘ੮ˑ˺͐੮˺ʠ੮ɻʩɘ˺ͅੴ੮ʇͷʇ˦੮˺˦੮ɘ੮ʡ˺˺ʁ੮ʁɘ;ੳૂ੮)͙̼ʮ˦ʡ੮ɘ੮˚˺̼˦ʮ˦ʡ੮ͅʩʮʠ͐ੴ੮ ͅʩʇ੮ɘ˦ʁ੮ɘ੮ʩɘˑʠચʁ˺Έʇ˦੮˺͐ʩʇ̼੮˦͙̼ͅʇͅ੮͸ʇ̼ʇ੮ʠɘɻʇʁ੮͸ʮ͐ʩ੮͙̹੮͐˺੮͐͸ʇ˦͐;੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ʩɘʁ੮ ɻ˺˚ʇ੮ʮ˦੮ʁ͙̼ʮ˦ʡ੮͐ʩʇ੮˦ʮʡʩ͐ੵ੮ુä˺˚ʇ͐ʮ˚ʇͅ੮;˺͙੮͸ɘˑˌ੮ʮ˦ੴ੮ɘ˦ʁ੮͐ʩʇ̼ʇૄʁ੮ɺʇ੮˦˺ɺ˺ʁ;੮ʮ˦੮͐ʩʇ੮

78

T H E C O N S E RVATO R S H I P C O N T I N U U M

͐ͅɘʠʠ੮ɘ̼ʇɘ੮ɺʇɻɘ͙ͅʇ੮ʇͷʇ̼;˺˦ʇ੮͸ɘͅ੮ʮ˦੮͐ʩʇ੮˚ʮʁʁˑʇ੮˺ʠ੮̹͙͐͐ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦͐˺੮ˑ˺ɻˌʇʁ੮ ͅʇɻˑ͙ͅʮ˺˦੮˺̼੮ʮ˦ˈʇɻ͐ʮ˦ʡ੮͐ʩʇ˚੮͸ʮ͐ʩ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮˚ʇʁͅੳ੮ä˺੮;˺͙੮ˈ͙˚̹੮ʮ˦੮ɘ˦ʁ੮ʩʇˑ̹੮˺͙͐ੳૂ੮ U੮ϲʮ˦ɘˑˑ;੮ͷʮͅʮ͐ʇʁ੮Ø/ä੮ʮ˦੮৲ৰ৲৲ੳ੮îʩʇ੮͐ͅɘʠʠ੮U੮̹ͅ˺ˌʇ੮͐˺੮͸ʇ̼ʇ੮͸ɘ̼˚ੴ੮ɺ͙͐੮͐ʩʇ੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮ ͸ɘͅ੮ɻ˺ˑʁੳ੮îʩʇ;੮͸ʇ̼ʇ੮˺ͷʇ̼ϲˑ˺͸ʮ˦ʡੴ੮ͅ˺੮ɘ੮ʩɘˑʠચʁ˺Έʇ˦੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʇ̼ʇ੮ɻ̼ɘ˚˚ʇʁ੮ʮ˦੮ʡ͙̼˦ʇ;ͅ੮ʮ˦ͅʮʁʇ੮ɘ੮˦ɘ̼̼˺͸੮ɻ˺˚˚˺˦੮ɘ̼ʇɘੳ੮îʩʇ੮̼ʇ͐ͅ੮͸ʇ̼ʇ੮ɺʇʩʮ˦ʁ੮ʩʇɘͷ;੮˚ʇ͐ɘˑ੮ʁ˺˺̼ͅ੮͐ʩɘ͐੮ ͸˺͙ˑʁ੮ϲʮ͐੮̼ʮʡʩ͐੮ʮ˦੮ɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ˈɘʮˑੳ ͅ੮‡͙̼ͅʇ੮k˺˦ʇͅ੮ʁʇͅɻ̼ʮɺʇʁ੮ʮ͐ੴ੮ʩʇ̼੮͐ʇɘ˚ૄͅ੮˺ͷʇ̼ɘ̼ɻʩʮ˦ʡ੮ʡ˺ɘˑ੮͸ɘͅ੮͐˺੮ʁ̼ʮͷʇ੮͐ʩʇ੮ɻʇ˦͙ͅͅ੮ʁ˺͸˦੮ɺ;੮˚ʮʁʁɘ;੮͐˺੮˚ɘˌʇ੮͸ɘ;੮ʠ˺̼੮ɘ੮˦ʇ͸੮̼˺͙˦ʁ੮˺ʠ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮͸ɘˑˌʮ˦ʡ੮ʮ˦੮ ˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐੮˺̼੮৵ৱ৵ৰʇʁੳ੮Ø/ä੮ʮͅ੮ˑʇʡʇ˦ʁɘ̼;੮ʠ˺̼੮ʮ͐ͅ੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅੳ੮š˦ʇ੮͸˺˚ɘ˦੮ɻɘ˚ʇ੮ ৱ৵ৰ੮͐ʮ˚ʇͅੴ੮˚˺͐ͅˑ;੮ͅʇɘ̼ɻʩʮ˦ʡ੮ʠ˺̼੮̹̼ʇʡ˦ɘ˦ɻ;੮͐ʇ͐ͅͅੳ੮Ĕʩʇ˦੮˺˦ʇ੮ɻɘ˚ʇ੮͙̹੮̹˺ͅʮ͐ʮͷʇੴ੮ͅʩʇ੮ ̼ʇʠ͙ͅʇʁ੮ɘ˦੮˺ʠʠʇ̼੮˺ʠ੮ɘ੮ʩ˺͐ʇˑ੮̼˺˺˚੮˺̼੮ͅʩʇˑ͐ʇ̼੮ɺʇʁ੮ɘ˦ʁ੮ˑʇʠ͐ੳৼਂ੮Ø/ä੮ʮͅ੮ɘˑͅ˺੮˚;͐ʩʮɻɘˑ੮ʠ˺̼੮ ͐ʩʇ੮̼͙͐ʩˑʇͅͅ˦ʇͅͅ੮˺ʠ੮ʮ͐ͅ੮ʁʮͅɻʩɘ̼ʡʇͅੳ੮U͐੮ͅʇʇ˚ʇʁ੮ʇͷʇ̼;˺˦ʇ੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʮ˦੮ ͐ʩʇ੮ɻʮ͐;੮ʩɘʁ੮ʩʇɘ̼ʁ੮ɘɺ˺͙͐੮͐ʩʇ੮͐ʮ˚ʇ੮ʮ͐੮̼ʇˑʇɘͅʇʁ੮ɘ੮ɺˑ˺˺ʁચɻ˺ͷʇ̼ʇʁ੮˚ɘ˦੮ʠ˺͙˦ʁ੮ʇɘ͐ʮ˦ʡ੮ ɘ੮ʁʇɘʁ੮̼ɘɻ˺˺˦੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮Pʇ੮͸ɘͅੴ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ʁʇ͐ʇ̼˚ʮ˦ʇʁੴ੮˚ʇʇ͐ʮ˦ʡ੮ʩʮͅ੮ɺɘͅʮɻ੮ ˦ʇʇʁ੮ʠ˺̼੮ʠ˺˺ʁੳৼਃ îʩʇ੮˚ɘ˦ɘʡʇ˚ʇ˦͐੮˺ʠ੮Ø/ä੮ʩɘͅ੮̼͐ʮʇʁ੮ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮ʁʮ͙̼͐ͅɺʮ˦ʡ੮ɘ˦ʁ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʮˑˑʇʡɘˑ੮̼͐ͅɘ͐ʇʡʮʇͅ੮͐˺੮ʇ˚̹͐;੮ʮ͐ͅ੮ɺʇʁͅ੮ફ˺̼ੴ੮˺ʠ͐ʇ˦ੴ੮ʡ͙̼˦ʇ;ͅબੳ੮/˚ʮˑ;੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮ɺɘɻˌ੮ʮ˦੮ ͐ʩʇ੮ʇɘ̼ˑ;੮৲ৰৱৰͅੴ੮͐ʩʇ;ૄʁ੮ʮ˦͐ʇ̼ͷʮʇ͸੮̹ʇ˺̹ˑʇ੮ʮ˦੮͐ʩʇ੮͸ɘʮ͐ʮ˦ʡ੮̼˺˺˚੮͐˺੮͙̼͐˦੮͐ʩʇ˚੮ɘ͸ɘ;੮ ɺʇʠ˺̼ʇ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʠ˺̼˚ɘˑˑ;੮ɘʁ˚ʮ͐͐ʇʁ੮ફ˺͐ʩʇ̼͸ʮͅʇੴ੮Ø/ä੮͸˺͙ˑʁ੮ɺʇ੮̼ʇή͙ʮ̼ʇʁ੮ɺ;੮ʠʇʁʇ̼ɘˑ੮ˑɘ͸੮͐˺੮ʡʮͷʇ੮͐ʩʇ˚੮ɘ੮͐ʩ˺̼˺͙ʡʩ੮͸˺̼ˌ͙̹બੳ੮U˦੮৲ৰৱ৸ੴ੮/˚ʮˑ;ૄͅ੮ͅ˺˦੮ʇ˦ɻ˺͙˦͐ʇ̼ʇʁ੮äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺੮Iʇ˦ʇ̼ɘˑૄͅ੮̹ʮ˺˦ʇʇ̼ʮ˦ʡ੮˦ʇ͸੮ɘ̹̹̼˺ɘɻʩ੮͐˺੮ʁʇ͐ʇ̼੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅੵ੮ુͷʇ̼͐ʮɻɘˑ੮ ͐ʩʇ̼ɘ̹;ੴૂ੮˺̼੮˚ɘˌʮ˦ʡ੮ʮ͐੮ʮ˚̹˺ͅͅʮɺˑʇ੮ʠ˺̼੮͸ɘʮ͐ʮ˦ʡચ̼˺˺˚੮ɻʩɘʮ̼ͅ੮͐˺੮̼ʇɻˑʮ˦ʇੳ੮ુU͐੮͸ɘͅ੮ˈ͙͐ͅ੮ ʩ˺̼̼ʮɺˑʇੴૂ੮ͅʩʇ੮͐˺ˑʁ੮˚ʇੳ੮ુPʇૄʁ੮ʡ˺੮͐˺੮Ø/ä੮ɘ˦ʁ੮͸˺͙ˑʁ˦ૄ͐੮ͅˑʇʇ̹੮ʠ˺̼੮ʇʮʡʩ͐ʇʇ˦੮ʩ˺͙̼ͅੳ੯ੳ੯ੳ੯ੳ੮ )˺੮͐ʩʇ;੮ʁ˺੮ͷʇ̼͐ʮɻɘˑ੮͐ʩʇ̼ɘ̹;੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɘ੮ɺ̼˺ˌʇ˦੮ˑʇʡ੺ૂ੮îʩʇ;੮̼ʇˑɘͽʇʁ੮͐ʩʇ੮̹˺ˑʮɻ;੮͸ʩʇ˦੮̹ɘ͐ʮʇ˦͐ͅ੮ˌʇ̹͐੮ɻ˺˚ʮ˦ʡ੮ɘ˦;͸ɘ;੮ɘ˦ʁ੮ͅˑʇ̹͐੮˺˦੮͐ʩʇ੮ϲˑ˺˺̼ੳৼ਄੮ફ˦੮ৱ৸৴৵੮ɘ̼͐ʮɻˑʇ੮ in the ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Uʯ̎ȡʯɷ̙͇੮̼ʇɻ˺ʡ˦ʮΈʇʁ੮ુäˑʇʇ̹યૄͅર੯ੳ੯ੳ੯ੳ੮U˚̹˺̼͐ɘ˦ɻʇ੮ʮ˦੮Ø̼ʇͷʇ˦͐ʮ˦ʡ੮U˦ͅɘ˦ʮ͐;ੴૂ੮ɺ͙͐੮͐ʩʇ੮ˌ˦˺͸ˑʇʁʡʇ੮ͅʇʇ˚ͅ੮͐˺੮ʩɘͷʇ੮ɺʇʇ˦੮ˑ˺͐ͅੳ৽৻બ H˺̼੮˚ɘ˦;੮;ʇɘ̼ͅੴ੮Ø/ä੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮˺˦੮͐ͅɘʠʠ੮͐˺੮ʩʇˑ̹੮ˑʮ˦ˌ੮ʠ̼ʇή͙ʇ˦͐੮ ϲˑ;ʇ̼ͅ੮͐˺੮͐ʩʇ੮͐ʩʮ˦ʡͅ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɘͅˌʮ˦ʡ੮ʠ˺̼ੴ੮ˑʮˌʇ੮ʩ˺͙ͅʮ˦ʡ੮˺̼੮ʮ˦ɻ˺˚ʇ੮͙̹̹ͅ˺̼͐ͅੳ੮‡˺͸੮͐ʩʇ;੮ʁ˺ੴ੮ɺ͙͐੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮ɻɘ˦੮̼ʇʠʇ̼੮̹ʇ˺̹ˑʇ੮˺˦ˑ;੮͐˺੮͐ʩʮ˦ʡͅ੮͐ʩɘ͐੮ʇͽʮ͐ͅੳ੮ ‡͙̼ͅʇ੮)͸;ʇ̼੮ɘʁ˚ʮ͐͐ʇʁ੮͐˺੮˚ʇੴ੮ૃîʩʇ੮˚ɘʮ˦੮̼˺ˑʇ੮˺ʠ੮˺͙̼੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮ʮͅ੮͐˺੮ʇͽ̹ˑɘʮ˦੮ ͐˺੮̹ʇ˺̹ˑʇ੮͸ʩ;੮͸ʇ੮ɻɘ˦ૄ͐੮ʩʇˑ̹੮͐ʩʇ˚ੵ੮ુU੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮;˺͙੮ʩɘͷʇ੮˦˺੮ʩ˺͙ͅʮ˦ʡੴ੮˦˺੮ʠ˺˺ʁੴ੮ ɺ͙͐੮͐ʩɘ͐ૄͅ੮˦˺͐੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ɘ˦੮/Û੮ɻɘ˦੮ʩʇˑ̹੮;˺͙੮͸ʮ͐ʩੳૄૄ੮ૄ੮U͐ૄͅ੮˦˺͐੮ʇͷʇ˦੮ɻˑʇɘ̼੮͸ʩɘ͐੮͐ʩʇ੮ /Û੮ͅʩ˺͙ˑʁ੮ɺʇ੮˺ʠʠʇ̼ʮ˦ʡ੮͐˺੮ͅ˺˚ʇ˺˦ʇ੮ˑʮˌʇ੮kʇ̼ɘʁੳ੮/˚ʮˑ;੮͸˺͙ˑʁ੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮ʩʮ˚੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘ˦ʁ੮˚ʇʁʮɻɘ͐ʇʁੴ੮ɺ͙͐੮͸ʩʇ˦੮ʩʇૄͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘ˦ʁ੮˚ʇʁʮɻɘ͐ʇʁ੮ʩʮͅ੮ͅ;˚̹͐˺˚ͅ੮ ɻˑʇɘ̼੮ή͙ʮɻˌˑ;ੴ੮ʩʇ੮͸ʮ˦ͅ੮ʩʮͅ੮ʩʇɘ̼ʮ˦ʡ੮ɘͅˌʮ˦ʡ੮ʠ˺̼੮̼ʇˑʇɘͅʇੴ੮ˑʇɘͷʇͅੴ੮ɘ˦ʁ੮͐ʩʇ੮ɻ;ɻˑʇ੮ɺʇʡʮ˦ͅ੮

EMERGENCY ROOM

79

ɘʡɘʮ˦ੳ੮äʩʇૄͅ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩɘ͐੮ʩʇ੮ʩɘͅ੮ɺʇʇ˦ੴ੮ʮ˦੮ʇʠʠʇɻ͐ੴ੮ɺˑɘɻˌɺɘˑˑʇʁ੮ʠ̼˺˚੮˦ʇɘ̼ˑ;੮ʇͷʇ̼;੮ ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐੮ʮ˦੮͐ʩʇ੮"ɘ;ੳ ä˺˚ʇ੮ɻ˺͙˦͐ʮʇͅૄ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼ͅ੮ʩɘͷʇ੮̼͐ʮʇʁ੮͐˺੮ͅˌʮ̼͐੮͐ʩʇ੮ʁʮͅ˚ʮͅͅʮͷʇ੮ɻ˺˦˦ɘ͐ʮ˺˦੮˺ʠ੮ ુʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅૂ੮ɺ;੮̼ʇˑɘɺʇˑʮ˦ʡ੮͐ʩʇ˚੮ુʠ̼ʮʇ˦ʁˑ;੮ʠɘɻʇͅੳૂ੮îʩʮͅ੮ʮͅ੮ɘ੮ʇ͙̹ʩʇ˚ʮͅ˚ੳ੮îʩʇͅʇ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮ʠ̼͙̼͐ͅɘ͐ʮ˦ʡੳ੮‡͙̼ͅʇ੮)͸;ʇ̼੮ͅʩɘ̼ʇʁ੮)̼ੳ੮Ûɘ˦ʁૄͅ੮̹̼ʮʁʇ੮ɘ͐੮̹̼˺ͷʮʁʮ˦ʡ੮̹͙ɺˑʮɻ੮ ͅʇ̼ͷʮɻʇͅ੮͐˺੮͐ʩʇ੮̹˺˺̼ੴ੮ɺ͙͐੮ɘͅ੮ɘ੮͐ͅʇ͸ɘ̼ʁ੮ʠ˺̼੮͐ʩʇ੮˦͙̼ͅʇͅૄ੮͙˦ʮ˺˦ੴ੮ʩʇ੮͸ɘͅ੮ɘˑͅ˺੮͸ʮ͐˦ʇͅͅ੮͐˺੮ ͐ʩʇ੮ɺ͙̼˦˺͙͐੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅ੮̹̼˺ͷ˺ˌʇʁੵ੮ૃîʩʇ̼ʇ੮ɘ̼ʇ੮ʁʇϲʮ˦ʮ͐ʇˑ;੮̹ʇ˺̹ˑʇ੮͸ʩʇ̼ʇ੮ʇͷʇ̼;˺˦ʇ੮ʮͅ੮̼˺ˑˑʮ˦ʡ੮͐ʩʇʮ̼੮ʇ;ʇͅੳ੯ੳ੯ੳ੯ੳ੮Øɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ˌ˦˺͸੮͸ʩɘ͐੮͐˺੮ͅɘ;੮ય͐˺੮͐ͅɘ;રੴ੮ુUૄ˚੮̹ˑɘ˦˦ʮ˦ʡ੮ ͐˺੮ʩ͙̼͐੮˚;ͅʇˑϲ੺ૂ੮ુP˺͸੺ૂ੮ુĔʮ͐ʩ੮ɘ੮ʡ͙˦ੳૂ੮/ͷʇ̼;˺˦ʇ੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮˚˺͐ʮ˺˦ͅੳ੮Ĕʇ੮ ̼ʇͅʇ˦͐੮͐ʩʇ˚੮ɺʇɻɘ͙ͅʇ੮͸ʇ੮͸ɘ˦͐੮͐˺੮ɺʇ੮̼͐ʇɘ͐ʮ˦ʡ੮̹ʇ˺̹ˑʇੳૄ੮îʩʇ੮˦͙̼ͅʇͅ੮͸˺͙ˑʁ੮ˑ˺ɺɺ;੮͐ʩʇ੮ ̹ʩ;ͅʮɻʮɘ˦੮͐˺੮̼ʇ˚˺ͷʇ੮͐ʩʇ੮৵ৱ৵ৰ੮ʩ˺ˑʁੳ੮ૃä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ;ૄˑˑ੮͐ʩ̼˺͸੮ɘ੮͐ɘ˦̼͙͐˚ੴ੮ɘ˦ʁ੮͸ʇૄˑˑ੮ ɘʡ̼ʇʇ੮͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ʮʡ˦˺̼ʇ੮ʮ͐ੳૄ੮Pʮͅ੮ͅʇ˦ͅʇ੮˺ʠ੮ʩʮͅ੮˚ʇʁʮɻɘˑ੮ͷ˺ɻɘ͐ʮ˺˦੮ɺʇʮ˦ʡ੮͐ʩ͸ɘ̼͐ʇʁ੮ ɘˑʮʡ˦ͅ੮͸ʮ͐ʩ੮͐ʩʇ੮˚˺̼ʇ੮ɻɘˑˑ˺͙ͅ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ɻ˺˦ɻʇ̼˦ͅ੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼ͅੴ੮͸ʩ˺੮ ʩɘͷʇ੮˦˺੮͸ɘ;੮͐˺੮ɺʮˑˑ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺ͅʇ੮ʁʮɘʡ˦˺ͅʮͅ੮ʮͅ੮ુʩ˺˚ʇˑʇͅͅ੮ɘ˦ʁ੮ʩ͙˦ʡ̼;ੳૂ৽ৼ îʩʇ੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅ੮̹̼ʇͅʇ˦͐ͅ੮ɘ˦੮˺ʁʁ੮͐͸ʮ͐ͅ੮˺˦੮͐ʩɘ͐੮ɻˑɘͅͅʮɻɘˑ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ʮ˦ͅɘ˦ʮ͐;੮ɘͅ੮ુʁ˺ʮ˦ʡ੮͐ʩʇ੮ͅɘ˚ʇ੮͐ʩʮ˦ʡ੮˺ͷʇ̼੮ɘ˦ʁ੮˺ͷʇ̼੮ɘʡɘʮ˦੮ɘ˦ʁ੮ʇͽ̹ʇɻ͐ʮ˦ʡ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮̼ʇ͙ͅˑ͐ੳૂ੮U˦੮kɘ̼ʇʁૄͅ੮ɻɘͅʇੴ੮/Ûͅ੮ͅʇʇ˚੮͐˺੮ɺʇ੮ʁ˺ʮ˦ʡ੮͐ʩʇ੮ͅɘ˚ʇ੮͐ʩʮ˦ʡ੮˺ͷʇ̼੮ɘ˦ʁ੮˺ͷʇ̼੮ ɘʡɘʮ˦ੴ੮̼ʇɻ˺ʡ˦ʮΈʮ˦ʡ੮͐ʩɘ͐੮͐ʩʇ੮̼ʇ͙ͅˑ͐੮͸ʮˑˑ੮ɺʇ੮͐ʩʇ੮ͅɘ˚ʇઝɘ˦˺͐ʩʇ̼੮ͷʮͅʮ͐੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅੴ੮ ʁɘ;ͅੴ੮˺̼੮ફʮʠ੮ʩʇૄͅ੮ʮ˦੮ˈɘʮˑબ੮˚ɘ;ɺʇ੮͸ʇʇˌͅ੮ˑɘ͐ʇ̼ੳ੮Ě˺͙੮ɻɘ˦ૄ͐੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͐ʩʮͅ੮ˈ͙͐ͅ੮ʮ˦੮͐ʇ̼˚ͅ੮ ˺ʠ੮ ̼ʇͅ˺͙̼ɻʇ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅੳ੮ U͐ૄͅ੮ ɘˑͅ˺੮ ɘ੮ ̹̼˺ʁ͙ɻ͐੮ ˺ʠ੮ ͐ʩʇ੮ ˑɘɻˌ੮ ˺ʠ੮ ʇͽ͐ʇ̼˦ɘˑ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ͐˺੮ ͅ˦ɘ̹੮ɘ˦੮/Û੮˺͙͐੮˺ʠ੮̹ʇ˺̹ˑʇચ̹̼˺ɻʇͅͅʮ˦ʡ੮˚˺ʁʇ੮ɘ˦ʁ੮˚ɘˌʇ੮ʮ͐੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ʮ˦੮ɘ੮ɻ˺ʩʇ̼ʇ˦͐੮ ̹ʇ˺̹ˑʇચɻʩɘ˦ʡʮ˦ʡ੮̼͐ͅɘ͐ʇʡ;ੳ U੮͐ɘˑˌʇʁ੮͐˺੮/˚ʮˑ;੮ɘ੮ʠʇ͸੮˚˺˦͐ʩͅ੮ˑɘ͐ʇ̼ੴ੮ɘ˦ʁ੮kɘ̼ʇʁ੮͸ɘͅ੮͙̹੮͐˺੮ৱ৸ৱ੮ͷʮͅʮ͐ͅ੮ʮ˦੮ɘ੮;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ ʩɘˑʠੳ੮äʩʇ੮ʩɘʁ੮ɺʇʇ˦੮ˑ˺ɺɺ;ʮ˦ʡ੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮ʡʇ͐੮ʩʮ˚੮ɻ˺˦ͅʇ̼ͷʇʁੴ੮͐˺੮˦˺੮ɘͷɘʮˑੳ੮U˦͐ͅʇɘʁੴ੮ʩʇ੮ ʩɘʁ੮̼ʇɻʇ˦͐ˑ;੮ɺʇʇ˦੮ɘ̼̼ʇ͐ͅʇʁ੮ʠ˺̼੮ˌ˦˺ɻˌʮ˦ʡ੮˺ͷʇ̼੮ͅʮʁʇ͸ɘˑˌ੮͐ɘɺˑʇͅ੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɘ˦ʁ੮ʁɘ˚ɘʡʮ˦ʡ੮ɘ੮ɻɘ̼ੳ੮Pʇ੮ˑʮˌʇʁ੮ʮ͐੮ʮ˦੮ˈɘʮˑੴ੮ͅʩʇ੮ͅɘʮʁੴ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ʡ˺͐੮͐˺੮͐ɘˑˌ੮͐˺੮͐ʩʇ੮ʡ͙ɘ̼ʁͅੳ

SPITTING OUT SUBSTANCE USERS Uʠ੮͐ʩʇ̼ʇૄͅ੮˺˦ʇ੮͸ɘ;੮͐˺੮ɺʇ੮̹ͅʮ͐੮˺͙͐੮˺ʠ੮ɘ˦੮/Û੮ή͙ʮɻˌˑ;ੴ੮ʮ͐ૄͅ੮͐˺੮ɺʇ੮ˑɘɺʇˑʇʁ੮ɘͅ੮ɘ˦੮ુɘʁʁʮɻ͐ૂ੮ ̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑੳ৽৽੮îʩʮͅ੮ʮͅ੮ɘ੮ɺʮ͐੮˺ʁʁ੮ɺʇɻɘ͙ͅʇ੮ˑʮ͐ʇ̼ɘˑˑ;੮ʇͷʇ̼;˺˦ʇ੮U੮͐ɘˑˌʇʁ੮͐˺੮ ̼ʇɻ˺ʡ˦ʮΈʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͐͸˺੮ɘ̼ʇ੮˦˺͐੮ʇʮ͐ʩʇ̼ઃ˺̼ੳ੮Øͅ;ɻʩʮɘ̼͐;ૄͅ੮ͷʇ̼;੮˺͸˦੮ɺʮɺˑʇੴ੮͐ʩʇ੮)ʮɘʡ˦˺͐ͅʮɻ੮ɘ˦ʁ੮ä͐ɘ͐ʮ͐ͅʮɻͅ੮{ɘ˦͙ɘˑ੮ફ)ä{બੴ੮ˑʮ͐ͅͅ੮ુ˚ʇ͐ʩɘ˚̹ʩʇ͐ɘ˚ʮ˦ʇ੮͙ͅʇ੮ʁʮͅ˺̼ʁʇ̼ૂ੮ɘͅ੮ɘ˦੮ ʮˑˑ˦ʇͅͅ੮ˈ͙͐ͅ੮ˑʮˌʇ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੳ੮˦ʁ੮ɘˑ͐ʩ˺͙ʡʩ੮#ɘˑʮʠ˺̼˦ʮɘ੮˺˦ɻʇ੮ͅʩɘ̼̹ˑ;੮ʁʇˑʮ˦ʇɘ͐ʇʁ੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅੴ੮͐ʩʇ੮ɻ͙̼̼ʇ˦͐੮͸ɘ͐ɻʩ͸˺̼ʁ੮ʮͅ੮ુʮ˦͐ʇʡ̼ɘ͐ʮ˺˦ૂ੮

80

T H E C O N S E RVATO R S H I P C O N T I N U U M

˺ʠ੮͐ʩʇ੮͐͸˺੮͙˦ʁʇ̼੮͐ʩʇ੮ͅʮ˦ʡˑʇ੮̼˺˺ʠ੮˺ʠ੮ુɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩੳૂ৽৾੮š˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮͐ʩʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮˚ʇ͐ʩ੮͙ͅʇ੮ˑ˺˺ˌ੮ɘ˦੮ɘ͸ʠ͙ˑ੮ˑ˺͐੮ˑʮˌʇ੮͐ʩʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ੮ˈ͙͐ͅʮʠ;ʮ˦ʡ੮ ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁ੮ɘͅ੮͐ʩʇ੮ˑ˺ʡʮɻɘˑ੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮ʇʮ͐ʩʇ̼ੳ੮ͅ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮̹͙͐੮ʮ͐ੴ੮ુĚ˺͙੮ʩʇɘ̼੮ ʁ˺ɻ͐˺̼ͅ੮ͅɘ;ʮ˦ʡੴ੮ૃîʩʇ੮̹˺ˑʮɻʇ੮ɘ̼ʇ੮ˈ͙͐ͅ੮ɺ̼ʮ˦ʡʮ˦ʡ੮͙ͅ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮͙˦ʁʇ̼੮͐ʩʇ੮ʮ˦ϲˑ͙ʇ˦ɻʇੳૄ੮˦ʁ੮͸ʇૄ̼ʇ੮ˑʮˌʇੴ੮ૃ˺ˌɘ;ੴ੮৸৵જ৹ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʇ੮ͅʇʇ੮ʩɘͷʇ੮ɘ੮ɻ˺˚ɺʮ˦ɘ͐ʮ˺˦੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮ʁ̼͙ʡ੮͙ͅʇੳ੮ä˺੮ʩ˺͸੮ʁ˺੮;˺͙੮ʇͽ̹ʇɻ͐੮͙ͅ੮͐˺੮̹ɘ̼ͅʇ੮͐ʩɘ͐੮˺͙͐੺ૄૂ /Û੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɘ̼ʇ੮ή͙ʮɻˌ੮͐˺੮ʁ˺੮͐ʩʇ੮̹ɘ̼ͅʮ˦ʡ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮U੮ɻ˺͙ˑʁ੮ʩʇɘ̼੮)̼ੳ੮Ûɘ˦ʁ੮ ̼͙͐ͅʡʡˑʮ˦ʡ੮͐˺੮ɺɘˑɘ˦ɻʇ੮ʩʮͅ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮͐˺੮̹̼˺ͷʮʁʮ˦ʡ੮ɻɘ̼ʇ੮ɘ˦ʁ੮͐ʩʇ੮ͅʇ˦ͅʇ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ ˚ʮʡʩ͐੮ɺʇ੮̹ʇ˺̹ˑʇ੮˚˺̼ʇ੮ʁʇͅʇ̼ͷʮ˦ʡ੮͐ʩɘ˦੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅੵ੮ુîʩʇ੮˦͙˚ɺʇ̼੮˺˦ʇ੮યˑɘɺ˺̼ɘ͐˺̼;ર੮͐ʇ͐ͅ੮͸ʇ੮ʁ˺੮ʠ˺̼੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ɘ̼ʇ੮;˺͙˦ʡ੮ɘ˦ʁ੮˺͐ʩʇ̼͸ʮͅʇ੮ʩʇɘˑ͐ʩ;੮ʮͅ੮ʠ˺̼੮͐ͅʮ˚͙ˑɘ˦͐੮ʁ̼͙ʡ੮͙ͅʇ੮ય˚ʇ͐ʩરੳ੯ੳ੯ੳ੯ੳ੮U੮˚ʇɘ˦ੴ੮͐ʩʇ̼ʇૄͅ੮˺ɺͷʮ˺͙ͅˑ;੮͐ʩʇ੮ɻ˺ʇͽʮ͐ͅʇ˦ɻʇ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ɘɺ͙ͅʇ੮ɺ͙͐੯ੳ੯ੳ੯ੳૂ੮Pʇ੮ʩʇͅʮ͐ɘ͐ʇʁ੮ɺʇʠ˺̼ʇ੮ɻ˺˦͐ʮ˦͙ʮ˦ʡੴ੮ુĔʇ੮ʩɘͷʇ੮ ̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ʩɘͷʇ੮ɻʩʇ͐ͅ੮̹ɘʮ˦ੴ੮ˑɘɻʇ̼ɘ͐ʮ˺˦ͅੴ੮ɺ̼˺ˌʇ˦੮ɺ˺˦ʇͅੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ;ૄ̼ʇ੮͸ʮ͐ʩ੮ ɻʩʮˑʁ̼ʇ˦ੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮͸ʩ;੮ɘ̼ʇ੮͐ʩʇ;੮͸ɘʮ͐ʮ˦ʡ੺੮"ʇɻɘ͙ͅʇ੮;˺͙ૄͷʇ੮ʡ˺͐੮͐ʩʮͅ੮̹ɘ͐ʮʇ˦͐੮͸ʩ˺੮ʁʮʁ੮ɘ੮ ɺ͙˦ɻʩ੮˺ʠ੮˚ʇ͐ʩ੮ɘ˦ʁ੮ʮͅ੮ɘɻ͐ʮ˦ʡ੮˺͙͐ੳૂ੮îʩʇ̼ʇૄͅ੮ɘ੮ʁʮϲϲʮɻ͙ˑ͐ચ͐˺ચͅʩɘˌʇ੮ͅʇ˦ͅʇ੮͐ʩɘ͐ੴ੮ʁʇ̹ͅʮ͐ʇ੮ ˚ʇ͐ʩɘ˚̹ʩʇ͐ɘ˚ʮ˦ʇૄͅ੮ʮ˦ɻ̼ʇʁʮɺˑʇ੮ɘʁʁʮɻ͐ʮͷʇ੮̹˺͐ʇ˦ɻ;ੴ੮͙ͅʇ̼ͅ੮ɻɘ˦੮͸ʩʮ͐ʇચˌ˦͙ɻˌˑʇ੮͐ʩʇʮ̼੮ ͸ɘ;੮ʮ˦͐˺੮ɘɺ͐ͅɘʮ˦ʮ˦ʡ੮ʠ̼˺˚੮͐ʩʇ˚ੳ੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɻɘ˦ૄ͐੮ˌʮɻˌ੮͐ʩʇʮ̼੮ʩɘˑˑ͙ɻʮ˦ɘ͐ʮ˺˦ͅ੮ͅ˺੮ʇɘͅʮˑ;ੳ੮˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˦͙̼ͅʇ੮ɘʁ˚ʮ͐͐ʇʁੴ੮ુr˺˺ˌੴ੮U੮ʁ˺੮͸ɘ˦͐੮ ̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ɘʁʁʮɻ͐ʇʁ੮͐˺੮ʁ̼͙ʡͅ੮͐˺੮ʩɘͷʇ੮ɘɻɻʇͅͅ੮͐˺੮̼͐ʇɘ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ɺ͙͐੮U੮͐ʩʮ˦ˌ੮͸ʇ੮ ɘˑˑ੮ʠʇʇˑ੮ɘ੮ˑʮ͐͐ˑʇ੮ɺʮ͐੮ˑʮˌʇੴ੮ૃîʩɘ͐ૄͅ੮˦˺͐੮͸ʩɘ͐੮͸ʇૄ̼ʇ੮ʩʇ̼ʇ੮ʠ˺̼ੳૄૂ /Ûͅ੮ʩɘͷʇ੮ɘ੮ʩʮʡʩˑ;੮ʇʠʠʇɻ͐ʮͷʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ʠ˺̼੮͐ʩʇ੮ʮ˚˚ʇʁʮɘ͐ʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮ʁ̼͙ʡ੮ ͙ͅʇੴ੮͸ʩʮɻʩ੮ʮͅ੮̹̼ʇͷʇ˦͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮͙ͅʮ˦ʡ੮ʁ̼͙ʡͅੳ੮ʠ͐ʇ̼੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅੴ੮͐ʩʇ;ૄˑˑ੮˦˺੮ ˑ˺˦ʡʇ̼੮˚ʇʇ͐੮ʁɘ˦ʡʇ̼˺͙ͅ˦ʇͅͅ੮˺̼੮ʁʮͅɘɺʮˑʮ͐;੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ɘ˦੮˺˦ʡ˺ʮ˦ʡ੮ʩ˺ˑʁੳ੮š˦ʇ੮ɻ˺˚˚͙˦ʮ͐;੮̹̼˺ͷʮʁʇ̼੮ͅʇʇ͐ʩʇʁੴ੮ુU੮͸˺̼ˌ੮͸ʮ͐ʩ੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ʩʮʡʩʇ͐ͅ੮͙͐ʮˑʮΈʇ̼ͅ੮˺ʠ੮ɺʇʩɘͷʮ˺̼ɘˑ੮ ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮ʮ˦੮˚;੮ɻ˺͙˦͐;ੳ੮U੮ʩɘͷʇ੮˺˦ʇ੮͸˺˚ɘ˦੮͸ʩ˺੮͸ʮˑˑ੮͐ɘˌʇ੮˚ʇ͐ʩ੮ɘ˦ʁ੮͐ʩʇ˦੮ ͐ʩ̼ʇɘ͐ʇ˦ͅ੮˺͐ʩʇ̼ͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳ੮äʩʇૄˑˑ੮ʡ˺੮͐˺੮͐ʩʇ੮/Û੮ય˺˦੮ɘ੮৵ৱ৵ৰરੳ੮"͙͐੮ʮʠ੮ͅʩʇ੮͐ɘˌʇͅ੮ ʩʇ̼੮˚ʇʁͅ੮ɻ˺˺̹ʇ̼ɘ͐ʮͷʇˑ;੮͸ʩʮˑʇ੮͐ʩʇ̼ʇੴ੮ɘ˦ʁ੮ͅʩʇૄͅ੮˦˺͐੮ʩʮʡʩ੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮ɘ੮ ̹ʮ̹ʇ੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮ʩʇ̼ੴ੮͐ʩʇ;ૄˑˑ੮ͅɘ;ੴ੮ૃäʩʇૄͅ੮˦˺੮ˑ˺˦ʡʇ̼੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳૄૂ੮äʩʇ੮͸ʇ˦͐੮˺˦ੴ੮ ુ"˺˺˚ઝ͐ʩʇ;੮̼͐ͅʇʇ͐੮ʩʇ̼ੳ੮"ɘɻˌ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳૂ੮H˺̼͐;੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ͐੮äH੮Iʇ˦ʇ̼ɘˑ੮ɘ̼ʇ੮ʁʮͅɻʩɘ̼ʡʇʁ੮͸ʮ͐ʩ˺͙͐੮ͅ˺੮˚͙ɻʩ੮ɘͅ੮ɘ੮̼ʇʠʇ̼̼ɘˑઝˑʮˌʇˑ;੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;ૄ̼ʇ੮ʁʇʇ˚ʇʁ੮ ˚ʇ͐ʩ੮͙ͅʇ̼ͅੴ੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅੴ੮˺̼੮ɺ˺͐ʩੳ৽৿ ͅ੮˚͙ɻʩ੮ɘͅ੮˚ʇ͐ʩ੮ʩɘͅ੮ɻ˺˚ʇ੮͐˺੮ʁ˺˚ʮ˦ɘ͐ʇ੮͐ʩʇͅʇ੮ʁʮͅɻ͙ͅͅʮ˺˦ͅੴ੮͐ʩʇ੮ʩʮʡʩʇ͐ͅ੮͙͐ʮˑʮΈʇ̼ͅ੮ ˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ͅʇ̼ͷʮɻʇͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɘ̼ʇ੮̹ʇ˺̹ˑʇ੮̼͙͐ͅʡʡˑʮ˦ʡ੮͸ʮ͐ʩ੮ɘˑɻ˺ʩ˺ˑʮͅ˚ੳ৽਀ Over ɘ੮ϲʮͷʇચ;ʇɘ̼੮̹ʇ̼ʮ˺ʁੴ੮ϲʮͷʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʇ̼ʇ੮̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮ɺ;੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ɘ˚ɺ͙ˑɘ˦ɻʇͅ੮ ৱੴ৷৸ৱ੮ ͐ʮ˚ʇͅੴ੮ ɘ͐੮ ɘ੮ ɻ˺͐ͅ੮ ˺ʠ੮ ʠ˺͙̼੮ ˚ʮˑˑʮ˺˦੮ ʁ˺ˑˑɘ̼ͅੳ৽ਁ੮ Ĕʩʇ˦੮ U੮ ͷʮͅʮ͐ʇʁ੮ ʮ˦੮ ৲ৰ৲৲ੴ੮ ˚͙ˑ͐ʮ̹ˑʇ੮ɻʮ͐;੮ɘʡʇ˦ɻʮʇͅ੮͸ʇ̼ʇ੮͸̼ʮ˦ʡʮ˦ʡ੮͐ʩʇʮ̼੮ʩɘ˦ʁͅ੮˺ͷʇ̼੮˺˦ʇ੮˺ʠ੮͐ʩʇ˚ੳ੮Pʇ੮͸˺͙ˑʁ੮

EMERGENCY ROOM

81

ɺʇ੮ʠ˺͙˦ʁ੮ɺʇˑˑʮʡʇ̼ʇ˦͐ˑ;੮ʁ̼͙˦ˌ੮ɘ˦ʁ੮ͅɻ̼ʇɘ˚ʮ˦ʡ੮̼ɘɻʮɘˑ੮ʇ̹ʮ͐ʩʇ͐ͅ੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐੶੮˺͐ʩʇ̼੮ ͐ʮ˚ʇͅੴ੮ʩʇ੮͸˺͙ˑʁ੮ɻˑɘʮ˚੮ʩʇ੮͸ɘͅ੮͙ͅʮɻʮʁɘˑ੮˺̼੮̹ˑɘ˦˦ʇʁ੮͐˺੮ͅʩ˺˺͐੮ͅ˺˚ʇ˺˦ʇੳ੮U˦੮͐͸˺੮˺ʠ੮ʩʮͅ੮ ৵ৰৱ੮ʇ˦ɻ˺͙˦͐ʇ̼ͅ੮͸ʮ͐ʩ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ͅʇ̼ͷʮɻʇͅ੮ʮ˦੮͐ʩʇ੮̹ɘ͐ͅ੮;ʇɘ̼ੴ੮̹ɘ̼ɘ˚ʇʁʮɻͅ੮̼ʇͷʮͷʇʁ੮ʩʮ˚੮ ɺʇɻɘ͙ͅʇ੮ʩʮͅ੮ʩʇɘ̼͐੮ʩɘʁ੮͐ͅ˺̹̹ʇʁੳ੮Pʇ੮͸˺͙ˑʁ੮ͅʇʇ˚੮͐˺੮ϲʮ͐੮̹̼ʇ͐͐;੮ͅ˺ˑʮʁˑ;੮͙˦ʁʇ̼੮͐ʩʇ੮ʁɘ˦ʡʇ̼੮͐˺੮ͅʇˑʠ੮ɘ˦ʁ੮ʁɘ˦ʡʇ̼੮͐˺੮˺͐ʩʇ̼ͅ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ɘ੮৵ৱ৵ৰੳ੮"͙͐੮ʮ˦੮͐ʩʇ੮ʁ˺Έʇ˦ͅ੮˺ʠ੮͐ʮ˚ʇͅ੮ʩʇ੮ ʩɘʁ੮ɺʇʇ˦੮ɺ̼˺͙ʡʩ͐੮͐˺੮Ø/ä੮˺˦੮ɘ੮৵ৱ৵ৰੴ੮ʩʇ੮ɻˑʇɘ̼ʇʁ੮͙̹੮ɺ;੮˚˺̼˦ʮ˦ʡੴ੮ɻˑʇɘ̼ˑ;੮ɘ̼͐ʮɻ͙ˑɘ͐ʇʁ੮ ʩʮͅ੮ʁʇͅʮ̼ʇ੮͐˺੮ˑʇɘͷʇੴ੮ɘ˦ʁ੮͸ɘͅ੮ʁ̼ʮ˦ˌʮ˦ʡ੮ɘʡɘʮ˦੮ɘͅ੮ͅ˺˺˦੮ɘͅ੮ʩʇ੮̼ʇɘɻʩʇʁ੮͐ʩʇ੮ϲʮ̼͐ͅ੮ˑʮή͙˺̼੮ ͐ͅ˺̼ʇ੮˺ʠʠ੮ʩ˺̹ͅʮ͐ɘˑ੮̹̼˺̹ʇ̼͐;ੳ îʩʇ੮̹̼˺ɺˑʇ˚੮ʮͅ˦ૄ͐੮͐ʩʇ੮ˑɘ͸ੳ੮੮ͅʇ̹ɘ̼ɘ͐ʇ੮ͅʇɻ͐ʮ˺˦੮˺ʠ੮rØä੮̹ͅʇɻʮϲʮɻɘˑˑ;੮̹̼˺ͷʮʁʇʁ੮ʠ˺̼੮ ͐ʩʇ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮˺ʠ੮ુɻʩ̼˺˦ʮɻ੮ʮ˦ʇɺ̼ʮɘ͐ʇͅੴૂ੮͸ʩ˺੮͸ʇ̼ʇ੮ɘ੮ͅʮΈɘɺˑʇ੮ɻʩ͙˦ˌ੮˺ʠ੮ ͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̼ʇͅʮʁʇ˦͐ͅੴ੮ʮ˦੮ɘ੮ુ̹ͅʇɻʮɘˑʮΈʇʁ੮ʠɘɻʮˑʮ͐;ੳૂ੮੮ˑɘ͐ʇ̼੮ˑɘ͸੮̹ʇ̼˚ʮ͐͐ʇʁ੮͐ʩʇ੮ͅɘ˚ʇ੮ ʠ˺̼੮ ુ͙ͅʇ̼ͅ੮ ˺ʠ੮ ɻ˺˦̼͐˺ˑˑʇʁ੮ ͙ͅɺ͐ͅɘ˦ɻʇͅੳૂ৽ਂ੮ "͙͐੮ ͐ʩʇͅʇ੮ ̹̼˺ͷʮͅʮ˺˦ͅ੮ ɘ̼ʇ੮ ɺɘͅʮɻɘˑˑ;੮ ˦ʇͷʇ̼੮ ɘ̹̹ˑʮʇʁੳ৽ਃ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɘɻ͙͐ɘˑˑ;੮̼͐ʮʇʁ੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮˺˦ʇ੮˺ʠ੮ʮ͐ͅ੮ϲʮͷʇ੮͙̹ͅʇ̼ચ͙͐ʮˑʮΈʇ̼ͅ੮ ͸ʮ͐ʩ੮ɻʩ̼˺˦ʮɻ੮ɘˑɻ˺ʩ˺ˑʮͅ˚ੴ੮ɺ͙͐੮ʡɘͷʇ੮͙̹੮͸ʩʇ˦੮ʮ͐੮ɻ˺͙ˑʁ˦ૄ͐੮ϲʮ˦ʁ੮ɘ੮ુ̹ͅʇɻʮɘˑʮΈʇʁ੮ʠɘɻʮˑʮ͐;ૂ੮ ͸ʮˑˑʮ˦ʡ੮͐˺੮͐ɘˌʇ੮͐ʩʇ˚ੳ৽਄੮{˺͐ͅ੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅ੮ɘ̼ʇ੮ͷ˺ˑ͙˦͐ɘ̼;ੳ੮îʩʇ;੮ɘ̼ʇ˦ૄ͐੮ ʁʇͅʮʡ˦ʇʁ੮͐˺੮ͅʇ̼ͷʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘˑͅ˺੮ʩɘͷʇ੮ɘ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ৾৻੮੮̹ͅ˺ˌʇ̹ͅʇ̼ͅ˺˦੮ ʠ˺̼੮˺˦ʇ੮˺ʠ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ˑɘ̼ʡʇ͐ͅ੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ͷʮʁʇ̼ͅ੮͐˺ˑʁ੮˚ʇੴ੮ુØʇ˺̹ˑʇ੮͸ʩ˺੮ ɘ̼ʇ੮ɘɻ͐ʮͷʇˑ;੮̹ͅ;ɻʩ˺͐ʮɻੴ੮ɻɘ˦ૄ͐੮ʡ˺੮͐˺੮͐ʩʇ੮ɺɘ͐ʩ̼˺˺˚੯ੳ੯ੳ੯ੳ੮͸ʇ੮ɻɘ˦ૄ͐੮˚ɘ˦ɘʡʇ੮͐ʩɘ͐੮ʮ˦੮ɘ੮ ৱৰৰચɺʇʁ੮ય͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇર੮ʠɘɻʮˑʮ͐;ੴ੮ʮ͐ૄͅ੮˦˺͐੮ͅɘʠʇ੮ʠ˺̼੮͐ʩʇ˚ੴ੮˺̼੮ʠ˺̼੮˺͐ʩʇ̼੮̹ʇ˺̹ˑʇੳ੮ä˺ੴ੮˺͙̼੮ યʮ˦͐ɘˌʇર੮ɘͅͅʇͅͅ˺̼੮ͅɘ;ͅ੮ૃîʩʮͅ੮̹ʇ̼ͅ˺˦੮˦ʇʇʁͅ੮ɘ੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇૄ੮ɘ˦ʁ੮Uૄˑˑ੮͐ʇˑˑ੮͐ʩʇ˚ੴ੮ ૃI͙;ͅੴ੮͐ʩʇ̼ʇ੮ʮͅ੮˦˺੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇੳૄૂ ‡͙̼ͅʇ੮k˺˦ʇͅ੮͸ɘͅ੮ɻˑʇɘ̼੮ɘɺ˺͙͐੮͐ʩʇ੮̼ʇ͙ͅˑ͐ੳ੮ુU͐ૄͅ੮ɘ੮ͅɘʁੴ੮ͅɘʁ੮ͅʮ͙͐ɘ͐ʮ˺˦ੳ੮Øʇ˺̹ˑʇ੮ʡʇ͐੮ ͐˺ͅͅʇʁ੮˺͙͐੮ʮ˦͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐੮͸ʇɘ̼ʮ˦ʡ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ɺɘ˦ʁ੮˺̼੮͐ʩʮ˦੮ɺˑ͙ʇ੮ͅɻ̼͙ɺ੮̹ɘ˦͐ͅੴ੮ʮ˦͐˺੮ ͐ʩʇ੮ʇˑʇ˚ʇ˦͐ͅ੮͸ʮ͐ʩ੮ɘ੮ɺ͙ͅ੮͐˺ˌʇ˦੮ʮʠ੮͐ʩʇ;ૄ̼ʇ੮ˑ͙ɻˌ;੮ɘ˦ʁ੮˚ɘ;ɺʇ੮ɘ੮˚ʇɘˑ੮ʮ˦੮͐ʩʇʮ̼੮ɺʇˑˑ;ੴ੮ ɘ˦ʁ੮ɘ੮ˑʮ͐ͅ੮˺ʠ੮̼ʇͅ˺͙̼ɻʇͅ੮˺˦੮ɘ੮̹ʮʇɻʇ੮˺ʠ੮̹ɘ̹ʇ̼ੳ੮˦ʁ੮͐ʩɘ͐ૄͅ੮ʮ͐ੳૂ੮˦ʁ੮͐ʩʇ˦ੴ੮͐ʩʇ੮̼͐ɘʡʮɻ੮ ʮ̼˺˦;ੵ੮ુä˺੮ʮʠ੮;˺͙ૄ̼ʇ੮̼͐;ʮ˦ʡ੮͐˺੮͙̼ͅͷʮͷʇੴ੮ʮ͐ૄͅ੮ʁɘ˦ʡʇ̼˺͙ͅ੮ɘ͐੮˦ʮʡʩ͐ੴ੮ͅˑʇʇ̹ʮ˦ʡ੮˺͙͐ͅʮʁʇ੮ɻɘ˦੮ ̹͙͐੮;˺͙੮ɘ͐੮̼ʮͅˌੳ੮Ě˺͙੮˦ʇʇʁ੮͐˺੮͐ͅɘ;੮ɘ͸ɘˌʇੳ੮#˺ʠʠʇʇ੮͸˺˦ૄ͐੮ɻ͙͐੮ʮ͐ੳૂ੮ä˺੮͸ʩɘ͐੮ʁ˺੮;˺͙੮͐ɘˌʇ੮ ɘʠ͐ʇ̼੮͐ʩʇ੮/Û੮ͅʇ˦ʁͅ੮;˺͙੮͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɺʇɻɘ͙ͅʇ੮;˺͙ૄ̼ʇ੮͙ͅʮ˦ʡ੮͙ͅɺ͐ͅɘ˦ɻʇͅ੺ ુ{ʇ͐ʩੳૂ

FUTILITY AND GRAVE DISABILITY Ĕʇૄͷʇ੮ ɻ˺ͷʇ̼ʇʁ੮ ˚˺͐ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ɘ̼ɻʩʇ͐;̹ʇͅ੮ ˺ʠ੮ ̹ͅ;ɻʩ੮ /Û੮ ̹ɘ͐ʮʇ˦͐ͅੵ੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ɘɻ͙͐ʇˑ;੮ʁɘ˦ʡʇ̼˺͙ͅੴ੮˚ɘˑʮ˦ʡʇ̼ʇ̼ͅੴ੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅੴ੮˺̼੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅੳ੮îʩʇ̼ʇૄͅ੮˺˦ʇ੮ ˑʇʠ͐ੵ੮̹ʇ˺̹ˑʇ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ɺ;੮ɻʩ̼˺˦ʮɻ੮̹ͅ;ɻʩ˺ͅʮͅੳ

82

T H E C O N S E RVATO R S H I P C O N T I N U U M

Ĕʩʇ˦੮ U੮ ̹ͅ˺ˌʇ੮ ͐˺੮ {ɘ͐͐ੴ੮ ɘ੮ ͐ʩʮ̼ʁચ;ʇɘ̼੮ ̹ͅ;ɻʩʮɘ̼͐;੮ ̼ʇͅʮʁʇ˦͐੮ ʮ˦੮ r˺ͅ੮ ˦ʡʇˑʇͅੴ੮ ʩʇ੮ ͐˺ˑʁ੮˚ʇ੮ʩʇ੮ʩɘʁ੮ʮ˦ʮ͐ʮɘˑˑ;੮̹ˑɘ˦˦ʇʁ੮͐˺੮ʁ˺੮ʇ˚ʇ̼ʡʇ˦ɻ;੮˚ʇʁʮɻʮ˦ʇੳ੮Ĕʩʇ˦੮ʩʇ੮ʩɘʁ੮ʩʮͅ੮ ̹ͅ;ɻʩʮɘ̼͐;੮̼˺͐ɘ͐ʮ˺˦੮ɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʩʇ੮̼ʇɘˑʮΈʇʁ੮͐ʩɘ͐੮ુ̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇͷʇ̼ʇ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੴ੮ ʇ̹ͅʇɻʮɘˑˑ;੮ ̹ͅ;ɻʩ˺ͅʮͅઝU੮ ˈ͙͐ͅ੮ ̼ʇɘˑˑ;੮ ʇ˦ˈ˺;ʇʁ੮ ͐ʩ˺ͅʇ੮ ̹ɘ͐ʮʇ˦͐ͅૂ੮ ɘ˦ʁ੮ ͅ͸ʮ͐ɻʩʇʁ੮ ̼͐ɘɻˌͅੳ੮ "͙͐੮ ʩʇ੮ ͸ɘͅ੮ ή͙ʮɻˌˑ;੮ ͅ˺ɻʮɘˑʮΈʇʁ੮ ʮ˦͐˺੮ ɘ੮ ͅʇ˦ͅʇ੮ ˺ʠ੮ ʠ͙͐ʮˑʮ͐;੮ ɘ̼˺͙˦ʁ੮ ͸ʩɘ͐੮͐˺੮ʁ˺੮͸ʮ͐ʩ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺ੴ੮˺˦੮͐ʩʇʮ̼੮ʠɘɻʇੴ੮˚ʮʡʩ͐੮ͅʇʇ˚੮ˑʮˌʇ੮ʡ˺˺ʁ੮ɻɘ˦ʁʮʁɘ͐ʇͅ੮ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ š˦ʇ੮˺ʠ੮ʩʮͅ੮ɻˑʮʇ˦͐ͅ੮˺˦੮͐ʩʇ੮HäØ੮͐ʇɘ˚੮͸ʩʇ̼ʇ੮ʩʇ੮͸ɘͅ੮ɻ͙̼̼ʇ˦͐ˑ;੮̼͐ɘʮ˦ʮ˦ʡ੮͸ɘͅ੮ɘ˦੮ ʇˑʁʇ̼ˑ;੮͸˺˚ɘ˦੮͸ʩ˺੮ˑʮͷʇͅ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ʮ˦੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼ੴ੮͸ʇɘ̼ʮ˦ʡ੮ͅʇͷʇ˦੮ˑɘ;ʇ̼ͅ੮˺ʠ੮ ɻˑ˺͐ʩʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮͙ͅ˚˚ʇ̼੮ʩʇɘ͐ੳ੮äʩʇ੮ʩɘͅ੮ɘ੮ુɻ˺˚̹ˑʇͽ੮ʁʇˑ͙ͅʮ˺˦ɘˑ੮ͅ;͐ͅʇ˚ૂ੮͐ʩɘ͐੮ ʮ˦ɻˑ͙ʁʇͅ੮ɺʇˑʮʇͷʮ˦ʡ੮ͅʩʇ੮͸˺˦੮͐ʩʇ੮ˑ˺͐͐ʇ̼;੮ɘ˦ʁ੮˦ʇʇʁͅ੮͐˺੮͐ͅɘ;੮ʮ˦੮̹ˑɘɻʇ੮͙˦͐ʮˑ੮ͅ˺˚ʇ˺˦ʇ੮ ɺ̼ʮ˦ʡͅ੮ʩʇ̼੮͐ʩʇ੮͸ʮ˦˦ʮ˦ʡͅੳ੮îʩʮͅ੮̹̼ʇͷʇ˦͐ͅ੮ʩʇ̼੮ʠ̼˺˚੮ɘɻɻʇ̹͐ʮ˦ʡ੮͐ʩʇ੮ʩ˺͙ͅʮ˦ʡ੮ʩʇ̼੮HäØ੮ ʩɘͅ੮ˑʮ˦ʇʁ੮͙̹੮ʠ˺̼੮ʩʇ̼ੳ੮"͙͐੮ͅʩʇૄͅ੮͐ͅʮˑˑ੮˦˺͐੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੴ੮ʮ˦੮͐ʩʇ੮ɺɘ̼ʇ͐ͅ੮ͅʇ˦ͅʇੵ੮ુäʩʇ੮ ʩɘͅ੮͐ʩʇ੮͸ʩʇ̼ʇ͸ʮ͐ʩɘˑ੮͐˺੮͙ͅʇ੮ɻɘͅʩ੮ʡʮͷʇ˦੮͐˺੮ʩʇ̼੮͐˺੮ʡ˺੮͐˺੮ɘ੮৷જৱৱੴ੮˺̼੮ʇɘ͐੮;˺ʡ͙̼͐੮ʠ̼˺˚੮ ɘ੮ʩ˺˚ʇˑʇͅͅ੮ͅʩʇˑ͐ʇ̼ੳૂ੮äʩʇ੮ʁ˺ʇͅ੮˦˺͐ੴ੮ʩʇ੮˦˺͐ʇʁੴ੮ʩɘͷʇ੮͐ʩʇ੮͸ʩʇ̼ʇ͸ʮ͐ʩɘˑ੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ʠ͐ʇ̼੮ʁʇɻɘʁʇͅ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮ʩʇ੮͸ɘͅ˦ૄ͐੮˺̹͐ʮ˚ʮ͐ͅʮɻ੮ɘɺ˺͙͐੮ʩʇ̼੮̹̼˺̹ͅʇɻ͐ͅੵ੮ ુîʩʇ੮ ˑ˺˦ʡʇ̼੮ ͐ʩʇ੮ ʁʇˑ͙ͅʮ˺˦ͅ੮ ̹ʇ̼ͅʮ͐ͅੴ੮ ͐ʩʇ੮ ˑʇͅͅ੮ ˑʮˌʇˑ;੮ ͐ʩʇ;੮ ɘ̼ʇ੮ ͐˺੮ ɺʇ੮ ̼ʇ̹ͅ˺˦ͅʮͷʇ੮ ͐˺੮ ̼͐ʇɘ͐˚ʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮/ͷʇ˦੮ʮʠ੮U੮ʩɘʁ੮ʩʇ̼੮ɻ˺˦ͅʇ̼ͷʇʁ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮;ʇɘ̼ͅੴ੮˺˦੮͐ʩʇ੮ ɺʇ͐ͅ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮͸ʇ੮ʩɘͷʇੴ੮ͅʩʇ੮˚ʮʡʩ͐੮˚ɘˌʇ੮˺˦ˑ;੮ɘ੮͐ʮ˦;੮ʮ˚̹̼˺ͷʇ˚ʇ˦͐ੴ੮ˑʮˌʇ੮ৱৰ੮̹ʇ̼ɻʇ˦͐ੴ੮ɺʇɻɘ͙ͅʇ੮ͅʩʇૄͅ੮ɺʇʇ˦੮˺ʠʠ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ͅ˺੮ˑ˺˦ʡੳૂ ˚˺˦ʡ੮͐ʩ˺ͅʇ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮͐ʩʇ੮͸˺˚ɘ˦ૄͅ੮ɻ͙̼̼ʇ˦͐੮ͅʮ͙͐ɘ͐ʮ˺˦੮ʮͅ੮{ɘ͐͐੮ʩʮ˚ͅʇˑʠੳ੮ Pʇ੮ͅɘ͸੮ʩʇ̼੮ɘ੮;ʇɘ̼੮ɺʇʠ˺̼ʇ੮ʁ͙̼ʮ˦ʡ੮ʩʮͅ੮/Û੮̼˺͐ɘ͐ʮ˺˦ੳ੮ુä˺˚ʇ˺˦ʇ੮ˑʮˌʇ੮ʩʇ̼ੴ੮;˺͙੮˺ʠʠʇ̼੮ ʇͷʇ̼;͐ʩʮ˦ʡੵ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੴ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʮ˦͐ʇ˦ͅʮͷʇ੮˺͙̹͐ɘ͐ʮʇ˦͐ੳ੮îʩʇ;੮ˈ͙͐ͅ੮ ̼ʇʠ͙ͅʇ੮ʮ͐ੴ੮ɘ˦ʁ੮ͅ˺੮;˺͙੮ʁʮͅɻʩɘ̼ʡʇ੮͐ʩʇ˚੮͸ʮ͐ʩ੮ɘ˦੮õɺʇ̼ੴૂ੮ʩʇ੮ʇͽ̹ˑɘʮ˦ʇʁੳ੮Pʇ੮̼ʇɻ˺͙˦͐ʇʁ੮ ͸ʩɘ͐੮ʩʇ੮͸̼˺͐ʇ੮ʮ˦੮ʩʇ̼੮ϲʮˑʇੵ੮ુIʮͷʇ˦੮ʩʇ̼੮ˑ˺˦ʡ͐ͅɘ˦ʁʮ˦ʡ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮̹ͅ;ɻʩ˺͐ʮɻ੮ͅ;˚̹͐˺˚ͅੴ੮͸ʇ੮͙̹ͅͅʇɻ͐੮͐ʩɘ͐੮ʩʇ̼੮ˑʮ˚ʮ͐ʇʁ੮ʮ˚̹̼˺ͷʇ˚ʇ˦͐੮ʮͅ੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮͸ʮ͐ʩ੮ʩʇ̼੮̹ͅ;ɻʩ˺͐ʮɻ੮ ɺɘͅʇˑʮ˦ʇੴ੮ ɘ˦ʁ੮ ͅʩʇ੮ ʩɘͅ੮ ˑʮˌʇˑ;੮ ̼ʇɘɻʩʇʁ੮ ͐ʩʇ੮ ˚ɘͽʮ˚͙˚੮ ɺʇ˦ʇϲʮ͐੮ ˺ʠ੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳૂ੮{˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐ˑ;ੴ੮͐ʩ˺͙ʡʩੴ੮ુͅʩʇ੮͸ɘͅ੮ɘˑʇ̼͐੮ɘ˦ʁ੮˺̼ʮʇ˦͐ʇʁ੮ɘ˦ʁ੮ɘɺˑʇ੮͐˺੮ ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮ʇͽ̹̼ʇͅͅ੮ʩʇ̼੮ʁʇͅʮ̼ʇ੮͐˺੮̼ʇ͙̼͐˦੮͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮äʩʇ੮ʩɘͅ੮ʁʇ˚˺˦̼͐ͅɘ͐ʇʁ੮͐ʩɘ͐੮ ͅʩʇ੮ʮͅ੮ɘɺˑʇ੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼ੴ੮ʁʇ̹ͅʮ͐ʇ੮ʩʇ̼੮ʁʇˑ͙ͅʮ˺˦ɘˑ੮ͅ;͐ͅʇ˚ੴ੮ ɘ˦ʁ੮ʁ˺ʇͅ੮˦˺͐੮˚ʇʇ͐੮ɻ̼ʮ͐ʇ̼ʮɘੳૂ৾ৼ ુ)˺ʇͅ੮˦˺͐੮˚ʇʇ͐੮ɻ̼ʮ͐ʇ̼ʮɘੴૂ੮͸ʩʇ˦੮̹̼˺̹ʇ̼ˑ;੮ʁ˺ɻ͙˚ʇ˦͐ʇʁੴ੮ʮͅ੮͐ʩʇ੮˚ɘʡʮɻ੮̹ʩ̼ɘͅʇ੮͐ʩɘ͐੮ ̼ʇˑʇɘͅʇͅ੮ɘ˦੮/Û੮ɻˑʮ˦ʮɻʮɘ˦੮ʠ̼˺˚੮ˑʮɘɺʮˑʮ͐;੮ʠ˺̼੮ɘ੮ʁʮͅɻʩɘ̼ʡʇੳ੮U͐ૄͅ੮ɘˑͅ˺੮ɻ˺ʁʇੳ੮‡˺͸ੴ੮͸ʩʇ˦੮ {ɘ͐͐ૄͅ੮˺͸˦੮HäØ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮̼ʇˑʇɘͅʇʁ੮ʠ̼˺˚੮ɘ੮৵ৱ৵ৰ੮ɘ˦ʁ੮ʁʮͅɻʩɘ̼ʡʇʁ੮ɺ;੮ɘ˦੮/Ûੴ੮ʩʇ੮ɻɘ˦੮ ʇɘͅʮˑ;੮̼ʇɘʁ੮ɺʇ͐͸ʇʇ˦੮͐ʩʇ੮ˑʮ˦ʇͅੵ੮ુîʩʇ;੮ͅɘ;ੴ੮ૃîʩʇ;੮ʁ˺˦ૄ͐੮˚ʇʇ͐੮ʩ˺ˑʁ੮ɻ̼ʮ͐ʇ̼ʮɘੴૄ੮ɺ͙͐੮ʮ͐ૄͅ੮ ̼ʇɘˑˑ;੮͐ʩɘ͐੮˦˺੮ʩ˺̹ͅʮ͐ɘˑ੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ɘˌʇ੮͐ʩʇ˚ੳૂ

EMERGENCY ROOM

83

͐੮͐ʩʇ੮͐ͅɘ̼͐੮˺ʠ੮͐ʩʮͅ੮ɺ˺˺ˌ੮U੮̼ʇͷʮʇ͸ʇʁ੮ʇͷʮʁʇ˦ɻʇ੮͐ʩɘ͐ੴ੮ͅʩ˺̼͐ˑ;੮ɘʠ͐ʇ̼੮rØä੮͸ʇ˦͐੮ʮ˦͐˺੮ ʇʠʠʇɻ͐ੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɺʇɻɘ˚ʇ੮͐ʩʇ੮ɻɘ͐ɻʩɘˑˑ੮ɻɘ͐ʇʡ˺̼;੮͐ʩɘ͐੮̹̼˺ͷʮʁʇʁ੮ɘ˦੮ʇɘͅ;੮̼˺͙͐ʇ੮ ʮ˦͐˺੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɺʇʁੳ੮੮ৱ৹৸৷੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɻˑɘʮ˚ʇʁ੮͐ʩɘ͐੮͐ʩ̼ʇʇચ ϲʮʠ͐ʩͅ੮˺ʠ੮ʩ˺ˑʁͅ੮͸ʇ̼ʇ੮˺˦੮͐ʩɘ͐੮ɺɘͅʮͅੳ৾৽ Today, clinicians see it as a losing bet for win˦ʮ˦ʡ੮ɘ˦੮ɘʁ˚ʮͅͅʮ˺˦ੳ੮ુU੮ʁ˺˦ૄ͐੮ʇͷʇ˦੮ˌ˦˺͸੮͸ʩɘ͐੮ʮ͐੮˚ʇɘ˦ͅ੮ɘ˦;˚˺̼ʇੴ੮̹ɘ͐ʮʇ˦͐ͅ੮ˑ˺ͅʮ˦ʡ੮ ͸ʇʮʡʩ͐ੴ੮ˑ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੯ੳ੯ੳ੯ੳ੮Uૄͷʇ੮˦ʇͷʇ̼੮ʡ˺͐͐ʇ˦੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮યʠ˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;રੴૂ੮ ˺˦ʇ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅ੮͐˺ˑʁ੮˚ʇੳ੮੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ͐੮͐ʩʇ੮ͅɘ˚ʇ੮ɻˑʮ˦ʮɻ੮ɻ˺˦ɻ͙̼̼ʇʁੵ੮ ુUʠ੮;˺͙ૄ̼ʇ੮ϲʮˑˑʮ˦ʡ੮˺͙͐੮ɘ੮৵ৱ৵ৰੴ੮;˺͙੮ʩɘͷʇ੮͐˺੮ɻʩʇɻˌ੮ɘ੮ɺ˺ͽੴ੮ɘ˦ʁ੮Uૄˑˑ੮ɘˑ͸ɘ;ͅ੮ʁ˺੮ʁɘ˦ʡʇ̼੮ ͐˺੮ ͅʇˑʠ੮ ˺̼੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ˺͐ʩʇ̼ͅੳ੮ I̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;ੴ੮ ͐ʩʇ;੮ ય/Û੮ ɻˑʮ˦ʮɻʮɘ˦ͅર੮ ɘ̼ʇ੮ ˈ͙͐ͅ੮ ˦˺͐੮ ʮ˚̹̼ʇͅͅʇʁ੮ɺ;੮͐ʩɘ͐ੳૂ৾৾੮ͅ੮;˺͙ૄˑˑ੮ͅʇʇ੮ʮ˦੮͐ʩʇ੮˦ʇͽ͐੮ɻʩɘ̹͐ʇ̼ੴ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ͅʇʇ੮͐ʩʇͅʇ੮ˌʮ˦ʁͅ੮˺ʠ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ɘͅ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ʁʮͅɻʩɘ̼ʡʇ੮˺˦ɻʇ੮ɘʁ˚ʮ͐͐ʇʁੴ੮ɘ˦ʁ੮͐ʩ͙ͅ੮ɘͅ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ˑʮɘɺʮˑʮ͐ʮʇͅੳ H˺̼੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ˑʮˌʇ੮{ɘ͐͐ੴ੮͐ʩʮͅ੮ʇ˦ʁˑʇͅͅ੮ɻ;ɻˑʇ੮˺ʠ੮ʩ˺ˑʁͅ੮ɘ˦ʁ੮ή͙ʮɻˌ੮̼ʇˑʇɘͅʇͅ੮ʮͅ੮ˈ͙͐ͅ੮ ̹ɘ̼͐੮ ˺ʠ੮ ͐ʩʇ੮ ̹ɘɻˌɘʡʇ੮ ˺ʠ੮ ͸˺̼ˌʮ˦ʡ੮ ʮ˦੮ ̹͙ɺˑʮɻ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɻɘ̼ʇ੮ ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘੳ੮ H˺̼੮ ͐ʩ˺ͅʇ੮͸ʩ˺੮ͅʮʡ˦ʇʁ੮͙̹੮ʠ˺̼੮ɻˑɘͅͅʮɻ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮˚ʇʁʮɻʮ˦ʇੴ੮͐ʩʇ੮ʁʮͅʮˑˑ͙ͅʮ˺˦˚ʇ˦͐੮ʮͅ੮͐ͅɘ̼ˌʇ̼ੳ੮ ̼ˈ͙˦ੴ੮ ɘ੮ ̼ʇͅʮʁʇ˦͐੮ ̼˺͐ɘ͐ʮ˦ʡ੮ ͐ʩ̼˺͙ʡʩ੮ ̹͙ɺˑʮɻ੮ ʩ˺̹ͅʮ͐ɘˑ੮ /Ûͅ੮ ʮ˦੮ ‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ʁʇͅɻ̼ʮɺʇʁ੮͐ʩʇ੮ʡ̼ʮ˚੮ɻʩ˺ʮɻʇͅ੮ʠɘɻʮ˦ʡ੮ʩʮ˚ੵ੮ુͅ੮ɘ˦੮/Û੮̹ʩ;ͅʮɻʮɘ˦ੴ੮;˺͙੮ʩɘͷʇ੮͐˺੮ϲʮʡʩ͐੮;˺͙̼੮ ɺɘ͐͐ˑʇͅੳ੮Ě˺͙੮ɻɘ˦ૄ͐੮˚ɘˌʇ੮͙̼ͅʇ੮ʇͷʇ̼;੮ʁʮͅɻʩɘ̼ʡʇ੮ʮͅ੮ͅɘʠʇੳૂ੮ä˺˚ʇ͐ʮ˚ʇͅ੮ʩʇ੮͸˺͙ˑʁ੮ɘ̼ʡ͙ʇ੮ ͸ʮ͐ʩ੮ʁ˺ɻ͐˺̼ͅ੮͙̹͐ͅɘʮ̼ͅ੮͐˺੮ɘʁ˚ʮ͐੮ͅ˺˚ʇ˺˦ʇੴ੮ુɺ͙͐੮;˺͙੮ɻɘ˦ૄ͐੮ʁ˺੮͐ʩɘ͐੮͸ʮ͐ʩ੮ʇͷʇ̼;੮ͅʮ˦ʡˑʇ੮ ̹ɘ͐ʮʇ˦͐ੴ੮˺̼੮;˺͙੮ˑ˺ͅʇ੮;˺͙̼੮ˈ˺ɺੳૂ੮Pʇ੮ͅɘ͸੮̹ˑʇ˦͐;੮˺ʠ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ુ;˺͙੮ˌ˦˺͸੮͐ʩʇ;੮˦ʇʇʁ੮ ͐˺੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁੴૂ੮ɺ͙͐੮ʇͷʇ˦੮ʮʠ੮ʩʇ੮ɘʁ˚ʮ͐͐ʇʁ੮͐ʩʇ˚੮ʠ˺̼੮ͅ˺˚ʇ੮ુɺ͙ˑˑͅʩʮ͐੮̼ʇɘͅ˺˦ੴૂ੮ʮ˦੮ϲʮͷʇ੮ ʁɘ;ͅ੮ુ͐ʩʇ;ૄˑˑ੮ɺʇ੮ʁʮͅɻʩɘ̼ʡʇʁ੮˺˦ʇ੮͸ɘ;੮˺̼੮ɘ˦˺͐ʩʇ̼ੳૂ੮Hʇ͙ʁʮ˦ʡ੮͸ʮ͐ʩ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼ͅ੮͸ɘͅ੮˦˺͐੮͸ʩɘ͐੮ʩʇ੮̼͐ɘʮ˦ʇʁ੮ʠ˺̼ੵ੮ુɘʠ͐ʇ̼੮Uૄͷʇ੮ʠ˺͙ʡʩ͐੮યʠ˺̼੮͐ʩ˺ͅʇ੮̹ɘ͐ʮʇ˦͐ͅરੴ੮U੮ɘ˚੮ɺʇɘ͐ʇ˦੮ ͐˺੮͐ʩʇ੮ʡ̼˺͙˦ʁ੮ʇ˚˺͐ʮ˺˦ɘˑˑ;੮ɘ˦ʁ੮˚ʇ˦͐ɘˑˑ;ੳૂ੮";੮ɻ˺˚̹ɘ̼ʮͅ˺˦ੴ੮ુɘ੮̼͐ɘ͙˚ɘ੮યˑʮˌʇ੮ɘ੮ʡ͙˦ͅʩ˺͐੮ ͸˺͙˦ʁર੮ʮͅ੮ͅ˺੮ʇɘͅ;ੴ੮ή͙ʮɻˌੴ੮͸ʇ੮ˌ˦˺͸੮ɘˑˑ੮͐ʩʇ੮͐ͅʇ̹ͅੴ੮ય͐ʩʇ੮/Ûર੮͸˺̼ˌͅ੮ˑʮˌʇ੮ɘ੮͸ʇˑˑચ˺ʮˑʇʁ੮ ˚ɘɻʩʮ˦ʇੳ੮îʩ˺ͅʇ੮ɻɘͅʇͅ੮ɘ̼ʇ੮͸ʩʇ̼ʇ੮˚;੮͐ʮ˚ʇੴ੮ʇʠʠ˺̼͐੮ɘ˦ʁ੮ʇ˦ʇ̼ʡ;੮ʡ˺ੳૂ ͅ੮͸ʮ͐ʩ੮̹˺ˑʮɻʇ੮ʁ˺ʮ˦ʡ੮৵ৱ৵ৰͅੴ੮͐ʩʇ˦ੴ੮/Ûͅ੮ɻɘ˦੮ʇɘͅʮˑ;੮˺ͷʇ̼ˑ˺˺ˌ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ˈ͙͐ͅ੮ ̼ʇɘˑˑ;ੴ੮̼ʇɘˑˑ;੮ͅʮɻˌੳ੮)̼ੳ੮Ûɘ˦ʁ੮ɘʁ˚ʮ͐͐ʇʁੴ੮ુUʠ੮;˺͙ૄ̼ʇ੮ˈ͙͐ͅ੮ʩʇɘ̼ʮ˦ʡ੮ͷ˺ʮɻʇͅੴ੮ɺ͙͐੮;˺͙ૄ̼ʇ੮ ˦˺͐੮̹ʇʇʮ˦ʡ੮˺˦੮͐ʩʇ੮ϲˑ˺˺̼ੴ੮ɺɘͅʮɻɘˑˑ;੮ɺʇʩɘͷʮ˦ʡ੮;˺͙̼ͅʇˑʠ੯ੳ੯ੳ੯ੳ੮;˺͙ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮͸ɘʮ͐੮ʩ˺͙̼ͅ੮ ɘ˦ʁ੮ʩ˺͙̼ͅ੮͐˺੮ɺʇ੮ͅʇʇ˦ੳૂ੮‡͙̼ͅʇ੮)͸;ʇ̼੮ɻ˺˦ɻ͙̼̼ʇʁੵ੮ૃîʩɘ͐੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʮͅ੮ͅʮɻˌ੮ʮ˦੮͐ʩʇ੮ ɻ˺̼˦ʇ̼ੴ੮ή͙ʮʇ͐ੴ੮͸ʮ͐ʩ੮ɘ੮ʁʮ͐ͅ˺̼͐ʇʁ੮̼ʇɘˑʮ͐;੮˺ʠ੮͸ʩɘ͐੮ʮͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮͐˺੮͐ʩʇ˚ੴ੮ɘ˦ʁ੮͐ʩʇ;ૄ̼ʇ੮ ˌʇʇ̹ʮ˦ʡ੮͐˺੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮˦˺͐੮ʁ̼ɘ͸ʮ˦ʡ੮ɘ˦;੮ɘ͐͐ʇ˦͐ʮ˺˦ੴૄ੮ʩʇ੮ɻ˺˦ʠʇͅͅʇʁੴ੮ૃ͸ʇˑˑੴ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ ʡʇ͐੮ɘ˦;੮ɘ͐͐ʇ˦͐ʮ˺˦ੳ੮˦ʁ੮͸ʩʇ˦੮;˺͙੮ϲʮ˦ɘˑˑ;੮ʡʇ͐੮͐˺੮͐ʩʇ˚ੴ੮;˺͙੮ɘͅˌੴ੮ુ̼ʇ੮;˺͙੮̼ʇɘʁ;੮͐˺੮ ʡ˺੺ૂ੮ɘ˦ʁ੮͐ʩʇ;੮ͅɘ;ੴ੮ુ;ʇͅੴૂ੮ɘ˦ʁ੮͐ʩʇ;੮ˈ͙͐ͅ੮ʡ˺ੳૄ੮îʩʮͅ੮˺̼ʮʇ˦͐ɘ͐ʮ˺˦੮˚ɘ;੮ʩʇˑ̹੮ʇͽ̹ˑɘʮ˦੮͸ʩ;੮ ͐ʩʇ̼ʇ੮ɘ̼ʇ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮˚˺̼ʇ੮˚ʇ˦੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐ʩɘ˦੮͸˺˚ʇ˦ੴ੮ʡʮͷʇ˦੮ʡʇ˦ʁʇ̼ʇʁ੮ ʁʮ̹ͅɘ̼ʮ͐ʮʇͅ੮ʮ˦੮͸ʩʇ͐ʩʇ̼੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɻ˺˚ʇͅ੮˺͙͐੮ɘͅ੮ˑ˺͙ʁ੮ʁʮ͙̼͐ͅɺɘ˦ɻʇ੮˺̼੮ ή͙ʮʇ͐੮͸ʮ͐ʩʁ̼ɘ͸ɘˑੳ৾৿

84

T H E C O N S E RVATO R S H I P C O N T I N U U M

ુîʩɘ͐ૄͅ੮ˈ͙͐ͅ੮͐ʩʇ੮˦ɘ͙̼͐ʇ੮˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮˚ʇʁʮɻʮ˦ʇੴૂ੮)̼ੳ੮Ûɘ˦ʁ੮ɻ˺˦ɻˑ͙ʁʇʁੳ੮ુĚ˺͙ૄ̼ʇ੮ ɘˑ͸ɘ;ͅ੮˚ɘˌʮ˦ʡ੮͐ʩʇͅʇ੮ʁʇɻʮͅʮ˺˦ͅ੮ˌ˦˺͸ʮ˦ʡ੮͐ʩɘ͐੮ʇͷʇ̼;੮ʁʇɻʮͅʮ˺˦੮͐˺੮ʮ˦͐ʇ˦ͅʮʠ;੮ɻɘ̼ʇ੮ʮͅ੮ɘ੮ ʁʇɻʮͅʮ˺˦੮͐˺੮ʮʡ˦˺̼ʇ੮ͅ˺˚ʇ˺˦ʇ੮ʇˑͅʇૄͅ੮ɻɘ̼ʇੳ੮U͐ૄͅ੮ɘ੮Έʇ̼˺ચ͙ͅ˚੮ʡɘ˚ʇੳૂ

CONCLUSION: NEGATIVE DISCRETION U͐੮ʮͅ੮˺ʠ͐ʇ˦੮ͅɘʮʁ੮͐ʩɘ͐੮ʡʇ͐͐ʮ˦ʡ੮ɘʁ˚ʮ͐͐ʇʁ੮͐˺੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͸ɘ̼ʁ੮ʮͅ੮ʩɘ̼ʁʇ̼੮ ͐ʩɘ˦੮ʡʇ͐͐ʮ˦ʡ੮ʮ˦͐˺੮Pɘ̼ͷɘ̼ʁੳ৾਀੮U੮ʁ˺˦ૄ͐੮͐ʩʮ˦ˌ੮͐ʩɘ͐੮͐ʩʮͅ੮ɻˑɘʮ˚੮˚ɘˌʇͅ੮ɘ˦;੮ͅʇ˦ͅʇ੮ફɘ˦ʁੴ੮ʮ˦੮ ɘ˦;੮ɻɘͅʇੴ੮͐ʩʇ੮ɘʁ˚ʮ͐੮̼ɘ͐ʇ੮ʠ˺̼੮৵ৱ৵ৰͅ੮ʮͅ੮ɘɺ˺͙͐੮৲৵੮̹ʇ̼ɻʇ˦͐ੴ੮ɘ˦ʁ੮͐ʩʇ੮Pɘ̼ͷɘ̼ʁ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮ ̼ɘ͐ʇ੮ʮͅ੮৵੮̹ʇ̼ɻʇ˦͐બੳ੮"͙͐੮ʮ͐੮ʮͅ੮ɻʇ̼͐ɘʮ˦੮͐ʩɘ͐੮˚ɘ˦;੮ʠɘ˚ʮˑʮʇͅੴ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ɘ˦ʁ੮ ʩ˺͙ͅʮ˦ʡ੮̹̼˺ͷʮʁʇ̼ͅ੮ɘ˦ͽʮ˺͙ͅˑ;੮ɘ͸ɘʮ͐੮͐ʩʇ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮ʁʇɻʮͅʮ˺˦ͅ੮˺ʠ੮/Û੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ ɘ˦ʁ੮ɘ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʁʮͅɘ̹̹˺ʮ˦͐ʇʁ੮͸ʩʇ˦੮͐ʩʇ;੮ɘ̼̼ʮͷʇੳ੮ફH˺̼੮̹ʇ˺̹ˑʇ੮ʩʇˑʁ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੴ੮ ɺʇʮ˦ʡ੮ુ̼ʇˈʇɻ͐ʇʁૂ੮ʠ̼˺˚੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮͐ͅɘ;੮̹̼˺ɺɘɺˑ;੮ʁ˺ʇͅ੮˦˺͐੮ɺ̼ʮ˦ʡ੮͐ʩʇ੮ͅɘ˚ʇ੮ͅʇ˦ͅʇ੮ ˺ʠ੮ʁʮͅɘ̹̹˺ʮ˦͐˚ʇ˦͐ੳબ /Û੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ʠ˺̼੮͐ʩʇʮ̼੮̹ɘ̼͐ੴ੮ɻɘ˦੮ɻ͙ˑ͐ʮͷɘ͐ʇ੮ɘ˦੮ʮ˚ɘʡʇ੮˺ʠ੮̹ʇ̼ͅ˺˦ɘˑ੮̹˺͐ʇ˦ɻ;੮͐ʩɘ͐੮ ʠ͙ʇˑͅ੮͐ʩʇ੮ͅʇʇ˚ʮ˦ʡ੮ɘ̼ɺʮ̼͐ɘ̼ʮ˦ʇͅͅ੮˺ʠ੮͐ʩʇʮ̼੮ʁʇɻʮͅʮ˺˦ͅੳ੮ͅ੮˺˦ʇ੮/Û੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸̼˺͐ʇ੮ ʮ˦੮ ʩʇ̼੮ ˚ʇ˚˺ʮ̼ੴ੮ ુU੮ ̹ʮɻ͙̼͐ʇ੮ ˚;ͅʇˑʠ੮ ͐ͅɘ˦ʁʮ˦ʡ੮ ˺˦੮ ͐ʩʇ੮ ɻ˺̼˦ʇ̼੮ ˺ʠ੮ äɘ˦ʇ੮ ɘ˦ʁ੮ U˦ͅɘ˦ʇ੮ ʁʮ̼ʇɻ͐ʮ˦ʡ੮̼͐ɘϲϲʮɻੳ੮Ě˺͙ૄ̼ʇ੮ʮ˦ੴ੮;˺͙ૄ̼ʇ੮˺͙͐ੳ੮ä͐ʇ̹੮˺ͷʇ̼੮͐ʩʇ੮ʮ˦ͷʮͅʮɺˑʇ੮ˑʮ˦ʇ੮ɘ˦ʁ੮ͅʇʇ੮͸ʩɘ͐੮ ʩɘ̹̹ʇ˦ͅੳૂ৾ਁ੮ Ěʇ͐੮ ͐ʩʮͅ੮ ɘ̹̹ɘ̼ʇ˦͐੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ɻ˺˚ʇͅ੮ ˦˺͐੮ ʠ̼˺˚੮ ʡɘ͐ʇˌʇʇ̹ʮ˦ʡ੮ ɘɻɻʇͅͅ੮ ͐˺੮ ɘɺ͙˦ʁɘ˦͐੮̼ʇͅ˺͙̼ɻʇͅੴ੮ɺ͙͐੮ʠ̼˺˚੮̼͐ʮɘʡʮ˦ʡ੮ɘˑˑ˺ɻɘ͐ʮ˺˦੮˺ʠ੮ͅɻɘ̼ɻʇ੮˺˦ʇͅੳ Ûʇͅ˺͙̼ɻʇͅ੮̹ˑɘ;੮ɘ੮̼˺ˑʇ੮ʮ˦੮ɲ˃́‫ף‬ʣȡʯ͇੮̹ʇ˺̹ˑʇ੮˚ɘˌʇ੮ʮ͐੮͐ʩ̼˺͙ʡʩ੮ɘ˦੮/Û੮ʮ˦͐˺੮ɘ੮ɺʇʁੴ੮ ɺ͙͐੮ ̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ ʮʁʇ˦͐ʮ͐ʮʇͅ੮ ɘ˦ʁ੮ ̹̼ʇʠʇ̼ʇ˦ɻʇͅ੮ ͸ʇʮʡʩ੮ ʩʇɘͷʮˑ;੮ ˺˦੮ who੮ ʁ˺ʇͅੳ੮ ä˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮k˺ͅʩ੮äʇʮ˚੮̹ͅʇ˦͐੮͐͸˺੮;ʇɘ̼ͅ੮͸ʮ͐ʩ੮ɘ˚ɺ͙ˑɘ˦ɻʇ੮ɻ̼ʇ͸ͅ੮ʮ˦੮ɘ੮#ɘˑʮʠ˺̼˦ʮɘ੮ɻ˺͙˦͐;ੴ੮ ͅʩ͙͐͐ˑʮ˦ʡ੮ɺʇ͐͸ʇʇ˦੮̼ʮɻʩੴ੮͸ʩʮ͐ʇ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁͅ੮ɘ˦ʁ੮̹˺˺̼ʇ̼ੴ੮ɺ̼˺͸˦੮˺˦ʇͅੳ੮Øɘ̼ɘ˚ʇʁʮɻͅ੮͸ʇ̼ʇ˦ૄ͐੮ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮ʇɘͅ;੮ɻɘͅʇͅ੮˺ʠ੮ͅʇʇ˚ʮ˦ʡˑ;੮ʁʇͅʇ̼ͷʮ˦ʡ੮̹ʇ˺̹ˑʇઝ˚ɘ;ɺʇ੮ɘ੮ ͅʇ˦ʮ˺̼੮ɻʮ͐ʮΈʇ˦੮˦ʇʇʁʮ˦ʡ੮ɘ੮̼͐ɘ˦̹ͅ˺̼͐੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮͐ʩʇ੮ϲˑ͙ઝɺ͙͐੮ʮ˦͐ͅʇɘʁ੮ͅ˺͙ʡʩ͐੮ ˺͙͐੮͐ʩʇ੮ʩɘ̼ʁੴ੮͙˦̹ˑʇɘͅɘ˦͐੮˺˦ʇͅઝˑʮˌʇ੮ʡ͙˦ͅʩ˺͐੮͸˺͙˦ʁ੮ͷʮɻ͐ʮ˚ͅ੮ʠ̼˺˚੮ʁ̼͙ʡ੮ʁʇɘˑͅ੮ʡ˺˦ʇ੮ ɺɘʁੳ੮îʩɘ͐ૄͅ੮˦˺͐੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮͸ʇ̼ʇ੮ુ̼͐ɘ͙˚ɘ੮ˈ͙˦ˌʮʇͅੴૂ੮ʩʇ੮ɘ̼ʡ͙ʇʁੳ੮U˦͐ͅʇɘʁੴ੮͐ʩʇ;੮͸ʇ̼ʇ੮ ̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͸ʩ˺੮͸ɘ˦͐ʇʁ੮͐˺੮ʇͽʇ̼ɻʮͅʇ੮͐ʩʇ੮ુɻ̼ɘʠ͐ૂ੮˺ʠ੮͐ʩʇʮ̼੮ુɻʩ˺ͅʇ˦੮ͷ˺ɻɘ͐ʮ˺˦ੴૂ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮̹ɘ̼ɘ˚ʇʁʮɻʮ˦ʇੳ৾ਂ Ě˺͙੮ɻ˺͙ˑʁ੮ͅɘ;੮͐ʩʇ੮ͅɘ˚ʇ੮ʠ˺̼੮͐ʩʇ੮/Û੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮͸ʩ˺੮̼ʇɻʇʮͷʇ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮͐ʩ˺ͅʇ੮ ̹ɘ̼ɘ˚ʇʁʮɻͅ੮ɘ̼ʇ੮ʁ̼˺̹̹ʮ˦ʡ੮˺ʠʠੳ੮Uʠ੮;˺͙ૄ̼ʇ੮ɘ੮ʩɘ˚˚ʇ̼ੴ੮;˺͙੮ˑ˺˺ˌ੮ʠ˺̼੮˦ɘʮˑͅੳ੮Uʠ੮;˺͙ૄ̼ʇ੮ɘ˦੮ /Û੮̹ʩ;ͅʮɻʮɘ˦ੴ੮;˺͙੮ˑ˺˺ˌ੮ʠ˺̼੮ɘɻ͙͐ʇ੮ɻ̼ʮͅʇͅੳ੮îʩ˺ͅʇ੮ɻɘͅʇͅ੮ϲʮˑˑ੮͙̹੮;˺͙̼੮ɘͷɘʮˑɘɺˑʇ੮ɺʇʁͅੳ੮Ě˺͙੮ ʁ˺˦ૄ͐੮ˑ˺˺ˌ੮ʠ˺̼੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ɘ˦ʁ੮ɻʩ̼˺˦ʮɻ੮̹ͅ;ɻʩ˺ͅʮͅੳ੮Ø͙͐੮ɘ˦˺͐ʩʇ̼੮ ͸ɘ;ੴ੮ʮ˦੮˚˺͐ͅ੮ɻɘͅʇͅੴ੮;˺͙੮ʁ˺˦ૄ͐੮ɘʁ˚ʮ͐੮̹˺͐ʇ˦͐ʮɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮Ě˺͙੮ʁʮͅɻʩɘ̼ʡʇ੮͐ʩʇ˚ੳ

CHAPTER 4

INPATIENT

K

ate’s forty years of contact with California’s mental health system have given her the kind of window into the transforming role of psychiatric hospitals that you can only get from being locked, repeatedly, inside them.ৼ Her saga started early: when she was eleven, her mother—battling her own mental health challenges without “any support, or treatment, or even acknowledgment” of her illness—decided “she didn’t want to be a mom anymore.” She sent Kate to a residential school in the Northeast, where she was left alone to cope with the accumulating effects of her traumatic childhood, struggles with her sexual orientation, and sense of alienation from the privileged children of Ivy League families surrounding her. She made a “kind of pitiful attempt to ɻ͙͐੮˚;੮͸̼ʮ͐ͅͅੴૂ੮͸ʇ˦͐੮͐˺੮͐ʩʇ੮ʮ˦ϲʮ̼˚ɘ̼;ੴ੮ɘ˦ʁ੮͸ɘͅ੮ͅʇ˦͐੮ɺɘɻˌ੮͐˺੮ɻˑɘͅͅʇͅ੮͐ʩʇ੮˦ʇͽ͐੮ʁɘ;ੳ ͐੮ ϲʮʠ͐ʇʇ˦ੴ੮ ʩʇ̼੮ ˚˺͐ʩʇ̼੮ ̼ʇ͙̼͐˦ʇʁ੮ ɘ˦ʁ੮ ɺ̼˺͙ʡʩ͐੮ ʩʇ̼੮ ͐˺੮ ͐ʩʇ੮ "ɘ;੮ ̼ʇɘੳ੮ nɘ͐ʇ੮ recounted that she was “suffering a lot from depression,” then paused to say, ુU੮ʁ˺˦ૄ͐੮̼ʇɘˑˑ;੮ˑʮˌʇ੮͐ʩʇ੮͸˺̼ʁ੮ૃ͙ͅʠʠʇ̼ʮ˦ʡૄ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ͅ˺˚ʇ੮ʮ˦͐ʇ̼ʇ͐ͅʮ˦ʡ੮ɺʇ˦ʇϲʮ͐ͅ੮ to emotional pain: increased empathy and creativity.” She put some of that suffering, and the creativity it brought, into poetry. Her mom read some (presumɘɺˑ;੮͸ʮ͐ʩ˺͙͐੮nɘ͐ʇૄͅ੮ɻ˺˦ͅʇ˦͐બ੮ɘ˦ʁ੮͐ʩʇ˦੮ɻ˺˚˚ʮ͐͐ʇʁ੮ʩʇ̼੮ફʁʇϲʮ˦ʮ͐ʇˑ;੮͸ʮ͐ʩ˺͙͐੮nɘ͐ʇૄͅ੮ ɻ˺˦ͅʇ˦͐બੳ੮ુU੮͸ɘͅ੮ʩ˺̼̼ʮϲʮʇʁ੮ɘ͐੮͐ʩʇ੮ʮʁʇɘ੮˺ʠ੮ɺʇʮ˦ʡ੮̹͙͐੮ʮ˦੮ɘ੮˚ʇ˦͐ɘˑ੮ʩ˺̹ͅʮ͐ɘˑੳ੮ˑˑ੮U੮ʩɘʁ੮ ͐˺੮ʡ˺੮˺˦੮͸ɘͅ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮ɘ˦͐ʮή͙ʇ੮ʮ˚ɘʡʇͅ੮˺ʠ੯ੳ੯ੳ੯ੳ੮One Flew Over the Cuckoo’s Nest.” She was sixteen. To Kate’s surprise, the hospital was not all “horrible and brutal and straightjackets.” In 1981, the private hospital where she stayed had a “rehabilitative attitude.” They wanted her to continue her education and get “job skills, social skills, life skills, cooking skills.” Patients would leave a few times a week to go bowling or for a picnic. Most stayed one or two months. This was before a new generation

86

T H E C O N S E RVATO R S H I P C O N T I N U U M

of antidepressants like Prozac hit the market, and the available medications had such strong side effects that her doctor—who met with her in now unthinkable one-hour chunks to conduct psychotherapy—didn’t even raise the possibility of ̹ʮˑˑͅੳ੮ુU͐੮͸ɘͅ੮˺ʁʁ੮ય͐˺੮ɺʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁર੮ɘ˦ʁ੮U੮͸ɘͅ੮ͅɻɘ̼ʇʁੴૂ੮ͅʩʇ੮̼ʇϲˑʇɻ͐ʇʁੴ੮ુɺ͙͐੮ʮ͐੮͸ɘͅ੮ not a horrible experience. It was actually a bit of relief, because I no longer had to pretend to be normal.” She didn’t want to romanticize it, though. Once when she was upset and banging her wrist on a bedstand, they put her in a seclusion room “and told me if I acted up while I was there, they would tie me down.” Even if she wasn’t forcibly injected with medication or put in physical restraints, she saw those things imposed on others, “and living with that constant threat, in itself, is frightening.” The situation was bad enough that Kate took advantage of the then less intense security measures to “AWOL” (run away) several times. U͐੮͸ɘͅ੮˺˦੮˺˦ʇ੮ʇͅɻɘ̹ʇੴ੮ɘʠ͐ʇ̼੮ʠ˺͙̼੮˺̼੮ϲʮͷʇ੮˚˺˦͐ʩͅੴ੮͐ʩɘ͐੮ʮ͐੮ɺʇɻɘ˚ʇ੮ɻˑʇɘ̼੮͐˺੮ʩʇ̼੮͐ʩɘ͐੮ the hospital’s rehabilitative program wasn’t helping her prepare for life in the ɻ˺˚˚͙˦ʮ͐;ੵ੮ુU੮̼ʇ˚ʇ˚ɺʇ̼੮͸ɘˑˌʮ˦ʡ੮ʁ˺͸˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮ɺʇʮ˦ʡ੮ʠ̼ʇʇ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͐ʩʮ˦ˌʮ˦ʡੴ੮ ૃU੮˦˺੮ˑ˺˦ʡʇ̼੮ˌ˦˺͸੮ʩ˺͸੮͐˺੮ˑʮͷʇ੮ʮ˦੮͐ʩʇ੮˺͙͐ͅʮʁʇ੮͸˺̼ˑʁ੯ੳ੯ੳ੯ੳ੮͸ʩɘ͐੮ɘ˚੮U੮ʡ˺ʮ˦ʡ੮͐˺੮ʁ˺੮͸ʮ͐ʩ੮ ˚;ͅʇˑϲ੺ૄ੮U੮ʩɘʁ੮˦˺੮˚˺˦ʇ;ੴ੮U੮ʩɘʁ੮˦˺͸ʩʇ̼ʇ੮͐˺੮ʡ˺ੴ੮U੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮ɘ˦;੮ʠ̼ʮʇ˦ʁͅੳૂ੮äʩʇ੮ turned around and checked back in. Staff responded by taking away her shoes. As she neared eighteen, the hospital started taking her to visit residential treat˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅੳ੮äʩʇ੮ͅɘʮʁ੮ુ˦˺ૂ੮͐˺੮ϲʮͷʇ੮˺̼੮ͅʮͽੴ੮ɘ˦ʁ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̼ʇ̹ͅʇɻ͐ʇʁ੮ʩʇ̼੮͸ʮͅʩʇͅੵ੮ ુîʩʇ;੮ˌʇ̹͐੮˚ʇ੮ɘ੮˚˺˦͐ʩ੮˺̼੮͐͸˺੮͐˺੮ϲʮ˦ʁ੮˚ʇ੮ɘ੮ʡ˺˺ʁ੮̹ˑɘɻʇ˚ʇ˦͐ੳ੮îʩʇ;੮͸ʇ̼ʇ˦ૄ͐੮ʡ˺ʮ˦ʡ੮ to place me anywhere I didn’t want to go.” Kate lived through the last days of a now defunct model of extended inpatient care. Some psychiatrists remembered this epoch wistfully. Dr. Salay, who works as a public psychiatrist in Northern California, recalled the difference when she was in training: “We had a patient that had bipolar disorder and she had children at home, and we kept her in the hospital until her mania went away, until she ͸ɘͅ੮ͅɘʠʇ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮˚͙͐ͅ੮ʩɘͷʇ੮ˌʇ̹͐੮ʩʇ̼੮ˑʮˌʇ੮ɘ੮˚˺˦͐ʩ੮˺̼੮͐͸˺੮˚˺˦͐ʩͅੳ੮U੮͐ʩʮ˦ˌ੮͐ʩʇ̼ʇ੮͸ɘͅ੮ more comfort with the paternalism involved with that.” Now, she tells me, “you know there’s a clock ticking. It [hospitalization] is so short, you have three days ͐˺੮ϲʮʡ͙̼ʇ੮ʮ͐੮˺͙͐ੳ੮"͙͐੮˚ʇʁͅ੮ʁ˺˦ૄ͐੮͸˺̼ˌ੮͐ʩɘ͐੮ʠɘ͐ͅੳ੯ੳ੯ੳ੯ੳ੮˦;੮ˌʮ˦ʁ੮˺ʠ੮ʁʇʇ̹੮ʩʇɘˑʮ˦ʡ੮˦ʇʇʁͅ੮ to happen in an outpatient setting.” There is little evidence that prolonged hospitalizations actually produced any outcome beyond dependence on the hospital.৽ Still, Kate describes a humanism to a previous era of inpatient care that had disappeared when she went back.

I N PAT I E N T

87

H̼˺˚੮͐͸ʇ˦͐;੮͐˺੮͐ʩʮ̼͐;ચϲʮͷʇੴ੮nɘ͐ʇ੮͸˺̼ˌʇʁ੮ɘ੮̼ɘ˦ʡʇ੮˺ʠ੮ˈ˺ɺͅ੮͸ʮ͐ʩ੮ɻʩʮˑʁ̼ʇ˦ੴ੮ʁ˺˚ʇ͐ͅʮɻ੮ violence survivors, and people with disabilities; she saw a therapist occasionally, but was off medication. Then she enrolled in a PhD program, which was “excellent academically and horrible interpersonally.” Within a month, she was seriously depressed and dealing with intrusive thoughts of hurting herself. She ɻ˺˦ϲʮʁʇʁ੮ʮ˦੮ɘ੮ɻɘ˚̹͙ͅ੮͐ʩʇ̼ɘ̹ʮ͐ͅੳ੮îʩʇ੮͐ʩʇ̼ɘ̹ʮ͐ͅ੮ͅɘʮʁੴ੮ુĔʮˑˑ੮;˺͙੮ʇͽɻ͙ͅʇ੮˚ʇ੮ʠ˺̼੮ɘ੮ ˚ʮ˦͙͐ʇ੺ૂ੮nɘ͐ʇ੮͸ɘʮ͐ʇʁੴ੮ુɘ˦ʁ੮͐ʩʇ੮˦ʇͽ͐੮͐ʩʮ˦ʡ੮U੮ˌ˦˺͸ੴ੮͐ʩʇ̼ʇૄͅ੮ɘ੮̹˺ˑʮɻʇ˚ɘ˦੮ɘ͐੮͐ʩʇ੮ʁ˺˺̼੮ with handcuffs to take me to the hospital.” The therapist may have felt obligated to report Kate because of a risk of self-harm, but for Kate, it was shocking: “The amount of force, threat of force, lies, and betrayal that’s involved in trying to get people help is just outrageous.” îʩ͙ͅ੮ɺʇʡɘ˦੮ϲʮʠ͐ʇʇ˦੮;ʇɘ̼ͅ੮ʁ˺˚ʮ˦ɘ͐ʇʁ੮ɺ;੮ુʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ɘˑˑ੮ˌʮ˦ʁͅ੮˺ʠ੮̼͐ʇɘ͐ment programs, lots of ambulance rides, lots of police visits, lots of suicide attempts.” Out of both desperation and coercion, she tried thirty different medications, which gave her little but side effects. Hospitals saw her as “not only an object, but a bad and broken object.” The Magna Carta that was supposed to give her the right to refuse unwanted treatment was a meaningless scrap of paper. She described going before a judge to contest her fourteen-day 5250 following a ͅʇͷʇ˦͐;ચ͐͸˺ચʩ˺͙̼੮৵ৱ৵ৰੵ੮ુU͐ૄͅ੮͐ʩʇ੮ɻ̼ɘΈ;੮̹ʇ̼ͅ˺˦ૄͅ੮͸˺̼ʁ੮ɘʡɘʮ˦͐ͅ੮͐ʩʇ੮͐ͅɘʠʠ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮;˺͙੮ always lose.” The patients’ rights advocate supposed to represent her “just sat there.” With no real oversight, “they [hospitals] can do anything. I’ve seen other patients beaten; I’ve seen them spit at by staff; I’ve seen them tied up for no reason; I’ve been insulted, degraded, told horrible things by staff, threatened with ɘˑˑ੮ˌʮ˦ʁͅ੮˺ʠ੮͙͐ͅʠʠੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮ɘˑˑ੮͐ʩʇͅʇ੮͙̹̹ͅ˺ͅʇʁ੮̼ʮʡʩ͐ͅ੮͐ʩɘ͐੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹ɘ͐ʮʇ˦͐੮ is supposed to have, ever since the [LPS Act], more and more rights—those don’t mean anything.” These hospitalizations were nasty, brutish, but—at least compared to the ˚˺˦͐ʩͅ੮ͅʩʇ੮̹ͅʇ˦͐੮ʮ˦͐ʇ̼˦ʇʁ੮ɘͅ੮ɘ੮͐ʇʇ˦ઝͅʩ˺̼͐ੳ੮Ĕʩʇ˦੮ͅʩʇ੮͸ɘͅ੮ʠ˺̼͐;ચϲʮͷʇੴ੮͐ʩ˺͙ʡʩੴ੮ͅʩʇ੮ had an intentional overdose serious enough that it put her in a coma. Her parents reappeared, armed with her father’s discovery that “he could become my guardian and choose a locked placement for me for the foreseeable future.” Yet Kate had a realization that is surprisingly common after near-fatal suicide attempts: she wanted to live. “The problem is that no one believed me,” she recounted. ુîʩʇ;੮ˈ͙͐ͅ੮͐ʩ˺͙ʡʩ͐੮U੮͸ɘ˦͐ʇʁ੮͐˺੮ʡʇ͐੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮ϲʮ˦ʮͅʩ੮͐ʩʇ੮ˈ˺ɺੳૂ੮Pʇ̼੮ inpatient psychiatrist told her that he didn’t want to conserve her. “If it were up to me, I’d discharge you now,” he admitted, “but your family has threatened to

88

T H E C O N S E RVATO R S H I P C O N T I N U U M

͙ͅʇ੮˚ʇੳ੯ੳ੯ੳ੯ੳ੮ä˺੮Uૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮ͅʮʡ˦੮͐ʩʇ੮̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮͐ʩʇ੮ˈ͙ʁʡʇ੮͐˺੮ʁʇɻˑɘ̼ʇ੮;˺͙੮ʡ̼ɘͷʇˑ;੮ ʁʮͅɘɺˑʇʁੳૂ੮äʩʇ੮͸ɘͅ੮͐ʇ̼̼ʮϲʮʇʁੵ੮ુUૄʁ੮ɺʇʇ˦੮ʮ˦੮ɘ˦ʁ੮˺͙͐੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʠ˺̼੮ ͅ˺੮ˑ˺˦ʡ੮͐ʩɘ͐੮U੮ˌ˦ʇ͸੮ɘɺ˺͙͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮ʮ͐੮ͅʇʇ˚ʇʁ੮ʩ˺̼̼ʮɺˑʇ੮͐˺੮˚ʇੳ੮ I would lose my rights and freedoms as an adult.” Kate had an unlikely savior. A week before her court date, her insurance company sent the hospital a letter announcing that, because she was not beneϲʮ͐ʮ˦ʡ੮ʠ̼˺˚੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮͐ʩʇ;੮͸˺͙ˑʁ੮˦˺੮ˑ˺˦ʡʇ̼੮̹ɘ;ੳ੮ુ"ˑʇͅͅ੮͐ʩʇ੮ʮ˦͙̼ͅɘ˦ɻʇ੮ʮ˦ʁ͙̼͐ͅ;ੴૂ੮ ͅʩʇ੮ ɻ˺˦ʠʇͅͅʇʁੴ੮ ̼ʇˑ͙ɻ͐ɘ˦͐ˑ;ੳ੮ Pʇ̼੮ ͙ͅɺͅʇή͙ʇ˦͐੮ ુʁʮͅɻʩɘ̼ʡʇ੮ ̹ˑɘ˦ૂ੮ ͸ɘͅ੮ ʠɘ̼੮ ʠ̼˺˚੮ ͐ʩʇ੮ ϲʮͷʇ੮˺̼੮ͅʮͽ੮ͷʮͅʮ͐ͅ੮͐˺੮ˑ˺ɻɘˑ੮͐ͅʇ̹ચʁ˺͸˦੮̹̼˺ʡ̼ɘ˚ͅ੮ͅʩʇ੮͸ɘͅ੮ʡ̼ɘ˦͐ʇʁ੮ɘͅ੮ɘ੮͐ʇʇ˦ੵ੮ુîʩʇ;੮ opened the door and kicked me out. Put me on the curb with a plastic bag of clothing. Not a single referral, not a single medication, not a single person to pick me up. Nothing.” Fearful that her father would still pursue a conservatorship, and dedicated to “surviving rather than dying,” she began to construct a new community support system. She found a therapist, an acupuncturist, and a bodyworker doing trauma release, Reiki, and breath therapy. She started visiting a peer-run Wellness and Advocacy Center (funded by the 2004 Mental Health Services Act): “I realized if I do not take responsibility for the care and feeding of my mental health, other people are going to in a way that’s very painful to me.” She hasn’t been back to the hospital since 2016. Or, rather, she hasn’t been back as a patient. At the time of her interview in 2021, she was starting to volunteer as a peer support worker at the psychiatric crisis unit in Sonoma County: “It’s my old stomping ground, ͸ʩʇ̼ʇ੮U੮͸ɘͅ੮ʩʇˑʁ੮ɘʡɘʮ˦͐ͅ੮˚;੮͸ʮˑˑ੮˚͙ˑ͐ʮ̹ˑʇ੮͐ʮ˚ʇͅੳૂ੮"͙͐੮˦˺͸ੴ੮ͅʩʇૄˑˑ੮ɺʇ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ people to help them realize that hospitalization “is not all there is, and they have every right to be pissed off, and no, I’m not going to help them burn the unit down, but provide whatever sort of support and connection I can.” Debates in California often refer to “barriers to hospitalization” and a “lack of beds” but too often ignore what it means to be hospitalized and to be stuck in one of those beds. Kate speaks to how the harms of long-term institutionalization that disconnected people from the community have been partly replaced by the harms of short-term institutionalization geared toward medicating someone just enough that they can be abandoned anew. Her story and this chapter are a window into a part of the conservatorship continuum where the state’s delegation to private entities is particularly conͅʇή͙ʇ˦͐ʮɘˑੳ੮ î˺੮ ̹͙͐੮ ʮ˦੮ ̹ˑɘɻʇ੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ɘ˦੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ ɻˑʮ˦ʮɻʮɘ˦੮ ˚͙͐ͅ੮ ϲʮˑʇ੮ an application with the county stating that, despite several weeks of hospital

I N PAT I E N T

89

ɻɘ̼ʇੴ੮ɘ੮̹ʇ̼ͅ˺˦੮ʮͅ੮͐ͅʮˑˑ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮ͅ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ͅʩ˺͸ͅੴ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ʮ˦ɻʇ˦͐ʮͷʇͅੴ੮ market forces, and administrative pressures drive how psychiatrists make these ʁʇɻʮͅʮ˺˦ͅੴ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̼͙͐˚̹ʮ˦ʡ੮ˑʇʡɘˑ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ɘ˦ʁ੮˚ʇʁʮɻɘˑ੮ˈ͙ʁʡ˚ʇ˦͐੮ʮ˦੮ʁʇ͐ʇ̼˚ʮ˦ing who gets conserved.

MANAGING CARE, DENYING CARE Inpatient psychiatrists can override a patient’s desire to leave after a seventy͐͸˺ચʩ˺͙̼੮৵ৱ৵ৰ੮ɺ;੮̹ˑɘɻʮ˦ʡ੮͐ʩʇ˚੮˺˦੮ɘ੮ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮৵৲৵ৰ੮ʩ˺ˑʁੳ੮"͙͐੮͐ʩʇ;੮ʩɘͷʇ੮ˑʇͅͅ੮ ˑʇͷʇ̼ɘʡʇ੮˺ͷʇ̼੮͐ʩʇ੮ϲʮ˦ɘ˦ɻʮʇ̼ͅ੮˺ʠ੮͐ʩ˺ͅʇ੮͐ͅɘ;ͅੳ੮ͅ੮nɘ͐ʇ੮ʠ˺͙˦ʁੴ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺̹ͅʮ͐ɘˑʮΈɘtions can be a rare instance where patients’ interests align with those of insurance companies (or county behavioral health departments, which act like insurance companies): both want to shorten a forced stay in an inpatient ward.৾ They ensure that the vast majority of people on a 5250 don’t stay all fourteen days.৿ When LPS arrived in 1967, lengths of stay in state hospitals were already drop̹ʮ˦ʡ੮ ʁ̼ɘ˚ɘ͐ʮɻɘˑˑ;ੳ੮ ˦੮ ɘ̼͐ʮɻˑʇ੮ ̹͙ɺˑʮͅʩʇʁ੮ ͐ʩɘ͐੮ ;ʇɘ̼੮ ή͙˺͐ʇʁ੮ ɘ੮ ͅ˺ɻʮɘˑ੮ ͸˺̼ˌʇ̼੮ ͸ʩ˺੮ ˺ɺͅʇ̼ͷʇʁੴ੮ુîʩʇ੮̹͙ɺˑʮɻ੮ʩɘͅ੮ʁʮϲϲʮɻ͙ˑ͐;੮ˌʇʇ̹ʮ˦ʡ੮͙̹੮͸ʮ͐ʩ੮̼ɘ̹ʮʁ੮ɻʩɘ˦ʡʇͅ੮͐ɘˌʮ˦ʡ੮̹ˑɘɻʇ੮ in mental illness treatment. Whereas they are used to thinking in terms of three to four months’ hospitalization, doctors now routinely turn them out in several ͸ʇʇˌͅੳ੮îʩʇ੮ʠɘ˚ʮˑ;੮ʮͅ੮˺ʠ͐ʇ˦੮ɺʇ͸ʮˑʁʇ̼ʇʁ੮ɘ˦ʁ੮ɘͅˌͅੴ੮ૃPʇ੮ʮͅ˦ૄ͐੮ɻ͙̼ʇʁੴ੮ʮͅ੮ʩʇ੺ૄ੮îʩʇ˦੮͸ʇ੮ tell them that the hospital goal is not cure but getting over a crisis.”਀ Shortening ͐ͅɘ;ͅ੮̼ʇϲˑʇɻ͐ʇʁ੮ɺ˺͐ʩ੮͐ʩʇ੮̼ɘ̹ʮʁ੮ɻˑ˺͙̼ͅʇ੮˺ʠ੮ɺʇʁͅ੮ɘ˦ʁ੮ɘ੮˦ʇ͸੮˺̹͐ʮ˚ʮͅ˚੮ɘɺ˺͙͐੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ ̼ʇɘˑˑ;੮ ʁʮʁ੮ ͅʇʇ˚੮ ͐˺੮ ɻɘˑ˚੮ ͅ;˚̹͐˺˚ͅ੮ ή͙ʮɻˌˑ;ੳਁ LPS accelerated the plummeting decline in length of commitments; in just two years after it went into effect, the average for state hospitals went from 180 to 15 days.ਂ Lengths of stay in hospitals kept collapsing, but the reason was no longer innovative new treatments or expanding legal rights. In the post-LPS years, private hospitals boomed, taking advantage of more patients with insurance covering mental health treatment.ਃ੮ફH̼ɘ˦ˌ੮rɘ˦͐ʇ̼˚ɘ˦੮̹ͅʇɻʮϲʮɻɘˑˑ;੮ʩ˺̹ʇʁ੮͐ʩʇ੮ˑɘ͸੮͸˺͙ˑʁ੮ encourage a “pooling of public and private resources” in new community hospitals.਄બ੮";੮͐ʩʇ੮ৱ৹৸ৰͅੴ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʇ̼ʇ੮͙ͅɻʩ੮ɘ੮ˑ͙ɻ̼ɘ͐ʮͷʇ੮̹̼˺̹˺ͅʮ͐ʮ˺˦੮͐ʩɘ͐੮ private hospitals would send mobile teams to recruit patients in county ERs or advertise their services to people who, upon arrival, would be placed on a hold.ৼ৻ In the 1990s, though, insurance companies cracked down with a vengeance. Psychiatry was, according to one analyst, “more severely walloped by managed

90

T H E C O N S E RVATO R S H I P C O N T I N U U M

care policies than any other branch of medicine.”ৼৼ The shifting winds of the market spurred waves upon waves of closures. Relative to the population, California had only 58 percent of the acute-care psychiatric beds in 2019 that it ʩɘʁ੮ʮ˦੮ৱ৹৹৵੮ફͅʇʇ੮ϲʮʡ͙̼ʇ੮৳ੳৱબੳৼ৽੮Ø̼ʮͷɘ͐ʇ੮ʮ˦͙̼ͅɘ˦ɻʇ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮͐ʇɻʩ˦ʮή͙ʇͅ੮ˑʮˌʇ੮̹̼ʇɘ͙thorizations and doctor-to-doctor utilization reviews to keep patients moving.ৼ৾ After realignment, county behavioral health departments, which pay for all hospitalizations for people on Medi-Cal, piled on. ‘Honestly, it [insurance oversight] can’t get any stricter. Our length of stay can’t go down further,’ Dr. Swati, the clinical director of one psychiatric hospital told me. ‘Yes, our average stay is seven days, but that’s pulled up by a small number of people. Eighty percent of our patients are here for four days.’ৼ৿ U˦̹ɘ͐ʮʇ˦͐੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ͷɘ̼;੮ ʮ˦੮ ͐ʩʇʮ̼੮ ͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮ ͐˺੮ ͸ɘʡʇ੮ ή͙ʮͽ˺͐ʮɻ੮ ɺɘ͐͐ˑʇͅ੮ ͸ʮ͐ʩ੮ insurance and hospital administration.ৼ਀ Jenny, a nurse who worked in the same hospital as Dr. Swati, recounted, “We had some very old-school psychiatrists. When the utilization review people [from administration] were like, ‘You’ve got to get them out [of the hospital],’ they were like, ‘Screw you, I’m not listening to ;˺͙ੳૄૂ੮äʩʇ੮ͅʮʡʩʇʁੴ੮ુ"͙͐੮͸ʇૄͷʇ੮ʩɘʁ੮ɘ੮ˑ˺͐੮˺ʠ੮͙̼͐˦˺ͷʇ̼ੳ੮‡˺͸ੴ੮͸ʇ੮ʩɘͷʇ੮͐ͅɘʠʠ੮˚ʇʇ͐ʮ˦ʡͅ੮ where [the unit with the] shortest length of stay gets a pizza.” Most professionals I interviewed were neither actively resisting nor enthusiastically collaborating ͸ʮ͐ʩ੮ϲʮ˦ɘ˦ɻʮɘˑ੮˚ʮɻ̼˺˚ɘ˦ɘʡʇ˚ʇ˦͐੶੮͐ʩʇ;੮͸ʇ̼ʇ੮ͅʮ˚̹ˑ;੮̼ʇͅʮʡ˦ʇʁ੮͐˺੮ʮ͐ੳ I speak to an exhausted-looking Dr. Wagner, a twenty-year veteran of public ̹ͅ;ɻʩʮɘ̼͐;ੴ੮ʮ˦੮͐ʩʇ੮ɻɘʠʇ͐ʇ̼ʮɘ੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʩʇ̼ʇ੮ʩʇ੮ʩɘͅ੮ˈ͙͐ͅ੮ϲʮ˦ʮͅʩʇʁ੮ɘ੮ͅʩʮʠ͐ੳ੮Pʇ੮ tells me that he prefers working with uninsured or Medi-Cal patients, because for the ones with private insurance, the pressure to discharge is overwhelming. “The insurance companies want us to get the patients out as fast as possible. They have their own doctors who want to know in a detailed way why they ય̹ɘ͐ʮʇ˦͐ͅર੮ɘ̼ʇ˦ૄ͐੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ʠ˺̼੮ɘ˦੮˺͙̹͐ɘ͐ʮʇ˦͐੮̹̼˺ʡ̼ɘ˚ੳ੮P˺˦ʇ͐ͅˑ;ੴ੮U੮ʁ˺˦ૄ͐੮ϲʮʡʩ͐੮ it too hard,” he tells me. ુ"ʇɻɘ͙ͅʇ੮;˺͙੮ˌ˦˺͸੮;˺͙ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ˑ˺ͅʇ੺ૂ੮U੮ɘͅˌੳ “I know I’m going to lose, and their mind is made up before they even call.” ુP˺͸੮ʁ˺ʇͅ੮͐ʩɘ͐੮ʇͷʇ˦੮ʡʇ͐੮ͅʇ͐੮͙̹੺ૂ੮U੮̹̼ʇͅͅੳ ુîʩʇ;ૄˑˑ੮ͅɻʩʇʁ͙ˑʇ੮ɘ੮̼ʇͷʮʇ͸੮ʮ˦੮ɘ੮ͷʇ̼;੮̹ͅʇɻʮϲʮɻ੮͐ʮ˚ʇʠ̼ɘ˚ʇੴ੮ɘ˦ʁ੮ʮʠ੮;˺͙ૄ̼ʇ੮˦˺͐੮̼ʇɘɻʩable in ten minutes, you forfeit your opportunity to argue for a longer length of stay. They hold all the cards.” Dr. Wagner knows that the ability to sign 5250 paper͸˺̼ˌ੮ʡʮͷʇͅ੮ʩʮ˚੮ɘ̹̹ɘ̼ʇ˦͐੮ɻ˺˦̼͐˺ˑ੮˺ͷʇ̼੮̹ɘ͐ʮʇ˦͐ͅੳ੮"͙͐੮ʩʇ੮ʠʇʇˑͅ੮ɺʇ̼ʇʠ͐੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;੮ over the faceless administrators who are the real deciders of who stays in his care.

I N PAT I E N T

91

š˦ʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ʇͷʇ̼ચ͐ʮʡʩ͐ʇ˦ʮ˦ʡ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮̼ʇʮ˚ɺ͙̼ͅʮ˦ʡ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͐ͅɘ;ͅ੮ʮͅ੮ the virtual disappearance of voluntary hospitalization for the poorest and most severely ill.ৼਁ Matt, the psychiatry resident in Southern California, recalled from his time training at a county hospital, “When I was there, I probably had a total of eighty patients. And one of them was voluntary. It was a big deal,” he laughed.ৼਂ rØä੮ ɘɻ͙͐ɘˑˑ;੮ ̹ͅʇɻʮϲʮɻɘˑˑ;੮ ʇ˦ͷʮͅʮ˺˦ʇʁ੮ ͐ʩɘ͐੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ͸˺͙ˑʁ੮ ɺʇ੮ ˺ʠʠʇ̼ʇʁ੮ ͷ˺ˑ͙˦͐ɘ̼;੮ inpatient services and would be placed on a 5250 only if they were not “willing or able to accept [hospitalization].”ৼਃ Today, though, if a person with Medi-Cal on a 5150 decides they want to stay, it’s usually a sign that they need to leave. ˦˺͐ʩʇ̼੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮̼ʇˑɘ͐ʇͅ੮͐˺੮͸ʩ˺੮͐ͅɘ;ͅੳ੮Ûʇ˚ʇ˚ɺʇ̼੮͐ʩʇ੮̹̼ʇͷʮ˺͙ͅ੮͐͸˺੮ɻʩɘ̹ters, where people deemed a danger to self or others were more likely to be held on a 5150 and admitted by an ER, compared to those alleged to be gravely disɘɺˑʇʁ੺੮Ĕʩʇ˦੮ʮ͐੮ɻ˺˚ʇͅ੮͐˺੮͸ʩ˺੮̼ʇ˚ɘʮ˦ͅ੮ɺʇ;˺˦ʁ੮͐ʩʇ੮ϲʮ̼͐ͅ੮ʠʇ͸੮ʁɘ;ͅੴ੮˚;੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ ͙ͅʡʡʇ͐ͅʇʁ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺ɺɘɺʮˑʮ͐ʮʇͅ੮ϲˑʮ̹ੳ੮)̼ੳ੮Ĕɘʡ˦ʇ̼੮̼ʇ̹˺̼͐ʇʁੴ੮ુUʠ੮ͅ˺˚ʇ˺˦ʇ੮ʩɘʁ੮ɘ੮˦ʇɘ̼੮ ˑʇ͐ʩɘˑ੮ય͙ͅʮɻʮʁʇર੮ɘ͐͐ʇ˚̹͐੯ੳ੯ੳ੯ੳ੮U੮ʁ˺˦ૄ͐੮͐ʩʮ˦ˌ੮˺˦ʇ੮ʁɘ;੮˺ʠ੮˦˺͐੮ɺʇʮ˦ʡ੮͙ͅʮɻʮʁɘˑ੮ʮͅ੮ʇ˦˺͙ʡʩੳ੮ "͙͐੮ͅ˺˚ʇ੮ʮ˦͙̼ͅɘ˦ɻʇ੮ɻ˺˚̹ɘ˦ʮʇͅ੮͸ʮˑˑ੮ͅɘ;ੴ੮ૃUʠ੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮͙ͅʮɻʮʁɘˑ੮͐˺ʁɘ;ੴ੮͐ʩʇ;੮˦ʇʇʁ੮͐˺੮ ʡ˺ੳૄૂ੮ä˺˚ʇ˺˦ʇૄͅ੮ɘɻ͙͐ʇ੮̼ʮͅˌ੮͐˺੮ͅʇˑʠ੮˚ʮʡʩ͐੮ɺʇ੮ή͙ʮɻˌˑ;੮ɻɘˑ˚ʇʁ੮˺˦੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐ੳ੮ Someone’s chronic inability to care for themselves, maybe less so.

DISCHARGING THE GRAVELY DISABLED ૃîʩɘ͐੯ੳ੯ੳ੯ੳ੮ɻɘ˦ૄ͐੮ɺʇ੮̹˺ͅͅʮɺˑʇੳૄ Dr. Cai, my host on a tour of the psychiatry unit in a county hospital, is lookʮ˦ʡ੮ɘ͐੮ɘ੮͸ʩʮ͐ʇɺ˺ɘ̼ʁ੮ˑʮ͐ͅʮ˦ʡ੮͙̹ɻ˺˚ʮ˦ʡ੮ʁʮͅɻʩɘ̼ʡʇͅ੮ʠ̼˺˚੮ʩʇ̼੮͐͸ʇ˦͐;ચϲʮͷʇચɺʇʁ੮͙˦ʮ͐ੳ੮ There’s only one name written. Her cry of dismay suggests that the implications are dire. There’s an ER full of patients downstairs waiting to be brought upstairs, ɺ͙͐੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑૄͅ੮ ુɺʇʁ੮ ϲˑ˺͸ૂઝɻ˺˦͙ͅˑ͐ɘ˦͐ચ̹ͅʇɘˌ੮ ʠ˺̼੮ ͐ʩʇ੮ ͅ˚˺˺͐ʩ੮ ɺɘˑɘ˦ɻʮ˦ʡ੮ ˺ʠ੮ admissions and discharges—has slowed to a trickle.ৼ਄ How is this possible in a ͅ;͐ͅʇ˚੮˺ʠ੮̼ʇˑʇ˦͐ˑʇͅͅ੮̹̼ʇ͙̼ͅͅʇ੮͐˺੮ʡʇ͐੮̹ɘ͐ʮʇ˦͐ͅ੮˺͙͐੮ɘͅ੮ή͙ʮɻˌˑ;੮ɘͅ੮̹˺ͅͅʮɺˑʇ੺ The paradox, Dr. Cai explains, is that while her unit and the one next door ʩɘͷʇ੮ϲʮʠ͐;੮ɺʇʁͅ੮ɺʇ͐͸ʇʇ˦੮͐ʩʇ˚ੴ੮˺˦ˑ;੮͐ʇ˦੮͐˺੮͐͸ʇˑͷʇ੮ɘ̼ʇ੮ુʮ˦੮̹ˑɘ;ૂ੮ɘ͐੮ɘ˦;੮͐ʮ˚ʇੳ੮îʩʇ੮ rest are occupied by patients who are, in effect, living there. There’s a woman with developmental disabilities whose family won’t take her back and whose application has been refused by every step-down program around. A younger man with a degenerative neurological condition ‘doesn’t really have a severe

92

T H E C O N S E RVATO R S H I P C O N T I N U U M

mental illness’ but has been here for three years ‘because he can’t be managed by a nursing home.’ Ditto for a woman with dementia: ‘I don’t really know why she’s on psychiatry,’ except that she keeps falling and needing to go to the medical hospital, so it’s easier to keep her nearby. These patients are gravely disabled because no one outside the hospital is willing to feed, clothe, and shelter them. Dr. Cai is facing a problem as old as psychiatric hospitals themselves. In the nineteenth century, state asylum superintendents complained that, even though they “cured” most patients rapidly, their facilities were nonetheless gradually “silting up” with intractable cases.৽৻ They argued for greater funding from state legislatures to expand their buildings or, absent that, simply crammed two or three times as many patients into wards as they were designed for. Neither option is available to Dr. Cai. Even as insurance companies have driven private hospitals to close, county governments have subjected public hospitals to harsh austerity. Her facility lost half its psychiatric beds in the Great Recession.৽ৼ Many rooms ɘˑ̼ʇɘʁ;੮ʩɘͷʇ੮͐ʩ̼ʇʇ੮̹ɘ͐ʮʇ˦͐ͅ੮ͅˑʇʇ̹ʮ˦ʡ੮ʮ˦੮͐ʩʇ˚ੳ੮ä˺੮͐ʩʇ੮ͅ˺ˑ͙͐ʮ˺˦੮ʮͅ੮͐˺੮ϲʮ˦ʁ੮ɘ੮͸ɘ;੮͐˺੮ declare patients no longer gravely disabled and to discharge them. Discharge planning starts at day one of an admission. According to Jess, an inpatient social worker, the hospital begins at the same time to “push back” on anyone who would like to see a person conserved. The easiest option is to return someone to wherever they came from—even if that homeless shelter, board and care home, or family was the one begging for the person to be admitted. Devon, a social worker in a supported housing complex, occasionally writes ৵ৱ৵ৰ੮ ʩ˺ˑʁͅ੮ ˺˦੮ ̼ʇͅʮʁʇ˦͐ͅ੮ ͸ʩ˺ͅʇ੮ ʩ˺˚ʇͅ੮ ɘ̼ʇ੮ ˺ͷʇ̼ϲˑ˺͸ʮ˦ʡ੮ ͸ʮ͐ʩ੮ ʡɘ̼ɺɘʡʇ੮ ɘ˦ʁ੮ ʠʇɻʇͅੳ੮ äʩʇૄˑˑ੮ɻɘˑˑ੮ʩʇ̼੮ʮ˦̹ɘ͐ʮʇ˦͐੮ʇή͙ʮͷɘˑʇ˦͐੮͐˺੮̼͐;੮͐˺੮̹̼ʇ͙̼ͅͅʇ੮͐ʩʇ˚੮͐˺੮ˌʇʇ̹੮ɘ੮̼ʇͅʮʁʇ˦͐੮ˑ˺˦ʡʇ̼ੴ੮ɺ͙͐੮ʮ͐੮˺ʠ͐ʇ˦੮ɺɘɻˌϲʮ̼ʇͅੵ੮ુUૄ˚੮ͅʩ˺˺͐ʮ˦ʡ੮˚;ͅʇˑʠ੮ʮ˦੮͐ʩʇ੮ʠ˺˺͐੮ͅɘ;ʮ˦ʡੴ੮ૃUૄ˚੮ɘ੮ˑʮɻʇ˦ͅʇʁ੮ mental health provider and I’m on their care team [in housing],’ because they’ll say, ‘Well, they have someone looking out for them, they have a key, that’s a safe discharge plan, send them home.’”৽৽ "˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ʩ˺˚ʇͅ੮ ˺̼੮ ʠɘ˚ʮˑʮʇͅ੮ ɻɘ˦੮ ̼ʇʠ͙ͅʇ੮ ͐˺੮ ͐ɘˌʇ੮ ̹ʇ˺̹ˑʇ੮ ɺɘɻˌੳ੮ îʩʮͅ੮ creates—like so many places in the conservatorship continuum—a back-andforth between agencies and providers all claiming they’re not the right setting for a complex case. Dr. Cai sees it this way: ‘We’re really the only people who don’t say no. Shelters say no, IMDs [locked step-down units] say no, SRO યͅʮ˦ʡˑʇચ̼˺˺˚੮˺ɻɻ͙̹ɘ˦ɻ;ર੮ʩ˺͐ʇˑͅ੮ͅɘ;੮˦˺ੳ੮Ĕʩʇ˦੮͸ʇ੮̼͐;੮͐˺੮ʁʮͅɻʩɘ̼ʡʇੴ੮͸ʇ੮ʡʇ͐੮ɘ੮ɺʮʡ੮‡ણšੳૄ੮ As for those same entities’ complaints that hospitals also say “no” to admitting

I N PAT I E N T

93

͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮ɘˑˑ੮͐ʩʇ੮͐ʮ˚ʇ੺੮äʩʇ੮̹˺ʮ˦͐ͅ੮˺͙͐ੴ੮ૃU͐ૄͅ੮ˑʮˌʇ੮I̼ɘ˦ʁ੮#ʇ˦̼͐ɘˑ੮ä͐ɘ͐ʮ˺˦ੳ੮Uʠ੮;˺͙੮ ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ˦;੮̼͐ɘʮ˦ͅ੮ʡ˺ʮ˦ʡ੮˺͙͐ੴ੮ʩ˺͸੮ɻɘ˦੮;˺͙੮ʩɘͷʇ੮˚˺̼ʇ੮̼͐ɘʮ˦ͅ੮ɻ˺˚ʮ˦ʡ੮ʮ˦੺ૄ A few years ago, these kinds of disputes might have been resolved by simply dumping patients on the street. California lawmakers have tried to crack down ˺˦੮͐ʩʇ੮̹̼ɘɻ͐ʮɻʇੳ੮੮৲ৰৱ৸੮ˑɘ͸੮̼ʇή͙ʮ̼ʇͅ੮͐ʩɘ͐੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɻ˺˦˦ʇɻ͐੮ʩ˺˚ʇˑʇͅͅ੮̹ɘ͐ʮʇ˦͐ͅ੮͐˺੮ “community resources, treatment, shelter, and other supportive services” that have “agreed to accept the homeless patient.”৽৾ Another discharge social worker I spoke to told me she likes the law: “it gives us guidelines, as a universal, ‘these are the bare minimum things that people concretely need in their lives when they ˑʇɘͷʇ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૄૂ੮"͙͐੮͐ʩʇ੮ɺɘ̼ʇ੮˚ʮ˦ʮ˚͙˚੮ɻɘ˦੮ɺʇੴ੮͸ʇˑˑੴ੮̼ʇɘˑˑ;੮˚ʮ˦ʮ˚ɘˑੵ੮ʮ˦੮ͅ˺˚ʇ੮ cases, it might be “just an overnight chair” in a shelter “and they have to leave in the morning.” Of course, patients have to actually agree to accept the resources proposed by that plan, which many don’t. Jess told me she had recently discharged someone from a 5150 “with no follow-up appointments or linkages.” The client’s plan for ͅʇˑʠચɻɘ̼ʇ੮͸ɘͅ੮ુ͐˺੮͐ɘˌʇ੮"Ûî੮ય"ɘ;੮̼ʇɘ੮Ûɘ̹ʮʁ੮î̼ɘ˦ͅʮ͐ર੮͐˺੮ˑʮͷʇ੮ʮ˦੮Øʇ˺̹ˑʇૄͅ੮Øɘ̼ˌ੮ʮ˦੮ "ʇ̼ˌʇˑʇ;ੴ੮͐ͅʇɘˑ੮ɻˑ˺͐ʩʇͅ੮ʠ̼˺˚੮îɘ̼ʡʇ͐ੴ੮ɘ˦ʁ੮ʡ˺੮͐˺੮ɘ੮ʠ̼ʇʇ੮ɺ̼ʇɘˌʠɘ͐ͅ੮ˑ˺ɻɘ͐ʮ˺˦੮ʁ˺͸˦੮͐ʩʇ੮ street.” Compared to many discharge plans she hears, it sounded “pretty fair and reasonable,” which to her shows how low the bar for a “safe” discharge has fallen. Even with the law in effect, one recent study found that more than half of psychiatric inpatients in one Los Angeles hospital who were homeless when admitted were homeless upon discharge.৽৿ There’s one other way to get patients out, even when their previous shelter is refusing to take them back or the patient is holding out for a new housing ˺̹͐ʮ˺˦ੳ੮ îʩʇ੮ ˺̼ʮʡʮ˦ɘˑ੮ rØä੮ ɻ͐੮ ʡɘͷʇ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ͐ʩʇ੮ ̼ʮʡʩ͐੮ ͐˺੮ ϲʮˑʇ੮ ɘ੮ ͸̼ʮ͐੮ ˺ʠ੮ ʩɘɺʇɘͅ੮ corpus to ask a judge to be released from the hospital during a fourteen-day ৵৲৵ৰੳ੮U͐੮ʁʮʁ˦ૄ͐੮̼ʇή͙ʮ̼ʇ੮ɘ੮ʩʇɘ̼ʮ˦ʡ੮ʮʠ੮̹ɘ͐ʮʇ˦͐ͅ੮ʁʮʁ˦ૄ͐੮ɘͅˌ੮ʠ˺̼੮˺˦ʇੳ੮"͙͐੮ʮ˦੮ৱ৹৷৹ੴ੮ɘ੮r˺ͅ੮ ˦ʡʇˑʇͅ੮)ʮ̼͐ͅʮɻ͐੮#˺͙̼͐ੴ੮ˑɘ͐ʇ̼੮ɺɘɻˌʇʁ੮͙̹੮ɺ;੮͐ʩʇ੮‡ʮ˦͐ʩ੮#ʮ̼ɻ͙ʮ͐ੴ੮̼͙ˑʇʁ੮͐ʩɘ͐੮ɻ˺˦ϲʮ˦ʇment without judicial review was unconstitutional. Doe v. Gallinot੮̼ʇή͙ʮ̼ʇͅ੮͐ʩɘ͐੮ all patients on a fourteen-day 5250 have a hearing within four days to determine if there is “probable cause” for their continued detention.৽਀ This new intrusion of law into the realm of medicine may not have been as ͅʮʡ˦ʮϲʮɻɘ˦͐੮ɘͅ੮ʮ͐੮ͅ˺͙˦ʁͅੳ੮H˺̼੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ͅʩ˺͸ʮ˦ʡ੮ુ̹̼˺ɺɘɺˑʇ੮ɻɘ͙ͅʇૂ੮ʮͅ੮ɘ੮ˑ˺͸੮ɺɘ̼ੳ৽ਁ The ̹ɘ͐ʮʇ˦͐ͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮ʁʮʁ੮˦˺͐੮ϲʮ˦ʁ੮͐ʩʇͅʇ੮ʩʇɘ̼ʮ˦ʡͅ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮̼ʮʡ˺̼˺͙ͅੳ੮U˦ʁʮͷʮʁ͙ɘˑͅ੮ɘ̼ʇ੮ represented by a patients’ rights advocate, not an attorney, and heard by a hearing ˺ϲϲʮɻʇ̼ੴ੮˦˺͐੮ɘ੮ˈ͙ʁʡʇੴ੮͸ʩ˺੮ʮͅ੮ˑɘ̼ʡʇˑ;੮͙˦ɺ˺͙˦ʁ੮ɺ;੮͐ͅɘ˦ʁɘ̼ʁ੮ˑʇʡɘˑ੮̼͙ˑʇͅ੮˺ʠ੮ʇͷʮʁʇ˦ɻʇੳ

94

T H E C O N S E RVATO R S H I P C O N T I N U U M

"͙͐੮Doe v. Gallinot did create a new discharge option. Jess explained that hospitals can “throw” hearings by choosing not to present evidence that a person meets grave disability criteria. Hospitals can also opt not to discredit a patient’s plan for providing food, clothing, and shelter that is more grounded in delusions than reality.৽ਂ Jess elaborated: “The doctor doesn’t think there’s any point in keeping them, and it’s much easier to have [the patient] win their probable cause hearing because the psychiatrist can’t be held accountable for what hap̹ʇ˦ͅ੮˦ʇͽ͐ੴ੮ʮ͐ૄͅ੮˦˺͐੮˺˦੮͐ʩʇʮ̼੮ˑʮɻʇ˦ͅʇੴ੮ʮ͐ૄͅ੮˦˺͐੮˺˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૂ੮੮ʩʇɘ̼ʮ˦ʡ੮˺ϲϲʮɻʇ̼੮ U੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ ɻ˺˦ɻ͙̼̼ʇʁ੮ ͐ʩɘ͐੮ ͐ʩʮͅ੮ ુʁʇϲʮ˦ʮ͐ʇˑ;ૂ੮ ʩɘ̹̹ʇ˦ʇʁੴ੮ ̹˺ʮ˦͐ʮ˦ʡ੮ ˺͙͐ੵ੮ ુ̹̼ʇ͐͐;੮ ˚͙ɻʩ੮ɘˑˑ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮U੮ͅʇʇ੮͸˺͙ˑʁ੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ય˚˺̼ʇર੮̼͐ʇɘ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ɺ͙͐੮˚˺͐ͅ੮˺ʠ੮ ͐ʩʇ੮͐ʮ˚ʇੴ੮ʮ͐ૄͅ੮˦˺͐੮ʮ˦੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ૄͅ੮ɺʇ͐ͅ੮ʮ˦͐ʇ̼ʇ͐ͅ੮ϲʮ˦ɘ˦ɻʮɘˑˑ;੮͐˺੮ˌʇʇ̹੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ੳૂ Losing probable cause hearings solves multiple problems for hospitals. Dr. Cai tells me that when COVID shut down many of the housing and social service providers hospitals typically rely on,৽ਃ discharges by the courts became one of ͐ʩʇ੮ɺʮʡʡʇ͐ͅ੮͸ɘ;ͅ੮͐˺੮ʡʇ͐੮̹ɘ͐ʮʇ˦͐੮ુϲˑ˺͸ੳૂ੮îʩ˺ͅʇ੮͸ʮ˦˦ʮ˦ʡ੮ɘ੮ʩʇɘ̼ʮ˦ʡ੮͐ʇɻʩ˦ʮɻɘˑˑ;੮ˑʇɘͷʇ੮ ુɘʡɘʮ˦͐ͅ੮˚ʇʁʮɻɘˑ੮ɘʁͷʮɻʇੴૂ੮͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮͅ੮˦˺੮ˑ˺˦ʡʇ̼੮̼ʇή͙ʮ̼ʇʁ੮͐˺੮ͅʇ͐੮͙̹੮ outpatient care or shelter on their behalf. That, Jess claimed, helps account for why you still see people dumped on the hospital sidewalk with a plastic bag of belongings, in an era when patient dumping is supposed to be illegal. There’s no evidence of how common thrown hearings are (although they’re common enough that in San Francisco they have a moniker, “Cindy Lei hearʮ˦ʡͅੴૂ੮ɘʠ͐ʇ̼੮ɘ੮ʁ˺ɻ͐˺̼੮͸ʩ˺੮͙̹̹ͅ˺ͅʇʁˑ;੮̹ʇ̼ʠʇɻ͐ʇʁ੮͐ʩʇ੮̹̼ɘɻ͐ʮɻʇબੳ੮"͙͐੮͐ʩʇ;੮ɘ̼ʇ੮̼ʇͷʇɘˑing. Sometimes law and medicine are neither conspiring to control patients ˦˺̼੮ʮ˦੮ɻ˺˦ϲˑʮɻ͐੮˺ͷʇ̼੮͐ʩʇ੮̹̼ʮ˺̼ʮ͐;੮˺ʠ੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇ੮ͷʇ̼͙ͅͅ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੳ੮Ûɘ͐ʩʇ̼ੴ੮ʮ˦੮ some cases, medicine leverages the legal procedures that are supposed to protect patients in order to release them. The sovereign power LPS grants hospitals over people with grave disabilities is power that hospitals actively abdicate.

OUTSOURCING REFERRALS ˑˑ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʠɘɻʇ੮ʮ˦͐ʇ˦ͅʇ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ʁʮͅʮ˦ɻʇ˦͐ʮͷʇͅ੮͐˺੮ˌʇʇ̹ʮ˦ʡ੮̹ɘ͐ʮʇ˦͐ͅ੮ʠ˺̼੮ɘ੮ˑ˺˦ʡ੮ ̹ʇ̼ʮ˺ʁ੮˺ʠ੮͐ʮ˚ʇੳ੮"͙͐੮ɘͅ੮Øʩʮˑੴ੮͐ʩʇ੮ʠɘ͐ʩʇ̼੮˺ʠ੮ɘ੮͐ʩʮ̼͐;ચ;ʇɘ̼ચ˺ˑʁ੮ͅ˺˦੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺ɘʠʠʇɻtive disorder living in Los Angeles, learned, who owns the hospital shapes how much sway those disincentives have over psychiatrists’ decisions to apply for a conservatorship.

I N PAT I E N T

95

ʠ͐ʇ̼੮ɘ੮ϲʮ̼͐ͅ੮৵ৱ৵ৰੴ੮Øʩʮˑૄͅ੮ͅ˺˦੮kɘɻ˺ɺ੮͐ͅɘ;ʇʁ੮ʠ˺̼੮ɘ੮˚˺˦͐ʩ੮ʮ˦੮ɘ੮˦˺˦̹̼˺ϲʮ͐੮ʩ˺̹ͅʮ͐ɘˑੳ੮ He recalled, “That was the best psychiatrist he’s had, a Russian guy, and he told me, ‘Your son may never be back to what you think is normal, but we’re going ͐˺੮ʁ˺੮͐ʩʇ੮ɺʇ͐ͅ੮͸ʇ੮ɻɘ˦ੳૄૂ੮Pʮͅ੮ͅ˺˦੮͸ɘͅ੮̼ʇˑʇɘͅʇʁ੮˺˦੮˺̼ɘˑ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ή͙ʮ͐੮͐ɘˌʮ˦ʡ੮ʮ͐ੴ੮ and launched into a chaotic period during which he was hospitalized four more times, each in a different private facility. Phil (like Michael and Julie, in chapter 1) ͐ͅɘ̼͐ʇʁ੮͐ɘˌʮ˦ʡ੮ɻˑɘͅͅʇͅ੮͸ʮ͐ʩ੮͐ʩʇ੮ˑ˺ɻɘˑ੮‡{U੮ɘϲϲʮˑʮɘ͐ʇ੮ɘ˦ʁ੮ɻ˺˦ͷʮ˦ɻʇʁ੮ʩʮ˚ͅʇˑʠ੮͐ʩɘ͐੮ his son needed a conservatorship: “What I learned is that every psychotic episode almost fries the brain. It’s like shooting up a lot of heroin. That’s why the sooner a patient is taken care of, the better, and that’s not done in the current system unless you have a conservatorship.” Phil’s pleas to the inpatient psychiatrists, though, were in vain: “On the third hospitalization, I called every day to talk to my son’s psychiatrist, and I never could get him to talk to me.” On the fourth, he cornered a psychiatrist in the hall͸ɘ;ੴ੮ɺ͙͐੮̼ʇɻʇʮͷʇʁ੮ɘ੮ϲˑɘ͐੮ુ˦˺ૂ੮͸ʩʇ˦੮ʩʇ੮ɘͅˌʇʁ੮ʩʮ˚੮͐˺੮ɘ̹̹ˑ;੮ʠ˺̼੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ Øʩʮˑ੮ͅʇʇ˚ʇʁ੮͐˺੮ʩɘͷʇ੮ɺʇ͐͐ʇ̼੮ˑ͙ɻˌ੮˺˦੮͐ʩʇ੮ϲʮʠ͐ʩ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮ʮ˦੮ɘ੮ͅ˚ɘˑˑ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ facility. A month in, “he [the psychiatrist] calls me in, and says ‘What do you ͐ʩʮ˦ˌ੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ʩɘ̹̹ʇ˦੮͸ʩʇ˦੮ʩʇૄͅ੮ʁʮͅɻʩɘ̼ʡʇʁ੺ૄ੮˦ʁ੮U੮ͅɘʮʁੴ੮ૃšʩੴ੮ʩʇૄˑˑ੮̹̼˺ɺɘɺˑ;੮ be okay for a few months, and then he’ll be hospitalized again.’ And he said, ‘It’s worse than that. Your son has a good probability he’ll die.’” Phil reiterated his plea for a conservatorship, adding “He’s not welcome back at my home.” Phil had learned from NAMI that refusing to take a family member back is one strategy to force the doctor’s hand. The doctor replied, “I’ll work on it.” It didn’t pan out. A few days later, he received a call that Jacob was being ʁʮͅɻʩɘ̼ʡʇʁੳ੮ Øʩʮˑ੮ ʩɘʁ੮ ˦˺੮ ʁ˺͙ɺ͐ͅ੮ ɘɺ˺͙͐੮ ͸ʩɘ͐੮ ͸ɘͅ੮ ɺʇʩʮ˦ʁ੮ ͐ʩʇ੮ ʁʇɻʮͅʮ˺˦ੵ੮ ુ"ɘͅʮɻɘˑˑ;ੴ੮ʮ͐ૄͅ੮ɻ˺͐ͅੳ੮Ĕʩʇ˦੮ɘ੮̹ɘ͐ʮʇ˦͐੮ϲʮ̼͐ͅ੮ɻʩʇɻˌͅ੮ʮ˦ੴ੮͐ʩʇ;੮ʡʇ͐੮̼ʇʮ˚ɺ͙̼ͅʇʁ੮ɘ੮͙ͅɺ͐ͅɘ˦͐ʮɘˑ੮ ɘ˚˺͙˦͐ੳ੯ੳ੯ੳ੯ੳ੮"͙͐੮ɘʠ͐ʇ̼੮ɘ੮ʠʇ͸੮͸ʇʇˌͅੴ੮͐ʩɘ͐੮ʡ˺ʇͅ੮ʁ˺͸˦ੳ੮îʩʇ;੮યʩ˺̹ͅʮ͐ɘˑͅર੮͸˺͙ˑʁ੮̼ɘ͐ʩʇ̼੮ have new people coming in because they make more money. I have argued the point, ‘Isn’t one good long hospitalization better than seven or twenty short hos̹ʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੺ૄ੮˦ʁ੮͐ʩʇ;੮ͅɘʮʁੴ੮ૃĚʇͅੴ੮ɺ͙͐੮͐ʩɘ͐ૄͅ੮˦˺͐੮͐ʩʇ੮͸ɘ;੮ʮ͐੮͸˺̼ˌͅੳૄૂ੮Pʇૄͅ੮̼ʮʡʩ͐ੳ੮ To be fully reimbursed by Medi-Cal, a hospital needs to convince the county mental health department that a patient meets strict “medical necessity” criteria.৽਄ Once someone no longer meets this standard, the hospital may be paid only an “administrative” rate that is hundreds of dollars a day lower.৾৻ Or the county might refuse to pay entirely. A patient stuck four months waiting for a conservatorship and a step-down placement could represent a loss of more than $20,000.

96

T H E C O N S E RVATO R S H I P C O N T I N U U M

It’s unsurprising that Jacob’s hospitalizations were all in private facilities. Eighty percent of acute-care beds in the state are in private hospitals, and half ɘ̼ʇ੮ʮ˦੮ʠ˺̼ચ̹̼˺ϲʮ͐੮˺˦ʇͅੳ৾ৼ In theory, explained Dr. Rod Shaner, the former medical director of Los Angeles County’s Department of Mental Health, this improves ͐ʩʇ੮ή͙ɘˑʮ͐;੮˺ʠ੮ɻɘ̼ʇੴ੮ɘͅ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɻ˺˚̹ʇ͐ʇ੮ʠ˺̼੮ɻ˺˦̼͐ɘɻ͐ͅ੮͐˺੮͐ɘˌʇ੮ɻ˺͙˦͐;੮̹ɘ͐ʮʇ˦͐ͅੳ੮U˦੮ practice, he said, a dearth of beds makes it hard for the county to actually impose ή͙ɘˑʮ͐;੮ɻ˺˦̼͐˺ˑͅੳ It’s particularly hard, he opined, to get private facilities to make conservatorship applications, even when it’s clinically indicated. In Los Angeles, 54 percent ˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɺʇʁͅ੮ɘ̼ʇ੮ʮ˦੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʠɘɻʮˑʮ͐ʮʇͅੴ੮ɺ͙͐੮͐ʩʇ;੮˚ɘˌʇ੮˺˦ˑ;੮৲৲੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ conservatorship applications. Only 12 percent of LA’s beds are in county hospi͐ɘˑͅੴ੮ɺ͙͐੮͐ʩʇ;੮̹̼˺ʁ͙ɻʇ੮৳৹੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ફͅʇʇ੮ϲʮʡ͙̼ʇ੮৴ੳৱબੳ৾৽ The pattern holds across three other counties that provided me with data. One county public guardian looking at these numbers told me, “There are [private] facilities that can do involuntary holds, and they don’t do a single referral [to conservatorship] ʮ˦੮͐ʩʇ੮ʇ˦͐ʮ̼ʇ੮;ʇɘ̼ੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ɘ̼ʇ੮ɘʁ˚ʮ͐͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮˺˦੮৵ৱ৵ৰͅੴ੮͐ʩʇ;੮ɘ̼ʇ੮ʩ˺ˑʁʮ˦ʡ੮͐ʩʇ˚੮ ɘͅ੮ ˑ˺˦ʡ੮ ɘͅ੮ ͐ʩʇ;੮ ɘ̼ʇ੮ ʡʇ͐͐ʮ˦ʡ੮ ̹ɘʮʁ੮ ˺˦੮ ͐ʩʇ੮ યɘɻ͙͐ʇર੮ {ʇʁʮચ#ɘˑ੮ ̼ɘ͐ʇ੯ ੳ੯ ੳ੯ ੳ੮ ɺ͙͐੮ ɘͅ੮ ͅ˺˺˦੮ ɘͅ੮ͅ˺˚ʇ˺˦ʇ੮˦˺੮ˑ˺˦ʡʇ̼੮˚ʇʇ͐ͅ੮ૃ˚ʇʁʮɻɘˑ੮˦ʇɻʇͅͅʮ͐;ੴૄ੮͐ʩʇ;੮ɘ̼ʇ੮ʁʮͅɻʩɘ̼ʡʮ˦ʡ੮͐ʩʇ˚ੳ੯ੳ੯ੳ੯ੳ੮ Ě˺͙ૄ̼ʇ੮ͅʇʇʮ˦ʡ੮͐ʩ˺ͅʇ੮̹ʇ˺̹ˑʇ੮ɻ;ɻˑʮ˦ʡ੮ɺɘɻˌ੮ʮ˦͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮˺˦੮ɘ੮ʠ̼ʇή͙ʇ˦͐੮ɺɘͅʮͅੳૂ৾৾ Just like Phil’s son.

60 Beds Conservatorship applications

Percentage of beds/referrals

50 40 30 20 10 0

For-profit

Non-profit

County

Federal (VA)

4.1 Conservatorship applications in Los Angeles, by hospital ownership, 2021 Sourceੵ੮r੮šϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੶੮#ɘˑʮʠ˺̼˦ʮɘ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ͷʮɻʇͅ

I N PAT I E N T

97

Public hospitals also lose money on conservatorships. From 2016 to 2018, psyɻʩʮɘ̼͐ʮɻ੮ɺʇʁͅ੮ɘ͐੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮Iʇ˦ʇ̼ɘˑੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ʇ̼ʇ੮ϲʮˑˑʇʁ੮৷৹੮̹ʇ̼cent of the time by people whose care was not fully reimbursed as “acute.” It cost $21.4 million a year to pay for individuals who were occupying scarce beds not because they needed hospital care, but because they were waiting for a conserͷɘ͐˺̼ͅʩʮ̹੮˺̼੮͙ͅɺͅʇή͙ʇ˦͐੮̹ˑɘɻʇ˚ʇ˦͐ੳ৾৿੮"͙͐੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮͙˦ʁʇ̼੮̹̼ʇ͙̼ͅͅʇ੮ʠ̼˺˚੮ county supervisors, who themselves might be under pressure from parents with the resources and wherewithal to harangue them, are more willing to eat the ϲʮ˦ɘ˦ɻʮɘˑ੮ˑ˺ͅͅ੮͐ʩɘ͐੮ɻ˺˚ʇͅ੮ʠ̼˺˚੮ɘ̹̹ˑ;ʮ˦ʡ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ৾਀ In private hospitals, the pressure goes the other way.৾ਁ Matt, the resident introduced in the previous chapter, recounted, “In [hospital], if you want to conserve someone, you have to present the case to the ‘conservatorship committee,’ and ͐ʩʇ;੮˚ɘˌʇ੮͐ʩʇ੮ʁʇɻʮͅʮ˺˦੯ੳ੯ੳ੯ੳ੮͸ʮ͐ʩ੮͐ʩʇ੮ˌ˦˺͸ˑʇʁʡʇ੮͐ʩɘ͐੮͐ʩʇ;ૄˑˑ੮ͅʮ͐੮ʮ˦੮ɘ੮ɺʇʁ੮ʠ˺̼੮ʩ˺͸ever many months, and not allow the hospital to make money on that bed. So the ɻ˺˚˚ʮ͐͐ʇʇ੮ˈ͙͐ͅ੮ʁʇ˦ʮʇͅ੮ʇͷʇ̼;͐ʩʮ˦ʡੳ੯ੳ੯ੳ੯ੳ੮ય#ˑʮ˦ʮɻʮɘ˦ͅર੮ˌ˦˺͸੮͐ʩɘ͐੮ʮ͐ૄͅ੮˦˺͐੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ solution, you have to discharge.” While there’s ample debate about whether private or public facilities deliver better care, what’s clear is that the “social control function” of a hospital—that is, whether it will continue to coerce and constrain a person past the point where doing so is lucrative—depends on who owns it.৾ਂ Public authorities do have some leverage. After learning his son would be imminently discharged—only a week after being informed that, absent a conservatorship, he would die—Phil made a phone call to Dr. Shaner, whom he had met through NAMI. Dr. Shaner, in Phil’s retelling, warned the hospital that he could yank their authorization to take involuntary patients if they didn’t make an application. When I talked to Dr. Shaner, we didn’t discuss this speɻʮϲʮɻ੮ɻɘͅʇੴ੮ɺ͙͐੮ʩʇ੮ɻ˺˦ϲʮ̼˚ʇʁ੮ʮ͐ૄͅ੮ɘ੮̼ʇɘˑ੮ʮʠ੮̼ɘ̼ʇˑ;੮͙ͅʇʁ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮̹̼ʇ̼˺ʡɘ͐ʮͷʇੳ੮Pʇ੮ explained, “The regulations give county mental health directors a tremendous amount of discretion about who is designated [to take LPS patients].” He went on, “So, at times, we would get complaints”—for example, from parents like Phil or county supervisors—“and we would go to those hospitals and remind them of their responsibilities as a designated hospital to be referring anyone that meets criteria [for a conservatorship.]”৾ਃ What Dr. Shaner did was a risky gambit. Some private hospitals have deliberately dropped their LPS designation so that they can focus on voluntary patients with private insurance.৾਄ Dr. Shaner knew LA County couldn’t afford to lose any more beds for involuntary patients on MediCal. “Our bark was always worse than our bite,” he admitted.

98

T H E C O N S E RVATO R S H I P C O N T I N U U M

In this case, though, it worked. The hospital applied, Phil’s son was conserved, and he was sent to a state hospital for half a year before being discharged back home. It’s not a happy ending. For Phil, schizoaffective disorder had not so much ɘϲϲˑʮɻ͐ʇʁ੮kɘɻ˺ɺ੮ɘͅ੮ʮ͐੮̼ʇ̹ˑɘɻʇʁ੮ʩʮ˚੮͸ʮ͐ʩ੮ɘ੮˦ʇ͸੮̹ʇ̼ͅ˺˦ੵ੮ુͅ੮ɘ੮ˌʮʁ੮ʩʇ੮͸ɘͅ੮͐ʩʇ੮ͅ˚ɘ̼͐ʇ͐ͅ੮ in the class, but now, he’s just sitting in a chair in his room. Doesn’t have the TV on, doesn’t read, just sits. I ask him what’s going on, and he just looks at me.” At least now Phil can make sure he gets his monthly antipsychotic injection. Phil is conͷʮ˦ɻʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩɘͅ੮ˌʇ̹͐੮kɘɻ˺ɺ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ʠ˺͙̼੮;ʇɘ̼ͅੳ੮"͙͐੮ʡʇ͐ting it exposed how, in California’s delegated hospital system, the market trumps medicine—except when the state exercises the authority it has but rarely uses.

THE LAST RESORT ? The headwinds to applying for conservatorship are strong. Some inpatient psyɻʩʮɘ̼͐ʮ͐ͅͅ੮ɘ̹̹ˑ;੮ɘ˦;͸ɘ;ੳ੮Ĕʩʇ˦੺੮‡˺੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ʩɘͅ੮ʇͷʇ̼੮ɘ˦ͅ͸ʇ̼ʇʁ੮͐ʩʮͅ੮ή͙ʇ͐ͅʮ˺˦੮ ɺ;੮ ή͙˺͐ʮ˦ʡ੮ ͐ʩʇ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ Ĕʇˑʠɘ̼ʇ੮ ɘ˦ʁ੮ U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ #˺ʁʇૄͅ੮ ʁʇϲʮ˦ʮ͐ʮ˺˦੮ ˺ʠ੮ ʡ̼ɘͷʇ੮ disability back to me. “The Code” is not an “external authority,” an abstract ʠ˺̼ɻʇઝˑʮˌʇ੮͐ʩʇ੮"ʮɺˑʇઝ͐ʩɘ͐੮ʡʮͷʇͅ੮ુʇͽɻˑ͙ͅʮ˺˦ɘ̼;੮̼ʇɘͅ˺˦ͅૂ੮͐ʩɘ͐੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ʠʇʇˑ੮ɻ˺˚pelled to follow.৿৻੮îʩʇ੮#˺ʁʇ੮ͅʇ͐ͅ੮͸ʩʇ˦੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ʮͅ੮ɘˑˑ˺͸ʇʁ੮͐˺੮ϲʮˑʇ੮ɘ˦੮ɘ̹̹ˑʮcation but creates no obligation to do so. So psychiatrists, like other street-level bureaucrats, make decisions that balance their professional ethos with an awareness that there are invariably more people who meet the grave disability criterion than there are resources to conserve them. Given that a conservatorship is the most restrictive way to keep treating someone (outside of a prison, perhaps), we should be relieved that it’s not the ϲʮ̼͐ͅ੮ ͐˺˺ˑ੮ ʠ˺̼੮ ͸ʩʮɻʩ੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ ̼ʇɘɻʩੳ੮ )̼ੳ੮ Ĕɘʡ˦ʇ̼੮ ʇͽ̹ˑɘʮ˦ʇʁ੮ ʠ˺̼੮ ͸ʩ˺˚੮ ʩʇૄʁ੮ ɘ̹̹ˑ;੮ɺ;੮͐ʮɻˌʮ˦ʡ੮˺ʠʠ੮͸ʩɘ͐੮ʩʇ੮͸˺͙ˑʁ੮̼͐;੮ϲʮ̼͐ͅੵ੮ુõ͙ͅɘˑˑ;ੴ੮ʮ͐ૄͅ੮યʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘͷʇર੮ failed all lower levels of care. They’ve been working with an intensive outpatient ͐ʇɘ˚ੴ੮͐ʩʇ;ૄͷʇ੮̼͐ʮʇʁ੮ɘ˦੮)õ੮યɻ͙͐ʇ੮)ʮͷʇ̼ͅʮ˺˦੮õ˦ʮ͐રੴ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̹ˑɘɻʇ˚ʇ˦͐ੴ੮ˑʮͷʮ˦ʡ੮ independently, and repeatedly come to the emergency room. They just have a lot of trouble with medication compliance, end up in and out of different cycles of care, and don’t seem to maintain outside of a structured environment.” In certain ɻ˺͙˦͐ʮʇͅੴ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʮ˦ʠ˺̼˚ɘˑˑ;੮̼ʇή͙ʮ̼ʇ੮͐ʩɘ͐੮ɘ੮̹ʇ̼ͅ˺˦੮ʩɘͷʇ੮ɘ੮ɻʇ̼͐ɘʮ˦੮˦͙˚ber of hospitalizations, with an unsuccessful discharge to the community, before they’ll approve an application.৿ৼ

I N PAT I E N T

99

This idea that someone is gravely disabled—in the sense of needing a conservatorship— only when they’ve “failed” (or been failed by) everything else is an illustration of a social model of disability.৿৽ The central idea is this: rather than being an inherent feature of certain kinds of bodies and minds (as posited by the medical model), disability is created by a society that is ill adapted to those ͷɘ̼ʮɘ͐ʮ˺˦ͅੳ੮"ʇʮ˦ʡ੮ʮ˦੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼੮ʮͅ੮ɘ੮ʁʮͅɘɺˑʮ˦ʡ੮ʮ˚̹ɘʮ̼˚ʇ˦͐੮ʮ˦ͅ˺ʠɘ̼੮ɘͅ੮ɺ͙ͅʮ˦ʇͅͅʇͅ੮ are unwilling to install access ramps; the limitations of being blind vary with whether a building put its signs in braille. Similarly, a “grave” disability is not something that kicks in automatically when someone’s symptoms reach a certain level of severity. It emerges once someone has exhausted the available alternatives to conservatorship, which vary enormously from county to county. In 2019, Los Angeles County conducted a thorough survey of its options for providing intensive care. “Peer respite centers”—where a person can stay for up to two weeks with nonmedical support from other people with lived experience of mental illness—are a “highly effective alternative to hospitalization during crises.”৿৾੮"͙͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩɘͅ੮˺˦ˑ;੮͐͸˺ੴ੮͸ʮ͐ʩ੮͐͸ʇ˦͐;੮ɺʇʁͅ੮ɺʇ͐͸ʇʇ˦੮͐ʩʇ˚ੳ੮š͐ʩʇ̼੮ clients might be able to stay out of locked facilities if their board and care homes offered “enhanced residential treatment”—but board and cares are “closing rapidly because their business model is broken”৿৿ (more on that in chapter 8). Partial P˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮Ø̼˺ʡ̼ɘ˚ͅ੮ફɘˑͅ˺੮ˌ˦˺͸˦੮ɘͅ੮ʁɘ;੮̼͐ʇɘ͐˚ʇ˦͐બ੮ɘ̼ʇ੮ɘ੮ુʡ̼ʇɘ͐੮˺̹͐ʮ˺˦ੳૂ੮"͙͐੮ Medi-Cal reforms have starved them for funds.৿਀ The report concluded that if all these crisis services were in place, the county would actually need only about half its current number of acute-care beds.৿ਁ Now, as Dr. Wagner told me, there are people who can’t take advantage of alternatives to conservatorship, even if they exist: “If you have somebody who is really depressed or really psychotic and isn’t organized enough, doesn’t have the motivation or the will to take care of basic things,” there’s no choice but to apply. He went on: “Often people are gravely disabled who may have a place to live, an SRO or apartment, but they’re too psychotic to sleep there, or worried that their place is bugged, or their food is being poisoned, so they won’t eat, even though they have money and can go buy food. Those are examples of how illness can interact with one’s normal circumstances and make them abnormal to the point of being gravely disabled.” The point here, though, is that “normal circumstances” vary. People’s grave disabilities are a function of both their capacity to use the supports in their environment and what supports aren’t available at all.

100

T H E C O N S E RVATO R S H I P C O N T I N U U M

îʩʮͅ੮ͅ˺ɻʮɘˑ੮˚˺ʁʇˑ੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮ɻ˺˦ϲʮ̼˚ʇʁ੮ɺ;੮͐ʩʇ੮ʠɘɻ͐੮͐ʩɘ͐੮͸ʩʇ͐ʩʇ̼੮ someone counts as gravely disabled is, in practice, county dependent. The psychiatrist at a Northern Californian university hospital was initially insistent that nonclinical factors didn’t play into decision making, telling me, “you’re not going to send a person to the street if they’re completely psychotic, covered in their own feces.” Eventually, though, he conceded that, on the margins, conservatorship petitions depended on whether a given county had the facilities that would allow him to transfer a newly conserved person and liberate a bed: “If it’s a wobbler and I think, ‘this person is from San Francisco’”—which has longer delays in organizing placements than this psychiatrist’s home county—“maybe it’s not even worth applying.” Counties’ political choices about how to fund and organize mental health systems can render some people, miraculously, not gravely disabled despite their ɻˑʮ˦ʮɻɘˑ੮͐ͅɘ͐ʇઝɘ͐੮ˑʇɘ͐ͅ੮ʮ˦੮͐ʩʇ੮ͅʇ˦ͅʇ੮͐ʩɘ͐੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʮˑˑ੮ϲʮ˦ʁ੮ͅ˺˚ʇ੮͸ɘ;੮͐˺੮ʁʮͅcharge them without a conservatorship.

CONCLUSION: DELEGATED DISCRETION The simplest reason there aren’t more people on LPS conservatorships in California is that there aren’t enough beds in hospitals willing to conserve them. Hɘ̼੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮ɘ੮ˑʇʡɘˑ੮ɻɘ͐ʇʡ˺̼;੮͸ʮ͐ʩ੮ɘ੮ϲʮͽʇʁ੮ɘ˦ʁ੮ɻˑʇɘ̼੮˚ʇɘ˦ʮ˦ʡੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ ʮͅ੮ɘ੮ͅˑʮ̹̹ʇ̼;੮͐ͅɘ˦ʁɘ̼ʁ੮͐ʩɘ͐੮ʇͽ̹ɘ˦ʁͅ੮͐˺੮ϲʮˑˑ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɺʇʁͅ੮͸ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮ɘͷɘʮˑɘɺˑʇ੮ and shrinks to justify emptying them when they’re not. Evan, a Public Defender whom you’ll meet in a later chapter, put it nicely: “We have seventy-two beds at ય#˺͙˦͐;੮P˺̹ͅʮ͐ɘˑરੳ੮Uʠ੮ɘˑˑ੮ͅʇͷʇ˦͐;ચ͐͸˺੮ɘ̼ʇ੮ϲʮˑˑʇʁ੮͙̹ੴ੮͐ʩʇ˦੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮˚ʇɘ˦ͅ੮ ˺˦ʇ੮ ͐ʩʮ˦ʡੳ੯ ੳ੯ ੳ੯ ੳ੮ Uʠ੮ ͸ʇ੮ ɺ͙ʮˑ͐੮ ɘ੮ ͅʇɻ˺˦ʁ੮ ɘɻ͙͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ͐˺˚˺̼̼˺͸ੴ੮ ͸ʇ੮ ʁ˺͙ɺˑʇʁ੮ ˺͙̼੮ ɻɘ̹ɘɻʮ͐;ੳ੯ੳ੯ੳ੯ੳ੮U੮͐ʩʮ˦ˌ੮͸ʇ੮͸˺͙ˑʁ੮ϲʮ˦ʁ੮͐ʩɘ͐੮͐ʩʇ̼ʇૄͅ੮ɘɻ͙͐ɘˑˑ;੮˦˺͸੮ৱ৴৴੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˚ʇʇ͐੮ ͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮˦ʁ੮ʮʠ੮͸ʇ੮ͅʩ̼͙˦ˌ੮ʮ͐੮ʁ˺͸˦੮͐˺੮͐ʩʮ̼͐;ચͅʮͽੴ੮͸ʇૄʁ੮ϲʮ˦ʁ੮ that a lot of people, it turns out, are not gravely disabled.” Financial factors weigh not just on the number of beds but on how they get used. For people like Kate, whose narrative began this chapter, insurance companies’ tight oversight has the positive side effect of ensuring that most hospital stays are short, protecting patients from conservatorship when law fails to. For families and outpatient clinicians, on the other hand, reimbursement rules and utilization reviews create a cycle of short, ineffectual admissions. They

I N PAT I E N T

101

̼ʇ̹̼ʇͅʇ˦͐੮ɘ˦੮͙˦ˈ͙͐ͅʮϲʮɘɺˑʇ੮ʮ˦̼͙͐ͅʮ˺˦੮˺˦੮ʁʇɻʮͅʮ˺˦ͅ੮͐ʩɘ͐੮ͅʩ˺͙ˑʁ੮ɺʇ੮̹͙̼ʇˑ;੮ʮ˦੮͐ʩʇ੮ realm of medicine. Either way, inpatient psychiatrists serve as a veto point on the conservatorship continuum, but not an independent authority capable of pushing a conservatorship through. Instead, delegation means that insurance companies deciding who meets criteria for payment, county supervisors subjecting hospitals to budget cuts, and investors calculating whether it’s worth staying in the inpatient psych business have the real discretion to decide who moves to the next step in the conservatorship continuum.

CHAPTER 5

PUBLIC GUARDIAN

E

arly in this project, a group of research assistants and I reached out to ͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʮ˦੮˚˺͐ͅ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅੳ੮Ĕʇ੮ ˦ʇͷʇ̼੮ʩʇɘ̼ʁ੮ɺɘɻˌ੮ʠ̼˺˚੮͐ʩʇ੮˚ɘˈ˺̼ʮ͐;ੳ੮੮ʠʇ͸੮ʁʇɻˑʮ˦ʇʁ੮˺͙̼੮̼ʇή͙ʇ͐ͅͅ੮͸ʮ͐ʩ੮ ɘ੮ ˦˺͐ʇ੮ ˺ʠ੮ ͙̹ͅͅʮɻʮ˺˦੮ ɘɺ˺͙͐੮ ͸ʩ;੮ ɘ˦;˺˦ʇ੮ ͸ɘͅ੮ ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ ʮ˦੮ ͐ʩʇʮ̼੮ ˺ɺͅɻ͙̼ʇ੮ ɘʡʇ˦ɻ;ੳ੮ ફîʩʮͅ੮ ͸ɘͅ੮ ɺʇʠ˺̼ʇ੮ ͐ʩʇ੮ "̼ʮ͐˦ʇ;੮ ä̹ʇɘ̼ͅ੮ ͐ͅ˺̼;੮ ɺ̼˺ˌʇੳબ੮ Ĕʩʇ˦੮ ˚;੮ "ɘ;੮ ̼ʇɘજɺɘͅʇʁ੮ ͐ʇɘ˚੮ʁʮʁ੮ʩʇɘ̼੮ɺɘɻˌ੮ʠ̼˺˚੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ʩʮ˦͐ʇ̼ˑɘ˦ʁͅੴ੮ʮ͐੮͸ɘͅ੮ɘ੮ͷʮʇ͸੮ʮ˦͐˺੮͸ʩɘ͐੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮ˑ˺˺ˌ੮ˑʮˌʇ੮ʮ˦੮ɘ̼ʇɘͅ੮͐ʩɘ͐੮ˑʮͷʇ੮͙˦ʁʇ̼੮͐ʩʇ੮ͅɘ˚ʇ੮ˑɘ͸ͅ੮ɺ͙͐੮͸ʮ͐ʩʮ˦੮ɘˑ˚˺͐ͅ੮ ɘˑʮʇ˦੮ʇɻ˺˦˺˚ʮɻ੮ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅੳ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩɘͅ੮ʁʇˑʇʡɘ͐ʇʁ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮͐˺੮ɻ˺͙˦͐ʮʇͅ੮ʠ˺̼੮͸ʩʮɻʩ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ɻɘ˦੮ɺʇ੮ɘˑ˚˺͐ͅ੮͙˦͐ʇ˦ɘɺˑ;੮ ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ʠ͙˦ʁ੮ɘ˦ʁ੮ʮ˚̹ˑʇ˚ʇ˦͐ੳ H̼˺˦͐ʮʇ̼੮#˺͙˦͐;੮ફ͐ʩɘ͐ૄͅ੮ɘ੮̹ͅʇ͙ʁ˺˦;˚બ੮ʮͅ੮ɘɺ˺͙͐੮ʩɘˑʠ੮ɘͅ੮ʁʇ˦ͅʇ੮ɘͅ੮{˺˦ʡ˺ˑʮɘੳ੮îʩʇ੮ ɻ˺͙˦͐;ૄͅ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮P͙˚ɘ˦੮äʇ̼ͷʮɻʇͅ੮ʮͅ੮͐ʮ˦;ੴ੮ͅ˺੮Øɘ̼͐ʮɻˌઝɘ੮˚ʮˑʮ͐ɘ̼;੮ͷʇ͐ʇ̼ɘ˦੮ ͸ʩ˺੮ ͸˺̼ˌʇʁ੮ ʩʮͅ੮ ͸ɘ;੮ ͙̹੮ ͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ͷʇ̼੮ ͐͸ʇ˦͐;੮ ;ʇɘ̼ͅઝʩɘͅ੮ ͐ʩʇ੮ ʇ˦͐ʮ̼ʇ੮ ɻɘͅʇˑ˺ɘʁ੮ ˺ʠ੮ ͐ʩʇ੮ rØä੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ ˺ϲϲʮɻʇ੮ ફ͸ʩʮɻʩ੮ ʩɘͅ੮ ͅʮͽ੮ ̹ʇ˺̹ˑʇબੳ੮ Pʇ੮ ɘˑͅ˺੮ɻ˺ͷʇ̼ͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ʠ˺̼੮ʮ˦ચʩ˺˚ʇ੮͙̹̹ͅ˺̼͐ͅੴ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ɘ˦ʁ੮ɘʁ͙ˑ͐੮ ̹̼˺͐ʇɻ͐ʮͷʇ੮ͅʇ̼ͷʮɻʇͅੳ੮îʩʇ̼ʇૄͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮͐ʩɘ͐੮ʠʇʇˑͅ੮˚˺̼ʇ੮ʩ͙˚ɘ˦ʇ੮ɘɺ˺͙͐੮͐ʩʇ੮̹ɘ͐ʩ͸ɘ;੮ ˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮ͅ˚ɘˑˑʇ̼੮ɻ˺͙˦͐ʮʇͅੵ੮ુš˦ʇ੮ʁɘ;ੴ੮͐ʩʇ੮äʩʇ̼ʮʠʠ੮ɻɘˑˑʇʁੴ੮ɘ˦ʁ੮ͅɘʮʁੴ੮ ૃĔʩʇ̼ʇૄͅ੮͐ʩɘ͐੮ʡ͙;੮͸ʇ੮ɘˑ͸ɘ;ͅ੮ͅʇʇ੮˺˦੮͐ʩʇ੮ɻ˺̼˦ʇ̼੮˺˦੮͐ʩʇ੮͸ɘ;੮͐˺੮͸˺̼ˌ੺ૄ੮U੮ɻʩʇɻˌ੮͸ʮ͐ʩ੮ ɘ੮ɻ˺͙˦͐;੮͐ͅɘʠʠ੮˚ʇ˚ɺʇ̼੮͸ʩ˺੮͙͙ͅɘˑˑ;੮ʡʮͷʇͅ੮ʩʮ˚੮ɘ੮ɻ˺͙̹ˑʇ੮ʁ˺ˑˑɘ̼ͅੴ੮ɘ˦ʁ੮͐ʩʇ;੮ͅɘ;ੴ੮ૃĔʇ੮ ʩɘͷʇ˦ૄ͐੮ͅʇʇ˦੮ʩʮ˚ੳૄ੮Ĕʇ੮ͅʇ˦ʁ੮ͅ˺˚ʇ˺˦ʇ੮˺͙͐੮͐˺੮ʁ˺੮ɘ੮͸ʇˑʠɘ̼ʇ੮ɻʩʇɻˌੴ੮ɘ˦ʁ੮͸ʩʇ˦੮͸ʇ੮ϲʮ˦ʁ੮ ʩʮ˚ੴ੮ʩʇૄͅ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʇʁੳૂ੮îʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ɻ˺˦ͷʇ˦ʇʁ੮ɘ੮˚ʇʇ͐ʮ˦ʡઝ͸ʩʮɻʩ੮ʮͅ੮ ʇɘͅ;੮͸ʩʇ˦੮ʇͷʇ̼;˺˦ʇ੮͸˺̼ˌͅ੮ʮ˦੮͐ʩʇ੮ͅɘ˚ʇ੮ɺ͙ʮˑʁʮ˦ʡઝʁ͙̼ʮ˦ʡ੮͸ʩʮɻʩ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮̼ʇɻ˺˚˚ʇ˦ʁʇʁ੮ɘ੮৵ৱ৵ৰੴ੮͐ʩʇ੮̹˺ˑʮɻʇ੮͸ʇ˦͐੮͐˺੮ʇͽʇɻ͙͐ʇ੮ʮ͐ੴ੮ɘ˦ʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦੮͸ɘͅ੮͸ɘʮ͐ʮ˦ʡ੮ʮ˦੮͐ʩʇ੮͸ʮ˦ʡͅ੮͐˺੮ϲʮˑʇ੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ

P U B L I C G UA R D I A N

103

ʠ͐ʇ̼੮͐ʩɘ͐੮৵ৱ৵ৰੴ੮͐ʩ˺͙ʡʩੴ੮ʮ͐੮ʡʇ͐ͅ੮ɻ˺˚̹ˑʮɻɘ͐ʇʁੳ੮Ĕʩʇ˦੮U੮͐ɘˑˌ੮˺˦੮͐ʩʇ੮̹ʩ˺˦ʇ੮͐˺੮ēʮɻચ ͐˺̼ੴ੮Øɘ̼͐ʮɻˌૄͅ੮˦˺͸੮̼ʇ͐ʮ̼ʇʁ੮ɻ˺͙˦͐ʇ̼̹ɘ̼͐੮ʮ˦੮͐ʩʇ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮)ʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ʩʇૄͅ੮ ͙̹੮ɘ͐੮ʩʮͅ੮ɘ̹̹ˑʇ੮ʠɘ̼˚੮ુʮ˦੮͐ʩʇ੮˚ʮʁ͐ͅ੮˺ʠ੮̹ˑɘ˦͐ʮ˦ʡ੮ͅ˺˚ʇ੮ɻ˺˦ʮʠʇ̼ͅੳૂ੮rʮˌʇ੮͐͸ʇ˦͐;ચϲʮͷʇ੮ ˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅੴ੮H̼˺˦͐ʮʇ̼੮ʩɘͅ੮˦˺੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑੳৼ Instead, ͐ʩʇ;੮͐ɘˌʇ੮̹ʇ˺̹ˑʇ੮˺˦੮৵ৱ৵ৰͅ੮͐˺੮͐ʩʇ੮ˑ˺ɻɘˑ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮͸ʩʮɻʩ੮ɻɘˑˑͅ੮ɘ̼˺͙˦ʁ੮ ͐˺੮ϲʮ˦ʁ੮ɘ੮ɺʇʁੳ੮Uʠ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮ϲʮ˦ʁ੮˺˦ʇੴ੮͐ʩʇ;੮ʁ̼˺̹੮͐ʩʇ੮ʩ˺ˑʁੳ੮/ͷʇ˦੮ʮʠ੮͐ʩʇ;੮ʁ˺੮ϲʮ˦ʁ੮ɘ੮ ɺʇʁੴ੮ʡʇ͐͐ʮ˦ʡ੮̹ɘ͐ʮʇ˦͐ͅ੮͐ʩʇ̼ʇ੮ʮͅ੮ʩɘ̼ʁੳ੮͐੮˦ʮʡʩ͐ੴ੮͐ʩʇ̼ʇૄͅ੮˺˦ˑ;੮˺˦ʇ੮ͅʩʇ̼ʮʠʠ੮˺˦੮ʁ͙͐;੮ʠ˺̼੮ ͐ʩʇ੮͸ʩ˺ˑʇ੮ɻ˺͙˦͐;ੳ੮îʩʇ̼ʇૄͅ੮˺˦ˑ;੮ʇͷʇ̼੮ɘ੮ͅʮ˦ʡˑʇ੮ɘ˚ɺ͙ˑɘ˦ɻʇੳ੮‡ʇʮ͐ʩʇ̼੮ɻɘ˦੮ͅɘʠʇˑ;੮˚ɘˌʇ੮ ͐ʩʇ੮ϲʮͷʇચʩ˺͙̼੮̼˺͙˦ʁ੮̼͐ʮ̹੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩɘ͐੮ɻ˺˦̼͐ɘɻ͐ͅ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺͙˦͐;ੳ੮îʩʇ̼ʇૄͅ੮ ɘ˦˺͐ʩʇ̼ੴ੮ ɻˑ˺ͅʇ̼ੴ੮ ʩ˺̹ͅʮ͐ɘˑੴ੮ ɺ͙͐੮ ͐ʩʇ;੮ ʁ˺˦ૄ͐੮ ͐ɘˌʇ੮ H̼˺˦͐ʮʇ̼ૄͅ੮ ɻˑʮʇ˦͐ͅੳ੮ ફU੮ ʇͽ̹ˑ˺̼ʇ੮ ͐ʩʇ੮ ɻʩɘ˺ͅ੮˺ʠ੮ɻ˺˦̼͐ɘɻ͐ʮ˦ʡ੮ʮ˦੮ɻʩɘ̹͐ʇ̼੮৷ੳબ੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮ ͅʇ˦ʁͅ੮ʠ˺ˑˌͅ੮ʮ˦੮ɘ੮ɻ˺͙˦͐;੮ɻɘ̼੮͸ʮ͐ʩ੮ɘ੮ͅɻ̼ʇʇ˦੮ɺʇ͐͸ʇʇ˦੮͐ʩʇ੮ʁ̼ʮͷʇ̼੮ɘ˦ʁ੮͐ʩʇ੮ɺɘɻˌ੮ͅʇɘ͐ੳ੮U͐ૄͅ੮ ˦˺͐੮ɘ੮ʡ̼ʇɘ͐੮ͅ˺ˑ͙͐ʮ˺˦ੳ੮੮̹ʇ̼ͅ˺˦੮ʮ˦੮ɘ˦੮ɘʁˈɘɻʇ˦͐੮ɻ˺͙˦͐;੮ʁʮʇʁ੮ɺ;੮͙ͅʮɻʮʁʇ੮͸ʩʮˑʇ੮ɺʇʮ˦ʡ੮ ̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮ʮ˦੮ɘ੮ͷʇʩʮɻˑʇ੮ˑʮˌʇ੮͐ʩʮͅ੮˺˦ʇੳ š˦ɻʇ੮ ͅ˺˚ʇ˺˦ʇ੮ ʠ̼˺˚੮ H̼˺˦͐ʮʇ̼੮ #˺͙˦͐;੮ ˺˦੮ {ʇʁʮચ#ɘˑ੮ ʮͅ੮ ʮ˦੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑੴ੮ ͐ʩʇ;ૄ̼ʇ੮ ɘ੮͐ʮɻˌʮ˦ʡ੮ϲʮ˦ɘ˦ɻʮɘˑ੮͐ʮ˚ʇ੮ɺ˺˚ɺੳ੮ēʮɻ͐˺̼੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩɘͅ੮ɘ੮ɺ͙ʁʡʇ͐੮˺ʠ੮ ɘɺ˺͙͐੮ଏ৲৵ৰੴৰৰৰ੮̹ʇ̼੮;ʇɘ̼੮͐˺੮̹ɘ;੮ʠ˺̼੮ˑ˺ɻˌʇʁ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ʠ˺̼੮ɘˑˑ੮ʮ͐ͅ੮ɻˑʮʇ˦͐ͅ੮ફ͸ʩʮɻʩ੮ ͸˺͙ˑʁ˦ૄ͐੮ɻ˺ͷʇ̼੮ɘ੮;ʇɘ̼੮ʮ˦੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ɘ੮ͅʮ˦ʡˑʇ੮̹ʇ̼ͅ˺˦બੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁચ ʮɘ˦ૄͅ੮˺ϲϲʮɻʇੴ੮͸ʮ͐ʩ੮ɘ੮;ʇɘ̼ˑ;੮ɺ͙ʁʡʇ͐੮˺ʠ੮ɘ̼˺͙˦ʁ੮ଏৱ৲ৰੴৰৰৰੴ੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮˚͙ɻʩ੮͐˺੮ˌʮɻˌ੮ ʮ˦ੳ੮ îʩʇ;੮ ͐ʩ͙ͅ੮ ɘͅͅʇͅͅ੮ ή͙ʮɻˌˑ;੮ ͐˺੮ ʁʇ͐ʇ̼˚ʮ˦ʇ੮ ʮʠ੮ ͐ʩʇ੮ ̹ʇ̼ͅ˺˦ૄͅ੮ ̹̼˺ɺˑʇ˚ͅ੮ ɘ̼ʇ੮ ˚˺͐ͅˑ;੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ʮ˦੮͸ʩʮɻʩ੮ɻɘͅʇ੮͐ʩʇ;੮ɻɘ˦੮ɻ˺͙˦͐੮˺˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮̼ʇˑʇɘͅʇ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ ή͙ʮɻˌˑ;ੳ੮Uʠ੮͐ʩʇ;ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮̼ʇή͙ʮ̼ʇ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʩ͙͐ͅˑʇͅ੮ ͐˺੮̹̼˺ɻʇͅͅ੮͐ʩʇʮ̼੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮ʡʇ͐੮͐ʩʇ˚੮͐˺੮ɘ੮ɻʩʇɘ̹ʇ̼੮͐ͅʇ̹ચʁ˺͸˦ੳ੮ɻɻ˺̼ʁʮ˦ʡ੮͐˺੮ Øɘ̼͐ʮɻˌੴ੮ˑ˺ɻˌʇʁ੮͙ͅɺɘɻ͙͐ʇ੮ͅʇ͐͐ʮ˦ʡͅ੮ફU{)ͅબ੮ɘ̼ʇ੮ુ̹̼˺ʩʮɺʮ͐ʮͷʇˑ;੮ʇͽ̹ʇ˦ͅʮͷʇੳૂ੮ˑ˚˺͐ͅ੮ ʇͷʇ̼;˺˦ʇ੮ʡ˺ʇͅ੮͐˺੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇੴ੮͸ʩʮɻʩ੮ɻɘ˦੮ɺʇ੮̹ɘʮʁ੮ʠ˺̼੮ɺ;੮͐ʩʇ੮ ɻˑʮʇ˦͐ૄͅ੮˺͸˦੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙̼ʮ͐;੮ɻʩʇɻˌੳ੮îʩʇ੮ɻ˺͙˦͐;੮ʩɘͅ੮˺˦ʇ੮̹̼ʮͷɘ͐ʇˑ;੮̼͙˦੮ʩ˺˚ʇੳ੮U͐੮ʮͅ੮ ɻ͙̼̼ʇ˦͐ˑ;੮ϲʮˑˑʇʁ੮͸ʮ͐ʩ੮ʇɘͅʮʇ̼ચ͐˺ચʩ˺͙ͅʇ੮͙˦ɻ˺˦ͅʇ̼ͷʇʁ੮ɻˑʮʇ˦͐ͅੴ੮ͅ˺੮ɘˑˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘ̼ʇ੮ ͙͐ͅɻˌ੮˺͙͐੮˺ʠ੮ɻ˺͙˦͐;ੳ Given these challenges, I’m not surprised that the number of people conચ ͅʇ̼ͷʇʁ੮ɺ;੮H̼˺˦͐ʮʇ̼੮#˺͙˦͐;੮ʩɘͅ੮ʁʇɻˑʮ˦ʇʁੳ੮îʩʇ੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʮͅ੮˦˺͐੮̼͐ͅʮɻ͐ʇ̼੮˺ͷʇ̼ͅʮʡʩ͐੮ ʠ̼˺˚੮͐ʩʇ੮ɻ˺͙̼͐ͅੴ੮͸ʩʮɻʩੴ੮ɘͅ੮ʠɘ̼੮ɘͅ੮ēʮɻ͐˺̼੮ɘ˦ʁ੮Øɘ̼͐ʮɻˌ੮ɻɘ˦੮̼ʇɻɘˑˑੴ੮ʩɘͷʇ੮˦ʇͷʇ̼੮͙̼͐˦ʇʁ੮ ʁ˺͸˦੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ēʮɻ͐˺̼੮ʩɘͅ੮˦˺੮ʁ˺͙ɺ͐੮ɘɺ˺͙͐੮͐ʩʇ੮̼ʇɘˑ੮ reason: “It’s crass but true: there’s a lack of beds, there aren’t the resources, the ɺʇʁͅ੮͐ʩɘ͐੮ʇͽʮ͐ͅ੮ɘ̼ʇ੮ʮ˦ɻ̼ʇʁʮɺˑ;੮ʇͽ̹ʇ˦ͅʮͷʇੳૂ੮îʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇ੮ફʮੳʇੳੴ੮Øɘ͐ચ ̼ʮɻˌબ੮ʮͅ੮˦˺˚ʮ˦ɘˑˑ;੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ੳ੮"͙͐੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮̹˺͸ʇ̼੮͐˺੮̹ˑɘɻʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮ɘ੮

104

T H E C O N S E RVATO R S H I P C O N T I N U U M

locked facility doesn’t give them any authority to make the county pay for that ̹ˑɘɻʇ˚ʇ˦͐ઝ˚ʇɘ˦ʮ˦ʡ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ɘɻ͙͐ɘˑˑ;੮ʩɘͷʇ੮˚͙ɻʩ੮ɘ͙͐ʩ˺̼ʮ͐;ੳ Given the limited resources available, conservatorship is reserved for the ͅή͙ʇɘˌʮʇ͐ͅ੮͸ʩʇʇˑͅੳ੮ēʮɻ͐˺̼੮͐ʇˑˑͅ੮˚ʇੴ੮ુ৹৹੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮͐ʮ˚ʇ੮યͅ˺˚ʇ˺˦ʇ੮ʮͅ੮ɻ˺˦ચ served], there are community members and other agencies putting pressure ˺˦੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩੳ੯ੳ੯ੳ੯ੳ੮U͐੮˚ɘ;੮ɺʇ੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅ੮͸ʩ˺੮ɘ̼ʇ੮ˈ͙͐ͅ੮ʇͽɘ̹ͅʇ̼ચ ɘ͐ʇʁੳ੮U͐੮˚ɘ;੮ɺʇ੮͐ʩʇ੮ˑ˺ɻɘˑ੮ͅʩʇ̼ʮʠʠ੮͸ʩ˺੮ʮͅ੮ʮ˦͐ʇ̼ͷʇ˦ʮ˦ʡ੮̼ʇʡ͙ˑɘ̼ˑ;੮ɘ˦ʁ੮̼ʇɘˑˑ;੮ʡʇ͐ચ ͐ʮ˦ʡ੮ ͐ʮ̼ʇʁ੮ ˺ʠ੮ ʮ͐ੳ੮ U͐੮ ˚ɘ;੮ ɺʇ੮ ˚ʇ̼ɻʩɘ˦͐ͅ੮ ͸ʩʇ̼ʇ੮ ͐ʩʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮ ʮͅ੮ ʩɘ˦ʡʮ˦ʡ੮ ˺͙͐੮ ɘ˦ʁ੮ɺʇʮ˦ʡ੮ʁʮ̼͙̹͐ͅʮͷʇੳૂ੮rʮˌʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʇͷʇ̼;͸ʩʇ̼ʇੴ੮Øɘ̼͐ʮɻˌ੮ʠʇʇˑͅ੮͐ʩʇͅʇ੮ ʁʇ˚ɘ˦ʁͅ੮ʡʇ͐͐ʮ˦ʡ੮ˑ˺͙ʁʇ̼ੳ੮H̼˺˦͐ʮʇ̼੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮˚͙ɻʩ੮ʮ˦੮͐ʩʇ੮͸ɘ;੮˺ʠ੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮ ̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮ɺ͙͐੮ʮ͐੮ʮͅ੮ʠɘɻʮ˦ʡ੮͐ʩʇ੮̹ɘ͐ʩ˺ˑ˺ʡʮʇͅ੮˺ʠ੮̼͙̼ɘˑ੮˚ʇ̼ʮɻɘੵ੮ુĔʇૄ̼ʇ੮ͅʇʇʮ˦ʡ੮ ɘ˦੮ʮ˦ɻ̼ʇɘͅʇ੮ʮ˦੮ʮ͙ͅͅʇͅ੮ɘ̼˺͙˦ʁ੮ʁ̼͙ʡ੮͙ͅʇੴ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ɘɺ͙ͅʇੴ੮˺̹ʮ˺ʮʁ੮͙ͅʇੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮ ͐ʩʇ;ૄ̼ʇ੮ ʮ˦੮ ͐ʩʇ੮ ɻ̼ʮ˚ʮ˦ɘˑચˈ͙͐ͅʮɻʇ੮ ͅ;͐ͅʇ˚੮ ͷʇ̼͙ͅͅ੮ ʡʇ͐͐ʮ˦ʡ੮ ̼͐ʇɘ͐˚ʇ˦͐ੴ੮ ɘ˦ʁ੮ ͐ʩɘ͐ૄͅ੮ ɺʇɻ˺˚ʮ˦ʡ੮ɘ˦੮ʮ͙ͅͅʇੳૂ U੮ʩɘʁ੮̼ʇɘʁ੮ʇ˦˺͙ʡʩ੮˺ʠ੮ͅ˺ɻʮɘˑ੮͐ʩʇ˺̼ʮ͐ͅͅ੮ˑʮˌʇ੮{ʮɻʩʇˑ੮H˺͙ɻɘ͙ˑ͐੮ɘ˦ʁ੮‡ʮˌ˺ˑɘͅ੮Û˺ͅʇ੮ to suspect that public guardians might seize on this opportunity to “govern ̼ʮͅˌ;੮ ̹˺̹͙ˑɘ͐ʮ˺˦ͅૂ੮ ͐ʩ̼˺͙ʡʩ੮ ɘ˦੮ ʇͽ̹ɘ˦ʁʮ˦ʡ੮ ͸ʇɺ੮ ˺ʠ੮ ͙̼ͅͷʇʮˑˑɘ˦ɻʇ੮ ɘ˦ʁ੮ ɻ˺˦̼͐ͅɘʮ˦͐ੳ৽ "͙͐੮˚ɘ˦;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐ɘˑˌ੮ˑʮˌʇ੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ɘ̼ʮɘ˦ͅੳ੮ુØʩʮˑ˺ͅ˺̹ʩʮɻɘˑˑ;ੴ੮U੮ɘ˚੮ɘ੮ ʠɘ˦੮˺ʠ੮͐ʩʇ੮#˺˦͐ͅʮ͙͐͐ʮ˺˦ੴૂ੮Øɘ̼͐ʮɻˌ੮͐ͅɘ͐ʇͅੳ੮Pʇ੮ɘʁʁͅੴ੮ુĚ˺͙੮ͅʩ˺͙ˑʁ੮ʩɘͷʇ੮ɘ੮ʩʮʡʩ੮ɺɘ̼ૂ੮ ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɺʇɻɘ͙ͅʇ੮ ુʮ͐ૄͅ੮ ɘ੮ ɺʮʡ੮ ʁʇɘˑ੮ ͐˺੮ ͐ɘˌʇ੮ ɘ͸ɘ;੮ ̹ʇ˺̹ˑʇૄͅ੮ ̼ʮʡʩ͐ͅੳૂ੮ Pʇ੮ ɘɻˌ˦˺͸ˑʇʁʡʇͅ੮͐ʩɘ͐੮ુ͸ʇ੮ʩɘͷʇ੮ɘ੮ɻ̼ʮͅʮͅ੮͸ʮ͐ʩ੮̹ʇ˺̹ˑʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ ʮ˦੮ˈɘʮˑੴ੮ɺ͙͐੮U੮ʁ˺˦ૄ͐੮̼ʇɘˑˑ;੮ͅʇʇ੮ʩ˺͸੮͐ʩʮͅ੮યʇͽ̹ɘ˦ʁʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ʮͅ੮ɘ੮ͅ˺ˑ͙͐ʮ˺˦੮ ͐˺੮͐ʩɘ͐ੳૂ੮{˺͐ͅ੮̹̼˺̹˺ͅɘˑͅ੮͐˺੮ʮ˦ɻ̼ʇɘͅʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʁ˺˦ૄ͐੮ʮ˦ɻˑ͙ʁʇ੮˚˺̼ʇ੮ʠ͙˦ʁͅ੮ ʠ˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੳ੮ુĚ˺͙੮ɻɘ˦੮ɻ˺˦ͅʇ̼ͷʇ੮̹ʇ˺̹ˑʇ੮ɘˑˑ੮;˺͙੮͸ɘ˦͐ੴૂ੮ʩʇ੮˦˺͐ʇͅੴ੮ુɺ͙͐੮͸ʩɘ͐੮ ʁ˺੮;˺͙੮ʁ˺੮͸ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੺੮Ĕʇ੮ʩɘͷʇ੮ɘ੮̹ɘ͙ɻʮ͐;੮˺ʠ੮̹ˑɘɻʇ˚ʇ˦͐੮˺̹͐ʮ˺˦ͅ੮͐˺੮ ʩʇˑ̹੮͐ʩʇͅʇ੮̹ʇ˺̹ˑʇੳૂ Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮˺ϲϲʮɻʇͅ੮ɘ̼ʇ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘʡʇ˦ɻ;੮͐˺੮͸ʩʮɻʩ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩɘͅ੮ ʁʇˑʇʡɘ͐ʇʁ੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮ ͅ੮ ͸ʮ͐ʩ੮ ʇͷʇ̼;੮ ˺͐ʩʇ̼੮ ͐ͅʇ̹੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺˦͐ʮ˦͙͙˚ੴ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮ɘ੮ͷʇ͐˺੮̹˺ʮ˦͐੮͐ʩɘ͐੮ɻɘ˦੮ʁʮͅή͙ɘˑʮʠ;੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮ɻ˺˦ͅʇ̼ͷɘચ ͐˺̼ͅʩʮ̹ੳ੮îʩʇ;੮ʁ˺੮ͅ˺੮ɺ;੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮͐ʩʇ੮ɺ͙̼ʁʇ˦੮˺ʠ੮ʇ˦͙̼ͅʮ˦ʡ੮͐ʩʇ੮͙̼ͅͷʮͷɘˑ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ɻʩ̼˺˦ʮɻ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ʇͷʇ˦੮ ʠ͙̼͐ʩʇ̼ઝͅ˺˚ʇ͐ʮ˚ʇͅ੮ ˺˦͐˺੮ ˺͐ʩʇ̼੮ ɘʡʇ˦ɻʮʇͅ੮ ɺ͙͐੮ ˚˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮˺˦͐˺੮ʠɘ˚ʮˑʮʇͅ੮ɘ˦ʁ੮͐ʩ˺ͅʇ੮ɻʩ̼˺˦ʮɻɘˑˑ;੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮̹ʇ̼ͅ˺˦ͅ੮͐ʩʇ˚ચ ͅʇˑͷʇͅੳ੮I͙ɘ̼ʁʮɘ˦ͅ੮ʩɘͷʇ੮ɘ੮̹̼ʮ˦ɻʮ̹ˑʇʁ੮ɘ˦ʁ੮̼͐ͅʮɻ͐੮ʮ˦͐ʇ̼̹̼ʇ͐ɘ͐ʮ˺˦੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ criteria but also a practical recognition that neither the state nor counties have ʇͷʇ̼੮ɻ˺˚˚ʮ͐͐ʇʁ੮͐ʩʇ੮̼ʇͅ˺͙̼ɻʇͅ੮˦ʇɻʇͅͅɘ̼;੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮ʇͷʇ̼;˺˦ʇ੮͸ʩ˺˚੮˺͐ʩʇ̼ͅ੮ʮ˦੮͐ʩʇ੮ ɻ˺˦͐ʮ˦͙͙˚੮˚ʮʡʩ͐੮ˑɘɺʇˑ੮ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ

P U B L I C G UA R D I A N

105

BACK-WARD BUREAUCRATS #˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ɘͅ੮͐ʩʇ੮͙˦̼ʇ˚ɘ̼ˌʇʁ੮͐ʩʮ̼ʁ੮̼ɘʮˑ੮˺ʠ੮rØäੳ੮îʩʇ੮ৱ৹৶৶੮ુ)ʮˑʇ˚˚ɘ੮˺ʠ੮ {ʇ˦͐ɘˑ੮#˺˚˚ʮ͐˚ʇ˦͐ͅૂ੮̼ʇ̹˺̼͐੮͐ʩɘ͐੮ɺʇɻɘ˚ʇ੮͐ʩʇ੮ɺɘͅʮͅ੮ʠ˺̼੮rØä੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮̹˺ˑચ icy makers should carefully bifurcate a “voluntary system for providing prompt ɘͅͅʮ͐ͅɘ˦ɻʇ੯ੳ੯ੳ੯ੳ੮͸ʮ͐ʩ˺͙͐੮ɘ˦;੮͐ͅʮʡ˚ɘ੮˺̼੮ˑ˺ͅͅ੮˺ʠ੮ˑʮɺʇ̼͐;ૂ੮ɘ˦ʁ੮ɘ˦੮ુʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ͅ;͐ͅʇ˚੮ ʠ˺̼੮ʮʁʇ˦͐ʮʠ;ʮ˦ʡ੮ɘ˦ʁ੮ͅʇ̹ɘ̼ɘ͐ʮ˦ʡ੮ʁɘ˦ʡʇ̼˺͙ͅ੮̹ʇ̼ͅ˺˦ͅૂ੮͐ʩ̼˺͙ʡʩ੮ͅʩ˺̼͐ચ͐ʇ̼˚੮ʩ˺̹ͅʮ͐ɘˑચ ʮΈɘ͐ʮ˺˦ͅੳ৾੮îʩʇ੮͐͸˺ચʩ͙˦ʁ̼ʇʁચ̹ɘʡʇ੮̼ʇ̹˺̼͐੮ʁʇͷ˺͐ʇʁ੮˺˦ˑ;੮ʠ˺͙̼ੴ੮˦ʇɘ̼੮͐ʩʇ੮ʇ˦ʁੴ੮͐˺੮ʮ͐ͅ੮ plan “to provide individualized treatment, supervision, and placement services ɺ;੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚੮ʠ˺̼੮̹ʇ̼ͅ˺˦ͅ੮͸ʩ˺੮ɘ̼ʇ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳૂ੮îʩʇ੮ˑʇʡʮͅચ lators predicted that most of the people conserved by the mental health system ͸˺͙ˑʁ੮ɺʇ੮ુɘʡʇʁ੮ͅʇ˦ʮˑʇ੮̹ʇ̼ͅ˺˦ͅ੮˺̼੮̹ʩ;ͅʮɻɘˑˑ;੮ʁʇɺʮˑʮ͐ɘ͐ʇʁ੮ɘˑɻ˺ʩ˺ˑʮɻͅૂ੮͸ʩ˺੮ɺʇˑ˺˦ʡʇʁ੮ ʮ˦੮ુ̹ͅʇɻʮɘˑ੮ʠɘɻʮˑʮ͐ʮʇͅૂ੮ફ˦˺͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅબੳ৿੮äʩ˺̼͐ˑ;੮ɘʠ͐ʇ̼͸ɘ̼ʁੴ੮ɘ੮˚ɘˈ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ ˺ʠ੮rØä੮͙ͅʇʁ੮ɘ੮ʩɘ˦ʁʠ͙ˑ੮˺ʠ੮̹ɘʡʇͅ੮͐˺੮ɻ˺˦ɻˑ͙ʁʇ੮͐ʩɘ͐੮͐ʩʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚੮ ુɘ̹̹ʇɘ̼ʇʁ੮͐˺੮ɺʇ੮˺̹ʇ̼ɘ͐ʮ˦ʡ੮ͅ˚˺˺͐ʩˑ;ੳૂ਀੮U͐੮͸ɘͅ੮͐ʩʇ੮ˑɘ͐ͅ੮̼ʇɘˑ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ɘ˦ɘˑ;ͅʮͅ੮˺ʠ੮ rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ɘ˦ʁ੮ʮ͐੮͸ɘͅ੮̹͙ɺˑʮͅʩʇʁ੮ʮ˦੮ৱ৹৷ৱੳ ͅ੮˚ɘ̼ʡʮ˦ɘˑ੮ɘͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ɘͅ੮͐˺੮͐ʩʇ੮ͷʮͅʮ˺˦੮ʠ˺̼੮͐ʩʇ੮rØä੮ͅ;͐ͅʇ˚੮ફɻ˺˚̹ɘ̼ʇʁ੮ ͐˺੮ͷ˺ˑ͙˦͐ɘ̼;੮˺͙̹͐ɘ͐ʮʇ˦͐੮ͅʇ̼ͷʮɻʇͅ੮˺̼੮ͅʩ˺̼͐ચ͐ʇ̼˚੮ʩ˺ˑʁͅબੴ੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ʇ˺̹ˑʇ੮˺˦੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼˺ͅʇ੮ʁ̼ɘ˚ɘ͐ʮɻɘˑˑ;ੵ੮ʠ̼˺˚੮৲ੴ৶ৱ৳੮ʮ˦੮ৱ৹৷ৱ੮͐˺੮˚˺̼ʇ੮͐ʩɘ˦੮ৱ৵ੴৰৰৰ੮ɺ;੮৲ৰৰৰੳਁ ä͙̼ͷʇ;ͅ੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮ʮ˦੮͐ʩʇ੮ৱ৹৸ৰͅ੮ͅʩ˺͸ʇʁ੮͐ʩɘ͐੮˚˺͐ͅ੮ʩɘʁ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮˺̼੮˺͐ʩʇ̼੮̹ͅ;ચ ɻʩ˺͐ʮɻ੮ʁʮͅ˺̼ʁʇ̼ͅੳਂ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ુʩʇˑ̹યʇʁર੯ੳ੯ੳ੯ੳ੮ʇˑʮ˚ʮ˦ɘ͐ʇ੮͐ʩʇʮ̼੮ɻʩɘ˺͐ʮɻ੮ˑʮʠʇ੮͐ͅ;ˑʇͅੴ੮ their cycle of admissions and discharge from hospitals and jails, and/or their living ˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳૂਃ੮/ɘ̼ˑ;੮˺˦ੴ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ͷʮʁʇʁ੮͐ʩʮͅ੮͐ͅɘɺʮˑʮ͐;੮ɺ;੮̹ˑɘɻʮ˦ʡ੮˚ɘ˦;੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʮ˦੮͐ʩʇ੮̼ʇ˚ɘʮ˦ʮ˦ʡ੮ɺʇʁͅ੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳ਄ County public guardians ͸ʇ̼ʇ੮ɺɘɻˌચ͸ɘ̼ʁ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮ɘɻ͐ʮ˦ʡੴ੮ɘͅ੮ɘ੮ৱ৹৷৲੮̹̼˺ϲʮˑʇ੮̹͙͐੮ʮ͐ੴ੮ɘͅ੮ુʠɘ͐ʩʇ̼ચ̹̼˺͐ʇɻ͐˺̼ੴ੮ ˈɘʮˑʇ̼ੴ੮ɘʮʁʇચʁʇચɻɘ˚̹੮ɘ˦ʁ੮̹ɘ;˚ɘ͐ͅʇ̼ૂ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ɘ͙ͅͅ˚ʇʁ੮͐˺੮ɺʇ੮ʩʇˑ̹ˑʇͅͅੳৼ৻ ͐੮ɘ੮̹ͅɘ̼ͅʇˑ;੮ɘ͐͐ʇ˦ʁʇʁ੮৲ৰ৲৲੮̹̼ʇͅͅ੮ɻ˺˦ʠʇ̼ʇ˦ɻʇੴ੮äɻɘ̼ˑʇ͐੮P͙ʡʩʇͅੴ੮͐ʩʇ੮ʇͽʇɻ͙͐ʮͷʇ੮ ʁʮ̼ʇɻ͐˺̼੮ ˺ʠ੮ ͐ʩʇ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ä͐ɘ͐ʇ੮ ͅͅ˺ɻʮɘ͐ʮ˺˦੮ ˺ʠ੮ Ø͙ɺˑʮɻ੮ ʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼ͅੴ੮ Ø͙ɺˑʮɻ੮ I͙ɘ̼ʁʮɘ˦ͅ੮ɘ˦ʁ੮Ø͙ɺˑʮɻ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅੴ੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮͐ʩʮͅ੮ɺɘɻˌ͐ͅ˺̹੮ͅ;͐ͅʇ˚੮˺ʠ੮ʮ˦͐ͅʮચ ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮͸ɘͅ੮ુ˺˦੮͐ʩʇ੮ͷʇ̼ʡʇ੮˺ʠ੮ɻ˺ˑˑɘ̹ͅʇੳૂ੮îʩʇ੮ϲʮ͙̼ͅͅʇͅ੮͐ͅɘ̼͐੮ɘ͐੮͐ʩʇ੮͐˺̹ੳ੮Ø͙ɺˑʮɻ੮ guardians are the only mandatory county social service program that receives no ʁʮ̼ʇɻ͐੮͐ͅɘ͐ʇ੮ϲʮ˦ɘ˦ɻʮ˦ʡੳৼৼ੮P͙ʡʩʇͅ੮ɺʇ͸ɘʮˑʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɘͅͅ˺ɻʮɘ͐ʮ˺˦੮ʩɘͅ੮̹ˑʇɘʁʇʁ੮͸ʮ͐ʩ੮ ͐ʩʇ੮ˑʇʡʮͅˑɘ͐˺̼ͅ੮͸ʩ˺੮ʩɘͷʇ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮ɺʮˑˑͅ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮͐ʩʇ੮ˑɘ͐ͅ੮ ʠ˺͙̼੮;ʇɘ̼ͅ੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ʠ͙˦ʁʮ˦ʡ੮͐˺੮̹ɘ;੮ʠ˺̼੮͐ʩʇ੮˺ϲϲʮɻʇͅ੮͐ʩɘ͐੮͸˺͙ˑʁ੮ɺʇ੮ʁ˺ʮ˦ʡ੮͐ʩʇ੮ɻ˺˦ચ ͅʇ̼ͷʮ˦ʡੴ੮͐˺੮˦˺੮ɘͷɘʮˑੳ

106

T H E C O N S E RVATO R S H I P C O N T I N U U M

r˺˦ʡ͐ʮ˚ʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ͅʇ˦ͅʇʁ੮ʡ̼˺͸ʮ˦ʡ੮ʮ˦ʁʮʠʠʇ̼ʇ˦ɻʇ੮͐˺͸ɘ̼ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ચ ͅʩʮ̹੮ʮ˦੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮˺ͷʇ̼੮͐ʩʇ੮ɻ˺͙̼ͅʇ੮˺ʠ੮͐ʩʇʮ̼੮ɻɘ̼ʇʇ̼ͅੳ੮ͅ੮˺˦ʇ੮͸ʩ˺੮͐ͅɘ̼͐ʇʁ੮ʮ˦੮ ͐ʩʇ੮ৱ৹৸ৰͅ੮̼ʇɻ˺͙˦͐ʇʁੴ੮ɺɘɻˌ੮͐ʩʇ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ફ){Pબ੮ ʩɘʁ੮ɘ˦੮rØä੮̹˺ʮ˦͐੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮͸˺͙ˑʁ੮ɘ͐͐ʇ˦ʁ੮͐ʩʇ੮ɘ˦˦͙ɘˑ੮ɻ˺˦ʠʇ̼ʇ˦ɻʇ੮˺ʠ੮ɻ˺͙˦͐;੮̹͙ɺચ ˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ˦ʁ੮͸˺͙ˑʁ੮ˑʮɘʮͅʇ੮͸ʮ͐ʩ੮͐ʩʇ˚੮ɘɺ˺͙͐੮̹ʇ˦ʁʮ˦ʡ੮ˑʇʡʮͅˑɘ͐ʮ˺˦ੳ੮){Pੴ੮͸ʩʮɻʩ੮ ɘ̹̹ɘ̼ʇ˦͐ˑ;੮͸ɘͅ੮ʁʇʇ̹ˑ;੮ʁ;ͅʠ͙˦ɻ͐ʮ˺˦ɘˑੴৼ৽੮ʁʮͅɘ̹̹ʇɘ̼ʇʁ੮ʮ˦੮৲ৰৱ৲੮ɘ˦ʁ੮͸ɘͅ੮˚ʇ̼ʡʇʁ੮ʮ˦͐˺੮ ͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ͷʮɻʇͅ੮ફ)P#äબੳ੮îʩʇ੮rØä੮˺ϲϲʮɻʇ੮ɻˑ˺ͅʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ ̼͐ɘ˦ͅʠʇ̼ੴ੮ɘ˦ʁ੮ʁ;ͅʠ͙˦ɻ͐ʮ˺˦ɘˑ੮˺ͷʇ̼ͅʮʡʩ͐੮͸ɘͅ੮̼ʇ̹ˑɘɻʇʁ੮͸ʮ͐ʩ੮˦˺˦ʇੳ U˦ʁʇʇʁੴ੮͸ʩʇ˦੮U੮ɘͅˌʇʁ੮ɘ˦੮˺ϲϲʮɻʮɘˑ੮ɘɺ˺͙͐੮)P#äૄͅ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮͸ʮ͐ʩ੮̼ʇ̹ͅʇɻ͐੮͐˺੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͅ;͐ͅʇ˚ੴ੮ ͐ʩʇ;੮ ̼ʇ̹ͅ˺˦ʁʇʁੴ੮ ુʮ͐ૄͅ੮ ˚˺̼ʇ੮ ʁʇˑʇʡɘ͐ʇʁ੮ ય͐˺੮ ɻ˺͙˦͐ʮʇͅર੮ ɘ˦ʁ੮ʮ͐੮ʩɘͅ˦ૄ͐੮ɺʇʇ˦੮ɘ੮͐˺̹੮̹̼ʮ˺̼ʮ͐;੮ʡʮͷʇ˦੮ʇͷʇ̼;͐ʩʮ˦ʡ੮ʇˑͅʇ੮ʡ˺ʮ˦ʡ੮˺˦ૂઝ˦ɘ˚ʇˑ;ੴ੮ɘ੮ʩ͙ʡʇ੮ ̼ʇʠ˺̼˚੮ ͐˺੮ ͐ʩʇ੮ ଏৱৰৰ੮ ɺʮˑˑʮ˺˦ચ̹ˑ͙ͅ੮ {ʇʁʮચ#ɘˑ੮ ̹͙ɺˑʮɻ੮ ʮ˦͙̼ͅɘ˦ɻʇ੮ ̹̼˺ʡ̼ɘ˚ੴ੮ ˺ʠ੮ ͸ʩʮɻʩ੮ ˺˦ˑ;੮ɘ੮ͅ˚ɘˑˑ੮̹˺̼͐ʮ˺˦੮͸ʇ˦͐੮͐˺੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮š˦ʇ੮ ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮͐ʩʇ੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮ɻʇ˦̼͐ɘˑʮΈʇʁ੮ˑʇɘʁʇ̼ͅʩʮ̹੮ʮͅ੮͸ʮˑʁˑ;੮ʁʮʠʠʇ̼ʇ˦͐੮ʮ˦͐ʇ̼̹̼ʇચ ͐ɘ͐ʮ˺˦੮˺ʠ੮rØä੮ˑɘ͸੮ɺ;੮ɻ˺͙˦͐;੮ɘ̼˺͙˦ʁ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ɘͅ੮ɺɘͅʮɻ੮ɘͅ੮͸ʩʇ˦੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɻɘ˦੮ ̼ʇʠ͙ͅʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮˺̼੮͸ʩʇ͐ʩʇ̼੮ʠɘ˚ʮˑʮʇͅ੮ɻɘ˦੮ͅʇ̼ͷʇ੮ɘͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅੳ੮îʩʮͅ੮˚ɘˌʇͅ੮ɻ˺˦ચ ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ૄͅ੮ͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼੮ͅʇʇ˚੮ɘ̼ɺʮ̼͐ɘ̼;੮ɘ˦ʁ੮ɻɘ̹̼ʮɻʮ˺͙ͅ੮ͅʮ˦ɻʇ੮ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮ ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮ͷɘ̼;੮ɺ;੮Έʮ̹੮ɻ˺ʁʇੳৼ৾ Ø͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ʩɘͷʇ੮ ˦˺͐੮ ʠɘ̼ʇʁ੮ ˚͙ɻʩ੮ ɺʇ͐͐ʇ̼੮ ɘ͐੮ ɘ੮ ɻ˺͙˦͐;੮ ˑʇͷʇˑੳ੮ îʩʇ੮ šϲϲʮɻʇ੮ ˺ʠ੮ ͐ʩʇ੮ Ø͙ɺˑʮɻ੮ I͙ɘ̼ʁʮɘ˦੮ ɻɘ˦੮ ɺʇ੮ ɘ੮ ͐ͅɘ˦ʁɘˑ˺˦ʇ੮ ɘʡʇ˦ɻ;੮ ˺̼੮ ɘ੮ ͙ͅɺʁʮͷʮͅʮ˺˦੮ ˺ʠ੮ ˚ʇ˦ચ ͐ɘˑ੮ ʩʇɘˑ͐ʩੴ੮ ͅ˺ɻʮɘˑ੮ ͅʇ̼ͷʮɻʇͅੴ੮ ˺̼੮ ɘʡʮ˦ʡ੮ ɘ˦ʁ੮ ʁʮͅɘɺʮˑʮ͐;੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅੳ੮ Ĕʩɘ͐ʇͷʇ̼੮ ͐ʩʇ੮ ˑ˺ɻɘ͐ʮ˺˦ੴ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮˚ɘ̼ʡʮ˦ɘˑʮΈʇʁੴ੮˚͙ɻʩ੮ˑʮˌʇ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͐ʩʇ;੮ͅʇ̼ͷʇੳৼ৿ Counચ ͐ʮʇͅ੮̼͐ʇɘ͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˦˺͐੮ɘͅ੮ɘ˦੮˺ɺˑʮʡɘ͐ʮ˺˦੮͐˺͸ɘ̼ʁ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˦ʇʇʁ੮ʮ͐੮ɺ͙͐੮ ɘͅ੮ɘ˦੮˺̹͐ʮ˺˦੮ɘͷɘʮˑɘɺˑʇ੮˺˦ˑ;੮ɘͅ੮ʠ͙˦ʁͅ੮ɘˑˑ˺͸ੳ੮š˦ʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮ʩʇ̼੮ ɻ˺͙˦͐;੮ʇͅͅʇ˦͐ʮɘˑˑ;੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુšˌɘ;ੴ੮͐ʩʮͅ੮ʮͅ੮ʩ˺͸੮˚͙ɻʩ੮˚˺˦ʇ;੮͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ʡʮͷʇ੮ ;˺͙੮ʠ˺̼੮rØä੮યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅરੴ੮ʁ˺˦ૄ͐੮ɻ˺˚ʇ੮ɺɘɻˌ੮͐˺੮͐ʩʇ੮͐ɘɺˑʇ੮ʠ˺̼੮ɘ˦;੮˚˺̼ʇ੶੮ʮʠ੮;˺͙̼੮ ɻɘͅʇͅ੮ʡ˺੮͙̹ੴ੮͐ʩɘ͐ૄͅ੮;˺͙̼੮̹̼˺ɺˑʇ˚ੳૂ੮/ɻ˺˦˺˚ʮɻ੮ɻ̼ʮͅʇͅ੮˚ʮʡʩ͐੮ˑʇɘʁ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ʮ˚̹˺ͅʇ੮ ɺʇˑ͐ચ͐ʮʡʩ͐ʇ˦ʮ˦ʡ੮˺˦੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮ʠ˺̼ɻʮ˦ʡ੮͐ʩʇ˚੮͐˺੮ʁʇɻˑɘ̼ʇ੮͐ʩɘ͐੮ͅ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ચ ɘˑͅ੮ʩɘͷʇ੮̹ͅ˺˦͐ɘ˦ʇ˺͙ͅˑ;੮̼ʇɻ˺ͷʇ̼ʇʁ੮ɘ˦ʁ੮ɻɘ˦੮ɺʇ੮ʇͽ̹͙˦ʡʇʁ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻɘͅʇ੮̼˺ˑˑͅੳৼ਀੮੮͐ʇ˦ʠ˺ˑʁ੮ʁʮʠʠʇ̼ʇ˦ɻʇ੮ʮ˦੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ʇ˺̹ˑʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੮ફ̼ʇˑɘ͐ʮͷʇ੮͐˺੮ ͐ʩʇ੮̹˺̹͙ˑɘ͐ʮ˺˦બ੮ɺʇ͐͸ʇʇ˦੮ɻ˺͙˦͐ʮʇͅ੮ɘˑ˚˺͐ͅ੮ɻʇ̼͐ɘʮ˦ˑ;੮̼ʇϲˑʇɻ͐ͅ੮ʁʮʠʠʇ̼ʇ˦ɻʇͅ੮ʮ˦੮ʠ͙˦ʁચ ʮ˦ʡੴ੮˦˺͐੮˦ʇʇʁ੮ફHʮʡ͙̼ʇ੮৵ੳৱબੳৼਁ ä͐ɘ͐ʇ੮ɘ˦ʁ੮ɻ˺͙˦͐;੮˦ʇʡˑʇɻ͐੮ϲʮˑ͐ʇ̼ͅ੮ʮ˦͐˺੮ʩ˺͸੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮̹ʇ̼ʠ˺̼˚੮͐ʩʇʮ̼੮ɺɘͅʮɻ੮ ʠ͙˦ɻ͐ʮ˺˦ͅੵ੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇʠʇ̼̼ɘˑͅ੮ɘ˦ʁ੮ͅʇ̼ͷʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮îʩʇ̼ʇ੮ʮͅ੮ ˦˺੮͐ͅɘ˦ʁɘ̼ʁ੮̹̼˺ϲʮˑʇ੮ʠ˺̼੮ʁʇ̹͙͐;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ફ͐ʩʇ੮ɘɻ͙͐ɘˑ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮͅ੮͙͙ͅચ ɘˑˑ;੮ɘ੮ʩʮʡʩʇ̼ચ̼ɘ˦ˌʮ˦ʡ੮ɻ˺͙˦͐;੮˺ϲϲʮɻʮɘˑ੮͸ʩ˺੮ʁ˺ʇͅ੮˦˺͐੮̹ˑɘ;੮ɘ˦;੮ʁɘ;ચ͐˺ચʁɘ;੮̼˺ˑʇ੮ʮ˦੮͐ʩʇ੮

P U B L I C G UA R D I A N

107

8

Conservatees per 10,000

7 6 5 4 3 2 1

go Di e

Ke

rn n Sa

to en am

cr Sa

Al

am

ed a

st a

a

Co

nt ra

Ve

ge an Or

nt ur Co

Sa

n

Jo

aq

ui

n

sid e

o

er

rn Be n

Ri v

ad in

no es Fr

at eo M n

Sa

Sa

Sa

n

Fr

an

cis co

0

5.1 Øʇ̼˚ɘ˦ʇ˦͐੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮̼ʇˑɘ͐ʮͷʇ੮͐˺੮̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮৲ৰ৲ৰ Sourceੵ੮äH੮"͙ʁʡʇ͐੮ɘ˦ʁ੮rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅ

˺ϲϲʮɻʇબੳ੮U˦੮˚˺͐ͅ੮ɻ˺͙˦͐ʮʇͅੴ੮͐ʩʇ;੮˦ʇʇʁ੮͐˺੮ʩɘͷʇ੮ɘ͐੮ˑʇɘ͐ͅ੮ɘ੮ɺɘɻʩʇˑ˺̼ૄͅ੮ʁʇʡ̼ʇʇੳ੮îʩʇ੮ʩʇɘʁ੮˺ʠ੮ ͐ʩʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮͐ʇ˦ʁͅ੮͐˺੮ɺʇ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʩ˺੮ʩɘͅ੮͸˺̼ˌʇʁ੮͐ʩʇʮ̼੮͸ɘ;੮͙̹੮͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮˺̼੮ͅ˺ɻʮɘˑ੮ͅʇ̼ͷʮɻʇ੮ͅ;͐ͅʇ˚ੳ੮"͙͐੮͸ʩɘ͐ʇͷʇ̼੮͐ʩʇʮ̼੮ɺɘɻˌʡ̼˺͙˦ʁͅੴ੮͐ʩʇ;੮ ʠɘɻʇ੮ɘ੮ͅʮ˚ʮˑɘ̼੮ʁʮˑʇ˚˚ɘੵ੮˦˺੮˦ʇ͸੮ʠ͙˦ʁʮ˦ʡ੮ʮͅ੮ɘ͙͐˺˚ɘ͐ʮɻɘˑˑ;੮͙˦ˑ˺ɻˌʇʁ੮͸ʩʇ˦੮ͅ˺˚ʇ˺˦ʇ੮ ʡʇ͐ͅ੮ɻ˺˦ͅʇ̼ͷʇʁੳ੮{˺̼ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮˚ʇɘ˦੮ˑɘ̼ʡʇ̼੮ɻɘͅʇˑ˺ɘʁͅઝʠ̼ʇή͙ʇ˦͐ˑ;੮ɘ̼˺͙˦ʁ੮ͅʮͽ͐;੮ ̹ʇ̼੮ʡ͙ɘ̼ʁʮɘ˦ੴ੮ɺ͙͐੮̼ɘ˦ʡʮ˦ʡ੮͙̹੮͐˺੮˺˦ʇ੮ʩ͙˦ʁ̼ʇʁ੮ʮ˦੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮̼͐ͅɘ̹̹ʇʁ੮ɻ˺͙˦͐ʮʇͅੳ š˦ɻʇ੮ʇ͐ͅɘɺˑʮͅʩʇʁੴ੮˚ɘ˦;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮͸ʮˑˑ੮ɺʇ੮̼ʇ˦ʇ͸ʇʁ੮;ʇɘ̼੮ɘʠ͐ʇ̼੮;ʇɘ̼ੴ੮ͅ˺੮ ʮ͐੮ ˚ɘˌʇͅ੮ ͅʇ˦ͅʇ੮ ˦˺͐੮ ͐˺੮ ˌʇʇ̹੮ ͐ʩʇ੮ ʠ̼˺˦͐੮ ʁ˺˺̼੮ ˺ʠ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ ˺ϲϲʮɻʇ੮ ͐˺˺੮ ʠɘ̼੮ ˺̹ʇ˦ੳৼਂ੮ îʩʇ੮ ˌʇ;੮ ˚˺˚ʇ˦͐੮ ͐˺੮ ʇͽʇ̼ɻʮͅʇ੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ʮͅ੮ ʁ͙̼ʮ˦ʡ੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ੳ੮ îʩʇ੮ ̹̼˺ɻʇͅͅ੮ ˑ˺˺ˌͅ੮ ˑʮˌʇ੮ ͐ʩʮͅੵ੮ ϲʮͷʇ੮ ʁɘ;ͅ੮ ɺʇʠ˺̼ʇ੮ ͐ʩʇ੮ ʇͽ̹ʮ̼ɘ͐ʮ˺˦੮ ˺ʠ੮ ɘ੮ ৵৲৵ৰੴ੮ʮʠ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮͸ɘ˦͐ͅ੮͐˺੮ˌʇʇ̹੮ɘ੮̹ʇ̼ͅ˺˦੮ɘͅ੮ɘ˦੮ʮ˦̹ɘ͐ʮʇ˦͐ੴ੮͐ʩʇ;੮ʩɘͷʇ੮͐˺੮ϲʮˑʇ੮ʠ˺̼੮ ɘ੮ ͐ʩʮ̼͐;ચʁɘ;੮ ͐ʇ˚̹˺̼ɘ̼;੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳৼਃ੮ k͙ʁʡʇͅ੮ ͙͙ͅɘˑˑ;੮ ͅʮʡ˦੮ ͐ʩɘ͐੮ ˺̼ʁʇ̼੮ ͸ʮ͐ʩચ ˺͙͐੮ɘ੮ʩʇɘ̼ʮ˦ʡੳ੮îʩʇ˦੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ˑɘ͙˦ɻʩʇͅ੮ɘ˦੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ʮ˦͐˺੮͸ʩʇ͐ʩʇ̼੮ ͐˺੮ɘ̹̹ˑ;੮ʠ˺̼੮ɘ੮˺˦ʇચ;ʇɘ̼੮̹ʇ̼˚ɘ˦ʇ˦͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮îʩɘ͐੮˚ʇɘ˦ͅ੮̼ʇͷʮʇ͸ʮ˦ʡ੮͐ʩʇ੮ medical record, speaking to family and outpatient providers, and, ultimately, ʮ˦͐ʇ̼ͷʮʇ͸ʮ˦ʡ੮͐ʩʇ੮̹˺͐ʇ˦͐ʮɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʠ̼˺˚੮ɘ੮ɻ˺͙˦͐;੮ʇͷʇ˦੮ ͅ˚ɘˑˑʇ̼੮͐ʩɘ˦੮H̼˺˦͐ʮʇ̼੮͸ɘͅ੮ʠ̼ɘ˦ˌ੮ɘɺ˺͙͐੮͐ʩʇ੮̹͙̼̹˺ͅʇ੮˺ʠ੮͐ʩʇͅʇ੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ͅੵ੮ુયϲʮˑʮ˦ʡ੮ ʠ˺̼ર੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮͐ʩʇ੮ˑɘ͐ͅ੮͐ʩʮ˦ʡ੮;˺͙੮͸ɘ˦͐੮͐˺੮ʁ˺੮ɘͅ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੳૂ

108

T H E C O N S E RVATO R S H I P C O N T I N U U M

੮͐ʩ˺̼˺͙ʡʩ੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ɺ;੮ɘ੮ʁʇ̹͙͐;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮͅ੮ɘ˦੮ʮ˚̹˺̼͐ɘ˦͐੮ɻʩʇɻˌ੮˺˦੮ ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅૄ੮̹˺͸ʇ̼ੳ੮k˺ͅʇ̹ʩ੮)ʇͷʮɻ˺੮͸˺̼ˌʇʁ੮ͷʮ̼͙͐ɘˑˑ;੮ʇͷʇ̼;͸ʩʇ̼ʇ੮ʮ˦੮͐ʩʇ੮ ͅ;͐ͅʇ˚ઝ˺͙̹͐ɘ͐ʮʇ˦͐੮͐ʇɘ˚ੴ੮U{)ੴ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐ઝɺʇʠ˺̼ʇ੮ɻ˺˚ʮ˦ʡ੮͐˺੮͐ʩʇ੮äɘ˦੮)ʮʇʡ˺੮ Ø͙ɺˑʮɻ੮#˺˦ͅʇ̼ͷɘ͐˺̼ૄͅ੮šϲϲʮɻʇੳ੮Pʇ੮ʁʇͅɻ̼ʮɺʇʁ੮˺˦ʇ੮̼ʇʠʇ̼̼ɘˑੳৼ਄ The individual had eleven ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮ʮ˦੮͐͸ʇˑͷʇ੮˚˺˦͐ʩͅੳ੮ુU੮͐ʩ˺͙ʡʩ͐ੴ੮ૃ͸˺͸ੴ੮ʩʇૄͅ੮ɘ੮ͅʩ˺ʇ੮ʮ˦੯ੳ੯ੳ੯ੳ੮ʠ˺̼੮ɻ˺˦ચ ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮k˺ͅʇ̹ʩ੮ɻ˺˦ɻˑ͙ʁʇʁੳ੮"͙͐ੴ੮ʁ˺ʮ˦ʡ੮ʁ͙ʇ੮ʁʮˑʮʡʇ˦ɻʇੴ੮ʩʇ੮͐ͅʮˑˑ੮ɻ˺˚ɺʇʁ੮͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑૄͅ੮ ̼ʇɻ˺̼ʁͅੳ੮ Pʇ੮ ͸ɘͅ੮ ͅʩ˺ɻˌʇʁੵ੮ ુîʩʇ̼ʇ੮ ͸ʇ̼ʇ੮ ʇˑʇͷʇ˦੮ ʮʁʇ˦͐ʮɻɘˑ੮ ʁʮͅɻʩɘ̼ʡʇ੮ ̹ˑɘ˦ͅੳ੮/ͷʇ̼;੮͐ʮ˚ʇ੮͐ʩʇ;੮͐ͅɘ;ʇʁ੮ɘɺ˺͙͐੮͐ʩʇ੮ͅɘ˚ʇ੮ˑʇ˦ʡ͐ʩੴ੮͐ʩʇ;੮ʩɘʁ੮͐ʩʇ੮ͅɘ˚ʇ੮˚ʇʁͅઝ˦˺੮ ɘ͐͐ʇ˚̹͐੮ ͐˺੮ ʡʇ͐੮ ͐ʩʇ˚੮ ˺˦੮ ɘ˦੮ ʮ˦ˈʇɻ͐ɘɺˑʇ੮ યɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻરઝ͸ʇ˦͐੮ ͐˺੮ ɘ˦੮ ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ˑʮͷʮ˦ʡ੮ʠɘɻʮˑʮ͐;ઝ˦˺੮ɘ͐͐ʇ˚̹͐੮͐˺੮ʡʇ͐੮͐ʩʇ˚੮ʮ˦੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮͐ͅɘ̼͐ʇʁ੮͐ʩʇ੮ ;ʇɘ̼੮͸ʮ͐ʩ˺͙͐੮ɘ˦੮ય˺͙̹͐ɘ͐ʮʇ˦͐ર੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼ੴ੮ɘ˦ʁ੮ʇ˦ʁʇʁ੮͸ʮ͐ʩ˺͙͐੮ɘ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼ੳૂ੮ Pʇ੮͸ɘͅੴ੮ʮ˦੮ʩʮͅ੮˺͸˦੮͸˺̼ʁͅੴ੮ુʠ͙̼ʮ˺͙ͅૂੵ੮ુĔʩɘ͐੮ɘ̼ʇ੮;˺͙੮ʁ˺ʮ˦ʡ੮̼ʇʠʇ̼̼ʮ˦ʡ੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੮ for conservatorship after you’ve done absolutely nothing to get them more care ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੺ૂ੮Ûʇʠ͙ͅʮ˦ʡ੮͐ʩɘ͐੮̼ʇʠʇ̼̼ɘˑੴ੮ʮ˦੮ʩʮͅ੮ͷʮʇ͸ੴ੮ʇ˦ɘɻ͐ʇʁ੮͐ʩʇ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ˺ʠ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮˺ʠʠʇ̼ͅ੮ુʇͷʇ̼;੮ɻʩɘ˦ɻʇ੮͐˺੮ˌʇʇ̹੮͐ʩɘ͐੮̹ʇ̼ͅ˺˦੮ʠ̼ʇʇੳૂ There are legal mandates and good ethical reasons for guardians to insist on ̼͐;ʮ˦ʡ੮ʇͷʇ̼;੮ˑʇͅͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ϲʮ̼͐ͅੳ੮"͙͐੮ʮ͐ૄͅ੮ɘˑͅ˺੮̼ʇͷʇɘˑʮ˦ʡੳ੮#˺˚˚͙˦ʮ͐;ચ ɺɘͅʇʁ੮ͅ˺ˑ͙͐ʮ˺˦ͅ੮͐ʇ˦ʁ੮͐˺੮ɺʇ੮̹̼˺ͷʮʁʇʁ੮ɺ;੮͐ʩʇ੮̹̼ʮͷɘ͐ʇ੮ફʠ˺̼ચ̹̼˺ϲʮ͐੮˺̼੮˦˺˦̹̼˺ϲʮ͐બ੮ͅʇɻચ ͐˺̼ੴ੮ ɘ˦ʁ੮ ̹ɘʮʁ੮ ʠ˺̼੮ ̹ɘ̼͐ˑ;੮ ɺ;੮ ʠʇʁʇ̼ɘˑ੮ {ʇʁʮɻɘʮʁ੮ ʁ˺ˑˑɘ̼ͅੳ੮ ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ˚ɘˌʇͅ੮ ͅ˺˚ʇ˺˦ʇ੮ ɘ੮ ̼͙͐ˑ;੮ ̹͙ɺˑʮɻ੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;ੴ੮ ʁ̼ɘ͸ʮ˦ʡ੮ ˺˦੮ ˚˺̼ʇ੮ ˑʮ˚ʮ͐ʇʁ੮ ɻ˺͙˦͐;੮ ʠ͙˦ʁͅੳ੮ ˦ʁ੮͐ʩɘ͐ૄͅ੮ɘ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮͐ʩɘ͐੮͐ʩʇ੮̹͙ɺˑʮɻ੮ͅʇɻ͐˺̼ੴ੮͐ʩ̼˺͙ʡʩ੮ʮ͐ͅ੮ʮ˦ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮̹͙ɺચ ˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮˺ϲϲʮɻʇͅੴ੮ʮͅ੮̼ʇˑ͙ɻ͐ɘ˦͐੮͐˺੮͐ɘˌʇੳ

PLACEMENTS, PLACEMENTS, PLACEMENTS /ͷʇ˦੮͐ɘˌʮ˦ʡ੮͐ʩʇͅʇ੮ʠ͙˦ʁʮ˦ʡ੮ɻ˺˦̼͐ͅɘʮ˦͐ͅ੮ʮ˦͐˺੮ɘɻɻ˺͙˦͐ੴ੮ʮ͐ૄͅ੮ʩɘ̼ʁ੮͐˺੮ˑ˺˺ˌ੮ɘ͐੮͐ʩʇ੮ɻɘͅʇ੮ ˺ʠ੮{ɘ̼ˌ੮Ûʮ̹̹ʇʇੴ੮ɘ˦ʁ੮˦˺͐੮͐ʩʮ˦ˌ੮ͅ˺˚ʇ੮ɻ˺͙˦͐;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮ʁ̼ɘ͸ʮ˦ʡ੮ͅʩɘ̼̹੮ ˑʮ˦ʇͅ੮ ɘ̼˺͙˦ʁ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ͐ʩɘ͐੮ ɘ̼ʇ੮ ʮ˦ʇͽ̹ˑʮɻɘɺˑʇ੮ ɘ˦ʁ੮ ʮ˦ʩ͙˚ɘ˦ʇੳ৽৻੮ {ɘ̼ˌ੮ ʩɘʁ੮ ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ ʁʮͅ˺̼ʁʇ̼੮ ɘͅ੮ ͸ʇˑˑ੮ ɘͅ੮ ɘ੮ ̼͐ɘ͙˚ɘ͐ʮɻ੮ ɺ̼ɘʮ˦੮ ʮ˦ˈ͙̼;੮ ʠ̼˺˚੮ ɘ੮ ˚˺͐˺̼ɻ;ɻˑʇ੮ ɘɻɻʮʁʇ˦͐੮͐ʩɘ͐੮ɻ˺͐ͅ੮ʩʮ˚੮ɺ˺͐ʩ੮ʇ;ʇͅ੮ɘ˦ʁ੮˺˦ʇચ͐ʩʮ̼ʁ੮˺ʠ੮ʩʮͅ੮ʠ̼˺˦͐ɘˑ੮ˑ˺ɺʇੳ੮͐੮ϲʮʠ͐;ચ˦ʮ˦ʇ੮ years old, he had been almost constantly homeless since 2007, and during that ͐ʮ˚ʇ੮̼ɘɻˌʇʁ੮͙̹੮˺˦ʇ੮ʩ͙˦ʁ̼ʇʁ੮ɘ̼̼ʇ͐ͅͅ੮ʠ˺̼੮ʮˑˑʇʡɘˑ੮ɻɘ˚̹ʮ˦ʡ੮ɘ˦ʁ੮ͷɘʡ̼ɘ˦ɻ;ੳ੮Pʇ੮͸ɘͅ੮ɘ੮ ɻ˺˚˚͙˦ʮ͐;੮ϲʮͽ͙̼͐ʇੴ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̹͙ͅʩʮ˦ʡ੮ʩʮͅ੮ͅʩ˺̹̹ʮ˦ʡ੮ɻɘ̼͐੮ʮ˦͐˺੮̼͐ɘϲϲʮɻੴ੮͸ʩʇ̼ʇ੮ʩʇ੮ ͸ɘͅ੮ʩʮ͐ੴ੮͸ʮ͐ʩ੮˦ʇɘ̼੮ʠɘ͐ɘˑ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅੴ੮͐͸ʮɻʇੳ੮Pʇ੮͸ɘͅ੮̼ʇʡ͙ˑɘ̼ˑ;੮ɺʇɘ͐ʇ˦੮ɘ˦ʁ੮̼˺ɺɺʇʁ੮ ɺ;੮˺͐ʩʇ̼੮͙˦ʩ˺͙ͅʇʁ੮̹ʇ˺̹ˑʇੳ

P U B L I C G UA R D I A N

109

{ɘ̼ˌ੮͸ɘͅ੮ˑ˺˦ʡ੮ˌʇ̹͐੮ɘˑʮͷʇ੮ɺ;੮ʩʮͅ੮ͅʮ͐ͅʇ̼ͅ੮rʮ˦ʁɘ੮Ø̼ʮͷɘ͐͐ʇ੮ɘ˦ʁ੮#ɘ͐ʩʇ̼ʮ˦ʇ੮Ûʮ̹̹ʇʇ੮ ɘ˦ʁ੮ɘ੮͐˺͸˦੮Hɘɻʇɺ˺˺ˌ੮ʡ̼˺͙̹੮͐ʩɘ͐੮̼ʇ̹˺̼͐ʇʁ੮˺˦੮ʩʮ˚੮ɘ˦ʁ੮ɺ̼˺͙ʡʩ͐੮ʩʮ˚੮ɺɘͅʮɻ੮˦ʇɻʇͅચ ͅʮ͐ʮʇͅੳ੮rʮ˦ʁɘ੮̹ͅʇ˦͐੮ʇ˦˺͙ʡʩ੮͐ʮ˚ʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮͐˺੮ͅ˺͙˦ʁ੮ɻ̼ʇʁʮɺˑʇ੮͸ʩʇ˦੮ͅʩʇ੮͐ͅɘ͐ʇʁੴ੮ ુPʇ੮ʮͅ੮͐ʩʇ੮͸˺̼͐ͅ੮˺ʠ੮͐ʩʇ੮͸˺̼͐ͅ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦ૂ੮ʮ˦੮ēɘɻɘͷʮˑˑʇੴ੮ɘ੮͐˺͸˦੮˺ʠ੮ৱ৲ৰੴৰৰৰ੮ ʮ˦੮ä˺ˑɘ˦˺੮#˺͙˦͐;ੴ੮ˈ͙͐ͅ੮˦˺̼͐ʩ੮˺ʠ੮šɘˌˑɘ˦ʁ੮ɘ˦ʁ੮͐ʩʇ੮/ɘ͐ͅ੮"ɘ;ੳ੮Ě˺͙੮ɻ˺͙ˑʁ੮͙̼͐˦੮͐ʩʇ੮ failure of attempts to get him conserved into a parable of civil rights protections ̼͙͐˚̹ʮ˦ʡ੮ɻ˺˚˚˺˦੮ͅʇ˦ͅʇੳ੮"͙͐੮ʮ͐੮ʮͅ੮ɘˑͅ˺੮ɘ੮͐ͅ˺̼;੮ɘɺ˺͙͐੮͐ʩʇ੮ʮ˦ʇͷʮ͐ɘɺˑʇ੮ʮ˚̹ʇ̼ɘ͐ʮͷʇͅ੮ ˺ʠ੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮͸ʩ˺੮˚͙͐ͅ੮ɘʁɘ̹͐੮͐˺੮ɘ੮ͅʮ͙͐ɘ͐ʮ˺˦੮͸ʩʇ̼ʇ੮͐ʩʇ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ ɘͷɘʮˑɘɺˑʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʁ˺˦ૄ͐੮˚ɘ͐ɻʩ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˦ʇʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ ੮ʠʇ͸੮;ʇɘ̼ͅ੮ɘʠ͐ʇ̼੮ʩʮͅ੮ɘɻɻʮʁʇ˦͐੮ʮ˦੮ৱ৹৸৷ੴ੮{ɘ̼ˌ੮ɺʇʡɘ˦੮͐˺੮ʁʇͷʇˑ˺̹੮ʁʇˑ͙ͅʮ˺˦ͅ੮ɘ˦ʁ੮ ɺʇɻɘ˚ʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮˚ʇ˦ɘɻʮ˦ʡੳ੮Pʮͅ੮ʠɘ˚ʮˑ;੮͐ͅɘ̼͐ʇʁ੮ɻɘˑˑʮ˦ʡ੮͐ʩʇ੮̹˺ˑʮɻʇੴ੮͸ʩ˺੮͙͙ͅɘˑˑ;੮ ɘ̼̼ʇ͐ͅʇʁ੮ʩʮ˚੮ɺ͙͐੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮͐˺˺ˌ੮ʩʮ˚੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮Pʮͅ੮ˑ˺˦ʡʇ͐ͅ੮͐ͅɘ;੮͸ɘͅ੮͐͸˺੮ ͸ʇʇˌͅੴ੮͸ʩʮɻʩ੮ʮͅ੮͐˺੮ͅɘ;੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮˦ʇͷʇ̼੮ɘͅˌʇʁ੮ʠ˺̼੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮îʩɘ͐੮ ˚ɘʁʇ੮ ʩʮͅ੮ ʠɘ˚ʮˑ;੮ ʩʮͅ੮ ʡ͙ɘ̼ʁʮɘ˦੮ ɺ;੮ ʁʇʠɘ͙ˑ͐ੳ੮ îʩʇ;੮ ̹͙͐੮ ʩʮ˚੮ ʮ˦੮ ɘ੮ ͙ͅɺͅʮʁʮΈʇʁ੮ ɘ̹ɘ̼͐ચ ˚ʇ˦͐ੴ੮ʠ̼˺˚੮͸ʩʮɻʩ੮ʩʇ੮͸ɘͅ੮ʇͷʮɻ͐ʇʁ੮ʮ˦੮৲ৰৰ৷ੳ੮Pʮͅ੮ͅʮ͐ͅʇ̼ͅ੮ɘ˦ʁ੮˚˺͐ʩʇ̼੮͸ʇ̼ʇ੮ɘʮˑʮ˦ʡ੮ɘ˦ʁ੮ ͸ʇ̼ʇ੮ʮ˦੮˦˺੮͐ͅɘ͐ʇ੮͐˺੮͐ɘˌʇ੮ʩʮ˚੮ʮ˦ੴ੮ɘ˦ʁ੮͐ʩʇ੮ˑɘ͐ͅ੮͐ʮ˚ʇ੮{ɘ̼ˌૄͅ੮˚˺͐ʩʇ̼੮ͷʮͅʮ͐ʇʁ੮ʩʮ˚ੴ੮ʩʇ੮ ͐ʩ̼ʇɘ͐ʇ˦ʇʁ੮͐˺੮ˌʮˑˑ੮ʩʇ̼ઝ˺̼ੴ੮ʮ˦੮ʩʮͅ੮˚ʮ˦ʁੴ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮͸ɘͅ੮ʮ˚̹ʇ̼ͅ˺˦ɘ͐ʮ˦ʡ੮ʩʮͅ੮ ˚˺͐ʩʇ̼ઝ͸ʮ͐ʩ੮ ɘ˦੮ ɘͽʇੳ੮ )ʇ̹ͅʮ͐ʇ੮ ɺʇʮ˦ʡ੮ ɻ˺˦͐ͅɘ˦͐ˑ;੮ ʮ˦੮ ͐ʩʇ੮ ͐ʩ̼˺ʇͅ੮ ˺ʠ੮ ͙˦˚ʇʁʮɻɘ͐ʇʁ੮ ̹ͅ;ɻʩ˺ͅʮͅੴ੮ʮ˦੮͐ʩʇ੮͐ʇ˦੮͙ͅɺͅʇή͙ʇ˦͐੮;ʇɘ̼ͅ੮ʩʇ੮͸ɘͅ੮৵ৱ৵ৰʇʁ੮˺˦ˑ;੮˺˦ɻʇੳ੮rʮ˦ʁɘ੮̹ͅʇɻ͙ˑɘ͐ʇͅੴ੮ ̹̼˺ɺɘɺˑ;੮ɘɻɻ͙̼ɘ͐ʇˑ;ੴ੮͐ʩɘ͐੮̹˺ˑʮɻʇ੮ʮ˦੮ä˺ˑɘ˦˺੮ˈ͙͐ͅ੮ʁ˺˦ૄ͐੮͙ͅʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɘͅ੮͐ʩʇ੮ ɺɘͅʮͅ੮ʠ˺̼੮ɘ੮ʩ˺ˑʁੳ ੮ʠʇ͸੮͐ʮ˚ʇͅੴ੮͐ʩʇ;੮ʡ˺͐੮ɻˑ˺ͅʇ̼੮͐˺੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮rʮ˦ʁɘੴ੮ʩʇ̼੮ͅʮ͐ͅʇ̼੮#ɘ͐ʩʇ̼ચ ʮ˦ʇੴ੮ ɘ˦ʁ੮ ͙̹̹ͅ˺̼͐ʇ̼ͅ੮ ͐ʩʇ;੮ ˚͙͐ͅʇ̼ʇʁ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ʠɘ˚ʮˑ;ચɘʁͷ˺ɻɘɻ;੮ ɻ˺˚˚͙˦ʮ͐;੮ ͅʇ˦͐੮ an avalanche of messages to everyone ranging from the county human services ʁʇ̹ɘ̼͐˚ʇ˦͐੮͐˺੮͐ʩʇ੮Ĕʩʮ͐ʇ੮P˺͙ͅʇੳ੮U˦੮৲ৰৱ৷ੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺˺ˌ੮˦˺͐ʮɻʇੳ੮{ɘ̼ˌ੮ʩɘʁ੮ɺʇʇ˦੮ ˚ʮͅͅʮ˦ʡ੮ʠ˺̼੮ɘ੮ʠʇ͸੮͸ʇʇˌͅੴ੮ɺ͙͐੮ʇͷʇ˦͙͐ɘˑˑ;੮rʮ˦ʁɘ੮ʡ˺͐੮ɘ੮ˌ˦˺ɻˌ੮˺˦੮ʩʇ̼੮ʁ˺˺̼੮ʠ̼˺˚੮ɘ੮ ēɘɻɘͷʮˑˑʇ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼੮ɘ˦ʁ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ʠ̼˺˚੮ɘ੮˦˺˦̹̼˺ϲʮ͐੮͸ʩ˺੮ʩɘʁ੮ʠ˺͙˦ʁ੮ʩʮ˚ੳ੮ îʩʇ;੮̹̼˺˚ʮͅʇʁ੮͐ʩʇ̼ʇ੮͸ɘͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ɘ੮˚ʇʇ͐ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮ɘ˦ʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺੮ʁʮͅɻ͙ͅͅ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮äʩʇ੮ʡ˺͐੮ɘ੮˚ʇͅચ ͅɘʡʇ੮ɘ੮ʠʇ͸੮͸ʇʇˌͅ੮ˑɘ͐ʇ̼੮͐ʩɘ͐੮ુʮ͐੮ય͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ʁʮʁ˦ૄ͐੮ʡ˺੮͐ʩ̼˺͙ʡʩੳૂ੮îʩʇ;੮ʁʮʁ੮ ϲʮ˦ʁ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੵ੮ɘ੮ɺ˺ɘ̼ʁʮ˦ʡ੮ʩ˺˚ʇੴ੮͸ʩʇ̼ʇ੮ʩʇ੮ˑɘ͐ͅʇʁ੮ુɘɺ˺͙͐੮͐ʩ̼ʇʇ੮ʁɘ;ͅૂ੮ɺʇʠ˺̼ʇ੮ ͐ʩʇ੮ ͙̹ͅʇ̼ͷʮͅ˺̼੮ ɻɘˑˑʇʁ੮ ͐ʩʇ੮ ̹˺ˑʮɻʇੳ੮ ુîʩʇ੮ ˚ɘ˦ɘʡʇ̼੮ ͸ɘͅ੮ ɺʇʡʡʮ˦ʡ੮ ͐ʩʇ੮ ̹˺ˑʮɻʇ੮ ˦˺͐੮ ͐˺੮ ɘ̼̼ʇ͐ͅ੮ʩʮ˚੮ɺ͙͐੮͐˺੮̹ˑʇɘͅʇ੮͐ɘˌʇ੮ʩʮ˚੮͐˺੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻ̼ʮͅʮͅ੮̹ˑɘɻʇੴૂ੮rʮ˦ʁɘ੮͐˺ˑʁ੮˚ʇੳ੮ ુîʩʇ;੮ʁʮʁ੮˦ʇʮ͐ʩʇ̼ੳ੮îʩʇ;੮̹͙͐੮ʩʮ˚੮ɺɘɻˌ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳૂ îʩʇ੮ ɻ˺͙˦͐;੮ ʁʮʁ੮ ˦˺͐੮ ʡʮͷʇ੮ rʮ˦ʁɘ੮ ɘ˦੮ ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ ʠ˺̼੮ ͐ʩʇʮ̼੮ ʁʇɻʮͅʮ˺˦ੴ੮ ɺ͙͐੮ ˚;੮ ̼ʇͅʇɘ̼ɻʩ੮˺ʠʠʇ̼ͅ੮ɘ੮ʠʇ͸੮ʩ;̹˺͐ʩʇͅʇͅੳ੮ˑ͐ʩ˺͙ʡʩ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʁʇͅɻ̼ʮɺʇ੮͙ͅɺ͐ͅɘ˦ɻʇ੮

110

T H E C O N S E RVATO R S H I P C O N T I N U U M

͙ͅʇ੮ɘͅ੮͙ɺʮή͙ʮ͐˺͙ͅ੮ɘ˚˺˦ʡ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͐ʩʇ;੮ɻ˺˦ͅʇ̼ͷʇੴ੮͐ʩʇ;੮ɻɘ˦੮̼ʇʠ͙ͅʇ੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮ɺ;੮ claiming that a person has only substance issues and not a mental disorder as ̼ʇή͙ʮ̼ʇʁ੮ɺ;੮͐ʩʇ੮ˑɘ͸ੳ੮ͅ੮͸ʮ͐ʩ੮/Û੮ʁ˺ɻ͐˺̼ͅੴ੮͐ʩʇ̼ʇ੮˚ʮʡʩ͐੮ɺʇ੮ɘ੮ɺʮ͐੮˺ʠ੮˚˺̼ɘˑ੮ˈ͙ʁʡ˚ʇ˦͐੮ ɺʇʩʮ˦ʁ੮͙ͅɻʩ੮ɘ੮ͷʇ͐˺ੴ੮ɺ͙͐੮ɘˑͅ˺੮ɘ੮̹͙̼ʇˑ;੮̹̼ɘɻ͐ʮɻɘˑ੮ɻɘˑɻ͙ˑɘ͐ʮ˺˦ੳ੮r˺ɻˌʇʁ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ hospitals can force someone to be sober but rarely have comprehensive addicચ ͐ʮ˺˦੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮͸˺˦ૄ͐੮ʩ˺ˑʁ੮ͅ˺˚ʇ˺˦ʇ੮͐ʩʇ;੮ͅʇʇ੮ɘͅ੮˺˦ˑ;੮ɘ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼੮ʠ˺̼੮ɘ˦੮ ʇͽ͐ʇ˦ʁʇʁ੮̹ʇ̼ʮ˺ʁੳ੮ͅ੮k˺ͅʇ̹ʩ੮)ʇēʮɻ˺ੴ੮͐ʩʇ੮ʠ˺̼˚ʇ̼੮ʁʇ̹͙͐;੮ʠ̼˺˚੮äɘ˦੮)ʮʇʡ˺੮̹͙͐੮ʮ͐ੴ੮ ુîʩʇ̼ʇૄͅ੮ˑʮ͐ʇ̼ɘˑˑ;੮˦˺੮̹ˑɘɻʇੴ੮ʇͽɘɻ͐ˑ;੮Έʇ̼˺੮̹ˑɘɻʇͅੴ੮͸ʩʇ̼ʇ੮;˺͙੮ɻɘ˦੮ʠ˺̼ɻʇ੮ɘ੮̹ʇ̼ͅ˺˦੮͐˺੮ ̼ʇɻʇʮͷʇ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮ä˺੮ʮ͐੮͸˺͙ˑʁ˦ૄ͐੮˚ɘˌʇ੮ɘ˦;੮ͅʇ˦ͅʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮ ͅ˺˚ʇɺ˺ʁ;ੴ੮˺ϲϲʮɻʮɘˑˑ;੮ɻ̼͙˚̹ˑʇ੮͙̹੮͐ʩʇʮ̼੮ˑʮɺʇ̼͐ʮʇͅੴ੮ɘ˦ʁ੮͐ʩʇ˦੮˦˺͐੮ɺʇ੮ɘɺˑʇ੮͐˺੮ʁ˺੮ɘ˦;ચ ͐ʩʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩɘ͐੮ɘ͙͐ʩ˺̼ʮΈɘ͐ʮ˺˦ੳ੮îʩɘ͐੮̹˺͸ʇ̼੮͸˺͙ˑʁ੮ɘˑˑ˺͸੮;˺͙੮͐˺੮ʁ˺੮˦˺͐ʩʮ˦ʡੳૂ੮îʩɘ͐੮ ͅɘʮʁੴ੮rʮ˦ʁɘ੮͐ʇˑˑͅ੮˚ʇੴ੮ɘˑ͐ʩ˺͙ʡʩ੮{ɘ̼ˌ੮˚ʮʡʩ͐੮ʩɘͷʇ੮̼͙˦੮ʮ˦͐˺੮˺͐ʩʇ̼੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮ ʁ˺ʮ˦ʡ੮˚ʇ͐ʩ੮ɘ˦ʁ੮ˈ˺ʮ˦੮ʮ˦ੴ੮ͅʩʇ੮ʁʮʁ˦ૄ͐੮͐ʩʮ˦ˌ੮ʩʮͅ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮͸ɘͅ੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮ʇ˦˺͙ʡʩ੮ ͐˺੮ɺʇ੮͙ͅʇʁ੮͐˺੮ʁʮͅή͙ɘˑʮʠ;੮ʩʮ˚੮ʠ̼˺˚੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ Ø͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ɻɘ˦੮ ʇͷ˺ˌʇ੮ ˺͐ʩʇ̼੮ ̼ʇɘͅ˺˦ͅ੮ ͐˺੮ ͅʩ͙ϲϲˑʇ੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ʠ˺̼੮ ͙˦͸ɘ˦͐ʇʁ੮ફ̹˺͐ʇ˦͐ʮɘˑબ੮ɻˑʮʇ˦͐ͅ੮˺˦͐˺੮˺͐ʩʇ̼੮ɘʡʇ˦ɻʮʇͅੴ੮˺˦͐˺੮ʠɘ˚ʮˑʮʇͅੴ੮˺̼੮˺˦͐˺੮͐ʩ˺ͅʇ੮ ɻˑʮʇ˦͐ͅ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮U˦੮äʇ̹͐ʇ˚ɺʇ̼੮৲ৰৱ৹ੴ੮{ɘ̼ˌ੮͸ɘͅ੮ʩʮ͐੮ɺ;੮ɘ੮ɻɘ̼ੳ੮šϲϲʮɻʇ̼ͅ੮ͷʮͅʮ͐ʇʁ੮ʩʮ˚੮ ͸ʩʇ˦੮ʩʇ੮͸ɘͅ੮ɻ̼;ʮ˦ʡ੮ʮ˦੮̹ɘʮ˦੮˺˦੮͐ʩʇ੮ͅʮʁʇ͸ɘˑˌੴ੮ɺ͙͐੮ʩʇ੮̼ʇʠ͙ͅʇʁ੮ʩʇˑ̹੮ɘ˦ʁ੮ͅ˺੮ʁʮʁ˦ૄ͐੮ ʡʇ͐੮ɘ˦;ੳ੮U͐੮͐˺˺ˌ੮rʮ˦ʁɘ੮͐͸˺੮͸ʇʇˌͅ੮͐˺੮ʡʇ͐੮ʩʮ˚੮͐˺੮ʡ˺੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ɘ੮͸˺̼ͅʇ˦ʮ˦ʡ੮ ɘɺͅɻʇͅͅ੮ʮ˦੮ʩʮͅ੮ɺ̼ɘʮ˦ੳ੮Ĕʩʇ˦੮ͅʩʇ੮ʩʇɘ̼ʁ੮͐ʩɘ͐੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ɘͅ੮̹ˑɘ˦˦ʮ˦ʡ੮͐˺੮̹͙͐੮ʩʮ˚੮ ʮ˦੮ɘ੮͐ɘͽʮ੮͙̹˺˦੮̼ʇˑʇɘͅʇੴ੮rʮ˦ʁɘ੮ɘ˦ʁ੮#ɘ͐ʩʇ̼ʮ˦ʇ੮˚˺ɺʮˑʮΈʇʁ੮͐ʩʇʮ̼੮͙̹̹ͅ˺̼͐ʇ̼ͅ੮ʮ˦͐˺੮ɘ੮ ુɻ˺ˑˑʇɻ͐ʮͷʇ੮ϲʮ͐ૂ੮͙˦͐ʮˑ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɘʡ̼ʇʇʁ੮͐˺੮̹ˑɘɻʇ੮ʩʮ˚੮ʮ˦੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇ੮ʠ˺̼੮ ͐ʩʮ̼͐;੮ʁɘ;ͅੳ੮ʠ͐ʇ̼੮͐͸ʇ˦͐;੮ʁɘ;ͅੴ੮ʩʇ੮ˈ͙˚̹ʇʁ੮͐ʩʇ੮ʠʇ˦ɻʇ੮ʮ˦੮͐ʩʇ੮ɺɘɻˌ;ɘ̼ʁ੮ɘ˦ʁ੮͐˺˺ˌ੮˺ʠʠੳ੮ îʩʇ˦ੴ੮ʮ˦੮Hʇɺ̼͙ɘ̼;੮৲ৰ৲ৰੴ੮ʩʇ੮͸ɘͅ੮̼͙͐ͅɻˌ੮ɺ;੮ɘ˦˺͐ʩʇ̼੮ɻɘ̼ੳ੮ʠ͐ʇ̼੮ͅʇͷʇ̼ɘˑ੮͙̼ͅʡʇ̼ʮʇͅੴ੮ʩʇ੮ ʇ˦ʁʇʁ੮͙̹੮ʮ˦੮ɘ੮̼ʇʩɘɺ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮˦ʇʮʡʩɺ˺̼ʮ˦ʡ੮‡ɘ̹ɘ੮#˺͙˦͐;ੳ੮îʩʇ̼ʇੴ੮͐ʩʇ੮̹ʩ;ͅʮɻʮɘ˦੮ ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ફ͸ʩ˺੮ɘ̹̹ɘ̼ʇ˦͐ˑ;੮ʩɘʁ੮ʩʇɘ̼ʁ੮ɘɺ˺͙͐੮{ɘ̼ˌૄͅ੮ɻɘͅʇ੮ʇͷʇ˦੮ɺʇʠ˺̼ʇ੮ʩʇ੮ ɘ̼̼ʮͷʇʁબ੮ ͐ʩ˺͙ʡʩ͐੮ ͐ʩɘ͐੮ ʩʇ੮ ͅʩ˺͙ˑʁ੮ ɺʇ੮ ɻ˺˦ͅʇ̼ͷʇʁ੮ ɘ˦ʁ੮ ɻ˺˦͐ɘɻ͐ʇʁ੮ ͐ʩʇ੮ ‡ɘ̹ɘ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ੴ੮͸ʩ˺੮ɻ˺˦ɻ͙̼̼ʇʁੳ "͙͐੮͐ʩʇ;੮ɻ˺˦͐ɘɻ͐ʇʁ੮͐ʩʇ੮͸̼˺˦ʡ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੳ੮U˦੮ɘ੮ʁʇˑʇʡɘ͐ʇʁ੮ͅ;͐ͅʇ˚ੴ੮ɻ˺͙˦ચ ͐ʮʇͅ੮ɘ̼ʇ੮˺˦ˑ;੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮͐ʩʇʮ̼੮˺͸˦੮̼ʇͅʮʁʇ˦͐ͅੳ੮îʩʮͅ੮ɻ̼ʇɘ͐ʇͅ੮̹ˑʇ˦͐;੮˺ʠ੮˺̹̹˺̼͙͐ચ ˦ʮ͐ʮʇͅ੮ʠ˺̼੮ɺ͙ɻˌચ̹ɘͅͅʮ˦ʡੴ੮ʡʮͷʇ˦੮ʩ˺͸੮˚ɘ˦;੮˺ʠ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ʠɘɻʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̼ʇ੮ ʩ˺˚ʇˑʇͅͅ੮ɘ˦ʁ੮ˑɘɻˌ੮ɘ੮ϲʮͽʇʁ੮ɘʁʁ̼ʇͅͅੳ৽ৼ੮U˦੮ɘ˦;੮ɻɘͅʇੴ੮{ɘ̼ˌૄͅ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮͸ʇ˦͐੮ɺɘɻˌ੮ ͐˺੮ä˺ˑɘ˦˺੮#˺͙˦͐;ੳ੮";੮͐ʩɘ͐੮͐ʮ˚ʇੴ੮ʩʇ੮ʩɘʁ੮ɺʇʇ˦੮ʠʇʁੴ੮ɺɘ͐ʩʇʁੴ੮ɘ˦ʁ੮˺˦੮˚ʇʁʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ ͅʮͽ੮˚˺˦͐ʩͅઝ͐ͅʮˑˑ੮ʁʇˑ͙ͅʮ˺˦ɘˑੴ੮ɺ͙͐੮˚˺̼ʇ੮ˑ͙ɻʮʁ੮͐ʩɘ˦੮rʮ˦ʁɘ੮ʩɘʁ੮ͅʇʇ˦੮ʩʮ˚੮ʮ˦੮ʁʇɻɘʁʇͅੳ੮ ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ʠ̼˺˚੮ä˺ˑɘ˦˺੮ɻɘ˚ʇ੮˺͙͐ੴ੮˚ʇ͐੮͸ʮ͐ʩ੮ʩʮ˚੮ʠ˺̼੮͐ʩʮ̼͐;੮˚ʮ˦͙͐ʇͅੴ੮ɘ˦ʁ੮ ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮ʩʇ੮ʁʮʁ੮˦˺͐੮˚ʇʇ͐੮͐ʩʇʮ̼੮ɻ˺͙˦͐;ૄͅ੮ɻ̼ʮ͐ʇ̼ʮɘੳ੮îʩʇ੮ʁʮ̹ͅɘ̼ʮ͐;੮ʮ˦੮ʁʇϲʮ˦ʮ͐ʮ˺˦ͅ੮

P U B L I C G UA R D I A N

111

results from the fact that some counties put far more money into their public ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐ʩɘ˦੮˺͐ʩʇ̼ͅੴ੮ɻ̼ʇɘ͐ʮ˦ʡ੮̹ͅɘɻʇ੮ʠ˺̼੮ɘ੮˚˺̼ʇ੮ʇͽ̹ɘ˦ͅʮͷʇ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮˺ʠ੮ɻ̼ʮ͐ʇચ ̼ʮɘੳ੮rʮ˦ʁɘ੮ͅɘ;ͅ੮͐ʩɘ͐੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ɻ̼ʮʇʁ੮͸ʮ͐ʩ੮ʩʇ̼੮͸ʩʇ˦੮͐ʩʇ;੮ʩʇɘ̼ʁ੮ ͐ʩʇ੮˦ʇ͸ͅੳ /ͷʇ̼;੮˺˦ɻʇ੮ʮ˦੮ɘ੮͸ʩʮˑʇੴ੮rʮ˦ʁɘ੮˚ɘ˦ɘʡʇʁ੮͐˺੮ʡʇ͐੮ͅ˺˚ʇ˺˦ʇ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮͐ɘˑˌ੮ ͸ʮ͐ʩ੮ ʩʇ̼੮ ɘɺ˺͙͐੮ ʩʇ̼੮ ɺ̼˺͐ʩʇ̼ૄͅ੮ ɻɘͅʇੳ੮ U˦੮ ˺˦ʇ੮ ˑʇ͐͐ʇ̼ੴ੮ ͐ʩʇ੮ ɻ˺͙˦͐;ૄͅ੮ ɘ͐͐˺̼˦ʇ;੮ ̹ʮ˦˦ʇʁ੮ {ɘ̼ˌૄͅ੮̹ˑʮʡʩ͐੮˺˦੮rØä੮ˑɘ͸ੴ੮͐ͅɘ͐ʮ˦ʡੴ੮ુîʩʮͅ੮ʮͅ੮˦˺͐੮ɘ੮ͅʮ͙͐ɘ͐ʮ˺˦੮͐ʩɘ͐੮͸ʇ੮ʩɘͷʇ੮ʮʡ˦˺̼ʇʁੴ੮ ˦˺̼੮͐ʩɘ͐੮͸ʇ੮ɻ˺˦ʁ˺˦ʇੳ੮îʩʇ੮ˑɘ͸੮̼ʇή͙ʮ̼ʇͅ੮̼͐ͅʮ˦ʡʇ˦͐੮͐ͅɘ˦ʁɘ̼ʁͅ੮યʠ˺̼ર੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ͐ͅɘ˦ʁɘ̼ʁͅ੮͐ʩɘ͐੮ͅ˺੮ʠɘ̼੮͸ʇ੮ɻɘ˦˦˺͐੮˚ʇʇ͐ੳૂ੮U˦੮̼ʇɘˑʮ͐;ੴ੮͐ʩʇ੮ˑɘ͸੮ʮͅ੮ͷɘʡ͙ʇੴ੮͸ʩʮɻʩ੮ʮͅ੮͸ʩ;੮ ͅ˺˚ʇ੮ɻ˺͙˦͐ʮʇͅ੮ɘɻ͙͐ɘˑˑ;੮͸˺͙ˑʁ੮ʁʇɻˑɘ̼ʇ੮{ɘ̼ˌ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ rʮ˦ʁɘ੮ ʡ˺͐੮ ɘ੮ ˚˺̼ʇ੮ ʩ˺˦ʇ͐ͅ੮ ɘ˦ͅ͸ʇ̼੮ ʮ˦੮ ɘ੮ ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮ ͸ʮ͐ʩ੮ ɘ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ੵ੮ {ɘ̼ˌ੮͸ɘͅ੮ʮ˦੮ɘ੮#ɘ͐ɻʩચ৲৲ੳ੮U˦੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ͷʮʇ͸ੴ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʩʇɘʁ੮ʮ˦ˈ͙̼ʮʇͅ੮ʁ˺੮˦˺͐੮ ή͙ɘˑʮʠ;੮ʠ˺̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮͸ʩʇ̼ʇɘͅ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮͸ʩʮɻʩ੮ɘ̼ʇ੮ ̹̼ʮ˚ɘ̼ʮˑ;੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʩʇɘʁ੮ʮ˦ˈ͙̼ʮʇͅੴ੮ʁʇ˚ʇ˦͐ʮɘੴ੮˺̼੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ ફɘ˦ʁ੮ʡʮͷʇ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ͅʇ͐੮˺ʠ੮̹˺͸ʇ̼ͅੴ੮˚˺̼ʇ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ϲʮ˦ɘ˦ɻʮɘˑ੮˚ɘ˦ɘʡʇ˚ʇ˦͐੮ɘ˦ʁ੮ ˚ʇʁʮɻɘˑ੮ɻɘ̼ʇબੴ੮͸ʇ̼ʇ੮˦˺͐੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ৽৽ Ĕʩʮˑʇ੮{ɘ̼ˌૄͅ੮ɻ˺˚ɺʮ˦ɘ͐ʮ˺˦੮ʮͅ੮̼ɘ̼ʇੴ੮ʮ͐੮ʮͅ੮˦˺͐੮͙˦ʮή͙ʇੳ৽৾੮îʩʇ੮ɻ˺͙˦͐ʮʇͅ੮U੮̹ͅ˺ˌʇ੮͸ʮ͐ʩ੮ ʁʮͷʇ̼ʡʇʁ੮˺˦੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ;੮͸˺͙ˑʁ੮ɻ˺˦ͅʇ̼ͷʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮˺˦੮͐˺̹੮˺ʠ੮ ʁʇ˚ʇ˦͐ʮɘੴ੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼ʮʇͅੴ੮˺̼੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮͙˦ʁʇ̼੮rØäੳ੮"͙͐੮ ͐ʩʇ;੮ɘˑˑ੮ɘʡ̼ʇʇʁ੮͐ʩɘ͐੮͐ʩʇ੮˚˺̼ʇ੮˺ʠ੮͐ʩ˺ͅʇ੮ɺ˺ͽʇͅ੮;˺͙੮ɻʩʇɻˌ੮ɘ͐੮˺˦ɻʇੴ੮͐ʩʇ੮ʩɘ̼ʁʇ̼੮ʮ͐੮ʮͅ੮͐˺੮ ϲʮ˦ʁ੮ɘ੮̹ˑɘɻʇ˚ʇ˦͐ੳ੮{ɘ̼ˌੴ੮rʮ˦ʁɘ੮˺˦ɻʇ੮̹͙͐੮ʮ͐ੴ੮ુʠɘˑˑͅ੮ʮ˦͐˺੮ɘ੮ˑ˺͐੮˺ʠ੮ʁʮʠʠʇ̼ʇ˦͐੮ɻɘ͐ʇʡ˺̼ʮʇͅੴ੮ ͐ʩɘ͐ૄͅ੮͸ʩ;੮ʩʇ੮ˌʇʇ̹ͅ੮ʠɘˑˑʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ɻ̼ɘɻˌͅੳૂ੮k˺ͅʇ̹ʩʮ˦ʇੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ ʠ˺̼੮ɘ੮˚ʮʁͅʮΈʇ੮ɻ˺ɘ͐ͅɘˑ੮ɻ˺͙˦͐;ੴ੮ʁʮʁ੮ɘʡ̼ʇʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮ͅ˺˚ʇ˺˦ʇ੮͸ʮ͐ʩ੮ˈ˺ʮ˦͐੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮ɘ੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼;ੳ੮äʩʇ੮͐˺ˑʁ੮˚ʇ੮ʩʇ̼੮˺ϲϲʮɻʇ੮ɻ˺˦͐ɘɻ͐ʇʁ੮ɘ੮ʩ͙˦ʁ̼ʇʁ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮͐ͅɘ͐ʇ੮˺˦੮͐ʩʇʮ̼੮ɺʇʩɘˑʠੴ੮͐˺੮˦˺੮ɘͷɘʮˑੳ৽৿੮/ͷʇ˦੮͸ʩʇ˦੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁચ ʮɘ˦ͅ੮ϲʮ˦ʁ੮ɘ੮ʠɘɻʮˑʮ͐;੮͸ʮˑˑʮ˦ʡ੮͐˺੮͐ɘˌʇ੮ɘ੮ɻ˺˚̹ˑʇͽ੮ɻɘͅʇੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ઝ͸ʩʮɻʩੴ੮ɘʡɘʮ˦ੴ੮ɻ˺˦̼͐˺ˑͅ੮͐ʩʇ੮ɺ͙ʁʡʇ͐੮ʠ˺̼੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɻɘ̼ʇઝ˚ʮʡʩ͐੮˦˺͐੮ ̹ɘ;੮ʠ˺̼੮ʮ͐ੳ੮îʩɘ͐੮͸ɘͅ੮̹̼˺ɺɘɺˑ;੮͐ʩʇ੮ʇɘͅʮʇ͐ͅ੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʠ˺̼੮{ɘ̼ˌૄͅ੮̹ˑʮʡʩ͐ੵ੮˦˺੮ɘͷɘʮˑચ ɘɺˑʇ੮̹ˑɘɻʇ˚ʇ˦͐ੴ੮˦˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ৽਀

MANAGING THE “HOMELESS LIFESTYLE” ͅ੮ ɘ੮ ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮ ৵৲৵ৰ੮ ʁ̼ɘʡʡʇʁ੮ ʮ˦͐˺੮ ɘ੮ ͐ʩʮ̼͐;ચʁɘ;੮ ͐ʇ˚̹˺̼ɘ̼;੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ˚˺͐ͅ੮˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮U੮͐ɘˑˌʇʁ੮͐˺੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ʠʇˑ͐੮͐ʩɘ͐੮ʁ˺ɻ͐˺̼ͅੴ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅੴ੮ ˈ͙ʁʡʇͅੴ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮ɘ˦ʁ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮͸ʇ̼ʇ੮ɘˑˑ੮ͅɻʩʇ˚ʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ͅɘ˚ʇ੮

112

T H E C O N S E RVATO R S H I P C O N T I N U U M

medical-legal plot to take away their rights. They’re half right. There’s a broad conspiracy among government actors in the conservatorship continuum, but sometimes it is actually directed toward restoring people’s rights—and, in so doing, holding down conservatorship caseloads. Finding a (somewhat) willing third party, such as a family member, is one way to do this. The other is to declare some potential conservatees responsible for their own survival by showing that the miserable living conditions they inhabited before the hospital were a conscious choice. Tamara has worn many hats in her twenty years in the mental health system, but the main thrust of her work has been revealingly similar across her career: getting people out of locked facilities and off conservatorship. At the very beginning of college, she had an internship in a state hospital. The unit was “dark, ˦˺͐੮͸ʇˑˑ੮ˑʮ͐ૂ੮ɘ˦ʁ੮ʠʇˑ͐੮ˑʮˌʇ੮ɘ੮̹̼ʮͅ˺˦ੳ੮äʩʇ੮͸ɘͅ੮ુ͐ʇ̼̼ʮϲʮʇʁੴ੮͐ʇ̼̼ʮϲʮʇʁੴ੮͐ʇ̼̼ʮϲʮʇʁૂ੮˺ʠ੮͐ʩʇ੮ clients: “There was always a lot of noise. Initially, they were spitting at me, they were always trying to grope me, grab at me, all of those things. It freaked me out.” Yet, when she managed to connect with an otherwise mute man who had been interned since he dismembered his family at age twelve, something clicked. She discovered that many of those individuals had been stuck in state hospitals for years, so “I really pushed for them to go to the socialization center, play games during the day, see people out in the community [on a day pass].” Her desire to watch clients move to less restrictive environments continued when she became a deputy public guardian in a county in the Central Valley. As in the state hospital, there were “people who had been on conservatorship for ͐͸ʇˑͷʇੴ੮ϲʮʠ͐ʇʇ˦ੴ੮˦ʮ˦ʇ͐ʇʇ˦੮;ʇɘ̼ͅ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮U੮͸ɘͅ੮ˑʮˌʇੴ੮ૃä˺੮͸ʩɘ͐ૄͅ੮ɺʇʮ˦ʡ੮ʁ˺˦ʇ੮͐˺੯ੳ੯ੳ੯ੳ੮ break this cycle?’ I don’t want conservatorship to be a permanent sentence.” She would hustle to convince contracted outpatient teams to take a look at her clients or bring them from the state hospital to visit local, unlocked board and cares. The biggest successes in passing the public baton were achieved when she ɻ˺͙ˑʁ੮ˑʮ˦ˌ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɺɘɻˌ੮͐˺੮͐ʩʇʮ̼੮ʠɘ˚ʮˑʮʇͅੳ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮͐ͅɘ͙͐͐ʇͅ੮ɘ̼ʇ੮ή͙ʮ͐ʇ੮ɻˑʇɘ̼੮ ͐ʩɘ͐੮ુɘ੮̹ʇ̼ͅ˺˦੮ʮͅ੮˦˺͐੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੯ੳ੯ੳ੯ੳ੮ʮʠ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮͅ੮ɻɘ̹ɘɺˑʇ੮˺ʠ੮ͅɘʠʇˑ;੮͙̼ͅͷʮͷing in freedom with the help of willing and responsible family members, friends, or third parties.”৽ਁ For public guardians, convincing a family member to step forward provides an easy reason to turn down an application, while for public defenders, it is a cut-and-dried way to beat an application in court. Tamara admitted that “nine times out of ten times the family wasn’t involved” (as you’ve ͅʇʇ˦ੴ੮ʮʠ੮ͅ˺˚ʇ˺˦ʇ੮ʩɘͅ੮ુ͸ʮˑˑʮ˦ʡૂ੮ʠɘ˚ʮˑ;ੴ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ή͙ʮɻˌˑ;੮ʁʮͅɻʩɘ̼ʡʇͅ੮͐ʩʇ੮̹ʇ̼ͅ˺˦બੳ੮

P U B L I C G UA R D I A N

113

Uʠ੮ ͅʩʇ੮ ɻ˺͙ˑʁੴ੮ ͐ʩ˺͙ʡʩੴ੮ îɘ˚ɘ̼ɘ੮ ͸˺͙ˑʁ੮ ̼ʮ˦ʡ੮ ͙̹੮ ͐ʩʇ੮ ʠɘ˚ʮˑ;੮ ɘ˦ʁ੮ ͅɘ;ੴ੮ ુૃrʇ͐ૄͅ੮ ̼͐;੮ ɘ੮ ̹ʩ˺˦ʇ੮ɻɘˑˑ੮ય͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇરੴ੮ͅʇʇ੮ʩ˺͸੮͐ʩɘ͐੮ʡ˺ʇͅੴૄ੮˺̼੮ૃĚ˺͙੮ɻ˺͙ˑʁ੮ɻ˺˚ʇ੮͸ʮ͐ʩ੮ me when I go visit, see for yourself, and be part of the treatment team meeting ɘ˦ʁ੮ʡʮͷʇ੮;˺͙̼੮ʮ˦̹͙͐ੳૄ੯ੳ੯ੳ੯ੳ੮"ʇɻɘ͙ͅʇ੮U੮̼ʇɘˑˑ;੮ͅɘ͸੮͐ʩɘ͐੮͸ʩʇ˦੮ʠɘ˚ʮˑ;੮͸ɘͅ੮͙̹̹ͅ˺̼͐ʮͷʇੴ੮ there was a higher likelihood that the conservatee would be successful [in leaving conservatorship].” A few years before our conversation, Tamara switched titles again and became a county patients’ rights advocate. Advocates represent mental health clients in probable cause hearings (four days into a 5250), investigate complaints, and accompany them to meetings with doctors or public guardians. She kept pursuing the same goal: getting people out of locked settings. In her new position, she ʁʮͅɻ˺ͷʇ̼ʇʁ੮͐ʩɘ͐੮˺ʠ͐ʇ˦੮ͅʩʇ੮˦ʇʇʁʇʁ੮͐˺੮ͅʩ˺͸੮ɘ੮ʩʇɘ̼ʮ˦ʡ੮˺ϲϲʮɻʇ̼੮˺̼੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ only that someone was, to borrow a phrase I heard many times, “successfully ˚ɘ˦ɘʡʮ˦ʡ੮͐ʩʇ੮ʩ˺˚ʇˑʇͅͅ੮ˑʮʠʇ͐ͅ;ˑʇૂ੮ɺ;੮ɘɻή͙ʮ̼ʮ˦ʡ੮ͅ˺˚ʇ੮ͅʮ˚͙ˑɘɻ̼͙˚੮˺ʠ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩing, and shelter. As Tamara reminded me, “just because someone is homeless doesn’t mean they’re gravely disabled.” Instead, a good conservatorship investigator or advocate is “out there looking at what their homelessness looks like.” äʩʇ੮ʡɘͷʇ੮˚ʇ੮ɘ˦੮ʇͽɘ˚̹ˑʇੳ੮š˦ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુૃĚʇͅੴ੮Uૄ˚੮ʩ˺˚ʇˑʇͅͅੴ੮ɺ͙͐੮ I’m not gravely disabled, I can get food at seven քੳՖੳ at this McDonald’s on this street. I can go to this 7–11 on these days, and I can get something to drink. And I can go pick up cans and turn them in to get this amount of money.’” Tamara told me she would never defend someone’s “survival plan” to a hearing ˺ϲϲʮɻʇ̼੮͙˦ˑʇͅͅ੮ͅʩʇ੮ɻʩʇɻˌʇʁ੮ʮ͐੮˺͙͐੮ʩʇ̼ͅʇˑʠੳ੮U˦੮͐ʩʮͅ੮ɻɘͅʇੴ੮ુU੮͸ʇ˦͐੮͐˺੮͐ʩʇ੮{ɻ)˺˦ɘˑʁૄͅੴ੮ U੮ɘͅˌʇʁ੮͐ʩ˺ͅʇ੮ή͙ʇ͐ͅʮ˺˦ͅੵ੮ૃ)˺੮;˺͙੮ˌ˦˺͸੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੺੮)˺੮;˺͙੮ʠʇʇʁ੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੺ૄ੮ îʩʇ੮͐ͅɘʠʠ੮ͅɘʮʁੴ੮ૃ;ʇͅੳૄ੮U੮͸ʇ˦͐੮͐˺੮͐ʩʇ੮৷જৱৱੴ੮ɘ˦ʁ੮͐ʩʇ੮͐ͅɘʠʠ੮͸ʇ̼ʇ੮ˑʮˌʇੴ੮ૃšʩ੮˚;੮ʡ˺ͅʩੴ੮ʮͅ੮ ʩʇ੮˺ˌɘ;੺ૄ੮ૃšʩ੮;ʇͅੴ੮͸ʇૄˑˑ੮ʡʮͷʇ੮ʩʮ˚੮͐ʩʮͅ੮͐ʩɘ͐੮ɘ˦ʁ੮͐ʩʇ੮˺͐ʩʇ̼ੳૄ੮˦ʁ੮͐ʩʇ˦੮U੮͸ʇ˦͐੮͐˺੮͐ʩʇ੮ ̼ʇɻ;ɻˑʮ˦ʡ੮ɻ˺˚̹ɘ˦;੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮U੮ͷʇ̼ʮϲʮʇʁ੮ʮ͐ੳૂ੮äʩʇ੮ʡ˺͐੮͐ʩɘ͐੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮̼ʇˑʇɘͅʇʁੳ੮š˦੮ other occasions, she’d dig through someone’s tent at an encampment to make sure they had a stove or check in at the local Salvation Army to see if they came to get clothing. Not everyone’s plan for survival puts them above the “successfully managʮ˦ʡૂ੮ ɺɘ̼ੳ੮ îɘ˚ɘ̼ɘૄͅ੮ ˺ˑʁ੮ ɺ˺ͅͅ੮ ɘ͐੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ ˺ϲϲʮɻʇੴ੮ )ɘ̼̼ʇˑˑੴ੮ ʇͽ̹ˑɘʮ˦ʇʁ੮ ͐ʩɘ͐੮͐ʩʇ;੮͸˺͙ˑʁ੮ϲʮˑʇ੮̹ʇ͐ʮ͐ʮ˺˦ͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ુɻ˺˚ʮ˦ʡ੮ʮ˦੮͙ͅ˦ɺ͙̼˦ʇʁ੮ʠ̼˺˚੮ʇͽ̹˺͙̼ͅʇੴ੮ ˑɘɻˌʮ˦ʡ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ɻˑ˺͐ʩʮ˦ʡੴ੮͐ʩʇʮ̼੮ˑɘɺ੮͸˺̼ˌ੮ͅʩ˺͸ͅ੮̼ʇɘˑˑ;੮̹˺˺̼੮ʠ˺˺ʁ੮ʮ˦͐ɘˌʇੳ੯ੳ੯ੳ੯ੳ੮ Ĕʇ੮ˑ˺˺ˌ੮ʠ˺̼੮͐ʩ˺ͅʇ੮ɺʮ˺ˑ˺ʡʮɻɘˑ੮ʮ˦ʁʮɻɘ͐˺̼ͅ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ʮͅ੮˦˺͐੮ʁ˺ʮ˦ʡ੮͸ʇˑˑੳૂ੮"ʇʮ˦ʡ੮ homeless was a skill that some, but not all, severely mentally ill people mastered.

114

T H E C O N S E RVATO R S H I P C O N T I N U U M

Pʇ੮ɻ˺˦̼͐ɘ͐ͅʇʁ੮͐ʩʇ੮ɻɘͅʇ੮˺ʠ੮ુͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʩɘͅ੮ϲʮͷʇ੮˺̼੮͐ʇ˦੮;ʇɘ̼ͅ੮˺ʠ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ˑʮͷʮ˦ʡ੮ ˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɘ˦ʁ੮˦˺͐੮ɘ੮ˑ˺͐੮˺ʠ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮˺̼੮̼͙˦ચʮ˦ͅ੮͸ʮ͐ʩ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ૂ੮͸ʮ͐ʩ੮ ુͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅ੮˦ʮ˦ʇ͐ʇʇ˦ੴ੮͐ʩʇ;ૄͷʇ੮˦ʇͷʇ̼੮ɺʇʇ˦੮ʩ˺˚ʇˑʇͅͅੴ੮ɺ͙͐੮˦˺͸੮͐ʩʇ;ૄ̼ʇ੮ʮ˦੮͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ͅɘ;ʮ˦ʡੴ੮ૃU੮ɻɘ˦੮ˑʮͷʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳૄૂ੮U˦ͷʇ͐ͅʮʡɘ͐˺̼ͅ੮͸˺͙ˑʁ੮ʇͽ̹ˑ˺̼ʇੴ੮ુ)˺੮͐ʩʇ;੮ ̼ʇɘˑˑ;੮ˌ˦˺͸੮͸ʩɘ͐੮͐ʩɘ͐੮˚ʇɘ˦ͅ੺੮Ě˺͙੮ɘͅˌ੮͐ʩʇ˚ੴ੮ૃP˺͸੮͸˺͙ˑʁ੮;˺͙੮ʡʇ͐੮͐ʩʮͅ੮ɘ˦ʁ੮͐ʩɘ͐੺ૄ੮ ɘ˦ʁ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮̹ʮʇɻʇ੮ʮ͐੮͐˺ʡʇ͐ʩʇ̼ੳ੮ä˺੮͐ʩɘ͐ૄͅ੮ɘ˦੮ʇɘͅʮʇ̼੮˺˦ʇ੮͐˺੮ͅɘ;ੴ੮ૃîʩʇ;੮ʁ˺˦ૄ͐੮ˌ˦˺͸੮ ͸ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮ʡʇ͐͐ʮ˦ʡ੮͐ʩʇ˚ͅʇˑͷʇͅ੮ʮ˦͐˺ૄ੮યɘ˦ʁ੮ϲʮˑʇ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹રੳૂ ̼˺͙˦ʁ੮͐ʩʇ੮͐ͅɘ͐ʇੴ੮U੮̹˺ͅʇʁ੮͐ʩʮͅ੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮͸ʩʇ˦੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅઝ͸ʩʮɻʩ੮ͅʇʇ˚ͅੴ੮ ɺ;੮ʁʇϲʮ˦ʮ͐ʮ˺˦ੴ੮͐˺੮ʇ˦͐ɘʮˑ੮ɘ੮ˑɘɻˌ੮˺ʠ੮ͅʩʇˑ͐ʇ̼ઝ̹˺ͅʇʁ੮ɘ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮‡ʇɘ̼ˑ;੮ʇͷʇ̼;੮ ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮̹ͅ˺ˌʇ੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠ੮ɻʩ˺ʮɻʇ੮ɘ˦ʁ੮ɘʡʇ˦ɻ;ੳ੮k˺ͅʇ̹ʩʮ˦ʇੴ੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦੮ ʠ̼˺˚੮ɘ˦੮͙ˑ̼͐ɘˑʮɺʇ̼ɘˑ੮ɻ˺ɘ͐ͅɘˑ੮ɻ˺͙˦͐;ੴ੮ʇ˚̹ʩɘͅʮΈʇʁ੮͐ʩɘ͐੮ʩʇ̼੮˺ϲϲʮɻʇ੮͸ɘͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦ˑ;੮ ˺˦੮ɘ੮ͅ˚ɘˑˑ੮˦͙˚ɺʇ̼੮˺ʠ੮ુ˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮͙˦ʠ˺̼͙͐˦ɘ͐ʇˑ;੮ɘˑͅ˺੮ʩ˺˚ʇˑʇͅͅૂ੮ and “constantly getting 5150ed or arrested for bathing naked in the fountain ʁ˺͸˦͐˺͸˦੮˺̼੮̼͐ʇ̹ͅɘͅͅʮ˦ʡ੮ʮ˦੮ɘ੮̼ʇ͐ͅɘ͙̼ɘ˦͐ੳૂ੮îʩ˺ͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɘ̼ʇ੮ુ˦˺͐੮˚ɘˌʮ˦ʡ੮ʮ͐੮ ɘͅ੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦ੳ੮Ě˺͙ૄ̼ʇ੮˦˺͐੮˚ɘ˦ɘʡʮ˦ʡ੮͐ʩʇ੮ʩ˺˚ʇˑʇͅͅ੮ˑʮʠʇ͐ͅ;ˑʇ੮ʮ˦੮ɘ˦੮ɘ̹̹̼˺ચ ̹̼ʮɘ͐ʇ੮͸ɘ;ੴ੮ɘ͐੮ˑʇɘ͐ͅ੮˦˺͐੮ʇ˦˺͙ʡʩ੮͐˺੮˦˺͐੮ɺ̼ʮ˦ʡ੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮;˺͙̼ͅʇˑʠੳૂ੮H˺̼੮ʩʇ̼ੴ੮͐ʩʇ੮ ʁʇɻʮͅʮ˺˦੮͸ʩʇ͐ʩʇ̼੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮ͅ˺˚ʇ˺˦ʇ੮ʁʇ̹ʇ˦ʁʇʁ੮˺˦੮͸ʩʮɻʩ੮͸ɘͅ੮͐ʩʇ੮˚˺̼ʇ੮ʇʠʠʇɻચ tive strategy to minimize government involvement: not intervening at all or ͙ͅʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐˺੮̼ʇʁ͙ɻʇ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʇͽ̹ʇ˦ͅʮͷʇ੮ɻ˺˦͐ɘɻ͐੮͸ʮ͐ʩ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇચ ˚ʇ˦͐੮ɘ˦ʁ੮/Ûͅੳ îɘ˚ɘ̼ɘ੮ ɘ̼͐ʮɻ͙ˑɘ͐ʇʁ੮ ͐˺੮ ˚ʇ੮ ʩʇ̼੮ ˺̹̹˺ͅʮ͐ʮ˺˦੮ ͐˺੮ ʇͽ̹ɘ˦ʁʮ˦ʡ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੵ੮ ુU੮ʁ˺˦ૄ͐੮ˑʮˌʇ੮ʮ͐ੳ੯ੳ੯ੳ੯ੳ੮Øʇ˺̹ˑʇ੮ʩɘͷʇ੮ɘ੮̼ʮʡʩ͐੮͐˺੮ˑʮͷʇ੮͸ʩʇ̼ʇ੮͐ʩʇ;੮͸ɘ˦͐੮͐˺੮ˑʮͷʇੳ੮Uʠ੮͐ʩʇ;੮͸ɘ˦͐੮ ͐˺੮ˑʮͷʇ੮ʮ˦੮ɘ੮͐ʇ˦͐ੴ੮͐ʩɘ͐ૄͅ੮ϲʮ˦ʇੳૂ੮äʩʇૄʁ੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ɻ˺˚ʇ੮͙̹੮͸ʮ͐ʩ੮ુ˺͐ʩʇ̼੮ ͅ˺ˑ͙͐ʮ˺˦ͅ੮ ͐˺੮ ͸˺̼ˌ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ˺˦ʇચ͐˺ચ˺˦ʇੴ੮ ͐˺੮ ʩʇˑ̹੮ ͐ʩʇ˚ૂઝɘͅ੮ ͅʩʇ੮ ʩɘͅ੮ ʩʇ̼੮͸ʩ˺ˑʇ੮ɻɘ̼ʇʇ̼ੳ੮îɘ˚ɘ̼ɘ੮ʮͅ੮"ˑɘɻˌ੮ɘ˦ʁ੮͸ʇˑˑ੮ɘ͸ɘ̼ʇ੮͐ʩɘ͐੮͸ʩʇ˦੮;˺͙੮ɻ˺ʇ̼ɻʇ੮̹ʇ˺̹ˑʇ੮ ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ɘ̼ʇ੮̹˺˺̼੮ɘ˦ʁ੮ͅʮɻˌੴ੮;˺͙੮͸ʮ˦ʁ੮͙̹੮ɻ˺ʇ̼ɻʮ˦ʡ੮˚ʮ˦˺̼ʮ͐ʮʇͅ੮ʠ˺̼੮͸ʩ˺˚੮̼ɘɻચ ʮͅ˚੮ɘ˦ʁ੮ʇͽɻˑ͙ͅʮ˺˦੮ɻ˺˦̼͐ʮɺ͙͐ʇ੮ɺ˺͐ʩ੮͐˺੮ɘ˦੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ ͅʩʇˑ͐ʇ̼੮ɘ˦ʁ੮͐˺੮ʮˑˑ˦ʇͅͅੳ੮Pʇ̼੮ʇ˚̹ʩɘͅʮͅ੮˺˦੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮ʮͅ੮ͅʮ˦ɻʇ̼ʇੳ U͐ૄͅ੮ɘˑͅ˺੮ɘ੮˦ʇɻʇͅͅʮ͐;ੳ੮ુîʩʇ੮ɘɻ͐੮˺ʠ੮ʁʇϲʮ˦ʮ˦ʡ੮ɘ੮ʁʮͅɘɺʮˑʮ͐;ੴૂ੮͐ʩʇ੮̹˺ˑʮ͐ʮɻɘˑ੮ͅɻʮʇ˦͐ʮ͐ͅ੮ )ʇɺ˺̼ɘʩ੮ä͐˺˦ʇ੮̹˺ͅʮ͐ͅੴ੮ુʁʇ͐ʇ̼˚ʮ˦ʇͅ੮͸ʩɘ͐੮ʮͅ੮ʇͽ̹ʇɻ͐ʇʁ੮˺ʠ੮͐ʩʇ੮˦˺˦ચʁʮͅɘɺˑʇʁઝ͸ʩɘ͐੮ ʮ˦ˈ͙̼ʮʇͅੴ੮ ʁʮͅʇɘͅʇੴ੮ ʮ˦ɻɘ̹ɘɻʮ͐ʮʇͅੴ੮ ɘ˦ʁ੮ ̹̼˺ɺˑʇ˚ͅ੮ ͐ʩʇ;੮ ͸ʮˑˑ੮ ɺʇ੮ ʇͽ̹ʇɻ͐ʇʁ੮ ͐˺੮ ͐˺ˑʇ̼ɘ͐ʇ੮ ʮ˦੮ ͐ʩʇʮ̼੮ ˦˺̼˚ɘˑ੮ ͸˺̼ˌʮ˦ʡ੮ ˑʮͷʇͅੳૂ৽ਂ੮ )̼ɘ͸ʮ˦ʡ੮ ɘ੮ ̹ʇ̼ʮ˚ʇ͐ʇ̼੮ ɘ̼˺͙˦ʁ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ͐ʩɘ͐੮ ʇͽɻˑ͙ʁʇͅ੮ ˚ɘ˦;੮ ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇૄͅ੮ ɻ˺˦ʁʮ͐ʮ˺˦੮ ɘͅ੮ ˦˺̼˚ɘˑ੮ ɘ˦ʁ੮ ʠ̼ʇʇˑ;੮ ɻʩ˺ͅʇ˦੮ ʮͅ੮˦ʇɻʇͅͅɘ̼;੮͐˺੮̹̼ʇͷʇ˦͐੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮˺ͷʇ̼͸ʩʇˑ˚ʇʁ੮ɺ;੮͐ʩʇ੮͐ʮʁɘˑ੮ ͸ɘͷʇ੮˺ʠ੮˚ʮͅʇ̼;੮͸ɘͅʩʮ˦ʡ੮˺ͷʇ̼੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ͷɘɻɘ˦͐੮ˑ˺͐ͅੴ੮͙˦ʁʇ̼̹ɘͅͅʇͅੴ੮ɘ˦ʁ੮̼˺ɘʁͅʮʁʇ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐ͅੳ

P U B L I C G UA R D I A N

115

“DUMPED ON” BY DIVERSION Uʠ੮ ͐ʩʇ̼ʇૄͅ੮ ˺˦ʇ੮ ̼͐ʇ˦ʁ੮ ʩɘ̹̹ʇ˦ʮ˦ʡ੮ ુʮ˦ʁ͙̼͐ͅ;੮ ͸ʮʁʇૂ੮ ʠ˺̼੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮ ʮ͐ૄͅ੮ ɘ˦੮ ુʇ˦˺̼˚˺͙ͅ੮ ͅʩʮʠ͐੮ ˺ʠ੮ ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ ɻɘͅʇͅ੮ ˺˦͐˺੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮ ɘɻɻ˺̼ʁʮ˦ʡ੮ ͐˺੮ äɻɘ̼ˑʇ͐੮P͙ʡʩʇͅ੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦ͅੳ੮)ɘ̼̼ʇˑˑੴ੮͐ʩʇ੮#ʇ˦ચ ̼͐ɘˑ੮ēɘˑˑʇ;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੴ੮ʁʇɘʁ̹ɘ˦˦ʇʁੴ੮ુ{ʮͅʇ̼;੮ˑ˺ͷʇͅ੮ɻ˺˚̹ɘ˦;ੳ੯ੳ੯ੳ੯ੳ੮îʩʇ੮˚ɘˈ˺̼ʮ͐;੮ ˺ʠ੮͙ͅ੮ʩɘͷʇ੮˦˺͐ʮɻʇʁ੮͐ʩɘ͐੮͐ʩʇ੮યɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑર੮̼ʇʠʇ̼̼ɘˑͅ੮ʩɘͷʇ੮ʮ˦ɻ̼ʇɘͅʇʁ੮̼ɘ̹ʮʁˑ;੯ੳ੯ੳ੯ੳ੮ યɘ˦ʁ੮͐ʩʇ;ર੮͐ʇ˦ʁ੮͐˺੮ɺʇ੮ɘ੮ˑ˺͐੮˚˺̼ʇ੮˺ʠ੮ɘ੮ɻʩɘˑˑʇ˦ʡʇੳૂ੮îʩʮͅ੮˺˦ʡ˺ʮ˦ʡ੮̹̼˺ɻʇͅͅ੮˺ʠ੮ɺ͙̼ʁʇ˦੮ ͅʩʮʠ͐ʮ˦ʡ੮ʠ̼˺˚੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ͅ;͐ͅʇ˚੮˺˦͐˺੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩઃɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻ˺˚̹ˑʇͽ੮ʩɘͅ੮ɻ̼ʇɘ͐ʇʁ੮ɘ੮ͅʩ˺ͷʮ˦ʡ੮˚ɘ͐ɻʩ੮͐ʩɘ͐੮͐ͅɘ͐ʇ੮̹˺ˑʮɻ;੮ʩɘͅ੮ɻ̼ʇɘ͐ʇʁ੮ɺ͙͐੮ʁ˺˦ʇ੮ˑʮ͐͐ˑʇ੮ ͐˺੮̼ʇͅ˺ˑͷʇੳ #ɘˑʮʠ˺̼˦ʮɘ੮͐ͅɘ͙͐͐ʇͅ੮ɘˑˑ˺͸੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ʠ̼˺˚੮͐ʩʇ੮ુ̹̼˺ʠʇͅચ ͅʮ˺˦ɘˑ੮̹ʇ̼ͅ˺˦੮ʮ˦੮ɻʩɘ̼ʡʇ੮˺ʠ੮̹̼˺ͷʮʁʮ˦ʡ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ͐੮ɘ੮ɻ˺͙˦͐;੮ˈɘʮˑੴૂ੮ ˈ͙͐ͅ੮ ˑʮˌʇ੮ ʠ̼˺˚੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑੳ৽ਃ੮ "͙͐੮ ͷʇ͐ʇ̼ɘ˦੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ U੮ ̹ͅ˺ˌʇ੮ ͐˺੮ ͅɘʮʁ੮ ͙ͅɻʩ੮ ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ ͙ͅʇʁ੮ ͐˺੮ ɺʇ੮ ̼ɘ̼ʇੳ੮ Ûʮɻˌ੮ Ĕʇʮͅͅੴ੮ ɘ੮ ʠ˺̼ʇ˦ͅʮɻ੮ ̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅ੮ ͸ʩ˺੮ ͸˺̼ˌʇʁ੮ ʠ˺̼੮ɘ੮ʁʇɻɘʁʇ੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅૄͅ੮ʮ˦ʠɘ˚˺͙ͅ੮î͸ʮ˦੮î˺͸ʇ̼ͅ੮ˈɘʮˑੴ੮ʩɘʁ੮͐ʩʇ੮ͅɘ˚ʇ੮ʮ˚̹̼ʇͅચ ͅʮ˺˦ੳ੮"ʇʠ˺̼ʇ੮ʩʇ੮͐ͅɘ̼͐ʇʁ੮ʩʮͅ੮ˈ˺ɺ੮ʮ˦੮৲ৰৱ৶ੴ੮͐ʩʇ੮ˈɘʮˑ੮͸ɘͅ੮ɘ̹̹ˑ;ʮ˦ʡ੮˺˦ˑ;੮ʠ˺̼੮ુͅή͙ʇɘˌ;੮ ͸ʩʇʇˑૂ੮ɻɘͅʇͅ੮͸ʩʇ˦੮͐ʩʇ;੮͸ʇ̼ʇ੮̼ʇɻʇʮͷʮ˦ʡ੮̹̼ʇ͙̼ͅͅʇ੮ʠ̼˺˚੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੴ੮ʠɘ˚ʮˑʮʇͅੴ੮ ˺̼੮ɻ˺͙˦͐;੮͙̹ͅʇ̼ͷʮͅ˺̼ͅੳ੮ʠ͐ʇ̼੮ɘˑˑੴ੮ͅʮ˦ɻʇ੮͐ʩʇ੮ˈɘʮˑ੮̹̼˺ͷʮʁʇͅ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼ੴ੮ ુ͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮યʠ˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ર੮ɘ͐੮ʠɘɻʇ੮ͷɘˑ͙ʇ੮ʮͅ੮˦ʇͷʇ̼੮˚ʇ͐ੴૂ੮˚ɘˌʮ˦ʡ੮̹̼˺ͷʮ˦ʡ੮͐ʩɘ͐੮ ɘ˦੮ʮ˦˚ɘ͐ʇ੮ή͙ɘˑʮϲʮʇͅ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˚̹ˑʮɻɘ͐ʇʁੳ৽਄੮îʩʇ˦੮ɘʡɘʮ˦ੴ੮Ûʮɻˌ੮ɘ͙̼ͅͅʇʁ੮ ˚ʇੴ੮ ͐ʩʇ੮ ˈɘʮˑ੮ ͸ɘͅ੮ ɻ̼ɘ˚˚ʇʁ੮ ʠ͙ˑˑ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ુɻɘ˦˦˺͐੮ ͐ɘˌʇ੮ ɻɘ̼ʇ੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ˑʮͷʮ˦ʡ੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅੴ੮͐ʩʇ;ૄ̼ʇ੮ˑʮͷʮ˦ʡ੮ʮ˦੮ͅή͙ɘˑ˺̼ੴ੮ʡ˦ɘ͐ચϲʮˑˑʇʁ੮ɻʇˑˑͅੴ੮ʠʇɻɘˑ੮˚ɘ͐͐ʇ̼ੴ੮ʩ˺̼̼ʮϲʮɻ੮ͅɻʇ˦͐ੴ੮ યɘ˦ʁર੮͐ʩɘ͐੮ʮͅ੮ͅ˺˚ʇ˺˦ʇ੮˦˺͐੮͐ʇ˦ʁʮ˦ʡ੮͐˺੮͐ʩʇʮ̼੮ͅʩʇˑ͐ʇ̼ੳ੮îʩʇ;ૄ̼ʇ੮ʮ͙ͅͅʇʁ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɺ͙͐੮ ͐ʩʇ;ૄ̼ʇ੮˦˺͐੮͸ʇɘ̼ʮ˦ʡ੮ʮ͐ੴ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮ʇͽɻʩɘ˦ʡʇ੮˺͙͐੮ͅ˺ʮˑʇʁ੮ɻˑ˺͐ʩʮ˦ʡੳૂ੮Pʇ੮͙˦ɘ̹˺ˑ˺ʡʇ͐ચ ʮɻɘˑˑ;੮͙̹̹ʇʁ੮͐ʩʇ੮̼ʩ;͐ʩ˚੮˺ʠ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅੵ੮ુUʠ੮͐ʩʇͅʇ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʇ̼ʇ੮̹̼ʇͅʇ˦͐ʇʁ੮͐˺੮ɘ੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੴ੮ય͐ʩʇ;ર੮͸˺͙ˑʁ੮ɺʇ੮ɘʁ˚ʮ͐͐ʇʁ੮͐˺੮ɘ੮̹ͅ;ચ ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮৹৹੮˺͙͐੮˺ʠ੮ৱৰৰ੮͐ʮ˚ʇͅੳ੯ੳ੯ੳ੯ੳ੮યîʩʇ;ર੮ɘ̼ʇ੮ʩ˺̼̼ʮϲʮɻɘˑˑ;੮ʮˑˑੳૂ ä˺˚ʇ੮˺ʠ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮˺˦੮͐ʩʇ੮̼ʇɻʇʮͷʮ˦ʡ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇͅʇ੮̼ʇʠʇ̼̼ɘˑͅੴ੮͐ʩ˺͙ʡʩੴ੮ɘ̼ʇ੮̼ʇˑ͙ɻચ ͐ɘ˦͐੮͐˺੮͐ɘˌʇ੮͐ʩʇ˚੮˺˦ੳ੮î˺ʁੴ੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮̼͙˦˦ʮ˦ʡ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇ੮ʮ˦੮ ɘ੮ ͸ʇɘˑ͐ʩ;੮ ɻ˺ɘ͐ͅɘˑ੮ ɻ˺͙˦͐;੮ ʠ˺̼੮ ϲʮʠ͐ʇʇ˦੮ ;ʇɘ̼ͅੴ੮ ʮͅ੮ ̹̼˺͙ʁ੮ ˺ʠ੮ ʩɘͷʮ˦ʡ੮ ɘ੮ ɻ˺˚̹ɘ̼ɘ͐ʮͷʇˑ;੮ ˑɘ̼ʡʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮ʁʇϲʮ˦ʇͅ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɺ̼˺ɘʁˑ;ੳ੮"͙͐ੴ੮ʩʇ੮ͅɘʮʁੴ੮ ુĔʇૄ̼ʇ੮ͅʇʇʮ˦ʡ੮ɘ੮ˑ˺͐੮˚˺̼ʇ੮ʠ˺̼ʇ˦ͅʮɻ੮ɻˑʮʇ˦͐ͅ੮ɻ˺˚ʮ˦ʡ੮˺͙̼੮͸ɘ;ੳ੯ੳ੯ੳ੯ੳ੮ä˺˚ʇ͐ʮ˚ʇͅੴ੮ʮ͐੮ʠʇʇˑͅ੮ ˑʮˌʇ੮͸ʇૄ̼ʇ੮ɺʇʮ˦ʡ੮ʁ͙˚̹ʇʁ੮˺˦ੳ੮ૃîʩʮͅ੮̹ʇ̼ͅ˺˦੮ʮͅ੮ʮ˦੮ˈɘʮˑੴ੮͐ʩʇ;ૄ̼ʇ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑੴ੮͐ʩʇ;ૄ̼ʇ੮ ̼ʇɘʁ;੮͐˺੮ʡ˺੮ɺ͙͐੮˦˺͐੮ͅɘʠʇ੮͐˺੮ʡ˺੮˺͙͐੮˺˦੮͐ʩʇʮ̼੮˺͸˦ੳૄ੮îʩɘ˦ˌͅੴ੮ɺ͙͐੮͐ʩɘ͐ૄͅ੮˦˺͐੮̼ʇɘˑˑ;੮

116

T H E C O N S E RVATO R S H I P C O N T I N U U M

͸ʩɘ͐੮͸ʇૄ̼ʇ੮ʩʇ̼ʇ੮ʠ˺̼ੳૂ੮U੮ʩʇɘ̼ʁ੮͐ʩɘ͐੮ʇͽɘɻ͐੮̹ʩ̼ɘͅʇઝુʁ͙˚̹ʇʁ੮˺˦ૂઝʠ̼˺˚੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ʮ˦੮ͅʇͷʇ̼ɘˑ੮˺͐ʩʇ̼੮ɻ˺͙˦͐ʮʇͅੳ {;੮̼ʇͅʇɘ̼ɻʩ੮͙ͅʡʡʇ͐ͅͅ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮͐͸˺੮̹˺ˑʇͅ੮͐˺੮͐ʩʇ੮̹˺̹͙ˑɘ͐ʮ˺˦੮˺ʠ੮̹ʇ˺̹ˑʇ੮ ͙ͅɺˈʇɻ͐ʇʁ੮͐˺੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੵ੮͐ʩʇ੮ુʁʮ̼͙̹͐ͅʮͷʇૂ੮ɘ˦ʁ੮͐ʩʇ੮ુʁʮͅɘɺˑʇʁੳૂ੮îʩʇ੮ʠ˺̼˚ʇ̼ੴ੮ ɘͅ੮;˺͙ૄͷʇ੮ͅʇʇ˦ੴ੮ɘ̼ʇ੮ʇɘͅʮʇ̼੮͐˺੮৵ৱ৵ৰ੮ɘ˦ʁ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ʡʇ͐੮͐ʩ̼˺͙ʡʩ੮ɘ˦੮/Ûੴ੮͸ʩʮˑʇ੮ ͐ʩʇ੮ˑɘ͐͐ʇ̼ੴ੮͸ʩʇ˦੮ɘʁ˚ʮ͐͐ʇʁੴ੮͐ͅɘ;੮ˑ˺˦ʡʇ̼੮ʮ˦੮ʩ˺̹ͅʮ͐ɘˑͅੳ੮îʩʇ;ૄ̼ʇ੮͐ʩʇ੮ʡ̼˺͙̹੮̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ͅʇʇ੮ ɘͅ੮ ˚˺̼ʇ੮ ʁʇͅʇ̼ͷʮ˦ʡ੮ ˺ʠ੮ ɘ˦ʁ੮ ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ ʠ˺̼੮ ͐ʩʇʮ̼੮ ͅʇ̼ͷʮɻʇͅੳ੮ ʠ͐ʇ̼੮ all, a public guardian’s ability to keep a person and the community safe is ˺˦ˑ;੮ɘͅ੮ʡ˺˺ʁ੮ɘͅ੮͐ʩʇʮ̼੮ɘɺʮˑʮ͐;੮͐˺੮ʡʇ͐੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦͐˺੮ɘ੮ͅʇɻ͙̼ʇ੮ʠɘɻʮˑʮ͐;ੳ੮˦ʁ੮̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ʁ˺˦ૄ͐੮ ʩ˺ˑʁ੮ ͐ʩʇ੮ ˌʇ;ͅ੮ ͐˺੮ ͐ʩ˺ͅʇ੮ ʠɘɻʮˑʮ͐ʮʇͅੴ੮ ˚˺͐ͅ੮ ˺ʠ੮ ͸ʩʮɻʩ੮ ɘ̼ʇ੮ ̹̼ʮͷɘ͐ʇੳ੮ {ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ʩɘͷʇ੮ ʇͷʇ̼;੮ ʮ˦ɻʇ˦͐ʮͷʇ੮ ˦˺͐੮ ͐˺੮ ͐ɘˌʇ੮ ɻˑʮʇ˦͐ͅ੮ ͸ʩ˺੮ ʩɘͷʇ੮ ɘ੮ ˑʇ˦ʡ͐ʩ;੮ ʩʮ͐ͅ˺̼;੮ ˺ʠ੮ ͷʮ˺ˑʇ˦ɻʇੴ੮ ͸ʩʮɻʩ੮ ɻ˺͙ˑʁ੮ ̹͙͐੮ ɺ˺͐ʩ੮ ˺͐ʩʇ̼੮ ̼ʇͅʮʁʇ˦͐ͅ੮ ɘ˦ʁ੮ ͐ʩʇʮ̼੮ ˑʮɻʇ˦ͅʇ੮ɘ͐੮̼ʮͅˌੳ੮ͅ੮˺ʠ੮šɻ͐˺ɺʇ̼੮৲ৰ৲৲ੴ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ɻ˺˦ͅʇ̼ͷʇʁ੮͸ʩʮˑʇ੮ ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʇʁ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ˈɘʮˑ੮ʩɘʁ੮ɺʇʇ˦੮͸ɘʮ͐ʮ˦ʡ੮ৱੴ৲ৰৰ੮ʁɘ;ͅ੮͐˺੮̼͐ɘ˦ͅʠʇ̼੮͐˺੮ ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʠɘɻʮˑʮ͐;ੳ৾৻ Ĕʩʇ˦੮ ͸ʇ੮ ̹ͅ˺ˌʇੴ੮ î˺ʁ੮ ͸ɘͅ੮ ̹͙ˑˑʮ˦ʡ੮ ʩʮͅ੮ ʩɘʮ̼੮ ˺͙͐੮ ˺ͷʇ̼੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ ͸ʩ˺੮ ુʩɘͅ੮ ɺʇʇ˦੮ɺɘ˦˦ʇʁ੮ʠ̼˺˚੮˚;੮˺͸˦੮યɻ˺͙˦͐;ર੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʩʇૄͅ੮ɺʇʇ˦੮ɺɘ˦˦ʇʁ੮ʠ̼˺˚੮#̼ʇ͐ͅ͸˺˺ʁ੮ યɘ੮ ˚ɘˈ˺̼੮ ̹̼ʮͷɘ͐ʇ੮ ̹̼˺ͷʮʁʇ̼੮ ˺ʠ੮ ˑ˺ɻˌʇʁ੮ ɺʇʁͅરੴ੮ ɘ˦ʁ੮ ʩʇૄͅ੮ ɺʇʇ˦੮ ɺɘ˦˦ʇʁ੮ ʠ̼˺˚੮ ʇͷʇ̼;ચ ͸ʩʇ̼ʇੳૂ੮î˺ʁ੮͙ͅʡʡʇ͐ͅʇʁ੮͐ʩɘ͐੮͐ʩʮͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ʁʮʁ੮˦˺͐੮ʩɘͷʇ੮ɘ੮ુ̼ʇɘˑૂ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ ˑʮˌʇ੮ ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ੮ ɺ͙͐੮ ɘ੮ ુͷʇ̼;੮ ͅʇ̼ʮ˺͙ͅ੮ ̹ʇ̼ͅ˺˦ɘˑʮ͐;੮ ʁʮͅ˺̼ʁʇ̼ੴૂ੮ ͸ʩʮɻʩੴ੮ ˑʮˌʇ੮ ͙ͅɺચ ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ʁʇ˚ʇ˦͐ʮɘੴ੮˺̼੮ɘ੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼;ੴ੮ɻɘ˦੮ɻ̼ʇɘ͐ʇ੮ͅ˺˚ʇ੮͸ʮʡʡˑʇ੮̼˺˺˚੮ ʠ˺̼੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺੮ʁʇ˦;੮ɘ˦੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ੳ੮š˦੮ɘ੮̹̼ʇͷʮ˺͙ͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮͐ʩʮͅ੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮ુ͐ɘˑˌʇʁ੮ɘɺͅ˺ˑ͙͐ʇˑ;੮ɻ̼ɘΈ;ૂ੮͐˺੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴ੮͸ʩ˺੮˚ɘ˦ɘʡʇʁ੮͐˺੮ʡʇ͐੮ʩʮ˚੮ ɻ˺˦ͅʇ̼ͷʇʁ੮ɘ˦ʁ੮ͅʇ˦͐੮ʩʮ˚੮͐˺੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ʩʇ̼ʇ੮ʩʇ੮ή͙ʮɻˌˑ;੮ɻʇɘͅʇʁ੮ʁʮ̹ͅˑɘ;ʮ˦ʡ੮ ɘ˦;੮̹ͅ;ɻʩ˺͐ʮɻ੮ͅ;˚̹͐˺˚ͅੳ੮Pʇ੮͸ɘͅ੮ɘ੮ુʩ˺͐੮̹˺͐ɘ͐˺ૂ੮˦˺੮˺˦ʇ੮͸ɘ˦͐ʇʁੵ੮ુĔʇ੮͸ʇ̼ʇ੮͙͐ͅɻˌ੮ ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ય͐ͅɘ͐ʇર੮ʩ˺̹ͅʮ͐ɘˑ੮ͅɘ;ͅੴ੮ૃPʇ੮ʁ˺ʇͅ˦ૄ͐੮˦ʇʇʁ੮͐˺੮ɺʇ੮ʩʇ̼ʇੴૄ੮ɘ˦ʁ੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮ ̹ˑɘɻʇ˚ʇ˦͐੮ͅɘ;ͅੴ੮ૃĔʇˑˑੴ੮͸ʇ੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮ʩʮ˚ੳૄૂ Ĕʩʮˑʇ੮ʩʇ੮ˑʮ˦ʡʇ̼ʇʁ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʮ͐ʩ˺͙͐੮ɘ੮ʁʮͅɻʩɘ̼ʡʇ੮̹ˑɘ˦ੴ੮ʩʇ੮ɘͅͅɘ͙ˑ͐ʇʁ੮ ͅ˺˚ʇ˺˦ʇੴ੮͸ʇ˦͐੮͐˺੮ˈɘʮˑੴ੮ɘ˦ʁ੮͸ɘͅ੮ɻ͙̼̼ʇ˦͐ˑ;੮͸ɘʮ͐ʮ˦ʡ੮͐˺੮̼ʇ͙̼͐˦੮͐˺੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑૄͅ੮ ʠ˺̼ʇ˦ͅʮɻ੮ ͙˦ʮ͐ੳ੮ ુU੮ ʁ˺˦ૄ͐੮ ˌ˦˺͸੮ ʮʠ੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ʡʇ͐ͅ੮ ͐˺੮ ̹ʮɻˌ੮ ɘ˦ʁ੮ ɻʩ˺˺ͅʇੴ੮ ɺ͙͐੮ ͐ʩʇ;੮͸ʮˑˑ੮ય̼͐;੮˦˺͐੮͐˺੮͐ɘˌʇ੮ʩʮ˚੮ɺɘɻˌરੴૂ੮î˺ʁ੮̹ͅʇɻ͙ˑɘ͐ʇʁੳ੮U˦੮͐ʩʮͅ੮ɻɘͅʇੴ੮ʩʇ੮̹ˑɘ˦˦ʇʁ੮͐˺੮ ̹͙ͅʩ੮ɺɘɻˌ੮˺˦੮͐ʩʇ੮ˈɘʮˑੴ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੴ੮ɘ˦ʁ੮ʁʮ̼͐ͅʮɻ͐੮ɘ͐͐˺̼˦ʇ;੮ɺ;੮ͅɘ;ʮ˦ʡੴ੮ુîʩʇ̼ʇૄͅ੮ ˦˺͐ʩʮ˦ʡ੮͸ʇ੮ɻɘ˦੮ʁ˺੮ʠ˺̼੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦ੴ੮˦˺੮̹ˑɘɻʇ੮͸ʮˑˑ੮ɘɻɻʇ̹͐੮ʩʮ˚ੳૄૂ੮î˺ʁૄͅ੮ʡ˺ɘˑ੮͸ɘͅ੮͐˺੮ ɻ˺˦ͷʮ˦ɻʇ੮ɘ੮ˈ͙ʁʡʇ੮͐˺੮ˈ͙͐ͅ੮ʁ̼˺̹੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮Pʇ੮ɻ˺˦ɻˑ͙ʁʇʁੴ੮ુPʇૄͅ੮ɘ੮;˺͙˦ʡ੮ ʡ͙;ੴ੮˺˦ˑ;੮ˑʮˌʇ੮͐ʩʮ̼͐;੮;ʇɘ̼ͅ੮˺ˑʁੴ੮ɺ͙͐੮ʩʇ੮͸ʮˑˑ੮̹̼˺ɺɘɺˑ;੮ɺʇ੮͐ɘˌʇ˦੮ɻɘ̼ʇ੮˺ʠ੮ɺ;੮͐ʩʇ੮ˈ͙ʁʮɻʮɘˑ੮ ͅ;͐ͅʇ˚ੴ੮˦˺͐੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳૂ

P U B L I C G UA R D I A N

117

"͙͐੮Ûʮɻˌੴ੮͐ʩʇ੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅ੮ɺɘɻˌ੮ɘ͐੮î͸ʮ˦੮î˺͸ʇ̼ͅ੮ˈɘʮˑੴ੮ʮͅ˦ૄ͐੮͸ʮˑˑʮ˦ʡ੮͐˺੮͐ɘˌʇ੮˦˺੮ ʠ˺̼੮ɘ˦੮ɘ˦ͅ͸ʇ̼ੳ੮Ĕʩʇ˦੮Ûʮɻˌ੮˚ɘ˦ɘʡʇͅ੮͐˺੮ʡʇ͐੮ɻˑʮʇ˦͐ͅ੮ɻ˺˦ͅʇ̼ͷʇʁੴ੮͐ʩʇ;੮ˑʇɘͷʇ੮ˈɘʮˑ੮ʠ˺̼੮͐ʩʇ੮ ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮͸ɘʮ͐੮ʠ˺̼੮ɘ੮ˑ˺ɻˌʇʁ੮͙ͅɺɘɻ͙͐ʇ੮ફU{)બ੮ɺʇʁ੮͸ʮˑˑʮ˦ʡ੮͐˺੮͐ɘˌʇ੮ʠ˺̼ʇ˦ͅʮɻ੮ ɻɘͅʇͅੳ੮Pʇ੮ɻˑɘʮ˚ͅ੮͐ʩɘ͐੮ɘͅ੮͐ʩʇ੮˚˺˦͐ʩͅ੮͸ʇɘ̼੮˺˦ੴ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʮˑˑ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮̹ʇ̼ચ suade the public guardian that the person is stable enough to go off conservatorચ ͅʩʮ̹੮ɘ˦ʁ੮ɻɘ˦੮͙̼ͅͷʮͷʇ੮ʮ˦੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻɘ̼ʇ੮ ʠ̼˺˚੮ɘ˦੮HäØ੮͐ʇɘ˚ੳ੮U˦੮Ûʮɻˌૄͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇੴ੮͐ʩʇ;੮˚ɘˌʇ੮ʮ͐੮ુʠ˺̼͐;ચʇʮʡʩ͐੮ʩ˺͙̼ͅ੮ɘ˦ʁ੮ʡʇ͐੮ ̼ʇɘ̼̼ʇ͐ͅʇʁੳૂ੮Pʮͅ੮ɘ̹̹̼˺ɘɻʩੴ੮͐ʩ˺͙ʡʩੴ੮͸ɘͅ੮͐˺੮ુɻ˺˦͐ʮ˦͙ʇ੮યɘ̹̹ˑ;ʮ˦ʡરੴ੮ʁʇ̹ͅʮ͐ʇ੮ˌ˦˺͸ʮ˦ʡ੮ ͐ʩɘ͐੮͐ʩʇ̼ʇ੮͸ɘͅ੮ɘ੮ʡ˺˺ʁ੮ɻʩɘ˦ɻʇ੮͐ʩɘ͐੮ʮ͐੮͸ɘͅ˦ૄ͐੮ʡ˺ʮ˦ʡ੮͐˺੮͸˺̼ˌ੮˺͙͐ੳ੯ੳ੯ੳ੯ੳ੮U੮͸ɘ˦͐ʇʁ੮͐˺੮ ϲˑ˺˺ʁ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮͸ʮ͐ʩ੮ɘͅ੮˚ɘ˦;੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘͅ੮̹˺ͅͅʮɺˑʇੳૂ੮Pʇ੮ʩ˺̹ʇʁ੮ ͐ʩʇ੮ ɻ˺͙˦͐;੮ ͸˺͙ˑʁ੮ ʮ˦ͷʇ͐ͅ੮ ʮ˦੮ ˚˺̼ʇ੮ ˑ˺ɻˌʇʁ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ʠ˺̼੮ ˈ͙͐ͅʮɻʇચ ʮ˦ͷ˺ˑͷʇʁ੮ɻˑʮʇ˦͐ͅੳ ੮̼͙̼ɘˑ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮̼ʇɻ˺͙˦͐ʇʁ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮̼͐ͅɘ͐ʇʡ;੮ʠ˺̼੮͙ͅʮ˦ʡ੮ˑɘ͸੮͐˺੮ʠ˺̼ɻʇ੮ ˚ʇʁʮɻʮ˦ʇૄͅ੮ʩɘ˦ʁੳ੮Pʇ੮͐˺ˑʁ੮˚ʇ੮͐ʩʇ੮ɻ˺͙˦͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮ʩɘʁ੮ʁʇɻˑɘ̼ʇʁ੮ ʮ͐੮͸˺͙ˑʁ˦ૄ͐੮͐ɘˌʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇʠʇ̼̼ɘˑͅ੮ʠ̼˺˚੮ˈɘʮˑ੮ɺʇɻɘ͙ͅʇ੮ુʮʠ੮;˺͙ૄ̼ʇ੮ʮ˦੮ɻ͙͐ͅ˺ʁ;੮ ɘˑˑ੮˺ʠ੮;˺͙̼੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼੮˦ʇʇʁͅ੮ɘ̼ʇ੮ɺʇʮ˦ʡ੮˚ʇ͐ੴ੮˦˺੮˚ɘ͐͐ʇ̼੮ʩ˺͸੮ɻ̼ɘΈ;੮ ;˺͙੮ɘ̼ʇੳૂ੮Pʮͅ੮͐ɘɻ͐ʮɻઝ͸ʩʮɻʩੴ੮ʩʇ੮͐˺ˑʁ੮˚ʇੴ੮ʩʇ੮ʩɘʁ੮͙ͅɻɻʇͅͅʠ͙ˑˑ;੮ʇͽʇ̼ɻʮͅʇʁ੮͐ʩʇ੮ɘʠ͐ʇ̼ચ ˦˺˺˦੮ɺʇʠ˺̼ʇ੮͸ʇ੮˚ʇ͐ઝ͸ɘͅ੮͐˺੮ɺʇɘ͐੮ʩʮͅ੮̹ͅ;ɻʩ˺͐ʮɻ੮ɻˑʮʇ˦͐ͅૄ੮ɻʩɘ̼ʡʇͅ੮ʮ˦੮ɻ˺͙̼͐ੴ੮ͅ˺੮͐ʩʇ;੮ ͸˺͙ˑʁ੮ɺʇ੮̼ʇˑʇɘͅʇʁ੮ʠ̼˺˚੮ɻ͙͐ͅ˺ʁ;ੳ੮Pʇૄʁ੮͐ʩʇ˦੮ɻɘˑˑ੮ɘ੮˚˺ɺʮˑʇ੮ɻ̼ʮͅʮͅ੮͐ʇɘ˚੮ʠ˺̼੮ɘ੮৵ৱ৵ৰ੮ ʇͷɘˑ͙ɘ͐ʮ˺˦੮˺˦੮͐ʩʇ੮͐ͅʇ̹ͅ੮˺ʠ੮͐ʩʇ੮ɻ˺͙̼͐ʩ˺͙ͅʇੳ੮îʩɘ͐੮ɻ˺͙ˑʁ੮ʡʇ͐੮͐ʩʇ˚੮ʮ˦͐˺੮͐ʩʇ੮ɻ˺͙˦͐;੮ ʩ˺̹ͅʮ͐ɘˑ੮ɘͅ੮ɘ੮̼ʇʡ͙ˑɘ̼ੴ੮˦˺˦ʠ˺̼ʇ˦ͅʮɻ੮̹ɘ͐ʮʇ˦͐ੳ îʩʇ੮̹ɘ͐ʩ͸ɘ;ͅ੮ʠ˺̼੮͐ʩʇͅʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮̼ʇʠʇ̼̼ɘˑͅ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̼ʇ੮˚͙ˑ͐ʮચ ̹ˑ;ʮ˦ʡ੮˺ͷʇ̼੮͐ʮ˚ʇੴ੮ɘͅ੮̹ɘ̼͐੮˺ʠ੮͸ʇˑˑચʮ˦͐ʇ˦͐ʮ˺˦ʇʁ੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ʁ˺͸˦ͅʮΈʇ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ɻɘ̼ɻʇ̼ɘˑ੮ ͅ;͐ͅʇ˚ੳ੮ ä͐ɘ͐ʇ੮ ˑʇʡʮͅˑɘ͐ʮ˺˦੮ ̹ɘͅͅʇʁ੮ ʮ˦੮ ৲ৰৱ৸੮ ɘˑˑ˺͸ͅ੮ ɻ˺͙̼͐ͅ੮ ͐˺੮ ̼ʇʠʇ̼੮ ̹ʇ˺̹ˑʇ੮ for conservatorship if they are unsuccessful in less restrictive diversion proચ ʡ̼ɘ˚ͅ੮ફʮ˦੮͸ʩʮɻʩ੮ɘ੮̹ʇ̼ͅ˺˦੮ɘʡ̼ʇʇͅ੮͐˺੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮˺̼ʁʇ̼੮͐˺੮ʡʇ͐੮ɻʩɘ̼ʡʇͅ੮ʁ̼˺̹̹ʇʁબੳ৾ৼ ˦˺͐ʩʇ̼੮̼˺͙͐ʇ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɺʇʡʮ˦ͅ੮͸ʩʇ˦੮ɻ˺͙̼͐ͅ੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮͐ʩɘ͐੮ͅ˺˚ʇચ ˺˦ʇ੮ʮͅ੮ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮͐˺੮͐ͅɘ˦ʁ੮̼͐ʮɘˑ੮ɘ˦ʁ੮ͅʇ˦ʁ੮͐ʩʇ˚੮͐˺੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮˺̼੮ɘ˦੮ʮ˦ચˈɘʮˑ੮ ̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ੳ੮r˺ͅ੮˦ʡʇˑʇͅ੮#˺͙˦͐;੮̼ʇ̹˺̼͐ʇʁ੮ɘ੮৳৵ৰ੮̹ʇ̼ɻʇ˦͐੮ʮ˦ɻ̼ʇɘͅʇ੮ʮ˦੮͙ͅɻʩ੮ ̼ʇʠʇ̼̼ɘˑͅ੮ ʠ̼˺˚੮ ৲ৰৱৰ੮ ͐˺੮ ৲ৰৱ৵ੳ৾৽੮ Uʠ੮ ɘ͐੮ ͐ʩʇ੮ ʇ˦ʁ੮ ˺ʠ੮ ͐͸˺੮ ;ʇɘ̼ͅ੮ ͐ʩʇ੮ ̹ʇ̼ͅ˺˦੮ ʮͅ੮ ʁʇʇ˚ʇʁ੮ incapable of being restored to competency, they too can be sent for conservaચ ͐˺̼ͅʩʮ̹ੳ৾৾੮ ੮ ৲ৰ৲ৱ੮ ɺʮˑˑੴ੮ ʮ˦͐ʇ˦ʁʇʁ੮ ͐˺੮ ɻˑʇɘ̼੮ ɘ੮ ɺɘɻˌˑ˺ʡ੮ ˺ʠ੮ ɻ˺˚̹ʇ͐ʇ˦ɻ;੮ ɻɘͅʇͅੴ੮ ˚ɘʁʇ੮ ʮ͐੮ ͅ˺੮ ͐ʩɘ͐੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ʠ˺͙˦ʁ੮ ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮ ͐˺੮ ͐ͅɘ˦ʁ੮ ̼͐ʮɘˑ੮ ʠ˺̼੮ ˚ʮͅʁʇ˚ʇɘ˦˺̼੮ ɻʩɘ̼ʡʇͅ੮ɻɘ˦੮ɺʇ੮̼ʇʠʇ̼̼ʇʁ੮ʁʮ̼ʇɻ͐ˑ;੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͸ʮ͐ʩ˺͙͐੮̹ɘͅͅʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ ̼ʇ͐ͅ˺̼ɘ͐ʮ˺˦੮̹̼˺ɻʇͅͅੳ৾৿ For all these legislative reforms, the state has not limited ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮͐˺੮̼ʇʠ͙ͅʇ੮͐ʩʇͅʇ੮˦ʇ͸੮̹˺͐ʇ˦͐ʮɘˑ੮ɻˑʮʇ˦͐ͅੳ੮˦ʁ੮ɘͅ੮ˑ˺˦ʡ੮ɘͅ੮

118

T H E C O N S E RVATO R S H I P C O N T I N U U M

͐ʩʇʮ̼੮ɺ͙ʁʡʇ͐ͅ੮ɘ̼ʇ੮͐ͅɘʡ˦ɘ˦͐੮ɘ˦ʁ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ˑʮ˚ʮ͐ʇʁੴ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ˑʮˌʇ੮î˺ʁ੮͸ʮˑˑ੮ ɻ˺˦͐ʮ˦͙ʇ੮͐˺੮ʁ˺੮ͅ˺ੳ ä˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮̼˚ɘ˦ʁ˺੮rɘ̼ɘચ{ʮˑˑɜ˦੮ʁʇͅɻ̼ʮɺʇͅ੮ʩ˺͸੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘʡʇ˦ɻʮʇͅ੮ʇ˦ʡɘʡʇ੮ ʮ˦੮ુ̹ʇ˺̹ˑʇ੮ʇͽɻʩɘ˦ʡʇયͅરૂ੮ɘͅ੮͐ʩʇ;੮ુ̼͙͐ͅʡʡˑʇ੮ʇʮ͐ʩʇ̼੮͐˺੮ɘɺʁʮɻɘ͐ʇ੮˺̼੮˺ɺ͐ɘʮ˦੮̼ʇ̹ͅ˺˦ͅʮચ ɺʮˑʮ͐;੮ʠ˺̼੮̹ʇ˺̹ˑʇੴ੮ɻɘͅʇˑ˺ɘʁͅੴ੮ɘ˦ʁ੯ੳ੯ੳ੯ੳ੮͐ʩʇ੮̹͙ɺˑʮɻ੮̼ʇͷʇ˦͙ʇ੮ય˺̼੮ɻ˺͐ͅͅર੮ɘ͐͐ɘɻʩʇʁ੮͐˺੮ ͐ʩʇ˚ੳૂ੮rɘ̼ɘચ{ʮˑˑɜ˦੮̹͙͐ͅ੮ʮ͐੮˚ʮˑʁˑ;੮͸ʩʇ˦੮ʩʇ੮ͅɘ;ͅ੮͐ʩʇ੮̼ʇ͙ͅˑ͐੮ʮͅ੮ુય˦˺͐ર੮ɻ˺ʩʇ̼ʇ˦͐੮̹˺̹ચ ͙ˑɘ͐ʮ˺˦੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮ʮ˦੮͸ʩʮɻʩ੮͐ʩʇ੮˚˺ͷʇ˚ʇ˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮ɺʇ͐͸ʇʇ˦੮͐ͅɘ͐ʇ੮ɘʡʇ˦ɻʮʇͅ੮ ʮͅ੮̼ɘ͐ʮ˺˦ɘˑˑ;੮ɻ˺˺̼ʁʮ˦ɘ͐ʇʁੳૂ੮U˦͐ͅʇɘʁੴ੮ʮ͐੮ͅʩ˺͸ͅ੮ʩ˺͸੮ˑɘ͸੮ɘ˦ʁ੮˚ʇʁʮɻʮ˦ʇ੮ɘ̼ʇ੮ʇ˦ʡɘʡʇʁ੮ ʮ˦੮ɘ˦੮˺˦ʡ˺ʮ˦ʡ੮̹̼˺ɻʇͅͅ੮˺ʠ੮ુ̼ʇʁʮ̼͐ͅʮɺ͙͐ʮ˦ʡ੮͐ʩʇ੮̹˺˺̼ૂ੮ɺʇ͐͸ʇʇ˦੮ͅʇ͐͐ʮ˦ʡͅ੮͐ʩɘ͐੮ʁ˺˦ૄ͐੮ ͸ɘ˦͐੮͐ʩʇ˚ੳ৾਀

CONCLUSION: RESIDUAL DISCRETION Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮˺ɺˑʮʡɘ͐ʇʁੴ੮ɺ;੮ɺ˺͐ʩ੮͐ʩʇ੮rØä੮͐ͅɘ͙͐͐ʇ੮ɘ˦ʁ੮͐ʩʇ੮ä͙̹̼ʇ˚ʇ੮#˺͙̼͐ૄͅ੮ ruling in Olmstead v. L.C. by Zimring, to ensure that disabled individuals go into the ુˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇૂ੮ͅʇ͐͐ʮ˦ʡ੮̹˺ͅͅʮɺˑʇੳ৾ਁ੮{ɘ˦;੮ʠʇ̼ͷʇ˦͐ˑ;੮ɺʇˑʮʇͷʇ੮͐ʩɘ͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͅʩ˺͙ˑʁ੮ɺʇ੮ɘ੮ˑɘ͐ͅ੮̼ʇͅ˺̼͐ੳ੮î˺੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮ʩ˺͸੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮˺̹ʇ̼ɘ͐ʇੴ੮͐ʩ˺͙ʡʩੴ੮;˺͙੮ need to look not just at legal mandates and ethical precepts but also at the underચ ˑ;ʮ˦ʡ੮ˑ˺ʡʮɻ੮˺ʠ੮˚ʇ̼ʮɻɘૄͅ੮ʠʇʇɺˑʇ੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇੳ੮Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮˦˺͐੮ɻʩɘ̼ʡʇʁ੮͸ʮ͐ʩ੮ ̹͙͐͐ʮ˦ʡ੮ʇͷʇ̼;˺˦ʇ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ʩ˺੮˚ʮʡʩ͐੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ʮ͐ੳ੮îʩʇ;੮ʮ˦͐ͅʇɘʁ੮ ˺̹ʇ̼ɘ͐ʇ੮˺˦੮͐ʩʇ੮̹̼ʮ˦ɻʮ̹ˑʇ੮˺ʠ੮ુ͙ͅɺͅʮʁʮɘ̼ʮ͐;ੴૂ੮˺̼੮͐ʩʇ੮ʮʁʇɘ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺ˑˑʇɻ͐ʮͷʮ͐;੮ͅʩ˺͙ˑʁ੮ ͐ͅʇ̹੮ʮ˦੮˺˦ˑ;੮͸ʩʇ˦੮͐ʩʇ੮ɻɘ̹ɘɻʮ͐;੮˺ʠ੮͐ʩʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɘ˦ʁ੮͐ʩʇ੮ʠɘ˚ʮˑ;੮͐˺੮̹̼˺ͷʮʁʇ੮ʮͅ੮ʠ͙ˑˑ;੮ ʇͽʩɘ͙͐ͅʇʁੳ৾ਂ ‡˺˦ʇ͐ʩʇˑʇͅͅੴ੮ʩ˺͸੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘɻ͐੮˺˦੮͐ʩʇͅʇ੮̹̼ʮ˦ɻʮ̹ˑʇͅ੮ʮͅ੮̼ʇ˚ɘ̼ˌɘɺˑ;੮ʮ˦ɻ˺˦ચ ͅʮ͐ͅʇ˦͐ੴ੮͐ʩɘ˦ˌͅ੮͐˺੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ɘɺʁʮɻɘ͐ʮ˺˦੮˺ʠ੮ɘ˦;੮̼˺ˑʇ੮ʮ˦੮͐ͅɘ˦ʁɘ̼ʁʮΈʮ˦ʡ੮̹̼ɘɻ͐ʮɻʇͅੳ੮Øɘ͙ˑੴ੮ ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ʮ˦੮ɘ੮˚ʇʁʮ͙˚ચͅʮΈʇ੮‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɻ˺͙˦͐;ੴ੮͐˺ˑʁ੮˚ʇੴ੮ુîʩʇ੮ʁʇϲʮ˦ʮચ ͐ʮ˺˦੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ͅ˺͙˦ʁͅ੮ͅʮ˚̹ˑʇ੯ੳ੯ੳ੯ੳ੮ɺ͙͐੮˺̹ʇ̼ɘ͐ʮ˺˦ɘˑˑ;ੴ੮ʩ˺͸੮ʁ˺ʇͅ੮͐ʩɘ͐੮ˑ˺˺ˌ੺੯ੳ੯ੳ੯ੳ੮ Ě˺͙੮ɻɘ˦੮ˑ˺˺ˌ੮ɘ̼˺͙˦ʁ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅੴ੮ɘ˦ʁ੮͸ʇૄ̼ʇ੮ɘˑˑ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ʇˑˑ੮;˺͙੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ ʁʮʠʠʇ̼ʇ˦͐ੳૂ੮ P˺͸ʇͷʇ̼੮ ʮ͐੮ ʮͅ੮ ʇͽʇ̼ɻʮͅʇʁੴ੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ˚˺͐ͅˑ;੮ ʡ˺ʇͅ੮ ʮ˦੮ ɘ੮ ˦ʇʡɘ͐ʮͷʇ੮ ʁʮ̼ʇɻચ ͐ʮ˺˦ੳ੮U͐ૄͅ੮ʇɘͅ;੮͐˺੮͙̼͐˦੮ʁ˺͸˦੮̼ʇʠʇ̼̼ɘˑͅੴ੮ɺ͙͐੮ɻ˺˦ͅʇ̼ͷʮ˦ʡ੮˚˺̼ʇ੮̹ʇ˺̹ˑʇ੮ʮͅ੮ʩɘ̼ʁੵ੮˺ϲϲʮɻʇͅ੮ ɻɘ˦੮˺˦ˑ;੮ʇͷɘˑ͙ɘ͐ʇੴ੮˦˺͐੮ͅ˺ˑʮɻʮ͐ੴ੮̼ʇʠʇ̼̼ɘˑͅੳ੮"͙ʁʡʇ͐ͅ੮ɘ̼ʇ੮ϲʮͽʇʁ੮ʇͷʇ˦੮ʮʠ੮ɻɘͅʇˑ˺ɘʁͅ੮ʡ˺੮͙̹ੳ੮ {˺̼ʇ੮̹ʇ͐ʮ͐ʮ˺˦ͅ੮ʁ˺੮˦˺͐੮˚ɘʡʮɻɘˑˑ;੮ɻ̼ʇɘ͐ʇ੮˚˺̼ʇ੮ɺʇʁͅ੮ʮ˦੮ˑ˺ɻˌʇʁ੮͐ͅʇ̹ચʁ˺͸˦੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮ U͐ૄͅ੮͙˦͙̼̹̼ͅʮͅʮ˦ʡ੮͐ʩɘ͐੮ͅ˺੮˚ɘ˦;੮̹˺͐ʇ˦͐ʮɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͸ʮ˦ʁ੮͙̹੮ʮ˦੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅઝ˺ʠ͐ʇ˦੮͐ʩʇ੮˺˦ˑ;੮̹͙ɺˑʮɻ੮ɘʡʇ˦ɻʮʇͅ੮͐ʩɘ͐੮ɻɘ˦˦˺͐੮̼ʇʠ͙ͅʇ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ુή͙ɘˑʮચ ϲʮʇʁૂ੮ʠ˺̼੮͐ʩʇʮ̼੮ુͅʇ̼ͷʮɻʇͅੳૂ

P U B L I C G UA R D I A N

119

In the end, though, public guardians’ negative discretion plays a residual role ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮ˑ͐ʩ˺͙ʡʩ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʮ˦੮ͅ˺˚ʇ੮ͅ˚ɘˑˑʇ̼੮ counties told me that they rejected as much as a third of applications, in larger ɻ˺͙˦͐ʮʇͅ੮ˑʮˌʇ੮ˑɘ˚ʇʁɘੴ੮r˺ͅ੮˦ʡʇˑʇͅੴ੮˺̼੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮͐ʩʇ੮˺ϲϲʮɻʇͅઝ͙˦ʁʇ̼੮ʮ˦ɻ̼ʇɘͅચ ʮ˦ʡ੮̹̼ʇ͙̼ͅͅʇ੮ʠ̼˺˚੮ɻ˺͙˦͐;੮͙̹ͅʇ̼ͷʮͅ˺̼ͅੴ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੴ੮ɘ˦ʁ੮ʠɘ˚ʮˑʮʇͅઝϲʮˑʇ੮˺˦੮ͷʮ̼ચ ͙͐ɘˑˑ;੮ʇͷʇ̼;੮̼ʇʠʇ̼̼ɘˑੳ৾ਃ੮{˺͐ͅ੮˺ʠ੮͐ʩʇ੮̼ʇɘˑ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ʩɘͅ੮ɺʇʇ˦੮ʁʇˑʇʡɘ͐ʇʁ੮ʇɘ̼ˑʮʇ̼੮˺˦੮ ͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮͐˺੮ʇ˦͐ʮ͐ʮʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮˺ʠ͐ʇ˦੮̹̼ʮͷɘ͐ʇ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮̹͙ɺˑʮɻੳ Ûʇͅ˺͙̼ɻʇ੮ɻ˺˦̼͐ͅɘʮ˦͐ͅੴ੮̼ʇʡ͙ˑɘ͐˺̼;੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅੴ੮ɘ˦ʁ੮ɘ੮ˑɘɻˌ੮˺ʠ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮˚ʮʡʩ͐੮ ʇͽ̹ˑɘʮ˦੮ ͸ʩ;੮ ͅ˺˚ʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ ͅʇʇ˚੮ ϲˑɘʡ̼ɘ˦͐ˑ;੮ ͙˦ɘɺˑʇ੮ ͐˺੮ ˚ʇʇ͐੮ ͐ʩʇʮ̼੮ ɺɘͅʮɻ੮ ˦ʇʇʁͅ੮ʁ˺˦ૄ͐੮ɘʁͷɘ˦ɻʇ੮ʠ͙̼͐ʩʇ̼੮ɘˑ˺˦ʡ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮îʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮˚ɘˌʇ੮͐ʩʇ੮˺͙͐ચ ɻ˺˚ʇͅ੮ͅʇʇ˚੮ɘ˦;੮ˑʇͅͅ੮ɻ̼͙ʇˑੳ੮Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ʁʇɻʮͅʮ˺˦ͅ੮ˑʇʠ͐੮rʮ˦ʁɘ੮Ûʮ̹̹ʇʇ੮ʠʇʇˑʮ˦ʡ੮ɘͅ੮ ʠ˺̼ͅɘˌʇ˦੮ɘͅ੮ʩʇ̼੮ɺ̼˺͐ʩʇ̼ੴ੮ɺˑʮ˦ʁ੮ɘ˦ʁ੮̹ͅ;ɻʩ˺͐ʮɻ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮˺ϲ੮ēɘɻɘͷʮˑˑʇੳ੮îʩʇ੮ʁɘ;੮ ͸ʇ੮̹ͅ˺ˌʇੴ੮ʮ͐੮͸ɘͅ੮̼ɘʮ˦ʮ˦ʡੴ੮ɘ˦ʁ੮rʮ˦ʁɘ੮͸ɘͅ੮ˑʇɘͷʮ˦ʡ੮͐˺੮ɺ̼ʮ˦ʡ੮{ɘ̼ˌ੮ͅ˺˚ʇ੮ʁ̼;੮ɻˑ˺͐ʩʇͅੳ੮ ͐੮ˑʇɘ͐ͅ੮ͅʩʇ੮ˌ˦ʇ͸੮͸ʩʇ̼ʇ੮͐˺੮ˑ˺˺ˌੳ੮ʠ͐ʇ̼੮ʩʮͅ੮ˑɘ͐ͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮ʩʇ੮ɘͅˌʇʁ੮͐˺੮ɺʇ੮ ʁ̼˺̹̹ʇʁ੮˺ʠʠ੮˺˦੮͐ʩʇ੮ͷʇ̼;੮̼͐ͅʇʇ͐੮͸ʩʇ̼ʇ੮ʩʇ੮ʩɘʁ੮͐͸ʮɻʇ੮ɺʇʇ˦੮ʩʮ͐੮ɺ;੮ɘ੮ɻɘ̼ੳ੮Pʮͅ੮ʠɘͷ˺̼ʮ͐ʇ੮ ̹ͅ˺͐੮͸ɘͅ੮̼ʮʡʩ͐੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮ɘ੮ɻ˺͙˦͐;੮˺ϲϲʮɻʇ੮ɺ͙ʮˑʁʮ˦ʡੳ੮U͐੮ʩ˺͙ͅʇͅ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੳ

CHAPTER 6

COURT

‘H

ow many patients have you treated and evaluated as a psychiatrist?’ Andy, the county counsel who represents the public guardʮɘ˦ૄͅ੮˺ϲϲʮɻʇੴ੮ɘͅˌͅੳ੮Uૄ˚੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮ʠʇ͸੮̹ʇ˺̹ˑʇ੮̹ʩ;ͅʮɻɘˑˑ;੮̹̼ʇͅʇ˦͐੮ʮ˦੮ ͐ʩʇ੮ɻ˺͙̼̼͐˺˺˚੮ʠ˺̼੮˺˦ʇ੮ɘʠ͐ʇ̼˦˺˺˦ૄͅ੮˚˺͐ͅˑ;੮ͷʮ̼͙͐ɘˑ੮ʩʇɘ̼ʮ˦ʡ੮ʠ˺̼੮ɘ੮rɘ͐ʮ˦ɘ੮͸˺˚ɘ˦੮ʮ˦੮ ʩʇ̼੮˚ʮʁચ͐ʩʮ̼͐ʮʇͅੳ੮äʩʇૄͅ੮ͅʮ͐͐ʮ˦ʡ੮ʮ˦੮ɘ੮ʡ̼ɘ;੮ʩ˺˺ʁʮʇ੮ʮ˦ͅʮʁʇ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮̼˺˺˚ੴ੮͐ʩʇ੮ɻɘ˚ʇ̼ɘ੮ ɘ੮ɺʮ͐੮͐˺˺੮ɻˑ˺ͅʇ੮͐˺੮ʩʇ̼੮ʠɘɻʇੳ îʩʇ੮ʁ˺ɻ͐˺̼ੴ੮ˈ͙͐ͅ੮͐ʩ̼ʇʇ੮;ʇɘ̼ͅ੮˺͙͐੮˺ʠ੮˚ʇʁ੮ͅɻʩ˺˺ˑ੮ɺ͙͐੮˺˦੮͐ʩʇ੮ʠ̼˺˦͐੮ˑʮ˦ʇͅ੮˺ʠ੮#ɘˑʮચ ʠ˺̼˦ʮɘૄͅ੮ ͅ;͐ͅʇ˚੮ ˺ʠ੮ ̼ɘ̹ʮʁੴ੮ ̼ʇͷ˺ˑͷʮ˦ʡચʁ˺˺̼੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ ˑ˺˺ˌͅ੮ ɺʇ˚͙ͅʇʁੵ੮ૃU੮ʁ˺˦ૄ͐੮ˌ˦˺͸ੴ੮͐ʩ˺͙ͅɘ˦ʁͅ੺ૄ #˺͙˦͐;੮ɻ˺͙˦ͅʇˑ੮ʮͅ੮ˑɘ;ʮ˦ʡ੮͐ʩʇ੮͐ͅɘ˦ʁɘ̼ʁ੮ʠ˺͙˦ʁɘ͐ʮ˺˦੮͐˺੮ʇ͐ͅɘɺˑʮͅʩ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮ ͐ͅɘ̼ઝɘ˦ʁ੮˺˦ˑ;ઝ͸ʮ͐˦ʇͅͅ੮ʮͅ੮ɘ˦੮ʇͽ̹ʇ̼͐੮ή͙ɘˑʮϲʮʇʁ੮͐˺੮ɘ˦ͅ͸ʇ̼੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮ɘ˦ʮ˚ɘ͐ʮ˦ʡ੮ ͐˺ʁɘ;ૄͅ੮ʩʇɘ̼ʮ˦ʡੳ੮k͙ʁʡʇ੮)ɘͷʮͅੴ੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮ʁ˺ʮ˦ʡ੮rØä੮ɻɘͅʇͅ੮ɘˑ˚˺͐ͅ੮ʇͽɻˑ͙ͅʮͷʇˑ;੮ ʠ˺̼੮ɘ੮;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ʩɘˑʠ੮ʮ˦੮ɘ੮ä˺͙͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɻ˺͙˦͐;ੴ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͸ʩɘ͐੮͐ʩɘ͐੮ή͙ʇ͐ͅʮ˺˦੮͸ɘͅ੮ɘ੮ʠʇ͸੮˚ʮ˦͙͐ʇͅ੮̹̼ʮ˺̼ੵ੮ૃ{ͅੳ੮I˺˦ΈɘˑʇΈੴ੮͸ʇૄ̼ʇ੮ʩʇ̼ʇ੮͐˺ʁɘ;੮͐˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮ʮʠ੮ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͸ʮˑˑ੮ɺʇ੮ɘ̹̹˺ʮ˦͐ʇʁ੮ʠ˺̼੮;˺͙ੳ੮îʩʇ੮ʮ͙ͅͅʇ੮͐˺ʁɘ;੮ʮͅ੮͐˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮ʮʠ੮;˺͙੮ɘ̼ʇ੮ ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ɘͅ੮ɘ੮̼ʇ͙ͅˑ͐੮˺ʠ੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳૄ îʩɘ͐੮ʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦੮͸ʮˑˑ੮ʁʇ̹ʇ˦ʁ੮˺˦੮)̼ੳ੮Øɘ̼ˌૄͅ੮cultural authority: his capacity, ɘͅ੮Øɘ͙ˑ੮ä͐ɘ̼̼੮ʇͽ̹ˑɘʮ˦ͅ੮ʮ͐ੴ੮͐˺੮ુʁʇϲʮ˦ʇ੯ੳ੯ੳ੯ੳ੮ય͐ʩʇર੮̼ʇɘˑʮ͐;ૂ੮˺ʠ੮ɘ੮̹ɘ͐ʮʇ˦͐ૄͅ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ɘ˦ʁ੮ ʩɘͷʇ੮͐ʩɘ͐੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ુ̹̼ʇͷɘʮˑ੮ɘͅ੮ͷɘˑʮʁ੮ɘ˦ʁ੮̼͙͐ʇੳૂৼ੮"͙͐੮ʮ˦੮͐ʩʮͅ੮ɻɘͅʇੴ੮Uૄ˚੮̼͙͐ͅɻˌ੮ɺ;੮ ͐ʩʇ੮͸ʇɘˌ੮͙˦ʁʇ̼̹ʮ˦˦ʮ˦ʡͅ੮˺ʠ੮͐ʩʮͅ੮ɘ͙͐ʩ˺̼ʮ͐;ੳ੮îʩʇ੮ʁ˺ɻ͐˺̼੮ʩɘͅ੮ɺʇʇ˦੮̼͐ʇɘ͐ʮ˦ʡ੮ʩʇ̼੮ʠ˺̼੮ ʠ˺͙̼੮͸ʇʇˌͅੴ੮ͅʇʇͅ੮ʩʇ̼੮ૃ˺˦ɻʇ੮ɘ੮͸ʇʇˌ੮͐˺੮ɻʩʇɻˌ੮ʮ˦ੴૄ੮ɘ˦ʁ੮͐ʩʮͅ੮͙͙ͅɘˑˑ;੮͐ɘˌʇͅ੮ૃɘɺ˺͙͐੮͐ʇ˦੮ ͐˺੮ϲʮʠ͐ʇʇ˦੮˚ʮ˦͙͐ʇͅੳૄ )̼ੳ੮Øɘ̼ˌ੮ʡʮͷʇͅ੮ʩʮͅ੮ʁʮɘʡ˦˺ͅʮͅੴ੮ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੳ੮Pʇ੮ɘʁʁͅੴ੮ૃäʩʇ੮ʩɘͅ੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮˚͙ˑ͐ʮ̹ˑʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅઝૄ

C O U RT

121

ૃšɺˈʇɻ͐ʮ˺˦ੴૄ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ɻ͙͐ͅ੮ʮ˦ੳ k͙ʁʡʇ੮ )ɘͷʮͅ੮ ˑ˺˺ˌͅ੮ ͙̹੮ ɘ˦ʁ੮ ̼ɘ̹ʮʁˑ;੮ ʁʇɻˑɘ̼ʇͅੵ੮ ૃä͙͐ͅɘʮ˦ʇʁੳ੮ ä̼͐ʮˌʇ੮ ͐ʩɘ͐੮ ʠ̼˺˚੮ ͐ʩʇ੮ ̼ʇɻ˺̼ʁੳૄ îʩʮͅ੮˺ɺˈʇɻ͐ʮ˺˦੮̼ʇͷʇɘˑͅ੮ɘ੮ˌʇ;੮ʁ;˦ɘ˚ʮɻ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼͐ʮɘˑͅઝɘ˦ʁ੮͸ʩ;੮ʁ˺ɻ͐˺̼ͅૄ੮ɻ͙ˑ͙̼͐ɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮͸ʮ͐ʩʮ˦੮͐ʩʇ˚੮ͅʇʇ˚ͅ੮ͅ˺੮ˑʮ˚ʮ͐ʇʁੳ੮U˦੮ɘ੮৲ৰৱ৶੮̼͙ˑʮ˦ʡ੮ʮ˦੮People v. Sanchezੴ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮ä͙̹̼ʇ˚ʇ੮#˺͙̼͐੮ʁʇɻ̼ʇʇʁ੮͐ʩɘ͐੮ʇͽ̹ʇ̼͐੮͸ʮ͐˦ʇͅͅʇͅ੮ɻɘ˦˦˺͐੮͐ʇ͐ͅʮʠ;੮͐˺੮ʠɘɻ͐ͅ੮͐ʩʇ;੮ʩɘͷʇ੮ˑʇɘ̼˦ʇʁ੮͐ʩ̼˺͙ʡʩ੮ʮ˦ɘʁ˚ʮͅͅʮɺˑʇ੮ʩʇɘ̼ͅɘ;ੳ৽ That case had nothʮ˦ʡ੮͐˺੮ʁ˺੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ફ͐ʩʇ੮ૃʇͽ̹ʇ̼͐ૄ੮͸ɘͅ੮ɘ੮̹˺ˑʮɻʇ੮ʁʇ͐ʇɻ͐ʮͷʇ੮̹ͅʇɻʮɘˑʮΈʇʁ੮ʮ˦੮ ʡɘ˦ʡͅબੴ੮ɺ͙͐੮͐ʩʇ੮̼ʇ͙ͅˑ͐੮͸ɘͅ੮͐˺੮͐ʮʡʩ͐ˑ;੮̼ʇ̼͐ͅʮɻ͐੮͐ʩʇ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ɻ˺˚ʮ˦ʡ੮ʮ˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩʇɘ̼ʮ˦ʡͅੳ੮˦੮ʇͽ̹ʇ̼͐੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ˈ͙ʁʡ˚ʇ˦͐੮̼ʇή͙ʮ̼ʇͅ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ͅ˺˚ʇ˺˦ʇૄͅ੮ ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅ੮˺̼੮˺͙̹͐ɘ͐ʮʇ˦͐੮̹̼˺ͷʮʁʇ̼ͅੴ੮ɘͅ੮͸ʇˑˑ੮ɘͅ੮̼ʇͷʮʇ͸ʮ˦ʡ੮̼ʇɻ˺̼ʁͅ੮ʠ̼˺˚੮̹̼ʇͷʮ˺͙ͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੳ੮͐੮ɘ੮˚ʮ˦ʮ˚͙˚ੴ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮̼ʇˑ;੮˺˦੮͸ɘ̼ʁ੮͐ͅɘʠʠઝ͐ʩʇ੮˦͙̼ͅʇͅ੮ ˺̼੮͐ʇɻʩͅ੮͸ʩ˺੮̹ͅʇ˦ʁ੮ʇʮʡʩ͐ચʩ˺͙̼੮ͅʩʮʠ͐ͅ੮͸ʮ͐ʩ੮̹ɘ͐ʮʇ˦͐ͅੴ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ϲʮʠ͐ʇʇ˦ચ˚ʮ˦͙͐ʇ੮ ̼˺͙˦ʁͅઝ͐˺੮ϲʮˑˑ੮͐ʩʇ˚੮ʮ˦ੳ੮‡˺˦ʇ੮˺ʠ੮͐ʩɘ͐੮ʮͅ੮ɘʁ˚ʮͅͅʮɺˑʇ੮ʮ˦੮ɻ˺͙̼͐੮ʮʠ੮͐ʩʇ̼ʇૄͅ੮ɘ੮̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ͅɘͷͷ;੮ʇ˦˺͙ʡʩ੮͐˺੮˺ɺˈʇɻ͐੮ɘ˦ʁ੮ɘ੮ˈ͙ʁʡʇ੮͸ʩ˺੮ʮͅ੮ɻɘ͙ʡʩ͐੮͙̹੮˺˦੮͐ʩʇ੮ɻɘͅʇ੮ˑɘ͸ੳ Sanchez੮ ʇͽ̹ˑɘʮ˦ͅ੮ ɻ˺͙˦͐;੮ ɻ˺͙˦ͅʇˑૄͅ੮ ͐ͅʮˑ͐ʇʁ੮ ʮ˦̼͐˺ʁ͙ɻ͐ʮ˺˦੮ ͐˺੮ ʩʮͅ੮ ˦ʇͽ͐੮ ή͙ʇ͐ͅʮ˺˦ੵ੮ ૃU˦੮ɘ˦ͅ͸ʇ̼ʮ˦ʡੴ੮U੮͸˺͙ˑʁ੮ˑʮˌʇ੮;˺͙੮͐˺੮ˑʮ˚ʮ͐੮;˺͙̼ͅʇˑʠ੮͐˺੮;˺͙̼੮ʁʮ̼ʇɻ͐੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮ɘ˦ʁ੮ ʮ˦͐ʇ̼ɘɻ͐ʮ˺˦ͅ੮͸ʮ͐ʩ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ੳ੮Ĕʩɘ͐੮ɘ̼ʇ੮͐ʩʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮͐ʩɘ͐੮;˺͙੮ ͅʇʇ੮ʮ˦੮{ͅੳ੮I˺˦ΈɘˑʇΈ੺ૄ îʩʇ੮ʁ˺ɻ͐˺̼੮̼ʇ̹ˑʮʇͅੴ੮ૃäʩʇ੮ʮͅ੮ή͙ʮ͐ʇ੮̹ɘ̼ɘ˦˺ʮʁੳ੮äʩʇ੮͐ɘˑˌͅ੮˦˺˦ͅʇ˦ͅʮɻɘˑˑ;੮ɘ˦ʁ੮˚ɘˌʇͅ੮ ʮˑˑ˺ʡʮɻɘˑ੮͐ͅɘ͐ʇ˚ʇ˦͐ͅ੮ɘɺ˺͙͐੮͸ʩʇ̼ʇ੮ͅʩʇ੮͸ʮˑˑ੮ʡ˺੮ʮʠ੮̼ʇˑʇɘͅʇʁੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮ͅʩʇ੮ͅɘ;ͅ੮ͅʩʇ੮ ͸ʮˑˑ੮ʡ˺੮ʩ˺˚ʇੴ੮˺͐ʩʇ̼੮͐ʮ˚ʇͅ੮ͅʩʇ੮ͅɘ;ͅ੮͐ʩɘ͐੮ͅʩʇ੮͸ʮˑˑ੮ʡ˺੮͐˺੮͐ʩʇ੮H˺͙̼͐ʩ੮ä̼͐ʇʇ͐੮"̼ʮʁʡʇ੮ યɘ੮ ˦˺͐˺̼ʮ˺͙ͅੴ੮ ɘ˦ʁ੮ ̹ͅʇ͙ʁ˺˦;˚˺͙ͅੴ੮ ʩ˺˚ʇˑʇͅͅ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐રੳ੮ Ĕʇૄͷʇ੮ ͐ɘˑˌʇʁ੮ ͐˺੮ ʩʇ̼੮ ɘɺ˺͙͐੮ʡ˺ʮ˦ʡ੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮ʩʇ̼੮ʠɘ˚ʮˑ;ੴ੮ɺ͙͐੮ͅʩʇ੮̼ʇʠ͙ͅʇͅੳૄ ‘And how is her judgment?’ ૃU͐ૄͅ੮ʠɘʮ̼ੴ੮ɺ͙͐੮ͅʩʇ੮ʩɘͅ੮˦˺੮ʮ˦ͅʮʡʩ͐੮ʮ˦͐˺੮ʩʇ̼੮ɻ˺˦ʁʮ͐ʮ˺˦ੳૄ Ø̼ʮ˺̼੮͐˺੮rØäੴ੮ɘ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ʩʇɘ̼ʮ˦ʡ੮˚ʮʡʩ͐੮ʩɘͷʇ੮͐ͅ˺̹̹ʇʁ੮͐ʩʇ̼ʇੳ੮{ͅੳ੮I˺˦ΈɘˑʇΈ੮ ʩɘͅ੮ ɘ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ɘ˦ʁ੮ ʁ˺ʇͅ˦ૄ͐੮ ̼ʇɻ˺ʡ˦ʮΈʇ੮ ʩʇ̼੮ ˦ʇʇʁ੮ ʠ˺̼੮ ̼͐ʇɘ͐˚ʇ˦͐ੳ৾ But that’s ˦˺͐੮͸ʩɘ͐੮͐ʩʮͅ੮ʩʇɘ̼ʮ˦ʡ੮ʮͅ੮ɘɺ˺͙͐ੳ੮#˺͙˦͐;੮ɻ˺͙˦ͅʇˑ੮͐ʩʇ˦੮ɘͅˌͅੴ੮ૃUͅ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ʡ̼ɘͷʇˑ;੮ disabled?’ ૃĚʇͅੴ੮ͅʩʇ੮ʁ˺ʇͅ੮˚ʇʇ͐੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɻ̼ʮ͐ʇ̼ʮɘੳૄ ‘And what is the nexus between her mental illness and her grave disability?’ ૃ‡ʇͽ͙ͅૄ੮ʮͅ੮ɘ˦੮˺ʁʁ੮͐ʇ̼˚ੴ੮ɺ͙͐੮ʮ͐ૄͅ੮ɘ˦˺͐ʩʇ̼੮͐ʩʮ˦ʡ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʮͅ੮ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼ੵ੮ɘ੮ɻˑʇɘ̼੮ ɻɘ͙ͅʇચɘ˦ʁચʇʠʠʇɻ͐੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮ɺʇ͐͸ʇʇ˦੮{ͅੳ੮I˺˦ΈɘˑʇΈૄͅ੮̹ɘ͐ʩ˺ˑ˺ʡ;੮ɘ˦ʁ੮ʩʇ̼੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮ʩʇ̼੮ɺɘͅʮɻ੮˦ʇʇʁͅੳ

122

T H E C O N S E RVATO R S H I P C O N T I N U U M

îʩʇ੮ʁ˺ɻ͐˺̼੮̼ʇʮ͐ʇ̼ɘ͐ʇͅੴ੮ૃĔʇˑˑੴ੮ͅʩʇ੮ʩɘͅ੮ͷʇ̼;੮̹˺˺̼੮ʮ˦ͅʮʡʩ͐ੳ੮äʩʇ੮ɻ˺͙ˑʁ੮˦˺͐੮ɻɘ̼ʇ੮ʠ˺̼੮ ʩʇ̼ͅʇˑʠ੮˺˦੮ʩʇ̼੮˺͸˦ੳ੮U੮͙̹ͅͅʇɻ͐੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮˦˺˦ɻ˺˚̹ˑʮɘ˦͐੮͸ʮ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮͸ʩʮɻʩ੮ ˑʇʁ੮͐˺੮ʩʇ̼੮̼ʇˑɘ̹ͅʇ੮ɘ˦ʁ੮̼ʇɘʁ˚ʮͅͅʮ˺˦੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૄ #˺͙˦͐;੮ ɻ˺͙˦ͅʇˑ੮ ɘͅˌͅ੮ ʮʠ੮ ʩʇ੮ ͐ʩʮ˦ˌͅ੮ {ͅੳ੮ I˺˦ΈɘˑʇΈ੮ ͸˺͙ˑʁ੮ ɻ˺˦͐ʮ˦͙ʇ੮ ͐ɘˌʮ˦ʡ੮ ͐ʩʇ੮ ͐͸˺੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻͅ੮ͅʩʇૄͅ੮̹̼ʇͅɻ̼ʮɺʇʁ੮˺͙͐ͅʮʁʇ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮ૃU੮ʩɘͷʇ˦ૄ͐੮ɘͅˌʇʁ੮ʩʇ̼ੴ੮ɺ͙͐੮ U੮ʩɘͷʇ੮ɘ੮ʩʮʡʩ੮͙̹ͅͅʮɻʮ˺˦੮͐ʩɘ͐੮ͅʩʇ੮͸˺͙ˑʁ੮˦˺͐ੴૄ੮)̼ੳ੮Øɘ̼ˌ੮ɻ˺˦ɻˑ͙ʁʇͅੳ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ૄͅ੮ɻ̼˺ͅͅ੮ʇͽɘ˚ʮ˦ɘ͐ʮ˺˦੮ʮͅ੮ͅʩ˺̼͐ੳ੮ૃPɘͷʇ੮;˺͙੮ˑ˺˺ˌʇʁ੮ʮ˦͐˺੮͸ʩʇ̼ʇ੮ ͅʩʇ੮͸ɘ˦͐ͅ੮͐˺੮ʡ˺੮ɘ͐੮͐ʩʇ੮H˺͙̼͐ʩ੮ä̼͐ʇʇ͐੮/˦ɻɘ˚̹˚ʇ˦͐੺ૄ )̼ੳ੮Øɘ̼ˌ੮˺ʠʠʇ̼ͅ੮ɘ੮ɻ͙̼͐ੴ੮ૃ‡˺ੳૄ ૃ̼ʇ੮;˺͙੮ɘ͸ɘ̼ʇ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮̼ʇͅ˺͙̼ɻʇͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɻʩ˺˺ͅʇ੮͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮ ʇ˦ɻɘ˚̹˚ʇ˦͐੮ɘ˦ʁ੮͸ɘ˦͐੮͐˺੮ɘͷɘʮˑ੮͐ʩʇ˚ͅʇˑͷʇͅ੮˺ʠ੮͐ʩʇ˚੺ૄ îʩʇ੮ʁ˺ɻ͐˺̼ૄͅ੮̼ʇ̹ͅ˺˦ͅʇ੮ʮͅ੮ʮ˚̹ɘͅͅʮͷʇੵ੮ૃUૄ˚੮͙̼ͅʇ੮͐ʩʇ̼ʇ੮ɘ̼ʇੳ੮"͙͐੮ͅʩʇ੮͸˺͙ˑʁ੮ɺɘͅʮɻɘˑˑ;੮ ɺʇ੮ʁʮͅɻʩɘ̼ʡʇʁ੮͸ʮ͐ʩ੮˦˺੮ʠ˺ˑˑ˺͸ચ͙̹ੳ੮U͐ૄͅ੮˦˺͐੮ɘ੮ʡ˺˺ʁ੮̹ˑɘ˦ੳૄ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮͙̼͐˦ͅ੮͐˺੮{ͅੳ੮I˺˦ΈɘˑʇΈ੮ફ˺̼੮̼ɘ͐ʩʇ̼ੴ੮ʩʇ̼੮ʮ˚ɘʡʇ੮˺˦੮͐ʩʇ੮ͅɻ̼ʇʇ˦બ੮ ɘ˦ʁ੮ɘͅˌͅ੮ʮʠ੮ͅʩʇૄʁ੮ˑʮˌʇ੮͐˺੮̹ͅʇɘˌ੮͐˺੮͐ʩʇ੮ˈ͙ʁʡʇੳ੮îʩʇ੮͸˺˚ɘ˦੮ͅɘ;ͅ੮ૃ;ʇͅૄ੮ɘ˦ʁੴ੮͸ʮ͐ʩ˺͙͐੮ prompting, starts explaining why she doesn’t want a conservatorship, except that ͅʩʇૄͅ੮͐˺˺੮ή͙ʮʇ͐੮͐˺੮ʩʇɘ̼ੳ੮îʩʇ੮ɻ˺͙̼͐੮̼ʇ̹˺̼͐ʇ̼੮͐ʩ̼˺͸ͅ੮͙̹੮ʩʇ̼੮ʩɘ˦ʁͅ੮ʮ˦੮ʇͽɘ̹ͅʇ̼ɘ͐ʮ˺˦ੳ੮ Pʇ̼੮ˑɘ͸;ʇ̼੮ɻ͙͐ͅ੮ʩʇ̼੮˺ʠʠ੮ɘ˦ʁ੮ɘͅˌͅ੮ʩʇ̼੮̹˺ʮ˦͐ʇʁˑ;੮͸ʩʇ̼ʇ੮ͅʩʇ੮͸˺͙ˑʁ੮ʡ˺੶੮ͅʩʇ੮ͅɘ;ͅ੮äɘˑͷɘ͐ʮ˺˦੮äʩʇˑ͐ʇ̼ੴ੮̼ʮʡʩ͐੮ɺ;੮͐ʩʇ੮ʇ˦ɻɘ˚̹˚ʇ˦͐ੳ ૃĔʩʇ˦੮͸ʇ̼ʇ੮;˺͙੮ˑɘ͐ͅ੮ɘ͐੮äɘˑͷɘ͐ʮ˺˦੺ૄ ૃ੮˚˺˦͐ʩ੮ɘʡ˺ੳૄ ૃP˺͸੮ˑ˺˦ʡ੮ʩɘͷʇ੮;˺͙੮̼ʇˑʮʇʁ੮˺˦੮͐ʩʇ˚੺ૄ ૃH˺͙̼੮;ʇɘ̼ͅ੯ੳ੯ੳ੯ੳ੮͐͸˺੮;ʇɘ̼ͅੴૄ੮ͅʩʇ੮ʠ͙˚ɺˑʇͅੳ ૃUͅ੮͐ͅɘ;ʮ˦ʡ੮͸ʮ͐ʩ੮;˺͙̼੮ʠɘ˚ʮˑ;੮͸ʩɘ͐੮;˺͙੮͸ɘ˦͐੺ૄ ૃ‡˺ੴૄ੮{ͅੳ੮I˺˦ΈɘˑʇΈ੮̼ʇ̹ˑʮʇͅੴ੮ʇ˚̹ʩɘ͐ʮɻɘˑˑ;ੳ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮͙ͅ˚˚ɘ̼ʮΈʇͅੵ੮ૃšˌɘ;ੳ੮ä˺ੴ੮ʮʠ੮;˺͙੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁੴ੮;˺͙੮͸˺͙ˑʁ੮ ʡ˺੮͐˺੮äɘˑͷɘ͐ʮ˺˦੮ʠ˺̼੮ͅʩʇˑ͐ʇ̼ੳ੮Ĕʩɘ͐੮͸˺͙ˑʁ੮;˺͙੮ʁ˺੮ʠ˺̼੮ʠ˺˺ʁ੮ɘ˦ʁ੮ɻˑ˺͐ʩʮ˦ʡ੺ૄ ૃUૄʁ੮ˈ͙͐ͅ੮͙ͅʇ੮͸ʩɘ͐੮͐ʩʇ;੮ʩɘͷʇ੮͐ʩʇ̼ʇੳૄ੮îʩʇ̼ʇૄͅ੮ɘ੮ɻʇ̼͐ɘʮ˦੮͐ʇ˦ͅʮ˺˦੮ʮ˦੮͐ʩʮͅ੮ʁʮͅɻʩɘ̼ʡʇ੮ ̹ˑɘ˦ੳ੮Ĕʩʇ˦੮U੮̹ͅ˺ˌʇ੮͐˺੮͐ʩʇ੮ʩʇɘʁ੮˺ʠ੮äɘˑͷɘ͐ʮ˺˦ੴ੮ʩʇ੮˚˺ɘ˦ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮̼ʇͅʮʁʇ˦͐ͅ੮͐ʩʇ;੮ ͅʇ˦͐੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ʇ̼ʇ੮ɻ˺˚ʮ˦ʡ੮ɺɘɻˌ੮ɺɘ̼ʇˑ;੮͐ͅɘɺʮˑʮΈʇʁ੮ɘ˦ʁ੮͙˦͸ʮˑˑʮ˦ʡ੮͐˺੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ʮ˦੮͐ʩʇ੮ͅʩʇˑ͐ʇ̼ૄͅ੮̹̼˺ʡ̼ɘ˚˚ʮ˦ʡੳ Ě˺͙੮ ɻɘ˦੮ ͐ʇˑˑ੮ ͐ʩɘ͐੮ ɘ੮ ɻɘͅʇ੮ ʮͅ੮ ̼͐ͅɘʮʡʩ͐ʠ˺̼͸ɘ̼ʁ੮ ʮʠ੮ ɻ˺͙˦͐;੮ ɻ˺͙˦ͅʇˑ੮ ʁ˺ʇͅ˦ૄ͐੮ ɺ˺͐ʩʇ̼੮ ͙ͅɺˈʇɻ͐ʮ˦ʡ੮ ɘ੮ ̹ɘ͐ʮʇ˦͐੮ ͐˺੮ ɻ̼˺ͅͅચʇͽɘ˚ʮ˦ɘ͐ʮ˺˦ੳ੮ Pʇ̼ʇੴ੮ ͐ʩ˺͙ʡʩੴ੮ ˦ʁ;੮ ʮͅ˦ૄ͐੮ ͐ɘˌʮ˦ʡ੮ ɻʩɘ˦ɻʇͅੵ੮ૃîʩʇ੮ʁ˺ɻ͐˺̼੮͐ʇ͐ͅʮϲʮʇʁ੮͐ʩɘ͐੮;˺͙੮ʩɘͷʇ੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ੮)˺੮;˺͙੮ɺʇˑʮʇͷʇ੮͐ʩɘ͐੮ you have a mental illness?’

C O U RT

123

{ͅੳ੮I˺˦ΈɘˑʇΈ੮ʡʮͷʇͅ੮ʩʮ˚ੴ੮Uૄ˚੮͙̼ͅʇੴ੮͐ʩʇ੮ɘ˦ͅ͸ʇ̼੮ʩʇૄͅ੮ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼ੵ੮ૃ‡˺ੴ੮U੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳૄ #˺͙˦ͅʇˑ੮ʡ˺ʇͅ੮˺˦ੳ੮ૃîʩʇ੮ʁ˺ɻ͐˺̼੮ͅɘ;ͅ੮͐ʩɘ͐੮;˺͙੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ੮Ĕʩ;੮͸˺͙ˑʁ੮;˺͙੮ʁ˺੮͐ʩɘ͐੮ʮʠ੮;˺͙੮ʁ˺˦ૄ͐੮ɺʇˑʮʇͷʇ੮;˺͙੮ʩɘͷʇ੮˺˦ʇ੺ૄ੮îʩʇ̼ʇૄͅ੮ɘ੮̹ɘ͙ͅʇੳ੮ ૃĚ˺͙ૄʁ੮ˌʇʇ̹੮͐ɘˌʮ˦ʡ੮ʮ͐੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮;˺͙੮ʁ˺˦ૄ͐੮ɺʇˑʮʇͷʇ੮;˺͙੮ʩɘͷʇ੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੺ૄ੮ʩʇ੮ ɻ˺˦͐ʮ˦͙ʇͅੴ੮ͅˌʇ̹͐ʮɻɘˑˑ;ੳ ૃĚʇͅੳૄ ૃ˦ʁ੮ʩ˺͸੮͸˺͙ˑʁ੮;˺͙੮ɘͷ˺ʮʁ੮ɻ˺˚ʮ˦ʡ੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʡɘʮ˦੺ૄ੮ʩʇ੮ɘͅˌͅੳ ૃU੮͸˺͙ˑʁ੮͐ͅɘ;੮ʮ˦੮͐ʩʇ੮ͅʩʇˑ͐ʇ̼ੳૄ îʩʇ੮ ͐ʇ͐ͅʮ˚˺˦;੮ ʮͅ੮ ʁ˺˦ʇੴ੮ ɘ˦ʁ੮ ͐ʩʇ̼ʇ੮ ʮͅ੮ ˦˺੮ ͐ʮ˚ʇ੮ ʠ˺̼੮ ʁʇˑʮɺʇ̼ɘ͐ʮ˺˦ੳ੮ k͙ʁʡʇ੮ )ɘͷʮͅ੮ ͐ͅɘ̼͐ͅ੮ʩɘˑ͐ʮ˦ʡˑ;ੳ੮äʩʇ੮˦˺͐ʇͅੴ੮ૃ{ͅੳ੮I˺˦ΈɘˑʇΈૄͅ੮ɘʠʠʇɻ͐੮ͅʇʇ˚ͅ੮ͷʇ̼;੮͙˦͙͙ͅɘˑ੯ੳ੯ੳ੯ੳ੮Uૄ˚੮˦˺͐੮ ͙̼ͅʇ੮͸ʩɘ͐੮ɘʁˈʇɻ͐ʮͷʇ੮͐˺੮͙ͅʇੳ੯ੳ੯ੳ੯ੳ੮äʩʇ੮ʮͅ੮˚˺˦˺͐˺˦ʇੴ੮ʩʇ̼੮ʇͽ̹̼ʇͅͅʮ˺˦੮ʮͅ੮˦˺͐੮ɻʩɘ˦ʡʮ˦ʡੳ੮ #˺͙ˑʁ੮͐ʩʮͅ੮ɺʇ੮ɘ˦੮ʇʠʠʇɻ͐੮˺ʠ੮͐ʩʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੺ૄ îʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮̼ʇ̹ˑʮʇͅੴ੮ૃU͐੮ɻ˺͙ˑʁ੮ɺʇੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ੮˦ʇʡɘ͐ʮͷʇ੮ͅ;˚̹͐˺˚ͅ੮ય˺ʠ੮ ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘરૄઝˑʮˌʇ੮ ɘ੮ ʁ͙ˑˑʇʁ੮ ɘʠʠʇɻ͐੮ ˺̼੮ ͅˑ˺͸੮ ɻ˺ʡ˦ʮ͐ʮ˺˦ઝૃɺʇɻ˺˚ʇ੮ ˚˺̼ʇ੮ ̹̼˺˦˺͙˦ɻʇʁ੮͸ʮ͐ʩ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ʇ̹ͅʇɻʮɘˑˑ;੮͸ʮ͐ʩ੮͸ʩɘ͐੮ͅʩʇ੮ʮͅ੮̹̼ʇͅɻ̼ʮɺʇʁੳૄ ૃšˌɘ;ੴૄ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʡ˺ʇͅ੮˺˦ੳ੮ૃîʩʮͅ੮ɻ˺˚̹ˑʮɻɘ͐ʇͅ੮˚;੮ˈ˺ɺ੮ɘ੮ˑʮ͐͐ˑʇ੮ɺʮ͐ੳ੮U੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ੮ ʡ˺˺ʁ੮͐ɘˌʇ੮˺˦੮ʩʇ̼੮̹ʇ̼ͅ˺˦ɘˑʮ͐;ੴ੮˺̼੮͸ʩʇ̼ʇ੮ͅʩʇૄͅ੮ɻ˺˚ʮ˦ʡ੮ʠ̼˺˚ੳ੮Uͅ੮͐ʩʇ̼ʇ੮ɘ˦;੮ɘ̼ʡ͙˚ʇ˦͐੺ૄ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʡʮͷʇͅ੮ɘ੮ɺ̼ʮʇʠ੮͐ͅɘ͐ʇ˚ʇ˦͐ੴ੮̼ʇ˚ɘ̼ˌʮ˦ʡੴ੮ૃäʩʇ੮ʩɘͅ੮ɘ੮̹ˑɘ˦੮ʠ˺̼੮ ʠ˺˺ʁੴ੮ ɻˑ˺͐ʩʮ˦ʡੴ੮ ɘ˦ʁ੮ ͅʩʇˑ͐ʇ̼ੳ੮ äʩʇ੮ ʁʮͅɻ͙ͅͅʇʁ੮ ɺʇʮ˦ʡ੮ ͸ʮ͐ʩ੮ ʩʇ̼੮ ʠɘ˚ʮˑ;ੴ੮ ɺ͙͐੮ ʮ͐ૄͅ੮ ʩʇ̼੮ ɻʩ˺ʮɻʇ੮˦˺͐੮͐˺ੳ੮H˺͙̼͐ʩ੮ä̼͐ʇʇ͐੮ʮͅ੮͸ʩʇ̼ʇ੮ͅʩʇ੮͸ɘ˦͐ͅ੮͐˺੮̼ʇ͙̼͐˦ੳ੮U͐ૄͅ੮ʩʇ̼੮ɻ˺˚˚͙˦ʮ͐;ੳ੮äʩʇ੮ ʮͅ੮˚ʇʁ੮ɻ˺˚̹ˑʮɘ˦͐ੴ੮ɘ˦ʁ੮ͅʩʇ੮ɻɘ˦੮ʡʇ͐੮ͅʇ̼ͷʮɻʇͅ੮ɘ͐੮äɘˑͷɘ͐ʮ˺˦ੳૄ #˺͙˦͐;੮ɻ˺͙˦ͅʇˑ੮̼ʇ̹ˑʮʇͅੴ੮ૃäɘˑͷɘ͐ʮ˺˦੮ʮͅ੮ɘ੮̼ʇɘˑˑ;੮͙˦̼͙͐ͅɻ͙̼͐ʇʁ੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐ੳ੮äʩʇૄͅ੮ ˑʮˌʇˑ;੮͐˺੮̼ʇʡ̼ʇͅͅ੮ɘ˦ʁ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʇੳૄ k͙ʁʡʇ੮)ɘͷʮͅ੮ˌ˦˺͸ͅ੮͐ʩɘ͐੮ʩ˺͸ʇͷʇ̼੮ͅʩʇ੮̼͙ˑʇͅੴ੮̹ʇ˺̹ˑʇ੮͸ʮˑˑ੮ɺʇ੮ɘ˦ʡ̼;੮ɘ͐੮ʩʇ̼ੳ੮Ĕʩʇ˦੮ ͅʩʇ੮ʁʇɻʮʁʇͅ੮ɘʡɘʮ˦͐ͅ੮ʡ̼ɘ˦͐ʮ˦ʡ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ͅʩʇૄͅ੮ˑɘɻˌʮ˦ʡ੮ʮ˦੮ɻ˺˚̹ɘͅͅʮ˺˦੮ʠ˺̼੮ ̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮ફુU੮͸˺̼ˌʇʁ੮ɘͅ੮ɘ˦੮ɘ͐͐˺̼˦ʇ;੮ɘ͐੮ɘ੮̹͙ɺˑʮɻ੮ʮ˦͐ʇ̼ʇ͐ͅ੮ˑɘ͸੮ϲʮ̼˚੮ ʁ˺ʮ˦ʡ੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ̹̼ʇͷʇ˦͐ʮ˺˦ੴૂ੮ ͅʩʇ੮ ɻ˺͙˦͐ʇ̼ͅ੮ ͐˺੮ ˚ʇੳબ੮ Uʠ੮ ͅʩʇ੮ ʁ˺ʇͅ੮ ʡ̼ɘ˦͐੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮˺͐ʩʇ̼ͅ੮͸ʮˑˑ੮ɻˑɘʮ˚੮ͅʩʇૄͅ੮ʠɘʮˑʮ˦ʡ੮ʮ˦੮ʩʇ̼੮̼˺ˑʇ੮ɘͅ੮͐ʩʇ੮ˑɘ͐ͅ੮ˑʮ˦ʇ੮˺ʠ੮ʁʇʠʇ˦ͅʇ੮ ˺ʠ੮̹ʇ˺̹ˑʇૄͅ੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅੳ੮ફäʩʇૄͅ੮ɘ͸ɘ̼ʇੵ੮ુîʩʇ੮"̼ʮ͐˦ʇ;੮યä̹ʇɘ̼ͅર੮ɻɘͅʇ੮ʩɘͅ੮˚ɘʁʇ੮˚ʇ੮ ͐ʩʮ˦ˌ੮ʩɘ̼ʁ੮ɘɺ˺͙͐੮͸ʩɘ͐੮͸ʇૄ̼ʇ੮ʁ˺ʮ˦ʡ੮ʩʇ̼ʇੳ੮̼ʇ੮͐ʩʇͅʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ɘɺ͙ͅʮͷʇ੺੮U͐ૄͅ੮ my worst nightmare that this is One Flew Over the Cuckoo’s Nestੴ੮ɘ˦ʁ੮Uૄ˚੮̹ˑɘ;ʮ˦ʡ੮ ɘ੮̼˺ˑʇ੮ʮ˦੮ʮ͐ੳૂબ Ĕʩʇ˦੮U੮ɻ˺˚˚ʇ˦͐ʇʁ੮˺˦੮͐ʩʇ੮ˑɘɻˌ੮˺ʠ੮˺ͷʇ̼ͅʮʡʩ͐੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮͐ͅɘ͐ʇ੮˺ϲϲʮɻʮɘˑͅ੮ U੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ ̼ʇ˚ʮ˦ʁʇʁ੮ ˚ʇ੮ ͐ʩɘ͐੮ ͸ɘͅ੮ ͙̹̹ͅ˺ͅʇʁ੮ ͐˺੮ ɻ˺˚ʇ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ɻ˺͙̼͐ͅੳ੮

124

T H E C O N S E RVATO R S H I P C O N T I N U U M

U͐ૄͅ੮ ɻ˺˦ͅʮ͐ͅʇ˦͐੮ ͸ʮ͐ʩ੮ ɘ੮ ˑ˺˦ʡચ̼͙˦˦ʮ˦ʡ੮ ̹ɘ͐͐ʇ̼˦੮ ʮ˦੮ ˚ʇ̼ʮɻɘ˦੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ͐˺੮ ͙ͅʇ੮ ɘʁͷʇ̼ͅɘ̼ʮɘˑ੮ɻ˺͙̼͐੮̹̼˺ɻʇʇʁʮ˦ʡͅ੮͐˺੮͙ͅɺ͐ͅʮ͙͐͐ʇ੮ʠ˺̼੮͸ʩɘ͐੮˚ʮʡʩ͐੮ɻ˺˚ʇ੮ʠ̼˺˚੮̹ͅʇɻʮɘˑʮΈʇʁ੮ ɻʮͷʮˑ੮ͅʇ̼ͷɘ˦͐ͅ੮ʇ˦ʠ˺̼ɻʮ˦ʡ੮ʁʇ͐ɘʮˑʇʁ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮ʮ˦੮˚͙ɻʩ੮˺ʠ੮/͙̼˺̹ʇੳ৿ The result is a ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮ુ̼ʇˑʮʇͅ੮ʩʇɘͷʮˑ;੮˺˦੮͐ʩʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮˺ʠ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ˈ͙ʁʡʇͅੴ੮ thereby creating a system in which decisions are unpredictable and potentially ʮ˦ɻ˺˦ͅʮ͐ͅʇ˦͐ੳૂ਀ îʩʮͅ੮ʮͅ੮̼͙͐ʇੴ੮͐˺੮ɘ੮̹˺ʮ˦͐ੳ੮k͙ʁʡʇͅ੮ʩɘͷʇ੮͙ͅɺ͐ͅɘ˦͐ʮɘˑ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ʮ˦੮ʁʇɻʮʁʮ˦ʡ੮͸ʩ˺੮ ʡ˺ʇͅ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮"͙͐੮ɘͅ੮U੮ͅʩ˺͸੮ʮ˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੴ੮˚ɘ˦;੮ɘ̼ʇ੮ʠ̼͙̼͐ͅɘ͐ʇʁ੮ɺ;੮ ͐ʩʇʮ̼੮ˑɘɻˌ੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʡʇ͐੮ˑɘ͸;ʇ̼ͅ੮͐˺੮̼ʇ̹̼ʇͅʇ˦͐੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʇʠʠʇɻ͐ʮͷʇˑ;ੴ੮˚ɘˌʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ͅʩ˺͸੮͙̹੮ʮ˦੮ɻ˺͙̼͐੮͐˺੮ɘͅͅʇ̼͐੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅੴ੮˺̼੮ʇͽ̼͐ɘɻ͐੮͙ͅʇʠ͙ˑ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ ʠ̼˺˚੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੳ੮Ĕʩʮˑʇ੮ɻ˺͙̼̼͐˺˺˚ͅ੮ɘ̼ʇ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮ɺʇ੮͐ʩʇ੮̹ˑɘɻʇ੮͸ʩʇ̼ʇ੮ˑɘ͸੮ɘ˦ʁ੮ ˚ʇʁʮɻʮ˦ʇ੮ ɻ˺˚ʇ੮ ʮ˦͐˺੮ ͷʮͅʮɺˑʇ੮ ɘ˦ʁ੮ ˺̹ʇ˦੮ ɻ˺˦ϲˑʮɻ͐ੴ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʩʇɘ̼ʮ˦ʡͅ੮ ̼ʇͷʇɘˑ੮ ͐ʩʇ੮͸ʇɘˌ˦ʇͅͅʇͅ੮˺ʠ੮ɺ˺͐ʩੳਁ

ENSURING THE “RIGHT TO HAVE RIGHTS” U˦੮ɘ੮ৱ৹৶৶੮ʩʇɘ̼ʮ˦ʡ੮ʩʇˑʁ੮ʮ˦੮͐ʩʇ੮ˑʇɘʁચ͙̹੮͐˺੮͐ʩʇ੮̹ɘͅͅɘʡʇ੮˺ʠ੮rØäੴ੮)̼ੳ੮ä͙͐ɺɺˑʇɺʮ˦ʇੴ੮͐ʩʇ੮ ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮#˺˚˚͙˦ʮ͐;੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮̼͐ʮʇʁ੮͐˺੮ʁʇʠʇ˦ʁ੮ ͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮͐ͅɘ˦ʁɘ̼ʁ੮ફ͸ʩʮɻʩ੮ɘˑˑ˺͸ʇʁ੮ʠ˺̼੮ʮ˦͐ʇ̼˦˚ʇ˦͐੮˺ʠ੮ ̹ʇ˺̹ˑʇ੮͸ʩ˺੮˦ʇʇʁʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ɺ͙͐੮͸ʩ˺੮͸ʇ̼ʇ੮˦˺͐੮ʁɘ˦ʡʇ̼˺͙ͅબ੮͐˺੮ͅˌʇ̹͐ʮɻɘˑ੮ˑʇʡʮͅˑɘ͐˺̼ͅੵ੮ુ#˺˚˚ʮ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ʮʠ੮;˺͙੮ˑ˺˺ˌ੮ɘ͐੮͐ʩʇ੮ʇ͐;˚˺ˑ˺ʡ;੮˺ʠ੮͐ʩʇ੮͸˺̼ʁੴ੮˚ʇɘ˦ͅ੯ੳ੯ੳ੯ੳ੮ૃ͐˺੮ ɻ˺˦˦ʇɻ͐ૄ੮ʮ˦੮͐ʩʇ੮ͅʇ˦ͅʇ੮˺ʠ੮ૃ̹͙͐͐ʮ˦ʡ੮ʮ˦੮͐˺͙ɻʩ੮͸ʮ͐ʩੴ੮˺̼੮ʇ˦̼͙͐͐ͅੳૄ੯ੳ੯ੳ੯ੳ੮U͐੮ʮͅ੮ɘ˦੮ɘʡ̼ʇʇ˚ʇ˦͐੮ ˺̼੮̹ˑʇʁʡʇ੮͐˺੮ʁ˺੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ૄͅ੮͸ʇˑʠɘ̼ʇੳૂ੮Pʇ੮͸ɘͅ੮ɘ̼͐ʮɻ͙ˑɘ͐ʮ˦ʡ੮͐ʩʇ੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ɺɘͅʇʁ੮˺˦੮parens patriae, the state’s obligation to serve ɘͅ੮ɘ੮ʡ͙ɘ̼ʁʮɘ˦੮ʠ˺̼੮ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮ɻʮ͐ʮΈʇ˦ͅੳ੮#ʩɘʮ̼˚ɘ˦੮kʇ̼˺˚ʇ੮Ĕɘˑʁʮʇ੮ʩɘʁ੮˦˺˦ʇ੮˺ʠ੮ʮ͐ੵ੮ ુîʩɘ͐੮˚ɘ;੮ɺʇ੮ʮʁʇɘˑˑ;੮͸ʩɘ͐੮ʮ͐੮ͅʩ˺͙ˑʁ੮ɺʇੴ੮ɺ͙͐੮ʮ˦੮ʠɘɻ͐ੴ੮͸ʩɘ͐੮ʮ͐੮ʮͅੴ੮ʮͅ੮ͅʮ˚̹ˑ;੮ʇͽ̼͐ʇ˚ʇ੮ ̹͙˦ʮͅʩ˚ʇ˦͐੮͐˺੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ɻ˺˚˚ʮ͐͐ʇʁੳૂਂ Ĕɘˑʁʮʇૄͅ੮ɘ̼ʡ͙˚ʇ˦͐੮͸˺˦੮˺͙͐ੳ੮îʩʇ੮ʇή͙ɘ͐ʮ˺˦੮˺ʠ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮͸ʮ͐ʩ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ʁʇ͐ʇ˦͐ʮ˺˦੮ʮͅ੮ɘ੮̹˺͸ʇ̼ʠ͙ˑ੮̼͐ͅɘ˦ʁ੮ʮ˦੮ˑʇʡɘˑ੮ɘ̹̹̼˺ɘɻʩʇͅ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳਃ੮U˦੮ɘ੮ ৱ৹৷৹੮̼͙ˑʮ˦ʡੴ੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮‡ʮ˦͐ʩ੮#ʮ̼ɻ͙ʮ͐੮#˺͙̼͐੮˺ʠ੮̹̹ʇɘˑͅ੮ɻ˺˦ɻˑ͙ʁʇʁ੮͐ʩɘ͐੮ુʠ̼˺˚੮ ͐ʩʇ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇ੮˺ʠ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮̼ʇͅʮ͐ͅͅ੮͐ʩʮͅ੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮યʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚ʮ͐˚ʇ˦͐રੴ੮͐ʩʇ̼ʇ੮ʮͅ੮ˑʮ͐͐ˑʇ੮͐˺੮ʁʮ͐ͅʮ˦ʡ͙ʮͅʩ੮ʮ͐੮ʠ̼˺˚੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮ʮ˦੮ɘ੮̹ʇ˦ɘˑ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ੳ੮ "ʇɻɘ͙ͅʇ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʠɘɻʮˑʮ͐;੮ʮͅ੮ɘ͙͐ʩ˺̼ʮΈʇʁ੮͐˺੮ɘʁ˚ʮ˦ʮ͐ͅʇ̼੮ʁ̼͙ʡͅ੮͐˺੮ʩʮ˚੮ɘʡɘʮ˦͐ͅ੮ʩʮͅ੮ ͸ʮˑˑੴ੮ ʁʇ͐ʇ˦͐ʮ˺˦੮ ͐ʩʇ̼ʇ੮ ˚ʮʡʩ͐੮ ɺʇ੮ ɻ˺˦ͅʮʁʇ̼ʇʁ੮ ˚˺̼ʇ੮ ͅʇͷʇ̼ʇ੮ ͐ʩɘ˦੮ ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮ ʮ˦੮ ɘ੮ ̹ʇ˦ɘˑ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ੳૂ਄

C O U RT

125

îʩʇ੮ɻ˺͙̼͐ͅ੮ʩɘͷʇ੮ʮ˦͐ͅɘˑˑʇʁ੮ˑʇʡɘˑ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮͐˺੮˚ɘ͐ɻʩੳ੮/ͷɘ˦ੴ੮ɘ੮͐͸ʇ˦͐;ચͅʇͷʇ˦ચ ;ʇɘ̼੮ ͷʇ͐ʇ̼ɘ˦੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ʮ˦੮ ɘ੮ ˑɘ̼ʡʇ੮ ‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ɻ˺͙˦͐;ੴ੮ ˺ɺͅʇ̼ͷʇʁੴ੮ ુĔʩʇ˦੮U੮͐ͅɘ̼͐ʇʁ੮ʁ˺ʮ˦ʡ੮͐ʩʮͅ੮͸˺̼ˌ੮યrØä੮ɻɘͅʇͅરੴ੮ʮ͐੮͸ɘͅ੮ɘ͐ͅ˺͙˦ʁʮ˦ʡ੮͐˺੮˚ʇ੮͐ʩʇ੮ʁ͙ʇ੮ ̹̼˺ɻʇͅͅ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͸ʩʮɻʩ੮ɘ̼ʇ੮̹̼ʇ͐͐;੮̼˺ɺ͙͐ͅ੮ɘ˦ʁ੮ ̹̼ʇ͐͐;੮ ʡʇ˦ʇ̼˺͙ͅੳૂ੮ Pʇ੮ ͅ˺͙˦ʁʇʁ੮ ʇ˦͐ʩ͙ͅʮɘ͐ͅʮɻ੮ ʮ˦੮ ͐ʩʇ੮ ͸ɘ;੮ ˺˦ˑ;੮ ɘ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ˚ʮʡʩ͐੮ɺʇ੮ɘͅ੮ʩʇ੮͐ʮɻˌʇʁ੮˺ʠʠ੮͐ʩ˺ͅʇ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅੵ੮ɘ੮̼ʮʡʩ͐੮͐˺੮ɘ੮ˈ͙̼;੮̼͐ʮɘˑੴ੮ɘ੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐੮ ͐ʩɘ͐੮ ɘ੮ ͙˦ɘ˦ʮ˚˺͙ͅ੮ ˈ͙̼;੮ ϲʮ˦ʁ੮ ͅ˺˚ʇ˺˦ʇ੮ ʮͅ੮ ʡ̼ɘͷʇˑ;੮ ʁʮͅɘɺˑʇʁ੮ ુɺʇ;˺˦ʁ੮ ɘ੮ ̼ʇɘͅ˺˦ɘɺˑʇ੮ ʁ˺͙ɺ͐ૂ੮ફ͐ʩʇ੮ͅɘ˚ʇ੮͐ͅɘ˦ʁɘ̼ʁ੮ɘͅ੮ʮ˦੮ɘ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ɻɘͅʇબੴ੮ɘ˦ʁ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮̼ʇɻ˺˦͐ʇ͐ͅ੮ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʇͷʇ̼;੮ͅʮͽ੮˚˺˦͐ʩͅੳ îʩʇ੮ ̹ʩʮˑ˺ͅ˺̹ʩʇ̼੮ Pɘ˦˦ɘʩ੮ ̼ʇ˦ʁ͐੮ ˺˦ɻʇ੮ ˺ɺͅʇ̼ͷʇʁ੮ ͐ʩɘ͐ੴ੮ ʮ˦੮ ɘ੮ ˚˺ʁʇ̼˦੮ ʇ̼ɘ੮ ͸ʩʇ˦੮̹˺ˑʮ͐ʮɻʮɘ˦ͅ੮ɘ˦ʁ੮ɘʁͷ˺ɻɘ͐ʇͅ੮ʁʇɻˑɘ̼ʇ੮͐ʩɘ͐੮ુʩ͙˚ɘ˦੮̼ʮʡʩ͐ͅૂ੮ɘ̼ʇ੮͙˦ʮͷʇ̼ͅɘˑ੮ɘ˦ʁ੮ ʮ˦ɘˑʮʇ˦ɘɺˑʇੴ੮ ˦˺͐੮ ʇͷʇ̼;˺˦ʇ੮ ʩɘͅ੮ ɘ੮ ુ̼ʮʡʩ͐੮ ͐˺੮ ʩɘͷʇ੮ ̼ʮʡʩ͐ͅੳૂৼ৻ That meta-right can ˺˦ˑ;੮ɻ˺˚ʇ੮ʠ̼˺˚੮ɘ੮ˑʇʡɘˑ੮˺̼੮̹˺ˑʮ͐ʮɻɘˑ੮ͅ;͐ͅʇ˚੮͸ʮˑˑʮ˦ʡ੮͐˺੮ʇ˚̹˺͸ʇ̼੮ͅ˺˚ʇ˺˦ʇ੮ɘͅ੮ɘ੮ ˑʇʡɘˑ੮ ͙ͅɺˈʇɻ͐ੳৼৼ੮ îʩʇ੮ ̹˺ʮ˦͐੮ ɻ˺͙ˑʁ੮ ɘ̹̹ˑ;੮ ͐˺੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮ U˦੮ ‡ʇ͸੮ Ě˺̼ˌ੮ ä͐ɘ͐ʇੴ੮ ɘ੮ ৱ৹৶৴੮̼ʇʠ˺̼˚੮͐˺੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮͐ͅɘ͙͐͐ʇͅ੮͸ɘͅ੮ɻ˺͙̹ˑʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ̼ʇɘ͐ʮ˺˦੮˺ʠ੮{ʇ˦͐ɘˑ੮P;ʡʮʇ˦ʇ੮rʇʡɘˑ੮äʇ̼ͷʮɻʇͅੴ੮ɘ੮͐ͅɘ͐ʇચϲʮ˦ɘ˦ɻʇʁ੮ʡ̼˺͙̹੮˺ʠ੮̹ͅʇɻʮɘˑʮΈʇʁ੮ˑɘ͸;ʇ̼ͅੴ੮͐ͅɘtioned within psychiatric hospitals, that represent everyone whose rights are ̼ʇ̼͐ͅʮɻ͐ʇʁ੮ʮ˦੮͐ʩʇ੮˦ɘ˚ʇ੮˺ʠ੮͐ʩʇʮ̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩੳৼ৽੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮̼ʇʠ˺̼˚ʇʁ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ ˑɘ͸ͅ੮ ʡɘͷʇ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ˚˺̼ʇ੮ ̼ʮʡʩ͐ͅ੮ ͐˺੮ ̼ʇʠ͙ͅʇ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ͐ʩɘ˦੮ ͐ʩ˺ͅʇ੮ ʮ˦੮ ‡ʇ͸੮ Ě˺̼ˌੴ੮ɺ͙͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮˦ʇͷʇ̼੮ɻ̼ʇɘ͐ʇʁ੮ɘ੮ɻ˺˚̹ɘ̼ɘɺˑʇ੮ʮ˦ʠ̼ɘ̼͙͐ͅɻ͙̼͐ʇ੮ʠ˺̼੮˚ɘˌʮ˦ʡ੮͐ʩ˺ͅʇ੮ ̼ʮʡʩ͐ͅ੮̼ʇɘˑੳৼ৾੮îʩɘ͐੮̼˺ˑʇੴ੮ʮ˦͐ͅʇɘʁੴ੮͸ɘͅ੮ˑʇʠ͐੮͐˺੮ɻ˺͙˦͐ʮʇͅੴ੮͸ʩʮɻʩ੮ʩɘͷʇ੮ʮ˦੮͙̼͐˦੮ɻʩɘ̼ʡʇʁ੮ ɘˑ̼ʇɘʁ;੮˺ͷʇ̼͸ʩʇˑ˚ʇʁ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅૄ੮˺ϲϲʮɻʇͅ੮͸ʮ͐ʩ੮͐ʩʇ੮͐ɘͅˌ੮˺ʠ੮̼ʇ̹̼ʇͅʇ˦͐ʮ˦ʡ੮ ̹˺͐ʇ˦͐ʮɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳৼ৿ îʩʇ੮ɺɘ̼̼ʮʇ̼ͅ੮͐˺੮ʇʠʠʇɻ͐ʮͷʇ੮ɘʁͷ˺ɻɘɻ;੮͐ͅɘ̼͐੮͸ʮ͐ʩ੮ʩ˺͸੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮͸ʮ˦ʁ੮͙̹੮ʮ˦੮ ͐ʩɘ͐੮̼˺ˑʇ੮ʮ˦੮͐ʩʇ੮ϲʮ̼͐ͅ੮̹ˑɘɻʇੳ੮/ͷɘ˦੮ʩɘʁ੮ɘˑ̼ʇɘʁ;੮ɺʇʇ˦੮ɘ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʠ˺̼੮˚˺̼ʇ੮͐ʩɘ˦੮ ɘ੮ʁʇɻɘʁʇ੮͸ʩʇ˦੮ુ˚;੮ɺ˺ͅͅ੮ɻɘˑˑʇʁ੮͙̹੮˺˦ʇ੮ʁɘ;੮ɘ˦ʁ੮ͅɘʮʁੴ੮ૃPʇ;ੴ੮͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮˚˺ͷʇ੮ ;˺͙੮ʮ˦͐˺੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮͙˦ʮ͐ੳૄૂ੮/ͷɘ˦੮ɻ˺͙ˑʁ˦ૄ͐੮̼ʇ˚ʇ˚ɺʇ̼੮ʮʠ੮ʩʇ੮ʩɘʁ੮ʇͷʇ̼੮ɘɻ͙͐ɘˑˑ;੮ ʇͽ̹̼ʇͅͅʇʁ੮ʮ˦͐ʇ̼ʇ͐ͅ੮ʮ˦੮ʮ͐ੳ੮"͙͐੮ʩʇ੮͐ʩ˺͙ʡʩ͐ੴ੮ુUૄ˚੮ɘˑ͸ɘ;ͅ੮͙̹੮ʠ˺̼੮ˑʇɘ̼˦ʮ˦ʡ੮˦ʇ͸੮͐ʩʮ˦ʡͅੴ੮ ɺ̼˺ɘʁʇ˦ʮ˦ʡ੮˚;੮ˌ˦˺͸ˑʇʁʡʇੳ੮ય˦ʁર੮ʮ͐ૄͅ੮ɘ੮˦ʮɻʇ੮ɺ̼ʇɘˌ੮ʠ̼˺˚੮͐ʩʇ੮̼ʇɘˑˑ;੮ʩʇɘͷ;ચʁ͙͐;੮ʠʇˑ˺˦;੮ɻɘͅʇˑ˺ɘʁੴ੮͸ʩʮɻʩ੮ʮͅ੮ͷʇ̼;੮̼͐ͅʇͅͅʠ͙ˑੳૂ੮äʮ˦ɻʇ੮͐ʩʇ੮̹̼˺ɻʇͅͅ੮˺ʠ੮ɺʇʮ˦ʡ੮ɘͅͅʮʡ˦ʇʁ੮ͅʇʇ˚ʇʁ੮ ɘ੮ɺʮ͐੮ʩɘ̹ʩɘΈɘ̼ʁੴ੮U੮ɘͅˌʇʁ੮ʩʮ˚੮͸ʩɘ͐੮̹̼ʇ̹ɘ̼ɘ͐ʮ˺˦੮ʩʇ੮ʩɘʁ੮͙̹˺˦੮͐ͅɘ̼͐ʮ˦ʡੵ੮ુ‡˺੮̼͐ɘʮ˦ʮ˦ʡ੮ ɘ͐੮ɘˑˑੴ੮Έʇ̼˺ੳ੮U੮͸ɘˑˌʇʁ੮ʮ˦੮͐ʩʇ̼ʇ੮͐ʩʇ੮ϲʮ̼͐ͅ੮ʁɘ;੮ɘ˦ʁ੮˚;੮ɻ˺ˑˑʇɘʡ͙ʇ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮͐ʩʇ̼ʇ੮ ͅʮͽ੮˚˺˦͐ʩͅ੮̼͐ɘʮ˦ʇʁ੮˚ʇੳ੮U͐੮͸ɘͅ੮ɘˑˑ੮˺˦੮͐ʩʇ੮ˈ˺ɺੳૂ੮ͅ੮ʩʇ੮ʁʇͅɻ̼ʮɺʇʁ੮ʮ͐ੴ੮ુU੮ʡ˺͐੮˺͙͐੮͐ʩʇ੮ )ʮɘʡ˦˺͐ͅʮɻ੮ɘ˦ʁ੮ä͐ɘ͐ʮ͐ͅʮɻͅ੮{ɘ˦͙ɘˑ੮ɘ˦ʁ੮U੮͐ͅɘ̼͐ʇʁ੮̼ʇɘʁʮ˦ʡੳૂ P˺˦ʇ͐ͅˑ;ੴ੮ɺʇʮ˦ʡ੮ɘͅͅʮʡ˦ʇʁ੮͐˺੮͐ɘˌʇ੮rØä੮ɻɘͅʇͅ੮ʠ˺̼੮˦˺੮ɘ̹̹ɘ̼ʇ˦͐੮̼ʇɘͅ˺˦੮ʮͅ੮ɺʇ͐͐ʇ̼੮ ͐ʩɘ˦੮ ͅ˺˚ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ˚˺͐ʮͷɘ͐ʮ˺˦ͅ੮ U੮ ʩʇɘ̼ʁੳ੮ š˦ʇ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ̼ʇɻ˺͙˦͐ʇʁੴ੮ ુš͙̼੮

126

T H E C O N S E RVATO R S H I P C O N T I N U U M

ɻ˺͙˦͐;੮ͅɘ;ͅੴ੮ૃUʠ੮;˺͙ૄͷʇ੮ʁ˺˦ʇ੮ɘ੮ʁʇɘ͐ʩ੮̹ʇ˦ɘˑ͐;੮ɻɘͅʇੴ੮;˺͙੮ɻɘ˦੮͐ɘˌʇ੮ɘ੮ɺ̼ʇɘˌ੮ɘ˦ʁ੮ʁ˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳૄૂ੮˦˺͐ʩʇ̼੮ʩ͙ʠʠʇʁੴ੮ુU੮͸ɘͅ੮ɺɘ˦ʮͅʩʇʁ੮͐˺੮˺͙̼੮rØä੮͙˦ʮ͐੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮˺ϲϲʮɻʇ੮ ̹˺ˑʮ͐ʮɻͅૂ੮ɘ˦ʁੴ੮͸ʮ͐ʩ੮˦˺੮̹̼ʇ̹ɘ̼ɘ͐ʮ˺˦ੴ੮ુU੮͸ɘͅ੮̹̼ʇ͐͐;੮ʮʡ˦˺̼ɘ˦͐੮ɘ˦ʁ੮ʮ˦ʇʠʠʇɻ͐ʮͷʇ੮ʠ˺̼੮͐͸˺੮ ;ʇɘ̼ͅੳૂ੮)ʇ̹ʮɻ͐ʮ˺˦ͅ੮˺ʠ੮ʩ˺͸੮ˈ͙ʁʡʇͅ੮ʡʇ͐੮͐ʩʇ੮ɘͅͅʮʡ˦˚ʇ˦͐੮ɻɘ˦੮ɺʇ੮ʇή͙ɘˑˑ;੮ɺˑʇɘˌੳ੮੮ৱ৹৹৲੮ ̹̼˺ϲʮˑʇ੮˺ʠ੮r˺ͅ੮˦ʡʇˑʇͅૄͅ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮৹৵ੴ੮͸ʩʮɻʩ੮ʩɘ˦ʁˑʇͅ੮rØä੮ɻɘͅʇͅੴ੮ʁʇͅɻ̼ʮɺʇʁ੮ʮ͐੮ ɘͅ੮͐ʩʇ੮ુʇή͙ʮͷɘˑʇ˦͐੮˺ʠ੮ɺʇʮ˦ʡ੮ͅʩʮ̹̹ʇʁ੮˺ʠʠ੮͐˺੮ˈ͙ʁʮɻʮɘˑ੮äʮɺʇ̼ʮɘૂ੮ફɺ˺͐ʩ੮˚ʇ͐ɘ̹ʩ˺̼ʮɻɘˑˑ;੮ ɘ˦ʁ੮̹ͅɘ͐ʮɘˑˑ;ੴ੮ɘͅ੮ɻɘͅʇͅ੮͸ʇ̼ʇ੮ʩʇɘ̼ʁ੮ʮ˦੮ɘ˦੮ʮ˦ʠɘ˚˺͙ͅˑ;੮̼͙˦ચʁ˺͸˦੮ɻ˺˦ͷʇ̼͐ʇʁ੮̹ʮɻˌˑʇ੮ ʠɘɻ͐˺̼;બੳৼ਀੮k͙ʁʡʇ੮Û˺ˈɘͅੴ੮͸ʩ˺੮ʩɘ˦ʁˑʇʁ੮rØä੮ɻɘͅʇͅ੮ʮ˦੮ɘ੮ˑɘ̼ʡʇ̼੮ͅ˺͙͐ʩʇ̼˦੮ɻ˺͙˦͐;ੴ੮͐˺ˑʁ੮ ˚ʇ੮͐ʩɘ͐ੴ੮ɘʠ͐ʇ̼੮̹ͅʇ˦ʁʮ˦ʡ੮˚˺͐ͅ੮˺ʠ੮ɘ੮ʁʇɻɘʁʇ੮ɘͅ੮ɘ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ˈ͙ʁʡʇੴ੮ૃîʩʇ;੮ɘͅˌʇʁ੮˚ʇ੮͐˺੮ ʡ˺੮͐˺੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻ˺͙̼͐ੳ੯ੳ੯ੳ੯ੳ੮U੮͸ɘͅ੮ɻ̼ʇ͐ͅʠɘˑˑʇ˦ੳ੯ੳ੯ੳ੯ੳ੮U͐੮͸ɘͅ੮͐ʩʇ੮ˑʇɘ͐ͅ੮̹̼ʇ͐ͅʮʡʮ˺͙ͅ੮ ɘͅͅʮʡ˦˚ʇ˦͐੮͐ʩʇ̼ʇ੮ʮͅੳૄ੮Pʮͅ੮̹̼ʇ̹ɘ̼ɘ͐ʮ˺˦੮͸ɘͅ੮ૃΈʇ̼˺ੴ੮˺˦੮͐ʩʇ੮ˈ˺ɺੳૄ Ĕʩʇ˦੮ /ͷɘ˦੮ ͐ͅɘ̼͐ʇʁੴ੮ ʩʇ੮ ʩɘʁ੮ ɘ੮ ͐ͅɘ̼͐ˑʮ˦ʡ੮ ̼ʇɘˑʮΈɘ͐ʮ˺˦ੵ੮ ુP˺ˑ;੮ ͅʩʮ͐ੴ੮ ˺͙̼੮ ˺ϲϲʮɻʇ੮ ʮͅ੮ ̼ʇɘˑˑ;ੴ੮̼ʇɘˑˑ;੮̹˺˺̼ˑ;੮ʇʁ͙ɻɘ͐ʇʁ੮˺˦੮͐ʩʮͅ੮ɘ̹ͅʇɻ͐੮˺ʠ੮˺͙̼੮͸˺̼ˌੳૂ੮Iʇ͐͐ʮ˦ʡ੮͙̹੮͐˺੮̹ͅʇʇʁ੮ ͸ɘͅ੮ɘ˦੮ʇ;ʇચ˺̹ʇ˦ʮ˦ʡ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇੵ੮ુš͙̼੮ɻ˺͙˦͐;੮ʮͅ੮ɘ੮ɺʮʡ੮̹ˑɘɻʇੴ੮ɘ˦ʁ੮U੮ʩɘʁ੮˦˺੮ʮʁʇɘ੮͐ʩɘ͐੮ ͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮˺̼੮ɘ੮͙ͅɺɘɻ͙͐ʇ੮ʠɘɻʮˑʮ͐;੮ʠ˺̼੮ʇˑʁʇ̼ˑ;੮̹ʇ˺̹ˑʇ੮ʮ˦੮ય#ʮ͐;રੳ੮U͐੮ ˺̹ʇ˦ʇʁ੮˚;੮ʇ;ʇͅ੮͐˺੮ɘ੮͸ʩ˺ˑʇ੮̹ɘ̼͐੮˺ʠ੮ͅ˺ɻʮʇ͐;੮͐ʩɘ͐੮U੮ʩɘʁ੮˦˺੮͸ɘ;੮˺ʠ੮ˌ˦˺͸ʮ˦ʡ੮ɘɺ˺͙͐੮ ˺͐ʩʇ̼͸ʮͅʇੳ੮ U੮ ʠʇˑ͐੮ ͅ˺̼͐੮ ˺ʠ੮ ʩ˺˦˺̼ʇʁੴ੮ ʡʮʠ͐ʇʁ੮ ͐˺੮ ˑʇɘ̼˦੮ ɘˑˑ੮ ˺ʠ੮ ͐ʩɘ͐ੳૂ੮ š͙͐ͅʮʁʇ੮ ˺ʠ੮ ˑɘ̼ʡʇੴ੮ ͙̼ɺɘ˦੮ɻ˺͙˦͐ʮʇͅੴ੮͐ʩʇ੮ˑ˺ʡʮ͐ͅʮɻͅ੮ɘ̼ʇ੮˚˺̼ʇ੮ɻ˺˚̹ˑʮɻɘ͐ʇʁੳ੮k˺ͅʩ੮ʩɘ˦ʁˑʇͅ੮ૃɘˑˑ੮͐ʩʇ੮͸ʇʮ̼ʁ੮ ɻʮͷʮˑ੮͙͐ͅʠʠ੮͐ʩɘ͐੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅૄ੮˺ϲϲʮɻʇͅ੮ʁ˺ੴૄ੮ɘͅ੮͸ʇˑˑ੮ɘͅ੮ˈ͙ͷʇ˦ʮˑʇ੮ˈ͙͐ͅʮɻʇੴ੮ʠ˺̼੮ɘ੮ͅ˚ɘˑˑੴ੮ ̼͙̼ɘˑ੮ɻ˺͙˦͐;ੳ੮Pʮͅ੮ɻ˺͙˦͐;੮ʩɘͅ੮˦˺੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ͅ˺੮ʩʮͅ੮rØä੮ɻˑʮʇ˦͐ͅ੮ɘ̼ʇ੮̹̼ͅʮ˦ˌˑʇʁ੮ɘ̼˺͙˦ʁ੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮ͅ੮ɘ੮̼ʇ͙ͅˑ͐੮˺ʠ੮͐ʩʇ੮ʁʮ͐ͅɘ˦ɻʇੴ੮ૃUૄˑˑ੮ʡ˺੮ɘ੮ʩɘˑʠચʩ˺͙̼੮˺̼੮˚ɘ;ɺʇ੮ ʠ˺̼͐;ચϲʮͷʇ੮ ˚ʮ˦͙͐ʇͅ੮ ɺʇʠ˺̼ʇ੮ ɘ੮ ʩʇɘ̼ʮ˦ʡ੮ ͐˺੮ ʡ˺੮ ˺ͷʇ̼੮ ͐ʩʇ੮ ̹ɘ̹ʇ̼ͅੳ੯ ੳ੯ ੳ੯ ੳ੮ îʩɘ͐ૄͅ੮ ˚;੮ ϲʮ̼͐ͅ੮ ͐ʮ˚ʇ੮˚ʇʇ͐ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇੳૄ੮š͐ʩʇ̼੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮ͅʩɘ̼ʇʁ੮ͅʮ˚ʮˑɘ̼੮ɻʩɘˑˑʇ˦ʡʇͅ੮̼͐ɘɻˌʮ˦ʡ੮ʁ˺͸˦੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮ɘͅ੮͐ʩʇ;੮ɺ˺͙˦ɻʇʁ੮ɘ˚˺˦ʡ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ʮ˦੮ɘ੮̹̼ʮͷɘ͐ʮΈʇʁੴ੮ʠ̼ɘʡ˚ʇ˦͐ʇʁੴ੮ɘ˦ʁ੮ʁʇɻʇ˦̼͐ɘˑʮΈʇʁ੮ͅ;͐ͅʇ˚ੳ Other barriers to rendering individuals subject to involuntary treatment into ̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ʩɘͷʇ੮̼ʮʡʩ͐ͅ੮ɘ̼ʇ੮˚˺̼ʇ੮ʇ͐ʩʮɻɘˑ੮͐ʩɘ˦੮̹̼ɘɻ͐ʮɻɘˑੳ੮îʩʇ੮ʡ͙ʮʁʇlines governing lawyers’ conduct in cases involving people alleged to be mentally ʮˑˑ੮ ɘ̼ʇ੮ ɻˑʇɘ̼ੵ੮ ɘ͐͐˺̼˦ʇ;ͅ੮ ુͅʩɘˑˑੴ੮ ɘͅ੮ ʠɘ̼੮ ɘͅ੮ ̼ʇɘͅ˺˦ɘɺˑ;੮ ̹˺ͅͅʮɺˑʇੴ੮ ˚ɘʮ˦͐ɘʮ˦੮ ɘ੮ ˦˺̼˚ɘˑ੮ ɻˑʮʇ˦͐ચˑɘ͸;ʇ̼੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹ੳૂৼਁ੮îʩʮͅ੮˚ʇɘ˦ͅ੮ʠ˺ˑˑ˺͸ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ુ͐ͅɘ͐ʇʁ੮ʮ˦͐ʇ̼ʇ͐ͅૂઝ ʮੳʇੳੴ੮ϲʮʡʩ͐ʮ˦ʡ੮ʠ˺̼੮͐ʩʇ˚੮͐˺੮ʡʇ͐੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʮʠ੮͐ʩɘ͐ૄͅ੮͸ʩɘ͐੮͐ʩʇ;੮ͅɘ;੮͐ʩʇ;੮͸ɘ˦͐ੳ੮ îʩʮͅ੮ɘ̹̹̼˺ɘɻʩ੮͸ɘͅ੮ɻ˺˚ʠ˺̼͐ɘɺˑʇ੮ʡ̼˺͙˦ʁ੮ʠ˺̼੮ɘ੮ͅʇɘͅ˺˦ʇʁ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ˑʮˌʇ੮/ͷɘ˦ੴ੮ ͸ʩ˺੮͐˺ˑʁ੮˚ʇੴ੮ુUૄͷʇ੮ɺʇʇ˦੮ɘ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʠ˺̼੮ɘˑ˚˺͐ͅ੮͐ʩʮ̼͐;੮;ʇɘ̼ͅੴ੮ͅ˺੮U੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ ɘ੮ʩɘ̼ʁ੮͐ʮ˚ʇ੮ˈ͙͐ͅ੮̹̼˺˚˺͐ʮ˦ʡ੮͸ʩɘ͐੮યɘ੮ɻˑʮʇ˦͐ૄͅર੮͐ͅɘ͐ʇʁ੮ʮ˦͐ʇ̼ʇ͐ͅ੮ʮͅੴ੮ʇͷʇ˦੮ʮʠ੮ʮ˦੮˚;੮ʩʇɘ̼͐੮ ˺ʠ੮ʩʇɘ̼͐ͅੴ੮U੮ˌ˦ʇ͸੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੮͸˺͙ˑʁ੮ɺʇ੮ɺʇ͐͐ʇ̼੮ʡʇ͐͐ʮ˦ʡ੮̼͐ʇɘ͐ʇʁ੮ʮ˦੮ɘ੮ʠɘɻʮˑʮ͐;੮̼ɘ͐ʩʇ̼੮ ͐ʩɘ˦੮͐ʩʇ੮ʩɘʮ̼ɺ̼ɘʮ˦ʇʁ੮ʁʮͅɻʩɘ̼ʡʇ੮̹ˑɘ˦੮͐ʩʇ;੮ʩɘͷʇੳૂ

C O U RT

127

š͐ʩʇ̼ͅੴ੮͐ʩ˺͙ʡʩੴ੮ɘ̼ʇ੮˚˺̼ʇ੮ɘ˚ɺʮͷɘˑʇ˦͐ੳ੮š˦ʇ੮̼ʇͅʇɘ̼ɻʩʇ̼੮͸ʩ˺੮˺ɺͅʇ̼ͷʇʁ੮ʩ͙˦ʁ̼ʇʁͅ੮ ˺ʠ੮rØä੮ʩʇɘ̼ʮ˦ʡͅ੮ʮ˦੮͐ʩʇ੮ˑɘ͐ʇ੮ৱ৹৸ৰͅ੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮͸ʇ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ ુˈ͙͐ͅ੮ ɘͅ੮ ɘ˦ͽʮ˺͙ͅ੮ ͐˺੮ ͅʇʇ੮ ͅ˺˚ʇ੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ɻˑʮʇ˦͐ͅ੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ ɘͅ੮ ͸ʇ̼ʇ੮ ͐ʩʇ੮ યɻ˺͙˦͐;੮ ɻ˺͙˦ͅʇˑર੮ɘ˦ʁ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮͸ʩ˺੮˺̹̹˺ͅʇʁ੮͐ʩʇ˚੮ʮ˦੮ɻ˺͙̼͐ੳૂৼਂ੮‡˺˦ʇ੮˺ʠ੮͐ʩʇ੮͐͸ʇ˦͐;੮˺̼੮ ͅ˺੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮ʁʇͅɻ̼ʮɺʇʁ੮ʡ˺ʮ˦ʡ੮ͅ˺੮ʠɘ̼੮ɘͅ੮͐˺੮ʮʡ˦˺̼ʇ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅૄ੮ ͸ʮͅʩʇͅੳ੮ä͐ʮˑˑੴ੮ͅ˺˚ʇ੮ɘʁ˚ʮ͐͐ʇʁ੮͐ʩɘ͐੮˦˺͐੮ɘˑˑ੮ɻɘͅʇͅ੮˚ʇ̼ʮ͐ʇʁ੮ή͙ʮ͐ʇ੮͐ʩʇ੮ͅɘ˚ʇ੮ͷʮʡ˺̼ੳ੮k˺ͅʩੴ੮ ͐ʩʇ੮̼͙̼ɘˑ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ੴ੮͐˺ˑʁ੮˚ʇੴ੮ૃĔʮ͐ʩ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੯ੳ੯ੳ੯ੳ੮ʮʠ੮˚;੮ɻˑʮʇ˦͐੮ ͅɘ;ͅੴ੮ૃU੮͸ɘ˦͐੮͐˺੮ɻ˺˦͐ʇ͐ͅੴૄ੮U੮ʁ˺੮͐ʩɘ͐ੴ੮U੮ʁ˺˦ૄ͐੮̼͐;੮͐˺੮̼͐ͅ˺˦ʡચɘ̼˚੮͐ʩʇ˚੮˺͙͐੮˺ʠ੮͐ʩɘ͐੯ੳ੯ੳ੯ੳ੮ ɺ͙͐੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮;˺͙੮ˌʮ˦ʁ੮˺ʠ੮͸ɘ˦͐੮͐ʩʇ˚੮͐˺੮͐ͅɘ;੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ ͐ͅʮˑˑ੮˺ɺͷʮ˺͙ͅˑ;੮˦ʇʇʁ੮ʮ͐ੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮;˺͙੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮͸ʮ˦ੳૄ õˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮ ʇͷʇ˦੮ /ͷɘ˦ઝ͸ʩ˺੮ ͷɘ͙˦͐ʇʁ੮ ͐ʩʇ੮ ʠɘɻ͐੮ ͐ʩɘ͐੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ɺʇ˦ʇϲʮ͐ʇʁ੮ ʠ̼˺˚੮ͅʮ˚ʮˑɘ̼੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮͐˺੮͐ʩ˺ͅʇ੮ɘɻɻ͙ͅʇʁ੮˺ʠ੮ͅʇ̼ʮ˺͙ͅ੮ɻ̼ʮ˚ʇͅઝɘʁ˚ʮ͐͐ʇʁ੮͐ʩɘ͐੮rØä੮ ɻɘͅʇͅ੮͸ʇ̼ʇ੮˦˺͐੮͐ʩʇ੮ͅɘ˚ʇ੮ˌʮ˦ʁ੮˺ʠ੮͸˺̼ˌੵ੮ુrʮɺʇ̼͐;੮ʮͅ੮ɘ͐੮͐ͅɘˌʇੴ੮˺ɺͷʮ˺͙ͅˑ;ੴ੮ɺ͙͐੮͐ʩʇͅʇ੮ ɘ̼ʇ੮ ɻʮͷʮˑ੮ ɻ˺˚˚ʮ͐˚ʇ˦͐ͅੴ੮ ˦˺͐੮ ɻ̼ʮ˚ʮ˦ɘˑ੮ ʩ˺ˑʁͅੳૂ੮ ‡˺੮ ˚ɘ͐͐ʇ̼੮ ʩ˺͸੮ ˚͙ɻʩ੮ ʩʇ੮ ˑʇɘ̼˦ʇʁੴ੮ ʩʇ੮ʠʇˑ͐ੴ੮̹ʮ͐͐ʮ˦ʡ੮ˑʇʡɘˑ੮ͷʇ̼͙ͅͅ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʇͽ̹ʇ̼͐ʮͅʇ੮ʮ˦੮rØä੮ɻɘͅʇͅ੮͸ɘͅ੮ɘ੮ˑ˺ͅʮ˦ʡ੮ɺɘ͐͐ˑʇੵ੮ ુU੮ʇ˦ˈ˺;ʇʁ੮ɻ̼˺ͅͅચʇͽɘ˚ʮ˦ʮ˦ʡ੮͐ʩʇ੮ʁ˺ɻ͐˺̼ͅੴ੮ɺ͙͐੮˺ɺͷʮ˺͙ͅˑ;੮U੮͸ɘͅ੮˺˦ˑ;੮ʡ˺ʮ˦ʡ੮͐˺੮ʡʇ͐੮ͅ˺੮ ʠɘ̼ੳ੮U੮͸ɘͅ˦ૄ͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʩɘͷʇ੮ɘ੮Øʇ̼̼;੮{ɘͅ˺˦੮યɘ੮ϲʮɻ͐ʮ˺˦ɘˑ੮ˑɘ͸;ʇ̼੮ʮ˦੮ɘ੮ৱ৹৶ৰͅ੮îē੮ͅʩ˺͸ર੮ ˚˺˚ʇ˦͐੮͸ʩʇ̼ʇ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮˺˦੮͐ʩʇ੮͐ͅɘ˦ʁ੮ɻʩɘ˦ʡʇʁ੮ʩʮͅ੮˺̹ʮ˦ʮ˺˦ੳૂ /ͷɘ˦੮ ϲʮ˦ʮͅʩʇʁ੮ ʩʮͅ੮ ɘͅͅʮʡ˦˚ʇ˦͐੮ ɺ͙͐੮ ͐ͅɘ;ʇʁ੮ ʮ˦ͷ˺ˑͷʇʁ੮ ʮ˦੮ ɘ੮ ɻ˺͙˦͐;੮ ͐ɘͅˌ੮ ʠ˺̼ɻʇ੮ ʠ˺ɻ͙ͅʇʁ੮˺˦੮ʁʮͷʇ̼͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮ʮ˦͐˺੮̼͐ʇɘ͐˚ʇ˦͐ઝͅ˺˚ʇ͐ʮ˚ʇͅ੮ʇͷʇ˦੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ੮H̼˺˚੮˚ɘ˦;੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅૄ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇͅੴ੮ɻ˺˦ϲˑʮɻ͐੮ɺʇ͐͸ʇʇ˦੮ˑɘ͸੮ ɘ˦ʁ੮˚ʇʁʮɻʮ˦ʇ੮ͅʇʇ˚ʇʁ੮͐˺੮ͅʇ̼ͷʇ੮͐ʩʇ੮ʮ˦͐ʇ̼ʇ͐ͅͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ˑʇͅͅ੮͸ʇˑˑ੮ ͐ʩɘ˦੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮̼ʮʡʩ͐ͅ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ˑ˺͐ͅ੮˺͙͐੮͐˺੮ફɻ˺ʇ̼ɻʇʁબ੮ɻɘ̼ʇੳ

CONSENTING TO COERCION ૃĔʇˑɻ˺˚ʇ੮ ͐˺੮ ͐ʩʇ੮ ˚ɘɻʩʮ˦ʇੴૄ੮ ˦ʁ;ੴ੮ ͐ʩʇ੮ ɻ˺͙˦͐;੮ ˑɘ͸;ʇ̼੮ ̼ʇ̹̼ʇͅʇ˦͐ʮ˦ʡ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ੴ੮ ʡ̼ʇʇ͐ͅ੮ ˚ʇ੮ ɘͅ੮ U੮ ͅʩ˺͸੮ ͙̹੮ ʮ˦੮ k͙ʁʡʇ੮ )ɘͷʮͅૄͅ੮ ɻ˺͙̼̼͐˺˺˚੮ ˺˦ʇ੮ ɘʠ͐ʇ̼˦˺˺˦ੳ੮ U੮ ή͙ʮɻˌˑ;੮ ͙˦ʁʇ̼͐ͅɘ˦ʁ੮ ͸ʩɘ͐੮ ʩʇ੮ ˚ʇɘ˦ͅੳ੮ {˺̼˦ʮ˦ʡͅ੮ ɘ̼ʇ੮ ʠ˺̼੮ ɻ˺˦͐ʇ͐ͅʇʁ੮ ʩʇɘ̼ʮ˦ʡͅ੮ ͐˺੮ ʁʇ͐ʇ̼˚ʮ˦ʇ੮ʮʠ੮ͅ˺˚ʇ˺˦ʇ੮˚ʇʇ͐ͅ੮͐ʩʇ੮͐ͅɘ˦ʁɘ̼ʁ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੵ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ ɺʇ;˺˦ʁ੮ɘ੮̼ʇɘͅ˺˦ɘɺˑʇ੮ʁ˺͙ɺ͐ੳ੮ʠ͐ʇ̼˦˺˺˦ͅ੮ɘ̼ʇ੮ʠ˺̼੮ʇͷʇ̼;͐ʩʮ˦ʡ੮ʇˑͅʇੳ There’s a report that one conservatee had his tooth extracted (this seems to ɺʇ੮ʩɘ̹̹;੮˦ʇ͸ͅબ੮ɘ˦ʁ੮ɘ˦˺͐ʩʇ̼੮ʠ˺̼੮͸ʩ˺˚੮͐ʩʇ੮ɻ˺͙̼͐੮˦ʇʇʁͅ੮͐˺੮ɘ͙͐ʩ˺̼ʮΈʇ੮ɺˑ˺˺ʁ੮ʁ̼ɘ͸ͅ੮ ͐˺੮ɻʩʇɻˌ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ˑʇͷʇˑͅੳ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʩɘͅ੮ʁʇ˚ɘ˦ʁʇʁ੮͙̹ʁɘ͐ʇͅ੮˺˦੮ͅʇͷʇ̼ɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͸ʩ˺੮ʩɘͷʇ੮ɺʇʇ˦੮͸ɘʮ͐ʮ˦ʡ੮˚˺˦͐ʩͅ੮͐˺੮̼͐ɘ˦ͅʠʇ̼੮ʠ̼˺˚੮ɘ˦੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮

128

T H E C O N S E RVATO R S H I P C O N T I N U U M

ʮ˦͐˺੮ɘ˦੮U{)੮˺̼੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮‡˺੮˦ʇ͸ͅੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ɘͅˌͅ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙̼͐੮ ˺̼ʁʇ̼੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺੮̹̼˺ͷʮʁʇ੮ʩʇ̼੮ɻˑʮʇ˦͐੮ɘ੮˦ʇ͸੮ͅʇ͐੮˺ʠ੮̹ɘ˦͐ͅੴ੮ͅʩ˺ʇͅੴ੮ɘ˦ʁ੮ ͙˦ʁʇ̼͸ʇɘ̼ੳ੮{ɘ˦;ੴ੮˚ɘ˦;੮ʩʇɘ̼ʮ˦ʡͅ੮ɘ̼ʇ੮̼ʇͅɻʩʇʁ͙ˑʇʁ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ɻˑʮʇ˦͐੮ʮͅ˦ૄ͐੮͐ʩʇ̼ʇੴ੮ the lawyer isn’t there, the translator isn’t there, the doctor isn’t there, or the ̹ɘ̹ʇ̼͸˺̼ˌ੮ʮͅ˦ૄ͐੮͐ʩʇ̼ʇੳ "͙͐੮˚˺͐ͅˑ;ੴ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘ੮̹ɘ̼ɘʁʇ੮˺ʠ੮ʮ˦͐ͅɘ˦ɻʇͅ੮͸ʩʇ̼ʇ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ɻɘˑˑͅ੮ɘ੮ɻɘͅʇ੮ɘ˦ʁ੮ ͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮͐ͅɘ˦ʁͅ੮͙̹੮ɘ˦ʁ੮ͅɘ;ͅੴ੮ૃä͙ɺ˚ʮ͐͐ɘˑੴ੮˦˺˦ચɘ̹̹ʇɘ̼ɘ˦ɻʇੳૄ੮îʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ ʩɘͅ੮ ɘ̹̹ˑʮʇʁ੮ ʠ˺̼੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦੮ ʩɘͅ੮ ɘ̹̹̼˺ͷʇʁ੮ ʮ͐ੴ੮ɘ˦ʁ੮͐ʩʇ੮ͅ˺˺˦ચ͐˺ચɺʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ʮͅ˦ૄ͐੮ɻ˺˦͐ʇ͐ͅʮ˦ʡ੮ʮ͐੮ɘ˦ʁ੮ʁʮʁ˦ૄ͐੮ɻ˺˚ʇ੮͐˺੮ɻ˺͙̼͐ੳৼਃ ̼ʡ͙ɘɺˑ;ੴ੮͐ʩʇ੮ɺʮʡʡʇ͐ͅ੮̼ʇɘͅ˺˦੮͐ʩʇ੮ʠ˺̼˚ɘˑ੮ˑʇʡɘˑ੮̼ʮʡʩ͐ͅ੮͐˺੮ʁ͙ʇ੮̹̼˺ɻʇͅͅ੮ɘʡɘʮ˦͐ͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̼ʇ˦ૄ͐੮ʇʠʠʇɻ͐ʮͷʇ੮ʮͅ੮͐ʩɘ͐੮˚ɘ˦;੮̹˺͐ʇ˦͐ʮɘˑ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʁ˺˦ૄ͐੮ʇͽʇ̼ɻʮͅʇ੮͐ʩʇ˚ੳ îʩʮͅ੮̼ʇɘˑˑ;੮͙̼̹̼ͅʮͅʇʁ੮˚ʇੳ੮äʩ˺͙ˑʁ˦ૄ͐੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ɺʇ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮͐ʩɘ͐ੴ੮ ɺ;੮ʁʇϲʮ˦ʮ͐ʮ˺˦ੴ੮̹ʇ˺̹ˑʇ੮͸ɘ˦͐੮͐˺੮ɻʩɘˑˑʇ˦ʡʇ੮ʮ˦੮ɻ˺͙̼͐੺੮"͙͐੮˚;੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮͐ʩɘ͐੮ɘʠ͐ʇ̼˦˺˺˦੮ ɘ̼ʇ੮ ɺɘɻˌʇʁ੮ ɺ;੮ ɘ੮ ৲ৰৰ৸੮ ͙͐ͅʁ;੮ ʠ̼˺˚੮ äɘ˦੮ )ʮʇʡ˺੮ ͐ʩɘ͐੮ ʠ˺͙˦ʁ੮ ͐ʩɘ͐੮ ৷৵੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩʇɘ̼ʮ˦ʡͅ੮͸ʇ˦͐੮͙˦ɻ˺˦͐ʇ͐ͅʇʁੳৼ਄੮U੮͸ɘͅ੮ϲˑɘɺɺʇ̼ʡɘ͐ͅʇʁ੮͸ʩʇ˦੮˺˦ʇ੮ ˈ͙ʁʡʇ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐ੴ੮ʮ˦੮ʩʮͅ੮ϲʮ̼͐ͅ੮;ʇɘ̼੮ɘͅ੮͐ʩʇ੮rØä੮ˈ͙ʁʡʇ੮ʮ˦੮ɘ੮ˑɘ̼ʡʇ੮ɻ˺͙˦͐;੮ʮ˦੮‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ʩʇ੮ʩɘʁ੮ુ˦ʇͷʇ̼੮ɘɻ͙͐ɘˑˑ;੮ʩɘʁ੮ɘ੮ʠ͙ˑˑચɺˑ˺͸˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼͐ʮɘˑੳૂ੮U੮ɘͅˌʇʁ੮ ʩ˺͸੮ʩʇ੮͐ʩ˺͙ʡʩ͐੮͐ʩɘ͐੮͸ɘͅ੮̹˺ͅͅʮɺˑʇੳ੮Pʇ੮͸ɘͅ˦ૄ͐੮͙̼ͅʇੵ੮ુU੮ʁ˺˦ૄ͐੮̼ʇɘˑˑ;੮ˌ˦˺͸੮͸ʩɘ͐੮͐ʩʇ੮ ̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʮͅ੮ɘʁͷʮͅʮ˦ʡ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ੴ੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠੴ੮ૃr˺˺ˌੴ੮ʁ˺੮;˺͙੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮ ;˺͙੮ʩɘͷʇ੮ɘ੮̼ʮʡʩ͐੮͐˺੮ɘ੮̼͐ʮɘˑ੺ૄ੮Uૄ˚੮̼ʇɘˑˑ;੮̼ʇˑʮɘ˦͐੮˺˦੮͐ʩʇ˚੮͐˺ੴ੮ˌʮ˦ʁ੮˺ʠੴ੮ʠʇ̼̼ʇ͐੮˺͙͐੮ય͸ʩɘ͐੮ ͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮͸ɘ˦͐ͅર੮ɘ˦ʁ੮̹̼˺͐ʇɻ͐੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅੳૂ U͐ૄͅ੮˦˺͐੮ɻˑʇɘ̼੮͐ʩɘ͐੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮ɘ̼ʇ੮ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮̹ˑɘ;ʮ˦ʡ੮͐ʩʮͅ੮̼˺ˑʇੳ੮U˦ʁʇʇʁੴ੮ ͅ˺˚ʇ੮ ɘ̼˚ચ͐͸ʮ͐ͅ੮ ͐ʩʇʮ̼੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ʮ˦͐˺੮ ɘʡ̼ʇʇʮ˦ʡ੮ ͐˺੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ৽৻੮ Øʩʮˑ੮ ફ͸ʩ˺ͅʇ੮ ͅ˺˦੮kɘɻ˺ɺ੮͸ɘͅ੮ɻ˺˦ͅʇ̼ͷʇʁ੮˺˦ˑ;੮͸ʩʇ˦੮͐ʩʇ੮r˺ͅ੮˦ʡʇˑʇͅ੮#˺͙˦͐;੮){P੮͐ʩ̼ʇɘ͐ʇ˦ʇʁ੮ ͐˺੮;ɘ˦ˌ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑૄͅ੮rØä੮ʁʇͅʮʡ˦ɘ͐ʮ˺˦બ੮̼ʇɻ˺͙˦͐ʇʁ੮͐ʩɘ͐ੴ੮ʠ˺̼੮˺˦ʇ੮̼ʇ˦ʇ͸ɘˑੴ੮ુ{;੮ͅ˺˦੮ ʁʮʁ˦ૄ͐੮ͅʩ˺͸੮͙̹ੴ੮ɺ͙͐੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ͅɘʮʁੴ੮ૃ#ɘˑˑ੮;˺͙̼੮ͅ˺˦ੳૄૂ੮Øʩʮˑ੮ʁʮʁੴ੮ɘ˦ʁ੮͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ͐˺ˑʁ੮ kɘɻ˺ɺੴ੮ ુrʮ͐ͅʇ˦ੴ੮ ;˺͙̼੮ ʠɘ͐ʩʇ̼੮ ͸ɘ˦͐ͅ੮ ͐˺੮ ɻ˺˦͐ʮ˦͙ʇ੮ ͐˺੮ ɺʇ੮ ;˺͙̼੮ ʡ͙ɘ̼ʁʮɘ˦ੳ੮Uʠ੮;˺͙੮ϲʮʡʩ͐੮ʮ͐ੴ੮ʮ͐ૄͅ੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ʡ˺˺ʁ੮ʠ˺̼੮;˺͙ੳ੯ੳ੯ੳ੯ੳ੮)˺੮;˺͙੮͸ɘ˦͐੮͐˺੮ɺʇ੮ ˺͙͐੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੺੮ય͐੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮;˺͙̼੮ʠɘ͐ʩʇ̼ર੮;˺͙੮ʡʇ͐੮;˺͙̼੮˺͸˦੮ɺʇʁ̼˺˺˚ੴ੮;˺͙੮ ʇɘ͐੮͸ʇˑˑੴ੮;˺͙̼੮ʠɘ͐ʩʇ̼੮ˑ˺ͷʇͅ੮;˺͙ੴ੮ʩʇૄͅ੮ɘ੮͐ʇ̼̼ʮϲʮɻ੮ʡ͙;ੳૂ੮ͅ੮Øʩʮˑ੮̼ʇ˚ʇ˚ɺʇ̼ʇʁ੮ʮ͐ੴ੮ુ{;੮ ͅ˺˦੮ͅɘ;ͅੴ੮ૃĔʇˑˑ੮U੮ʁ˺˦ૄ͐੮ˌ˦˺͸੯ੳ੯ੳ੯ੳૄ੮ɘ˦ʁ੮ʩʇ੮ͅɘ;ͅੴ੮ૃU͐ૄͅ੮;ʇͅ੮˺̼੮˦˺ੳ੮Ě˺͙੮ɘʡ̼ʇʇ੮͐˺੮ʮ͐੮˺̼੮˦˺͐ੴ੮ ɘ˦ʁ੮ʮʠ੮;˺͙੮ʁ˺˦ૄ͐ੴ੮U੮͐ʩʮ˦ˌ੮;˺͙̼੮ˑʮʠʇ੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮͸˺̼ͅʇੳૄ੮˦ʁ੮˚;੮ͅ˺˦੮ͅɘ;ͅੴ੮ૃšˌɘ;ੴૄ੮ ɘ˦ʁ੮ʩʇ੮ͅɘ;ͅੴ੮ૃI̼ʇɘ͐ੴૄ੮ɘ˦ʁ੮ʩʇ੮ʡ˺ʇͅ੮͙̹੮͐˺੮͐ʩʇ੮ˈ͙ʁʡʇ੮ɘ˦ʁ੮ͅɘ;ͅੴ੮ૃયkɘɻ˺ɺર੮ɘʡ̼ʇʇͅ੮͐˺੮ʮ͐ੳૄૂ îʩʇ੮͙˦ʁʇ̼ચ̼ʇͅ˺͙̼ɻʮ˦ʡ੮˺ʠ੮͐ʩʇ੮rØä੮ͅ;͐ͅʇ˚੮ɻ̼ʇɘ͐ʇͅ੮ɘʁʁʮ͐ʮ˺˦ɘˑ੮̹̼ʇ͙̼ͅͅʇͅ੮˺˦੮ɻˑʮʇ˦͐ͅ੮͐˺੮ɘɺˈ͙̼ʇ੮˺͐ʩʇ̼੮̼ʮʡʩ͐ͅੳ੮k͙̼;੮̼͐ʮɘˑͅ੮̼ʇή͙ʮ̼ʇ੮ɘ˦੮ʇ˦˺̼˚˺͙ͅ੮˚˺ɺʮˑʮΈɘ͐ʮ˺˦੮˺ʠ੮͐ʮ˚ʇ੮ ɘ˦ʁ੮̹ʇ̼ͅ˺˦˦ʇˑ੮ɘ˦ʁੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮ͅ˺˚ʇ੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅੴ੮ɘ̼ʇ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ˑʇɘʁ੮͐˺੮ɘ੮

C O U RT

129

ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɺʇʮ˦ʡ੮ʁʇ˦ʮʇʁੳ੮U˦੮˺˦ʇ੮ɻɘͅʇੴ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ɘͅˌͅ੮ɘ੮͸˺˚ɘ˦੮ʮʠ੮ͅʩʇ੮͸ɘ˦͐ͅ੮ ɘ੮ˈ͙̼;੮̼͐ʮɘˑ੮˺̼੮˺˦ʇ੮͸ʮ͐ʩ੮ˈ͙͐ͅ੮͐ʩʇ੮ˈ͙ʁʡʇੳ੮îʩʇ੮͸˺˚ɘ˦੮͐ɘˌʇͅ੮ɘ੮ˑ˺˦ʡ੮̹ɘ͙ͅʇ੮ɺʇʠ˺̼ʇ੮ͅɘ;ʮ˦ʡੴ੮ૃk͙̼;ੳૄ Pʇ̼੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮͐ʇˑˑͅ੮ʩʇ̼ੴ੮ૃîʩɘ͐ૄͅ੮˺ˌɘ;ੴ੮͐ʩɘ͐ૄͅ੮;˺͙̼੮̼ʮʡʩ͐ੳૄ "͙͐੮͸ʩʇ˦੮͐ʩʇ੮ɺɘʮˑʮʠʠ੮ɻ˺˚ʇͅ੮ɺɘɻˌ੮͸ʮ͐ʩ੮ɘ੮̼͐ʮɘˑ੮ʁɘ͐ʇ੮˚˺˦͐ʩͅ੮ʮ˦੮͐ʩʇ੮ʠ͙͙̼͐ʇੴ੮͐ʩʇ੮ ͸˺˚ɘ˦੮ɘͅˌͅੴ੮ૃ"ʇʠ˺̼ʇ੮͐ʩʇ˦ੴ੮ɻɘ˦੮U੮ˑʇɘͷʇ੮ય͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑર੺ૄ Pʇ̼੮ɘ͐͐˺̼˦ʇ;੮̼ʇ̹ˑʮʇͅੴ੮ૃ‡˺ੴ੮U੮͐ʩʮ˦ˌ੮;˺͙ૄˑˑ੮ʡ˺੮͐˺੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʠɘɻʮˑʮ͐;ੳૄ ૃU੮͐ʩʮ˦ˌ੮ʮ͐੮͸˺͙ˑʁ੮ɺʇ੮ɘ˦੮U{)ੴૄ੮k͙ʁʡʇ੮)ɘͷʮͅੴ੮ˑ˺˺ˌʮ˦ʡ੮ɘ͐੮ʩʇ̼੮̹ɘ̹ʇ̼͸˺̼ˌੴ੮ɘʁʁͅੳ îʩʇ੮͸˺˚ɘ˦ૄͅ੮˦ʇͽ͐੮̼ʇ̹ͅ˺˦ͅʇ੮ͅʇʇ˚ͅ੮ɻ˺˦ʠ͙ͅʇʁੴ੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮͐ͅɘ͐ʇͅੴ੮ૃä˺੮U੮ɻɘ˦੮ˑʇɘͷʇ੮ today?’ ૃĚ˺͙੮ɻɘ˦੮ʩɘͷʇ੮ɘ੮̼͐ʮɘˑ੮͸ʮ͐ʩ੮͐ʩʇ੮ˈ͙ʁʡʇ੮͐˺ʁɘ;ੴૄ੮͐ʩʇ੮ʁʇʠʇ˦ʁʇ̼੮̼ʇ̹ˑʮʇͅੳ ૃ˦ʁ੮ʮʠ੮ʮ͐ૄͅ੮ɘ੮ˈ͙̼;ੴ੮U੮͐ͅɘ;੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੺ૄ ૃU͐ૄͅ੮ˑʮˌʇˑ;੮;˺͙੮͸ʮˑˑ੮͐ͅɘ;੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ય͙˦͐ʮˑ੮͐ʩʇ੮̼͐ʮɘˑરੴૄ੮ʩʇ̼੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ ̼ʇʮ͐ʇ̼ɘ͐ʇͅੳ ૃîʩʇ˦੮ˈ͙ʁʡʇੴૄ੮͐ʩʇ੮͸˺˚ɘ˦੮̼ʇˑʇ˦͐ͅੳ੮k͙ʁʡʇ੮)ɘͷʮͅ੮͐ʩʇ˦੮ʁʇɻˑɘ̼ʇͅ੮ʩʇ̼੮͸ɘʮͷʇ̼੮˺ʠ੮ʩʇ̼੮ ̼ʮʡʩ͐੮͐˺੮ɘ੮ˈ͙̼;੮̼͐ʮɘˑ੮ૃˌ˦˺͸ʮ˦ʡੴ੮ʮ˦͐ʇˑˑʮʡʇ˦͐ੴ੮ɘ˦ʁ੮ͷ˺ˑ͙˦͐ɘ̼;ੴૄ੮͸ʩʮɻʩ੮ʠʇʇˑͅ੮˺ʁʁ੮ɺʇɻɘ͙ͅʇ੮ ͐ʩʇ੮̼ʇ͐ͅ੮˺ʠ੮͐ʩʇ੮̼͐ʮɘˑ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ʩ˺͸੮ͅʩʇ੮ʮͅ੮˦ʇʮ͐ʩʇ̼੮ˌ˦˺͸ʮ˦ʡ੮˦˺̼੮ʮ˦͐ʇˑˑʮʡʇ˦͐੮ɘɺ˺͙͐੮ ʩʇ̼੮ɻ˺˦ʁʮ͐ʮ˺˦੮ɘ˦ʁ੮͐ʩ͙ͅ੮̼ʇή͙ʮ̼ʇͅ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐ੳ ˦˺͐ʩʇ̼੮ ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ ʠ˺̼੮ ͐ʩʇ੮ ʩʮʡʩ੮ ̼ɘ͐ʇͅ੮ ˺ʠ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅૄ੮ ɻ˺˦ͅʇ˦͐ʮ˦ʡ੮ ͐˺੮ ɻ˺˦̼͐ͅɘʮ˦͐੮ʮͅ੮ͅʮ˚̹ˑ;੮͐ʩɘ͐੮͐ʩʇ;੮ʩɘͷʇ੮ɘɻɻ͙̼ɘ͐ʇˑ;੮ɘͅͅʇͅͅʇʁ੮͐ʩʇʮ̼੮ˑ˺͸੮ɻʩɘ˦ɻʇͅ੮˺ʠ੮͸ʮ˦˦ʮ˦ʡੳ੮ ͅ੮ k˺ͅʩੴ੮ ͐ʩʇ੮ ̼͙̼ɘˑ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼ੴ੮ ͐˺ˑʁ੮ ˚ʇੴ੮ ૃUʠ੮ ͐ʩʇ;੮ ͅɘ;੮ ͐ʩʇ;੮ ͸ɘ˦͐੮ ͐˺੮ ɻ˺˦͐ʇ͐ͅ੮ ͐ʩʇʮ̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮U੮͐ʇˑˑ੮͐ʩʇ˚ੴ੮ુîʩʇ;ૄˑˑ੮ɘͅˌ੮;˺͙੮ɘɺ˺͙͐੮;˺͙̼੮̹ˑɘ˦੮ʮʠ੮;˺͙ૄ̼ʇ੮˦˺͐੮ ˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳૂ੮Uʠ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮ɻ˺˚ʇ੮͙̹੮͸ʮ͐ʩ੮ʡ˺˺ʁ੮ɘ˦ͅ͸ʇ̼ͅੴ੮U੮ͅɘ;ੴ੮ુU͐੮ͅ˺͙˦ʁͅ੮ ˑʮˌʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʮͅ੮ ʩʇˑ̹ʠ͙ˑ੮ ʠ˺̼੮ ;˺͙ੴ੮ ;˺͙̼੮ ̹ˑɘ˦੮ ʮͅ˦ૄ͐੮ ͷʇ̼;੮ ʡ˺˺ʁੴ੮ ;˺͙੮ ʩɘͷʇ˦ૄ͐੮ ϲʮʡ͙̼ʇʁ੮͐ʩʮͅ੮˺͙͐ੴ੮ͅ˺੮̹̼˺ɺɘɺˑ;੮͐ʩʇ੮ɻ˺͙̼͐੮͸˺˦ૄ͐੮ˑʇ͐੮;˺͙੮˺ʠʠੳૄૄ੮H̼ʇή͙ʇ˦͐ˑ;ੴ੮͐ʩʇ;ૄˑˑ੮ͅɘ;ੴ੮ ુšˌɘ;ੴ੮U੮ɻɘ˦੮ˑʮͷʇ੮͸ʮ͐ʩ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳૄૄ੮ૄ੮ä˺˚ʇ੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦ͅ੮ʁ˺˦ૄ͐੮ʡʇ͐੮͐ʩɘ͐੮ʠɘ̼ੳ੮ #ˑʮʇ˦͐ͅ੮͸ʩ˺੮ɘ̼ʇ੮ɘɻ͙͐ʇˑ;੮̹ͅ;ɻʩ˺͐ʮɻੴ੮ɻɘ͐ɘ͐˺˦ʮɻੴ੮˺̼੮˚͙͐ʇ੮˚ʮʡʩ͐੮˦˺͐੮ɺʇ੮ɘ̼͐ʮɻ͙ˑɘ͐ʮ˦ʡ੮ ɘ˦;੮ɻˑʇɘ̼੮̹̼ʇʠʇ̼ʇ˦ɻʇ੮ɘɺ˺͙͐੮͐ʩʇʮ̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮rɘ͸;ʇ̼ͅ੮ʩɘͷʇ੮˦ʇʮ͐ʩʇ̼੮͐ʩʇ੮͐ʮ˚ʇ੮ ˦˺̼੮͐ʩʇ੮̼͐ɘʮ˦ʮ˦ʡ੮͐˺੮ʩʇˑ̹੮͐ʩʇ˚੮ʁʇͷʇˑ˺̹੮˺˦ʇੳ îʩʇ˦੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮̼ʇɘͅ˺˦ͅ੮͐ʩɘ͐੮ʩɘͷʇ੮ˑʮ͐͐ˑʇ੮͐˺੮ʁ˺੮͸ʮ͐ʩ੮ˑʇʡɘˑ੮ɘʁͷ˺ɻɘɻ;੮ɺ;੮ɘ͐͐˺̼˦ʇ;ͅੳ੮ Ĕʩʇ˦੮U੮̼ɘʮͅʇʁ੮͐ʩʮͅ੮ɻ˺˦̼͐ɘʁʮɻ͐˺̼;੮ʮʁʇɘ੮˺ʠ੮ɻ˺˦ͅʇ˦͐੮͐˺੮ɻ˺ʇ̼ɻʮ˺˦੮͸ʮ͐ʩ੮k͙ʁʡʇ੮Û˺ˈɘͅੴ੮ʩʇ੮ ̼ʇ̹ͅ˺˦ʁʇʁੴ੮ૃ{ɘ˦;੮͐ʮ˚ʇͅ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ɻ˺˚ʇͅ੮ʮ˦͐˺੮ɻ˺͙̼͐ੴ੮͐ʩʇ;੮͸ɘ˦͐੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ;੮ˑʮˌʇ੮͸ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮ʡʇ͐͐ʮ˦ʡੴ੮ʠ˺˺ʁ੮ɻˑ˺͐ʩʮ˦ʡ੮ͅʩʇˑ͐ʇ̼ੴ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ɘɻ͐ʮͷʮ͐ʮʇͅੴ੮ ͐ʩʇ;੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɺʇ੮ʩ˺˚ʇˑʇͅͅੳ੮˦;˺˦ʇ੮͸ʩ˺੮ʩɘͅ੮ˑʮͷʇʁ੮͐ʩ̼˺͙ʡʩ੮ʩʇɘ̼ʮ˦ʡ੮ͷ˺ʮɻʇͅ੮ ˌ˦˺͸ͅ੮͐ʩɘ͐ૄͅ੮˦˺͐੮ɘ੮ʠ͙˦੮͐ʩʮ˦ʡੳૄ੮îʩɘ͐ૄͅ੮͐ʩʇ੮ʩɘ̹̹ʮʇ͐ͅ੮̼ʇ˦ʁʇ̼ʮ˦ʡੵ੮͐ʩɘ͐੮ͅʇ̼ͷʮɻʇͅ੮ɘ̼ʇ੮ʩʮʡʩ੮ ʇ˦˺͙ʡʩ੮ή͙ɘˑʮ͐;੮͐ʩɘ͐੮̹ʇ˺̹ˑʇੴ੮ʇͷʇ˦͙͐ɘˑˑ;ੴ੮̼ʇɘˑʮΈʇ੮͐ʩʇ;੮͸ɘ˦͐੮͐ʩʇ˚ੳ

130

T H E C O N S E RVATO R S H I P C O N T I N U U M

"͙͐੮͸ʩ;੮ʁ˺ʇͅ੮ͅ˺˚ʇ˺˦ʇ੮˦ʇʇʁ੮͐˺੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੮͐˺੮ʡʇ͐੮ͅʩʇˑ͐ʇ̼੮ɘ˦ʁ੮ͅʇ̼ͷʮɻʇͅ੺੮Øʇ̼ʩɘ̹ͅੴ੮ʮ˦੮ͅ˺˚ʇ੮ɻɘͅʇͅੴ੮͐ʩʇ;੮˦ʇʇʁ੮ɘ੮̹ʇ̼ʮ˺ʁ੮˺ʠ੮ʠ˺̼ɻʇʁ੮˚ʇʁʮɻɘ͐ʮ˺˦੮͐˺੮ɻˑʇɘ̼੮͐ʩʇ੮ʩɘΈʇ੮ ˺ʠ੮ɘ˦˺ͅ˺ʡ˦˺ͅʮɘੴ੮͸ʩʮɻʩ੮ɻ˺͙ˑʁ੮ʩɘͷʇ੮ɺˑʮ˦ʁʇʁ੮͐ʩʇ˚੮͐˺੮͐ʩʇʮ̼੮˺͸˦੮ɘʮˑ˚ʇ˦͐ੳ੮"͙͐੮ɘͅ੮ ɘ˦˺͐ʩʇ̼੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮˚˺̼ʇ੮ɻ;˦ʮɻɘˑˑ;੮͐˺ˑʁ੮˚ʇੴ੮͐ʩʇ੮ɘ̹̹ʇɘˑ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʠ˺̼੮˚ɘ˦;੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʩʮ˦ʡʇͅ੮˺˦੮͐ʩʇ੮ʁʮ̼ʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅੵ੮ૃĚ˺͙੮͸˺͙ˑʁ੮ʇͽ̹ʇɻ͐੮͐ʩɘ͐੮ ʮʠ੮ɘ˦;ɺ˺ʁ;੮ʮͅ੮͐˺ˑʁੴ੮ુĚ˺͙ૄ̼ʇ੮˺˦੮ɘ੮̹ͅ;ɻʩયʮɘ̼͐ʮɻર੮ʩ˺ˑʁ੯ੳ੯ੳ੯ੳૂ੮ય͐ʩʇ;੮͸˺͙ˑʁ੮ɻ˺˦͐ʇ͐ͅ੮ʮ͐ર੮ ɺ͙͐੮ʮʠ੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ʮͅੴ੮ુU੮ʩɘͷʇ੮˦˺͸ʩʇ̼ʇ੮͐˺੮ʡ˺ੴ੮U੮˦ʇʇʁ੮ʩʇˑ̹੮ϲʮ˦ʁʮ˦ʡ੮ʩ˺͙ͅʮ˦ʡੴ੮ U੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮͐ʩʇ੮͙̹̹ͅ˺̼͐ੴ੮Uૄ˚੮˦˺͐੮ʁ˺ʮ˦ʡ੮͸ʇˑˑੴૂ੮ɘ੮ˑ˺͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮͸ʮˑˑʮ˦ʡ੮͐˺੮͐ͅɘ;੮ ͸ʩʇ˦੮ ͐ʩʇ;ૄ̼ʇ੮ ʡʇ͐͐ʮ˦ʡ੮ ͐ʩ̼ʇʇ੮ ˚ʇɘˑͅ੮ ɘ੮ ʁɘ;ੴ੮ ͐ʩʇ̼ʇૄͅ੮ ͅʩʇˑ͐ʇ̼ੴ੮ ɘ˦ʁ੮ ˦͙̼ͅʮ˦ʡ੮ ʠ˺̼੮ ͐ʩʇʮ̼੮ ˚ʇʁʮɻɘˑ੮˦ʇʇʁͅੳૄ U͐ૄͅ੮ɘ˦੮ʇ˦ʁʇ˚ʮɻ੮̹̼˺ɺˑʇ˚ੳ੮{ʇʁʮɻʮ˦ʇ੮˺ʠ͐ʇ˦੮͸˺˦ૄ͐੮˺̼੮ɻɘ˦ૄ͐੮̼͐ʇɘ͐੮ͅ˺˚ʇ˺˦ʇ੮͙˦͐ʮˑ੮ the law is involved (whether it’s mental health care in prison or a civil com˚ʮ͐˚ʇ˦͐੮ ͐˺੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ͐ʩɘ͐੮ ʁ˺ʇͅ˦ૄ͐੮ ͐ɘˌʇ੮ ͷ˺ˑ͙˦͐ɘ̼;੮ ̹ɘ͐ʮʇ˦͐ͅબੳ੮ îʩʮͅ੮ ˚ʇɘ˦ͅ੮ ͐ʩɘ͐ੴ੮ ʠ˺̼੮ͅ˺˚ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੴ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ʩɘͷʇ੮ુͅ˺ɻʮɘˑ੮̼ʮʡʩ͐ͅૂ੮͐˺੮ʩ˺͙ͅʮ˦ʡ੮ɘ˦ʁ੮ɻɘ̼ʇઝ͐ʩʇ੮ ˌʮ˦ʁ੮ʡ͙ɘ̼ɘ˦͐ʇʇʁ੮ʮ˦੮˺͐ʩʇ̼੮͸ʇɘˑ͐ʩ;੮ɻ˺͙˦̼͐ʮʇͅઝ̼ʇή͙ʮ̼ʇͅ੮̼ʇ˦˺͙˦ɻʮ˦ʡ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮͐˺੮ ʠ̼ʇʇʁ˺˚੮ɘ˦ʁ੮ɻʩ˺ʮɻʇੳ

MISSING EVIDENCE Ĕʩʇ˦੮ɻɘͅʇͅ੮ʁ˺੮˚ɘˌʇ੮ʮ͐੮͐˺੮̼͐ʮɘˑੴ੮˺͙͐ɻ˺˚ʇͅ੮˚ɘ;੮ʁʇ̹ʇ˦ʁ੮ˑʇͅͅ੮˺˦੮͐ʩʇ੮̼͐ͅʮɻ͐˦ʇͅͅ੮˺ʠ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ɘ˦ʁ੮ ˚˺̼ʇ੮ ˺˦੮ ͐ʩʇ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅ੮ ˺ʠ੮ ʁ˺ɻ͐˺̼ͅૄ੮ ɻ͙ˑ͙̼͐ɘˑ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ͐˺੮ ʮʁʇ˦͐ʮʠ;੮ʮ͐ੳ For one thing, the Sanchez decision sharply curtails the evidence judges can ɻ˺˦ͅʮʁʇ̼ੳ੮îʩʮͅ੮ɻ˺˚ʇͅ੮͐˺੮ɘ੮ʩʇɘʁ੮ʮ˦੮͐ʩʇ੮ʩʇɘ̼ʮ˦ʡ੮ʠ˺̼੮ɘ੮;˺͙˦ʡ੮˚ɘ˦੮ʁʮɘʡ˦˺ͅʇʁ੮͸ʮ͐ʩ੮ɘ੮ ˑʮ͐ɘ˦;੮˺ʠ੮̹ͅ;ɻʩ˺͐ʮɻੴ੮˚˺˺ʁੴ੮ɘ˦ʁ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼ͅੳ੮˦ʁ;ੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɻ˺͙˦ͅʇˑੴ੮ɘͅˌͅ੮ʩ˺͸੮͐ʩʇͅʇ੮ͅ;˚̹͐˺˚ͅ੮ɘʠʠʇɻ͐੮ʩʮͅ੮ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ ͅʩʇˑ͐ʇ̼ੳ੮Pʮͅ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮̼ʇ̹ˑʮʇͅੴ੮ૃĔʇˑˑੴ੮ʩʇ੮ʩɘͅ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮͐͸ʇ˦͐;੮͐ʮ˚ʇͅ੯ੳ੯ੳ੯ੳૄ ૃšɺˈʇɻ͐ʮ˺˦ੴૄ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʮ˦͐ʇ̼ˈʇɻ͐ͅੳ ૃä͙͐ͅɘʮ˦ʇʁੴૄ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʁʇɻˑɘ̼ʇͅੳ rɘ͐ʇ̼ੴ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮̼͐ʮʇͅ੮͐˺੮ʇͽ̹ˑɘʮ˦੮͐ʩɘ͐੮͐ͅɘʠʠ੮͐˺ˑʁ੮ʩʮ˚੮ʩʇ੮͸ɘͅ੮ૃɻʩʇʇˌʮ˦ʡૄ੮ʩʮͅ੮ ˚ʇʁʮɻʮ˦ʇ੮ફʩʮʁʮ˦ʡ੮ʮ͐੮ʮ˦੮ʩʮͅ੮˚˺͙͐ʩ੮͐˺੮ɘͷ˺ʮʁ੮͐ɘˌʮ˦ʡ੮ʮ͐બੴ੮͐ʇ͐ͅʮ˚˺˦;੮͐ʩɘ͐੮˚ʇʇ͐ͅ੮͐ʩʇ੮ ͅɘ˚ʇ੮ʠɘ͐ʇੳ੮îʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐ʩʇ˦੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ʁʮͅɻ͙ͅͅ੮͐ʩʇ੮˚ɘ˦ૄͅ੮͙˦̼ʇɘˑʮ͐ͅʮɻ੮ʁʮͅɻʩɘ̼ʡʇ੮̹ˑɘ˦ੴ੮˺ɺͅʇ̼ͷʮ˦ʡੴ੮ૃPʇ੮ͅɘ;ͅ੮͐ʩɘ͐੮ʩʮͅ੮̹ˑɘ˦੮ʮͅ੮͐˺੮ʡ˺੮ʩ˺˚ʇੴ੮ɺ͙͐੮ʩʮͅ੮˚˺͐ʩʇ̼੮͸˺˦ૄ͐੮ ɘɻɻʇ̹͐੮ʩʮ˚੮͙˦ˑʇͅͅ੮ʩʇૄͅ੮ʮ˦੮ɘ੮̼ʇɻ˺ͷʇ̼;੮̹̼˺ʡ̼ɘ˚੯ੳ੯ੳ੯ੳૄ੮îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮˺ɺˈʇɻ͐ͅ੮͐˺੮ ʩʇɘ̼ͅɘ;ੴ੮ɘ˦ʁ੮͐ʩʇ੮͐ʇ͐ͅʮ˚˺˦;੮ʮͅ੮̼͐ͅʮɻˌʇ˦ੳ

C O U RT

131

š˦੮ɻ̼˺ͅͅચʇͽɘ˚ʮ˦ɘ͐ʮ˺˦ੴ੮͐ʩʇ੮ˑɘ͸;ʇ̼੮̹̼ʇͅͅʇͅ੮˺˦੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ɺʇʩɘͷʮ˺̼ͅ੮͐˺੮͸ʩʮɻʩ੮ ͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ʩɘʁ੮̹̼ʇͷʮ˺͙ͅˑ;੮͐ʇ͐ͅʮϲʮʇʁੵ੮ૃĚ˺͙੮ͅɘʮʁ੮ʩʇ੮͸ɘͅ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ʩʮ˚ͅʇˑʠ੮ʮ˦੮ʩʮͅ੮ ̼˺˺˚ੳ੮P˺͸੮ɻ˺͙ˑʁ੮;˺͙੮ˌ˦˺͸੮͐ʩɘ͐੮ʮʠ੮;˺͙੮͸ʇ̼ʇ˦ૄ͐੮͐ʩʇ̼ʇ੺ૄ ૃä͐ɘʠʠ੮˺ɺͅʇ̼ͷʇʁ੮ʮ͐ੴૄ੮ʩʇ੮̼ʇ̹ˑʮʇͅੳ ૃ˦ʁ੮;˺͙੮ͅɘʮʁ੮͐ʩɘ͐੮ʩʇ੮ɘ͐͐ʇ˚̹͐ʇʁ੮͐˺੮ʡ˺੮Ĕšr੮ʠ̼˺˚੮͐ʩʇ੮ʠɘɻʮˑʮ͐;੺ૄ ૃĚʇͅੴૄ੮ɘʡɘʮ˦ੳ ૃ)ʮʁ੮ʩʇ੮͐ʇˑˑ੮;˺͙੮͐ʩɘ͐੺ૄ ૃ‡˺ੴ੮ʮ͐ૄͅ੮ʮ˦੮͐ʩʇ੮̼ʇɻ˺̼ʁͅੴૄ੮͐ʩʇ੮ͷʮͅʮɺˑ;੮ʮ̼̼ʮ͐ɘ͐ʇʁ੮ʁ˺ɻ͐˺̼੮̼ʇ̹ͅ˺˦ʁͅੳ ૃUૄ˚੮ ʡ˺ʮ˦ʡ੮ ͐˺੮ ˺ɺˈʇɻ͐੮ ͐˺੮ ͐ʩʮͅ੮ ͐ʇ͐ͅʮ˚˺˦;ੴ੮ ͸ʩʮɻʩ੮ ʮͅ੮ ˦˺͐੮ ɺɘͅʇʁ੮ ˺˦੮ ͐ʩʇ੮ ʁ˺ɻ͐˺̼ૄͅ੮ ˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮˺̼੮͸ʩɘ͐੮˚;੮ɻˑʮʇ˦͐੮ʩɘͅ੮͐˺ˑʁ੮ʩʮ˚ੴૄ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʁʇɻˑɘ̼ʇͅੳ੮k͙ʁʡʇ੮ )ɘͷʮͅ੮͙͐ͅͅɘʮ˦ͅ੮ɘʡɘʮ˦ੳ ͐੮͐ʩʇ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇ੮ʩʇɘ̼ʮ˦ʡੴ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ɻ˺˦ɻˑ͙ʁʇͅੴ੮ɘɻɻ͙̼ɘ͐ʇˑ;ੴ੮͐ʩɘ͐੮ͅʩʇ੮ૃʁʮʁ˦ૄ͐੮ ʩɘͷʇ੮˚͙ɻʩ੮ʩʇ̼ʇੴ੮ɘͅ੮U੮̼͙͐ͅɻˌ੮͐ʩʇ੮͐ʇ͐ͅʮ˚˺˦;੮ɘɺ˺͙͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ɻʩʇʇˌʮ˦ʡੴ੮ɘ˦ʁ੮ ʡ˺ʮ˦ʡ੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮ʠɘ˚ʮˑ;ੳૄ੮äʩʇ੮̼ʇˑʇɘͅʇͅ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ੳ Pʇ̼ʇੴ੮ ͸ʇ੮ ɻɘ˦੮ ͅʇʇ੮ ɘ੮ ʡʇ˦͙ʮ˦ʇ੮ ʮ˦ɻ˺˚̹ɘ͐ʮɺʮˑʮ͐;੮ ɺʇ͐͸ʇʇ˦੮ ͐ʩʇ੮ ˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮ ˺ʠ੮ ˚ʇʁʮɻʮ˦ʇ੮ɘ˦ʁ੮͐ʩʇ੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅ੮˺ʠ੮ˑɘ͸ੳ੮îʩʇ੮˚ʇʁʮɻɘˑ੮ͅ;͐ͅʇ˚੮ɘ͙ͅͅ˚ʇͅ੮͐ʩɘ͐੮ʩʮʡʩˑ;੮ ̹ɘʮʁ੮ ̹ͅʇɻʮɘˑʮ͐ͅͅ੮ ɻɘ˦੮ ̹ͅʇ˦ʁ੮ ɘ੮ ˚ʮ˦ʮͅɻ͙ˑʇ੮ ɘ˚˺͙˦͐੮ ˺ʠ੮ ͐ʮ˚ʇ੮ ͸ʮ͐ʩ੮ ͐ʩʇʮ̼੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ˺˦੮ ͐ʩʇ੮̹̼ʇ˚ʮͅʇ੮͐ʩɘ͐੮͐ͅɘʠʠ੮͸ʮˑˑ੮ϲʮˑˑ੮͐ʩʇ˚੮ʮ˦ੳ੮îʩʇ;੮̼ʇˑ;੮˺˦੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮͐˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮ ʮʠ੮̹ɘ͐ʮʇ˦͐ͅૄ੮ʁʮͅɻʩɘ̼ʡʇ੮̹ˑɘ˦ͅ੮ɻʩʇɻˌ੮˺͙͐ੳ੮"͙͐੮͐ʩʮͅ੮ʁʮͷʮͅʮ˺˦੮˺ʠ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮˚ʇɘ˦ͅ੮͐ʩɘ͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɻɘ˦˦˺͐੮˚ʇʇ͐੮͐ʩʇ੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅ੮͙˦ʁʇ̼੮ Sanchez੮ʠ˺̼੮̹̼˺ͷʮʁʮ˦ʡ੮ʇͽ̹ʇ̼͐੮͐ʇ͐ͅʮ˚˺˦;ੳ ˦˺͐ʩʇ̼੮ɻ˺̼ʇ੮ɻʩʇɻˌ੮˺˦੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͐ʇ͐ͅʮ˚˺˦;੮ʮͅ੮͐ʩʇ੮˚ɘ˦ʁɘ͐ʇ੮͐ʩɘ͐੮ɻ˺͙̼͐ͅ੮ુ˚ɘ;੮ ˦˺͐੮ɻ˺˦ͅʮʁʇ̼੮͐ʩʇ੮ˑʮˌʇˑʮʩ˺˺ʁ੮˺ʠ੮ʠ͙͙̼͐ʇ੮ʁʇ͐ʇ̼ʮ˺̼ɘ͐ʮ˺˦੮˺̼੮̼ʇˑɘ̹ͅʇૂ੮ʮ˦੮˚ɘˌʮ˦ʡ੮ɘ੮ʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦ੳ৽ৼ੮k͙ʁʡʇ੮)ɘͷʮͅૄͅ੮̼ʇɘʁʮ˦ʡ੮˺ʠ੮͐ʩʮͅ੮ɻɘͅʇ੮ˑɘ͸੮ʮͅ੮̼͐ͅʮ˦ʡʇ˦͐ੵ੮ુä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ̼ʇ੮ will be evidence that the person has been gravely disabled in the past and even ͐ʩ˺͙ʡʩ੮ʩʇ੮˺̼੮ͅʩʇ੮ˑ˺˺ˌͅ੮ϲʮ˦ʇ੮˦˺͸ੴ੮ʮͅ੮͐ͅɘɺˑʇੴ੮͐ʩʮ˦ʡͅ੮ɘ̼ʇ੮ʡ˺ʮ˦ʡ੮͸ʇˑˑੴ੮͐ʩʇ̼ʇૄͅ੮ɘ੮̼ʮͅˌ੮ ͐ʩɘ͐੮ʮʠ੮͐ʩʮͅ੮̹ʇ̼ͅ˺˦੮ʮͅ੮͐ɘˌʇ˦੮˺ʠʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ʠɘˑˑ੮ɘ̹ɘ̼͐੮ ʮ˦੮ɘ੮ɻ˺͙̹ˑʇ੮˺ʠ੮͸ʇʇˌͅੳ੯ੳ੯ੳ੯ੳ੮îʩɘ͐ૄͅ੮ˌʮ˦ʁ੮˺ʠ੮ɘ੮͐˺͙ʡʩ੮ͅʮ͙͐ɘ͐ʮ˺˦ੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ɻɘͅʇ੮ˑɘ͸ੴ੮ɘͅ੮ U੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮ʮ͐ੴ੮ʮͅ੮͐ʩɘ͐੮U੮ʩɘͷʇ੮͐˺੮ˑ˺˺ˌ੮ɘ͐੮ʩ˺͸੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮͅ੮͐˺ʁɘ;ੳૂ੮"͙͐੮͐ʩʇ̼ʇʮ˦੮ˑʮʇͅ੮ ͐ʩʇ੮ɺʮ˦ʁ੮ʠ˺̼੮ɻˑʮ˦ʮɻʮɘ˦ͅੵ੮͐ʩʇ੮ͷʇ̼;੮͙ͅɻɻʇͅͅ੮˺ʠ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮˚ɘˌʮ˦ʡ੮ɘ੮̹ɘ͐ʮʇ˦͐੮͐ʇ˚̹˺̼ɘ̼ʮˑ;੮ɻɘ̹ɘɺˑʇ੮˺ʠ੮˚ʇʇ͐ʮ˦ʡ੮͐ʩʇʮ̼੮ɺɘͅʮɻ੮˦ʇʇʁͅ੮͙˦ʁʇ̼ɻ͙͐ͅ੮ɘ˦;੮ɘ͐͐ʇ˚̹͐੮͐˺੮ɻ˺˦ͷʮ˦ɻʇ੮ ͐ʩʇ੮ɻ˺͙̼͐੮͐˺੮ɘˑˑ˺͸੮͐ʩʇ˚੮͐˺੮ɻ˺˦͐ʮ˦͙ʇ੮̼͐ʇɘ͐ʮ˦ʡ੮͐ʩɘ͐੮̹ɘ͐ʮʇ˦͐ੳ Iʮͷʇ˦੮ ͐ʩʮͅੴ੮ ˚ɘ˦;੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʩʇɘ̼ʮ˦ʡͅ੮ ફˑʮˌʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ͅબ੮ ʠ˺ɻ͙ͅ੮ ˺˦੮ ͸ʩʇ͐ʩʇ̼੮ ͐ʩʇ੮ ̹ɘ͐ʮʇ˦͐੮ ɻɘ˦੮ ̹̼ʇͅʇ˦͐੮ ͅ˺˚ʇ੮ ˚ʮ˦ʮ˚ɘˑˑ;੮ ̹ˑɘ͙ͅʮɺˑʇ੮ɺˑ͙ʇ̹̼ʮ˦͐੮ʠ˺̼੮ͅʇˑʠચɻɘ̼ʇ੮ɘ˦ʁ੮͸ʩʇ͐ʩʇ̼੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴ੮ɻʮ̼ɻ͙˚ͅɻ̼ʮɺʇʁ੮ʮ˦੮͸ʩɘ͐੮ ͐ʩʇ;੮ ɻɘ˦੮ ͐ʇˑˑ੮ ͐ʩʇ੮ ɻ˺͙̼͐ੴ੮ ɻɘ˦੮ ʮ˦ͷɘˑʮʁɘ͐ʇ੮ ʮ͐ੳ੮ )˺͙ʡੴ੮ ɘ੮ ͷʇ͐ʇ̼ɘ˦੮ ɻ˺͙˦͐;੮ ɻ˺͙˦ͅʇˑ੮ ʮ˦੮

132

T H E C O N S E RVATO R S H I P C O N T I N U U M

‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ɺ̼ɘʡʡʇʁ੮͐ʩɘ͐੮ુU੮͸ʮ˦੮৹৵੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮͐ʮ˚ʇੳૂ੮U˦੮ʠɘɻ͐ੴ੮ુUૄͷʇ੮ ˺˦ˑ;੮ˑ˺͐ͅ੮͐͸ʮɻʇੴ੮ɘ˦ʁ੮ʮ͐੮͸ɘͅ੮ʠ˺̼੮͐ʩʇ੮ͅɘ˚ʇ੮̹ʇ̼ͅ˺˦ੳૂ੮)˺͙ʡૄͅ੮ʁʇͅɻ̼ʮ̹͐ʮ˺˦ઝ͸ʩʮɻʩ੮ ͙˦ʁ˺͙ɺ͐ʇʁˑ;੮ɻ˺͙ˑʁ੮ɺʇ੮̼ʇɘʁ੮ɘͅ੮̹ʇˈ˺̼ɘ͐ʮͷʇઝɻɘ̹͙̼͐ʇͅ੮ʩ˺͸੮͐ʩʇ੮ˑʇʡɘˑ੮̹̼˺ɻʇͅͅ੮˺ʠ͐ʇ˦੮ ͅʇʇ˚ͅ੮ ͐˺੮ ͅʇ͐੮ ̹ɘ͐ʩ˺ˑ˺ʡ;੮ ͐˺੮ ͐ʩʇ੮ ͅʮʁʇੵ੮ ુPʇ੮ ͸ɘͅ੮ ɘͅ੮ ɻ̼ɘΈ;੮ ɘͅ੮ ɻ̼ɘΈ;੮ ɻ˺͙ˑʁ੮ ɺʇੳ੮ Pʇ੮ ɺʇˑʮʇͷʇʁ੮ʩʇ੮͸ɘͅ੮̼ʇɘˑˑ;੮ʠ̼˺˚੮ɘ˦˺͐ʩʇ̼੮̹ˑɘ˦ʇ͐ੳ੮Pʇ੮ɺʇˑʮʇͷʇʁ੮͐ʩʇ̼ʇ੮͸ɘͅ੮ɘ੮˚ʇɻʩɘ˦ʮɻɘˑ੮ ʁʇͷʮɻʇ੮ ʮ˦੮ ʩʮͅ੮ ɻʩʇ͐ͅ੮ ͐ʩɘ͐੮ ɻɘˑˑʇʁ੮ ʩʮ˚੮ ͐˺੮ ʁ˺੮ ͐ʩʮ˦ʡͅ੮ ʩʇ੮ ʁʮʁ˦ૄ͐੮ ͸ɘ˦͐੮ ͐˺੮ ʁ˺ੳ੮ Pʇ੮ɺʇˑʮʇͷʇʁ੮͐ʩʇ੮̹̼ʇͅʮʁʇ˦͐੮͸ɘͅ੮ɺ̼ɘʩɘ˚੮rʮ˦ɻ˺ˑ˦ੳ੮"͙͐੮ʩʇ੮ɻ˺͙ˑʁ੮ɘ̼͐ʮɻ͙ˑɘ͐ʇ੮ͷʇ̼;੮ ͸ʇˑˑ੯ ੳ੯ ੳ੯ ੳ੮ ͐ʩɘ͐੮ ʩʇ੮ ʩɘͅ੮ ääU੮ યʁʮͅɘɺʮˑʮ͐;੮ ʮ˦ɻ˺˚ʇર੮ ɘ˦ʁ੮ ͐ʩɘ͐੮ ʩʇ੮ ͸˺͙ˑʁ੮ ɺ͙ʁʡʇ͐੮ ɘ˦ʁ੮ ͸˺͙ˑʁ˦ૄ͐੮ɺ͙;੮ϲʮˑʇ͐੮˚ʮʡ˦˺˦੮ɘ˦ʁ੮̼͙˦੮˺͙͐੮˺ʠ੮˚˺˦ʇ;ੳ੮Pʇ੮͸ɘͅ੮̼͐ͅʇʇ͐੮ͅ˚ɘ̼͐ੳ੮Pʇ੮͸ɘͅ੮ ʠɘ˚ʮˑʮɘ̼੮͸ʮ͐ʩ੮͐ʩʇ੮ͅʩʇˑ͐ʇ̼੮ͅ;͐ͅʇ˚੮ɘ˦ʁ੮ɘɺˑʇ੮͐˺੮ɘ̼͐ʮɻ͙ˑɘ͐ʇ੮͐˺੮͐ʩʇ੮ͅɘ͐ʮͅʠɘɻ͐ʮ˺˦੮˺ʠ੮ ͐ʩʇ੮ˈ͙̼;੮͐ʩɘ͐੮ʩʇ੮ɻ˺͙ˑʁ੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮˺̼੮ͅʩʇˑ͐ʇ̼ੳૂ੮)˺͙ʡ੮ɻˑ˺ͅʇʁ੮ʩʮͅ੮ ˦ɘ̼̼ɘ͐ʮͷʇੵ੮ુPʇૄͅ੮ɺʇʇ˦੮ʮ˦੮͐ʩʇ੮ͅ;͐ͅʇ˚ੳ੮Û˺͙˦ʁ੮ɘ˦ʁ੮̼˺͙˦ʁੳ੮)˺ʇͅ˦ૄ͐੮͐ɘˌʇ੮ʩʮͅ੮˚ʇʁͅੳ੮ Ĕʇૄˑˑ੮ͅʇʇ੮ʩʮ˚੮ɘʡɘʮ˦ੳૂ /ͷʇ˦੮ ͐ɘˌʮ˦ʡ੮ ͐ʩʇͅʇ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅ੮ ʮ˦͐˺੮ ɘɻɻ˺͙˦͐ੴ੮ ͐ʩʇ̼ʇ੮ ͸ʇ̼ʇ੮ ͐ͅʮˑˑ੮ ɻɘͅʇͅ੮ ʮ˦੮ ͸ʩʮɻʩ੮ k͙ʁʡʇ੮)ɘͷʮͅ੮ͅʇʇ˚ʇʁ੮ˑ˺ɻˌʇʁ੮ʮ˦͐˺੮˚ɘˌʮ˦ʡ੮ʁʇɻʮͅʮ˺˦ͅ੮͐ʩɘ͐ੴ੮͐˺੮ɘ˦੮˺͙͐ͅʮʁʇ̼ੴ੮ɺ˺̼ʁʇ̼ʇʁ੮ ˺˦੮ ͙˦ʠɘ͐ʩ˺˚ɘɺˑʇੳ੮ {ͅੳ੮ #ɘ͐ͅʮˑˑ˺੮ ʮͅ੮ ɘ੮ ;˺͙˦ʡચ͐˺ચ˚ʮʁʁˑʇચɘʡʇʁ੮ rɘ͐ʮ˦ɘ੮ ͸ʩ˺੮ ɻɘ˚ʇ੮ ɺʇʠ˺̼ʇ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʠ˺̼੮ɘ˦੮ʮ˦ʮ͐ʮɘˑ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐੮ʠ˺̼੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੳ੮Pʇ̼੮ͅ˺ʠ͐੮ͷ˺ʮɻʇ੮ʮͅ੮ ˚ɘʁʇ੮ʇͷʇ˦੮ʩɘ̼ʁʇ̼੮͐˺੮ʮ˦͐ʇ̼̹̼ʇ͐੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮̼͐ʮɘˑ੮ɺ;੮͐ʩʇ੮ɻʩ˺̹̹;੮ή͙ɘˑʮ͐;੮˺ʠ੮ʩʇ̼੮ Ĕʇɺ/ͽ੮ɻ˺˦˦ʇɻ͐ʮ˺˦੮ɘ˦ʁ੮͐ʩʇ੮ʠɘɻ͐੮͐ʩɘ͐੮ʩʇ̼੮͸ʩʇʇˑɻʩɘʮ̼੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮̹ɘ̼ˌʇʁ੮͐˺˺੮ʠɘ̼੮ ɘ͸ɘ;੮ʠ̼˺˚੮͐ʩʇ੮˚ʮɻੳ੮Pʇ̼੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮)̼ੳ੮{˺̼͐˺˦ੴ੮ʮͅ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐;੮̼ʇͅʮʁʇ˦͐੮˺˦ʇ੮ɘ˦ʁ੮ɘ੮ʩɘˑʠ੮;ʇɘ̼ͅ੮˺͙͐੮˺ʠ੮˚ʇʁʮɻɘˑ੮ͅɻʩ˺˺ˑੳ੮äʩʇ੮ʡ̼ʇʇ͐ͅ੮͐ʩʇ੮ˈ͙ʁʡʇ੮ ͸ʮ͐ʩ੮ɘ੮ૃPʮ੸ૄ੮ͅ˺੮ɻʩʮ̹̹ʇ̼੮ʮ͐੮̹̼˺˚̹͐ͅ੮ɘ੮ʡ͙ʠʠɘ͸੮ʠ̼˺˚੮˦ʁ;ੳ੮Ěʇ͐੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺੮ͅʇʇ˚ͅ੮ ͐˺੮ɺʇ੮ɺʇ˦ʇϲʮ͐ʮ˦ʡ੮ʠ̼˺˚੮͐ʩʇ੮ʡ̼ʇɘ͐ʇ̼੮ɘ͐͐ʇ˦͐ʮͷʇ˦ʇͅͅ੮˺ʠ੮̼͐ɘʮ˦ʇʇͅ੮ͷʇ̼͙ͅͅ੮ɘ͐͐ʇ˦ʁʮ˦ʡ੮̹ʩ;ͅʮɻʮɘ˦ͅੵ੮ૃĔʩʇ˦੮ʁʮʁ੮;˺͙੮ˑɘ͐ͅ੮ʇͷɘˑ͙ɘ͐ʇ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੺ૄ੮ɻ˺͙˦ͅʇˑ੮ɘͅˌͅੳ੮ૃîʩʮͅ੮˚˺̼˦ʮ˦ʡੳૄ੮ U˦੮ʠɘɻ͐ੴ੮ͅʩʇૄͅ੮ɺʇʇ˦੮ͅʇʇʮ˦ʡ੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺੮ʇͷʇ̼;੮˚˺̼˦ʮ˦ʡઝɘ˦ʁ੮ૃͅ˺˚ʇ͐ʮ˚ʇͅ੮͐͸ʮɻʇ੮ɘ੮ ʁɘ;ૄઝͅʮ˦ɻʇ੮ͅʩʇ੮͸ɘͅ੮ɘʁ˚ʮ͐͐ʇʁ੮͐ʩ̼ʇʇ੮͸ʇʇˌͅ੮̹̼ʮ˺̼ੳ )̼ੳ੮{˺̼͐˺˦੮͐ʇ͐ͅʮϲʮʇͅ੮͐ʩɘ͐੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺੮ʩɘͅ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੴ੮ʩɘͅ੮ૃ˦˺੮ʮ˦ͅʮʡʩ͐ੴૄ੮ɘ˦ʁ੮ ʩɘͅ੮ʇͽ̹ˑʮɻʮ͐ˑ;੮͐˺ˑʁ੮ʩʇ̼੮ͅʩʇ੮͸ʮˑˑ੮˦˺͐੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ʮʠ੮̼ʇˑʇɘͅʇʁੳ੮{˺̼ʇ˺ͷʇ̼ੴ੮ͅʩʇ੮ʩɘͅ੮ ૃʁʇˑ͙ͅʮ˺˦ͅ੮˺ʠ੮̹ʇ̼ͅʇɻ͙͐ʮ˺˦ૄ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮P˺˚ʇˑʇͅͅ੮š͙̼͐ʇɘɻʩ੮îʇɘ˚੮ફ͸ʩʮɻʩੴ੮ ʡʮͷʇ˦੮ ͐ʩʇʮ̼੮ ʮ˦ͷ˺ˑͷʇ˚ʇ˦͐੮ ʮ˦੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ͅʩʇ੮ ʁʮʁ˦ૄ͐੮ ͸ɘ˦͐ੴ੮ ʮͅ੮ ˦˺͐੮ ɺɘͅʇˑʇͅͅબੳ੮ ૃäʩʇ੮ɺʇˑʮʇͷʇͅ੮͐ʩɘ͐੮Pšî੮ʮͅ੮̼͐;ʮ˦ʡ੮͐˺੮̹˺ʮͅ˺˦੮ʩʇ̼ੴ੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮̼͐;ʮ˦ʡ੮͐˺੮ʇˑʮ˚ʮ˦ɘ͐ʇ੮ ͐ʩʇ੮ુäʮ͐ͅʇ̼ͅ੮˺ʠ੮͐ʩʇ੮)ʮͷʮ˦ʇੴૂ੮ɘ˦ʁ੮͐ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮͐ɘˌʮ˦ʡ੮͐ʩʇ੮ʠ˺̼˚੮˺ʠ੮˦͙̼ͅʇͅ੮˺̼੮̹˺ˑʮɻʇ੮ ˺ϲϲʮɻʇ̼ͅ੮͐˺੮ͅ˦ʇɘˌ੮ʮ˦͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૄ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ૄͅ੮ɻ̼˺ͅͅચʇͽɘ˚ʮ˦ɘ͐ʮ˺˦੮̼͐ͅʮ̹ͅ੮ɺɘͅʮɻ੮˦ʇʇʁͅ੮ʁ˺͸˦੮͐˺੮ɘ੮˚ʮ˦ʮ˚͙˚ੵ੮ૃĚ˺͙੮͐ʇ͐ͅʮϲʮʇʁ੮ͅʩʇ੮͸˺͙ˑʁ˦ૄ͐੮ɘɻɻʇ̹͐੮ʠ˺˺ʁ੮ʠ̼˺˚੮͐ʩʇ੮Pšî੮͐ʇɘ˚੮˺˦੮͐ʩʇ੮˺͙͐ͅʮʁʇ੺ૄ ૃîʩɘ͐ૄͅ੮ɻ˺̼̼ʇɻ͐ੴૄ੮)̼ੳ੮{˺̼͐˺˦੮̼ʇ̹ͅ˺˦ʁͅੳ

C O U RT

133

ૃ"͙͐੮͸˺͙ˑʁ੮ͅʩʇ੮ɘɻɻʇ̹͐੮ʠ˺˺ʁ੮ʠ̼˺˚੮̹ʇ˺̹ˑʇ੮˦˺͐੮ʠ̼˺˚੮͐ʩʇ੮Pšî੮͐ʇɘ˚੺ૄ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮̹̼ʇͅͅʇͅੳ ૃĔʇૄ̼ʇ੮͸˺̼̼ʮʇʁ੮ͅʩʇ੮͸˺͙ˑʁ੮ɺʇ੮̹ɘ̼ɘ˦˺ʮʁ੮ɘ˦ʁ੮͐ʩʮ˦ˌ੮͐ʩʇ;ૄ̼ʇ੮͐ʩʇ੮Pšî੮͐ʇɘ˚ੴૄ੮ͅʩʇ੮ ̼ʇ̹ˑʮʇͅੳ ૃä˺ੴ੮ͅʩʇ੮͸˺͙ˑʁ੮˦˺͐੮ɘɻɻʇ̹͐੮ɘˑˑ੮ʠ˺˺ʁੴ੮ɺ͙͐੮ͅʩʇ੮ɻ˺͙ˑʁ੮ɘɻɻʇ̹͐੮ͅ˺˚ʇ੺ૄ ૃĚʇͅੴૄ੮)̼ੳ੮{˺̼͐˺˦੮ɻ˺˦ɻʇʁʇͅੳ Ĕʩʇ˦੮ʮ͐੮ʮͅ੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺ૄͅ੮͙̼͐˦੮͐˺੮͐ɘˑˌੴ੮ͅʩʇ੮ͅʇʇ˚ͅઝɘ˦;੮̹ɘ̼ɘ˦˺ʮɘ੮ɘͅʮʁʇઝ͐˺੮ʩɘͷʇ੮ ɺʇʇ˦੮͸ʇˑˑ੮ɻ˺ɘɻʩʇʁ੮˺˦੮͐ʩʇ੮ɻ̼͙ͽ੮˺ʠ੮͐ʩʇ੮̹̼˺ɻʇʁ͙̼ʇੳ੮"ʇʠ˺̼ʇ੮ͅʩʇ੮ʮͅ੮ͅ͸˺̼˦੮ʮ˦ੴ੮ͅʩʇ੮͐ͅɘ͐ʇͅੴ੮ ૃU੮ˈ͙͐ͅ੮͸ɘ˦͐੮;˺͙੮͐˺੮ˌ˦˺͸੮͐ʩɘ͐੮U੮ɻɘ˦੮͐ɘˌʇ੮ɻɘ̼ʇ੮˺ʠ੮˚;ͅʇˑʠੳૄ੮ä͐ʮˑˑੴ੮ʩʇ̼੮̹ˑɘ˦੮ʮͅ੮ˑʇͅͅ੮͐ʩɘ˦੮ ʩɘˑʠચɺɘˌʇʁੳ੮äʩʇ੮ͅɘ;ͅ੮ͅʩʇ੮͸ʮˑˑ੮ૃʡ˺੮ʮ˦͐˺੮ˑ˺˦ʡચ͐ʇ̼˚੮ʩ˺͙ͅʮ˦ʡૄ੮ɘ˦ʁੴ੮͸ʩʮˑʇ੮͸ɘʮ͐ʮ˦ʡੴ੮ૃ͐ʩʇ੮ ˚ʮ˦ʮ͐ͅʇ̼੮ʠ̼˺˚੮˚;੮ɻʩ͙̼ɻʩ੮͸ʮˑˑ੮̹͙͐੮˚ʇ੮ʮ˦੮ɘ੮ʩ˺͐ʇˑੳૄ੮äʩʇ੮ɻɘ˦ૄ͐੮˦ɘ˚ʇ੮͸ʩʮɻʩ੮ɻʩ͙̼ɻʩੳ੮ Pʇ̼੮̹ˑɘ˦੮ʠ˺̼੮ʠ˺˺ʁ੮ɘ˦ʁ੮ɻˑ˺͐ʩʮ˦ʡ੮ʮͅ੮͐ʩɘ͐੮ૃ͐ʩʇ੮ˑ˺˦ʡચ͐ʇ̼˚੮ʩ˺͙ͅʮ˦ʡ੮͸ʮˑˑ੮ʡʮͷʇ੮˚ʇ੮ʇͷʇ̼;͐ʩʮ˦ʡ੮ U੮ ˦ʇʇʁੳૄ੮ Pʇ̼੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼ੴ੮ ̹ʇ̼ʩɘ̹ͅ੮ ɘ͸ɘ̼ʇ੮ ͐ʩɘ͐੮ ʡʇ͐͐ʮ˦ʡ੮ ʮ˦͐˺੮ ˑ˺˦ʡચ͐ʇ̼˚੮ ʩ˺͙ͅʮ˦ʡ੮ʮͅ੮˦˺͐੮ͅ˺੮ʇɘͅ;ੴ੮ͅ͸ʮ͐ɻʩʇͅ੮͐˺੮ʩ;̹˺͐ʩʇ͐ʮɻɘˑͅੵ੮ૃä˺੮;˺͙੮͸˺͙ˑʁ੮ɘɻɻʇ̹͐੮ʩʇˑ̹੮ʠ̼˺˚੮ ɘ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼੮ʮʠ੮˺ʠʠʇ̼ʇʁ੺ૄ ૃĚʇͅੳૄ Pʇ̼੮ ˑɘ͸;ʇ̼੮ ͐ʩʇ˦੮ ̹ʮͷ˺͐ͅ੮ ͐˺੮ ʁʮͅɻ͙ͅͅʮ˦ʡ੮ {ͅੳ੮ #ɘ͐ͅʮˑˑ˺ૄͅ੮ ̹ˑɘ˦੮ ʠ˺̼੮ ɘʁʁ̼ʇͅͅʮ˦ʡ੮ ʩʇ̼੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩੳ੮äʩʇ੮˚ʮʡʩ͐੮ή͙ʮɻˌˑ;੮̼ʇʡ̼ʇ͐੮͐ʩʇ੮ͅ͸ʮ͐ɻʩੵ੮ૃĔʩʇ̼ʇ੮͸˺͙ˑʁ੮;˺͙੮ͅʇʇˌ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮʠ੮;˺͙੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁ੺ૄ {ͅੳ੮#ɘ͐ͅʮˑˑ˺੮̼ʇ̹ˑʮʇͅ੮ɻ˺˦ϲʮʁʇ˦͐ˑ;ੴ੮ૃU੮ʁ˺˦ૄ͐੮˦ʇʇʁ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮U੮ʁ˺˦ૄ͐੮ ʩɘͷʇ੮ɘ˦;੮ʩʮ͐ͅ˺̼;੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮ɘ˦ʁ੮ͅ˺੮U੮͸˺͙ˑʁ˦ૄ͐੮ʡ˺ੳૄ š˦੮ ɻ̼˺ͅͅચʇͽɘ˚ʮ˦ɘ͐ʮ˺˦ੴ੮ ɻ˺͙˦͐;੮ ɻ˺͙˦ͅʇˑ੮ ɺ̼ʮ˦ʡͅ੮ ͐ʩʇ੮ ɻ˺͙̼͐੮ ɺɘɻˌ੮ ͐˺੮ ʮ͐ͅ੮ ɻʇ˦̼͐ɘˑ੮ ʮ͙ͅͅʇੳ੮ૃĔʩʇ˦੮;˺͙੮͸ʇ̼ʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮͸ʩɘ͐੮͸ʇ̼ʇ੮;˺͙੮ʁ˺ʮ˦ʡ੮ʠ˺̼੮ʠ˺˺ʁ੺ૄ ૃU੮ɘͅˌʇʁ੮̹ʇ˺̹ˑʇ੮͐˺੮ɺ͙;੮ʮ͐੮ʠ˺̼੮˚ʇੴૄ੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺੮͐ͅɘ͐ʇͅੳ ૃ˦ʁ੮;˺͙੮͸ʇ̼ʇ˦ૄ͐੮͐ͅɘ;ʮ˦ʡ੮ʮ˦੮ɘ੮ͅʩʇˑ͐ʇ̼ੴ੮͸ʇ̼ʇ੮;˺͙੺੮Ě˺͙੮ˑʇʠ͐ੳૄ ૃ‡˺ੴ੮U੮͸ɘͅ˦ૄ͐ੴૄ੮ͅʩʇ੮ɘʁ˚ʮ͐ͅੳ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ˈ͙˚̹ͅ੮ʮ˦੮͐˺੮̹˺ͅʇ੮˺˦ʇ੮˚˺̼ʇ੮ή͙ʇ͐ͅʮ˺˦ੴ੮ૃš˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮;˺͙੮ were staying in a bus stop?’ ૃU੮͸ɘͅ੮ɻˑ˺ͅʇੴૄ੮ͅʩʇ੮̼ʇ̹ˑʮʇͅੳ੮˦ʁ੮͐ʩɘ͐੮ʮͅ੮ɘˑˑ੮͐ʩʇ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʩɘͅ੮͐˺੮ ͸ʇʮʡʩ੮͐ʩʮͅ੮͸˺˚ɘ˦ૄͅ੮͙̼ͅͷʮͷɘˑ੮ɘʡɘʮ˦͐ͅ੮ʩʇ̼੮ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੳ k͙ʁʡʇ੮)ɘͷʮͅ੮͐ͅɘ̼͐ͅ੮ʩʇ̼੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ͅˑ˺͸ˑ;੮ɘ˦ʁ੮˚ʇ͐ʩ˺ʁʮɻɘˑˑ;ੵ੮ૃĔʩɘ͐੮U੮ʩɘͷʇ੮ʩʇ̼ʇ੮ ʮͅ੮ɘ੮ʁʇˑ͙ͅʮ˺˦੮˺ʠ੮̹ʇ̼ͅʇɻ͙͐ʮ˺˦੮ɺ;੮͐ʩʇ੮Pšî੮͐ʇɘ˚ੴ੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ͅ˦ʇɘˌ੮ʮ˦͐˺੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ɘ˦ʁ੮ ͐ɘˌʇ੮ ɘ͸ɘ;੮ ͐ʩʇ੮ äʮ͐ͅʇ̼ͅ੮ ˺ʠ੮ ͐ʩʇ੮ )ʮͷʮ˦ʇੳૄ੮ äʩʇ੮ ʡ˺ʇͅ੮ ˺˦ੴ੮ ૃ͐ʩʇ੮ ˦ʇͽ͙ͅ੮ testimony’—about the relationship between her illness and her ability to meet ʩʇ̼੮ɺɘͅʮɻ੮˦ʇʇʁͅઝૃʮͅ੮͐ʩɘ͐੮ͅʩʇ੮˚ɘ;੮̼ʇʠ͙ͅʇ੮ͅʩʇˑ͐ʇ̼ੳ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮˦˺͐੮͙ͅʇʁ੮͐˺੮ ɻ˺˦ͅʇ̼ͷʇ੮ ̹ʇ˺̹ˑʇ੮ ˈ͙͐ͅ੮ ɺʇɻɘ͙ͅʇ੮ ͐ʩʇ;ૄ̼ʇ੮ ʩ˺˚ʇˑʇͅͅੳ੮ U੮ ɘ˚੮ ͷʇ̼;੮ ɻ˺˦ɻʇ̼˦ʇʁ੮ ɘɺ˺͙͐੮ ͐ʩʇ੮

134

T H E C O N S E RVATO R S H I P C O N T I N U U M

ʩ˺˚ʇˑʇͅͅੳ੮"͙͐੮Uૄ˚੮˦˺͐੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩɘ͐੮ʩʇ̼੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮ɺʇ੮ͅʩʇˑ͐ʇ̼ʇʁ੮ʮͅ੮ɺɘͅʇʁ੮˺˦੮ɘ੮ ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʠ̼˺˚੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ੮îʩɘ͐੮ˑʮ˦ˌɘʡʇ੮˚ʮʡʩ͐੮ͅʇʇ˚੮˦ɘ͙̼͐ɘˑੴ੮ɺ͙͐੮͐ʩʇ੮ ͐ʇ͐ͅʮ˚˺˦;੮̼͐ͅʮˌʇͅ੮˚ʇ੮ɘͅ੮ɘ੮ɺʮ͐੮͐ʇ˦͐ɘ͐ʮͷʇੳૄ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ੴ੮ͅ˚ʇˑˑʮ˦ʡ੮ɘ˦੮˺̹̹˺̼͙͐˦ʮ͐;ੴ੮ʁʇɻˑɘ̼ʇͅੴ੮ૃĚ˺͙̼੮ʩ˺˦˺̼ੴ੮˚ɘ;੮U੮ submit an argument?’ ˦ʁ;੮ ͸ɘͷʇͅ੮ ʩʇ̼੮ ˺ʠʠੴ੮ ͅ˺͙˦ʁʮ˦ʡ੮ ʮ˦ɻʇ˦ͅʇʁੵ੮ ૃîʩʇ੮ ɻ˺͙̼͐੮ ʩɘͅ੮ ɘˑ̼ʇɘʁ;੮ ˚ɘʁʇ੮ ʮ͐ͅ੮ ʁʇɻʮͅʮ˺˦ੳૄ k͙ʁʡʇ੮)ɘͷʮͅ੮ͅʮʡʩͅੴ੮ɘ˦ʁ੮ɘ˦˦˺͙˦ɻʇͅ੮ͅ˺ʠ͐ˑ;੮ɺ͙͐੮ϲʮ̼˚ˑ;ੴ੮ૃîʩʇ੮̹ʇ͐ʮ͐ʮ˺˦੮ʮͅ੮ʁʇ˦ʮʇʁੳૄ "ʇʠ˺̼ʇ੮{ͅੳ੮#ɘ͐ͅʮˑˑ˺੮ͅʮʡ˦ͅ੮˺ʠʠੴ੮ʩʇ̼੮ˑɘ͸;ʇ̼੮̹ˑʇɘʁͅ੮͸ʮ͐ʩ੮ʩʇ̼ੴ੮ૃ{ͅੳ੮#ɘ͐ͅʮˑˑ˺ੴ੮ʮʠ੮͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮˺ʠʠʇ̼ͅ੮͐˺੮̼͐ɘ˦̹ͅ˺̼͐੮;˺͙੮͐˺੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇੴ੮;˺͙੮ͅʩ˺͙ˑʁ੮ʡ˺ੴ੮˺ˌɘ;੺੮šˌɘ;੺ૄ੮ ‡˺੮̼ʇ̹ͅ˺˦ͅʇੳ îʩʇ੮͐ͅɘ˦ʁɘ̼ʁ੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮ʇͽɻˑ͙ʁʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ુ͙˦͙͙ͅɘˑ੮ ˺̼੮˦˺˦ɻ˺˦ʠ˺̼˚ʮ͐ͅ੮ˑʮʠʇ͐ͅ;ˑʇͅੴૂ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮ʇɻɻʇ˦̼͐ʮɻͅ੮˺̼੮ʁʇͷʮɘ˦͐ͅ੮͐ʩɘ͐੮ɻ̼ʮ͐ʮɻͅ੮ɘ̼ʡ͙ʇ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ʮͅ੮ ʁʇ̹ˑ˺;ʇʁ੮ ͐˺੮ ̼ʇ̹̼ʇͅͅੳ৽৽੮ Ĕʩɘ͐੮ ʠ̼͙̼͐ͅɘ͐ʇͅ੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੴ੮

TABLE 6.1

nʇ;੮rØä੮ɻɘͅʇ੮ˑɘ͸

Conservatorship ˃ɩ‫פ‬#ɲȡʣɃɐ̅̎

ৼ਄ਂਂ

)ʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦ͅ੮˺ʠ੮ુʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ૂ੮˚͙͐ͅ੮ુʇͽɻˑ͙ʁʇ੮͙˦͙͙ͅɘˑ੮˺̼੮ ˦˺˦ɻ˺˦ʠ˺̼˚ʮ͐ͅ੮ˑʮʠʇ͐ͅ;ˑʇͅੳૂ

Doe v. Gallinot

ৼ਄ਂ਄

Ûʇή͙ʮ̼ʇͅ੮ɘ੮ુ̹̼˺ɺɘɺˑʇ੮ɻɘ͙ͅʇૂ੮ʩʇɘ̼ʮ˦ʡ੮͐˺੮ɘ͙͐ʩ˺̼ʮΈʇ੮ɻ˺˦͐ʮ˦͙ʇʁ੮ ʁʇ͐ʇ˦͐ʮ˺˦੮͸ʮ͐ʩʮ˦੮ʠ˺͙̼੮ʁɘ;ͅ੮˺ʠ੮ɘ੮਀৽਀৻ੳ

Conservatorship ˃ɩ‫פ‬/ȡ̅ʚ͇

ৼ਄ਃ৾

੮̹ʇ̼ͅ˺˦੮ʮͅ੮˦˺͐੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ʮʠ੮͐ʩʇ;੮ɘ̼ʇ੮ુɻɘ̹ɘɺˑʇ੮˺ʠ੮ͅɘʠʇˑ;੮ ͙̼ͅͷʮͷʮ˦ʡ੮ʮ˦੮ʠ̼ʇʇʁ˺˚੮͸ʮ͐ʩ੮͐ʩʇ੮ʩʇˑ̹੮˺ʠ੮͸ʮˑˑʮ˦ʡ੮ɘ˦ʁ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅੴ੮ʠ̼ʮʇ˦ʁͅੴ੮˺̼੮͐ʩʮ̼ʁ੮̹ɘ̼͐ʮʇͅੳૂ

Conservatorship ˃ɩ‫"פ‬ɐʯɐ̢̙̀˃

ৼ਄ਃਁ

I̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮˚͙͐ͅ੮ɺʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮ɺɘͅʇʁ੮˺˦੮ɘ੮̹ʇ̼ͅ˺˦ૄͅ੮ɻ͙̼̼ʇ˦͐੮ ͐ͅɘ͐ʇੴ੮˦˺͐੮ɘ੮ુ̹ʇ̼ɻʇʮͷʇʁ੮ˑʮˌʇˑʮʩ˺˺ʁ੮˺ʠ੮ʠ͙͙̼͐ʇ੮̼ʇˑɘ̹ͅʇੳૂ

Ûɷɐ̎ɐ‫ףר̀ף‬ä͗‫{ףר‬ȡ͇̅‫ৼ ף̎إ‬਄ਃ਄ P˃̎̂ɷ͗ȡʚ

Øɘ͐ʮʇ˦͐ͅ੮͙ͅɺˈʇɻ͐੮͐˺੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮˚͙͐ͅ੮ʩɘͷʇ੮ɘ੮ͅʇ̹ɘ̼ɘ͐ʇ੮ ʩʇɘ̼ʮ˦ʡ੮˺˦੮͐ʩʇʮ̼੮ુɻɘ̹ɘɻʮ͐;ૂ੮͐˺੮̼ʇʠ͙ͅʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɺʇʠ˺̼ʇ੮͐ʩʇ;੮ɻɘ˦੮ɺʇ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮˚ʇʁʮɻɘ͐ʇʁੳ

Conservatorship ˃ɩ‫פ‬I̢ɐ̅̅ɐ̅˃

ৼ਄਄਄

੮̹ʇ̼ͅ˺˦੮ɻɘ˦੮ɺʇ੮ʠ˺͙˦ʁ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ʮʠ੮͐ʩʇ;੮ુˑɘɻˌ੮ʮ˦ͅʮʡʩ͐੯ੳ੯ੳ੯ੳ੮ ʁ˺ʇͅ੮˦˺͐੮ɺʇˑʮʇͷʇ੮ʩʇ੮˺̼੮ͅʩʇ੮˦ʇʇʁͅ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮͸ʮˑˑ੮˦˺͐੮͐ɘˌʇ੮ medication without supervision and as a result will be unable to ̹̼˺ͷʮʁʇ੮ʠ˺̼੮ʩʮͅ੮˺̼੮ʩʇ̼੮˺͸˦੮ɺɘͅʮɻ੮˦ʇʇʁͅੳૂ

People v. Sanchez

৽৻ৼਁ

/ͽ̹ʇ̼͐ͅ੮˚ɘ;੮͐ʇ͐ͅʮʠ;੮˺˦ˑ;੮ɘɺ˺͙͐੮ʁʮ̼ʇɻ͐੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦੮˺̼੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦ͅ੮ ͸ʮ͐ʩ੮ɘ੮̹ɘ͐ʮʇ˦͐੶੮ʡʇ˦ʇ̼ɘˑˑ;੮̹̼ʇɻˑ͙ʁʇͅ੮͐ʇ͐ͅʮ˚˺˦;੮ɺɘͅʇʁ੮˺˦੮͐ʩʇ੮˚ʇʁʮɻɘˑ੮ ̼ʇɻ˺̼ʁ੮˺̼੮͐ʩʮ̼ʁચ̹ɘ̼͐;੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅੳ

C O U RT

135

ʠɘ˚ʮˑʮʇͅੴ੮ ɘ˦ʁ੮ ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ˈ͙ʁʡʇͅ੮ ɘ˦ʁ੮ ˑɘ͸;ʇ̼ͅ੮ ͐ʩʇ˚ͅʇˑͷʇͅ੮ ʮͅ੮ ͐ʩɘ͐੮ {ͅੳ੮ #ɘ͐ͅʮˑˑ˺ૄͅ੮ ͅʮ͙͐ɘ͐ʮ˺˦ઝͅʮ͐͐ʮ˦ʡ੮ ʮ˦੮ ɘ੮ ͸ʩʇʇˑɻʩɘʮ̼੮ ɺ;੮ ɘ੮ ɺ͙ͅ੮ ͐ͅ˺̹ੴ੮ ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ɘɻɻʇ̹͐ʮ˦ʡ੮ ʠ˺˺ʁઝ ʁ˺ʇͅ˦ૄ͐੮ ͅʇʇ˚੮ ˑʮˌʇ੮ ɘ੮ ˑʮʠʇ͐ͅ;ˑʇ੮ ˦˺̼ੴ੮ ʡʮͷʇ˦੮ ʩʇ̼੮ ̹ͅ;ɻʩ˺͐ʮɻ੮ ͅ;˚̹͐˺˚ͅੴ੮ ɘ੮ ɻʩ˺ʮɻʇੳ੮ "͙͐੮ ʮ˦੮͐ʩʇ੮ʇ˦ʁੴ੮)̼ੳ੮{˺̼͐˺˦ૄͅ੮ɻ͙ˑ͙̼͐ɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʁʮɘʡ˦˺ͅʇ੮͐ʩʇ੮͸˺˚ɘ˦੮ɘͅ੮˚ʇʁʮɻɘˑˑ;੮ ʡ̼ɘͷʇˑ;੮ʮˑˑ੮ʁʮʁ੮˦˺͐੮̼͐ɘ˦ͅˑɘ͐ʇ੮ʮ˦͐˺੮ɺʇʮ˦ʡ੮ɘɺˑʇ੮͐˺੮ɻ˺˦ͷʮ˦ɻʮ˦ʡˑ;੮ʁʇϲʮ˦ʇ੮ʩʇ̼੮ɘͅ੮ˑʇʡɘˑˑ;੮ ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ

TOO SICK TO LOSE ͐੮͐ʩʇ੮̼ʮͅˌ੮˺ʠ੮͸ʩʮ̹ˑɘͅʩ੮ʠ˺̼੮͐ʩʇ੮̼ʇɘʁʇ̼ੴ੮U੮͸ɘ˦͐੮͐˺੮ʇ˚̹ʩɘͅʮΈʇ੮͐ʩɘ͐ੴ੮ʠ˺̼੮ɘˑˑ੮͐ʩʇͅʇ੮ˑʇʡɘˑ੮ ̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ɘ˦ʁ੮͐ʩʇʮ̼੮ʇͽɘɻ͐ʮ˦ʡ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮ɺ;੮ͅ˺˚ʇ੮ˈ͙ʁʡʇͅੴ੮͐ʩʇ੮ͷɘ͐ͅ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮ ̹ʇ˺̹ˑʇ੮ʠ˺̼੮͸ʩ˺˚੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ϲʮˑʇʁ੮ɺ;੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ ɘ̼ʇ੮ɻ˺˦ͅʇ̼ͷʇʁੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮ɘ˦ʁ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʠ̼˺˚੮˚˺̼ʇ੮͐ʩɘ˦੮͐͸˺੮ ʁ˺Έʇ˦੮ɻ˺͙˦͐ʮʇͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮ʇ͐ͅʮ˚ɘ͐ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺̹˺̼͐ʮ˺˦੮˺ʠ੮ɻɘͅʇͅ੮͐ʩɘ͐੮ʡ˺੮͐˺੮̼͐ʮɘˑ੮ ʮ˦੮͸ʩʮɻʩ੮̹ʇ͐ʮ͐ʮ˺˦ͅ੮ɘ̼ʇ੮ʡ̼ɘ˦͐ʇʁ੮̼ɘ˦ʡʇͅ੮ʠ̼˺˚੮৷ৰ੮͐˺੮ৱৰৰ੮̹ʇ̼ɻʇ˦͐੮ફɘ˦ʁ੮̼ʇ˚ʇ˚ɺʇ̼ੴ੮ɘͅ੮ ˚ɘ˦;੮ɘͅ੮͐ʩ̼ʇʇચή͙ɘ̼͐ʇ̼ͅ੮ʁ˺˦ૄ͐੮ʡ˺੮͐˺੮̼͐ʮɘˑ੮ɘ˦ʁ੮ɘ̼ʇ੮ʡ̼ɘ˦͐ʇʁ੮ɘ͙͐˺˚ɘ͐ʮɻɘˑˑ;੮ɺɘͅʇʁ੮˺˦੮ ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇૄͅ੮ુɻ˺˦ͅʇ˦͐ૂબੳ৽৾ š˦ʇ੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʮͅ੮͐ʩɘ͐ੴ੮ʮ˦੮ͅ˺˚ʇ੮ɻ˺͙˦͐ʮʇͅੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮ʁ˺˦ૄ͐੮͙ͅʇ੮Sanchez੮͐˺੮ˑʮ˚ʮ͐੮͐ʇ͐ͅʮ˚˺˦;ੳ੮ä˺˚ʇ੮ˈ͙ʁʡʇͅ੮ͅʇʇ˚੮͙˦ɻ˺˦ɻʇ̼˦ʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺˚̹ˑʇͽʮ͐;੮˺ʠ੮ ͅʩ˺͸ʮ˦ʡ੮ɘ੮ુ˦ʇͽ͙ͅૂ੶੮ɺʇʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮ʮͅ੮ʇ˦˺͙ʡʩੳ੮˦˺͐ʩʇ̼੮ʮͅ੮͐ʩɘ͐੮ ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʁ˺੮͐ʩʇʮ̼੮ˈ˺ɺͅ੮ɻ˺̼̼ʇɻ͐ˑ;ੳ੮ુU˦੮˺͙̼੮ɻ˺͙˦͐;ੴ੮͐ʩʇ;੮યˈ͙ʁʡʇͅર੮ˌ˦˺͸੮͸ʩʇ˦੮ ͸ʇ੮ɺ̼ʮ˦ʡ੮ɘ੮ɻɘͅʇੴ੮ʮ͐੮˚ʇʇ͐ͅ੮ɻ̼ʮ͐ʇ̼ʮɘੴૂ੮˺˦ʇ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺ˑʁ੮˚ʇੳ੮ુĔʇ੮ʁ˺˦ૄ͐੮ɺ̼ʮ˦ʡ੮ɻɘͅʇͅ੮ ɘ˦ʁ੮ʡ˺੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮͐ʩʇ੮ˈ͙ʁʡʇ੮͐˺੮ͅɘ;ੴ੮ૃ/ʩʩੴ੮ʮ͐੮ɻ˺͙ˑʁ੮ʡ˺੮ʇʮ͐ʩʇ̼੮͸ɘ;ੴ੮ʩʇૄͅ੮ɘ˦˦˺;ʮ˦ʡ੮͐ʩʇ੮ ɻ˺̹ͅੴ੮ͅ˺੮͸ʇ੮ϲʮˑʇʁ੮ˈ͙͐ͅ੮ʮ˦੮ɻɘͅʇੳૄૂ /ͷʇ˦੮ ͸ʩʇ˦੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ˚ɘ;੮ ɺʇ੮ ˑʇʡɘˑˑ;੮ ͸ɘ̼̼ɘ˦͐ʇʁੴ੮ ˚ɘ˦;੮ ʩʇɘ̼ʮ˦ʡͅ੮ ͐ͅʮˑˑ੮ ͙˦ʠ͙̼ˑ੮ɘͅ੮͸ʩɘ͐੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅͅ੮ɻɘˑˑ੮ɘ੮ુ͐ͅɘ͙͐ͅ੮ʁʇʡ̼ɘʁɘ͐ʮ˺˦੮ɻʇ̼ʇ˚˺˦;ૂ੮͐ʩɘ͐੮ɺ̼ʮ˦ʡͅ੮ɘɺ˺͙͐੮ ͐ʩʇ੮ુ̼ʮ͙͐ɘˑ੮ʁʇ̼͙͐ͅɻ͐ʮ˺˦ૂ੮˺ʠ੮͐ʩʇ੮˺˦ɻʇ੮ɘ͙͐˺˦˺˚˺͙ͅ੮͙ͅɺˈʇɻ͐੮ɘ˦ʁ੮͐ʩʇʮ̼੮̼ʇ̹ˑɘɻʇ˚ʇ˦͐੮ ͸ʮ͐ʩ੮ɘ੮̹ɘɻʮϲʮʇʁ੮˺ɺˈʇɻ͐ੴ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺˚੮ͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼੮ʩɘͅ੮ɻ˺˦ͅʮʡ˦ʇʁ੮͐˺੮ɘ੮ͅ˺ɻʮɘˑ੮ ʁʇɘ͐ʩੳ৽৿੮îʩʇ੮ʩʇɘ̼ʮ˦ʡ੮ʠ˺̼੮{ͅੳ੮k˺ʩ˦ͅ˺˦ੴ੮ɘ੮"ˑɘɻˌ੮͸˺˚ɘ˦੮ɻ˺˦ϲʮ˦ʇʁ੮ʮ˦੮ɘ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɺʇʡʮ˦ͅ੮͸ʮ͐ʩ੮ʮ͐ͅ੮˺͸˦੮͐͸ʇ˦͐;ચϲʮ̼͐ͅચɻʇ˦͙̼͐;੮̼ʮ͙͐ɘˑੵ੮͐ʇɻʩ˦ʮɻɘˑ੮ʮ͙ͅͅʇͅੳ੮U˦ʮ͐ʮɘˑˑ;ੴ੮ ͐ʩʇ੮ʁ˺ɻ͐˺̼੮ɘ̹̹ʇɘ̼ͅ੮͐˺੮ʩɘͷʇ੮ɻɘˑˑʇʁ੮ʮ˦੮ʠ̼˺˚੮ɘ੮ɻʇˑˑ੮̹ʩ˺˦ʇੴ੮͸ʮ͐ʩ੮˦˺੮ͷʮʁʇ˺੶੮͐ʩʇ੮̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮˺ɺˈʇɻ͐ͅੴ੮ʁʇɻˑɘ̼ʮ˦ʡੴ੮ૃ{;੮ɻˑʮʇ˦͐੮ʩɘͅ੮ɘ੮̼ʮʡʩ͐੮͐˺੮ɻ˺˦ʠ̼˺˦͐੮͐ʩʇ੮͸ʮ͐˦ʇͅͅੳૄ Ĕʩʇ˦੮ ˦ʁ;੮ ̹̼˺̹˺ͅʇͅ੮ ̼ʇͅɻʩʇʁ͙ˑʮ˦ʡੴ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ʮ˦ͅʮ͐ͅͅੴ੮ ૃ‡˺ੳ੮ Uૄͷʇ੮ ̼ʇɻʇʮͷʇʁ੮˚ɘ˦;੮ɻɘˑˑͅ੮ʠ̼˺˚੮{ͅੳ੮k˺ʩ˦ͅ˺˦ੳ੮äʩʇૄͅ੮ɺʇʇ˦੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮͐ʩʮͅ੮ʩʇɘ̼ʮ˦ʡ੮ʠ˺̼੮ɘ੮ ˑ˺˦ʡ੮͐ʮ˚ʇੳ੮Uૄʁ੮ˑʮˌʇ੮͐˺੮̼ʇή͙ʇ͐ͅ੮͐ʩʇ੮̹ʇ͐ʮ͐ʮ˺˦੮ɺʇ੮ʁʇ˦ʮʇʁੳૄ

136

T H E C O N S E RVATO R S H I P C O N T I N U U M

ૃîʩɘ͐੮ͅʇʇ˚ͅ੮ʩɘ̼ͅʩੴૄ੮˦ʁ;੮̼ʇ̹ˑʮʇͅੳ {ͅੳ੮ k˺ʩ˦ͅ˺˦ੴ੮ ɘ͐੮ ͐ʩʮͅ੮ ̹˺ʮ˦͐ੴ੮ ͐ͅɘ̼͐ͅ੮ ͐ɘˑˌʮ˦ʡ੮ ˑ˺͙ʁˑ;੮ ʮ˦͐˺੮ ͐ʩʇ੮ ˚ʮɻ̼˺̹ʩ˺˦ʇੴ੮ ૃUૄͷʇ੮ ˦ʇͷʇ̼੮ɺʇʇ˦੮ʮ˦੮˦˺੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮˚;੮ˑʮʠʇੴ੮U੮͸ɘ˦͐੮͐˺੮ʡ˺ੳ੮Uૄ˚੮̼ʇɘʁ;੮͐˺੮ˑʇɘͷʇੳ੮U੮͐ɘˌʇ੮˚;੮ ˚ʇʁͅ੮ɘ˦ʁ੮ʇͷʇ̼;͐ʩʮ˦ʡ੯ੳ੯ੳ੯ੳૄ੮îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɻ˺͙˦ͅʇˑੴ੮ɘ˦ʁ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ̼ʇ੮ʩɘʡʡˑʮ˦ʡ੮˺ͷʇ̼੮ɘ੮̼͐ʮɘˑ੮ʁɘ͐ʇੴ੮ɘ˦ʁ੮͐ʩʇ੮͸˺˚ɘ˦੮ɺʇʡʮ˦ͅ੮ɻ̼;ʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ɺɘɻˌʡ̼˺͙˦ʁੴ੮ૃĔʩɘ͐੮ɘɺ˺͙͐੮ɺʇʮ˦ʡ੮ʁʮͅɻʩɘ̼ʡʇʁ੺ૄ Ĕʩʇ˦੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʮ˦ʁʮɻɘ͐ʇͅ੮͐ʩɘ͐੮ͅʩʇૄͅ੮ˑʮˌʇˑ;੮͐˺੮͙ͅ˚˚ɘ̼ʮˑ;੮ʁʇ˦;੮͐ʩʇ੮̹ʇ͐ʮ͐ʮ˺˦ੴ੮ the psychiatrist suddenly discovers that she might actually have access to a ͷʮʁʇ˺੮ɻ˺˦˦ʇɻ͐ʮ˺˦੮ફUૄʁ੮̹ͅʇɻ͙ˑɘ͐ʇ੮ͅʩʇ੮ϲʮ˦ʮͅʩʇʁ੮ʁ̼ʮͷʮ˦ʡ੮ɘ˦ʁ੮ʡ˺͐੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑબੳ੮ äʩʇ੮ɻ˺˚ʇͅ੮˺˦ચͅɻ̼ʇʇ˦੮ɘ˦ʁ੮͐ʇ͐ͅʮϲʮʇͅ੮͐˺੮ɘ੮ˑʮ͐ɘ˦;੮˺ʠ੮̹̼˺ɺˑʇ˚ͅੵ੮{ͅੳ੮k˺ʩ˦ͅ˺˦੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ʩɘˑˑ͙ɻʮ˦ɘ͐ʮ˺˦ͅੴ੮̼ʇɘɻ͐ͅ੮͐˺੮ʮ˦͐ʇ̼˦ɘˑ੮͐ͅʮ˚͙ˑʮੴ੮ɘ˦ʁ੮ʮͅ੮ૃɘɺ͙ͅʮͷʇૄ੮͐˺͸ɘ̼ʁ੮͐ͅɘʠʠੳ੮ äʩʇ੮ ̼ʇʠ͙ͅʇʁ੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮ ͙˦͐ʮˑ੮ ͅʩʇ੮ ͸ɘͅ੮ ˺̼ʁʇ̼ʇʁ੮ ͐˺੮ ͐ɘˌʇ੮ ʮ͐੮ ફ͐ʩ̼˺͙ʡʩ੮ ɘ੮ ͅʇ̹ɘ̼ɘ͐ʇ੮ court procedure called a Riese੮̹ʇ͐ʮ͐ʮ˺˦બੳ੮ͅ੮ʠ˺̼੮ʩʇ̼੮ͅʇˑʠચɻɘ̼ʇੴ੮ૃͅʩʇ੮ʩɘͅ˦ૄ͐੮͐ɘˌʇ˦੮ ɘ੮ ͅʩ˺͸ʇ̼੮ ͅʮ˦ɻʇ੮ ͅʩʇ੮ ͸ɘͅ੮ ɘʁ˚ʮ͐͐ʇʁૄ੮ ɘ˦ʁ੮ ૃɻɘ˦ૄ͐੮ ʇͷʇ˦੮ ̼͐ɘ˦ͅʠʇ̼੮ ʩʇ̼ͅʇˑʠ੮ ʠ̼˺˚੮ ɘ੮ ɺʇʁ੮ ͐˺੮͐ʩʇ੮͸ʩʇʇˑɻʩɘʮ̼੮͙ͅʮ˦ʡ੮ɘ੮ˑʮʠ͐ੳૄ੮Pʇ̼੮̹ˑɘ˦੮͐˺੮ˑʮͷʇ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ʮͅ੮ૃ˦˺͐੮̼ʇɘˑʮ͐ͅʮɻੳ੮ äʩʇ੮ ʮͅ੮ ɺʇʁɺ˺͙˦ʁੴ੮ ͅʩʇ੮ ʩɘͅ੮ ˦˺੮ ̹ˑɘ˦ͅ੮ ʠ˺̼੮ ʩʇ̼੮ ˚ʇɘˑͅ੮ ˺̼੮ ɻ˺˚ʮ˦ʡ੮ ͐˺੮ ʩʇ̼੮ ˚ʇʁʮɻɘˑ੮ ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅੳૄ îʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮̼ʮͅʇͅ੮͐˺੮ʁʇʠʇ˦ʁ੮ʩʇ̼੮ɻˑʮʇ˦͐ੴ੮ɺ͙͐੮U੮ɻɘ˦੮ͅʇʇ੮͸ʩ;੮ʮ͐ૄͅ੮͙˦ˑʮˌʇˑ;੮ ͐˺੮ɺʇ੮ɻ˺˦ͷʮ˦ɻʮ˦ʡੵ੮ૃĔʩɘ͐੮ʮͅ੮ʩʇ̼੮̹ʩ;ͅʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦੺ૄ ૃäʩʇ੮ʮͅ੮˚˺̼ɺʮʁˑ;੮˺ɺʇͅʇੴૄ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮̼ʇ̹ˑʮʇͅੳ ૃä˺ੴ੮ͅʩʇ੮ʁ˺ʇͅ˦ૄ͐੮̼ʇή͙ʮ̼ʇ੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼੮ʠ˺̼੮̹ɘ̼ɘˑ;ͅʮͅ੮˺̼੮ɘ˦;͐ʩʮ˦ʡ੮ˑʮˌʇ੮͐ʩɘ͐੺ૄ ૃ‡˺ੴ੮ɺ͙͐੮ͅʩʇ੮ɻɘ˦ૄ͐੮͸ɘˑˌੳૄ Ĕʩʇ˦੮ʮ͐ૄͅ੮{ͅੳ੮k˺ʩ˦ͅ˺˦ૄͅ੮͙̼͐˦ੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʡ͙ʮʁʇͅ੮ʩʇ̼੮͐ʇ͐ͅʮ˚˺˦;ੴ੮ɺ͙͐੮ ˺˦ˑ;੮ʡʇ˦͐ˑ;ੳ੮ૃ)˺੮;˺͙੮˦ʇʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੺ૄ ૃ‡˺ੴૄ੮͐ʩʇ੮͸˺˚ɘ˦੮ͅʩ˺˺͐ͅ੮ɺɘɻˌੳ ૃ˦ʁ੮͸ʩɘ͐੮͸˺͙ˑʁ੮;˺͙੮ʁ˺੮ʮʠ੮;˺͙੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁ੺ૄ੮ͅʩʇ੮ɘͅˌͅੳ ૃU੮͸˺͙ˑʁ੮ʡ˺੮͐˺੮{ʮɘ˚ʮੳૄ ૃ)˺੮;˺͙੮˚ʇɘ˦੮{ʮɘ˚ʮੴ੮Hˑ˺̼ʮʁɘ੺ૄ੮ʩʇ̼੮ˑɘ͸;ʇ̼੮ή͙ʇ̼ʮʇͅੴ੮ʩ˺̹ʇʠ͙ˑˑ;ੳ ૃU੮ʩɘͷʇ੮˦˺੮ʮʁʇɘੴૄ੮{ͅੳ੮k˺ʩ˦ͅ˺˦੮̼ʇ̹ͅ˺˦ʁͅੳ੮ૃUૄͷʇ੮ˑʮͷʇʁ੮ʠ˺̼͐;ચʇʮʡʩ͐੮;ʇɘ̼ͅ੮˺˦੮˚;੮˺͸˦ੴ੮ U੮ɻɘ˦੮ʁ˺੮͐ʩʮ˦ʡͅ੮ʠ˺̼੮˚;ͅʇˑʠੳૄ੮îʩʇ੮͸˺˚ɘ˦੮͐ͅɘ͐ʇͅ੮͐ʩɘ͐੮ͅʩʇ੮ʩɘͅ੮˦˺੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɺ͙͐੮ ͐ɘˌʇͅ੮ʩʇ̼੮˚ʇʁͅ੮ʇͷʇ̼;੮ʁɘ;ઝɘ˦ʁ੮ʁ˺ʇͅ˦ૄ͐੮˦ʇʇʁ੮͐ʩʇ˚ੳ ૃ#ɘ˦੮ ;˺͙੮ ͐ʇˑˑ੮ ͙ͅ੮ ͸ʩɘ͐੮ ˚ʇʁͅ੮ ;˺͙ૄ̼ʇ੮ ͐ɘˌʮ˦ʡ੺ૄ੮ ʩʇ̼੮ ɘ͐͐˺̼˦ʇ;੮ ɘͅˌͅੴ੮ ˺̹ʇ˦ʮ˦ʡ੮ ɘ˦੮ ˺̹̹˺̼͙͐˦ʮ͐;੮ʠ˺̼੮{ͅੳ੮k˺ʩ˦ͅ˺˦੮͐˺੮ͅʩ˺͸੮ɘ੮ɺʮ͐੮˺ʠ੮ʮ˦ͅʮʡʩ͐ੳ ૃUૄͷʇ੮ʡ˺͐੮͐ʩʇ੮ɺ̼˺͸˦੮̹ʮˑˑੴ੮͐ʩʇ੮̹͙̼̹ˑʇ੮̹ʮˑˑੴ੮ɘ˦ʁ੮͐ʩʇ੮ʡ̼ʇʇ˦੮̹ʮˑˑੳૄ੮#˺͙˦͐;੮ɻ˺͙˦ͅʇˑ੮ ʁ˺ʇͅ˦ૄ͐੮ɺ˺͐ʩʇ̼੮͸ʮ͐ʩ੮ή͙ʇ͐ͅʮ˺˦ͅੳ

C O U RT

137

k͙ʁʡʇ੮)ɘͷʮͅ੮ɘͅˌͅ੮ʮʠ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘ੮ૃɻˑ˺ͅʮ˦ʡ੮ɘ̼ʡ͙˚ʇ˦͐ૄ੮ɘ˦ʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ ͐ͅɘ͐ʇͅੴ੮͙˦ʇ˦͐ʩ͙ͅʮɘ͐ͅʮɻɘˑˑ;ੴ੮͐ʩɘ͐੮ૃU੮͸ʮˑˑ੮ˈ͙͐ͅ੮˦˺͐ʇ੮ʠ˺̼੮͐ʩʇ੮ɻ˺͙̼͐੮͐ʩɘ͐੮ͅʩʇ੮ʁ˺ʇͅ੮˦˺͐੮ ͸ɘ˦͐੮ ͐˺੮ ɻ˺˦͐ʮ˦͙ʇ੮ ͐ʩʮͅ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳૄ੮ k͙ʁʡʇ੮ )ɘͷʮͅ੮ ʁʇɻˑɘ̼ʇͅੴ੮ ̼ɘ̹ʮʁˑ;ੴ੮ ͐ʩɘ͐੮ the public guardian has shown grave disability ‘beyond a reasonable doubt’ ɘ˦ʁ੮͐ʩɘ͐੮͐ʩʇ੮ૃˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮̹ˑɘɻʇ˚ʇ˦͐ૄ੮ʠ˺̼੮{ͅੳ੮k˺ʩ˦ͅ˺˦੮ʮͅ੮ɘ੮ͅˌʮˑˑʇʁ੮˦͙̼ͅʮ˦ʡ੮ ʠɘɻʮˑʮ͐;ੳ ૃšʩ੮͸˺͸ੴ੮˺ʩ੮͸˺͸੯ੳ੯ੳ੯ੳૄ੮{ͅੳ੮k˺ʩ˦ͅ˺˦੮ͅ˺ɺͅੳ ૃîɘˌʇ੮ɻɘ̼ʇੴૄ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ɻˑ˺ͅʇͅੳ

CONCLUSION: BLINDED DISCRETION Ĕʩɘ͐੮ U੮ ͅʇʇ੮ ʮ˦੮ k͙ʁʡʇ੮ )ɘͷʮͅૄͅ੮ ɻ˺͙̼̼͐˺˺˚੮ ʮͅ੮ ɘ੮ ̼͐ͅɘʮʡʩ͐ʠ˺̼͸ɘ̼ʁ੮ ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮ ˺ʠ੮ ͐ʩʇ੮ ˑɘ͸ઝɘͅ੮ͅʩʇ੮̼ʇɘʁͅ੮ʮ͐ੳ੮îʩɘ͐੮ˑɘ͸੮ʮͅ੮̼͐ͅʮɻ͐ੳ੮"͙͐੮͸ʩʇ˦੮ͅʩʇ੮̼͙ˑʇͅ੮ɘʡɘʮ˦͐ͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ʮ͐੮ ˺ʠ͐ʇ˦੮ ͅʇʇ˚ͅ੮ ˑʇͅͅ੮ ɘ੮ ̹̼˺ʁ͙ɻ͐੮ ˺ʠ੮ ͐ʩʇ੮ ̼ʮʡ˺̼˺͙ͅ੮ ͐ͅɘ˦ʁɘ̼ʁ੮ ʠ˺̼੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮͐ʩɘ˦੮͐ʩʇ੮˚ʇʁʮ˺ɻ̼ʮ͐;੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʇͽ̹ʇ̼͐ʮͅʇੳ੮Ĕʩʇ˦੮U੮ɘͅˌ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ɘɺ˺͙͐੮ {ͅੳ੮I˺˦ΈɘˑʇΈੴ੮͐ʩʇ੮͸˺˚ɘ˦੮͸ʩ˺ͅʇ੮ɻɘͅʇ੮͐ͅɘ̼͐ʇʁ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੴ੮ͅʩʇ੮ʇͽ̹̼ʇͅͅʇͅ੮ʩʇ̼੮ʇͽɘ̹ͅʇ̼ɘ͐ʮ˺˦ੵ੮ુU੮͸ʮͅʩ੮U੮ɻ˺͙ˑʁ੮ʡʇ͐੮ɺʇ͐͐ʇ̼੮͐ʇ͐ͅʮ˚˺˦;੮ʠ̼˺˚੮͐ʩʇ੮ʁ˺ɻ͐˺̼ͅੳ੮ˑˑ੮͐ʩʮͅ੮ʁ˺ɻ͐˺̼੮ ͅɘʮʁ੮ʮͅ੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮̹ɘ̼ɘ˦˺ʮʁ੮ɘ˦ʁ੮ͅʩʇ੮͐ɘˑˌʇʁ੮͐˺੮ʩʇ̼ͅʇˑʠੳ੮îʩɘ͐੮͸ɘͅ੮̼ʇɘˑˑ;੮̹̼ʇ͐͐;੮ ˚͙ɻʩ੮ʮ͐ੳૂ੮͐੮ˑʇɘ͐ͅ੮͐ʩʮͅ੮ʁ˺ɻ͐˺̼੮͸ɘͅ੮̹̼ʇͅʇ˦͐੮ʠ˺̼੮͐ʩʇ੮ʩʇɘ̼ʮ˦ʡੳ੮š˦ʇ੮˺ʠ੮͐ʩʇ੮˚˺͐ͅ੮ɻ˺˚mon reasons conservatorship petitions get denied, it turns out, is that physicians ʠɘʮˑ੮͐˺੮ͅʩ˺͸੮͙̹੮͐˺੮͐ʇ͐ͅʮʠ;ੳ৽਀ Then again, you don’t need great cultural authority to see that the people ɺʇʠ˺̼ʇ੮͐ʩʇ੮ɻ˺͙̼͐੮ɘ̼ʇ੮˺ʠ͐ʇ˦੮̼ʇɘˑˑ;ੴ੮̼ʇɘˑˑ;੮ʮ˚̹ɘʮ̼ʇʁੳ੮rʮˌʇ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੴ੮͐ʩʇ੮ ˺͐ʩʇ̼੮ˌʇ;੮̹͙ɺˑʮɻ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੴ੮ɻ˺͙̼͐ͅ੮ɻɘ˦੮˺˦ˑ;੮ʇͽʇ̼ɻʮͅʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ʮ˦੮ ͐ʩʇ੮ ͅ˚ɘˑˑ੮ ʠ̼ɘɻ͐ʮ˺˦੮ ˺ʠ੮ ɻɘͅʇͅ੮ ɺ̼˺͙ʡʩ͐੮ ɺʇʠ˺̼ʇ੮ ͐ʩʇ˚ੳ੮ Ø˺ˑʮɻʇੴ੮ /Ûͅੴ੮ ɘ˦ʁ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ʩɘͷʇ੮ʇͽ̹ʇˑˑʇʁ੮ͅ˺੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮͐ʩɘ͐ੴ੮˺˦ɻʇ੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮ ̼ʇɘɻʩʇͅ੮͐ʩʇ੮ɻ˺͙̼͐ͅੴ੮ʩʇɘ̼ʮ˦ʡͅ੮˺ʠ͐ʇ˦੮ͅʇʇ˚੮ˑʮˌʇ੮ɘ˦˺͐ʩʇ̼੮͐ͅʇ̹੮˺ʠ੮̼ɘ̹ʮʁ੮̹ʇ˺̹ˑʇ੮̹̼˺ɻʇͅͅʮ˦ʡ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘ੮ʁʇˑʮɻɘ͐ʇ੮ɺɘˑɘ˦ɻʮ˦ʡ੮˺ʠ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ɘ˦ʁ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੳ੮ͅ੮˺˦ʇ੮̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮͐˺ˑʁ੮˚ʇੴ੮ૃUૄͷʇ੮ɺʇʇ˦੮ʁ˺ʮ˦ʡ੮͐ʩʮͅ੮ʠ˺̼੮ͅʇͷʇ˦͐ʇʇ˦੮;ʇɘ̼ͅੳ੮ä˺˚ʇ੮̹ʇ˺̹ˑʇੴ੮Uૄͷʇ੮ͅʇʇ˦੮ ͐ʩʇ˚੮ͅ˺੮˚͙ɻʩ੮͐ʩʇ;ૄ̼ʇ੮ˑʮˌʇ੮ʠɘ˚ʮˑ;ੳૄ੮äʩʇ੮ͅʮʡʩʇʁੴ੮ૃU੮͙ͅʇʁ੮͐˺੮ɺʇ੮ɘɺˑʇ੮͐˺੮͸ʮ˦੮યɘ˦ʁ੮ʡʇ͐੮ ͐ʩʇ˚੮˺͙͐રੳ੮‡˺͸ੴ੮͐ʩʇ;ૄ̼ʇ੮ˈ͙͐ͅ੮͐˺˺੮ͅʮɻˌੳૄ )ʇ̹ͅʮ͐ʇ੮͐ʩʇ੮ˑɘɻˌ੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐ɘ͐ʮͷʇ੮ʇͷʮʁʇ˦ɻʇੴ੮k͙ʁʡʇ੮)ɘͷʮͅ੮ʠʇʇˑͅ੮{ͅੳ੮I˺˦ΈɘˑʇΈૄͅ੮ ͸˺˺ˑˑ;੮ ͙̼ͅͷʮͷɘˑ੮ ̹ˑɘ˦੮ ʮͅ੮ ʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮͷʇੳ੮ äʩʇ੮ ʁʇɻˑɘ̼ʇͅੴ੮ ૃ"ɘͅʇʁ੮ ˺˦੮ ͐ʩʇ੮ ͐ʇ͐ͅʮ˚˺˦;੮ ͐˺ʁɘ;ੴ੮U੮ϲʮ˦ʁ੮͐ʩɘ͐੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʩɘͅ੮˚ʇ͐੮ʮ͐ͅ੮ɺ͙̼ʁʇ˦੮ય͐˺੮ͅʩ˺͸੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮

138

T H E C O N S E RVATO R S H I P C O N T I N U U M

ɺʇ;˺˦ʁ੮ ɘ੮ ̼ʇɘͅ˺˦ɘɺˑʇ੮ ʁ˺͙ɺ͐રੳ੮ Uૄ˚੮ ʡ̼ɘ˦͐ʮ˦ʡ੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ îɘˌʇ੮ ɻɘ̼ʇ੮ ɘ˦ʁ੮ ͐ʩɘ˦ˌ੮;˺͙ੳૄ {ͅੳ੮ I˺˦ΈɘˑʇΈ੮ ʮͅ੮ ʇͽ̹̼ʇͅͅʮ˺˦ˑʇͅͅੳ੮ îʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ͙̼͐˦ͅ੮ ͐ʩʇ੮ ɻɘ˚ʇ̼ɘ੮ ˺ʠʠੴ੮ ɘ˦ʁ੮ ͅʩʇ੮ ʁʮͅɘ̹̹ʇɘ̼ͅ੮ʮ˦͐˺੮͐ʩʇ੮͸˺̼ˑʁ੮˺ʠ੮˚˺͐ͅˑ;੮̹̼ʮͷɘ͐ʇ੮ɻʩ̼˺˦ʮɻચɻɘ̼ʇ੮ʠɘɻʮˑʮ͐ʮʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮͐ʩʇ੮ ɻʇ˦͐ʇ̼̹ʮʇɻʇ੮˺ʠ੮͐ʩʇ੮˦ʇͽ͐੮̹ɘ̼͐੮˺ʠ੮͐ʩʮͅ੮ɺ˺˺ˌ੮ફϲʮʡ͙̼ʇ੮৶ੳৱબੳ

Factors explaining access

Only 10% of beds available to non “forensic” cases

State Hospital

Counties compete for for-profit beds, allowing “cherrypicking”

Mental health rehab center (IMD)

Shortage of beds allows exclusion of substance users, medical issues

Board and care home

Complex access process excludes some potential conservatees

Independent/ supported housing

Acute-care hospital

Not necessarily conserved

Under conservatorship

More structured/ intensive services

Skilled nursing facility

Insufficient level of service to prevent death or eviction Homeless shelter

Some conservatees are banned or refuse shelters Street

Less structured/ intensive services

6.1 The placement continuum

PART II

CARE AND COERCION UNDER CONSERVATORSHIP

CHAPTER 7

LOCKED IN

T

ʩʇ੮ϲʮ̼͐ͅ੮͐ʮ˚ʇ੮U੮ͷʮͅʮ͐੮ɘ੮ˑ˺ɻˌʇʁ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Ûʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮#ʇ˦͐ʇ̼੮ ફ{PÛ#બઝɻ˺ˑˑ˺ή͙ʮɘˑˑ;੮ ˌ˦˺͸˦੮ ɘͅ੮ ɘ˦੮ U{)੮ ફU˦͐ͅʮ͙͐͐ʮ˺˦੮ ʠ˺̼੮ {ʇ˦͐ɘˑ੮ )ʮͅʇɘͅʇબઝUૄ˚੮ ɘˑ˚˺͐ͅ੮ ʮ˦੮ ͐ʇɘ̼ͅੳ੮ ä˺ੴ੮ ͐˺˺ੴ੮ ʮͅ੮ n̼ʮ͐ͅʇ˦ੴ੮ ɘ੮ ˦͙̼ͅʇ੮ ʠ̼˺˚੮ ɘ੮ ɻ˺͙˦͐;੮ ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮ ͐˺͙̼ʮ˦ʡ੮ ʮ͐੮ ͸ʮ͐ʩ੮ ˚ʇੴ੮ ɘˑɺʇʮ͐੮ ʠ˺̼੮ ɘˑ˚˺͐ͅ੮ ʇͽɘɻ͐ˑ;੮ ͐ʩʇ੮ ˺̹̹˺ͅʮ͐ʇ੮̼ʇɘͅ˺˦ੳ U{)ͅ੮ ɘ̼ʇ੮ ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ̼ʇʠʇ̼̼ʇʁ੮ ͐˺੮ ɘͅ੮ ɘ੮ ɻ˺˚˚͙˦ʮ͐;੮ ̹ˑɘɻʇ˚ʇ˦͐੮ ફʮ˦੮ ɻ˺˦̼͐ɘ͐ͅ੮ ͐˺੮ ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑબ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮îʩʮͅ੮˺˦ʇ੮ʮͅ੮ɘ͐੮ˑʇɘ͐ͅ੮ɘ˦੮ʩ˺͙̼ૄͅ੮ʁ̼ʮͷʇ੮ʠ̼˺˚੮͐ʩʇ੮ ɻ˺˚˚͙˦ʮ͐;੮͸ʩʇ̼ʇ੮˚˺͐ͅ੮˺ʠ੮ʮ͐ͅ੮̼ʇͅʮʁʇ˦͐ͅ੮ɻ˺˚ʇ੮ʠ̼˺˚੮ફ͐͸˺੮ʩ˺͙̼ͅ੮ɺ;੮̹͙ɺˑʮɻ੮̼͐ɘ˦̹ͅ˺̼͐બੳ੮U͐ૄͅ੮ɘ˦੮ʮ˦ɘ͙̹ͅʮɻʮ˺͙ͅ੮̹ˑɘɻʇੳ੮Ě˺͙੮ʩɘͷʇ੮͐˺੮ˑ˺˺ˌ੮ɻɘ̼ʇʠ͙ˑˑ;੮ɘ͐੮͐ʩʇ੮ͷʮ˦ʇચɻ˺ͷʇ̼ʇʁ੮ ʠʇ˦ɻʇ੮ɘ̼˺͙˦ʁ੮ɘ˦੮ʇͽʇ̼ɻʮͅʇ੮ɘ̼ʇɘ੮˺͙͐੮ɺɘɻˌ੮͐˺੮̼ʇɘˑʮΈʇ੮͐ʩɘ͐੮ʮ͐ૄͅ੮͐˺̹̹ʇʁ੮͸ʮ͐ʩ੮ɺɘ̼ɺʇʁ੮ ͸ʮ̼ʇੳ੮Ĕʩʇ˦੮U੮̹ɘͅͅ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ͅˑʮʁʮ˦ʡ੮ʡˑɘͅͅ੮ʁ˺˺̼ͅੴ੮Uૄ˚੮ʡ̼ʇʇ͐ʇʁ੮ɺ;੮ɘ੮̼ʇɻʇ̹͐ʮ˺˦੮ɘ̼ʇɘ੮ ͐ʩɘ͐੮˚ʮʡʩ͐੮͸ʇˑɻ˺˚ʇ੮˚ʇ੮ʮ˦͐˺੮ɘ੮ʁʇ˦͐ʮ͐ͅૄͅ੮˺ϲϲʮɻʇੳ੮îʩʇ੮˦ʇͽ͐੮ʁ˺˺̼ੴ੮͐ʩ˺͙ʡʩੴ੮ʮͅ੮ˑ˺ɻˌʇʁੳ੮ U͐੮ˌʇʇ̹ͅ੮˚˺̼ʇ੮͐ʩɘ˦੮˺˦ʇ੮ʩ͙˦ʁ̼ʇʁ੮̹ʇ˺̹ˑʇ੮ɺʇʩʮ˦ʁ੮ʮ͐ੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʠ˺̼੮;ʇɘ̼ͅ੮ɘ͐੮ɘ੮͐ʮ˚ʇੳ {;੮ʩ˺͐ͅ੮ʮͅ੮äʮ˚˺˦ੴ੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ૄͅ੮˚ɘ˦ɘʡʇ̼ੳ੮ુĔʩʇ˦੮U੮ʡ̼ʇ͸੮͙̹ੴ੮͐ʩʮͅ੮͸ɘͅ੮˦˺͐੮˺˦੮ ˚;੮ˑʮ͐ͅ੮ય˺ʠ੮ɻɘ̼ʇʇ̼ͅરੴૂ੮äʮ˚˺˦੮͐ʇˑˑͅ੮˚ʇੳ੮Pʇ੮͐ͅɘ̼͐ʇʁ੮ʮ˦੮ʠ˺˺ʁ੮ͅʇ̼ͷʮɻʇ੮ʠ˺̼੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ ˑʮˌʇ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇͅ੮ɘ˦ʁ੮ʇͷʇ˦͙͐ɘˑˑ;੮ˈ͙˚̹ʇʁ੮˺ͷʇ̼੮͐˺੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦ੳ੮ુš˦ʇ੮ʁɘ;੮U੮ʡ˺͐੮ ɘ੮ɻɘˑˑ੮ʠ̼˺˚੮ɘ੮͸˺˚ɘ˦੮͸ʩ˺੮ͅɘʮʁੴ੮ૃP˺͸ૄʁ੮;˺͙੮ˑʮˌʇ੮͐˺੮͸˺̼ˌ੮ʮ˦੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੺ૄ੮ɘ˦ʁ੮ U੮ͅɘʮʁੴ੮ૃ̹̼˺ɺɘɺˑ;੮˦˺͐ੴૄૂ੮ʩʇ੮̼ʇɻ˺͙˦͐ͅੳ੮"͙͐੮ʩʇ੮͸ʇ˦͐੮ʠ˺̼੮͐ʩʇ੮ʮ˦͐ʇ̼ͷʮʇ͸੮ɘ˦ʁੴ੮ͅ˺˚ʇʩ˺͸ੴ੮ ુʠʇˑˑ੮ʮ˦੮ˑ˺ͷʇ੮͸ʮ͐ʩ੮ʮ͐ੳૂ੮Pʇ੮ͅʩ˺͙ˑʁ੮ʩɘͷʇ੮̼ʇ͐ʮ̼ʇʁ੮ϲʮͷʇ੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮ુɺ͙͐੮U੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺ੳૂ੮ îʩʇ̼ʇૄͅ੮ɘ˦੮ʮ˦ɻ˺˦ʡ̼͙ʮ͐;੮͐˺੮ʩ˺͸੮ʩʇ੮ʁʇͅɻ̼ʮɺʇͅ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ʩʇ੮͸˺̼ˌͅ੮͸ʮ͐ʩੴ੮˺˦ʇ੮͐ʩɘ͐੮ U੮ʇ˦ɻ˺͙˦͐ʇ̼ʇʁ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɘ͐੮͐ʩʇ੮˚˺͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮͸ʮ˦ʡ੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੵ੮ુš͙̼੮ɻˑʮʇ˦͐ͅ੮ɘ̼ʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੯ੳ੯ੳ੯ੳ੮˚ɘʁʇ੮ɺɘʁ੮ʁʇɻʮͅʮ˺˦ͅ੮ʠ˺̼੮͸ʩɘ͐ʇͷʇ̼੮̼ʇɘͅ˺˦ੴ੮ʩɘʁ੮ ɘ੮͐˺͙ʡʩ੮ˑʮʠʇੴ੮ɺʇʇ˦੮ɘɺ͙ͅʇʁ੮ʠ˺̼੮ˑ˺͐ͅ੮˺ʠ੮̼ʇɘͅ˺˦ͅੴ੮ɘ੮ˑ˺͐੮˺ʠ੮ʁ˺˚ʇ͐ͅʮɻ੮ͷʮ˺ˑʇ˦ɻʇૂઝɘ˦ʁੴ੮ʩʇ੮ ɘʁʁͅੴ੮ુɘ̼ʇ੮ͷʇ̼;੮ͅ͸ʇʇ͐੮͐˺੮ɺʇ੮͸ʮ͐ʩੳૂ

142

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

îʩʇ੮͸ɘ̼ʁ੮ʮ͐ͅʇˑʠ੮ʩɘͅ੮͐ʩʇ੮͸ʮʁʇ੮ʩɘˑˑ͸ɘ;ͅ੮ɘ˦ʁ੮ˑʮ˦˺ˑʇ͙˚੮ϲˑ˺˺̼ͅ੮˺ʠ੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇੴ੮ ͸ʩʮɻʩ੮˚ɘˌʇͅ੮ͅʇ˦ͅʇੴ੮ɺʇɻɘ͙ͅʇ੮ʮ͐੮͙ͅʇʁ੮͐˺੮ɺʇ੮˺˦ʇੳ੮Ĕʩɘ͐੮ʡʮͷʇͅ੮͐ʩʇ੮U{)੮ɘ੮ͷɘ͐ͅˑ;੮ʁʮʠʠʇ̼ʇ˦͐੮ʠʇʇˑ੮ʠ̼˺˚੮͐ʩʇ੮˦͙̼ͅʮ˦ʡ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ɘ˦ʁ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐ͅ੮Uૄͷʇ੮ͷʮͅʮ͐ʇʁੴ੮͐ʩ˺͙ʡʩੴ੮ʮͅ੮ʩ˺͸੮ ή͙ʮʇ͐੮ʮ͐੮ʮͅੳ੮îʩʇ੮U{)੮ʩɘͅ੮˦˺੮͐ͅɘʠʠ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੳ੮U˦͐ͅʇɘʁੴ੮ʮ͐੮ɻ˺˦̼͐ɘɻ͐ͅ੮ʠ˺̼੮̹ʩ;ͅʮɻʮɘ˦ͅ੮ ͐˺੮˚ʇʇ͐੮ʇɘɻʩ੮̼ʇͅʮʁʇ˦͐੮˺˦ɻʇ੮ʇͷʇ̼;੮͐͸˺੮͸ʇʇˌͅੳ੮Hʇʁʇ̼ɘˑ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮˚ʇɘ˦੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮ʮ˦੮U{)ͅ੮ɻɘ˦˦˺͐੮̼ʇɻʇʮͷʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮̹ɘʮʁ੮ʠ˺̼੮͐ʩ̼˺͙ʡʩ੮{ʇʁʮચ#ɘˑੴ੮ ͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮˦˺੮ˑʮɻʇ˦ͅʇʁ੮͐ʩʇ̼ɘ̹ʮ͐ͅͅ੮ɻ˺˚ʮ˦ʡ੮ʮ˦੮ʠ˺̼੮˺˦ʇચ˺˦ચ˺˦ʇ੮ͅʇͅͅʮ˺˦ͅੳ੮ {˺͐ͅ੮˺ʠ੮͐ʩʇ੮ɘɻ͐ʮͷʮ͐ʮʇͅ੮ɘ̼ʇ੮ʡ̼˺͙̹ͅ੮˺˦੮ɘ˦ʡʇ̼੮˚ɘ˦ɘʡʇ˚ʇ˦͐੮˺̼੮ˑʮͷʮ˦ʡ੮ͅˌʮˑˑͅ੮̹͙͐੮˺˦੮ɺ;੮ ુ̹̼˺ʡ̼ɘ˚੮ɻ˺͙˦ͅʇˑ˺̼ͅੴૂ੮͸ʩ˺ੴ੮äʮ˚˺˦੮ʇͽ̹ˑɘʮ˦ͅੴ੮ɘ̼ʇ੮ુ͙˦ɻʇ̼͐ʮϲʮʇʁ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸˺͙ˑʁ੮ ˺͐ʩʇ̼͸ʮͅʇ੮ɺʇ੮͸˺̼ˌʮ˦ʡ੮ɘ͐੮{ɻ)˺˦ɘˑʁૄͅੳૂ îʩʇ੮ͅʮ˦ʡˑʇ੮͙͐ͅʁ;੮U੮ɻ˺͙ˑʁ੮ϲʮ˦ʁ੮˺˦੮U{)ͅ੮ʮʁʇ˦͐ʮϲʮʇͅ੮͐ʩʇ੮ͷɘ͐ͅ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮̹ʇ˺̹ˑʇ੮ ʮ˦੮͐ʩʇ˚੮ɘͅ੮ʩɘͷʮ˦ʡ੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ͷʮ˺ˑʇ˦ɻʇੳৼ੮U੮ʁ˺˦ૄ͐੮ʠʇʇˑ੮̼ʇ˚˺͐ʇˑ;੮͙˦ͅɘʠʇੳ੮Ûʇͅʮʁʇ˦͐ͅ੮ ɘ̼ʇ੮ͅʩ͙ϲϲˑʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮͸ʮʁʇ੮ɻ˺̼̼ʮʁ˺̼ͅੴ੮ˑɘ̼ʡʇˑ;੮ɘˑ˺˦ʇੴ੮ˑɘ̼ʡʇˑ;੮ͅʮˑʇ˦͐ˑ;ੳ੮ä˺˚ʇ੮ɘ̼ʇ੮ ͅʮ͐͐ʮ˦ʡ੮ʮ˦੮̹ͅɘ̼͐ɘ˦੮̼˺˺˚ͅ੮͸ʮ͐ʩ੮˦˺͐੮˚͙ɻʩ੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮ˑ˺ɻˌʇ̼੮ɘ˦ʁ੮ɘ੮ʁʮͷʮʁʇ̼੮ɺʇ͐͸ʇʇ˦੮ ͐͸˺੮ɺʇʁͅੳ੮îʩʇ̼ʇૄͅ੮ɘ˦੮ɘɻ͐ʮͷʮ͐;੮̼˺˺˚੮͸ʮ͐ʩ੮ͅ˺˚ʇ੮ʇ˚̹͐;੮̹ˑɘ͐ͅʮɻ੮ʁʇɻˌ੮ɻʩɘʮ̼ͅ੮ɘ̼˺͙˦ʁ੮ ɘ੮îēੳ੮U੮ʡʇ͐੮͐ʩʇ੮ʮ˚̹̼ʇͅͅʮ˺˦੮͐ʩʇ̼ʇ੮ɘ̼ʇ˦ૄ͐੮ɘ੮ˑ˺͐੮˺ʠ੮ͷʮͅʮ͐˺̼ͅੴ੮ɺʇɻɘ͙ͅʇ੮̹ʇ˺̹ˑʇ੮͐ͅɘ̼͐੮ɻˑ͙͐ͅʇ̼ʮ˦ʡ੮ɘ̼˺͙˦ʁ੮͙ͅੳ੮š˦ʇ੮͐ɘˑˑੴ੮˚ʮʁʁˑʇચɘʡʇʁ੮˚ɘ˦੮͸ʮ͐ʩ੮ͅɻɘ̼ͅ੮ɘɻ̼˺ͅͅ੮ʩʮͅ੮ʠɘɻʇ੮ɻ˺˚ʇͅ੮͐˺੮ ͅʩɘˌʇ੮˚;੮ʩɘ˦ʁ੶੮ɘ˦˺͐ʩʇ̼੮˚ɘ˦੮͐ʇˑˑͅ੮˚ʇ੮ʩʇੴ੮͐˺˺ੴ੮ʮͅ੮ɘ੮̹̼˺ʠʇͅͅ˺̼ੴ੮ɘͅ੮ʩʇ੮ʡɘΈʇͅ੮ʮ˦͐ʇ˦͐ˑ;੮ ˺ͷʇ̼੮˚;੮ͅʩ˺͙ˑʁʇ̼ੳ ૃĚ˺͙ૄͷʇ੮ʡ˺͐੮͐˺੮ͅʇʇ੮͐ʩʮͅੴૄ੮n̼ʮ͐ͅʇ˦੮͐ʇˑˑͅ੮˚ʇ੶੮ɘ੮;˺͙˦ʡ੮͸˺˚ɘ˦੮ʩɘͅ੮ͅʩ˺͸˦੮ʩʇ̼੮ɘ੮˦˺͐ʇɺ˺˺ˌ੮˺ʠ੮̹˺ʇ̼͐;੮͸ʮ͐ʩ੮͐ʮ͐ˑʇͅ੮ˑʮˌʇ੮ુ{;੮U˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦ૂ੮ɘ˦ʁ੮ુr˺ɻˌʇʁ੮õ̹ੳૂ੮U͐ૄͅ੮ɘ͐੮͐ʩʮͅ੮ ̹˺ʮ˦͐੮͐ʩɘ͐੮n̼ʮ͐ͅʇ˦੮ɘ˦˦˺͙˦ɻʇͅੴ੮ુUૄ˚੮˦˺͐੮ɻ̼;ʮ˦ʡੴ੮̼ʇɘˑˑ;ੴૂ੮ʇͽ̹ˑɘʮ˦ʮ˦ʡ੮ɘ͸ɘ;੮͸ʇˑˑʮ˦ʡ੮ ͐ʇɘ̼ͅੳ੮U੮ʁ˺˦ૄ͐੮ͅɘ;੮ɘ˦;͐ʩʮ˦ʡੴ੮ɺ͙͐੮U੮ϲʮʡ͙̼ʇ੮͸ʇ੮ʠʇʇˑ੮͐ʩʇ੮ͅɘ˚ʇ੮͸ɘ;ੳ੮˦੮U{)੮ͅʇʇ˚ͅ੮ˑʮˌʇ੮ ɘ੮̼ʇɘˑˑ;੮ͅɘʁ੮̹ˑɘɻʇੳ U{)ͅ੮ɘ̼ʇ੮͙͙ͅɘˑˑ;੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ͅ˺̹੮ʠ˺̼੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ɘʠ͐ʇ̼੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ৽੮ îʩʮͅ੮ ʮͅ੮ ͐ʩʇ੮ ̹˺ʮ˦͐੮ ͸ʩʇ̼ʇ੮ ɘ੮ ɻɘ̼ʇʇ˦ʮ˦ʡ੮ ̼͐ɘˈʇɻ͐˺̼;੮ ͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚੮ͅˑ˺͸ͅ੮ʁ˺͸˦੮ʁ̼ɘ˚ɘ͐ʮɻɘˑˑ;ੳ੮î̼ʇɘ͐˚ʇ˦͐੮ʮͅ੮˚ʇɘ͙̼ͅʇʁ੮ʮ˦੮˚˺˦͐ʩͅ੮ɘ˦ʁ੮ ;ʇɘ̼ͅੴ੮˦˺͐੮ʩ˺͙̼ͅ੮˺̼੮ʁɘ;ͅੳ੮îʩʇ੮ʁʮϲϲʮɻ͙ˑ͐;੮˺ʠ੮ʡʇ͐͐ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦͐˺੮ɘ˦੮U{)੮͸ʇʮʡʩͅ੮ ˺˦੮͐ʩʇ੮˚ʮ˦ʁ੮˺ʠ੮ɘˑ˚˺͐ͅ੮ʇͷʇ̼;੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʇ̼੮͙̹̼͐ͅʇɘ˚ੳ੮Ĕʩʇ˦੮U੮ɘͅˌ੮äʮ˚˺˦੮ɘɺ˺͙͐੮ ɘʁ˚ʮͅͅʮ˺˦ͅੴ੮ʩʇ੮̹͙ˑˑͅ੮˺̹ʇ˦੮ɘ੮ϲʮˑʮ˦ʡ੮ɻɘɺʮ˦ʇ͐੮͙͐ͅʠʠʇʁ੮͸ʮ͐ʩ੮ʠ˺ˑʁʇ̼ͅੵ੮ુĔʇ੮ʡʇ͐੮͐ʇ˦੮˺̼੮ ͐͸ʇˑͷʇ੮˺ʠ੮͐ʩʇͅʇ੮̼ʇʠʇ̼̼ɘˑͅ੮ɘ੮͸ʇʇˌ੸ૂ੮ʩʇ੮ɘ˦˦˺͙˦ɻʇͅੳ ુH˺̼੮ʩ˺͸੮˚ɘ˦;੮˺̹ʇ˦ʮ˦ʡͅ੺ૂ੮U੮̹̼ʇͅͅੳ ુ‡˺˦ʇੳ੮ˑˑ੮͐ʩʇ੮ɺʇʁͅ੮ɘ̼ʇ੮ɘˑ͸ɘ;ͅ੮ʠ͙ˑˑੳૂ #˺͙˦͐ʮʇͅ੮ɻ˺˦̼͐ɘɻ͐੮͸ʮ͐ʩ੮U{)ͅ੮͐˺੮ʡʇ͐੮ɘɻɻʇͅͅ੮͐˺੮ɘ੮ɻʇ̼͐ɘʮ˦੮˦͙˚ɺʇ̼੮˺ʠ੮͐ʩʇʮ̼੮ɺʇʁͅੴ੮ ɺ͙͐੮͐ʩʇ੮U{)੮ɻɘ˦੮̼ʇʠ͙ͅʇ੮ɘ˦;੮̼ʇʠʇ̼̼ɘˑ੮ɘͅ੮͐˺˺੮ʁɘ˦ʡʇ̼˺͙ͅੴ੮͐˺˺੮͙˦͐ͅɘɺˑʇੴ੮͐˺˺੮˦˺˦ɻ˺˚̹ˑʮɘ˦͐ੴ੮˺̼੮͐˺˺੮˚ʇʁʮɻɘˑˑ;੮ɻ˺˚̹̼˺˚ʮͅʇʁ੮ફͅ˺˚ʇ͐ʮ˚ʇͅੴ੮̼͐ɘʡʮɻɘˑˑ;ੴ੮ʠ̼˺˚੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮

LO C K E D I N

143

ˑʮˌʇ੮ʁʮɘɺʇ͐ʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ͅʮʁʇ੮ʇʠʠʇɻ͐ͅ੮˺ʠ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅબੳ੮ˑ˚˺͐ͅ੮ɘˑˑ੮U{)ͅ੮ɘ̼ʇ੮̼͙˦੮ɺ;੮ ʠ˺̼ચ̹̼˺ϲʮ͐੮ ɻ˺˚̹ɘ˦ʮʇͅੴ੮ ɘ˦ʁ੮ ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ʮ͐ૄͅ੮ ɘ੮ ͅʇˑˑʇ̼ૄͅ੮ ˚ɘ̼ˌʇ͐੮ ʠ˺̼੮ ˑ˺ɻˌʇʁੴ੮ ͙ͅɺɘɻ͙͐ʇ੮ɻɘ̼ʇੳ äʮ˚˺˦ૄͅ੮ ɻ˺˚̹ɘ˦;੮ ˚˺͐ͅˑ;੮ ˚ɘ˦ɘʡʇͅ੮ ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇͅੳ੮ "͙͐੮ ʮ͐੮ ʩɘͅ੮ ̼ʇɘˑʮΈʇʁ੮ ͐ʩɘ͐੮ U{)ͅ੮ɘ̼ʇ੮ɘ੮ˑ͙ɻ̼ɘ͐ʮͷʇ੮ɺ͙ͅʮ˦ʇͅͅੳ੮ä͙̼ʇੴ੮{ʇʁʮɻɘ̼ʇ੮˚ʮʡʩ͐੮̹ɘ;੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇ੮ʇʮʡʩ͐੮ ʩ͙˦ʁ̼ʇʁ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;ੴ੮͸ʩʮˑʇ੮ɻ˺͙˦͐ʮʇͅ੮̹ɘ;੮͐ʩʮͅ੮U{)੮˺˦ˑ;੮͐ʩ̼ʇʇ੮ʩ͙˦ʁ̼ʇʁ੮ʁ˺ˑˑɘ̼ͅੳ੮ ુ"͙͐੮ ;˺͙੮ ɻɘ˦ૄ͐੮ ϲʮˑˑ੮ ɘ੮ ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇੴ੮ ͐ʩʇ;ૄ̼ʇ੮ ɘˑ͸ɘ;ͅ੮ ৷ৰજ৸ৰ੮ ̹ʇ̼ɻʇ˦͐੮ ʠ͙ˑˑੴૂ੮ äʮ˚˺˦੮ ʇͽ̹ˑɘʮ˦ͅੴ੮͸ʩʮˑʇ੮ુʩʇ̼ʇ੮͸ʇ੮ʩɘͷʇ੮ɘ੮͸ɘʮ͐ʮ˦ʡ੮ˑʮ͐ͅ੮˺ʠ੮ͅʇͷʇ˦͐;੮̹ʇ˺̹ˑʇੳૂ੮Øˑ͙ͅੴ੮ʮ˦੮ɘ੮˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇੴ੮ુ͐ʩʇ੮ʠʇʁͅ੮ɘ̼ʇ੮ɘˑ͸ɘ;ͅ੮ɻ˺˚ʮ˦ʡ੮͐˺੮ʁ˺੮ɘ˦੮ɘ͙ʁʮ͐੮ɘ˦ʁ੮ɘ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ɘˌʇ੮͐ʩʇ੮˚˺˦ʇ;੮ ɺɘɻˌૂ੮ ʠ˺̼੮ ͷʮ˺ˑɘ͐ʮ˦ʡ੮ ̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮ ˺̼੮ ʠ˺̼੮ ુɘʁͷʇ̼ͅʇ੮ ˺͙͐ɻ˺˚ʇͅੳૂ੮ î˺੮ ʁ̼ʮͷʇ੮ ʩ˺˚ʇ੮ ͐ʩʇ੮ ̹˺ʮ˦͐ੴ੮ʩʇ੮̹͙ˑˑͅ੮˺͙͐੮ɘ˦੮ʇ˦˺̼˚˺͙ͅ੮ɺʮ˦ʁʇ̼ੵ੮ુîʩʇͅʇ੮ɘ̼ʇ੮͐ʩʇ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮ʠ˺̼੮˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇͅੳૂ੮Pʇ੮͐ʩʇ˦੮̹̼ʮ˦͐ͅ੮˺ʠʠ੮͐ʩʇ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮ʠ˺̼੮{PÛ#ͅੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮ͅʇͷʇ˦੮̹ɘʡʇͅੳ #˺͙˦͐ʮʇͅ੮ ɘ̼ʇ੮ɻˑɘ˚˺̼ʮ˦ʡ੮ʠ˺̼੮˦ʇ͸੮U{)ͅੴ੮ɘ˦ʁ੮ʩʮͅ੮ ɻ˺˚̹ɘ˦;੮ ʮͅ੮ ˺ɺˑʮʡʮ˦ʡ੮ ͸ʮ͐ʩ੮ ɘ੮ ˦ʇ͸੮͐͸˺ચʩ͙˦ʁ̼ʇʁચɺʇʁ੮ʠɘɻʮˑʮ͐;ੳ੮˦ʁ੮͐ʩɘ͐ૄͅ੮͸ʩ;੮U੮ʠʇˑ͐੮ˑʮˌʇ੮ɻ̼;ʮ˦ʡੳ੮U੮ʩɘʁ੮ɺʇʇ˦੮ʩʇɘ̼ʮ˦ʡ੮ɘɺ˺͙͐੮͐ʩʇ੮ʁʇ̹ͅʇ̼ɘ͐ʇ੮˦ʇʇʁ੮ʠ˺̼੮˚˺̼ʇ੮ɘɻɻʇͅͅ੮͐˺੮U{)੮ɺʇʁͅ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮U੮ʠʇʇˑ੮ ʮ˦͐ʇ˦ͅʇ੮ɘʁ˚ʮ̼ɘ͐ʮ˺˦੮ʠ˺̼੮äʮ˚˺˦੮ɘ˦ʁ੮ʩʮͅ੮͐ʇɘ˚ੳ੮U੮ɺʇˑʮʇͷʇ੮ʩʮ˚੮͸ʩʇ˦੮ʩʇ੮ͅɘ;ͅ੮ʩʇ੮ˑ˺ͷʇͅ੮ ͐ʩʇ੮̼ʇͅʮʁʇ˦͐ͅੳ੮"͙͐੮͸ʩʇ˦੮U੮ϲʮ˦ɘˑˑ;੮ͅʇʇ੮ɘ˦੮U{)ੴ੮U੮̼ʇɘˑʮΈʇ੮͸ʇૄ̼ʇ੮ɻˑɘ˚˺̼ʮ˦ʡ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ ͐˺੮ͅʩ͙ϲϲˑʇ੮ɺʇ͐͸ʇʇ˦੮ʮ˦ˈʇɻ͐ʮ˺˦ͅ੮ʠ˺̼੮˚˺˦͐ʩͅੳ U͐੮ ͙̼͐˦ͅ੮ ˺͙͐ੴ੮ ͐ʩ˺͙ʡʩੴ੮ ͐ʩɘ͐੮ n̼ʮ͐ͅʇ˦੮ ʮͅ੮ ɘˑ˚˺͐ͅચɻ̼;ʮ˦ʡ੮ ʠ˺̼੮ ɘ੮ ʁʮʠʠʇ̼ʇ˦͐੮ ̼ʇɘͅ˺˦ੳ੮ ુîʩɘ͐ૄͅ੮ͅ˺੮ʡ̼ʇɘ͐ੴૂ੮ͅʩʇ੮ɻ˺˚˚ʇ˦͐ͅ੮͸ʩʇ˦੮äʮ˚˺˦੮˚ʇ˦͐ʮ˺˦ͅ੮͐ʩʇ੮˦ʇ͸੮ʠɘɻʮˑʮ͐;ੳ੮/ͷʇ̼;͐ʩʮ˦ʡ੮ ʮͅ੮ ̼ʇˑɘ͐ʮͷʇੳ੮ n̼ʮ͐ͅʇ˦੮ ʩʇˑ̹ͅ੮ ̼͙˦੮ ͐ʩʇ੮ ɻ˺͙˦͐;ૄͅ੮ ̹̼˺ʡ̼ɘ˚ͅ੮ ʠ˺̼੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ʩ˺˚ʇͅ੮ɘ˦ʁ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡੴ੮͸ʩʮɻʩ੮ɘ̼ʇ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮̹̼˺ͷʮʁʇ੮͐ʩʇ੮ˑʇͅͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮Ěʇ͐ͅʇ̼ʁɘ;ੴ੮ͅʩʇ੮͐ʇˑˑͅ੮˚ʇੴ੮ͅʩʇ੮ɻ˺˦ͅ˺ˑʇʁ੮ɘ੮ɻɘͅʇ͸˺̼ˌʇ̼੮ ͸ʩ˺੮͸ɘͅ੮ʩɘͷʮ˦ʡ੮ɘ˦੮ʇ˚˺͐ʮ˺˦ɘˑ੮ɺ̼ʇɘˌʁ˺͸˦੮ɘɺ˺͙͐੮ɘ੮̼ʇͅʮʁʇ˦͐੮ʡ˺ʮ˦ʡ੮ʮ˦੮ɘ˦ʁ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ʇͷʇ̼;੮ɻ˺͙̹ˑʇ੮˺ʠ੮ʁɘ;ͅੳ ુîʩʇ੮ ɻˑʮʇ˦͐੮ ̼ʇʠ͙ͅʇͅ੮ ͐˺੮ ɺʇ੮ ʮ˦੮ ɘ੮ ʩʮʡʩʇ̼੮ ˑʇͷʇˑ੮ ˺ʠ੮ ɻɘ̼ʇੳ੯ ੳ੯ ੳ੯ ੳ੮ rɘ͐ͅ੮ ͐ʮ˚ʇੴ੮ ͸ʇ੮ ʠ˺͙˦ʁ੮ ʩʮ˚੮ʮ˦੮͐ʩʇ੮ɺɘ͐ʩ̼˺˺˚ੴ੮ʁʇʠʇɻɘ͐ʮ˦ʡ੮˺˦੮ʩʮ˚ͅʇˑʠੴ੮ɺˑ˺˺ʁ੮͙ͅʡɘ̼੮˺ͷʇ̼੮৷ৰৰ੮યɘ˦੮ʇͽ̼͐ʇ˚ʇˑ;੮ ʁɘ˦ʡʇ̼˺͙ͅ੮ˑʇͷʇˑરੴ੮ɘˑ˚˺͐ͅ੮ʮ˦੮ɘ੮ɻ˺˚ɘੳ੮Pʇૄͅ੮͐ʩʮ̼͐;ચ˺˦ʇ੮ɘ˦ʁ੮ʡ˺ʮ˦ʡ੮ɺˑʮ˦ʁੳ੮ä˺ੴ੮͸ʩɘ͐੮ʁ˺੮ ͸ʇ੮ʁ˺੺ૂ੮ͅʩʇ੮ɘͅˌͅੳ ુP˺͸੮˚ɘ˦;੮˺ʠ੮͐ʩ˺ͅʇ੮ʠ˺ˑˌͅ੮ͅʩ˺͙ˑʁ੮ɺʇ੮ˑʮͷʮ˦ʡ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੺ૂ੮äʮ˚˺˦੮˚͙ͅʇͅੳ ુ‡˺˦ʇ੮˺ʠ੮͐ʩʇ˚ੴૂ੮n̼ʮ͐ͅʇ˦੮ɻ˺˦ɻˑ͙ʁʇͅੳ ુH˺̼੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇੴ੮͐ʩʮͅ੮યɘ˦੮U{)ર੮ʮͅ੮ˈ͙͐ͅ੮ɺʇ͐͐ʇ̼੮ɘ˦ʁ੮ͅɘʠʇ̼ੴૂ੮äʮ˚˺˦੮ɻ˺˚˚ʇ˦͐ͅੴ੮ ͸ʩʮˑʇ੮n̼ʮ͐ͅʇ˦੮˦˺ʁͅੳ੮š˦ʇ੮˺ʠ੮͐ʩʮͅ੮U{)ૄͅ੮̼ʇͅʮʁʇ˦͐ͅ੮ʩɘͅ੮ɺʇʇ˦੮ͅɘʠʇˑ;੮ʩʇ̼ʇ੮ʠ˺̼੮͐͸ʇ˦͐;੮ ;ʇɘ̼ͅੳ Iʇ͐͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮ʮͅੴ੮ʮ˦੮͐ʩʇ˺̼;ੴ੮͐ʩʇ੮̹˺ʮ˦͐੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ ͅ੮ ͐ʩʇ੮ ɻ˺͙̼͐ͅ੮ ʩɘͷʇ੮ ̼ʇɻ˺ʡ˦ʮΈʇʁੴ੮ ુ˺˦ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ̹̼ʮ˦ɻʮ̹ɘˑ੮ ̹˺͸ʇ̼ͅ੮ ͸ʩʮɻʩ੮ ͐ʩʇ੮ ɻ˺͙̼͐੮

144

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

˚ɘ;੮ʡ̼ɘ˦͐੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ʮͅ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮̹ˑɘɻʇ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ʮ˦੮ɘ˦੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ૂ੮ˑʮˌʇ੮ ɘ˦੮U{)ੳ৾੮U͐੮͙̼͐˦ͅ੮˺͙͐੮͐ʩɘ͐੮͐ʩʮͅ੮ʮͅ੮ɘ˦੮˺ͷʇ̼͐ͅɘ͐ʇ˚ʇ˦͐ੳ੮͙͐ʩ˺̼ʮ͐;੮ʮͅ੮ɘɻ͙͐ɘˑˑ;੮ʠ̼ɘʡ˚ʇ˦͐ʇʁ੮ ɘ˚˺˦ʡ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ફ͸ʩ˺੮ ͅʮʡ˦੮ ˺ʠʠ੮ ˺˦੮ ̹ˑɘɻʇ˚ʇ˦͐ͅબੴ੮ ɻ˺͙˦͐;੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ફ͸ʩ˺੮̹ɘ;੮ʠ˺̼੮͐ʩʇ˚બੴ੮ɘ˦ʁ੮̹̼ʮͷɘ͐ʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ફ͸ʩ˺੮ʇͽʇ̼ɻʮͅʇ੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ʮ˦੮͸ʩʮɻʩ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͐ʩʇ;੮͐ɘˌʇબੳ੮îʩʇ੮ɘˑ˚˺͐ͅ੮͸ʩ˺ˑʇͅɘˑʇ੮ʁʇˑʇʡɘ͐ʮ˺˦੮ɺ;੮ ͐ʩʇ੮͐ͅɘ͐ʇ੮˺ʠ੮͐ʩʇ੮ˑ˺ɻˌʇʁ੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚੮͐˺੮̹̼ʮͷɘ͐ʇ੮ʇ˦͐ʮ͐ʮʇͅ੮ ʩɘͷʇ੮ʡʮͷʇ˦੮͐ʩ˺ͅʇ੮ʇ˦͐ʮ͐ʮʇͅ੮͐ʩʇ੮͙̹̹ʇ̼੮ʩɘ˦ʁ੮ʮ˦੮ʁʇ͐ʇ̼˚ʮ˦ʮ˦ʡ੮͸ʩʇ̼ʇ੮ɘ˦ʁ੮ʩ˺͸੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʡʇ͐੮ͅʇ̼ͷʇʁઝɘ˦ʁੴ੮ɘͅ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ɻ˺˦ɻˑ͙ʁʇͅੴ੮͸ʩ˺੮ʡʇ͐ͅ੮ɻ˺˦ͅʇ̼ͷʇʁ੮ɘ͐੮ɘˑˑੳ

THE LAST ASYLUMS Ĕʇˑˑੴ੮ʩ˺ˑʁ੮˺˦ੳ੮îʩʇ̼ʇૄͅ੮˺˦ʇ੮̹ˑɘɻʇ੮͐ʩɘ͐੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɻɘ˦੮ʡʇ͐੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮ʮ˦੮ɘ੮ ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡ੮͐ʩɘ͐੮ʁʇϲʮ˦ʮ͐ʇˑ;੮ʁ˺ʇͅ੮˦˺͐੮˚ɘˌʇ੮͐ʩʇ˚੮ɘ੮ʁʇˑʇʡɘ͐ʇʁੴ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;ੵ੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑੳ੮ )ʇ̹ͅʮ͐ʇ੮ ͐ʩʇ੮ ˦ɘ̼̼ɘ͐ʮͷʇ੮ ͐ʩɘ͐੮ I˺ͷʇ̼˦˺̼੮ Ûʇɘʡɘ˦੮ ɻˑ˺ͅʇʁ੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɻʮ̼ɻɘ੮ ৱ৹৶৷ੴ੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ )ʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ʠ੮ ä͐ɘ͐ʇ੮ P˺̹ͅʮ͐ɘˑͅ੮ ʮͅ੮ ɘ੮ ͐͸˺ચɺʮˑˑʮ˺˦ચʁ˺ˑˑɘ̼ચɘચ;ʇɘ̼ੴ੮ৱ৳ੴৰৰৰચ͐ͅɘʠʠ੮ɺʇʩʇ˚˺͐ʩੳ৿੮U˦੮ϲʮͅɻɘˑ੮;ʇɘ̼੮৲ৰ৲ৱજ৲৲ੴ੮ʮ͐ͅ੮ϲʮͷʇ੮ ʩ˺̹ͅʮ͐ɘˑͅૄ੮ɘͷʇ̼ɘʡʇ੮ʁɘʮˑ;੮ɻʇ˦͙ͅͅ੮͸ɘͅ੮৶ੴ৹৲ৰ੮ફ͙̹੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮ͅʮ˦ɻʇ੮ʮ͐ͅ੮˦ɘʁʮ̼੮ʮ˦੮ৱ৹৸৹બੳ਀ îʩʮͅ੮˚ɘˌʇͅ੮ʮ͐੮͐ʩʇ੮ˑɘ̼ʡʇ͐ͅ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̹̼˺ʡ̼ɘ˚੮ʮ˦੮͐ʩʇ੮ɻ˺͙˦̼͐;੮ફ͸ʩʮɻʩ੮ʮͅ੮͙˦͙̼̹̼ͅʮͅʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮ˑɘ̼ʡʇ͐ͅ੮͐ͅɘ͐ʇબ੮ɘ˦ʁ੮͐ʩʇ੮ʠ˺͙̼͐ʩ੮ˑɘ̼ʡʇ͐ͅ੮̼ʇˑɘ͐ʮͷʇ੮͐˺੮̹˺̹͙ˑɘ͐ʮ˺˦੮ફ͸ʩʮɻʩ੮ ʮͅ੮ˑʇͅͅ੮˺ɺͷʮ˺͙ͅ੮ʠ˺̼੮͐ʩ˺ͅʇ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩɘ͐੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮͙˦ʮή͙ʇˑ;੮͙˦ʁʇ̼ʇή͙ʮ̹̹ʇʁ੮ʠ˺̼੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ɻɘ̼ʇબੳਁ U˦੮˚˺͐ͅ੮ɻɘͅʇͅੴ੮͐ʩʇ੮̼˺͙͐ʇ੮ʮ˦͐˺੮͐ʩ˺ͅʇ੮ɺʇʁͅ੮ʮͅ੮˦˺͐੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ͅ੮#ɘˑʮʠ˺̼˦ʮɘ੮͙̼͐ɺ˺ɻʩɘ̼ʡʇʁ੮ʮ͐ͅ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ͅ;͐ͅʇ˚੮ʮ˦੮͐ʩʇ੮ৱ৹৹ৰͅੴ੮˚ɘͅͅ੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮ ̹ͅʮˑˑʇʁ੮˺ͷʇ̼੮ʮ˦͐˺੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ;͐ͅʇ˚ੳ੮šͷʇ̼੮͐ʮ˚ʇੴ੮̹ʇ˺̹ˑʇ੮ʁʇʇ˚ʇʁ੮ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮͐˺੮͐ͅɘ˦ʁ੮̼͐ʮɘˑੴ੮ʠ˺͙˦ʁ੮˦˺͐੮ʡ͙ʮˑ͐;੮ɺ;੮̼ʇɘͅ˺˦੮˺ʠ੮ʮ˦ͅɘ˦ʮ͐;ੴ੮ɻ˺˚˚ʮ͐͐ʇʁ੮ɘͅ੮ͅʇͽ͙ɘˑˑ;੮ ͷʮ˺ˑʇ˦͐੮̹̼ʇʁɘ͐˺̼ͅੴ੮ɘ˦ʁ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮ʠ̼˺˚੮͐ʩʇ੮͐ͅɘ͐ʇ੮̹̼ʮͅ˺˦੮ͅ;͐ͅʇ˚੮ɻɘ˚ʇ੮͐˺੮ɻ˺˦͐ͅʮ͙͐͐ʇ੮˦ʇɘ̼ˑ;੮৹ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮̹˺̹͙ˑɘ͐ʮ˺˦੮ફ͐ʩʇ੮˦ɘ͐ʮ˺˦ɘˑ੮ɘͷʇ̼ɘʡʇ੮ʮͅ੮ɻˑ˺ͅʇ̼੮͐˺੮ʩɘˑϲબ੮ ફϲʮʡ͙̼ʇ੮ ৳ੳৱબੳਂ੮ îʩɘ͐੮ ˑʇɘͷʇͅ੮ ɘˑˑ੮ ˺ʠ੮ ɘɺ˺͙͐੮ ͅʇͷʇ˦੮ ʩ͙˦ʁ̼ʇʁ੮ ɺʇʁͅ੮ ʠ˺̼੮ ʡ̼ɘͷʇˑ;੮ ʁʮͅɘɺˑʇʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ îʩʇ੮ɘɻ͙͐ɘˑ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ɘɻɻʇͅͅʮ˦ʡ੮͐ʩ˺ͅʇ੮ɺʇʁͅ੮ɘ̼ʇ੮˺̹ɘή͙ʇੳ੮‡˺˦ʇ੮˺ʠ੮͐ʩʇ੮͸ɘ̼;੮̹͙ɺˑʮɻ੮ʇ˚̹ˑ˺;ʇʇͅ੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͸˺͙ˑʁ੮ʡ˺੮˺˦੮͐ʩʇ੮̼ʇɻ˺̼ʁ੮͐˺੮ʇͽ̹ˑɘʮ˦੮͐ʩʇ˚੮ ͐˺੮˚ʇੳ੮Ĕʩʇ˦੮U੮ɘͅˌʇʁ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͸ʩɘ͐੮͐ʩʇ੮͐;̹ʮɻɘˑ੮̹̼˺ϲʮˑʇ੮͸ɘͅੴ੮͐ʩʇ;੮˺ʠ͐ʇ˦੮ ̼ʇɘɻʩʇʁ੮ʠ˺̼੮͐ʩʇ੮˚˺͐ͅ੮ʇͽ̼͐ʇ˚ʇ੮ʇͽɘ˚̹ˑʇͅੵ੮ɘ੮ɻˑʮʇ˦͐੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮̹ͅʮʁʇ̼੮ʇʡʡͅ੮ ʮ˦੮ʩʮͅ੮˦ʇɻˌੴ੮͸ʩ˺੮̹ͅʇ˦͐੮ɘˑˑ੮ʁɘ;੮ʮ˦੮ʠ˺͙̼ચ̹˺ʮ˦͐੮̼ʇ̼͐ͅɘʮ˦͐ͅ੮͐˺੮ˌʇʇ̹੮ʩʮ˚੮ʠ̼˺˚੮ɻˑɘ͸ʮ˦ʡ੮ ͐ʩʇ˚੮˺͙͐੶੮ɘ੮̹ʇ̼ͅ˺˦੮ͅ˺੮̹ɘ̼ɘ˦˺ʮʁ੮͐ʩɘ͐੮ʩʇ੮͐ʩ˺͙ʡʩ͐੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʡ͙ɘ̼ʁ੮͸ɘͅ੮ɘ੮ʡʩ˺͐ͅ੮

LO C K E D I N

145

ɘ˦ʁ੮͸ʩ˺੮ɻ͙͐੮˺ʠʠ੮ʩʮͅ੮̹ʇ˦ʮͅ੮͐˺੮ɺʇ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮͐˺੮ɘ੮˚ʇʁʮɻɘˑ੮ʠɘɻʮˑʮ͐;੮ɘ˦ʁ੮ʇͅɻɘ̹ʇ੮ʩʮ˚ੳ੮ ੮ˑʇͅͅ੮ʁ̼ɘ˚ɘ͐ʮɻ੮͸ɘ;੮͐˺੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈʇ੮͐ʩʇ੮̹˺̹͙ˑɘ͐ʮ˺˦੮͐ʩɘ͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ͅʇ̼ͷʇ੮ʮͅ੮ ̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɻ˺˚ɺʮ˦ʇ੮˚͙ˑ͐ʮ̹ˑʇ੮ɻʩɘˑˑʇ˦ʡʇͅ੮͐ʩɘ͐ੴ੮ʇͷʇ˦੮˺˦੮͐ʩʇʮ̼੮˺͸˦ੴ੮͸˺͙ˑʁ੮ɺʇ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ɘʁʁ̼ʇͅͅੵ੮̼͐ʇɘ͐˚ʇ˦͐ચ̼ʇͅʮ͐ͅɘ˦͐੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɘ˦ʁ੮ͅʇ̼ʮ˺͙ͅ੮ɻ˺˚˺̼ɺʮʁ੮˚ʇʁʮɻɘˑ੮ ˦ʇʇʁͅ੶੮ʁʇʇ̹੮̼͐ɘ͙˚ɘ੮ɘ˦ʁ੮ɘ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼੶੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅ੮ʠ̼˺˚੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ɘ˦ʁ੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ͷʮ˺ˑʇ˦͐੮ɺʇʩɘͷʮ˺̼ੳ /ͷʇ˦੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ͅʇʇ˚੮͐˺੮ʠɘˑˑ੮ʮ˦͐˺੮˚ɘ˦;੮˺ʠ੮͐ʩʇͅʇ੮ɻɘ͐ʇʡ˺̼ʮʇͅੴ੮͐ʩʇ੮̹ɘ͐ʩ͸ɘ;੮ ʮ˦͐˺੮ɘ੮ɺʇʁ੮ʮͅ੮ɘ̼ʁ͙˺͙ͅੳ੮#˺͙˦͐ʮʇͅ੮͙ͅʇʁ੮͐˺੮ɺʇ੮ɘɺˑʇ੮͐˺੮ɺ͙;੮ɘɻɻʇͅͅ੮͐˺੮ɘ੮ɻʇ̼͐ɘʮ˦੮˦͙˚ɺʇ̼੮ ˺ʠ੮ɺʇʁͅ੮ɘ˦ʁ੮ʁʇɻʮʁʇ੮͸ʩ˺੮ʡ˺͐੮˺˦ʇੳ੮‡˺͸੮͐ʩʇ̼ʇૄͅ੮ɘ੮ɻ˺˚˚˺˦੮͸ɘʮ͐ˑʮ͐ͅ੮ɻ˺˦̼͐˺ˑˑʇʁ੮ɺ;੮͐ʩʇ੮ ͐ͅɘ͐ʇੳ੮š˦ʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮ુ͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ̼ʇ੮ɺɘͅʮɻɘˑˑ;੮˦˺͐੮ɘ˦੮ ˺̹͐ʮ˺˦ૂ੮͸ʩʮˑʇ੮ɘ˦˺͐ʩʇ̼੮ʁʮͅ˚ʮͅͅʇʁੴ੮ુ͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੺੮Ě˺͙੮˚ʮʡʩ͐੮ɘͅ੮͸ʇˑˑ੮ˈ͙͐ͅ੮ʠ˺̼ʡʇ͐੮ ʮ͐ੳૂ੮)̼ੳ੮#ɘʮੴ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ͐੮ɘ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ʇͽ̹̼ʇͅͅʇʁ੮ ͐ʩʇ੮ʁʇ̹ͅʇ̼ɘ͐ʮ˺˦੮˺ʠ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮̹ɘ͐ʮʇ˦͐ͅ੮ͅʩʇ੮ʩɘʁ੮ɻ˺˦ɻˑ͙ʁʇʁ੮ɻ˺͙ˑʁ੮˦˺͐੮ɺʇ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇˑ;੮̼͐ʇɘ͐ʇʁ੮ɺ;੮ʩʇ̼੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͙˦ʮ͐੮͐˺੮ɺʇ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁੵ੮ુĔʇ੮ʩɘͷʇ੮͸ʇʇˌˑ;੮ ˚ʇʇ͐ʮ˦ʡͅ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺͙˦͐;੮ય˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ૄͅર੮ૃî̼ɘ˦ͅʮ͐ʮ˺˦ͅ੮îʇɘ˚ੳૄ੯ੳ੯ੳ੯ੳ੮ U͐ૄͅ੮̼ʮʁʮɻ͙ˑ˺͙ͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ˦;੮˦ʇ͸ͅ੮ʠ˺̼੮͙ͅੵ੮ૃPʇૄͅ੮˦͙˚ɺʇ̼੮ʠ˺̼͐;ચ͐͸˺੮ ˺˦੮͐ʩʇ੮‡ɘ̹ɘ੮યä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑર੮͸ɘʮ͐ˑʮ͐ͅੳૄ੮Ĕʇˑˑੴ੮ʩʇ੮͸ɘͅ੮ʠ˺̼͐;ચ͐͸˺੮͐ʩ̼ʇʇ੮˚˺˦͐ʩͅ੮ɘʡ˺ੳૂਃ îʩʇ੮ɺɘɻˌˑ˺ʡ੮ʮͅ੮ʡʇ͐͐ʮ˦ʡ੮͸˺̼ͅʇੳ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩɘͅ੮ͅʇʇ˦੮ɘ˦੮ʇͽ̼͐ɘ˺̼ʁʮ˦ɘ̼;੮̼ʮͅʇ੮ʮ˦੮̹ʇ˺̹ˑʇ੮ ʠ˺͙˦ʁ੮ ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮ ͐˺੮ ͐ͅɘ˦ʁ੮ ̼͐ʮɘˑ੮ ફUäîબੳ੮ îʩʇͅʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ ɻʩɘ̼ʡʇʁ੮ ͸ʮ͐ʩ੮ ɘ੮ ɻ̼ʮ˚ʇ੮ ɺ͙͐੮ ʁʇʇ˚ʇʁ੮ ͙˦ɘɺˑʇ੮ ͐˺੮ ̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ ʮ˦੮ ͐ʩʇʮ̼੮ ʁʇʠʇ˦ͅʇੴ੮ ɘ̼ʇ੮ ̼ʇʠʇ̼̼ʇʁ੮ ͐˺੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮͐˺੮ɺʇ੮ુ̼ʇ͐ͅ˺̼ʇʁૂ੮͐˺੮ɻ˺˚̹ʇ͐ʇ˦ɻ;ੳ਄੮îʩʇ੮̹ͅʮˌʇ੮ʮ˦੮Uäî੮̼ʇʠʇ̼̼ɘˑͅ੮ફʁ̼ʮͷʇ˦੮ɺ;੮ ͸ʇˑˑચʮ˦͐ʇ˦͐ʮ˺˦ʇʁ੮ʇʠʠ˺̼͐ͅ੮˺ʠ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮͐˺੮ˌʇʇ̹੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮ ̹̼ʮͅ˺˦બ੮ʮͅ੮ɘ੮͐ͅɘ̼͐ˑʮ˦ʡ੮͸ʮ˦ʁ˺͸੮ʮ˦͐˺੮͐ʩʇ੮ʠɘʮˑ͙̼ʇͅ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ɻ˺͙˦͐;ચ̼͙˦੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ੳ੮ ɻɻ˺̼ʁʮ˦ʡ੮ ͐˺੮ ͐ͅɘ͐ʇ੮ ʁɘ͐ɘੴ੮ ৸৴੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ ͐ʩʇͅʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ʩɘͷʇ੮ ɘ੮ ̹ͅ;ɻʩ˺͐ʮɻ੮˺̼੮˚˺˺ʁ੮ʁʮͅ˺̼ʁʇ̼ੴ੮৴৶੮̹ʇ̼ɻʇ˦͐੮ʩɘͷʇ੮ͅʮͽ͐ʇʇ˦੮˺̼੮˚˺̼ʇ੮̹̼ʮ˺̼੮ɘ̼̼ʇ͐ͅͅੴ੮৴৷੮̹ʇ̼ɻʇ˦͐੮͸ʇ̼ʇ੮͙˦ͅʩʇˑ͐ʇ̼ʇʁ੮ʩ˺˚ʇˑʇͅͅ੮ɘ͐੮͐ʩʇ੮͐ʮ˚ʇ੮˺ʠ੮͐ʩʇʮ̼੮ɘˑˑʇʡʇʁ੮ɻ̼ʮ˚ʇੴ੮ɘ˦ʁ੮˦ʇɘ̼ˑ;੮ʩɘˑʠ੮ ̼ʇɻʇʮͷʇʁ੮˦˺੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩ̼˺͙ʡʩ੮{ʇʁʮચ#ɘˑ੮ͅʮͽ੮˚˺˦͐ʩͅ੮̹̼ʮ˺̼ੳৼ৻੮ä˺˚ʇ੮ ɻ˺˚˚ʇ˦͐ɘ͐˺̼ͅ੮ɘ̼ʇ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩɘ͐੮͐ʩʮͅ੮ʡ̼˺͙̹੮ʮͅ੮ɻ˺˦ʁʇ˚˦ʇʁ੮͐˺੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ ʮ˦੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ͅ;͐ͅʇ˚੮ɺ;੮͐ʩʇ੮̼͐ͅʮɻ͐˦ʇͅͅ੮˺ʠ੮ˑɘ͸ͅ੮ɘ̼˺͙˦ʁ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ੳৼৼ îʩ̼˺͙ʡʩ˺͙͐੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮U੮ʩɘͷʇ੮ɘˑͅ˺੮̹˺ʮ˦͐ʇʁ੮͐˺੮̼ʇͅʮ͐ͅɘ˦ɻʇ੮ɘ˚˺˦ʡ੮ɻ˺˚˚͙˦ʮ͐;੮̹̼˺ͷʮʁʇ̼ͅ੮͐˺੮̼͐ʇɘ͐ʮ˦ʡ੮͐ʩʇͅʇ੮ͅ˺̼͐ͅ੮˺ʠ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮͸ʩ˺੮˚ʮʡʩ͐੮ʩɘͷʇ੮ɻ˺ચ˺ɻɻ͙̼̼ʮ˦ʡ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ʁʮͅ˺̼ʁʇ̼ͅ੮ɘ˦ʁ੮ɘ̼ʇ੮ʁʮ̹̼ͅ˺̹˺̼͐ʮ˺˦ɘ͐ʇˑ;੮̹˺˺̼੮ɘ˦ʁ੮˦˺˦͸ʩʮ͐ʇੳ U˦੮{ɘ;੮৲ৰ৲ৱੴ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮̹̼˺̹˺ͅʇʁ੮ɘʁʁ̼ʇͅͅʮ˦ʡ੮͐ʩʇ੮ʡ̼˺͸ʮ˦ʡ੮Uäî੮͸ɘʮ͐ˑʮ͐ͅ੮ ɺ;੮ͅʩ͙͐͐ʮ˦ʡ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐˺੮rØä੮̹ɘ͐ʮʇ˦͐ͅ੮ʇ˦͐ʮ̼ʇˑ;੮͸ʮ͐ʩʮ˦੮͐ʩ̼ʇʇ੮;ʇɘ̼ͅੳ੮੮̼ɘ˦ʡʇ੮ ˺ʠ੮͐ͅɘˌʇʩ˺ˑʁʇ̼ͅੴ੮ˑʇʁ੮ɺ;੮͐ʩʇ੮#˺͙˦͐;੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮)ʮ̼ʇɻ͐˺̼ͅ੮ͅͅ˺ɻʮɘ͐ʮ˺˦ੴ੮ʩɘʁ੮ ɘ˦੮͙˦ʁʇ̼͐ͅɘ˦ʁɘɺˑʇ੮ɻ˺˦˦ʮ̹͐ʮ˺˦ੳ੮îʩʇ;੮˺ɺͅʇ̼ͷʇʁ੮͐ʩɘ͐੮ˑ˺ɻɘˑ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ફ˚˺͐ͅ੮˺ʠ੮͸ʩʮɻʩ੮

146

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ɘ̼ʇ੮̹̼ʮͷɘ͐ʇબ੮ુʩɘͷʇ੮͐ʩʇ੮˺̹͐ʮ˺˦੮͐˺੮ɘɻɻʇ̹͐੮˺̼੮ʁʇ˦;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹ɘ͐ʮʇ˦͐ͅੴૂ੮˚ʇɘ˦ʮ˦ʡ੮ ͐ʩʇ̼ʇ੮ɘ̼ʇ੮˺ʠ͐ʇ˦੮ુ˦˺੮͙ͅʮ͐ɘɺˑʇ੮˺̼੮͸ʮˑˑʮ˦ʡૂ੮̹̼˺ͷʮʁʇ̼ͅ੮ʠ˺̼੮͐ʩʇ੮ુʩʮʡʩચ̼ʮͅˌ੮̹˺̹͙ˑɘ͐ʮ˺˦ͅૂ੮ ɘ͐੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑੳৼ৽੮ {˺͐ͅ੮ ˑ˺ɻɘˑ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ɻɘ˦ૄ͐੮ ʇͷʇ˦੮ ʡʇ͐੮ ɘ੮ ˑʮɻʇ˦ͅʇ੮ ͐˺੮ ͐ɘˌʇ੮ ͅʇͽ੮ ˺ʠʠʇ˦ʁʇ̼ͅੳ੮ͅ੮˺˦ʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʁ˺ɻ͐˺̼੮ή͙ʮ̹̹ʇʁੴ੮ુĔʇૄ̼ʇ੮͐ʩʇ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇ੮ˑʮ˦ʇੳૂ )̼ੳ੮ P˺͸ʮʇੴ੮ ͸ʩ˺੮ ͸˺̼ˌͅ੮ ʮ˦੮ ɘ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑૄͅ੮ rØä੮ ͙˦ʮ͐ੴ੮ ɻ˺˦ϲʮ̼˚ʇʁ੮ ͐ʩɘ͐੮ ʩʮͅ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮˦˺͐੮ˈ͙͐ͅ੮ɻˑʮ˦ʮɻɘˑˑ;੮ɻ˺˚̹ˑʇͽ੮ɺ͙͐੮ɘˑͅ˺੮͙˦͸ʇˑɻ˺˚ʇ੮ʇˑͅʇ͸ʩʇ̼ʇੳ੮îʩʮͅ੮ʮͅ੮ ˦˺͐੮˺˦ˑ;੮͸ʩ;੮͐ʩʇ;੮ʡ˺੮͐˺੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮͐ʩʇ੮ϲʮ̼͐ͅ੮̹ˑɘɻʇ੮ɺ͙͐੮ɘˑͅ˺੮ɘ੮ɺɘ̼̼ʮʇ̼੮͐˺੮ ͐ʩʇʮ̼੮ ˑʇɘͷʮ˦ʡ੮ ફɘ˦ʁ੮ ͐ʩ͙ͅ੮ ɘ੮ ̼˺ɘʁɺˑ˺ɻˌ੮ ̹̼ʇͷʇ˦͐ʮ˦ʡ੮ ˺͐ʩʇ̼੮ ̹ɘ͐ʮʇ˦͐ͅੴ੮ ˑʮ˦ʡʇ̼ʮ˦ʡ੮ ʮ˦ɘ̹̹̼˺̹̼ʮɘ͐ʇˑ;੮ɘ͐੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʠ̼˺˚੮ɻ˺˚ʮ˦ʡબੳ੮Pʇ੮˺̹ʮ˦ʇʁ੮͐ʩɘ͐੮ɘ͐੮͸ʇʇˌˑ;੮͐ʇɘ˚੮ ˚ʇʇ͐ʮ˦ʡͅੴ੮ુîʩʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʮˑˑ੮ͅɘ;ੴ੮ૃĔʇૄͷʇ੮ɘ̹̹ˑʮʇʁ੮͐˺੮͐ʩʮͅ੮̹ˑɘɻʇੴ੮͐ʩʮͅ੮̹ˑɘɻʇੴ੮͐ʩʮͅ੮ ̹ˑɘɻʇૄ੮ɘ˦ʁ੮U੮ɻɘ˦੮̹͙͐੮ʮ˦੮˚;੮˦˺͐ʇͅ੮͐ʩɘ͐੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮͅ੮̼ʇɘʁ;੮͐˺੮ʡ˺ੴ੮ɺ͙͐੮͐ʩʇ੮ˑʮ˚ʮ͐ʮ˦ʡ੮ ʠɘɻ͐˺̼੮ɻ˺͙ˑʁ੮ɺʇ੮͐ʩ˺ͅʇ੮˺͐ʩʇ̼੮ʠɘɻʮˑʮ͐ʮʇͅੳૂ੮Uૄˑˑ੮ʁʮͅɻ͙ͅͅ੮ɺˑɘɻˌˑʮ͐ͅʮ˦ʡ੮ɘ˦ʁ੮ɻʩʇ̼̼;ચ̹ʮɻˌʮ˦ʡ੮ ɺ;੮̹̼ʮͷɘ͐ʇ੮̹̼˺ͷʮʁʇ̼ͅ੮ˑɘ͐ʇ̼੮ʮ˦੮͐ʩʇ੮ɻʩɘ̹͐ʇ̼ੴ੮ɺ͙͐੮ʩʇ੮ͅɘ͸੮ɺ˺͐ʩ੮͐ͅɘ̼ˌˑ;ੵ੮ુîʩʇ;੮ય̹̼ʮͷɘ͐ʇ੮ ʠɘɻʮˑʮ͐ʮʇͅર੮ ˚ʮʡʩ͐੮ ˑ˺˺ˌ੮ ɘ͐੮ ɘ੮ ̹ʇ̼ͅ˺˦ૄͅ੮ ʩʮ͐ͅ˺̼;੮ ɘ˦ʁ੮ ͅɘ;ੴ੮ ૃîʩʮͅ੮ ̹ʇ̼ͅ˺˦੮ ʮͅ੮ ˦˺͐੮ ɘɺˑʇ੮ ͐˺੮ ɻ˺˚ʇ੮ʩʇ̼ʇ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ʁʮʁ੮͙ͅɻʩ੮ɘ˦ʁ੮͙ͅɻʩ੮ɺɘɻˌ੮ʮ˦੮͐ʩʇ੮ʁɘ;ੳૄૂ੮U͐੮͸ɘͅੴ੮ʩʇ੮ͅɘʮʁੴ੮̼͐ɘʡʮɻ੮ ͐˺੮͐ʇˑˑ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮ʩɘʁ੮ɺɘ͐͐ˑʇʁ੮ʠ˺̼੮˚˺˦͐ʩͅ੮͐˺੮ʡʇ͐੮ɺʇ͐͐ʇ̼੮͐ʩɘ͐੮͐ʩʇ;੮͸˺͙ˑʁ੮͐ͅɘ;੮ɘ͐੮ ͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɘ̼ʡ͙ɘɺˑ;੮͐ʩʇ੮ͅ;͐ͅʇ˚ૄͅ੮˚˺͐ͅ੮ɻ˺˦̼͐ͅʮɻ͐ʮͷʇ੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇੴ੮ʠ˺̼੮ˑɘɻˌ੮ ˺ʠ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੳ îʩʇ੮̹͙ͅʩɺɘɻˌ੮͐˺੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼ૄͅ੮̹ˑɘ˦੮͐˺੮ͅʩ͙͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐˺੮rØä੮̹ɘ͐ʮʇ˦͐ͅ੮ ͸ɘͅ੮͙ͅɻɻʇͅͅʠ͙ˑੴ੮ɘ˦ʁ੮ʩʇ੮͸ʮ͐ʩʁ̼ʇ͸੮ʩʮͅ੮̹̼˺̹˺ͅɘˑੳ੮"͙͐੮͐ʩʇ੮ͅɘʡɘ੮ʡ˺ʇͅ੮˺˦ੳ੮U˦੮k͙˦ʇ੮৲ৰ৲ৱੴ੮ ɘ˦੮ɘ̹̹ʇˑˑɘ͐ʇ੮ɻ˺͙̼͐੮̼͙ˑʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩɘʁ੮ુͅ;͐ͅʇ˚ɘ͐ʮɻɘˑˑ;੮ͷʮ˺ˑɘ͐ʇʁ੮͐ʩʇ੮ʁ͙ʇ੮̹̼˺ɻʇͅͅ੮̼ʮʡʩ͐ͅ੮˺ʠ੮ɘˑˑ੮Uäî੮ʁʇʠʇ˦ʁɘ˦͐ͅૂ੮͸ʩ˺੮̼ʇ˚ɘʮ˦ʇʁ੮͙͐ͅɻˌ੮ʮ˦੮ˈɘʮˑ੮͸ʩʮˑʇ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ ɘ੮̹ͅ˺͐੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳৼ৾੮U͐੮˺̼ʁʇ̼ʇʁ੮͐ʩɘ͐੮ɘˑˑ੮͙ͅɻʩ੮ɻɘͅʇͅ੮ɺʇ੮ɘʁ˚ʮ͐͐ʇʁ੮͐˺੮͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮͸ʮ͐ʩʮ˦੮͐͸ʇ˦͐;ચʇʮʡʩ͐੮ʁɘ;ͅ੮˺ʠ੮ɺʇʮ˦ʡ੮ʠ˺͙˦ʁ੮ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐ੳ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ͸˺͙ˑʁ੮ʩɘͷʇ੮͐˺੮ʡʇ͐੮͐˺੮͐ʩʇ੮ɺɘɻˌ੮˺ʠ੮ɘ੮ˑʮ˦ʇ੮͐ʩɘ͐੮ʩɘʁ੮ͅ͸˺ˑˑʇ˦੮ફɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮͐ʩʇ੮̹̼˺ɻʇͅͅબ੮͐˺੮˚˺̼ʇ੮͐ʩɘ˦੮͐͸˺੮͐ʩ˺͙ͅɘ˦ʁ੮̹ʇ˺̹ˑʇੳ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͸ɘʮ͐੮ ˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮;ʇɘ̼੮˺˦੮ɘͷʇ̼ɘʡʇ੮ʠ˺̼੮ɘ੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇ੮͐ʩɘ͐੮͐ʩʇʮ̼੮̹ʩ;ͅʮɻʮɘ˦੮ɘ˦ʁ੮ɘ੮ˈ͙ʁʡʇ੮ ʁʇʇ˚੮˦ʇɻʇͅͅɘ̼;੮ɺ͙͐੮͐ʩɘ͐੮˦ʇʮ͐ʩʇ̼੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮˦˺̼੮ɻ˺͙˦͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮˦˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʩɘͷʇ੮͐ʩʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ɘɻ͙͐ɘˑˑ;੮ʡʇ͐੮ʠ˺̼੮͐ʩʇ˚ੳৼ৿ /ͷʇ˦੮͸ʩʇ˦੮ɺʇʁͅ੮ɘ̼ʇ੮ɘͷɘʮˑɘɺˑʇੴ੮ɻ˺͙˦͐ʮʇͅ੮˚͙͐ͅ੮̹ɘ;੮͐ʩʇ੮͐ͅɘ͐ʇ੮͐˺੮͙ͅʇ੮͐ʩʇ˚ઝɘ͐੮ɘ੮ ɻ˺͐ͅ੮˺ʠ੮˚˺̼ʇ੮͐ʩɘ˦੮͐ʩ̼ʇʇ੮ʩ͙˦ʁ̼ʇʁ੮͐ʩ˺͙ͅɘ˦ʁ੮ʁ˺ˑˑɘ̼ͅ੮̹ʇ̼੮;ʇɘ̼ੳ੮Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘˑˑ੮ ̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮̼ʇ˚ɘʮ˦੮ɘ˦੮ʇͅͅʇ˦͐ʮɘˑ੮̹ʮʇɻʇ੮˺ʠ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੴ੮͸ʩʇ̼ʇ੮ ɘ̼˺͙˦ʁ੮৳જ৵੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇʮ̼੮˚˺͐ͅ੮ɻʩɘˑˑʇ˦ʡʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘ̼ʇ੮̹ˑɘɻʇʁੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ʠ˺̼੮˚ɘ˦;੮;ʇɘ̼ͅੳ੮"͙͐੮͐ʩʇ੮̼ʇ͐ͅ੮ʁ˺˦ૄ͐੮˚˺ͷʇ੮͙̹੮ʮ˦͐˺੮͐ʩʇ੮˚˺͐ͅ੮̹͙ɺˑʮɻ੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮îʩʇ;੮͐ͅʇ̹੮ʁ˺͸˦੮ʮ˦͐˺੮ɘ˦੮ɘˑ˚˺͐ͅ੮ʇ˦͐ʮ̼ʇˑ;੮̹̼ʮͷɘ͐ʇ੮͸˺̼ˑʁ੮˺ʠ੮ˑ˺ɻˌʇʁ੮U{)ͅੴ੮ ͐˺੮͸ʩʮɻʩ੮͸ʇ੮˦˺͸੮͙̼͐˦ੳ

LO C K E D I N

1 47

BUYING BEDS IN A SELLER’S MARKET ʁͷ˺ɻɘ͐ʇͅ੮ ʠ˺̼੮ ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ ʠ̼˺˚੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ʇ˦ͷʮͅʮ˺˦ʇʁ੮ ̼ʇ̹ˑɘɻʮ˦ʡ੮ ͐ʩʇ˚੮ ͸ʮ͐ʩ੮ ɘ੮ ̼˺ɺ͙͐ͅ੮ ͅ;͐ͅʇ˚੮ ˺ʠ੮ ͷ˺ˑ͙˦͐ɘ̼;ੴ੮ ͙˦ˑ˺ɻˌʇʁ੮ ɻ˺˚˚͙˦ʮ͐;ચɺɘͅʇʁ੮ ɻɘ̼ʇੳৼ਀੮ U˦੮ ̹̼ɘɻ͐ʮɻʇੴ੮͐ʩʇ;੮ʡ˺͐੮U{)ͅੳ੮îʩʇ੮͐ͅ˺̼;੮ɺʇʩʮ˦ʁ੮͐ʩɘ͐੮ɻˑ͙˦ˌ;੮˚˺˦ʮˌʇ̼ੴ੮U˦͐ͅʮ͙͐͐ʮ˺˦੮ʠ˺̼੮ {ʇ˦͐ɘˑ੮)ʮͅʇɘͅʇੴ੮ʮͅ੮ɘ੮ˑʮ͐͐ˑʇ੮ʁ̼;ੳ੮U͐੮ʮͅ੮ɘˑͅ˺੮ʇͅͅʇ˦͐ʮɘˑ੮ʠ˺̼੮͙˦ʁʇ̼͐ͅɘ˦ʁʮ˦ʡ੮͸ʩ˺੮ʇͽʇ̼ɻʮͅʇͅ੮ ̹˺͸ʇ̼੮ʁʮ̼ʇɻ͐ˑ;੮˺ͷʇ̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ફʮ͐ૄͅ੮˦˺͐੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅબ੮ɘ˦ʁ੮͸ʩ˺੮ʩɘͅ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੳ Ĕʩʇ˦੮#˺˦ʡ̼ʇͅͅ੮̹ɘͅͅʇʁ੮͐ʩʇ੮ä˺ɻʮɘˑ੮äʇɻ͙̼ʮ͐;੮ɻ͐੮˚ʇ˦ʁ˚ʇ˦͐ͅ੮ʮ˦੮ৱ৹৶৵ੴ੮ɻ̼ʇɘ͐ʮ˦ʡ੮ {ʇʁʮɻɘ̼ʇ੮ ɘ˦ʁ੮ {ʇʁʮɻɘʮʁੴ੮ ʮ͐੮ ʮ˦ɻˑ͙ʁʇʁ੮ ɘ੮ ̹̼˺ͷʮͅʮ˺˦੮ ɺɘ̼̼ʮ˦ʡ੮ {ʇʁʮɻɘʮʁ੮ ʠ͙˦ʁͅ੮ ʠ̼˺˚੮ ʡ˺ʮ˦ʡ੮ ͐˺੮ U{)ͅੳ੮ ˦੮ U{)੮ ʮͅ੮ ɘ੮ ʠɘɻʮˑʮ͐;੮ ͸ʮ͐ʩ੮ ͅʮͽ͐ʇʇ˦੮ ˺̼੮ ˚˺̼ʇ੮ ɺʇʁͅੴ੮ ˺ʠ੮ ͸ʩʮɻʩ੮ ͐ʩʇ੮ ˚ɘˈ˺̼ʮ͐;੮ ɘ̼ʇ੮ ͙ͅʇʁ੮ ͐˺੮ ̼͐ʇɘ͐੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ુ˚ʇ˦͐ɘˑ੮ ʁʮͅʇɘͅʇͅૂ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ɺʇ͐͸ʇʇ˦੮ ͐ʩʇ੮ ɘʡʇͅ੮˺ʠ੮͐͸ʇ˦͐;ચ˺˦ʇ੮ɘ˦ʁ੮ͅʮͽ͐;ચʠ˺͙̼ੳৼਁ੮îʩʇ੮ˑʇʡʮͅˑɘ͐˺̼ͅૄ੮ʮ˦͐ʇ˦͐੮͸ɘͅ੮ɻˑʇɘ̼ੵ੮͐ʩʇ;੮ʁʮʁ˦ૄ͐੮ ͸ɘ˦͐੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮̹ʮɻˌʮ˦ʡ੮͙̹੮͐ʩʇ੮͐ɘɺ੮ʠ˺̼੮͐ʩʇ੮ʩ͙˦ʁ̼ʇʁͅ੮˺ʠ੮͐ʩ˺͙ͅɘ˦ʁͅ੮ ˺ʠ੮̹ʇ˺̹ˑʇ੮ͅʩ͙͐੮ɘ͸ɘ;੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮˦ɘ͐ʮ˺˦͸ʮʁʇੳৼਂ੮{ʇʁʮɻɘʮʁૄͅ੮U{)੮ʇͽɻˑ͙ͅʮ˺˦੮ ˚ɘ;੮ʩɘͷʇ੮ɻ˺˦̼͐ʮɺ͙͐ʇʁ੮˚˺̼ʇ੮͐˺੮ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮͐ʩɘ˦੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮ˑɘ͸;ʇ̼ͅੴ੮ ̹ʩɘ̼˚ɘɻʇ͙͐ʮɻɘˑ੮ʁʮͅɻ˺ͷʇ̼ʮʇͅੴ੮ɘ˦ʁ੮ɻ˺˚˚͙˦ʮ͐;ચɻɘ̼ʇ੮̹̼˺ʡ̼ɘ˚ͅ੮ɻ˺˚ɺʮ˦ʇʁੳৼਃ U˦੮͐ʩʇ੮ৱ৹৷ৰͅੴ੮̹̼ʮͷɘ͐ʇ੮ʇ˦̼͐ʇ̹̼ʇ˦ʇ͙̼ͅ੮͐ͅɘ̼͐ʇʁ੮˺ʠʠʇ̼ʮ˦ʡ੮#ɘˑʮʠ˺̼˦ʮɘ੮ɘ੮ફϲʮͅɻɘˑˑ;બ੮ʡ̼ʇɘ͐੮ ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮˺̼ʡɘ˦ʮΈʮ˦ʡ੮ɘ˦ʁ੮̹ɘ;ʮ˦ʡ੮ʠ˺̼੮ɻ͙͐ͅ˺ʁʮɘˑ੮ɻɘ̼ʇ੮ʮ˦੮͐ͅɘ͐ʇચ̼͙˦੮ʠɘɻʮˑʮ͐ʮʇͅੳৼ਄ U˦੮ৱ৹৷৳ੴ੮͐ʩʇ੮ɻ˺˚̹ɘ˦;੮˦˺͸੮ɻɘˑˑʇʁ੮#̼ʇ͐ͅ͸˺˺ʁ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮ɻ̼ʇɘ͐ʇʁ੮ɘ੮ͅˌʮˑˑʇʁ੮ ˦͙̼ͅʮ˦ʡ੮ʠɘɻʮˑʮ͐;੮͸ʮ͐ʩ੮ɘ੮ુ̹ͅʇɻʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ૂ੮ʠ˺̼੮ɻʩ̼˺˦ʮɻɘˑˑ;੮ʮˑˑ੮̹ʇ˺̹ˑʇ੮˺˦੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮‡͙̼ͅʮ˦ʡ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ɻ˺͙ˑʁ੮ɺʮˑˑ੮{ʇʁʮɻɘʮʁ੮ͅ˺੮ˑ˺˦ʡ੮ɘͅ੮͐ʩʇ;੮ɻˑɘʮ˚ʇʁ੮ ͐ʩɘ͐੮ ˚˺͐ͅ੮ ̼ʇͅʮʁʇ˦͐ͅૄ੮ ̹̼ʮ˦ɻʮ̹ɘˑ੮ ʁʮɘʡ˦˺ͅʮͅ੮ ͸ɘͅ੮ ͅ˺˚ʇ͐ʩʮ˦ʡ੮ ˺͐ʩʇ̼੮ ͐ʩɘ˦੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ৽৻੮U˦੮ৱ৹৸৷ੴ੮͐ʩʇ੮ʠʇʁͅ੮̼ʇɘˑʮΈʇʁ੮͐ʩʮͅ੮͸ɘͅ੮ɘ੮ͅɻɘ˚੮ɘ˦ʁ੮̼ʇή͙ʮ̼ʇʁ੮#ɘˑʮʠ˺̼˦ʮɘ੮͐˺੮̹ɘ;੮ ɺɘɻˌ੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮˚˺˦ʇ;ੳ੮îʩʮͅ੮ˑʇʠ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮˺˦੮͐ʩʇ੮ʩ˺˺ˌ੮ʠ˺̼੮ɺ˺͐ʩ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ ɘ˦ʁ੮͐ʩʇͅʇ੮U{)ͅੳ੮U˦੮͐ʩʇ੮ৱ৹৹ৱ੮̼ʇɘˑʮʡ˦˚ʇ˦͐੮̼ʇʠ˺̼˚ੴ੮͸ʩʮɻʩ੮ʠ͙̼͐ʩʇ̼੮ʁʮͷʇ͐ͅʇʁ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ ʠ̼˺˚੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ɻ˺˦̼͙͐ͅɻ͐ʮ˦ʡ੮ɘ੮ɻ˺ʩʇ̼ʇ˦͐੮ɻ˺˦͐ʮ˦͙͙˚੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੴ੮ʮ͐੮ ̹ɘͅͅʇʁ੮ɻ˺͐ͅͅ੮ʠ˺̼੮ɺ˺͐ʩ੮ʇ˦͐ʮ̼ʇˑ;੮˺˦͐˺੮ɻ˺͙˦͐ʮʇͅੳ "ʇɻɘ͙ͅʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ɺʇʁͅ੮ɘ͐੮͐ʩʇ੮͐ʮ˚ʇ੮ɻ˺͐ͅ੮͐ʩʇ੮ɻ˺͙˦͐ʮʇͅ੮˦ʇɘ̼ˑ;੮ϲʮͷʇ੮͐ʮ˚ʇͅ੮ɘͅ੮ ˚͙ɻʩ੮̹ʇ̼੮;ʇɘ̼੮ɘͅ੮ɘ˦੮U{)ੴ৽ৼ੮͐ʩʇ੮ʁʇˑʇʡɘ͐ʮ˺˦੮˺ʠ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ɘɻɻʇˑʇ̼ɘ͐ʇʁ੮ɻ˺͙˦͐ʮʇͅૄ੮ ʇʠʠ˺̼͐ͅ੮͐˺੮ʡʇ͐੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮˺͙͐੮˺ʠ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳ৽৽੮/˦͐ʇ̼̹̼ʮͅʮ˦ʡ੮ɻ˺˚̹ɘ˦ʮʇͅ੮ ˑʮˌʇ੮ #̼ʇ͐ͅ͸˺˺ʁ੮ ͸ʇ̼ʇ੮ ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ ̼ʇɺ̼ɘ˦ʁʮ˦ʡ੮ ͐ʩʇͅʇ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ɘͅ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ Ûʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮#ʇ˦͐ʇ̼ͅ੮ફ{PÛ#ͅબੴ੮˦˺͐੮ˈ͙͐ͅ੮͸ɘ̼ʇʩ˺͙ͅʇͅੳ੮ફ{˺͐ͅ੮̹ʇ˺̹ˑʇ੮͐ͅʮˑˑ੮ʮ˦ʠ˺̼˚ɘˑˑ;੮ɻɘˑˑ੮͐ʩʇ˚੮U{)ͅੳબ੮#;˦ʮɻͅ੮ʁʮͅɘʡ̼ʇʇੳ੮"ʇ͐͐;੮)ɘˑή͙ʮ͐ͅੴ੮˺ʠ੮͐ʩʇ੮˦˺˦̹̼˺ϲʮ͐੮#ɘˑʮʠ˺̼˦ʮɘ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮ä˺ɻʮɘˑ੮Ûʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮ʡʇ˦ɻʮʇͅੴ੮ʮ˦ͅʮ͐ͅͅ੮͐ʩɘ͐੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮ʡ˺ʮ˦ʡ੮

148

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ʮ˦͐˺੮U{)ͅ੮ɻ˺͙ˑʁ੮ɺʇ੮ʮ˦੮͙˦ˑ˺ɻˌʇʁ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ʮʠ੮ɻ˺͙˦͐ʮʇͅ੮ͅʩ˺͸ʇʁ੮ɘ੮ɺʮ͐੮˚˺̼ʇ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ ɻ˺˚˚ʮ͐˚ʇ˦͐੮ ɘ˦ʁ੮ ʮ˚ɘʡʮ˦ɘ͐ʮ˺˦ੳ৽৾੮ î˺੮ ʩʇ̼ੴ੮ {PÛ#ͅ੮ ɘ̼ʇ੮ ˈ͙͐ͅ੮ ુ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇͅ੮ ͸ʮ͐ʩ੮ʠʇ͸ʇ̼੮˦͙̼ͅʇͅੳૂ੮U˦ʁʇʇʁੴ੮ʇͽ̹ˑɘʮ˦ʇʁ੮˺˦ʇ੮U{)੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼ੴ੮͐ʩʇ੮ˑ˺ʡʮɻ੮˺ʠ੮͙̼͐˦ʮ˦ʡ੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇ੮ʮ˦͐˺੮ɘ੮ુ̼ʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮ɻʇ˦͐ʇ̼ૂ੮ʮͅ੮͐ʩɘ͐੮ુʮ˦͐ͅʇɘʁ੮˺ʠ੮ʩɘͷʮ˦ʡ੮͐͸˺੮ ˦͙̼ͅʇͅੴ੮;˺͙੮ɻ˺͙ˑʁ੮ʩɘͷʇ੮˺˦ʇ੮˦͙̼ͅʇੴ੮͸ʩʮɻʩ੮ˑʇ͐ͅ੮;˺͙੮͐ɘˌʇ੮͐ʩɘ͐੮˚˺˦ʇ;੮ɘ˦ʁ੮ʩʮ̼ʇ੮͐ʩ̼ʇʇ੮ ̼ʇɻ˺ͷʇ̼;੮ɻ˺ɘɻʩʇͅੳૂ੮îʩʮͅ੮ʩʮ˦͐ͅ੮ɘ͐੮͐ʩʇ੮͸ɘʡʇͅ੮ɘ˦ʁ੮ɻ̼ʇʁʇ˦͐ʮɘˑͅ੮˺ʠ੮͐ʩʇͅʇ੮ɻ˺ɘɻʩʇͅ੮ફʮʠ੮˦˺͐੮ ͐ʩʇʮ̼੮ή͙ɘˑʮ͐;੮ɘ˦ʁ੮ʁʇʁʮɻɘ͐ʮ˺˦બੳ îʩɘ͐੮ ɺ̼ʮ˦ʡͅ੮ ͙ͅ੮ ͐˺੮ ͐˺ʁɘ;ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ʩɘͅ੮ ɘɺ˺͙͐੮ ৲ੴৰৰৰ੮ ɺʇʁͅ੮ ʮ˦੮ {PÛ#ͅ੮ ɘ˦ʁ੮ ৲ੴৱৰৰ੮ʮ˦੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇͅੳ৽৿੮ä͐ɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʩɘͅ੮͐ʩ˺̼˺͙ʡʩˑ;੮ɘɺʁʮɻɘ͐ʇʁ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ϲʮ˦ɘ˦ɻʮ˦ʡ੮ɘ˦ʁ੮̼͙͐ͅɻ͙̼͐ʮ˦ʡ੮͐ʩʮͅ੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮ {ʇʁʮચ#ɘˑ੮ɻɘ˦˦˺͐੮ɺʇ੮͙ͅʇʁ੮ʠ˺̼੮U{)ͅੴ੮ɘ˦ʁ੮͐ʩʇ੮৲ৰৰ৴੮ુ˚ʮˑˑʮ˺˦ɘʮ̼ʇૄͅ੮͐ɘͽੴૂ੮˺̼੮{Päੴ੮ ɻɘ˦˦˺͐੮ʡ˺੮͐˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̹̼˺ʡ̼ɘ˚ͅੳ੮ä˺੮ɻ˺͙˦͐ʮʇͅ੮̹ɘ;੮ʠ˺̼੮U{)ͅ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ˑʮ˚ʮ͐ʇʁ੮ ̹˺͐੮ ˺ʠ੮ ͐ɘͽ੮ ʁ˺ˑˑɘ̼ͅ੮ ͐ʩʇ;੮ ʡʇ͐੮ ͐ʩ̼˺͙ʡʩ੮ ৱ৹৹ৱ੮ ̼ʇɘˑʮʡ˦˚ʇ˦͐ੳ੮ ēʮ̼͙͐ɘˑˑ;੮ ɘˑˑ੮ U{)੮ ɺʇʁͅ੮ ɘ̼ʇ੮ ̼͙˦੮ ɺ;੮ ̹̼ʮͷɘ͐ʇ੮ ʠ˺̼ચ̹̼˺ϲʮ͐ͅ੮ ફϲʮʡ͙̼ʇ੮ ৷ੳৱબੳ੮ îʩʇͅʇ੮ ɺ͙ͅʮ˦ʇͅͅʇͅ੮ ʩɘͷʇ੮ ˚ɘ˦ɘʡʇʁ੮ ͐˺੮ ʇͽ̹ɘ˦ʁ੮ ʇͷʇ˦੮ ɘͅ੮ ͸ɘͷʇͅ੮ ˺ʠ੮ ɘ͙͐ͅʇ̼ʮ͐;੮ ʩɘͷʇ੮ ɻˑ˺ͅʇʁ੮ ˦˺˦̹̼˺ϲʮ͐੮ ̹̼˺ͷʮʁʇ̼ͅ੮ ˺ʠ੮ ͙˦ˑ˺ɻˌʇʁ੮ ̼ʇͅʮʁʇ˦͐ʮɘˑ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ɘ˦ʁ੮ ͐ʮʡʩ͐ʇ˦ʮ˦ʡ੮ ʮ˦͙̼ͅɘ˦ɻʇ੮ ̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮ ʩɘͷʇ੮ ͅʩ͙͐͐ʇ̼ʇʁ੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳ੮#˺͙˦͐ʮʇͅ੮ʩɘͷʇ੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮̼͐ʮʇʁ੮͐˺੮ͅʇ͐੮͙̹੮͐ʩʇʮ̼੮ ˺͸˦੮U{)ͅੴ੮ɺ͙͐੮͐ʩʇ੮ɻ˺͐ͅͅ੮˺ʠ੮͙˦ʮ˺˦ʮΈʇʁ੮̹͙ɺˑʮɻ੮͐ͅɘʠʠ੮˚ɘˌʇ੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮͐ʩʇ˚੮˺͙͐੮ ˚͙ɻʩ੮ɻʩʇɘ̹ʇ̼ੳ৽਀

1,000 900

877

800 700 602 Beds

600 474

500 400 300 200 100 0

Crestwood

Other for-profit

Telecare

60

47

Non-profit

Public

7.1 š͸˦ʇ̼ઃ˺̹ʇ̼ɘ͐˺̼੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Ûʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮#ʇ˦͐ʇ̼ͅ੮ફ{PÛ#ͅબੴ੮৲ৰ৲৲ Sourceੵ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩɻɘ̼ʇ੮äʇ̼ͷʮɻʇͅ

LO C K E D I N

149

˦ʁ੮ ʩʇ̼ʇૄͅ੮ ͐ʩʇ੮ ˌʮɻˌʇ̼ੵ੮ ɻ˺͙˦͐ʮʇͅ੮ ɻ˺˚̹ʇ͐ʇ੮ ͸ʮ͐ʩ੮ ʇɘɻʩ੮ ˺͐ʩʇ̼੮ ʠ˺̼੮ ͐ʩʇͅʇ੮ ˑʮ˚ʮ͐ʇʁ੮ ̹ͅ˺͐ͅੳ੮ ˦੮ ɘ˦˺˦;˚˺͙ͅ੮ ̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮ ˺ʠ੮ ˺˦ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ͐͸˺੮ ˚ɘʮ˦੮ U{)੮ ̹̼˺ͷʮʁʇ̼ͅੴ੮ #̼ʇ͐ͅ͸˺˺ʁ੮ɘ˦ʁ੮îʇˑʇɻɘ̼ʇੴ੮ʮ˦ͅʮ͐ͅʇʁ੮͐ʩɘ͐੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ˑʇ͐੮ɻ˺͙˦͐ʮʇͅ੮ɺʮʁ੮ɘʡɘʮ˦͐ͅ੮ʇɘɻʩ੮ ˺͐ʩʇ̼ੳ੮"͙͐੮͐ʩʇ̼ʇૄͅ੮̹ˑʇ˦͐;੮˺ʠ੮ʁ˺ɻ͙˚ʇ˦͐ɘ͐ʮ˺˦੮˺ʠ੮͐ʩʮͅ੮ˑ˺˦ʡચ̼͙˦˦ʮ˦ʡ੮̹̼ɘɻ͐ʮɻʇੵ੮ɘͅ੮ʇɘ̼ˑ;੮ ɘͅ੮ৱ৹৸৵ੴ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮͸ɘͅ੮͐ʩ̼˺͸ʮ˦ʡ੮ʮ˦੮ɘ˦੮ʇͽ̼͐ɘ੮ϲʮʠ͐;੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;੮͐˺੮ͅ˦ɘ̹੮͙̹੮ ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇ੮ ɺʇʁͅ੮ ʠ˺̼੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ʮ˦੮ ˦ʇʮʡʩɺ˺̼ʮ˦ʡ੮ äɘ˦͐ɘ੮ #ˑɘ̼ɘੳ৽ਁ੮ k˺˦੮ äʩʇ̼ʮ˦ੴ੮ ͐ʩʇ੮ʠ˺̼˚ʇ̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʮ̼ʇɻ͐˺̼੮ʠ̼˺˚੮r˺ͅ੮˦ʡʇˑʇͅ੮#˺͙˦͐;ੴ੮͸ɘͅ੮˦˺͐੮ɘ̹˺ˑ˺ʡʇ͐ʮɻ੮ ͸ʩʇ˦੮U੮ɘͅˌʇʁ੮ʩʮ˚੮ɘɺ˺͙͐੮ʮ͐ੳ੮ુĔʇ੮ɘ̼ʇ੮͐ʩʇ੮৸ৰৰચ̹˺͙˦ʁ੮ʡ˺̼ʮˑˑɘੴ੮͸ʇ੮ɻɘ˦੮ʡʇ͐੮̹ʇ˺̹ˑʇૄͅ੮ ɘ͐͐ʇ˦͐ʮ˺˦ੴૂ੮ʩʇ੮͐˺ˑʁ੮˚ʇੳ੮ુĔʇ੮ɘ̼ʇ੮ʡ˺ʮ˦ʡ੮ɘʠ͐ʇ̼੮ʠɘɻʮˑʮ͐ʮʇͅ੮ͅɘ;ʮ˦ʡੴ੮ૃUʠ੮;˺͙ૄͷʇ੮ʡ˺͐੮ʇʮʡʩ͐;੮ ɺʇʁͅੴ੮ ͸ʇ੮ ͸ɘ˦͐੮ ͐ʩʇ˚੮ ɘˑˑੴ੮ ɘ˦ʁ੮ ͸ʇૄˑˑ੮ ˌʇʇ̹੮ ͐ʩʇ˚੮ ʠ͙ˑˑੳૄૂ੮ U੮ ̹̼ʇͅͅʇʁ੮ ʩʮ˚੮ ˺˦੮ ͸ʩʇ͐ʩʇ̼੮ ͐ʩʮͅ੮ɻ̼ʇɘ͐ʇʁ੮ɘ੮Έʇ̼˺ચ͙ͅ˚੮ɺɘ͐͐ˑʇ੮ɺʇ͐͸ʇʇ˦੮ɻ˺͙˦͐ʮʇͅੴ੮͸ʩʇ̼ʇɺ;੮˺˦ʇૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʡ˺͐੮ ʮ˦͐˺੮͐ʩʇ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ʠɘɻʮˑʮ͐;੮ɘ͐੮͐ʩʇ੮ɻ˺͐ͅ੮˺ʠ੮ɘ˦˺͐ʩʇ̼ૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɺʇʮ˦ʡ੮͙͐ͅɻˌ੮ʮ˦੮ ʮ˦ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮˺˦ʇͅੳ੮Pʇ੮̼ʇ̹ˑʮʇʁੴ੮ુĔʇૄ̼ʇ੮˦˺͐੮ɺ͙ˑˑʮʇͅ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ʩɘͷʇ੮৳ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮ ̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮ɺ͙͐੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮˦ʇʇʁੳ੮ä˺੮ʁ˺˦ૄ͐੮͐ʇˑˑ੮˚ʇੴ੮ૃU͐ૄͅ੮˦˺͐੮ʇή͙ʮ͐ɘɺˑʇੳૄૂ îʩʮͅ੮ ͅ;͐ͅʇ˚੮ ˺ʠ੮ ɻ˺˦̼͐ɘɻ͐ʮ˦ʡ੮ ͸ʮ͐ʩ੮ ̹̼ʮͷɘ͐ʇ੮ ̹̼˺ͷʮʁʇ̼ͅ੮ ˚ɘˌʇͅ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮ ʠʇʇˑੴ੮ɻ˺̼̼ʇɻ͐ˑ;ੴ੮͐ʩɘ͐੮͐ʩʇ;੮ˑɘɻˌ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮͸ʩʇ̼ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʇ˦ʁ੮͙̹ੳ੮#˺͙˦͐;੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮˦ʇʡ˺͐ʮɘ͐ʇ੮͐ʩʇ੮ɻ˺˦̼͐ɘɻ͐ͅ੮ɘ˦ʁ੮ʩ˺ˑʁ੮͐ʩʇ੮̹͙̼ͅʇ੮̼͐ͅʮ˦ʡͅੳ੮ ੮ʁʇ̹͙͐;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦੮˺˦ʇ੮ˑɘ̼ʡʇੴ੮̼ʮɻʩੴ੮ɘ˦ʁ੮͐ͅʮ˦ʡ;੮ɻ˺͙˦͐;੮̼ʇɻ˺͙˦͐ʇʁੴ੮ુĔʇ੮ ̼͐ʮʇʁ੮͐˺੮ʡʇ͐੮ɘ੮ɻ˺˦̼͐ɘɻ͐੮͸ʮ͐ʩ੮યU{)રੴ੮ʮ͐੮ʩɘͅ੮ɘ੮̼ʇɻ˺ͷʇ̼;੮˚˺ʁʇˑ੮યɘ˦ʁર੮͐ʩʇ;੮ɻɘ̼ʇ੮ɘɺ˺͙͐੮ ͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅੳ੮U੮ʡ˺͐੮˚;੮ɺ˺ͅͅ੮͐˺੮ɘʡ̼ʇʇ੮͐˺੮͐ɘˌʇ੮ɘ੮͐˺͙̼ੳ੮"͙͐੮͸ʇ੮ʁʮʁ˦ૄ͐੮યʡʇ͐੮͐ʩʇ੮ɻ˺˦̼͐ɘɻ͐રੴ੮ ɺʇɻɘ͙ͅʇ੮યʩʇ̼੮ɻ˺͙˦͐;ર੮ʁ˺ʇͅ˦ૄ͐੮̹ɘ;੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮˺͐ʩʇ̼੮ɻ˺͙˦͐ʮʇͅੳૂ੮Pʇ̼੮ɻ˺͙˦͐;੮ુˑ˺͐ͅૂ੮ ͅʮͽ੮ɺʇʁͅ੮ʮ˦੮͐ʩʇ੮ˑɘ͐ͅ੮;ʇɘ̼ੴ੮ુɘ˦ʁ੮͐ʩʇ;੮ય͐ʩʇ੮U{)ર੮͸ʇ̼ʇ੮ɻˑʇɘ̼੮ʮ͐ૄͅ੮ɺʇɻɘ͙ͅʇ੮r੮#˺͙˦͐;੮ ̹ɘʮʁ੮˚˺̼ʇੳૂ #ˑʇɘ̼ˑ;ੴ੮͐ʩʮͅ੮ͅ;͐ͅʇ˚੮ʩɘͅ੮ˑ˺ͅʇ̼ͅੳ੮H˺̼੮˺˦ʇ੮͐ʩʮ˦ʡੴ੮˚ʮ˦˦˺͸ͅ੮ˑʮˌʇ੮H̼˺˦͐ʮʇ̼੮#˺͙˦͐;੮ ˺ʠ͐ʇ˦੮ɻɘ˦ૄ͐੮̹ˑɘɻʇ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮ʮ˦੮U{)ͅ੮ɘ͐੮ɘˑˑੴ੮ʇͷʇ˦੮ʮʠ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੴ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩੴ੮ɘ˦ʁ੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘˑˑ੮ɘʡ̼ʇʇ੮ʮ͐ૄͅ੮͐ʩʇ੮̼ʮʡʩ͐੮ˑʇͷʇˑ੮˺ʠ੮ ɻɘ̼ʇੳ੮{ʇɘ˦͸ʩʮˑʇੴ੮̹̼ʮͷɘ͐ʇ੮ɻ˺˚̹ɘ˦ʮʇͅ੮ɺ͙ʮˑʁ੮͸ʩʇ̼ʇ੮ˑɘ˦ʁ੮ɘ˦ʁ੮ˑɘɺ˺̼੮ɘ̼ʇ੮ɻʩʇɘ̹ʇ̼੮ɘ˦ʁ੮ ɻ˺˚˚͙˦ʮ͐;੮ ̼ʇͅʮ͐ͅɘ˦ɻʇ੮ ͐˺੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ʠ˺̼੮ ɘ੮ ͐ͅʮʡ˚ɘ͐ʮΈʇʁ੮ ɻˑʮʇ˦͐ʇˑʇ੮ ʮͅ੮ ͸ʇɘˌʇ̼ੴ੮ ͸ʩʮɻʩ੮ ˚ʇɘ˦ͅ੮ɘ͸ɘ;੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺ɘ͐ͅੳ੮#˺˦ͅʮ͐ͅʇ˦͐੮͸ʮ͐ʩ੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ʡʇ˦ʇ̼ɘˑ੮ˑɘɻˌ੮˺ʠ੮˺ͷʇ̼ͅʮʡʩ͐੮ ˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮˦˺੮ʁɘ͐ɘ੮˺˦੮͸ʩʇ̼ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʇ˦ʁ੮͙̹ੳ੮ "͙͐੮˚ɘ˦;੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮ɘ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮͐ʩʇʮ̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͸ʇ̼ʇ੮ ̹ˑɘɻʇʁ੮ ˺͙͐੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ʩ˺˚ʇ੮ ɻ˺͙˦͐;੮ ફʮ˦ɻˑ͙ʁʮ˦ʡ੮ ৵৴੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅੴ੮ ʠ˺̼੮ ʇͽɘ˚̹ˑʇબੳ৽ਂ੮k˺ͅʇ̹ʩʮ˦ʇੴ੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦੮˺˦ʇ੮ɻ˺ɘ͐ͅɘˑ੮ɻ˺͙˦͐;ੴ੮̼ʇ̹˺̼͐ʇʁ੮ͅʩʇ੮ʩɘʁ੮ુɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘͅ੮ʠɘ̼੮˦˺̼͐ʩ੮ɘͅ੮äɘɻ̼ɘ˚ʇ˦͐˺੮ɘ˦ʁ੮ʠɘ̼੮ͅ˺͙͐ʩ੮ɘͅ੮r˺˦ʡ੮"ʇɘɻʩੳૂ îʩʮͅ੮ʁʮͅˑ˺ɻɘ͐ʮ˺˦੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʮ˦ˑɘ˦ʁ੮ʮͅ੮̹̼˺ɺɘɺˑ;੮ʮ˦ʇͷʮ͐ɘɺˑʇ੶੮ʮ͐ૄͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮ ͐˺੮ʁʮͅɘʁͷɘ˦͐ɘʡʇʁ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɘ˦ʁ੮͸ʮ͐ʩ˺͙͐੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮

150

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

"͙͐੮ ɻ˺˦̼͐ɘɻ͐ʮ˦ʡ੮ ˚ɘˌʇͅ੮ ʮ͐੮ ͸˺̼ͅʇੳ੮ š˦ʇ੮ ̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼੮ ˑɘ˚ʇ˦͐ʇʁੴ੮ ુĔʇ੮ ʩɘͷʇ੮ ɘ੮ ˑ˺ɻˌʇʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦੮͸ʮ͐ʩ੮ৱ৲ৰ੮ɺʇʁͅੴ੮ɘ˦ʁ੮˺͙̼੮ɻ˺͙˦͐;੮˺˦ˑ;੮ɻ˺˦̼͐ɘɻ͐ͅ੮ʠ˺̼੮ʠ˺͙̼੮˺ʠ੮͐ʩʇ˚ੳ੮ ä˺੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮ʡ˺੮˺͙͐੮˺ʠ੮ɻ˺͙˦͐;ੴ੮ɘ͸ɘ;੮ʠ̼˺˚੮ʠɘ˚ʮˑ;੮ɘ˦ʁ੮ʠ̼ʮʇ˦ʁͅੴ੮ɘ͸ɘ;੮ʠ̼˺˚੮͐ʩʇʮ̼੮ ͙̹̹ͅ˺̼͐੮ͅ;͐ͅʇ˚ੴ੮ʮ˦͐˺੮ɘ˦੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮ɘ˦ʁ੮ɻˑʮ˚ɘ͐ʇ੮͐ʩɘ͐ૄͅ੮͐˺͐ɘˑˑ;੮ʁʮʠʠʇ̼ʇ˦͐ੳ੮U͐ૄͅ੮˦˺͐੮ ʡ̼ʇɘ͐ੳ੮Øʇ˺̹ˑʇ੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʡʇ͐੮ͅʩʮ̹̹ʇʁ੮˺͙͐ੳૂ

BLACKLISTING AND CHERRY-PICKING îʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮U{)੮ɻɘ̼ʇ੮͐˺੮ɻ˺˦̼͐ɘɻ͐ʇʁ੮̹̼˺ͷʮʁʇ̼ͅ੮ʮͅ੮˦˺͐੮ˈ͙͐ͅ੮͐ʩɘ͐੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʡʇ͐੮ͅɻɘ͐͐ʇ̼ʇʁ੮ɘɻ̼˺ͅͅ੮ɘ˦੮ʮ˚˚ʇ˦ͅʇ੮͐ͅɘ͐ʇੳ੮U͐੮ɘˑͅ˺੮ʡʮͷʇͅ੮U{)੮̹̼˺ͷʮʁʇ̼ͅ੮ ʇ˦˺̼˚˺͙ͅ੮ ˑʇͷʇ̼ɘʡʇ੮ ʮ˦੮ ʁʇɻʮʁʮ˦ʡ੮ ͸ʩ˺੮ ͐˺੮ ͐ɘˌʇੳ੮ š˦੮ ̹ɘ̹ʇ̼ੴ੮ ɻ˺͙˦͐ʮʇͅ੮ ʩɘͷʇ੮ ͐ʩʇ੮ ̹̼ʮ˚ɘ̼;੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ͐˺੮ ʁʇɻʮʁʇ੮ ͸ʩ˺੮ ʡ˺ʇͅ੮ ʮ˦͐˺੮ ɘ˦੮ U{)ੳ੮ U੮ ̼ʇͷʮʇ͸ʇʁ੮ äɘ˦͐ɘ੮ "ɘ̼ɺɘ̼ɘૄͅ੮ ɻ˺˦̼͐ɘɻ͐੮͸ʮ͐ʩ੮#̼ʇ͐ͅ͸˺˺ʁੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮͸ʩʮɻʩ੮͐ͅɘ͐ʇͅ੮͐ʩɘ͐੮#̼ʇ͐ͅ͸˺˺ʁ੮ુͅʩɘˑˑ੮ɘʁ˚ʮ͐੮ ɻˑʮʇ˦͐ͅ੮͐˺੮#˺˦̼͐ɘɻ͐˺̼ૄͅ੮̹̼˺ʡ̼ɘ˚ͅ੮͙˦ˑʇͅͅ੮ɻ˺˚̹ʇˑˑʮ˦ʡ੮ɻˑʮ˦ʮɻɘˑ੮ɻʮ̼ɻ͙˚͐ͅɘ˦ɻʇͅ੮ʇͽʮ͐ͅ੮ ͐ʩɘ͐੮ɻ˺˦̼͐ɘʮ˦ʁʮɻɘ͐ʇ੮ɘʁ˚ʮͅͅʮ˺˦ੳૂ੮"͙͐੮ʇͷʇ̼;˺˦ʇ੮U੮͐ɘˑˌʇʁ੮͐˺ੴ੮˺˦੮ʇʮ͐ʩʇ̼੮ͅʮʁʇ੮˺ʠ੮͐ʩʇ੮ U{)੮ ɘʁ˚ʮͅͅʮ˺˦ͅ੮ ̹̼˺ɻʇͅͅੴ੮ ɘʡ̼ʇʇʁ੮ ͸ʩʇ̼ʇ੮ ͐ʩʇ੮ ̼ʇɘˑ੮ ͷʇ͐˺੮ ̹˺͸ʇ̼੮ ̼ʇ͐ͅʇʁੳ੮ ુĔʇ੮ ɘ̼ʇ੮ ɘ͐੮ ͐ʩʇ੮˚ʇ̼ɻ;੮˺ʠ੮͐ʩʇ੮˺̹ʇ̼ɘ͐˺̼ͅੴૂ੮˺˦ʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮̹͙͐੮ʮ͐ੳ੮U͐ૄͅ੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮̹͙̼ʇ͐ͅ੮ ʮˑˑ͙̼͐ͅɘ͐ʮ˺˦ͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ɘ͙͐ʩ˺̼ʮ͐;੮ɘͅ੮͐ʩʇ੮ɻɘ̹ɘɻʮ͐;੮͐˺੮ʡʮͷʇ੮ʇͽɻˑ͙ͅʮ˺˦ɘ̼;੮ ̼ʇɘͅ˺˦ͅੵ੮U{)ͅ੮ɻɘ˦੮ͅɘ;੮ુ˦˺ૂ੮͐˺੮ɘ੮ʡʮͷʇ˦੮ɻˑʮʇ˦͐੮ɘ˦ʁ੮͐ʩɘ͐ૄͅ੮ʇ˦˺͙ʡʩ੮ʠ˺̼੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮ ʩɘͷʇ੮͐˺੮ˑ˺˺ˌ੮ʇˑͅʇ͸ʩʇ̼ʇੳ Øʇ˺̹ˑʇ੮ʡʇ˦ʇ̼ɘˑˑ;੮ʡ˺੮͐˺੮U{)ͅ੮͸ʩʇ˦੮͐ʩʇ;ૄͷʇ੮ɺʇʇ˦੮̼ʇ̹ʇɘ͐ʇʁˑ;੮͙˦ɘɺˑʇ੮͐˺੮͐ͅɘɺʮˑʮΈʇ੮ ɘ͐੮˺͐ʩʇ̼੮ˑʇͷʇˑͅ੮˺ʠ੮ɻɘ̼ʇੳ੮)̼ੳ੮HɘΈʮ˺੮ʮͅ੮͐ʩʇ੮˚ʇʁʮɻɘˑ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮ɘ˦੮U{)੮ʮ˦੮‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੳ੮Pʇૄͅ੮ɘ˦੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐ʩ̼˺͙ʡʩ੮ɘ˦ʁ੮͐ʩ̼˺͙ʡʩੳ੮Pʇ੮͸˺̼ˌʇʁ੮ʮ˦੮ ɘ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɘ੮ˈɘʮˑ੮̹ͅ;ɻʩ੮͙˦ʮ͐ੴ੮ɘ˦ʁ੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮Pʇ੮ʩɘͅ੮ɺʇʇ˦੮ɘ੮ͷ˺ɻɘˑ੮ɘʁͷ˺ɻɘ͐ʇ੮ʠ˺̼੮rØä੮̼ʇʠ˺̼˚੮ͅʮ˦ɻʇ੮͐ʩʇ੮ͷʇ̼;੮ϲʮ̼͐ͅ੮͐ʮ˚ʇ੮ʩʇ੮ͅɘ͸੮ુ̹ɘ͐ʮʇ˦͐ͅ੮͸ʩ˺੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁ੮ ͸ʩʇ̼ʇ੮U੮͸ɘͅ੮ʮ˦੮ͅʩ˺ɻˌੴ੮ʡʇ͐͐ʮ˦ʡ੮ɻɘˑˑͅ੮ʠ̼˺˚੮ˑ˺ͷʇʁ੮˺˦ʇͅੴ੮ૃĔʩ;੮ʁʮʁ੮;˺͙੮ˑʇ͐੮͐ʩʇ˚੮ʡ˺੺ૄ੮ ɘ˦ʁ੮Uૄʁ੮ͅɘ;ੴ੮ૃU੮ʁʮʁ˦ૄ͐੮ˑʇ͐੮͐ʩʇ˚੮ʡ˺ੴ੮͐ʩʇ੮યˈ͙ʁʡʇર੮ˑʇ͐੮͐ʩʇ˚੮ʡ˺ੴૄ੮ૃĔʇˑˑ੮˦˺͸੮͐ʩʇ;ૄ̼ʇ੮ʮ˦੮ˈɘʮˑੴ੮ Uૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮͙ͅʇ੮;˺͙ੳૄૂ੮Pʇ੮ʩɘͅ੮˦ʇͷʇ̼੮͙˦ʁʇ̼͐ͅ˺˺ʁ੮ુ͐ʩʮͅ੮ʮʁʇɘ੮˺ʠ੮ɘˑˑ˺͸ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ ͸ʩ˺੮ʮͅ੮ͅ˺੮˚ʇ˦͐ɘˑˑ;੮ʮ˚̹ɘʮ̼ʇʁ੮͐˺੮˚ɘˌʇ੮͐ʩʇʮ̼੮˺͸˦੮ʁʇɻʮͅʮ˺˦ͅ੮ɘ˦ʁ੮͐ʩʇ˦੮ʩɘͷʮ˦ʡ੮͐ʩʇ˚੮ ʇ˦ʁ੮͙̹੮ʮ˦੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˈ͙͐ͅʮɻʇ੮ͅ;͐ͅʇ˚ੳૂ੮Pʇૄʁ੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ϲʮ̼͐ͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ʠ˺̼੮ɘ੮̹ͅ;ɻʩ˺͐ʮɻ੮ɺ̼ʇɘˌ੮ˑɘ͐ͅ੮ɘ͐੮ˑʇɘ͐ͅ੮ɘ੮˚˺˦͐ʩੴ੮ʠ˺ˑˑ˺͸ʇʁ੮ɺ;੮͐ʩʇ੮ͅˑ˺͸ੴ੮̼͙͐ͅɻ͙̼͐ʇʁ੮̼ʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮̹̼˺ʡ̼ɘ˚੮ʩʮͅ੮U{)੮˺ʠʠʇ̼ͅੳ îʩʇ੮˚˺̼˦ʮ˦ʡ੮͸ʇ੮̹ͅʇɘˌੴ੮ʩʇૄͅ੮ʁʇɘˑʮ˦ʡ੮͸ʮ͐ʩ੮ɘ੮ɻɘͅʇ੮͐ʩɘ͐ੴ੮ʩʇ੮͐ʇˑˑͅ੮˚ʇੴ੮ɻɘ̹͙̼͐ʇͅ੮ɺ˺͐ʩ੮ ͐ʩʇ੮ ˦ʇʇʁ੮ ʠ˺̼੮ U{)ͅ੮ ɘ˦ʁ੮ ̹ɘ͐ʮʇ˦͐ͅૄ੮ ɻʩɘ˺͐ʮɻ੮ ̼͐ɘˈʇɻ͐˺̼ʮʇͅ੮ ʮ˦͐˺੮ ͐ʩʇͅʇ੮ ʠɘɻʮˑʮ͐ʮʇͅੳ੮ îʩʇ੮ ̹ɘ͐ʮʇ˦͐੮ʮͅ੮ɘ੮͐͸ʇ˦͐;ચͅʮͽચ;ʇɘ̼ચ˺ˑʁ੮ɻʩʮˑʁ੮˺ʠ੮‡ʇ̹ɘˑʇͅʇ੮ʮ˚˚ʮʡ̼ɘ˦͐ͅ੮͸ʮ͐ʩ੮ɘ੮ʁʇʡ̼ʇʇ੮ʮ˦੮

LO C K E D I N

151

˚ʮɻ̼˺ɺʮ˺ˑ˺ʡ;੮ɘ˦ʁ੮̹ʩʮˑ˺ͅ˺̹ʩ;ੳ੮ુäʩ˺̼͐ˑ;੮ɘʠ͐ʇ̼੮ʡ̼ɘʁ͙ɘ͐ʮ˦ʡੴ੮ͅʩʇ੮ʩɘʁ੮ɘ੮ɺʮ̹˺ˑɘ̼੮ɺ̼ʇɘˌੴ੮ ɺʇˑʮʇͷʇʁ੮ͅʩʇ੮ʩɘʁ੮ɘ੮̼ʇˑʮʡʮ˺͙ͅ੮ɘ͸ɘˌʇ˦ʮ˦ʡੴ੮ɘ˦ʁ੮˦ʇʇʁʇʁ੮͐˺੮̹̼ͅʇɘʁ੮"͙ʁʁʩʮͅ˚੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮͸˺̼ˑʁੴૂ੮ʩʇ੮̼ʇɻ˺͙˦͐ͅੳ੮U˦੮͐ʩʇ੮̹ͅɘɻʇ੮˺ʠ੮ʇʮʡʩ͐੮˚˺˦͐ʩͅੴ੮ͅʩʇ੮̼͐ɘͷʇˑʇʁ੮ʠ̼˺˚੮U˦ʁʮɘ੮ ͐˺੮nʇ˦;ɘੴ੮ʡɘͷʇ੮ɘ͸ɘ;੮ɘˑˑ੮ʩʇ̼੮˚˺˦ʇ;ੴ੮ʩɘʁ੮ϲʮʠ͐ʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ɘ˦ʁ੮ʁʇˑʮɺʇ̼ɘ͐ʇˑ;੮ ʡ˺͐੮ʩʇ̼ͅʇˑʠ੮ɘ̼̼ʇ͐ͅʇʁ੮ʠ˺̼੮ɺ͙̼ʡˑɘ̼;੮͐˺੮ʩʇˑ̹੮ɺ̼ʮ˦ʡ੮"͙ʁʁʩʮͅ˚੮͐˺੮ʮ˦˚ɘ͐ʇͅ੮˺ʠ੮͐ʩʇ੮r˺ͅ੮ ˦ʡʇˑʇͅ੮#˺͙˦͐;੮ˈɘʮˑੳ੮ુîʩʇ੮ɺ˺͐͐˺˚੮ˑʮ˦ʇ੮ʮͅੴ੮ʩʇ̼ʇ੮ʮͅ੮ɘ੮ɺ̼ʮʡʩ͐੮;˺͙˦ʡ੮͸˺˚ɘ˦੮͸ʩ˺੮͸ɘͅ੮ ʩɘͷʮ˦ʡ੮ɘ੮̹ͅ;ɻʩ˺͐ʮɻ੮ɺ̼ʇɘˌੴ੮͐ʩʮͅ੮ʮͅ੮ɘ˦੮ʇ˚ʇ̼ʡʇ˦ɻ;ੴ੮ˑʮˌʇ੮ɘ੮ʩʇɘ̼͐੮ɘ͐͐ɘɻˌ੮˺ʠ੮͐ʩʇ੮ɺ̼ɘʮ˦ੴ੮ ɘ˦ʁ੮;ʇ͐੮ͅʩʇ੮ʩɘʁ੮͐˺੮ʡ˺੮͐ʩ̼˺͙ʡʩ੮ϲʮʠ͐ʇʇ˦੮̼ʇɘˑˑ;੮ʮ˦ʇʠʠʇɻ͐ʮͷʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅૂઝ͐ʩʇ;੮ ͙͙ͅɘˑˑ;੮ˑɘ͐ͅʇʁ੮ɘɺ˺͙͐੮ɘ੮͸ʇʇˌઝુɘ˦ʁ੮͐͸˺੮ˈɘʮˑʮ˦ʡͅ੮ɺʇʠ˺̼ʇ੮͐ʩʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ ϲʮ˦ɘˑˑ;੮ͅɘʮʁੴ੮ૃ/˦˺͙ʡʩ੮ʮͅ੮ʇ˦˺͙ʡʩੴ੮͐ʩʇ;੮˦ʇʇʁ੮͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮યU{)રੳૄ੮"͙͐੮ʮ͐ૄͅ੮˺˦ˑ;੮ɘʠ͐ʇ̼੮ ͐ʩʇͅʇ੮̼ʇ̹ʇɘ͐ʇʁ੮ʠɘʮˑʮ˦ʡͅੳૂ੮Pʇ̼੮̹ɘ̼ʇ˦͐ͅ੮ʩɘʁ੮ʇͷʇ˦੮ʩʮ̼ʇʁ੮ɘ੮̹̼ʮͷɘ͐ʇ੮ɘ͐͐˺̼˦ʇ;੮͐˺੮̹̼ʇ͙̼ͅͅʇ੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮̹͙ͅʩ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐ʩ̼˺͙ʡʩੳ )̼ੳ੮ HɘΈʮ˺੮ ˚ɘʁʇ੮ ʮ͐੮ ͅ˺͙˦ʁ੮ ɘͅ੮ ͐ʩ˺͙ʡʩ੮ ʮ͐ૄͅ੮ ˈ͙͐ͅ੮ ˺ɺͷʮ˺͙ͅ੮ ͐ʩɘ͐੮ ͅ˺˚ʇ˺˦ʇ੮ ˑʮˌʇ੮ ͐ʩʮͅ੮ ͸˺͙ˑʁ੮ɺʇ੮ɘʁ˚ʮ͐͐ʇʁ੮ʮʠ੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮ɘ˦੮U{)ੳ੮"͙͐੮͸ʩʇ˦੮U੮̹ͅ˺ˌʇ੮͐˺੮ɘ˦੮˺ɻɻ͙̹ɘ͐ʮ˺˦ɘˑ੮ ͐ʩʇ̼ɘ̹ʮ͐ͅ੮ ͸ʩ˺੮ ͸˺̼ˌʇʁ੮ ʠ˺̼੮ ˚˺̼ʇ੮ ͐ʩɘ˦੮ ɘ੮ ʁʇɻɘʁʇ੮ ʮ˦੮ ɘ˦੮ U{)੮ ̼͙˦੮ ɺ;੮ #̼ʇ͐ͅ͸˺˺ʁੴ੮ U੮̼ʇɘˑʮΈʇʁ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ɘ੮ʩ˺͐ͅ੮˺ʠ੮̼ʇɘͅ˺˦ͅ੮ʇͷʇ˦੮ͅ˺˚ʇ˺˦ʇ੮͸ʮ͐ʩ੮ɘ੮ͷʇ̼;੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮˚ʮʡʩ͐੮ɺʇ੮̼ʇʠ͙ͅʇʁ੮ʇ˦̼͐;ੳ੮Ĕʩʇ˦੮ͅʩʇ੮ˑ˺˺ˌʇʁ੮ɘ͐੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮̼ʇʠʇ̼̼ɘˑੴ੮ͅʩʇ੮͸˺͙ˑʁ੮ ˚ɘˌʇ੮͙̼ͅʇ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ɻ˺˦͐ʮ˦͙ʇʁ੮͐˺੮ʩɘͷʇ੮ͅʇͷʇ̼ʇ੮ͅ;˚̹͐˺˚ͅ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮͐ʩʇ;੮ ͸ʇ̼ʇ੮ુ͐ɘˌʮ˦ʡ੮͐ʩʇʮ̼੮˚ʇʁͅੴ੮ɻ˺˚̹ˑʮɘ˦͐੮͸ʮ͐ʩ੮ɘˑˑ੮̼͐ʇɘ͐˚ʇ˦͐ͅੳૂ੮H˺̼੮ʇͽɘ˚̹ˑʇੴ੮ુʮʠ੮͐ʩʇ;ૄ̼ʇ੮ ʁʮɘɺʇ͐ʮɻੴ੮ɘ̼ʇ੮͐ʩʇ;੮ɻ˺˚̹ˑʮɘ˦͐੮͸ʮ͐ʩ੮͐ʩʇʮ̼੮ϲʮ˦ʡʇ̼੮͐ͅʮɻˌͅ੺ૂ੮äʩʇ੮͸˺͙ˑʁ੮ɘˑͅ˺੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮ ͐ʩɘ͐੮ુ͐ʩʇ;ૄ̼ʇ੮˦˺͐੮̹͙˦ɻʩʮ˦ʡ੮͸ɘˑˑͅੴ੮ɺʇɘ͐ʮ˦ʡ੮͐ʩʇ੮ͅʩʮ͐੮˺͙͐੮˺ʠ੮ɘ˦;ɺ˺ʁ;ੴ੮ɻ͙͐͐ʮ˦ʡ੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮ʩɘ˦ʡʮ˦ʡ੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮ʠ˺̼੮ɘ͐੮ˑʇɘ͐ͅ੮͐͸˺੮͸ʇʇˌͅੳૂ ˑˑ੮͐ʩʇͅʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮˚ɘˌʇ੮ͅʇ˦ͅʇੳ੮U{)ͅ੮ʁ˺˦ૄ͐੮͙ͅʇ੮˚ʇɻʩɘ˦ʮɻɘˑ੮̼ʇ̼͐ͅɘʮ˦͐ͅੴ੮ʡʇ˦ʇ̼ɘˑˑ;੮ ɻɘ˦ૄ͐੮̹ʩ;ͅʮɻɘˑˑ;੮ʠ˺̼ɻʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮ʇͽ̹ʇɻ͐੮̼ʇͅʮʁʇ˦͐ͅ੮͐˺੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ʮ˦੮ɘͅ੮˚͙ɻʩ੮ ɘͅ੮͐ʩʮ̼͐;੮ʩ˺͙̼ͅ੮ɘ੮͸ʇʇˌ੮˺ʠ੮ʡ̼˺͙̹੮͐ʩʇ̼ɘ̹;ੳ੮"͙͐੮ɘ੮ͅʮ͙͐ɘ͐ʮ˺˦੮ʮ˦੮͸ʩʮɻʩ੮U{)ͅ੮˺ɺˑʮʡɘ͐ʇ੮ ͅ˺˚ʇ˺˦ʇ੮͐˺੮ͅʩ˺͸੮͐ʩʇʮ̼੮͐ͅɘɺʮˑʮ͐;੮ʠ˺̼੮͸ʇʇˌͅ੮ɺʇʠ˺̼ʇ੮ɘʁ˚ʮͅͅʮ˺˦੮ʮͅ੮ુ˺˦ʇ̼˺͙ͅ੯ੳ੯ੳ੯ੳ੮͙˦̼ʇɘˑʮ͐ͅʮɻ੯ੳ੯ੳ੯ੳ੮ɘ̼ɺʮ̼͐ɘ̼;੮ɘ˦ʁ੮ʇͽɻˑ͙ͅʮ˺˦ɘ̼;ૂ੮͐˺͸ɘ̼ʁ੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɻʩ̼˺˦ʮɻ੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ৽ਃ੮ ä͙ɻʩ੮ ɻ̼ʮ͐ʇ̼ʮɘ੮ ɘˑ˚˺͐ͅ੮ ʡ͙ɘ̼ɘ˦͐ʇʇ੮ ͐ʩɘ͐੮ ɘ˦੮ ʮ˦͙̼ͅɘ˦ɻʇ੮ ɻ˺˚̹ɘ˦;੮ ˺̼੮ ɻ˺͙˦͐;੮ ͸ʮˑˑ੮ ʁʇʇ˚੮ ͅ˺˚ʇ˺˦ʇ੮ ͐˺˺੮ ͐ͅɘɺˑʇ੮ ͐˺੮ ɺʇ੮ ʮ˦੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑઝ͐ʩ͙ͅ੮ ɻ͙͐͐ʮ˦ʡ੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑૄͅ੮ ̼ʇʮ˚ɺ͙̼ͅʇ˚ʇ˦͐ઝʁ͙̼ʮ˦ʡ੮ ͐ʩʇ੮ ͐ʩ̼ʇʇ੮ ͐˺੮ ͅʮͽ੮ ˚˺˦͐ʩͅੴ੮ ˺˦੮ ɘͷʇ̼ɘʡʇੴ੮ ͐ʩʇ;੮ ͸ɘʮ͐੮ ʠ˺̼੮ ɘ˦੮ U{)੮ɺʇʁੳ৽਄੮P˺̹ͅʮ͐ɘˑͅ੮ʩɘͷʇ੮ɘ੮̼ʇɘͅ˺˦੮˦˺͐੮͐˺੮̼͙ͅʩ੮ʮ͐ੴ੮͐ʩ˺͙ʡʩੴ੮ɺʇɻɘ͙ͅʇ੮U{)ͅ੮ɘˑͅ˺੮ ʩɘͷʇ੮͐ʩʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮͐˺੮ͅʇ˦ʁ੮ͅ˺˚ʇ˺˦ʇ੮ɺɘɻˌ੮ʮʠ੮ɘ੮̹ʇ̼ͅ˺˦੮ɻ˺˚˚ʮ͐ͅ੮ɘ੮ͷʮ˺ˑʇ˦͐੮ɘɻ͐੮˺̼੮ ̼ʇʠ͙ͅʇͅ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ H̼˺˚੮îʇ̼ʇͅɘ੮Øɘͅή͙ʮ˦ʮૄͅ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇੴ੮˚ɘ˦;੮U{)ͅ੮ɘ̼ʇ੮ʇ˦ʡɘʡʇʁ੮ʮ˦੮ુɻʩʇ̼̼;ચ̹ʮɻˌʮ˦ʡૂ੮ʠ̼˺˚੮ɘ੮̹˺˺ˑ੮˺ʠ੮ɘ̹̹ˑʮɻɘ˦͐ͅ੮͸ʮ͐ʩʮ˦੮͸ʩʮɻʩੴ੮ɘʁ˚ʮ͐͐ʇʁˑ;ੴ੮ʇͷʇ̼;˺˦ʇ੮ʮͅ੮ͅʇ̼ʮ˺͙ͅˑ;੮ ʮˑˑੴ੮ɺ͙͐੮ͅ˺˚ʇ੮˚˺̼ʇ੮ͅ˺੮͐ʩɘ˦੮˺͐ʩʇ̼ͅੳ੮Pʇ̼੮ͅ˺˦੮ʩɘͅ੮ɺʇʇ˦੮˺˦੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮

152

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ʠ˺̼੮͐͸ʇ˦͐;੮;ʇɘ̼ͅੴ੮ɺ͙͐੮ʮ͐੮ʩɘͅ˦ૄ͐੮ˌʇ̹͐੮ʩʮ˚੮͐ͅɘɺˑʇ੮ʇ˦˺͙ʡʩ੮͐˺੮̹̼ʇͷʇ˦͐੮ʠ˺̼͐;੮৵ৱ৵ৰͅ੮ ɘ˦ʁ੮̼ʇ̹ʇɘ͐ʇʁ੮ͅ˺ˈ˺͙̼˦ͅ੮ʮ˦੮U{)ͅੳ੮ʠ͐ʇ̼੮˺˦ʇ੮ˑ˺˦ʡ੮͐ͅɘ;ੴ੮ʩʇ੮͸ɘͅ੮ʁʮͅɻʩɘ̼ʡʇʁ੮͐˺੮ɘ˦੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮̹̼˺ͷʮʁʇ̼ੳ੮îʩʇ;੮ʠɘʮˑʇʁ੮͐˺੮ʡʮͷʇ੮ʩʮ˚੮ʩʮͅ੮ʮ˦ˈʇɻ͐ʮ˺˦ੴ੮ɘ˦ʁ੮ʩʇ੮͸ɘͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘʡɘʮ˦ੳ੮͐੮͐ʩʮͅ੮̹˺ʮ˦͐ੴ੮ͅʩʇ੮ʇͽ̹ˑɘʮ˦ͅੴ੮ુ˚;੮ͅ˺˦੮ʩɘʁ੮ૃɺ˺˚ɺʇʁ੮˺͙͐ૄ੮˺ʠ੮ͅʇͷʇ̼ɘˑ੮ #̼ʇ͐ͅ͸˺˺ʁ੮Hɘɻʮˑʮ͐ʮʇͅ੮ɘ˦ʁ੮͐ʩʇ;੮ͅɘʮʁੴ੮ૃ‡˺̹ʇੴ੮ʩʇ੮ɻɘ˦ૄ͐੮ɻ˺˚ʇ੮ɺɘɻˌੳૄૂ੮Iʇ͐͐ʮ˦ʡ੮ɘ੮ɺɘʁ੮ ̼ɘ̹੮ ͸ʮ͐ʩ੮ #̼ʇ͐ͅ͸˺˺ʁ੮ ʮͅ੮ ɘ੮ ɺɘʁ੮ ʁʇɘˑੴ੮ ͅʮ˦ɻʇ੮ ͐ʩʇ੮ ɻ˺˚̹ɘ˦;੮ ɻ˺˦̼͐˺ˑͅ੮ ৴৳੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ U{)੮ɺʇʁͅ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ફϲʮʡ͙̼ʇ੮৷ੳৱબੳ੮U͐ૄͅ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ɘ੮̹̼˺ɺˑʇ˚੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ ˑʮͷʇ੮ʮ˦੮‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ˑʮˌʇ੮îʇ̼ʇͅɘૄͅ੮ͅ˺˦ੴ੮͸ʩʇ̼ʇ੮#̼ʇ͐ͅ͸˺˺ʁૄͅ੮˚ɘ̼ˌʇ͐੮ͅʩɘ̼ʇ੮ ʮͅ੮ʇͷʇ˦੮ʩʮʡʩʇ̼ੳ ä˺੮͐ʩʇ੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅʇ˦͐੮ʩʮ˚੮͐˺੮͐ʩʇ੮˺˦ˑ;੮̹ˑɘɻʇ੮͐ʩɘ͐੮͸˺͙ˑʁ੮ɘʁ˚ʮ͐੮ʩʮ˚ੵ੮‡ɘ̹ɘ੮ ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑੳ੮îʇ̼ʇͅɘ੮ͅɘʮʁ੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ɘͅ੮ુʇͷʇ̼;͐ʩʮ˦ʡ੮U੮͸ɘͅ੮̼͐;ʮ˦ʡ੮͐˺੮ɘͷ˺ʮʁૂ੮ ʮ˦੮;ʇɘ̼ͅ੮˺ʠ੮ɘʁͷ˺ɻɘɻ;ੴ੮ɘ˦ʁ੮ʩʇ੮͸ɘͅ੮͙͐ͅɻˌ੮˺˦੮͐ʩʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͸ɘ̼ʁ੮˦ʮ˦ʇ͐;੮ʁɘ;ͅ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ɘ੮ɺʇʁੳ੮ä͐ʮˑˑੴ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮˚ɘ˦ɘʡʇʁ੮͐˺੮͐ͅɘɺʮˑʮΈʇ੮ʩʮ˚ੳ੮îʩʇ;੮ʇͷʇ˦੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩʇ੮˺˦ʇ੮#̼ʇ͐ͅ͸˺˺ʁ੮ʠɘɻʮˑʮ͐;੮ʩʇ੮ʩɘʁ˦ૄ͐੮ɺʇʇ˦੮͐˺੮ɘ˦ʁ੮͸ʮ͐ʩ੮͸ʩʮɻʩ੮ʩʇ̼੮ɻ˺͙˦͐;੮ ɻ˺˦̼͐ɘɻ͐ʇʁ੮͐˺੮ɻ˺˚ʇ੮͐ɘˌʇ੮ɘ੮ˑ˺˺ˌੳ੮ુPʮͅ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼੮͐ʩ˺͙ʡʩ͐੮ʩʇ੮͸ɘͅ੮̼ʇɘʁ;੮͐˺੮ʡ˺ੴ੮ ʩʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͐ʩ˺͙ʡʩ͐੮ʩʇ੮͸ɘͅ੮̼ʇɘʁ;੮͐˺੮ʡ˺ੴૂ੮ɺ͙͐੮͐ʩʇ੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮˺ʠ੮͐ʩʇ੮ɻ˺˚̹ɘ˦;੮ʁʇɻˑɘ̼ʇʁੴ੮ુ‡˺ੴ੮͸ʇ੮͐ʩʮ˦ˌ੮;˺͙੮˦ʇʇʁ੮ɘ੮ˑʮ͐͐ˑʇ੮ɺʮ͐੮˚˺̼ʇ੮͐ʮ˚ʇੳૂ੮H˺̼੮îʇ̼ʇͅɘੴ੮ʮ͐੮͸ɘͅ੮ ͐ʩʇ੮̹̼ʮ˚ʇ੮ʇͽɘ˚̹ˑʇ੮˺ʠ੮͐ʩʇ੮̼ʮͅˌͅ੮˺ʠ੮ુʩɘͷયʮ˦ʡર੮̹̼ʮͷɘ͐ʇ੮ɻ˺˚̹ɘ˦ʮʇͅ੮ˑʮˌʇ੮#̼ʇ͐ͅ͸˺˺ʁ੮ ɘ˦ʁ੮îʇˑʇɻɘ̼ʇ੮˚˺˦˺̹˺ˑʮΈʮ˦ʡ੮͐ʩʮͅ੮͸ʩ˺ˑʇ੮͐ʩʮ˦ʡૂੵ੮ુîʩʇ੮̹̼ʮͷɘ͐ʇ੮˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦ͅ੮ʡʇ͐੮͐˺੮ ʁʇɻʮʁʇੴ੮ૃ‡˺̹ʇੴ੮͸ʇૄ̼ʇ੮˦˺͐੮͐ɘˌʮ˦ʡ੮;˺͙ੴ੮;˺͙੮ʁ˺˦ૄ͐੮ˑ˺˺ˌ੮ʡ˺˺ʁ੮˺˦੮̹ɘ̹ʇ̼ੴૄૂ੮ͅʩʇ੮ͅʮʡʩʇʁੳ੮ Pʇ̼੮ͅ˺˦੮͸ɘͅ੮ͅ˺੮ʠ̼͙̼͐ͅɘ͐ʇʁੴ੮ͅʩʇ੮ͅɘ;ͅੴ੮͐ʩɘ͐੮ʩʇ੮ુɘɻ͐ʇʁ੮˺͙͐ૂ੮ɘʡɘʮ˦͐ͅ੮͐ͅɘʠʠੴ੮ʡ˺͐੮ɘ̼̼ʇ͐ͅʇʁ੮ ʠ˺̼੮ʠʇˑ˺˦;੮ɺɘ͐͐ʇ̼;ੴ੮ɘ˦ʁ੮̹ͅʇ˦͐੮͐ʩʇ੮˦ʇͽ͐੮ʠ˺͙̼੮;ʇɘ̼ͅ੮ɺ˺͙˦ɻʮ˦ʡ੮ɺʇ͐͸ʇʇ˦੮ͅ˺ˑʮ͐ɘ̼;੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮ɘ˦ʁ੮͐ʩʇ੮ʠ˺̼ʇ˦ͅʮɻ੮͸ʮ˦ʡ੮˺ʠ੮͐ʩɘ͐੮ͅɘ˚ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ õˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮ îʇ̼ʇͅɘ੮ ɻ˺˦ͷʮ˦ɻʇʁ੮ ʩʇ̼੮ ɻ˺͙˦͐;ੴ੮ #˺˦̼͐ɘ੮ #˺͐ͅɘੴ੮ ͐˺੮ ͅʇ˦ʁ੮ ʩʇ̼੮ ͅ˺˦੮ ͐˺੮ ɘ˦੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮U{)ੴ੮#ɘˑʮʠ˺̼˦ʮɘ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮î̼ɘ˦ͅʮ͐ʮ˺˦ͅ੮ફ#Øîબੴ੮ɘ˦ʁ੮ɘʠ͐ʇ̼੮͐ʩɘ͐ੴ੮ Øͅ;˦ʇ̼ʡ;ੴ੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ੳ੮î˺੮ʡʇ͐੮ʩʮ˚੮ʮ˦͐˺੮͐ʩʇ੮ˑɘ͐͐ʇ̼ੴ੮ ͅʩʇ੮ʩɘʁ੮͐˺੮ɻ˺˦ͷʮ˦ɻʇ੮ʩʇ̼੮ɻ˺͙˦͐;੮͐˺੮˚ɘˌʇ੮ɘ˦੮ʇͽɻʇ̹͐ʮ˺˦੮ɘ˦ʁ੮ͅʇ˦ʁ੮ʩʮ˚੮͐˺੮ɘ੮ʠɘɻʮˑʮ͐;੮ ͸ʮ͐ʩ੮͸ʩʮɻʩ੮͐ʩʇ;੮ʁʮʁ੮˦˺͐੮ɘˑ̼ʇɘʁ;੮ʩɘͷʇ੮ɘ੮ɻ˺˦̼͐ɘɻ͐੮ફ˚˺͐ͅ੮̹ɘ̼ʇ˦͐ͅ੮̹̼˺ɺɘɺˑ;੮ʁ˺˦ૄ͐੮ ʩɘͷʇ੮͐ʩʇ੮ɘɻɻʇͅͅ੮͐˺੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʇ̼ͅ੮ɘ˦ʁ੮͸ʩʇ̼ʇ͸ʮ͐ʩɘˑ੮͐˺੮ʁ˺੮͐ʩʮͅબੳ੮Ĕʩʇ˦੮͸ʇ੮͐ɘˑˌʇʁੴ੮ îʇ̼ʇͅɘ੮ͅɘʮʁ੮ʩʇ̼੮ͅ˺˦੮͸ɘͅ੮˺˦ʇ੮˺ʠ੮Øͅ;˦ʇ̼ʡ;ૄͅ੮ુ͐ͅɘ̼ͅૂ੮ɘ˦ʁ੮ɘɺ˺͙͐੮͐˺੮͐ͅɘ̼͐੮ɻ˺ˑˑʇʡʇੳ੮î˺੮ɺʇ੮ ɻˑʇɘ̼ੴ੮ɺ˺͐ʩ੮#Øî੮ɘ˦ʁ੮Øͅ;˦ʇ̼ʡ;੮ɘ̼ʇ੮̹̼ʮͷɘ͐ʇ੮ɘ˦ʁ੮ʠ˺̼ચ̹̼˺ϲʮ͐ੳ੮Øͅ;˦ʇ̼ʡ;੮ʩɘͅ੮ɘ੮˚ʮͅͅʮ˺˦੮ ˺ʠ੮͐ɘˌʮ˦ʡ੮ɻˑʮʇ˦͐ͅ੮͐ʩɘ͐੮ʩɘͷʇ੮ɺʇʇ˦੮ɺˑɘɻˌˑʮ͐ͅʇʁ੮ʇͷʇ̼;͸ʩʇ̼ʇ੮ʇˑͅʇ੮ɘ˦ʁ੮ϲʮ˦ʁʮ˦ʡ੮͸ɘ;ͅ੮͐˺੮ ʡʇ͐੮ͅʇʇ˚ʮ˦ʡˑ;੮͙˦ʁʮͅɻʩɘ̼ʡʇɘɺˑʇ੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡͅੳ੮Uʠ੮;˺͙੮͸ɘ˦͐੮͐˺੮ͅʇʇ੮ ͐ʩʇ੮̹˺͸ʇ̼੮˺ʠ੮ʇ˦̼͐ʇ̹̼ʇ˦ʇ͙̼ʮɘˑʮͅ˚ੴ੮͐ʩʮ˦ˌ੮ɘɺ˺͙͐੮͐ʩʇͅʇ੮ʠɘɻʮˑʮ͐ʮʇͅૄ੮˺͸˦ʇ̼ͅ੮͐ɘˌʮ˦ʡ੮˺˦੮ ˚˺͙˦͐ɘʮ˦ͅ੮˺ʠ੮ʁʇɺ͐੮͐˺੮͐ͅɘ̼͐੮̹̼˺ʡ̼ɘ˚ͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͸ɘ˦͐੮͐˺੮ʡʇ͐੮̼ʮʁ੮ ˺ʠੴ੮ɻ˺͙˦͐ʮʇͅ੮͸ɘ˦͐੮͐˺੮ʠɘ̼˚੮˺͙͐ੴ੮ɘ˦ʁ੮˦˺˦̹̼˺ϲʮ͐ͅ੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮͐˺͙ɻʩੳ

LO C K E D I N

153

U੮ɘ˚੮˦˺͐੮͐ʩʇ੮˺˦ˑ;੮˺˦ʇ੮͸˺˦ʁʇ̼ʮ˦ʡ੮͸ʩ;੮̹̼ʮͷɘ͐ʇ੮U{)ͅ੮ʡʇ͐੮͐˺੮ʇͽʇ̼ɻʮͅʇ੮ͅ˺੮˚͙ɻʩ੮ ɻ˺˦̼͐˺ˑ੮˺ͷʇ̼੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ͅ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮Ûʮɻˌ੮Ĕʇʮͅͅੴ੮͐ʩʇ੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅ੮ʮ˦੮͐ʩʇ੮ r˺ͅ੮ ˦ʡʇˑʇͅ੮ #˺͙˦͐;੮ ˈɘʮˑ੮ ͸ʩ˺੮ ̹ͅʇ˦͐੮ ;ʇɘ̼ͅ੮ ̼͐;ʮ˦ʡ੮ ͐˺੮ ʡʇ͐੮ ʠ˺̼˚ʇ̼ˑ;੮ ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʇʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʮ˦͐˺੮U{)ͅੴ੮˺ɺͅʇ̼ͷʇʁੴ੮ુĔʩɘ͐੮Uૄͷʇ੮ʠ˺͙˦ʁ੮ͅʩ˺ɻˌʮ˦ʡ੮˺ͷʇ̼੮͐ʩʇ੮;ʇɘ̼ͅ੮ʮͅ੮ ͐ʩɘ͐੮͐ʩʇ̼ʇૄͅ੮˦˺͐੮ͅ˺˚ʇ੮ˌʮ˦ʁ੮˺ʠ੮ɻ˺͙˦͐;ચ̼͙˦੮U{)੮͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮͐ʩ˺ͅʇ੮ˌʮ˦ʁͅ੮˺ʠ੮ ʮ͙ͅͅʇͅ੮યɻʩʇ̼̼;ચ̹ʮɻˌʮ˦ʡરੴ੮ɻ˺˚̹ɘ̼ʇʁ੮͐˺੮ɘ˦੮U{)੮͐ʩɘ͐ૄͅ੮̼͙˦੮̹̼ʮͷɘ͐ʇˑ;੮ɘ˦ʁ੮ɻɘ˦੮˚ɘˌʇ੮ ʁʇɻʮͅʮ˺˦ͅ੮ ͸ʮ͐ʩ˺͙͐੮ ɘ˦;ɺ˺ʁ;੮ ͐ɘˌʮ˦ʡ੮ ɘˑˑ੮ ͐ʩɘ͐੮ ˚͙ɻʩ੮ ˦˺͐ʮɻʇੳૂ੮ îʩʇ੮ ̼ʇɘͅ˺˦੮ ʮͅ੮ ̹ɘ̼͐ˑ;੮ ͐ʩɘ͐੮̹͙ɺˑʮɻˑ;੮̼͙˦੮ʠɘɻʮˑʮ͐ʮʇͅ੮ɻ˺͐ͅ੮˚˺̼ʇੴ੮ɘ˦ʁ੮̹ɘ̼͐ˑ;੮͐ʩɘ͐੮ɻ˺˚̹ɘ˦ʮʇͅ੮ˑʮˌʇ੮#̼ʇ͐ͅ͸˺˺ʁ੮ ʩɘͷʇ੮ɺ͙ʮˑ͐੮͙̹੮ɘ੮ʡʇ˦͙ʮ˦ʇ੮ʇͽ̹ʇ̼͐ʮͅʇ੮ʮ˦੮̼͐ʇɘ͐ʮ˦ʡ੮͐ʩʮͅ੮̹˺̹͙ˑɘ͐ʮ˺˦ੳ੮ä͐ʮˑˑੴ੮ɻ˺͙˦͐ʮʇͅ੮ˑʮˌʇ੮ äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɘ̼ʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ɻ˺˦ͅʮʁʇ̼ʮ˦ʡ੮ʩɘͷʮ˦ʡ੮͐ʩʇʮ̼੮˺͸˦੮ʁʇʁʮɻɘ͐ʇʁ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ ɺʇɻɘ͙ͅʇ੮ɻ˺˚̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˦̼͐ɘɻ͐ͅ੮ɺʇ͐͸ʇʇ˦੮ɻ˺͙˦͐ʮʇͅ੮ુ˺ʠ͐ʇ˦੮ˑʇɘʁͅ੮͐˺੮ʁʇˑɘ;ͅ੮ʮ˦੮ɻˑʮʇ˦͐੮̹ˑɘɻʇ˚ʇ˦͐੮ɘ˦ʁ੮ɘ੮ˑɘɻˌ੮˺ʠ੮̼͐ɘ˦̹ͅɘ̼ʇ˦ɻ;੮ɘɺ˺͙͐੮͐ʩ˺ͅʇ੮ʁʇˑɘ;ͅੳૂ৾৻ /ͷʇ˦੮͸ʮ͐ʩ˺͙͐੮ɘ੮̼ʇͷ˺ˑ͙͐ʮ˺˦ɘ̼;੮ͅʇʮΈ͙̼ʇ੮˺ʠ੮͐ʩʇ੮U{)੮ʮ˦ʁ͙̼͐ͅ;ੴ੮;˺͙੮ɻ˺͙ˑʁ੮ʮ˚ɘʡʮ˦ʇ੮ ɘ੮˚˺̼ʇ੮̼ɘ͐ʮ˺˦ɘˑ੮ͅ;͐ͅʇ˚ੳ੮U੮ɘͅˌʇʁ੮ɘ੮͐ͅɘ͐ʇ੮˺ϲϲʮɻʮɘˑ੮ɘɺ˺͙͐੮͐ʩʇ੮ʮ͙ͅͅʇੴ੮ɘ˦ʁ੮ͅʩʇ੮̼ʇ̹ˑʮʇʁੴ੮ ુîʩʮͅ੮ʮͅ੮ɘ੮ή͙ʇ͐ͅʮ˺˦੮͐ʩɘ͐੮͸ʇૄ̼ʇ੮̹˺ͅʮ˦ʡ੮̼ʮʡʩ͐੮˦˺͸੮͐˺੮ɻ˺͙˦͐ʮʇͅੴ੮ૃĔʩ;ੴ੮ʮʠ੮;˺͙ૄ̼ʇ੮ɻ˺˦̼͐ɘɻ͐ʮ˦ʡ੮͸ʮ͐ʩ੮U{)ͅੴ੮ʁ˺ʇͅ˦ૄ͐੮͐ʩʇ੮ɻ˺˦̼͐ɘɻ͐੮̼ʇή͙ʮ̼ʇ੮͐ʩɘ͐੮ɻʇ̼͐ɘʮ˦੮̹ʇ˺̹ˑʇ੮ɺʇ੮͐ɘˌʇ˦੺ૄૂ੮ äʩʇ੮͙˦ʁʇ̼͐ͅ˺˺ʁੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮͐ʩɘ͐੮͐ʩʇ੮ʠʇɘ̼੮ʮͅ੮͐ʩɘ͐੮ʮʠ੮ɘ੮ɻ˺͙˦͐;੮ɺʇɻ˺˚ʇͅ੮͐˺˺੮ʁʇ˚ɘ˦ʁʮ˦ʡੴ੮U{)੮˺̹ʇ̼ɘ͐˺̼ͅ੮͸ʮˑˑ੮ુˈ͙͐ͅ੮̼͙˦੮͐˺੮͐ʩʇ੮ʩʮˑˑͅૂ੮ɘ˦ʁ੮ʇʮ͐ʩʇ̼੮ʡ˺੮˺͙͐੮˺ʠ੮ɺ͙ͅʮ˦ʇͅͅ੮˺̼੮ ˺˦ˑ;੮ͅʇ̼ͷʇ੮ˑʇͅͅ੮ʇͽʮʡʇ˦͐੮ɻ˺͙˦͐ʮʇͅੳ੮Uʠ੮˺˦ˑ;੮͐ʩʇ̼ʇ੮͸ɘͅ੮ͅ˺˚ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʇ˦͐ʮ͐;ੴ੮ʩ˺ͷʇ̼ʮ˦ʡ੮˺ͷʇ̼੮͐ʩʇ੮ɻ˺͙˦͐ʮʇͅੴ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮ɺ̼ʮ˦ʡ੮˺̼ʁʇ̼੮͐˺੮͐ʩʮͅ੮ʁʇˑʇʡɘ͐ʇʁ੮ͅ;͐ͅʇ˚ੳ

THE HUMAN LOGJAM Ĕʩʇ˦੮ɘ੮ˈ͙ʁʡʇ੮ͅʮʡ˦ͅ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺̼ʁʇ̼ੴ੮͐ʩʇ;੮ɘˑͅ˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮͸ʩɘ͐੮ˑʇͷʇˑ੮˺ʠ੮ ̹ˑɘɻʇ˚ʇ˦͐੮ʮͅ੮͐ʩʇ੮ˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮˺̹͐ʮ˺˦ੳ੮îʩɘ͐੮˺̼ʁʇ̼੮ʮͅ੮˦˺੮ʡ͙ɘ̼ɘ˦͐ʇʇ੮ ͅ˺˚ʇ˺˦ʇ੮͸ʮˑˑ੮ʡʇ͐੮͐ʩʇ̼ʇੳ੮U˦͐ͅʇɘʁੴ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ʡʇ͐ͅ੮͐˺੮͐ɘˌʇ੮ɘ੮̹̼˺ͷʇ̼ɺʮɘˑ੮˦͙˚ɺʇ̼੮ ɘ˦ʁ੮ʇ˦͐ʇ̼੮ɘ੮ુʩ͙˚ɘ˦੮ˑ˺ʡˈɘ˚ૂ੮˺ʠ੮͙ͅʠʠʇ̼ʮ˦ʡ੮ɺ˺ʁʮʇͅ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ˑ˺ɻˌʇʁ੮ɺʇʁͅੳ৾ৼ k͙ʁʡʇ੮Û˺ˈɘͅ੮ʁʇͅɻ̼ʮɺʇʁ੮ʩ˺͸੮ʮ͐੮ˑ˺˺ˌʇʁ੮ʠ̼˺˚੮ʩʮͅ੮ͷɘ˦͐ɘʡʇ੮̹˺ʮ˦͐ੵ੮ૃîʩʇ੮ϲʮ̼͐ͅ੮̹ˑɘɻʇ੮ ͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮͐ʇ˦ʁ੮͐˺੮ʡ˺੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ɘ੮ˑ˺ɻˌʇʁ੮U{)ੳ੮îʩ˺ͅʇ੮ɺʇʁͅ੮ɘ̼ʇ੮ˈ͙͐ͅ੮ ɻ˺˚̹ˑʇ͐ʇˑ;੮ϲʮˑˑʇʁ੮͙̹ੳ੮Ĕʩʇ˦੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮̼ʇɘʁ;੮͐˺੮ˑʇɘͷʇ੮͐ʩɘ͐੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡ੮ɘ˦ʁ੮ʡ˺੮ ͐˺੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੴ੮͐ʩʇ੮ɺʇʁͅ੮ɘ̼ʇ੮ʮ˦ɻ̼ʇʁʮɺˑ;੮˺ͷʇ̼͙ͅɺͅɻ̼ʮɺʇʁੳ੯ੳ੯ੳ੯ੳ੮ä˺੮͐ʩɘ͐੮˚ʇɘ˦ͅ੮;˺͙੮ ͐ʩʇ˦੮ʩɘͷʇ੮̹ʇ˺̹ˑʇ੮ʮ˦੮ɘɻ͙͐ʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͸ʩ˺੮ɻɘ˦ૄ͐੮˚˺ͷʇੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮ɘ͐੮͐ʩʇ੮ ͐˺̹੮˺ʠ੮͐ʩʇ੮ʠ˺˺ʁ੮ɻʩɘʮ˦ੴ੮;˺͙ૄͷʇ੮ʡ˺͐੮̹ʇ˺̹ˑʇ੮͐ʩɘ͐੮ɘ̼ʇ੮ʮ˦੮̹ͅ;ɻʩ੮/Ûͅ੮͐ʩɘ͐੮ʩɘͷʇ੮ɺʇʇ˦੮ͅʮ͐͐ʮ˦ʡ੮͐ʩʇ̼ʇ੮ʠ˺̼੮͸ʇʇˌͅ੮ɘ˦ʁ੮˚˺˦͐ʩͅੳ੯ੳ੯ੳ੯ੳ੮îʩʇ੮͸ʩ˺ˑʇ੮ͅ;͐ͅʇ˚੮ʮͅ੮ˈ͙͐ͅ੮ʮ˦ɻ̼ʇʁʮɺˑ;੮ɺɘɻˌʇʁ੮ ͙̹੮ ɘ˦ʁ੮ ʁ˺ʇͅ˦ૄ͐੮ ɘˑˑ˺͸੮ ̹ʇ˺̹ˑʇ੮ ͐˺੮ ɺʇ੮ ʮ˦੮ ͐ʩʇ੮ ͅʇ͐͐ʮ˦ʡ੮ ͐ʩʇ;ૄ̼ʇ੮ ͙̹̹ͅ˺ͅʇʁ੮ ͐˺੮ ɺʇ੮ ʮ˦ੳૄ৾৽

154

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

Uૄ˚੮ ʡ˺ʮ˦ʡ੮ ͐˺੮ ɻˑ˺ͅʇ੮ ͐ʩʮͅ੮ ɻʩɘ̹͐ʇ̼੮ ɺ;੮ ̼ʇϲˑʇɻ͐ʮ˦ʡ੮ ˺˦੮ ʩ˺͸੮ ͐ʩʮͅ੮ ʁ̼ʮͷʇͅ੮ ʁʮͅɻ̼ʇ͐ʮ˺˦੮ ͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ îʩʮͅ੮ ʩ͙˚ɘ˦੮ ˑ˺ʡˈɘ˚੮ ˚ʇɘ˦ͅ੮ ͐ʩɘ͐੮ ˚ɘ˦;੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ɘ̼ʇ੮ ʮ˦੮ ̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ ˑʇͷʇˑͅ੮ ˺ʠ੮ ɻɘ̼ʇ੮ ʮ˦੮ ʁʮ̼ʇɻ͐੮ ʁʇϲʮɘ˦ɻʇ੮ ˺ʠ੮ ɻ˺͙̼͐੮ ˺̼ʁʇ̼ͅੳ੮ Ě˺͙੮ ˚ʮʡʩ͐੮ ͐ʩʮ˦ˌ੮ ͐ʩʮͅ੮ ʡʮͷʇͅ੮ ˑɘ͸੮ ͅ˺˚ʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʡʇ͐੮˚ʇʁʮɻʮ˦ʇ੮ફɘ˦ʁ੮ɺ͙̼ʇɘ͙ɻ̼ɘɻ;બ੮͐˺੮͐ɘˌʇ੮ɘɻ͐ʮ˺˦ੳ੮ä˺˚ʇ੮̹͙ɺˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼ͅ੮͐˺ˑʁ੮˚ʇ੮͐ʩʇ;੮͸˺͙ˑʁ੮ʁʇ˚ɘ˦ʁ੮̼ʇ̹ʇɘ͐ʇʁ੮ુ̹ˑɘɻʇ˚ʇ˦͐੮ʩʇɘ̼ʮ˦ʡͅૂ੮ɘ˦ʁ੮ɘͅˌ੮ ɻ˺͙̼͐ͅ੮͐˺੮ʩ˺ˑʁ੮ɻ˺͙˦͐ʮʇͅ੮ʮ˦੮ɻ˺˦͐ʇ˚̹͐੮ʠ˺̼੮˦˺͐੮ʡʇ͐͐ʮ˦ʡ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮˺͙͐੮˺ʠ੮ɘɻ͙͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ʠɘ͐ͅ੮ ʇ˦˺͙ʡʩੳ৾৾੮ "͙͐੮ )˺͙ʡੴ੮ ɘ੮ ˑɘ͸;ʇ̼੮ ͸ʩ˺੮ ̼ʇ̹̼ʇͅʇ˦͐ͅ੮ ɘ੮ ɻ˺͙˦͐;੮ ˺˦੮ ͐ʩʇ੮ ̼ʇɻʇʮͷʮ˦ʡ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇͅʇ੮ɻ˺˚̹ˑɘʮ˦͐ͅੴ੮͐˺ˑʁ੮˚ʇ੮͐ʩʇ੮ɻ˺͙̼͐ͅ੮ˌ˦ʇ͸੮͐ʩʇ̼ʇ੮͸ɘͅ੮˦˺͐ʩʮ˦ʡ੮ ʩʇ੮ɻ˺͙ˑʁ੮ʁ˺ੵ੮ુU͐ૄͅ੮˦˺͐੮˺˦ˑ;੮ૃ˚˺͐ͅ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇૄ੮ɘ˦ʁ੮ૃˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮̹ˑɘɻʇ˚ʇ˦͐ͅੴૄ੮ ʮ͐ૄͅ੮ɘˑͅ˺੮͐ʩʇ੮ૃɘͷɘʮˑɘɺˑʇ੮̹ˑɘɻʇ˚ʇ˦͐ੳૄ੯ੳ੯ੳ੯ੳ੮યîʩʇ੮ɻ˺͙̼͐ર੮ɻɘ˦ૄ͐੮ʇͽ̹ʇɻ͐੮͙ͅ੮͐˺੮̹ˑɘɻʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮ɘ੮̹ˑɘɻʇ੮͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮ʇͽʮ͐ͅੳ੮Ĕʩɘ͐੮ʁ˺੮;˺͙੮ʁ˺੺੮îʩʇ੮ˑʇʡʮͅˑɘ͙̼͐ʇ੮˦ʇʇʁͅ੮͐˺੮ɺʇ੮ ɺ͙ʮˑʁʮ˦ʡ੮˚˺̼ʇ੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮Uૄ˚੮˦˺͐੮ɘ੮ˑʇʡʮͅˑɘ͐˺̼ੳૂ Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮ɘˑͅ˺੮͐ɘˌʮ˦ʡ੮͐ʩʇ੮ˑ˺ʡˈɘ˚੮ʮ˦͐˺੮ɘɻɻ˺͙˦͐ੳ੮š˦ʇ੮͐˺ˑʁ੮˚ʇ੮ɺˑ͙˦͐ˑ;ੴ੮ ૃUʠ੮͐ʩʇ̼ʇ੮ʮͅ੮˦˺੮ɘͷɘʮˑɘɺʮˑʮ͐;੮˺ʠ੮ɘ˦੮˺˦ʡ˺ʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮ʠɘɻʮˑʮ͐;ੴ੮˺͙̼੮˺ϲϲʮɻʇ੮͸ʮˑˑ੮̼ʇʠ͙ͅʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͙˦͐ʮˑ੮ ͐ʩʇ੮ યɻ˺͙˦͐;ર੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ʠ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ʡʇ͐ͅ੮ ͐ʩɘ͐੮ ʮ˦੮ ̹ˑɘɻʇੳૄ੮ˑ͐ʩ˺͙ʡʩ੮͐ʩʇ̼ʇ੮ʮͅ੮˦˺੮̼ʇˑʮɘɺˑʇ੮͐˺̹ˑʮ˦ʇ੮˦͙˚ɺʇ̼੮ʠ˺̼੮͐ʩʇ੮͐ͅɘ͐ʇੴ੮˚ɘ˦;੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɻ˺͙˦͐ʮʇͅ੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐ੴ੮ɘͅ੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ફˑɘ̼ʡʇˑ;੮̹̼ʮͷɘ͐ʇબ੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ ͐ʩɘ͐੮˚ɘˌʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇʠʇ̼̼ɘˑͅ੮ɘ˦ʁ੮͐ʩʇ੮ફɘˑ˚˺͐ͅ੮ʇ˦͐ʮ̼ʇˑ;੮̹̼ʮͷɘ͐ʇબ੮͙ͅɺɘɻ͙͐ʇ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮͐ʩɘ͐੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʡ˺੮͐˺੮ʩɘͷʇ੮ɻˑ˺ͅʇʁੴ੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ʩɘͅ੮ ʠɘˑˑʇ˦੮ ͐˺੮ ˚ɘ͐ɻʩੳ੮ îʩʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦੮ ʮ˦੮ ɘ੮ ˑɘ̼ʡʇ੮ ͅ˺͙͐ʩʇ̼˦੮ ɻ˺͙˦͐;੮ ̼ʇ̹˺̼͐ʇʁ੮ɘ੮˺˦ʇચ͐ʩʮ̼ʁ੮ʁʇɻˑʮ˦ʇ੮ʮ˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇʠʇ̼̼ɘˑͅ੮ʮ˦੮͐ʩʇ੮̹ɘ͐ͅ੮ʁʇɻɘʁʇ੮ɘ˦ʁ੮ ʮ˦ͅʮ͐ͅʇʁ੮ુ͐ʩʇ੮̼ʇɘͅ˺˦੯ੳ੯ੳ੯ੳ੮ʮͅ੮̼͐ͅʮɻ͐ˑ;੮͐ʩɘ͐੮͐ʩʇ̼ʇૄͅ੮˦˺੮̹ˑɘɻʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͐˺੮ʡ˺ੳૂ੮îʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʁʇɻˑʮ˦ʇʁ੮৲ৱ੮̹ʇ̼ɻʇ˦͐੮ʠ̼˺˚੮৲ৰৱ৲੮͐˺੮৲ৰৱ৷ੴ੮ ˈ͙͐ͅ੮ɘͅ੮͐ʩʇ੮ɘͷɘʮˑɘɺʮˑʮ͐;੮˺ʠ੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮ʮ˦੮͐ʩʇ੮ɻʮ͐;੮ɻ˺ˑˑɘ̹ͅʇʁੳ৾৿ /ɘ̼ˑʮʇ̼੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੴ੮ʮ˦̹ɘ͐ʮʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ɘ̹̹ˑ;ʮ˦ʡ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɘ̼ʇ੮ ɺɘˑɘ˦ɻʮ˦ʡ੮ ͐ʩʇ੮ ͅɘ˚ʇ੮ ɻ˺˦ͅʮʁʇ̼ɘ͐ʮ˺˦ͅੳ੮ )̼ੳ੮ #ɘʮੴ੮ ͸˺̼ˌʮ˦ʡ੮ ʮ˦੮ ɘ੮ ̹͙ɺˑʮɻ੮ "ɘ;੮ ̼ʇɘ੮ ʩ˺̹ͅʮ͐ɘˑੴ੮ɘʁ˚ʮ͐͐ʇʁੴ੮ુĔʇ੮ɘˑ͸ɘ;ͅ੮͸ʇʮʡʩ੮͐ʩʇ੮̼ʇɘˑʮ͐ͅʮɻ੮ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅ੮˺ʠ੮͐ʩʇ੮ͅ;͐ͅʇ˚ੳ੮rʮˌʇ੮ ͸ʩʇ̼ʇ੮ʮͅ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʡ˺੮˺˦ɻʇ੮͸ʇ੮̹͙͐੮͐ʩʇ˚੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੺੮̼ʇ੮͐ʩʇ̼ʇ੮ ɘ˦;੮̹ˑɘɻʇͅ੮ʠ˺̼੮͐ʩʇ˚੮͐˺੮ʡ˺੺੮੮ˑ˺͐੮˺ʠ੮͐ʮ˚ʇͅੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ˦ૄ͐ੳૂ੮ͅ੮͙ͅɻʩੴ੮ુU੮͸ʮͅʩ੮U੮ɻ˺͙ˑʁ੮ ɺʇ੮ʮʁʇɘˑʮ͐ͅʮɻੴ੮ૃĔʇ੮̹͙͐੮ʇͷʇ̼;˺˦ʇ੮͸ʩ˺੮˚ʇʇ͐ͅ੮ɻ̼ʮ͐ʇ̼ʮɘ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳૄ੯ੳ੯ੳ੯ੳ੮"͙͐੮ ;˺͙੮ ͐ʩʮ˦ˌ੮ ʁ˺͸˦੮ ͐ʩʇ੮ ˑʮ˦ʇੴ੮ ૃˑˑ੮ ͐ʩʇ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ͸ʮˑˑ੮ ʩɘͷʇ੮ ɘ੮ ͸ɘʮ͐ˑʮ͐ͅ੮ ˺ʠ੮ ͐ʩ̼ʇʇ੮ ͐˺੮ ͅʮͽ੮ ˚˺˦͐ʩͅੴ੮ɘ˦ʁ੮ʮ˦੮͐ʩʇ੮˚ʇɘ˦͐ʮ˚ʇੴ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ɘʮ͐ʮ˦ʡੳૄૂ੮ îʩɘ͐੮ˑɘ͐ͅ੮ˑʮ˦ʇ੮ʮͅ੮ʮ˚̹˺̼͐ɘ˦͐ੳ੮äʩʇ੮˚ʮʡʩ͐੮ʁʇɻʮʁʇ੮͐ʩʇ੮ʮʁʇɘˑ੮˺̹͐ʮ˺˦੮͸˺͙ˑʁ੮ɺʇ੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮ʡ˺੮͐˺੮ɘ˦੮U{)ੴ੮ɺ͙͐੮͸ʩʇ˦੮͐ʩʇ੮ɻʩ˺ʮɻʇ੮ʮͅ੮ɺʇ͐͸ʇʇ˦੮ʠ˺̼ɻʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮͐ͅɘ;੮ʮ˦੮ ɘ˦੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑઝɘ˦੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮͐ʩɘ͐੮ʮͅ੮ɘɺͅ˺ˑ͙͐ʇˑ;੮˦˺͐੮ʁʇͅʮʡ˦ʇʁ੮ʠ˺̼੮ʁʇʇ̹੮

LO C K E D I N

155

ʩʇɘˑʮ˦ʡ੮˺̼੮ή͙ɘˑʮ͐;੮˺ʠ੮ˑʮʠʇઝɘ˦ʁ੮ˑʇ͐͐ʮ˦ʡ੮͐ʩʇ˚੮ʡ˺੮ɺɘɻˌ੮͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮͐ʩʇ੮ˑʇͅͅ੮ɻ̼͙ʇˑ੮ ˺̹͐ʮ˺˦੮˚ʮʡʩ͐੮ɺʇ੮͐ʩʇ੮ˑɘ͐͐ʇ̼ੳ ˦ʁੴ੮͐˺੮͐ɘˌʇ੮͙ͅ੮ɘˑˑ੮͐ʩʇ੮͸ɘ;੮ɺɘɻˌ੮͐˺੮͐ʩ˺ͅʇ੮̼͐ͅʇʇ͐ͅੴ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ɘ̼ʇ੮ɘˑͅ˺੮ˑʇɘ̼˦ʮ˦ʡ੮ ʠ̼˺˚੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮͸ʩ˺੮ʮͅ੮ɘ˦ʁ੮͸ʩ˺੮ʮͅ˦ૄ͐੮ˑʮˌʇˑ;੮͐˺੮ϲʮ˦ʁ੮ɘ੮̹ˑɘɻʇ˚ʇ˦͐੮ʠ͙̼͐ʩʇ̼੮ʁ˺͸˦੮ ͐ʩʇ੮ˑʮ˦ʇੳ੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮ʠ̼˺˚੮rØ)੮̼ʇϲˑʇɻ͐ʇʁ੮˺˦੮͸ʩ;੮ʩʇ̼੮˺ϲϲʮɻʇ̼ͅ੮͸ʇ̼ʇ੮৵ৱ৵ৰʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸ʇ̼ʇ੮ɘɻ͙͐ʇˑ;੮ʁɘ˦ʡʇ̼˺͙ͅ੮ɘ˦ʁ੮˦ʇʇʁʮ˦ʡ੮ͅʩ˺̼͐ચ͐ʇ̼˚੮͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦੮͸ʩʮˑʇ੮ ʁ̼ʮͷʮ˦ʡ੮ɺ;੮͐ʩ˺ͅʇ੮͸ʩ˺੮͸ʇ̼ʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੵ੮ુĔʇ੮ɻ˺͙ˑʁ੮ͅɻ˺˺̹੮͙̹੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ ˚ʮ˦ʮ˚ɘˑ੮ ʇʠʠ˺̼͐੮ ͐ʩɘ͐੮ ͷʇ̼;੮ ˚͙ɻʩ੮ ˚ʇʇ͐੮ ͐ʩɘ͐੮ ɻ̼ʮ͐ʇ̼ʮ˺˦੮ યʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;રੳ੮ {;੮ ˌʮʁͅ੮ ɻ˺͙ˑʁ੮̹̼˺ɺɘɺˑ;੮ͅɘ;ੴ੮ૃĔ˺͸੮͐ʩɘ͐੮̹ʇ̼ͅ˺˦੮ͅʩ˺͙ˑʁ੮ʩɘͷʇ੮ͅ˺˚ʇ੮ʩʇˑ̹ੳૄ੮੮ˑ˺͐੮˺ʠ੮͐ʩʇͅʇ੮ɘ̼ʇ੮ ˺ɺͷʮ˺͙ͅੳ੮"͙͐੮͸ʩʇ̼ʇ੮ʁ˺੮͐ʩʇ;੮ʡ˺੺੯ੳ੯ੳ੯ੳ੮P˺͸੮ʁ˺੮͸ʇ੮ʇ˦͙̼ͅʇ੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮ɺɘɻˌ੮ʩʇ̼ʇ੮ʮ˦੮ ͐ʩ̼ʇʇ੮ʁɘ;ͅ੺੮P˺͸੮ʁ˺੮͸ʇ੮ʡʇ͐੮̹ʇ˺̹ˑʇ੮ʩʇˑ̹੮͐ʩɘ͐ૄͅ੮˺ʠ੮ɘ˦;੮ˑ˺˦ʡʇͷʮ͐;੺੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ ɘ˦੮ʮ˦ʠ̼ɘ̼͙͐ͅɻ͙̼͐ʇ੮͐˺੮͙̹̹ͅ˺̼͐੮ɘ˦ʁ੮ͅʇ̼ͷʇ੮͐ʩɘ͐੮ɻ˺˚˚͙˦ʮ͐;ੳૂ rʇ͐ૄͅ੮̼ʇͷʮͅʮ͐੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮˚˺ʁʇˑ੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮U˦੮ɻʩɘ̹͐ʇ̼੮৴ੴ੮U੮ή͙˺͐ʇʁ੮ɘ੮̼ʇ̹˺̼͐੮ ʠ̼˺˚੮r˺ͅ੮˦ʡʇˑʇͅ੮ɻɘ͐ɘˑ˺ʡʮ˦ʡ੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮ˑɘɻˌ੮˺ʠ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮͐˺੮ʮ˦̹ɘ͐ʮʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ੮îʩʮͅ੮˚ʇɘ˦͐੮͐ʩɘ͐੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ɺʇʮ˦ʡ੮ɻˑɘͅͅʮϲʮʇʁ੮ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ ˦˺͐੮ ɺʇɻɘ͙ͅʇ੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ʮ˦͐ʇ̼˦ɘˑ੮ ̹ɘ͐ʩ˺ˑ˺ʡ;੮ ɺ͙͐੮ ɺʇɻɘ͙ͅʇ੮ ˺ʠ੮ ɘ੮ ˑɘɻˌ੮ ˺ʠ੮ ͅʇ̼ͷʮɻʇͅ੮ ͐ʩɘ͐੮ ͐ʩʇ;੮ɻ˺͙ˑʁ੮ɘɻɻʇͅͅ੮͸ʮ͐ʩ˺͙͐੮ɺʇʮ˦ʡ੮ɻˑɘͅͅʮϲʮʇʁ੮ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮îʩɘ͐੮ͅɘ˚ʇ੮̼ʇ̹˺̼͐੮ ɘˑͅ˺੮̼ʇɻ˺˚˚ʇ˦ʁʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮̼͐ʮ̹ˑʇ੮ʮ͐ͅ੮͐ͅ˺ɻˌ੮˺ʠ੮U{)੮ɺʇʁͅ੮ફɺ;੮ɘʁʁʮ˦ʡ੮͐ʩ̼ʇʇ੮ ͐ʩ˺͙ͅɘ˦ʁબੳ৾਀੮ U˦੮ ˺˦ʇ੮ ͅʇ˦ͅʇੴ੮ ͐ʩʮͅ੮ ɘ˦ɘˑ;ͅʮͅ੮ ʮ˚̹ˑʮʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇ̼ʇ੮ ɘ̼ʇ੮ ͐ʩ̼ʇʇ੮ ͐ʩ˺͙ͅɘ˦ʁ੮ ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮̹ʇ̼ͅ˺˦ͅ੮ʮ˦੮r੮ɻ͙̼̼ʇ˦͐ˑ;੮˦˺͐੮ɻ˺˦ͅʇ̼ͷʇʁ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ̼ʇ੮ʮͅ੮˦˺͸ʩʇ̼ʇ੮ ͐˺੮̹͙͐੮͐ʩʇ˚ੳ੮Uʠ੮;˺͙੮ˑ˺˺ˌ੮ɘ͐੮ʮ͐੮ʠ̼˺˚੮ɘ੮ͅ˺ɻʮɘˑ੮˚˺ʁʇˑੴ੮͐ʩ˺͙ʡʩੴ੮;˺͙੮ϲˑʮ̹੮͐ʩʇ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹ੵ੮ɻ͙̼̼ʇ˦͐ˑ;ੴ੮͐ʩ˺ͅʇ੮͐ʩ̼ʇʇ੮͐ʩ˺͙ͅɘ˦ʁ੮̹ʇ˺̹ˑʇઝ͸ʩɘ͐ʇͷʇ̼੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͐ͅɘ͐ʇ੮͐ʩʇ;੮ɘ̼ʇ੮ ʮ˦ઝɘ̼ʇ੮˦˺͐੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮͐ʩɘ͐੮͸˺͙ˑʁ੮˚ɘˌʇ੮͐ʩɘ͐੮ˑɘɺʇˑ੮ ˚ʇɘ˦ʮ˦ʡʠ͙ˑ੮ʁ˺˦ૄ͐੮ʇͽʮ͐ͅੳ

CONCLUSION: DELEGATION AND THE DECLINE OF PUBLIC AUTHORITY îʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ͅʩ˺͙ˑʁ੮ʁ̼ʮͷʇ੮ʩ˺˚ʇ੮͐͸˺੮̼ʇɻ͙̼̼ʮ˦ʡ੮̹˺ʮ˦͐ͅੳ੮îʩʇ੮ϲʮ̼͐ͅ੮ʮͅ੮͐ʩɘ͐ੴ੮͸ʩɘ͐ʇͷʇ̼੮͐ʩʇ੮͐ͅɘ͙͐͐ʇ੮ͅɘ;ͅੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮ʁʇϲʮ˦ʇʁ੮ɺ;੮ʇɻ˺˦˺˚ʮɻ੮ɘ˦ʁ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮ ʠ˺̼ɻʇͅੳ੮îʩʇ੮͐ͅɘ͐ʇ੮ɘɺʁʮɻɘ͐ʇʁ੮ʮ͐ͅ੮̼˺ˑʇ੮ʮ˦੮ʇ˦͙̼ͅʮ˦ʡ੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɺ;੮ ʁ˺͸˦ͅʮΈʮ˦ʡ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮ɻ˺˦ͷʇ̼͐ʮ˦ʡ੮͐ʩʇ˚੮͐˺੮ͅʇ̼ͷʮ˦ʡ੮ɘ੮ʠ˺̼ʇ˦ͅʮɻ੮̹˺̹͙ˑɘ͐ʮ˺˦ੳ੮ U{)ͅ੮͐ʩ͙ͅ੮ɺʇɻɘ˚ʇ੮͐ʩʇ੮ʁʇ͐ͅʮ˦ɘ͐ʮ˺˦੮ʠ˺̼੮˚˺͐ͅ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮îʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ U{)੮ɺʇʁͅੴ੮ʮ˦੮͙̼͐˦ੴ੮̼ʇϲˑʇɻ͐ͅ੮ɘ੮˚ʮͽ੮˺ʠ੮r;˦ʁ˺˦੮k˺ʩ˦ͅ˺˦જʇ̼ɘ੮ʠʇʁʇ̼ɘˑ੮{ʇʁʮɻɘʮʁ੮ˑʇʡʮͅˑɘ͐ʮ˺˦ੴ੮͐ʩʇ੮ʠ͙˦ʁʮ˦ʡ੮ʠ˺̼˚͙ˑɘͅ੮˺ʠ੮̼ʇɘˑʮʡ˦˚ʇ˦͐੮ફɻ̼ʇɘ͐ʇʁ੮͐˺੮ʁʇɘˑ੮͸ʮ͐ʩ੮ɘ੮ৱ৹৹ৱ੮͐ͅɘ͐ʇ੮

156

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ɺ͙ʁʡʇ͐੮ɻ̼ʮͅʮͅબੴ੮ɘ˦ʁ੮ɘ੮˚˺˦˺̹˺ˑʮΈʇʁ੮˚ɘ̼ˌʇ͐੮ʠ˺̼੮͐͸ʇ˦͐;ચʠ˺͙̼ચʩ˺͙̼੮ɻɘ̼ʇ੮ʁ˺˚ʮ˦ɘ͐ʇʁ੮ ɺ;੮ ɘ˦੮ ˺ʠʠͅʩ˺˺͐੮ ˺ʠ੮ ͐ʩʇ੮ ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇ੮ ʮ˦ʁ͙̼͐ͅ;ੳ੮ îʩʇ̼ʇ੮ ʩɘͅ੮ ɺʇʇ˦੮ ˦˺੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ˑʇɘʁʇ̼ͅʩʮ̹੮͐˺੮˚ɘ͐ɻʩ੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮U{)੮ɺʇʁͅ੮͐˺੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ ͙˦ɘɺˑʇ੮ ͐˺੮ ̹̼˺ͷʮʁʇ੮ ͐ʩʇʮ̼੮ ʠ˺˺ʁੴ੮ ɻˑ˺͐ʩʮ˦ʡੴ੮ ˺̼੮ ͅʩʇˑ͐ʇ̼੮ ɘͅ੮ ɘ੮ ̼ʇ͙ͅˑ͐੮ ˺ʠ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ੮ îʩʇ̼ʇ੮ʮͅ੮˦˺੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ɘͅ੮͐˺੮͸ʩʇ͐ʩʇ̼੮͐ʩ˺ͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮U{)੮ɻɘ̼ʇੳ৾ਁ îʩʇ੮ͅʇɻ˺˦ʁ੮̹˺ʮ˦͐੮ʮͅ੮ɘɺ˺͙͐੮͐ʩʇ੮ʁʮ̼͐ͅʮɺ͙͐ʮ˺˦੮˺ʠ੮̹˺͸ʇ̼੮ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻ˺˦͐ʮ˦͙͙˚ੳ੮Ûʇʠ˺̼˚ͅ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̼ʇ੮̹̼ʇʁʮɻɘ͐ʇʁ੮˺˦੮͐ʩʇ੮ɘ͙ͅͅ˚̹͐ʮ˺˦੮͐ʩɘ͐੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʩɘͷʇ੮͐ʩʇ੮ɻɘ̹ɘɻʮ͐;੮͐˺੮̼͐ɘ˦ͅʠ˺̼˚੮ɘ˦੮ʇͽ̹ɘ˦ʁʇʁ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ ˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮ˦͐˺੮˚˺̼ʇ੮̹ʇ˺̹ˑʇ੮ɺʇʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷʇʁੳ੮U͐੮ɘˑͅ˺੮̹̼ʇ͙ͅ˚ʇͅ੮͐ʩɘ͐੮͐ʩʇ;੮ ɻɘ˦੮͙ͅʇ੮͐ʩʇʮ̼੮̹ˑɘɻʇ˚ʇ˦͐੮̹˺͸ʇ̼੮͐˺੮̹͙͐੮͐ʩ˺ͅʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ͅ˺˚ʇ͸ʩʇ̼ʇੳ੮"͙͐੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ɻ˺˦̼͐˺ˑ੮˺ͷʇ̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮˺˦੮̹ɘ̹ʇ̼੮ʁ˺ʇͅ੮˦˺͐੮ʇͽ͐ʇ˦ʁ੮͐˺੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੳ੮îʩʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮͐ʩɘ͐੮ʇͽʇ̼ɻʮͅʇ੮ͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼੮͐˺੮ʮ˦͐ʇ̼˦੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ʠ˺̼੮ ;ʇɘ̼ͅ੮ ɘ͐੮ ɘ੮ ͐ʮ˚ʇ੮ ɘ̼ʇ੮ ̹ɘ̼ɘʁ˺ͽʮɻɘˑˑ;੮ ̹̼ʮͷɘ͐ʇ੮ ʇ˦͐ʮ͐ʮʇͅ੮ ˺ͷʇ̼੮ ͸ʩʮɻʩ੮ ͅ˺ͷʇ̼ʇʮʡ˦੮ʡ˺ͷʇ̼˦˚ʇ˦͐ͅ੮ʩɘͷʇ੮͙̼̹̼ͅʮͅʮ˦ʡˑ;੮ˑʮ͐͐ˑʇ੮ˑʇͷʇ̼ɘʡʇੳ î˺ʁੴ੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦੮‡˺̼͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ʁʇͅɻ̼ʮɺʇʁ੮ʩ˺͸੮ʩʮͅ੮˚ɘ˦;੮;ʇɘ̼ͅ੮ʮ˦੮ ͐ʩʇ੮ˈ˺ɺ੮ʩɘʁ੮˚ɘʁʇ੮ʩʮ˚੮˚˺ʁʇ͐ͅ੮ɘɺ˺͙͐੮͸ʩɘ͐੮ʩʇ੮ɻ˺͙ˑʁ੮ʁ˺ੳ੮ુĔʇ੮ɻ˺˚ʇ੮ɘɻ̼˺ͅͅ੮ɘͅ੮͐ʩʇ੮ ˺˦ʇͅ੮͸ʩ˺੮ʩɘͷʇ੮͐ʩʇੴ੮ή͙˺͐ʇચ͙˦ή͙˺͐ʇੴ੮ૃˑʇʡɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;ૄ੮͐˺੮̹͙͐੮ͅ˺˚ʇ˺˦ʇ੮ͅ˺˚ʇ͸ʩʇ̼ʇੴ੮ ɺ͙͐੮͐ʩʇ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮ʮͅ੮͐ʩʇ੮˺˦ʇ੮͸ʩ˺੮ʩ˺ˑʁ੮͐ʩʇ੮̹͙̼ͅʇ੮̼͐ͅʮ˦ʡͅੴૂ੮ ʩʇ੮˺ɺͅʇ̼ͷʇʁੳ੮Pʮͅ੮;ʇɘ̼ͅ੮˺ʠ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ʡɘͷʇ੮ʩʮ˚੮ɘ੮̼͐ͅ˺˦ʡ੮ͅʇ˦ͅʇ੮˺ʠ੮͸ʩʇ̼ʇ੮͸˺͙ˑʁ੮ɺʇ੮ ɺʇ͐ͅ੮ʠ˺̼੮ʩʮͅ੮ɻˑʮʇ˦͐ͅੴ੮ɺ͙͐੮ʩʇ੮ɻ˺͙ˑʁ੮˦˺͐੮˺ͷʇ̼̼͙ˑʇ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ʩɘ˦ʁˑʮ˦ʡ੮ʮ˦͐ɘˌʇͅ੮ɘ͐੮͐ʩʇ੮ U{)ੳ੮Pʇ੮ͅʮʡʩʇʁੴ੮ુîʩʮͅ੮ɻ̼ʇɘ͐ʇͅ੮̹̼˺ɺˑʇ˚ͅੴ੮ʮ͐੮ɻ̼ʇɘ͐ʇͅ੮̼͐ͅʮʠʇੴ੮ɺ͙͐੮U੮͸ʮˑˑ੮ͅɘ;੮͐ʩɘ͐੮ɘʠ͐ʇ̼੮ ϲʮʠ͐ʇʇ˦੮;ʇɘ̼ͅ੮˺ʠ੮ɺɘ͐͐ˑʮ˦ʡ੮͐ʩ˺ͅʇ੮ɺɘ͐͐ˑʇͅੴ੮Uૄͷʇ੮ͅ˺̼͐੮˺ʠ੮ʡʮͷʇ˦੮͙̹੮ɘ˦ʁ੮ʁʇɻʮʁʇʁ੮͸ʇ੮ʁ˺˦ૄ͐੮ ʩɘͷʇ੮͐ʩʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐ʩɘ͐੮͸ʇૄ̼ʇ੮ʡʮͷʇ˦੮ˑʇʡɘˑˑ;ੳૂ੮Ĕʩʇ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ʁʇɻʮʁʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ ˌʇ;ͅ੮͐˺੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮͸˺͙ˑʁ੮ɺʇ੮ʩʇˑʁ੮ɺ;੮̹̼ʮͷɘ͐ʇ੮̹̼˺ͷʮʁʇ̼ͅ੮ɘ˦ʁ੮͐ʩʇ੮ɺ͙ʁʡʇ͐ͅ੮͐˺੮̹ɘ;੮ ʠ˺̼੮͐ʩʇ˚੮ɻ˺˦̼͐˺ˑˑʇʁ੮ɺ;੮ɘ˦˺͐ʩʇ̼੮ɘʡʇ˦ɻ;ੴ੮͐ʩʇ;੮ɘɺʁʮɻɘ͐ʇʁ੮î˺ʁૄͅ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʠ˺̼੮ʩʮ˚ੳ

CHAPTER 8

STEPPED DOWN

I

ૄ˚੮˺˦੮ɘ੮͐˺͙̼੮˺ʠ੮ɘ੮ϲʮʠ͐;ચʠ˺͙̼ચɺʇʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੴ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇੴ੮ʮ˦੮ä˺͙͐ʩચ ʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੳ੮#ʮ˦ʁ;ੴ੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ૄͅ੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅੴ੮ʮͅ੮ʇͽ̹ˑɘʮ˦ʮ˦ʡ੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ૄͅ੮ ુ͐˺ˌʇ˦੮ʇɻ˺˦˺˚;ੳૂ੮Ûʇͅʮʁʇ˦͐ͅ੮ʡʇ͐੮͐ʩʮ̼͐;ચϲʮͷʇ੮̹˺ʮ˦͐ͅ੮ʠ˺̼੮ʡ˺ʮ˦ʡ੮͐˺੮ɘ੮ુʡ̼˺͙̹ੳૂ੮ Ĕʮ͐ʩ੮ʠ˺̼͐;੮̹˺ʮ˦͐ͅੴ੮͐ʩʇ;੮ɻɘ˦੮ɺ͙;੮ɘ੮)ʮʇ͐੮#˺ˌʇ੮ɘ͐੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ૄͅ੮ɻ˺˚˚ʮͅͅɘ̼;੶੮͸ʮ͐ʩ੮ ϲʮʠ͐;ੴ੮͐ʩʇ;੮ɻɘ˦੮ͅˌʮ̹੮͐ʩʇ੮ɘ̹ͅɘ̼͐ɘ˚ʇ੮ɘ˦ʁ੮ʡʇ͐੮ɘ੮̼ʇʡ͙ˑɘ̼ੳ Iʇ˺̼ʡʇੴ੮ɘ੮͸ʩʮ͐ʇ੮˚ɘ˦੮͸ʩ˺੮ˑ˺˺ˌͅ੮͐˺੮ɺʇ੮ʮ˦੮ʩʮͅ੮ϲʮʠ͐ʮʇͅੴ੮ͅʩ˺͸ͅ੮˚ʇ੮ʩʮͅ੮˦˺͐ʇɺ˺˺ˌੳ੮ Pʇ੮ ʩɘͅ੮ ৳ৰৰੴৰৰৰ੮ ̹˺ʮ˦͐ͅੳ੮ ˦;੮ ͸ɘ;੮ ;˺͙੮ ʁ˺੮ ͐ʩʇ੮ ˚ɘ͐ʩੴ੮ ৳ৰৰੴৰৰৰ੮ ̹˺ʮ˦͐ͅ੮ ˚ʇɘ˦ͅ੮ ͐ʩɘ͐੮ Iʇ˺̼ʡʇ੮ʩɘͅ੮ɺʇʇ˦੮ɘ͐੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ɘ੮ͷʇ̼;ੴ੮ͷʇ̼;੮ˑ˺˦ʡ੮͐ʮ˚ʇੳ੮Ĕʮ͐ʩ੮͐ʩʇ੮ʠ˺̼͙͐˦ʇ੮ʩʇૄͅ੮ ɘ˚ɘͅͅʇʁੴ੮ʩʇ੮ɻ˺͙ˑʁ੮ɺ͙;੮˺͙͐੮͐ʩʇ੮ʇ˦͐ʮ̼ʇ੮ɻ˺˚˚ʮͅͅɘ̼;ઝɘ੮ͅ˚ɘˑˑ੮ɻˑ˺ͅʇ͐੮͸ʮ͐ʩ੮ɘ੮̼ɘɻˌ੮˺ʠ੮ ɻˑ˺͐ʩʇͅੴ੮ɻ͙̹ͅ੮˺ʠ੮˦˺˺ʁˑʇ੮ͅ˺͙̹ੴ੮͐˺ʮˑʇ̼͐ʮʇͅੴ੮ɘ˦ʁ੮ɘ੮ʠ̼ʮʁʡʇ੮͸ʮ͐ʩ੮ɺɘˑ˺˦ʇ;੮ɘ˦ʁ੮;˺ʡ͙̼͐ઝ ʇͽɻʇ̹͐੮͐ʩɘ͐੮#ʮ˦ʁ;੮ʩɘͅ੮ɺʇʇ˦੮ˑʮ˚ʮ͐ʮ˦ʡ੮ʩʮ˚੮͐˺੮͐͸˺੮̹͙̼ɻʩɘͅʇͅ੮ɘ͐੮ɘ੮͐ʮ˚ʇੳ äʩʇૄͅ੮ ɺʇʇ˦੮ ͸˺̼ˌʮ˦ʡ੮ ͸ʮ͐ʩ੮ Iʇ˺̼ʡʇ੮ ˺˦੮ ʩʮͅ੮ ɺʇʩɘͷʮ˺̼੮ ʮ˦੮ ˺͐ʩʇ̼੮ ͸ɘ;ͅੴ੮ ͐˺˺ੳ੮ Ĕʩʇ˦੮ U੮˚ʇʇ͐੮ʩʮ˚੮ʮ˦੮͐ʩʇ੮ɘɻ͐ʮͷʮ͐;੮̼˺˺˚ੴ੮Iʇ˺̼ʡʇ੮ˑɘ͙˦ɻʩʇͅ੮ʮ˦͐˺੮ɘ˦੮ʮ˦͐ʇ˦ͅʇ੮̼ʇɻ˺͙˦͐ʮ˦ʡ੮˺ʠ੮ ʩ˺͸੮ʩʇ੮͐˺˺ˌ੮ʩʮͅ੮ɘɻɻ͙˚͙ˑɘ͐ʇʁ੮ϲʮͷʇચʁ˺ˑˑɘ̼੮ʡʮʠ͐੮ɻɘ̼ʁͅ੮ફ;˺͙੮ʡʇ͐੮˺˦ʇ੮ʮʠ੮;˺͙੮ʡ˺੮͐˺੮ϲʮͷʇ੮ ʡ̼˺͙̹ͅ੮ʮ˦੮ɘ੮͸ʇʇˌબੴ੮ɺ˺͙ʡʩ͐੮ɘ੮ʩɘ͐੮ɘ͐੮ɘ੮˦ʇɘ̼ɺ;੮̼͐ͅʮ̹੮˚ɘˑˑੴ੮ɘ˦ʁ੮̼͐ʮʇʁ੮͐˺੮̼ʇ͙̼͐˦੮ʮ͐ੵ੮ ૃîʩʇ;੮ͅ˺ˑʁ੮˚ʇ੮ɘ੮ʩɘ͐੮͐ʩɘ͐੮͸ɘͅ੮ʠ̼˺˚੮ēʮʇ͐˦ɘ˚ੴ੮U੮˺˦ˑ;੮͸ɘ˦͐ʇʁ੮˺˦ʇ੮ʠ̼˺˚੮{ɘˑɘ;ͅʮɘੴ੮ U੮͐˺ˑʁ੮͐ʩʇ˚ੴ੮ુU੮ʩɘͷʇ੮˚;੮̼ʮʡʩ͐ͅ੯ੳ੯ੳ੯ੳૄૄੰૄ ૃĚʇͅੴ੮ ;˺͙੮ ʁ˺੮ ʩɘͷʇ੮ ̼ʮʡʩ͐ͅੴૄ੮ #ʮ˦ʁ;੮ ʮ˦͐ʇ̼ˈʇɻ͐ͅੴ੮ ૃɺ͙͐੮ ͐ʩʇ̼ʇૄͅ੮ ɘˑͅ˺੮ ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ ɺʇʩɘͷʮ˺̼ੳૄ äʩʇ੮̹̼˺͙ʁˑ;੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐ੴ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮ʩʇ੮̼ʇ͙̼͐˦ʇʁ੮ɘ˦ʁ੮͙ͅʇʁ੮͐ʩʇ੮ʮ˦͐ʇ̼̹ʇ̼ͅ˺˦ɘˑ੮ ͅˌʮˑˑͅ੮ʩʇ੮ʩɘʁ੮ˑʇɘ̼˦ʇʁ੮ʮ˦੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮͐ʩ˺͙ͅɘ˦ʁͅ੮˺ʠ੮ʡ̼˺͙̹ͅ੮ʩʇ੮ʩɘͅ੮ɘ͐͐ʇ˦ʁʇʁ੮͐˺੮ʡʇ͐੮ɘ੮ ̼ʇʠ͙˦ʁੳ îʩʇ̼ʇ੮ɘ̼ʇ੮ͅʇͷʇ̼ɘˑ੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮͐˺੮˚ɘˌʇ੮ʩʇ̼ʇੳ੮îʩʇ੮ϲʮ̼͐ͅ੮ʮͅ੮͐ʩɘ͐੮Iʇ˺̼ʡʇ੮ʮͅ੮ˑ͙ɻˌ;੮ ͐˺੮ɺʇ੮ʮ˦੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮͐ʩɘ͐੮ʩɘͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ɘ˦ʁ੮ɘ੮͐˺ˌʇ˦੮ʇɻ˺˦˺˚;ੳ੮ˑɘ˦ੴ੮͸ʩ˺੮ ʩɘͅ੮ɺʇʇ˦੮͐ʩʇ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼੮ɘ͐੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ʠ˺̼੮͐ʩʮ̼͐ʇʇ˦੮;ʇɘ̼ͅੴ੮̹̼˺͙ʁˑ;੮͐ʇˑˑͅ੮

158

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

˚ʇੴ੮ુĔʇ੮̹̼˺ͷʮʁʇ੮ɘ੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇ੮͐ʩɘ˦੮˚˺͐ͅ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ʁ˺ੳૂ੮îʩʇ੮I͙ʇ͐ͅ੮ P˺˚ʇ੮ʩɘͅ੮ɘ੮͙˦ʮή͙ʇ੮̹ɘ̼͐˦ʇ̼ͅʩʮ̹੮͸ʮ͐ʩ੮͐ʩʇ੮ˑ˺ɻɘˑ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮͐˺੮ ̹̼˺ͷʮʁʇ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ˚ʇ˦͐੮ɘ˦ʁ੮̹ͅ;ɻʩ˺͐ʩʇ̼ɘ̹;੮ʮ˦ચʩ˺͙ͅʇੳ ુš͙̼੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮̼ɘ͐ʇ੮ʮͅ੮ɘ੮ˑ˺͐੮ˑ˺͸ʇ̼੮͐ʩɘ˦੮ɘ˦;͸ʩʇ̼ʇ੮ʇˑͅʇੴૂ੮ˑɘ˦੮͐ʇˑˑͅ੮˚ʇੴ੮ ʇͽ̹ˑɘʮ˦ʮ˦ʡ੮ ુʮ˦੮ ˚˺͐ͅ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇͅੴ੮ ͐ʩʇ੮ ɘɻ͐ʮͷʮ͐ʮʇͅ੮ ɘ̼ʇ੮ ˈ͙͐ͅ੮ ɺʮ˦ʡ˺੮ ˺̼੮ ɘ̼͐ͅ੮ ɘ˦ʁ੮ ɻ̼ɘʠ͐ͅઝૂ ુĔʩʇ̼ʇɘͅ੮͸ʇ੮ʩɘͷʇ੮̹̼˺ɻʇͅͅ੮ʡ̼˺͙̹ͅੴ੮ɻ˺ʁʇ̹ʇ˦ʁʇ˦ɻ;੮ʡ̼˺͙̹ͅੴ੮ɘ˦ʡʇ̼੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮ ʮ˦͐ʇ̼̹ʇ̼ͅ˺˦ɘˑ੮ʡ̼˺͙̹ͅੴૂ੮#ʮ˦ʁ;੮ʇˑɘɺ˺̼ɘ͐ʇͅੳ ˑɘ˦੮ʡ˺ʇͅ੮˺˦ੴ੮ુš͙̼੮͙ˑ͐ʮ˚ɘ͐ʇ੮ʡ˺ɘˑ੮ʩʇ̼ʇ੮ʮͅ੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮˚˺ͷʇ੮˺͙͐੮˺˦੮͐ʩʇʮ̼੮ ˺͸˦੮ɘ˦ʁ੮ɺʇɻ˺˚ʇ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ɘ˦ʁ੮ɘ੮̹̼˺ʁ͙ɻ͐ʮͷʇ੮˚ʇ˚ɺʇ̼੮˺ʠ੮ͅ˺ɻʮʇ͐;ੳ੮)˺ʇͅ੮͐ʩɘ͐੮ ʩɘ̹̹ʇ˦੺ૂ Pʇ੮ɘ˦ͅ͸ʇ̼ͅ੮ʩʮͅ੮˺͸˦੮ή͙ʇ͐ͅʮ˺˦ੵ੮ુ‡˺͐੮ͷʇ̼;੮˺ʠ͐ʇ˦ੳૂ îʩɘ͐ૄͅ੮ ͐ʩʇ੮ ͅʇɻ˺˦ʁ੮ ˺ɺͅʇ̼ͷɘ͐ʮ˺˦੮ ͐ʩɘ͐੮ U੮ ˚ɘˌʇ੮ ˺˦੮ ˚;੮ ͷʮͅʮ͐ੵ੮ ʠ˺̼੮ ͅ˺˚ʇ˺˦ʇ੮ ˑʮˌʇ੮ Iʇ˺̼ʡʇੴ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ʮͅ੮ʩ˺˚ʇੳ੮ુĔʇૄ̼ʇ੮ɘ੮ϲʮʠ͐;ચʠ˺͙̼ચɺʇʁ੮ʠɘ˚ʮˑ;ੴૂ੮ˑɘ˦੮͐ʇˑˑͅ੮˚ʇੴ੮ ˺ɺͅʇ̼ͷʮ˦ʡੴ੮ુ͸ʇ੮ʩɘͷʇ੮ɻˑʮʇ˦͐ͅ੮͸ʩʇ̼ʇ੮͐ʩʇʮ̼੮ʠɘ˚ʮˑʮʇͅ੮ˑʮͷʇ੮યʮ˦੮͐ʩʇ੮ͅɘ˚ʇ੮ɻʮ͐;ર੮ɘ˦ʁ੮͐ʩʇ;੮ ʁ˺˦ૄ͐੮ͅʇʇ੮͐ʩʇ˚ੳ੮/ͷʇ̼;੮;ʇɘ̼ੴ੮͸ʇ੮ʁ˺੮ɘ੮ɺʮʡ੮îʩɘ˦ˌͅʡʮͷʮ˦ʡ੮˚ʇɘˑੴ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮ ʡ˺ʮ˦ʡ੮͐˺੮ʡ˺੮ʩ˺˚ʇੳૂ੮îʩʇ̼ʇૄͅ੮˦˺੮ʁ˺͙ɺ͐੮͐ʩʮͅ੮ʮͅ੮ɻˑ˺ͅʇ̼੮͐˺੮͸ʩɘ͐੮˚ɘ˦;੮˺ʠ੮͙ͅ੮͸˺͙ˑʁ੮̼ʇɻચ ˺ʡ˦ʮΈʇ੮ɘͅ੮ɘ੮ʩ˺˚ʇ੮͐ʩɘ˦੮ɘ˦੮U{)ੳ੮Ûʇͅʮʁʇ˦͐ͅૄ੮ફͅʩɘ̼ʇʁબ੮̼˺˺˚ͅ੮ɘ̼ʇ੮ɻʩ˺ɻˌચʠ͙ˑˑ੮˺ʠ੮͐ʩʇʮ̼੮ ̹˺ͅͅʇͅͅʮ˺˦ͅ੶੮˚˺͐ͅ੮ʩɘͷʇ੮̹ʩ˺˦ʇͅੴ੮ɘ˦ʁ੮˚ɘ˦;੮ʩɘͷʇ੮ɻ˺˚̹͙͐ʇ̼ͅ੮͸ʮ͐ʩ੮ʮ˦͐ʇ̼˦ʇ͐ੳ੮#ʮ˦ʁ;੮ ͐ʇˑˑͅ੮˚ʇ੮͐ʩʇ;੮ʁʮͅɻ˺͙̼ɘʡʇ੮ͅʇͽ੮ɺʇ͐͸ʇʇ˦੮̼ʇͅʮʁʇ˦͐ͅੴ੮ɺ͙͐੮ʮ͐੮ʩɘ̹̹ʇ˦ͅੴ੮͸ʩʮɻʩ੮ʮͅ੮͸ʩ;੮͐ʩʇ੮ ɻ˺˚˚ʮͅͅɘ̼;੮ʩɘͅ੮ɘ੮ɺʮʡ੮ɺ˺ͽ੮˺ʠ੮ɻ˺˦ʁ˺˚ͅੳ੮{˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐ੴ੮͐ʩʮͅ੮ʮͅ੮ɘ੮ʩ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ɻɘ˦੮ ˑʇɘͷʇ੶੮͐ʩʇ੮ʠ̼˺˦͐੮ʁ˺˺̼੮ʮͅ੮͙˦ˑ˺ɻˌʇʁੴ੮ɘ˦ʁ੮̹ʇ˺̹ˑʇ੮ɻɘ˦੮̹ͅʇ˦ʁ੮͐ʩʇ੮ʁɘ;੮˺͙͐ͅʮʁʇ੮͸ɘˑˌʮ˦ʡ੮ ɘ̼˺͙˦ʁ੮ફʮ˦੮ɘ੮͙ͅɺ͙̼ɺ੮ʠɘ̼੮ʠ̼˺˚੮͐ʩʇ੮ɻʮ͐;੮ɻʇ˦͐ʇ̼બੳ U͐੮ʮͅੴ੮ɘˑͅ˺ੴ੮ɘ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮ˌʮ˦ʁ੮˺ʠ੮ʩ˺˚ʇੳ੮Ĕʩʮˑʇ੮͐ʩʇ੮ʠ̼˺˦͐੮ʁ˺˺̼੮ʮͅ੮ ͙˦ˑ˺ɻˌʇʁੴ੮ U੮ ̼ʇɘˑʮΈʇ੮ ʁ͙̼ʮ˦ʡ੮ ˚;੮ ͐˺͙̼੮ ͐ʩɘ͐੮ ˑʮʠʇ੮ ͸ʮ͐ʩʮ˦੮ ͐ʩʇ੮ I͙ʇ͐ͅ੮ P˺˚ʇ੮ ʮͅ੮ ̹̼ʇ͐͐;੮ ̼ʇ̼͐ͅʮɻ͐ʇʁੳ੮#ˑʮʇ˦͐ͅ੮ʩɘͷʇ੮͐˺੮ɘͅˌ੮ʠ˺̼੮ɘ੮ˌʇ;੮͐˺੮ʡ˺੮͐ʩʇ੮ͅʩ˺͸ʇ̼ͅੴ੮ͅ˺੮͐ͅɘʠʠ੮ɻɘ˦੮ˌʇʇ̹੮͐ɘɺͅ੮ ˺˦੮ ͸ʩ˺੮ ʮͅ੮ ͐ɘˌʮ˦ʡ੮ ɻɘ̼ʇ੮ ˺ʠ੮ ͐ʩʇʮ̼੮ ુɘɻ͐ʮͷʮ͐ʮʇͅ੮ ˺ʠ੮ ʁɘʮˑ;੮ ˑʮͷʮ˦ʡੳૂ੮ #ˑʮʇ˦͐ͅ੮ ɻɘ˦੮ ʁ˺੮ ͐ʩʇʮ̼੮ ˺͸˦੮ˑɘ͙˦ʁ̼;ੴ੮ɺ͙͐੮͐ʩʇ੮ͅ˺ɘ̹ੴ੮͐˺˺ੴ੮ʮͅ੮ˑ˺ɻˌʇʁੳ੮Ĕʇ੮͸ɘˑˌ੮̹ɘ͐ͅ੮ɘ੮ુ˚ʇʁ੮̼˺˺˚ૂ੮ϲʮˑˑʇʁ੮͸ʮ͐ʩ੮ ϲʮˑʮ˦ʡચɻɘɺʮ˦ʇ͐ચˑʮˌʇ੮ ʁ̼ɘ͸ʇ̼ͅ੮ ɘ˦ʁ੮ ɘ੮ ͸˺˚ɘ˦੮ ͅʮ͐͐ʮ˦ʡ੮ ʮ˦੮ ʠ̼˺˦͐੮ ˺ʠ੮ ɘ੮ ̼͐ɘ;੮ ͸ʮ͐ʩ੮ ɘ੮ ʠʇ͸੮ ʁ˺Έʇ˦੮̹ɘ̹ʇ̼੮ɻ͙̹ͅੳ੮îʩʇ੮͸˺˚ɘ˦੮ʮͅ੮ɻɘˑˑʮ˦ʡ੮˺͙͐੮˦ɘ˚ʇͅ੮˺ͷʇ̼੮͐ʩʇ੮ˑ˺͙ʁ̹ͅʇɘˌʇ̼ੴ੮ૃ‡ɘ͐ɘચ ͅʩɘੴ੮wake upੴૄ੮ૃ)ɘ˦ੴ੮it’s time for medsੳૄ {;੮͐ʩʮ̼ʁ੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦੮ʮͅ੮͐ʩɘ͐੮Iʇ˺̼ʡʇ੮˚ɘ;੮˦ʇͷʇ̼੮ʡʇ͐੮͐˺੮̹ͅʇ˦ʁ੮͐ʩʇ੮˦ʇ͐ͅ੮ʇʡʡ੮ʩʇૄͅ੮ ʇɘ̼˦ʇʁ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮͐˺ˌʇ˦੮ʇɻ˺˦˺˚;ੳ੮ʠ͐ʇ̼੮˺͙̼੮͐˺͙̼ੴ੮͸ʇ੮ɘ̼ʇ੮ˈ˺ʮ˦ʇʁ੮ɺ;੮k˺ʇˑੴ੮͸ʩ˺੮ ˺͸˦ͅ੮ ͐ʩʮͅ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ɘͅ੮ ͸ʇˑˑ੮ ɘͅ੮ ɘ੮ ˦ʇ͐͸˺̼ˌ੮ ˺ʠ੮ ˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇͅ੮ ʠ˺̼੮ ͅʇ˦ʮ˺̼ͅੳ੮ U੮ʩɘʁ੮ɺʇʇ˦੮ʩʇɘ̼ʮ˦ʡ੮ɘɺ˺͙͐੮ʩ˺͸੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮͸ʇ̼ʇ੮ɻˑ˺ͅʮ˦ʡ੮ ʇ˦੮˚ɘͅͅʇੳ੮#ˑʮʇ˦͐ͅૄ੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙̼ʮ͐;੮ʁʮͅɘɺʮˑʮ͐;੮ફä͙̹̹ˑʇ˚ʇ˦͐ɘˑ੮äʇɻ͙̼ʮ͐;੮U˦ɻ˺˚ʇੴ੮˺̼੮

STEPPED DOWN

159

ääUબ੮ɻʩʇɻˌͅੴ੮͐ʩʇ੮ʩ˺˚ʇૄͅ੮˚ɘʮ˦੮ͅ˺͙̼ɻʇ੮˺ʠ੮ϲʮ˦ɘ˦ɻʮ˦ʡੴ੮ʩɘͷʇ੮˦˺͐੮ˌʇ̹͐੮͙̹੮͸ʮ͐ʩ੮ɘ੮̼ʮͅʮ˦ʡ੮ ˚ʮ˦ʮ˚͙˚੮͸ɘʡʇੴ੮͸˺̼ˌʇ̼ͅૄ੮ɻ˺˚̹੮ɻ˺͐ͅͅੴ੮ɘ˦ʁ੮͐ʩʇ੮͐ʇ˚̹͐ɘ͐ʮ˺˦੮͐˺੮ͅʇˑˑ੮˺ʠʠ੮ɺ͙ʮˑʁʮ˦ʡͅ੮ ͐ʩɘ͐ੴ੮ʡʮͷʇ˦੮͐ʩʇ੮̹ͅʮˌʇ੮ʮ˦੮̹̼˺̹ʇ̼͐;੮ͷɘˑ͙ʇͅੴ੮ɻ˺͙ˑʁ੮ɺʇ੮̹͙͐੮͐˺੮˚˺̼ʇ੮ˑ͙ɻ̼ɘ͐ʮͷʇ੮͙ͅʇͅ੮͐ʩɘ˦੮ ʩ˺͙ͅʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੳ੮ä˺੮U੮͐ʩ̼˺͸੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮˺͙͐੮͐ʩʇ̼ʇੵ੮ુU੮ʩʇɘ̼੮ ɘ੮ˑ˺͐੮͐ʩɘ͐੮͐ʩʇ੮ʮ˦ʁ͙̼͐ͅ;੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ʮͅ੮ɻ˺ˑˑɘ̹ͅʮ˦ʡੳ੮ä˺੮ʩ˺͸੮ɘ̼ʇ੮;˺͙੮ɘɺˑʇ੮͐˺੮ ̹̼˺ͷʮʁʇ੮͙ͅɻʩ੮ɘ੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ͅʇ̼ͷʮɻʇ੺ૂ ˑɘ˦੮ή͙ʮ̹ͅੴ੮ુ";੮ˑ˺ͅʮ˦ʡ੮˚˺˦ʇ;ੳૂ k˺ʇˑ੮ ̹̼˺ͷʮʁʇͅ੮ ɘ੮ ͅˑʮʡʩ͐ˑ;੮ ˚˺̼ʇ੮ ͐ʩ˺̼˺͙ʡʩ੮ ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦ੴ੮ ɺ͙͐੮ ʮ͐ૄͅ੮ ɺɘͅʮɻɘˑˑ;੮ ͐ʩɘ͐ੳ੮ îʩʇ੮ʠɘɻʮˑʮ͐;੮͙ͅʇʁ੮͐˺੮ʩɘͷʇ੮ͅʇͷʇ˦͐;੮ɺʇʁͅੴ੮ɺ͙͐੮ુ͸ʇ੮͸ʇ̼ʇ੮ʠ˺̼ɻʇʁ੮͐˺੮̼ʇ͙ͅʇ੮ɘ੮̹˺̼͐ʮ˺˦੮ ˺ʠ੮͐ʩʇ੮ɺ͙ʮˑʁʮ˦ʡ੮ʠ˺̼੮ɘ੮ʩʮʡʩʇ̼੮ɘ˦ʁ੮ɺʇ͐͐ʇ̼੮͙ͅʇੴૂ੮͸ʩʮɻʩ੮͸ɘͅ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮͐ʩʇ੮˦͙̼ͅʮ˦ʡ੮ ʩ˺˚ʇ੮˦ʇͽ͐੮ʁ˺˺̼ੳ੮Pʇ੮ɻɘ͐ɻʩʇͅ੮ʩʮ˚ͅʇˑʠੵ੮ુîʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮ͅ˺͙˦ʁ੮̼ʮʡʩ͐ੴ੮ɺʇɻɘ͙ͅʇ੮͸ʇ੮͸ʇ̼ʇ੮ ʩʇˑ̹ʮ˦ʡ੮͐ʩʇ੮ɻˑʮʇ˦͐ͅੴ੮ɺ͙͐੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮͙ͅʇੳ੮îʩɘ͐੮ʩʇˑ̹ʇʁ੮͐˺੮̼ʮʡʩ͐ચͅʮʁʇ੮ϲʮ˦ɘ˦ɻʮɘˑˑ;੮͐ʩʇ੮ ɻ˺ˑˑʇɻ͐ʮͷʇ੮ ˺̹ʇ̼ɘ͐ʮ˺˦ੴ੮ ɺ͙͐੮ ͐ʩʮ˦ʡͅ੮ ʩɘͷʇ੮ ɺʇɻ˺˚ʇ੮ ˚˺̼ʇ੮ ɘ˦ʁ੮ ˚˺̼ʇ੮ ʁʮϲϲʮɻ͙ˑ͐ੳૂ੮ U੮ ɻɘ˦੮ ͅʇʇ੮͐ʩɘ͐ੴ੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮ʩʮͅ੮͐ͅɘʠʠੴ੮k˺ʇˑ੮ʮͅ੮ɺʇʮ˦ʡ੮ɻɘ̼ʇʠ͙ˑੵ੮ુUૄ˚੮˦˺͐੮̹ɘ͐͐ʮ˦ʡ੮˚;ͅʇˑʠ੮˺˦੮͐ʩʇ੮ ɺɘɻˌੴ੮ ɺ͙͐੮ ˺͐ʩʇ̼੮ ˺̹ʇ̼ɘ͐˺̼ͅ੮ ͸˺͙ˑʁ੮ ʩɘͷʇ੮ ɘɺɘ˦ʁ˺˦ʇʁ੮ ͐ʩʮͅ੮ ͐;̹ʇ੮ ˺ʠ੮ ̹̼˺ʡ̼ɘ˚੮ ɘ੮ ˑ˺˦ʡ੮ ͐ʮ˚ʇ੮ɘʡ˺ੳ੯ੳ੯ੳ੯ੳ੮îʩʮͅ੮ɺ̼ʮ˦ʡͅ੮ͅ˺੮˚͙ɻʩ੮˚ʇɘ˦ʮ˦ʡ੮͐˺੮˚ʇ੮ʮ˦੮˚;੮ˑʮʠʇੳ੮"͙͐੮͐ʩʇ̼ʇ੮ʡʇ͐ͅ੮͐˺੮ɘ੮ ̹˺ʮ˦͐੮͸ʩʇ̼ʇ੮;˺͙੮ɻɘ˦੮˺˦ˑ;੮ɺʇ੮ͅ˺੮ɻʩɘ̼ʮ͐ɘɺˑʇੳ੮r˺ͅʮ˦ʡ੮ଏ৲ৰੴৰৰৰ੮ɘ੮˚˺˦͐ʩ੯ੳ੯ੳ੯ੳ੮˺˦ˑ;੮͐ʩʇ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʡʇ͐ͅ੮͐˺੮ʁ˺੮͐ʩɘ͐ੳૂ U˦ʁʇʇʁੴ੮ ʮ͐ૄͅ੮ ɘ੮ ͅʇ˦ͅʇ੮ ˺ʠ੮ ̼ʇˈʇɻ͐ʮ˺˦੮ ɺ;੮ ˑ˺ɻɘˑ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ͐ʩɘ͐੮ ʮͅ੮ ͅ˺੮ ʠ̼͙̼͐ͅɘ͐ʮ˦ʡੳ੮ U˦੮͐ʩʇ੮̹ɘ͐ͅ੮;ʇɘ̼ੴ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮̹͙ˑˑʇʁ੮͐ʩʇ੮̹ˑ͙ʡ੮˺˦੮͐ʩʇ੮ɻˑʮ˦ʮɻɘˑ੮ ̹̼˺ʡ̼ɘ˚੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮͸ɘͅ੮̼͙˦˦ʮ˦ʡੴ੮ˑʇɘͷʮ˦ʡ੮k˺ʇˑ੮˺˦੮͐ʩʇ੮ʩ˺˺ˌ੮ʠ˺̼੮ɻ˺ͷʇ̼ʮ˦ʡ੮ ͐ʩʇ੮ʇ˦ʩɘ˦ɻʇʁ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ʩɘʁ੮ɺʇʇ˦੮̹̼˺ͷʮʁʮ˦ʡੳ੮ˑɘ˦ੴ੮͐ʩʇ੮˚ɘ˦ɘʡʇ̼ੴ੮ ʩɘͅ੮ɺʇʇ˦੮̼͐;ʮ˦ʡ੮͐˺੮͐ɘˌʇ੮ɘʁͷɘ˦͐ɘʡʇ੮˺ʠ੮ɘ੮ɻ˺͙˦͐;੮̹̼˺ʡ̼ɘ˚੮͐˺੮̹̼˺ͷʮʁʇ੮ɘ͙ʡ˚ʇ˦͐ʇʁ੮ ʠ͙˦ʁʮ˦ʡ੮ʠ˺̼੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ͅʇ̼ʮ˺͙ͅ੮ɻˑʮʇ˦͐ͅੴ੮ɺ͙͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʁʇˑɘ;ͅ੮ʮ˦੮ʡʇ͐͐ʮ˦ʡ੮ɘ̹̹̼˺ͷɘˑͅੳ੮ k˺ʇˑ੮ʩɘͅ੮͐ʩʇ੮ʮ˚̹̼ʇͅͅʮ˺˦੮͐ʩɘ͐੮ɻ˺͙˦͐;੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ુʮͅ੮ͅ˺੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮͐ʩʇ੮ʩ˺˚ʇˑʇͅͅੴ੮ ͐ʩʇ;ૄ̼ʇ੮̼ʇʁʮ̼ʇɻ͐ʮ˦ʡ੮͐ʩʇʮ̼੮ʠ͙˦ʁͅૂ੮͐˺੮̹ɘ;੮ʠ˺̼੮ͅʩʇˑ͐ʇ̼ͅ੮ɘ˦ʁ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡੳ੮îʩʮͅ੮ ʮͅੴ੮͸ʇ੮ɘˑˑ੮ɘʡ̼ʇʇੴ੮ɘ੮ˑ͙ʁʮɻ̼˺͙ͅ੮̼˺ɺɺʮ˦ʡ੮˺ʠ੮Øʇ͐ʇ̼੮͐˺੮̹ɘ;੮Øɘ͙ˑੵ੮ુîʩʇ੮ͅʇͽ;੮͐ʩʮ˦ʡ੮ʮͅ੮͐˺੮͐ɘˑˌ੮ ɘɺ˺͙͐੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮͸ʮ͐ʩ˺͙͐੮ɘɻˌ˦˺͸ˑʇʁʡʮ˦ʡ੮͐ʩɘ͐੮ÛHͅ੮યɘʁ͙ˑ͐੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ʠɘɻʮˑʮચ ͐ʮʇͅੴ੮͐ʩʇ੮ʠ˺̼˚ɘˑ੮̼ʇʡ͙ˑɘ͐˺̼;੮˦ɘ˚ʇ੮ʠ˺̼੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇર੮ɻˑ˺ͅʮ˦ʡ੮͸ʮˑˑ੮ɻ˺˦̼͐ʮɺ͙͐ʇ੮͐˺੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮ɺʇɻɘ͙ͅʇ੮ͅ˺੮˚ɘ˦;੮˺ʠ੮˺͙̼੮ɻˑʮʇ˦͐ͅੴ੮ʮʠ੮˦˺͐੮ʠ˺̼੮͙ͅੴ੮͐ʩʇ;੮͸˺͙ˑʁ੮ɺʇ੮ˑʮͷʮ˦ʡ੮ ˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳૂৼ îʩʇ̼ʇૄͅ੮ɘ੮ˑ˺͐੮͐˺੮ɻ̼ʮ͐ʮɻʮΈʇ੮ɘɺ˺͙͐੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳ੮{;੮ʩɘɻˌˑʇͅ੮ɻʇ̼͐ɘʮ˦ˑ;੮̼ʮͅʇ੮͸ʩʇ˦੮ k˺ʇˑ੮̼ʇ˚ʮ˦ʁͅ੮˚ʇੴ੮ુîʩʇͅʇ੮ɘ̼ʇ੮ɺ͙ͅʮ˦ʇͅͅʇͅੳ੮U͐੮ͅ˺੮ʩɘ̹̹ʇ˦ͅ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺ʁ͙ɻ͐੮ʮ˦ͷ˺ˑͷʇͅ੮ ʩ͙˚ɘ˦੮ɺʇʮ˦ʡͅੴ੮̹ʇ˺̹ˑʇ੮͐ɘˌʮ˦ʡ੮ɻɘ̼ʇ੮˺ʠ੮̹ʇ˺̹ˑʇੴ੮ɺ͙͐੮ʮ͐ૄͅ੮ɺ͙ͅʮ˦ʇͅͅੳૂ৽੮"͙͐੮͐ʩʇ˦੮U੮̼ʇ͐ʇˑˑ੮ ˚;ͅʇˑʠ੮ʩ˺͸੮˚͙ɻʩ੮˚˺˦ʇ;੮ʩʇ੮ʩɘͅ੮ɺʇʇ˦੮ˑ˺ͅʮ˦ʡ੮͐˺੮ˌʇʇ̹੮͐ʩʮͅ੮ɺ͙ͅʮ˦ʇͅͅ੮ʡ˺ʮ˦ʡੳ੮Ĕʩɘ͐ચ ʇͷʇ̼੮͐ʩʇ੮˚˺͐ʮͷʇͅ੮˺ʠ੮͐ʩʇʮ̼੮˺͸˦ʇ̼ͅ੮ɘ˦ʁ੮˺̹ʇ̼ɘ͐˺̼ͅੴ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅ੮̹̼˺ͷʮʁʇ੮ɘ੮

160

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ͅʇ̼ͷʮɻʇ੮˦˺੮˺˦ʇ੮ʇˑͅʇ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ͅʇʇ˚ͅ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ʮ˦͐ʇ̼ચ ʇ͐ͅʇʁ੮ʮ˦ੵ੮ɻ͙͐ͅ˺ʁʮɘˑ੮ɻɘ̼ʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺ੴ੮ʇͷʇ˦੮ɘʠ͐ʇ̼੮͐ʩ˺͙ͅɘ˦ʁͅ੮˺ʠ੮ͅʇͅͅʮ˺˦ͅ੮˺ʠ੮ʡ̼˺͙̹੮ ͐ʩʇ̼ɘ̹;ੴ੮˚ɘ;੮͐ͅʮˑˑ੮˦˺͐੮ɺʇ੮ɘɺˑʇ੮͐˺੮ˑʮͷʇ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;ੳ੮"˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ ʁʇˑʇʡɘ͐ʇʁ੮ɘ˦੮ʇͅͅʇ˦͐ʮɘˑ੮̼˺ˑʇ੮ɺ;੮͐ʩʇ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ʁʇͷʇˑ˺̹੮ɘ˦;੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੳ "˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ˑʮˌʇ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ɘ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮͐ʩʇ੮̹˺ʮ˦͐੮͸ʩʇ̼ʇ੮͐ʩʇ੮ɻ˺˦ચ ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻ˺˦͐ʮ˦͙͙˚੮ ʇ˦ʁͅੳ੮ #˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ʮ˦੮ U{)ͅ੮ ͐;̹ʮɻɘˑˑ;੮ ͐ͅʇ̹੮ ʁ˺͸˦੮ ʮ˦͐˺੮ ͐ʩʇ˚ੳ੮{˺͐ͅ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐੮ɘ͐੮ˑʇɘ͐ͅ੮ʩɘˑʠ੮˺ʠ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅ੮͸ʇ̼ʇ੮̹ˑɘɻʇʁ੮ ʮ˦੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳ੮îʩʮͅ੮ʮͅ੮͐ʩʇ੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇ੮ɘ͐੮͸ʩʮɻʩ੮ͅ˺˚ʇ੮ɻˑʮʇ˦͐ͅ੮͸ʮˑˑ੮ɺʇ੮͐ͅɘɺˑʇ੮ ʇ˦˺͙ʡʩ੮ ͐˺੮ ɻ˺˚ʇ੮ ˺ʠʠ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɘ˦ʁ੮ ˺͐ʩʇ̼ͅ੮ ͸ʮˑˑੴ੮ ɘ͐੮ ͐ʩʇ੮ ͷʇ̼;੮ ˑʇɘ͐ͅੴ੮ ̼ʇή͙ʮ̼ʇ੮ ˦˺੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮˺˦ɻʇચʇͷʇ̼;ચ͐ʩ̼ʇʇચ˚˺˦͐ʩͅ੮ɻʩʇɻˌચʮ˦੮ʠ̼˺˚੮͐ʩʇʮ̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੳ੮ Ĕʩʇ˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʡʇ͐ͅ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦͐˺੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੴ੮ʮ͐੮ʩɘͅ੮͙ͅɻɻʇʇʁʇʁ੮ʮ˦੮ ુʇ˦ɘɺˑʮ˦ʡ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮͸˺͙ˑʁ੮˺͐ʩʇ̼͸ʮͅʇ੮ɺʇ੮ˑ˺˦ʡચ͐ʇ̼˚੮̼ʇͅʮʁʇ˦͐ͅ੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮͐˺੮ˑʮͷʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮ɘ˦ʁ੮ɘɻʩʮʇͷʇ੮ɘ੮ɻ˺˦ͅʮʁʇ̼ɘɺˑʇ੮˚ʇɘ͙̼ͅʇ੮˺ʠ੮ɘ͙͐˺˦ચ ˺˚;੮ʮ˦੮͐ʩʇʮ̼੮ˑʮͷʇͅੴૂ੮ɘͅ੮͐͸˺੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮˺̹͐ʮ˚ʮ͐ͅʮɻɘˑˑ;੮̹͙͐੮ʮ͐੮ʁʇɻɘʁʇͅ੮ɘʡ˺ੳ৾ "͙͐੮͐ʩɘ͐੮ɻ˺˦͐ʮ˦͙͙˚੮ɻɘ˦੮ˑ˺˺̹੮ɺɘɻˌੳ੮#ˑʮʇ˦͐ͅ੮ʁʇ̹ɘ̼͐੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮͙˦ˑ˺ɻˌʇʁ੮ʁ˺˺̼ͅ੮ ˺ʠ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇͅ੮ ɘ˦ʁ੮ ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʇੳ੮ Ĕʩʇ˦੮ ͐ʩʇʮ̼੮ ʠ̼ɘʡʮˑʇ੮ ʇή͙ʮˑʮɺ̼ʮ͙˚੮ ɺ̼ʇɘˌͅੴ੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ˑʮˌʇ੮#ʮ˦ʁ;੮ϲʮʡʩ͐ੴ੮˺ʠ͐ʇ˦੮͙˦͙ͅɻɻʇͅͅʠ͙ˑˑ;ੴ੮͐˺੮ʡʇ͐੮͐ʩʇ˚੮ɺɘɻˌ੮ʮ˦͐˺੮͐ʩʇ੮ʩ˺ͅચ ̹ʮ͐ɘˑੳ੮˦ʁ੮ʮʠ੮ɘ˦ʁ੮͸ʩʇ˦੮̹ˑɘɻʇͅ੮ˑʮˌʇ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ɻˑ˺ͅʇੴ੮͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ˦ʁ੮ ͙̹੮ɺɘɻˌ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅઝ͐ʩʇ੮ͷʇ̼;੮ʮ˦ͅɘˑ͙ɺ̼ʮ˺͙ͅ੮ͅʮ͙͐ɘ͐ʮ˺˦੮͐ʩɘ͐੮̹͙͐੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ˚੮˺˦੮ ͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚੮ʮ˦੮͐ʩʇ੮ϲʮ̼͐ͅ੮̹ˑɘɻʇੳ੮îʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ʮͅ੮ɘɺ˺͙͐੮͐ʩʇ੮̼ʮͅˌͅ੮ ˺ʠ੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮ɻɘ̼ʇ੮͐˺੮̹̼ʮͷɘ͐ʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮͐ʩɘ͐੮͐ʩʇ੮˚ɘ̼ˌʇ͐੮˚ʮʡʩ͐੮ʁʇɻʮʁʇ੮ͅʩ˺͙ˑʁ੮˦˺੮ ˑ˺˦ʡʇ̼੮ʇͽʮ͐ͅੳ

BORED AND THE STATE DIDN’ T CARE îʩʇ̼ʇૄͅ੮ɘ੮͐;̹ʮɻɘˑ੮̹ɘ͐͐ʇ̼˦੮͸ʩʇ˦੮U੮ɺ̼ʮ˦ʡ੮͙̹੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳ੮îʩʇ੮̹ʇ̼ͅ˺˦੮Uૄ˚੮̹ͅʇɘˌચ ʮ˦ʡ੮͐˺੮ʁʇɻ̼ʮʇͅ੮͐ʩʇ੮ͅ˺̼̼;੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͸ʮ͐ʩʮ˦੮͐ʩʇ˚ੳ੮U˦੮͐ʩʇ੮˦ʇͽ͐੮ɺ̼ʇɘ͐ʩੴ੮͐ʩʇ;੮˚˺͙̼˦੮ ͐ʩɘ͐੮͐ʩʇͅʇ੮ͅ˺̼̼;੮̼͙͐ͅɻ͙̼͐ʇͅ੮ɘ̼ʇ੮̼ɘ̹ʮʁˑ;੮ɻˑ˺ͅʮ˦ʡੳ੮îʩʮͅ੮ʮͅ੮˦˺੮̹ɘ̼ɘʁ˺ͽੳ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ˦ʇʡˑʮʡʇ˦ɻʇ੮͐˺͸ɘ̼ʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅ੮ʡ˺ʇͅ੮ʩɘ˦ʁ੮ʮ˦੮ʩɘ˦ʁ੮͸ʮ͐ʩ੮ʮ͐ͅ੮ʁʇ̹ʇ˦ʁʇ˦ɻʇ੮ ˺˦੮͐ʩʇ˚ੳ U͐੮ʩɘͅ੮ɺʇɻ˺˚ʇ੮ɘ੮ɻ˺˚˚˺˦੮̼͐˺̹ʇ੮͐ʩɘ͐੮͐ʩʇ੮ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮˺ʠ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮચ ͐ɘˑͅ੮ʩɘ̹̹ʇ˦ʇʁ੮ɘͅ੮ɘ˦੮͙˦̹ˑɘ˦˦ʇʁੴ੮̹ʇˑˑચ˚ʇˑˑ੮ʁɘͅʩ੮ʠ˺̼੮͐ʩʇ੮ʇͽʮ͐ੳ৿੮îʩʮͅ੮ʮͅ੮˦˺͐੮ʇ˦͐ʮ̼ʇˑ;੮ ʠɘʮ̼ੳ੮ä͐ɘ̼͐ʮ˦ʡ੮ʮ˦੮ৱ৹৳৸ੴ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮P;ʡʮʇ˦ʇ੮ɻ̼ʇɘ͐ʇʁ੮ɘ੮ "͙̼ʇɘ͙੮˺ʠ੮ä˺ɻʮɘˑ੮Ĕ˺̼ˌੳ੮U͐੮ɻ͙ˑ͐ʮͷɘ͐ʇʁ੮ɘ੮˦ʇ͐͸˺̼ˌ੮˺ʠ੮ͅ˚ɘˑˑ੮ɺ˺ɘ̼ʁʮ˦ʡ੮ʩ˺˚ʇͅ੮͐˺੮͙̹ͅચ ̹˺̼͐੮ ʁʮͅɻʩɘ̼ʡʇʁ੮ ̹ɘ͐ʮʇ˦͐ͅੴ੮ ͸ʩ˺੮ ͸˺͙ˑʁ੮ ɘˑͅ˺੮ ɻ˺˦͐ʮ˦͙ʇ੮ ̼ʇɻʇʮͷʮ˦ʡ੮ ɻɘ̼ʇ੮ ʮ˦੮ ͐ͅɘ͐ʇચ̼͙˦੮

STEPPED DOWN

161

ɻˑʮ˦ʮɻͅੳ਀੮ îʩʇ੮ ʩʇɘʁ੮ ˺ʠ੮ ͐ʩʇ੮ ɺ͙̼ʇɘ͙੮ ʮ˦੮ /ˑ੮ {˺˦͐ʇੴ੮ ˺͙͐ͅʮʁʇ੮ r˺ͅ੮ ˦ʡʇˑʇͅੴ੮ ʇͽ̹ˑɘʮ˦ʇʁੴ੮ ુĔʩɘ͐੮͸ʇૄ̼ʇ੮ͅʇʇˌʮ˦ʡ੮̹̼ʮ˚ɘ̼ʮˑ;੮ʮͅ੮˦˺͐੮ʩ˺͙ͅʇͅ੮ɺ͙͐੮̹ʇ˺̹ˑʇ੮ય͐˺੮̼͙˦੮ɺ˺ɘ̼ʁʮ˦ʡ੮ʩ˺˚ʇͅરੳ੮ Ĕʇ੮˦ʇʇʁ੮͸ɘ̼˚ੴ੮ˑ˺ͷʮ˦ʡ੮͸˺˚ʇ˦ੳ੯ੳ੯ੳ੯ੳ੮Øʇ̼ʩɘ̹ͅ੮˺ˑʁʇ̼੮͸˺˚ʇ˦੮͸ʩ˺ͅʇ੮ɻʩʮˑʁ̼ʇ˦੮ʩɘͷʇ੮ ʡ̼˺͸˦੮͙̹੮ɘ˦ʁ੮ϲˑ˺͸˦੮͐ʩʇ੮˦ʇ͐ͅੴ੮˺̼੮;˺͙˦ʡʇ̼੮˺˦ʇͅ੮͸ʮ͐ʩ੮ͅ˚ɘˑˑ੮ʠɘ˚ʮˑʮʇͅ੮͸ʩ˺੮ɘ̼ʇ੮ʮ˦͐ʇ̼ચ ʇ͐ͅʇʁ੮ʮ˦੮̹̼˺ͷʮʁʮ˦ʡ੮ɘ੮ɻ˺˚˚͙˦ʮ͐;੮ͅʇ̼ͷʮɻʇੳૂਁ îʩʇ੮ͅʮ͙͐ɘ͐ʮ˺˦੮ɻʩɘ˦ʡʇʁ੮ʮ˦੮ৱ৹৶৳ੴ੮͸ʩʇ˦੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɺʇɻɘ˚ʇ੮ʇˑʮચ ʡʮɺˑʇ੮ʠ˺̼੮ʮʁ੮͐˺੮͐ʩʇ੮î˺͐ɘˑˑ;੮)ʮͅɘɺˑʇʁ੮ફ͸ʩʮɻʩ੮ʮ˦੮ৱ৹৷৲੮˚˺̼̹ʩʇʁ੮ʮ˦͐˺੮ääUબੳਂ੮îʩʮͅੴ੮ ʮ˦੮͐ʩʇ੮͸˺̼ʁͅ੮˺ʠ੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮˦ʁ̼ʇ͸੮äɻ͙ˑˑੴ੮ુ̼͐ɘ˦ͅʠ˺̼˚ʇʁ੮˚ʇ˦͐ɘˑ੮̹ɘ͐ʮʇ˦͐ͅ੮ʮ˦͐˺੮ɘ੮ ˑ͙ɻ̼ɘ͐ʮͷʇ੮ɻ˺˚˚˺ʁʮ͐;ૂ੮ʠ˺̼੮ɘ੮˦ʇ͸ੴ੮͙˦ɘɺɘͅʩʇʁˑ;੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʮ˦ʁ͙̼͐ͅ;ੳਃ੮#˺˚˚͙˦ʮ͐;੮ ̼ʇͅʮ͐ͅɘ˦ɻʇ੮ ̹͙ͅʩʇʁ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇͅ੮ ʮ˦͐˺੮ ˑ˺͸ચʮ˦ɻ˺˚ʇੴ੮ ˚ʮ˦˺̼ʮ͐;੮ ˦ʇʮʡʩɺ˺̼ʩ˺˺ʁͅੳ਄ /ɻ˺˦˺˚ʮʇͅ੮˺ʠ੮ͅɻɘˑʇ੮ˑʇʁ੮͐ʩʇ˚੮͐˺੮ʡ̼˺͸੮ʠ̼˺˚੮ͅ˚ɘˑˑ੮ʩ˺˚ʇͅ੮ʮ˦͐˺੮ˑɘ̼ʡʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅੳৼ৻ ͅ੮ ͐ʩʇ੮ Los Angeles Times੮ ʠ̼ʇ͐͐ʇʁ੮ ʮ˦੮ ৱ৹৷৲ੴ੮ ͐ʩʇ੮ ɘ͐͐ʇ˚̹͐੮ ͐˺੮ ુ̹͙͐੮ ɘ˦੮ ʇ˦ʁ੮ ͐˺੮ ૃ͸ɘ̼ʇચ ʩ˺͙ͅʮ˦ʡૄ੮ɘ͐੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʇ˦ʁʇʁ੮͙̹੮ɻ̼ʇɘ͐ʮ˦ʡ੮ͅɻ˺̼ʇͅ੮˺ʠ੮˚ʮ˦ʮɘ͙̼͐ʇ੮ૃ͸ɘ̼ʇʩ˺͙ͅʇͅૄૂ੮ ͐ʩɘ͐੮˺̹ʇ̼ɘ͐ʇʁ੮ɘͅ੮ુ̹˺˺̼ˑ;ચ͐ͅɘʠʠʇʁੴ੮̹˺˺̼ˑ;ચʇή͙ʮ̹̹ʇʁ੮˚ʮ˦ʮɘ͙̼͐ʇ੮˚ʇ˦͐ɘˑ੮ʩ˺̹ͅʮ͐ɘˑͅੳૂৼৼ ";੮ৱ৹৸ৰੴ੮͐ʩʮͅ੮ͅ;͐ͅʇ˚੮˺ʠ੮ુ̹̼ʮͷɘ͐ʮΈʇʁ੮˚ɘˑʮʡ˦੮˦ʇʡˑʇɻ͐ૂৼ৽੮ʩ˺͙ͅʇʁ੮৳৵ੴৰৰৰ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ ˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮͐ͅɘ͐ʇ͸ʮʁʇੳৼ৾ äʮ˦ɻʇ੮͐ʩʇ˦ੴ੮͐ʩʇ੮˚ɘʮ˦੮̹͙ɺˑʮɻ੮̹˺ˑʮɻ;੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩɘͅ੮˚ɘʮ˦͐ɘʮ˦ʇʁ੮͐˺͸ɘ̼ʁ੮ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ʩ˺˚ʇͅ੮ ʮͅ੮ ˦˺੮ ̹˺ˑʮɻ;੮ ɘ͐੮ ɘˑˑੳ੮ îʩʇ੮ ͐ͅɘ͐ʇ੮ ʇͷʇ˦͙͐ɘˑˑ;੮ ɻˑ˺ͅʇʁ੮ ͐ʩʇ੮ "͙̼ʇɘ͙੮ ˺ʠ੮ ä˺ɻʮɘˑ੮Ĕ˺̼ˌ੮˺˦੮͐ʩʇ੮ɘ͙ͅͅ˚̹͐ʮ˺˦੮͐ʩɘ͐੮ɻ˺͙˦͐ʮʇͅ੮͸˺͙ˑʁ੮̹ʮɻˌ੮͙̹੮͐ʩʇ੮ͅˑɘɻˌ੮ʮ˦੮˺̼ʡɘચ ˦ʮΈʮ˦ʡ੮ ˺˦ʡ˺ʮ˦ʡ੮ ̼ʇͅʮʁʇ˦͐ʮɘˑ੮ ɻɘ̼ʇ੮ ʠ˺̼੮ ɘ੮ ɻʩ̼˺˦ʮɻɘˑˑ;੮ ʮˑˑ੮ ̹˺̹͙ˑɘ͐ʮ˺˦ੳ੮ îʩʇ;੮ ʁʮʁ˦ૄ͐ੳৼ৿ Ĕʩʮˑʇ੮ ͐ͅɘ͐ʇ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ˌʇ̹͐੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ʠ˺̼੮ ˑʮɻʇ˦ͅʮ˦ʡ੮ ͐ʩʇͅʇ੮ ʠɘɻʮˑʮ͐ʮʇͅੴ੮ ͐ʩʇ੮ )ʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ ˺ʠ੮ Ø͙ɺˑʮɻ੮ Pʇɘˑ͐ʩੴ੮ {ʇ˦͐ɘˑ੮ P;ʡʮʇ˦ʇੴ੮ ɘ˦ʁ੮ ä˺ɻʮɘˑ੮ Ĕʇˑʠɘ̼ʇ੮ ɘˑˑ੮ ̹ͅʇ˦͐੮ ;ʇɘ̼ͅ੮ɘ̼ʡ͙ʮ˦ʡ੮͐ʩɘ͐੮ʁ˺ʮ˦ʡ੮ͅ˺੮͸ɘͅ੮˦˺͐੮ʮ˦੮͐ʩʇʮ̼੮̹͙̼ͷʮʇ͸ੳৼ਀੮"˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ɘ̼ʇ੮˦˺͐੮ ˈ͙͐ͅ੮͐ʩʇ੮ɻʩʇɘ̹ʇ͐ͅ੮̹ˑɘɻʇ੮͐˺੮̹͙͐੮ͅ˺˚ʇ˺˦ʇ੮͸ʮ͐ʩ੮ɘ੮ͅʇͷʇ̼ʇ੮ɘ˦ʁ੮ɻʩ̼˺˦ʮɻ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ ફϲʮʡ͙̼ʇ੮৸ੳৱબੳ੮îʩʇ;ૄ̼ʇ੮ɘˑͅ˺੮ɘˑ˚˺͐ͅ੮ʇ˦͐ʮ̼ʇˑ;੮̹ɘʮʁ੮ʠ˺̼੮ɺ;੮ɘ੮ʠʇʁʇ̼ɘˑ੮ʇ˦͐ʮ͐ˑʇ˚ʇ˦͐੮̹̼˺ચ ʡ̼ɘ˚੮ફääUબੳ੮ͅ੮ɘ੮̼ʇ͙ͅˑ͐ੴ੮͐ʩʇ;੮͸ʇ̼ʇ੮˺ʠ͐ʇ˦੮͐ʩʇ੮ˑɘ͐ͅ੮̼͙͐ͅɻ͙̼͐ʇͅ੮ˑʇʠ͐੮͐ͅɘ˦ʁʮ˦ʡ੮͸ʩʇ˦੮ ͐ͅɘ͐ʇ੮ɘ˦ʁ੮ɻ˺͙˦͐;੮ʡ˺ͷʇ̼˦˚ʇ˦͐ͅ੮ͅˑɘͅʩʇʁ੮ʠ͙˦ʁʮ˦ʡ੮ʠ˺̼੮˺͐ʩʇ̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʡ̼ɘ˚ͅੳ r˺͸੮ ʠ͙˦ʁʮ˦ʡੴ੮ ˚ʮ˦ʮ˚ɘˑ੮ ˺ͷʇ̼ͅʮʡʩ͐ੴ੮ ʮ˦ͷʮͅʮɺˑʇ੮ ɘ˦ʁ੮ ʁʇ̹ʇ˦ʁʇ˦͐੮ ̹ʇ˺̹ˑʇੴ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ̹̼˺ϲʮ͐੮˚˺͐ʮͷʇੵ੮ɘ੮ɻ˺ɻˌ͐ɘʮˑ੮ʠ˺̼੮ɻ̼͙ʇˑ͐;ੳ੮õ˦͐ʮˑ੮̼ʇɻʇ˦͐ˑ;ੴ੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʮ˦ʁ͙̼͐ͅ;੮ ʩɘͅ੮ɺʇʇ˦੮ͷʮͅʮɺˑʇ੮˺˦ˑ;੮ʮ˦੮˚˺˚ʇ˦͐ͅ੮˺ʠ੮̹ͅʇɻ͐ɘɻ͙ˑɘ̼੮ɘɺ͙ͅʇੳ੮U˦੮ৱ৹৸৵ੴ੮ʮ˦ͷʇ͐ͅʮʡɘ͐˺̼ͅ੮ʠ̼˺˚੮ ͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ä˺ɻʮɘˑ੮äʇ̼ͷʮɻʇͅ੮ͷʮͅʮ͐ʇʁ੮ɘ˦੮ʇʮʡʩ͐;ચ͐ʩ̼ʇʇચɺʇʁ੮ુʩ˺˚ʇૂ੮͸ʩʇ̼ʇ੮̼ʇͅʮચ ʁʇ˦͐ͅ੮͸ʇ̼ʇ੮ુϲʮˑ͐ʩ;ੴ੮͙˦͸ɘͅʩʇʁੴ੮ɘ˦ʁ੮ʁ̼ʇͅͅʇʁ੮ʮ˦੮ʡ̼ʮ˚;੮ɻˑ˺͐ʩʮ˦ʡੴૂ੮ˑʮͷʮ˦ʡ੮ɘ˚ʮʁ੮ુ̼˺ʁʇ˦͐੮ ʁ̼˺̹̹ʮ˦ʡͅ੮ɘ˦ʁ੮̹ͅ˺ʮˑʇʁ੮̹̼˺ʁ͙ɻʇ੮ͅ͸ɘ̼˚ʮ˦ʡ੮͸ʮ͐ʩ੮ϲˑʮʇͅૂ੮ɘ˦ʁ੮ͅˑʇʇ̹ʮ˦ʡ੮˺˦੮˚ɘ̼͐͐ʇͅͅʇͅ੮ ુͅ˺੮ ϲʮˑ͐ʩ;੮ ɘ˦ʁ੮ ̼˺ɘɻʩ੮ ʮ˦ʠʇ͐ͅʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ ͐ʇɘ˚੮ ˺̼ʁʇ̼ʇʁ੮ ય͐ʩʇ˚ર੮ ʁʇ̼͐ͅ˺;ʇʁ੮ ˺˦੮ ͐ʩʇ੮̹ͅ˺͐ੳૂৼਁ੮U˦੮ৱ৹৹৵ੴ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɻˑ˺ͅʇʁ੮ʁ˺͸˦੮ɘ੮ʩ˺˚ʇ੮͸ʩʇ̼ʇ੮ુ˺˦ʇ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɻ੮˚ɘ˦੮ ɺʇɘ͐੮ɘ˦˺͐ʩʇ̼੮͐˺੮ʁʇɘ͐ʩૂ੮͸ʩʮˑʇ੮͐ʩʇ੮ͅʇͷʇ˦͐;ચ͐ʩ̼ʇʇચɺʇʁ੮ʠɘɻʮˑʮ͐;ૄͅ੮ˑ˺˦ʇ੮͐ͅɘʠʠ੮˚ʇ˚ɺʇ̼੮

162

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

State hospital

964

Acute hospital (full rate)

888

Acute hospital (administrative rate)

693

Mental Health Rehabilitation Center (IMD)

370

Residential Treatment Facility (e.g. Progress Foundation)

260

Skilled Nursing Facility

246 156

“Augmented” Board and Care (e.g. Psynergy) 65

Full-Service Partnership/Supported Housing Board and Care

35 0

200

400

600

800

1,000

Cost per day Social Security (Federal only) Realignment (County)

Medi-Cal/MHSA (State/County)

Medi-Cal (State/Federal)

8.1 /͐ͅʮ˚ɘ͐ʇʁ੮ɻ˺͐ͅͅ੮˺ʠ੮৲৴ઃ৷੮ɻɘ̼ʇੴ੮৲ৰ৲৲ Sourceੵ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩɻɘ̼ʇ੮äʇ̼ͷʮɻʇͅ੶੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑͅ੶੮ɻ˺͙˦͐;੮ɻ˺˦̼͐ɘɻ͐ͅ *Noteੵ੮#˺͐ͅͅ੮˺ʠ੮̹̼˺ʡ̼ɘ˚ͅ੮ͷɘ̼;੮ɺ;੮ʠɘɻʮˑʮ͐;੮ɘ˦ʁ੮̼ʇʡʮ˺˦ੳ

͸ɘͅ੮͸ɘͅʩʮ˦ʡ੮ʁʮͅʩʇͅੳৼਂ੮š˦ʇ੮ʩ˺˚ʇ੮ʮ˦੮r˺˦ʡ੮"ʇɘɻʩ੮ɘɻɻ͙˚͙ˑɘ͐ʇʁ੮;ʇɘ̼ͅ੮˺ʠ੮ɻʮ͐ɘ͐ʮ˺˦ͅ੮ʠ˺̼੮ ͙˦ͅɘ˦ʮ͐ɘ̼;੮ʠ˺˺ʁੴ੮͐ʩʇʠ͐ͅ੮ʠ̼˺˚੮̼ʇͅʮʁʇ˦͐ͅ੮ɺ;੮͐ͅɘʠʠੴ੮ɘ˦ʁ੮ɘ˦੮˺ͷʇ̼ʁ˺ͅʇ੮ʁʇɘ͐ʩੳ੮#˺͙˦͐;੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮˺ϲϲʮɻʮɘˑͅ੮˺˦ˑ;੮͐ͅ˺̹̹ʇʁ੮̼ʇʠʇ̼̼ʮ˦ʡ੮ɻˑʮʇ˦͐ͅ੮͐ʩʇ̼ʇ੮͸ʩʇ˦੮ɘ੮͐ͅɘʠʠ੮˚ʇ˚ચ ɺʇ̼੮ ͸ɘͅ੮ ˌʮˑˑʇʁੳৼਃ੮ šɻɻɘͅʮ˺˦ɘˑˑ;ੴ੮ ̹˺ˑʮɻ;੮ ˚ɘˌʇ̼ͅ੮ ϲˑ˺ɘ͐ʇʁ੮ ̹̼˺̹˺ͅɘˑͅ੮ ͐˺੮ ɺʇ͐͐ʇ̼੮ ʠ͙˦ʁ੮ ˺̼੮˚˺̼ʇ੮ɻɘ̼ʇʠ͙ˑˑ;੮̼ʇʡ͙ˑɘ͐ʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੴ੮ɺ͙͐੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮͐ʩʇ੮ ˚˺͐ͅ੮ɻʩ̼˺˦ʮɻ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ɘͅ੮͐˺˺੮ɻ˺˦ͷʇ˦ʮʇ˦͐੮͐˺੮̼ʮͅˌ੮͙̹ͅʇ͐͐ʮ˦ʡੳৼ਄ îʩʮͅ੮ɘɺʁʮɻɘ͐ʮ˺˦੮˺ʠ੮ɘ˦;੮ɘɻ͐ʮͷʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮̼˺ˑʇ੮ʮ˦੮˺̼ʡɘ˦ʮΈʮ˦ʡ੮͐ʩʇ੮ુɻɘ̼ʇૂ੮ʮ˦੮͐ʩʇ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ͅ;͐ͅʇ˚੮ ʮͅ੮ ɘ̹̹ɘ̼ʇ˦͐੮ ʮ˦੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮ ʠɘɻʮˑʮ͐ʮʇͅੳ੮ {;੮ ʮ˦͐ʇ̼ͷʮʇ͸੮ ͸ʮ͐ʩ੮ äɘ͙ˑੴ੮͐ʩʇ੮˺͸˦ʇ̼੮ɘ˦ʁ੮˺̹ʇ̼ɘ͐˺̼੮˺ʠ੮˺˦ʇ੮˦ʮ˦ʇ͐;ચɺʇʁ੮ʠɘɻʮˑʮ͐;੮ʮ˦੮ä˺͙͐ʩʇ̼˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ ʇͷʇ˦͙͐ɘˑˑ;੮͙̼͐˦ʇʁ੮ʮ˦͐˺੮ફʮ˦੮ʩʮͅ੮͸˺̼ʁͅબ੮ɘ੮ુ͐ʩʇ̼ɘ̹;੮ͅʇͅͅʮ˺˦ੳૂ੮Pʇ੮͐˺ˑʁ੮˚ʇੴ੮ુ{;੮ʠɘɻʮˑʮ͐;੮ ʮͅ੮ɘ˦੮˺ˑʁʇ̼੮ʠɘɻʮˑʮ͐;ੳ੮U͐ૄͅ੮ɘ੮ɺɘ̼ʇચɺ˺˦ʇͅ੮ʠɘɻʮˑʮ͐;ੳ੮Ě˺͙̼੮˚˺͐ʩʇ̼੮͸˺͙ˑʁ੮˦˺͐੮͸ɘ˦͐੮͐˺੮ˑʮͷʇ੮ ʩʇ̼ʇੳૂ੮Ø̼ʇચ#šēU)ੴ੮͐ʩʇ;੮̼͐ʮʇʁ੮͐˺੮ʩɘͷʇ੮͐ʩʇ੮˺ɻɻɘͅʮ˺˦ɘˑ੮ɘɻ͐ʮͷʮ͐;ੴ੮ɺ͙͐੮ુ˚;੮̼ʇͅʮʁʇ˦͐ͅ੮ ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ˦੮ɘ͐͐ʇ˦͐ʮ˺˦੮̹ͅɘ˦੮˺ʠ੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮˚ʮ˦͙͐ʇੳ੮Ě˺͙੮ɻɘ˦੮̼͐;੮ͅ˺˚ʇ͐ʩʮ˦ʡੴ੮ɺ͙͐੮ ͐ʩʇ;ૄ̼ʇ੮ʩʮʡʩˑ;੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɻੴ੮͐ʩʇ;੮͸ɘˑˌ੮ʮ˦੮ɻʮ̼ɻˑʇͅ੮ɘ˦ʁ੮ͅ˚˺ˌʇ੮ɘˑˑ੮ʁɘ;ੳ੮îʩʇ;੮ʁ˺˦ૄ͐੮

STEPPED DOWN

163

͸ɘ˦͐੮͐˺੮ʁ˺੮ɘ˦;͐ʩʮ˦ʡ੮ʇˑͅʇੳ੮îʩʇ;੮ʁ˺˦ૄ͐੮ͅ˺ɻʮɘˑʮΈʇੴ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮͐ɘˑˌ੮͐˺੮ɘ˦;˺˦ʇੳૂ੮Pʇ੮ ̼ʇ͙̼͐˦ʇʁ੮͐˺੮ͅʇˑʠચϲˑɘʡʇˑˑɘ͐ʮ˺˦ੵ੮ુ˦੮˺͙͐ͅʮʁʇ੮̹ʇ̼ͅ˺˦੮ɻɘ˦੮ɻ̼ʮ͐ʮή͙ʇ੮˚ʇ੮ɘˑˑ੮͐ʩʇ;੮͸ɘ˦͐ੴ੮ ɘ˦ʁ੮U੮͸˺͙ˑʁ੮ͅɘ;ੴ੮ૃĚ˺͙ૄ̼ʇ੮ৱৰৰ੮̹ʇ̼ɻʇ˦͐੮̼ʮʡʩ͐ੳૄ੮"͙͐੮͸ʩɘ͐੮ʁ˺੮;˺͙੮ʇͽ̹ʇɻ͐੮ʠ˺̼੮͐ʩʮ̼͐;ચϲʮͷʇ੮ ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;੺ૂ îʩʮ̼͐;ચϲʮͷʇ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;੮ʮͅ੮͸ʩɘ͐੮;˺͙੮ʡʇ͐੮͸ʩʇ˦੮;˺͙੮͐ɘˌʇ੮ɘ੮̼ʇͅʮʁʇ˦͐ૄͅ੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙ચ ̼ʮ͐;੮ɻʩʇɻˌੴ੮ʡʮͷʇ੮͐ʩʇ˚੮ʠ˺͙̼੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;੮͐˺੮ɻ˺ͷʇ̼੮̹ʇ̼ͅ˺˦ɘˑ੮ʇͽ̹ʇ˦ͅʇͅੴ੮ɘ˦ʁ੮ʩɘ˦ʁ੮͐ʩʇ੮ ̼ʇ͐ͅ੮˺ͷʇ̼੮͐˺੮ɘ˦੮˺̹ʇ̼ɘ͐˺̼ੳ੮š̹ʇ̼ɘ͐˺̼ͅ੮ɘ̼ʇ੮ɻʩɘ̼ʡʇʁ੮͸ʮ͐ʩ੮̼͐ɘ˦ͅ˚͙͐ʮ˦ʡ੮͐ʩɘ͐੮ʮ˦͐˺੮ʠ˺˺ʁੴ੮ ˑ˺ʁʡʮ˦ʡੴ੮͙̹ͅʇ̼ͷʮͅʮ˺˦ੴ੮ɘͅͅʮ͐ͅɘ˦ɻʇ੮ʮ˦੮͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ʩ˺͙ͅʇˌʇʇ̹ʮ˦ʡੴ੮̼͐ɘ˦̹ͅ˺̼͐੮͐˺੮ ˚ʇʁʮɻɘˑ੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅੴ੮ɘ˦ʁੴ੮ʮʠ੮̼ʇͅʮʁʇ˦͐ͅ੮ɘ̼ʇ੮ˑ͙ɻˌ;ੴ੮ુɘɻ͐ʮͷʮ͐ʮʇͅੳૂ੮U੮ɘͅˌ੮äɘ͙ˑ੮ʩ˺͸੮ʩʇૄͅ੮ ͙̼ͅͷʮͷʮ˦ʡ੮˺˦੮͐ʩʮͅ੮̹ɘˑ̼͐;੮̼ɘ͐ʇੳ੮{͙ɻʩ੮ˑʮˌʇ੮k˺ʇˑ੮ફ͐ʩʇ੮˺͸˦ʇ̼੮˺ʠ੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇબੴ੮ʩʇ੮ ̼ʇ̹ˑʮʇʁੴ੮ુUૄ˚੮˦˺͐ੳ੮U੮˺͸ʇ੮͐ʩʇ੮ˑɘ˦ʁˑ˺̼ʁ੮˺ͷʇ̼੮ଏ৳৵ৰੴৰৰৰ੮ʮ˦੮̼ʇ˦͐ੳ੮U੮ʩɘͷʇ˦ૄ͐੮̹ɘʮʁ੮˚;ͅʇˑʠ੮ ʮ˦੮͐ʩ̼ʇʇ੮;ʇɘ̼ͅੳૂ੮Ĕʩʮˑʇ੮ääU੮ɺʇ˦ʇϲʮ͐ͅ੮ʩɘͷʇ੮ɺɘ̼ʇˑ;੮ˌʇ̹͐੮͙̹੮͸ʮ͐ʩ੮ʮ˦ϲˑɘ͐ʮ˺˦ੴ੮͐ʩʇ੮˚ʮ˦ચ ʮ˚͙˚੮͸ɘʡʇ੮ʩʇ੮̹ɘ;ͅ੮ʩʮͅ੮͐ͅɘʠʠੴ੮͐ʩʇ੮͸˺̼ˌʇ̼ͅૄ੮ɻ˺˚̹੮̹˺ˑʮɻ;੮ʩʇ੮ʩɘͅ੮͐˺੮̹͙̼ɻʩɘͅʇੴ੮ɘ˦ʁੴ੮ ˚˺̼ʇ੮̼ʇɻʇ˦͐ˑ;ੴ੮ʇͽ̼͐ɘ੮ʩ;ʡʮʇ˦ʇ੮̹̼ʇɻɘ͙͐ʮ˺˦ͅ੮ʮ˦੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮#šēU)੮ʩɘͷʇ੮̹͙ͅʩʇʁ੮ʩʮͅ੮ ʇͽ̹ʇ˦ͅʇͅ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮̼˺˺ʠੳ Ĕʩʇ˦੮äɘ͙ˑ੮ɻ˺˦ʠʇͅͅʇͅ੮͐ʩɘ͐੮͐ɘˌʮ˦ʡ੮˺ͷʇ̼੮͐ʩʇ੮ɺ͙ͅʮ˦ʇͅͅ੮ʠ̼˺˚੮ʩʮͅ੮˚˺͐ʩʇ̼ચʮ˦ચˑɘ͸੮ʮ˦੮ ৲ৰৰ৶੮͸ɘͅ੮͐ʩʇ੮ુ͸˺̼͐ͅ੮ʁʇɻʮͅʮ˺˦੮˺ʠ੮˚;੮ˑʮʠʇૂ੮ɘ˦ʁ੮͐ʩɘ͐੮ુ͐ʩʇ੮ʁɘ;੮U੮͸ɘˑˌ੮ɘ͸ɘ;ੴ੮͸ʩʮɻʩ੮ʮͅ੮ ͷʇ̼;੮ͅ˺˺˦ੴ੮U੮͸ʮˑˑ੮˦ʇͷʇ̼੮͙̼͐˦੮ɺɘɻˌੴૂ੮ʮ͐ૄͅ੮˦˺੮ʮʁˑʇ੮͐ʩ̼ʇɘ͐ੳ੮Pʇ੮ʩɘʁ੮ɘ˦˺͐ʩʇ̼੮ʩ͙˦ʁ̼ʇʁચɺʇʁ੮ ʠɘɻʮˑʮ͐;੮͐ʩɘ͐੮ʮ˦ͷʇ͐ͅ˺̼ͅ੮ɘʡ̼ʇʇʁ੮͐˺੮̼ʇ˦˺ͷɘ͐ʇ੮ɘ˦ʁ੮͙̼͐˦੮ʮ˦͐˺੮ɘ੮ʩʮʡʩચʇ˦ʁ੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮ ʠɘɻʮˑʮ͐;ઝ˺˦੮ ͐ʩʇ੮ ɻ˺˦ʁʮ͐ʮ˺˦੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ɻ͙̼̼ʇ˦͐੮ ̼ʇͅʮʁʇ˦͐ͅ੮ ˑʇɘͷʇੳ੮ ુĔʇ੮ ͷɘɻɘ͐ʇʁ੮ ͐ʩʇ˚ੴ੮ ͐ʩʇ;੮ɘˑˑ੮ʇ˦ʁʇʁ੮͙̹੮ʩ˺˚ʇˑʇͅͅ੮˺̼੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴૂ੮ʩʇ੮ɘʁ˚ʮ͐͐ʇʁੳ੮Pʇૄͅ੮͙˦ɘ̹˺ˑ˺ʡʇ͐ʮɻੵ੮ ુU੮ʩɘͷʇ੮ʡ˺˦ʇ੮͐˺੮ʇͷʇ̼;੮̹͙ɺˑʮɻ੮ʠ˺̼͙˚ੴ੮Uૄͷʇ੮ʡ˺˦ʇ੮͐˺੮͐ʩʇ੮ɻʮ͐;੮ɻ˺͙˦ɻʮˑੴ੮Uૄͷʇ੮ʡ˺˦ʇ੮͐˺੮͐ʩʇ੮ ɺ˺ɘ̼ʁ੮˺ʠ੮͙̹ͅʇ̼ͷʮͅ˺̼ͅ੮ɘ˦ʁ੮U੮;ʇˑˑʇʁ੮ɘ˦ʁ੮U੮;ʇˑˑʇʁ੮ɘ˦ʁ੮U੮;ʇˑˑʇʁૂ੮ɘɺ˺͙͐੮͐ʩʇ੮˦ʇʇʁ੮ʠ˺̼੮ ˚˺̼ʇ੮ʠ͙˦ʁͅੴ੮͐˺੮˦˺੮ɘͷɘʮˑੳ੮"ʇʠ˺̼ʇ੮#šēU)੮ʩʮ͐ੴ੮ʩʇ੮͸ɘͅ੮˦ʇʡ˺͐ʮɘ͐ʮ˦ʡ੮͐˺੮ુɺɘͅʮɻɘˑˑ;੮ͅʩ͙͐੮ ʮ͐੮યʩʮͅ੮̼ʇ˚ɘʮ˦ʮ˦ʡ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇર੮ʁ˺͸˦੮ɘ˦ʁ੮ˑʇɘͅʇ੮ʮ͐੮˺͙͐੮͐˺੮ͅ˺˚ʇ੮ʩ˺˚ʇˑʇͅͅ੮ͅʩʇˑ͐ʇ̼੮ ͐ʩɘ͐੮̹ɘ;ͅ੮ϲʮʠ͐;ચϲʮͷʇ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;ੴ੮ɘ˦ʁ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮̹̼˺ͷʮʁʇ੮ɘ˦;੮ɻɘ̼ʇੴ੮ɘ˦;੮ʠ˺˺ʁੴ੮ɘ˦;੮ ˚ʇʁʮɻɘ͐ʮ˺˦ͅੴ੮˺̼੮ɘ˦;͐ʩʮ˦ʡੳૂ äɘ͙ˑ੮ ʮͅੴ੮ ɻ˺˚̹ɘ̼ɘ͐ʮͷʇˑ;ੴ੮ ɘ੮ ʩ˺ˑʁ˺͙͐ੳ੮ ੮ ̼ʇ̹˺̼͐੮ ʠ̼˺˚੮ r˺ͅ੮ ˦ʡʇˑʇͅ੮ ʮ˦੮ ʇɘ̼ˑ;੮ ৲ৰৱ৸੮ ˺ɺͅʇ̼ͷʇʁ੮͐ʩɘ͐੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮͸ʇ̼ʇ੮ɻˑ˺ͅʮ˦ʡ੮ɘ͐੮ɘ˦੮ુɘˑɘ̼˚ʮ˦ʡ੮̼ɘ͐ʇੳૂ৽৻੮H˺͙̼੮;ʇɘ̼ͅ੮ ˑɘ͐ʇ̼ੴ੮৳৸੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ɺʇʁͅ੮ͅʇ̼ͷʮ˦ʡ੮ɘʁ͙ˑ͐ͅ੮͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ ʮ˦੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩɘʁੴ੮ʮ˦ʁʇʇʁੴ੮ʁʮͅɘ̹̹ʇɘ̼ʇʁੳ৽ৼ੮ä˺˚ʇ੮˺͸˦ʇ̼ͅ੮ʩɘͷʇ੮ͅ˺ˑʁ੮˺ʠʠ੮͐ʩʇʮ̼੮ͅ˚ɘˑˑʇ̼੮ ͅʮͽચɺʇʁ੮ ʩ˺˚ʇͅ੮ ͐˺੮ ˚ɘˌʇ੮ ˑ͙ͽ͙̼;੮ ʁ͸ʇˑˑʮ˦ʡͅ੮ ʠ˺̼੮ ˚ʮˑˑʇ˦˦ʮɘˑ੮ ͐ʇɻʩ੮ ͸˺̼ˌʇ̼ͅੳ৽৽੮ š͐ʩʇ̼ͅ੮ ʩɘͷʇ੮ʇ˚̹͐ʮʇʁ੮ɘ˦ʁ੮̼ʇϲʮˑˑʇʁ੮ˑɘ̼ʡʇ̼੮ʠɘɻʮˑʮ͐ʮʇͅ੮͸ʮ͐ʩ੮̹ʇ˺̹ˑʇ੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ ʁʮͅɘɺʮˑʮ͐ʮʇͅੴ੮ɘʁʁʮɻ͐ʮ˺˦ͅੴ੮˺̼੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੳ৽৾੮ʠ͐ʇ̼੮ɘˑˑੴ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘ˦ʁ੮ ɻ˺͙˦͐ʮʇͅ੮ʩɘͷʇ੮͐ɘˌʇ˦੮ɘ੮ʁʮ̼ʇɻ͐੮ʮ˦͐ʇ̼ʇ͐ͅ੮ʮ˦੮ʩ˺͙ͅʮ˦ʡ੮͐ʩʇͅʇ੮̹˺̹͙ˑɘ͐ʮ˺˦ͅੴ੮˺ʠ͐ʇ˦੮̹ɘ;ʮ˦ʡ੮ ͐͸˺੮͐˺੮ʠ˺͙̼੮͐ʮ˚ʇͅ੮ɘͅ੮˚͙ɻʩ੮̹ʇ̼੮ʁɘ;੮ɘͅ੮ääUੳ৽৿

164

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

CONTROLLING THE FRONT DOOR ͅ੮ ɘˑ͸ɘ;ͅੴ੮ U੮ ͸ɘͅ੮ ɻ͙̼ʮ˺͙ͅ੮ ɘɺ˺͙͐੮ ʩ˺͸੮ ͐ʩʇͅʇ੮ ϲʮ˦ɘ˦ɻʮɘˑ੮ ʠ˺̼ɻʇͅ੮ ͅʩɘ̹ʇʁ੮ ͸ʩ˺੮ ͸ʮ˦ʁͅ੮ ͙̹੮͸ʩʇ̼ʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮"ɘɻˌ੮ʮ˦੮͐ʩʇ੮ৱ৹৹ৰͅੴ੮ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮ʇͽ̹˺ͅʋͅ੮̼ʇͷʇɘˑʇʁ੮͐ʩɘ͐੮ ͅ˺˚ʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮˺̹ʇ̼ɘ͐˺̼ͅ੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅ੮͸ʇ̼ʇ੮ͅ˦ɘ͐ɻʩʮ˦ʡ੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮˺ʠ੮äˌʮʁ੮ Û˺͸੮˺̼੮ɘɺʁ͙ɻ͐ʮ˦ʡ੮͐ʩʇ˚੮ʠ̼˺˚੮͐ʩʇʮ̼੮ɻ˺˚̹ʇ͐ʮ͐˺̼ͅ੮͐˺੮ϲʮˑˑ੮ʇ˚̹͐;੮ɺʇʁͅੳ৽਀੮îʩʇ੮˺˦ʡ˺ચ ʮ˦ʡ੮ɻɘ͐ɘ̼͐ͅ˺̹ʩʮɻ੮ɻ˺ˑˑɘ̹ͅʇ੮˺ʠ੮͐ʩʇ੮ʮ˦ʁ͙̼͐ͅ;੮ʩɘͅ੮˺˦ʇ੮ɻˑʇɘ̼੮͙̹ͅʮʁʇ੮ʠ˺̼੮˺̹ʇ̼ɘ͐˺̼ͅ੮ˑʮˌʇ੮ äɘ͙ˑੵ੮͐ʩʇ;੮˦˺͐੮˺˦ˑ;੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮͐˺੮͸˺̼̼;੮ɘɺ˺͙͐੮˺̹ʇ˦੮ɺʇʁͅ੮ɺ͙͐੮ɻɘ˦੮ɺʇ੮ɻʩ˺˺ͅ;੮ɘɺ˺͙͐੮ ͸ʩ˺੮ϲʮˑˑͅ੮͐ʩʇ˚ੳ੮Ø̼ʮͷɘ͐ʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੴ੮ˑʮˌʇ੮U{)ͅੴ੮ɻɘ˦੮ɻʩʇ̼̼;ચ̹ʮɻˌ੮ɻˑʮʇ˦͐ͅ੮͸ʩ˺੮ ɘ̼ʇ੮ ̼ʇʠʇ̼̼ʇʁ੮ ͐˺੮ ͐ʩʇ˚੮ ɺ;੮ ɻ˺͙˦͐;੮ ʩ˺̹ͅʮ͐ɘˑͅੴ੮ ɻ˺˚˚͙˦ʮ͐;੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͐ʇɘ˚ͅੴ੮ ˺̼੮ ɻ˺͙̼͐ચ˺̼ʁʇ̼ʇʁ੮ʁʮͷʇ̼ͅʮ˺˦੮̹̼˺ʡ̼ɘ˚ͅੳ੮äɘ͙ˑ੮ʠʇʇˑͅ੮ɻ˺˚̹ˑʇ͐ʇˑ;੮̹˺͸ʇ̼ˑʇͅͅ੮ʮ˦੮͐ʩʇ੮ʠɘɻʇ੮˺ʠ੮ ʇɻ˺˦˺˚ʮɻ੮ɘ˦ʁ੮̹˺ˑʮɻ;੮ʠ˺̼ɻʇͅ੮ɺʇ;˺˦ʁ੮ʩʮͅ੮ɻ˺˦̼͐˺ˑઝ੮ɺ͙͐੮ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɘʁ˚ʮͅͅʮ˺˦ͅੴ੮ ʩʇ੮ʩɘͅ੮ʇ˦˺̼˚˺͙ͅ੮ʁʮͅɻ̼ʇ͐ʮ˺˦ੳ Pʇ੮ʡʇ͐ͅੴ੮ʩʇ੮͐˺ˑʁ੮˚ʇੴ੮ુ͐͸ʇ˦͐;੮̼ʇʠʇ̼̼ɘˑͅૂ੮ʠɘͽʇʁ੮̹ʇ̼੮ʁɘ;੮ʠ̼˺˚੮ુʇͷʇ̼;੮ʩ˺̹ͅʮ͐ɘˑૂ੮ɘ˦ʁ੮ ʩɘͅ੮˺˦ʇ੮͐˺੮͐͸˺੮˺̹ʇ˦ʮ˦ʡͅ੮̹ʇ̼੮˚˺˦͐ʩੳ੮Pʇ੮̹̼ʇʠʇ̼ͅ੮˦˺͐੮͐˺੮͐ɘˌʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʁʇ̹̼ʇͅચ ͅʮ˺˦੮ ɺʇɻɘ͙ͅʇ੮ ͐ʩʇ;੮ ુͅˑʇʇ̹੮ ͐ʩʇ੮ ͸ʩ˺ˑʇ੮ ʁɘ;ੳૂ੮ Pʇ੮ ͸˺˦ૄ͐੮ ͐ɘˌʇ੮ ɘ˦;˺˦ʇ੮ ͸ʮ͐ʩ੮ ɘ੮ ͅʇ̼ʮ˺͙ͅ੮ ͙ͅʮɻʮʁʇ੮̼ʮͅˌ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ʩɘʁ੮ɘ੮̼ʇͅʮʁʇ˦͐੮ʁʮʇ੮ɺ;੮͙ͅʮɻʮʁʇ੮ɘ˦ʁ੮ʮ͐੮͸ɘͅ੮ુˑʮͷʮ˦ʡ੮ʩʇˑˑૂ੮ʇͷʇ˦੮ ͐ʩ˺͙ʡʩ੮ુ͐ʩʇ̼ʇૄͅ੮˦˺੮͸ɘ;੮͐˺੮̹̼ʇͷʇ˦͐੮͙ͅʮɻʮʁʇੳૂ੮Pʇૄˑˑ੮˚ɘˌʇ੮ɘ˦੮ʇͽɻʇ̹͐ʮ˺˦੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮ ͸ʩ˺੮͸ɘͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘͅ੮ɘ੮ʁɘ˦ʡʇ̼੮͐˺੮ͅʇˑʠ੮ʠ˺̼੮ુ̼͙˦˦ʮ˦ʡ੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮̼͐ɘϲϲʮɻૂ੮ɺʇɻɘ͙ͅʇ੮ ુ͐ʩɘ͐ૄͅ੮ɘ੮̼ʇɘˑˑ;੮͸ʇɘˌૂ੮ɘ͐͐ʇ˚̹͐ੳ੮îʩʇ੮˺͐ʩʇ̼੮˺̹ʇ̼ɘ͐˺̼ͅ੮U੮͐ɘˑˌʇʁ੮͐˺੮ʩɘʁ੮͐ʩʇʮ̼੮˺͸˦੮̹̼ʇʠચ ʇ̼ʇ˦ɻʇͅੳ੮r͙ɻɘͅੴ੮͸ʩ˺੮˺͸˦ͅ੮ɘ˦˺͐ʩʇ̼੮ˑɘ̼ʡʇ੮ʠɘɻʮˑʮ͐;ੴ੮ͅɘʮʁ੮͐ʩɘ͐੮ʩʇ੮͐ͅ˺̹̹ʇʁ੮͐ɘˌʮ˦ʡ੮̼ʇʠʇ̼ચ ̼ɘˑͅ੮ ʁʮ̼ʇɻ͐ˑ;੮ ʠ̼˺˚੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɺʇɻɘ͙ͅʇ੮ ͐ʩʇ;੮ ͸ʇ̼ʇ੮ ʁʮͅɻʩɘ̼ʡʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮ ͐˺˺੮ ή͙ʮɻˌˑ;ੵ੮ ુɘ͐੮͐ʩʮ̼͐;ચϲʮͷʇ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;ੴ੮ʮ͐ૄͅ੮̼ʇɘˑˑ;੮˦˺͐੮͸˺̼͐ʩ੮͐ʩʇ੮̼ʮͅˌ੮˺ʠ੮ɺ̼ʮ˦ʡʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ ય͸ʮ͐ʩ੮̼ʇ̹ʇɘ͐ʇʁ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅર੮ʮ˦ੳૂ੮äɘ͙ˑ੮ʮͅ੮ɘ੮ɺʮ͐੮˚˺̼ʇ੮ʠ˺̼ʡʮͷʮ˦ʡੳ੮Pʇ੮͸˺˦ૄ͐੮͐ɘˌʇ੮ ͅ˺˚ʇ˺˦ʇ੮͸ʮ͐ʩ੮ϲʮͷʇ੮৵ৱ৵ৰͅ੮ʮʠ੮ʇͷʇ̼;੮͐ʮ˚ʇ੮ʮ͐੮͸ɘͅ੮ɺʇɻɘ͙ͅʇ੮ુʩʇ੮ͅˑɘ̹̹ʇʁ੮͐ʩʇ੮͐ͅɘʠʠੴ੮̹ͅʮ͐੮ɘ͐੮ ͐ʩʇ੮͐ͅɘʠʠੴ੮ɺ̼˺ˌʇ੮͸ʮ˦ʁ˺͸ͅ੮યʮ˦੮ɘ੮̹ˑɘɻʇ˚ʇ˦͐રੴૂ੮ɺ͙͐੮ʮʠ੮͐ʩ˺ͅʇ੮ϲʮͷʇ੮ɘ̼ʇ੮ુɺʇɻɘ͙ͅʇ੮ʩʇ੮͸ɘͅ੮ ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੴ੮͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮ʩʇ੮͸ɘͅ੮ˈ͙͐ͅ੮ˑʮͷʮ˦ʡ੮˺˦੮ɘ੮̹ɘ̼ˌ੮ɺʇ˦ɻʩ੮ɘ˦ʁ੮˦˺͐੮͐ɘˌʮ˦ʡ੮ ʩʮͅ੮˚ʇʁͅੴૂ੮ʩʇૄˑˑ੮͐ɘˌʇ੮ɘ੮ɻʩɘ˦ɻʇੳ੮Pʇ੮̼ʇɻˌ˺˦ͅੴ੮ુU੮ˌ˦˺͸੮U੮ɻɘ˦੮ʡʇ͐੮ʩʮ˚੮ʩʮͅ੮˚ʇʁͅ੮ʠ˺͙̼ੴ੮ ϲʮͷʇ੮͐ʮ˚ʇͅ੮ɘ੮ʁɘ;੮͐˺੮ˌʇʇ̹੮ʩʮ˚੮͐ͅɘɺˑʇੳૂ੮H˺̼੮ɘ˦˺͐ʩʇ̼੮˺̹ʇ̼ɘ͐˺̼ੴ੮͸ʩʇ͐ʩʇ̼੮˺̼੮˦˺͐੮ͅ˺˚ʇચ ˺˦ʇ੮ͅʩ˺͸ʇ̼ʇʁ੮̼ʇʡ͙ˑɘ̼ˑ;੮ʮ˦੮͐ʩʇʮ̼੮U{)੮͸ɘͅ੮ɘ੮ˌʇ;੮˚ʇ̼͐ʮɻ੮˺ʠ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ;੮͸ʇ̼ʇ੮̼ʇɘʁ;੮ ʠ˺̼੮ˑʇͅͅ੮̼͙͐ͅɻ͙̼͐ʇʁ੮ɻ˺˦ʡ̼ʇʡɘ͐ʇ੮ˑʮʠʇੳ੮îʩʇ੮̹˺ʮ˦͐੮ʮͅੴ੮͐ʩʇ੮˺͸˦ʇ̼੮˺ʠ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʮͅ੮ ͅ˺ͷʇ̼ʇʮʡ˦੮˺ͷʇ̼੮͸ʩ˺˚੮ͅʩʇ੮˺̼੮ʩʇ੮ͅʇ̼ͷʇͅੳ ä˺˚ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ʮ˦ʠ˺̼˚ɘˑ੮ ɘʁ˚ʮͅͅʮ˺˦ͅ੮ ɻ̼ʮ͐ʇ̼ʮɘ੮ ɘ̼ʇ੮ ɻ˺˦ͅʮ͐ͅʇ˦͐ੳ੮ äɘ͙ˑੴ੮ ˑɘ˦ੴ੮ ɘ˦ʁ੮ r͙ɻɘͅ੮ɘˑˑ੮ͅɻ̼ʇʇ˦੮˺͙͐੮̹ʇ˺̹ˑʇ੮͸ʩ˺ͅʇ੮̹̼ʮ˚ɘ̼;੮ʮ͙ͅͅʇ੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮͙ͅɺ͐ͅɘ˦ɻʇͅ੮ફ͸ʩʮɻʩੴ੮

STEPPED DOWN

165

ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮äɘ͙ˑੴ੮ʮͅ੮ɘ੮ˑ˺͐੮ɺʇɻɘ͙ͅʇ੮ુ͐ʩʇ੮ʇ˦͐ʮ̼ʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩ˺˚ʇˑʇͅͅ੮̹˺̹͙ˑɘ͐ʮ˺˦੮ʮͅ੮ ˺˦੮˚ʇ͐ʩੳ੮îʩɘ͐ૄͅ੮ˈ͙͐ͅ੮ɘ੮ʠɘɻ͐ૂબੳ੮r͙ɻɘͅ੮ʇˑɘɺ˺̼ɘ͐ʇʁ੮ʩʮͅ੮̼ʇɘͅ˺˦ʮ˦ʡੵ੮ુU੮͸˺͙ˑʁ੮ͅɘ;੮৶ৰ੮͐˺੮ ৷ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮˚;੮̼ʇͅʮʁʇ˦͐ͅ੮ʩɘͷʇ੮ɘ੮ʁ͙ɘˑ੮ʁʮɘʡ˦˺ͅʮͅ੮ʩʮ͐ͅ˺̼;੯ੳ੯ੳ੯ੳ੮યɺ͙͐ર੮U੮ʩɘͷʇ੮ɘ੮ɺʮʡ੮ ̹˺̹͙ˑɘ͐ʮ˺˦੮ʩʇ̼ʇ੮͐ʩɘ͐੮ʩɘͅ੮ɺʇʇ˦੮ͅ˺ɺʇ̼ੴ੮ͅ˺੮˺˦ʇ੮ͅʇʇʁ੮ɻɘ˦੮ɻ̼ʇɘ͐ʇ੮ʩɘͷ˺ɻ੮̼ʇɘˑˑ;੮ή͙ʮɻˌˑ;ੳૂ੮ Pʇૄͅ੮ɘ੮̼ʇɘˑʮ͐ͅੵ੮ુîʩʇ̼ʇ੮ɘ̼ʇ੮ɘ੮ʠʇ͸੮͐ʩɘ͐੮͐ͅʮˑˑ੮ʡ˺੮˺͙͐੮ɘ˦ʁ੮ʩɘͷʇ੮ɘ੮ɺʇʇ̼੮ɺʇʩʮ˦ʁ੮͐ʩʇ੮ˑʮή͙˺̼੮ ͐ͅ˺̼ʇੴ੮ɘ˦ʁ੮U੮ૃʁ˺˦ૄ͐੮ˌ˦˺͸੮ɘɺ˺͙͐੮ʮ͐ੴૄ੮ɺ͙͐੮U੮ˌ˦˺͸੮ɘɺ˺͙͐੮ʮ͐ੳૂ੮˦ʁ੮ʩʇૄˑˑ੮˚ɘˌʇ੮ʇͽɻʇ̹ચ ͐ʮ˺˦ͅ੮͐˺੮ʩʇˑ̹੮͐ʩʇ੮ɻ˺͙˦͐;੮˺͙̹͐ɘ͐ʮʇ˦͐੮͐ʇɘ˚ͅ੮͸ʮ͐ʩ੮͸ʩʮɻʩ੮ʩʇ੮ʩɘͅ੮ɘ੮ʡ˺˺ʁ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹ੳ੮ "͙͐੮;˺͙੮ɻɘ˦੮ή͙ʮɻˌˑ;੮ͅʇʇ੮͸ʩ;੮/Û੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ɘ˦ʁ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮˚ʮʡʩ͐੮ ɺʇ੮̼ʇˑ͙ɻ͐ɘ˦͐੮͐˺੮ɘʁͷɘ˦ɻʇ੮̹ʇ˺̹ˑʇ੮ʠ͙̼͐ʩʇ̼੮ɘˑ˺˦ʡ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮ʮʠ੮͐ʩʇ;੮ͅʇʇ˚੮˚˺̼ʇ੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮ ͙ͅʇ̼੮ ͐ʩɘ˦੮ ̹ͅ;ɻʩ˺͐ʮɻੵ੮ ͐ʩʇ̼ʇૄͅ੮ ɘ੮ ͷ˺ʮʁ੮ ˺ʠ੮ ͐ͅʇ̹ચʁ˺͸˦੮ ˺̹͐ʮ˺˦ͅ੮ ʠ˺̼੮ ͐ʩʇ˚ੴ੮ ͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ʡʇ͐੮͙͐ͅɻˌ੮͙̹̼͐ͅʇɘ˚੮ʮ˦੮͐ʩʇ੮ʩ͙˚ɘ˦੮ˑ˺ʡˈɘ˚੮˺ʠ੮ɘɻ͙͐ʇચɻɘ̼ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮U{)ͅੳ ˦˺͐ʩʇ̼੮̹˺̹͙ˑɘ͐ʮ˺˦੮ɺʇʮ˦ʡ੮ͅή͙ʇʇΈʇʁ੮˺͙͐੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ɺ;੮ʁʇɻˑʮ˦ʮ˦ʡ੮ɘͷɘʮˑચ ɘɺʮˑʮ͐;੮ʮͅ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɻ˺˚˺̼ɺʮʁ੮˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅੳ੮͐੮˺˦ʇ੮ʠ˺̼͙˚੮˺˦੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ ɻɘ̼ʇ੮ɻˑ˺͙̼ͅʇͅ੮ʩʇˑʁ੮˦ʇɘ̼੮äɘɻ̼ɘ˚ʇ˦͐˺੮ʮ˦੮ʇɘ̼ˑ;੮৲ৰৱ৸ੴ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ʠ̼˺˚੮ɘ੮ͅ˚ɘˑˑੴ੮ ̼͙̼ɘˑ੮ɻ˺͙˦͐;੮͐ͅ˺˺ʁ੮͙̹੮ɘ˦ʁ੮ʡ̼ʮ̹ʇʁੴ੮ુĔʇ੮˺˦ˑ;੮ʩɘͷʇ੮˺˦ʇ੮̹ˑɘɻʇ੮͐ʩɘ͐੮͐ɘˌʇͅ੮ääU੮ʮ˦੮˺͙̼੮ ɻ˺͙˦͐;ੳ੮U੮ˌ˦˺͸੮͐ʩʇ੮ʡ͙;੮͸ʩ˺੮̼͙˦ͅ੮ʮ͐੮ͷʇ̼;੮͸ʇˑˑੳ੯ੳ੯ੳ੯ੳ੮Pʇ੮ʡʇ͐ͅ੮͐˺੮ɺʇ੮ͅ˺੮̹ʮɻˌ;੮ɘ˦ʁ੮ͅ˺੮ ̹ͅʇɻʮϲʮɻ੮ɺʇɻɘ͙ͅʇ੮ʩʇૄͅ੮͐ʩʇ੮˺˦ˑ;੮˺˦ʇੳ੮Pʇ੮ɻɘ˦੮̹̼ɘɻ͐ʮɻɘˑˑ;੮ɻʩ˺˺ͅʇ੮ɺɘͅʇʁ੮˺˦੮͐ʩʇ੮ɻ˺ˑ˺̼੮ ˺ʠ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʩɘʮ̼ੳ੮˦ʁ੮ʩʇ੮ɻɘ˦੮ɻʇ̼͐ɘʮ˦ˑ;੮ͅɘ;ੴ੮ૃ‡˺੮˺˦ʇ੮͸ʮ͐ʩ੮ɘ੮͸ɘˑˌʇ̼੮ɺʇɻɘ͙ͅʇ੮U੮ˈ͙͐ͅ੮ ̹͙͐੮ʮ˦੮˦ʇ͸੮ϲˑ˺˺̼ͅੳૄૂ੮ͅ੮ɘˑ͸ɘ;ͅੴ੮͐ʩʇ̼ʇૄͅ੮ɘ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ˑ˺ʡʮɻ੮ʩʇ̼ʇ੮͐ʩɘ͐ੴ੮ˑʮˌʇ੮ʮ͐੮˺̼੮˦˺͐ੴ੮ʮͅ੮ ̹̼ʇ͐͐;੮ʮ˦ʇͅɻɘ̹ɘɺˑʇ੮ʠ˺̼੮ʠɘɻʮˑʮ͐ʮʇͅ੮˺̹ʇ̼ɘ͐ʮ˦ʡ੮˺˦੮ɘ੮͐ʮʡʩ͐੮˚ɘ̼ʡʮ˦ੳ੮ુUʠ੮͸ʇ੮˦ʇʇʁ੮͐˺੮ɻʩʇɻˌ੮ ͅ˺˚ʇ˺˦ʇૄͅ੮ɺˑ˺˺ʁ੮̹̼ʇ͙̼ͅͅʇ੮˺̼੮ʡʮͷʇ੮͐ʩʇ˚੮ɘ˦੮ʮ˦͙ͅˑʮ˦੮ɻʩʇɻˌੴ੮U੮ɻɘ˦ૄ͐੮͐ɘˌʇ੮͐ʩʇ˚੮͙˦ˑʇͅͅ੮ ͐ʩʇ;ૄ̼ʇ੮˺˦੮{ʇʁʮɻɘ̼ʇੴ੮ɺʇɻɘ͙ͅʇ੮ʮ͐੮ɻ˺ͷʇ̼ͅ੮ʠ˺̼੮ɘ੮˦͙̼ͅʇੴ੮ɘ˦ʁ੮{ʇʁʮચ#ɘˑ੮ʁ˺ʇͅ੮˦˺͐੸ૂ੮äɘ͙ˑ੮ ͐˺ˑʁ੮˚ʇੳ੮Pʇ੮ʮͅ੮͐ʩʇ੮ɘˑˑચ̹͙̼̹˺ͅʇ੮ɺ˺˺ˌˌʇʇ̹ʇ̼ੴ੮ʩɘ˦ʁ;˚ɘ˦ੴ੮ɘ˦ʁ੮ɘɻ͐ʮͷʮ͐;੮ɻ˺˺̼ʁʮ˦ɘ͐˺̼੮ ʠ˺̼੮ʩʮͅ੮ʠɘɻʮˑʮ͐;ੴ੮ɺ͙͐੮ʩʇૄͅ੮˦˺͐੮ɘ੮˦͙̼ͅʇ੮ɘ˦ʁੴ੮ɺ;੮̼ʇʡ͙ˑɘ͐ʮ˺˦ੴ੮ʮͅ੮˦˺͐੮ɘˑˑ˺͸ʇʁ੮͐˺੮̹̼ʇ͐ʇ˦ʁ੮ ͐˺੮ɺʇ੮˺˦ʇੳ "˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇ੮ ˺͸˦ʇ̼ͅ੮ ʡʇ͐੮ ɘ੮ ɺɘʁ੮ ̼ɘ̹ੳ੮ ä˺˚ʇ੮ ɻʇ̼͐ɘʮ˦ˑ;੮ ʁʇͅʇ̼ͷʇ੮ ʮ͐ੳ੮ "͙͐੮ ͸ʩʮˑʇ੮ ͐ʩʇͅʇ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ˚ʮʡʩ͐੮ ˑ˺˺ˌ੮ ˑʮˌʇ੮ ͐ʩʇ੮ ̹ˑɘɻʇ੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺˦͐ʮ˦͙͙˚੮ ͸ʩʇ̼ʇ੮ ˦ɘˌʇʁ੮ ɻɘ̹ʮચ ͐ɘˑʮͅ˚੮ʩɘͅ੮ɻ˺˚̹ˑʇ͐ʇˑ;੮ʁʮ̹ͅˑɘɻʇʁ੮̹͙ɺˑʮɻ੮ͅʇ̼ͷʮɻʇੴ੮˺͸˦ʇ̼ͅ੮ɘ̼ʇ੮͐ͅʮˑˑ੮ɺɘͅʮɻɘˑˑ;੮̼͐ͅʇʇ͐ચ ˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੳ੮îʩʇ;੮ʩɘͷʇ੮ɘ˦੮ʇͅͅʇ˦͐ʮɘˑ੮˚ʮͅͅʮ˺˦੮ʠ˺̼੮ɘ੮˦ʇʇʁ;੮̹˺̹͙ˑɘ͐ʮ˺˦੮ɘ˦ʁ੮˦˺͐੮ ˦ʇɘ̼ˑ;੮ʇ˦˺͙ʡʩ੮̼ʇͅ˺͙̼ɻʇͅ੮͐˺੮˚ʇʇ͐੮͐ʩɘ͐੮˦ʇʇʁੳ੮ä˺੮͐ʩʇ;੮̼͐ʮɘʡʇੳ੮õ˦ˑʮˌʇ੮ɘ੮ɻ˺͙˦͐;੮ɻˑʮ˦ʮɻૄͅ੮ ͐ͅɘʠʠੴ੮˺͸˦ʇ̼ͅ੮ɘ̼ʇ੮̹ɘʮʁ੮˺˦ˑ;੮͸ʩɘ͐ʇͷʇ̼੮ʮͅ੮ˑʇʠ͐੮ʠ̼˺˚੮͐ʩʇ੮̹˺͐੮˺ʠ੮̼ʇͅ˺͙̼ɻʇͅ੮͐ʩʇ;੮ʩɘͷʇ੮ ͐˺੮ʁ˺ˑʇ੮˺͙͐੮ʠ˺̼੮˺̹ʇ̼ɘ͐ʮ˦ʡ੮ɻ˺͐ͅͅੳ੮Iʮͷʇ˦੮͐ʩɘ͐੮˺˦ʇ੮̼ʇ̹˺̼͐੮ʇ͐ͅʮ˚ɘ͐ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɘͷʇ̼ɘʡʇ੮ ͐ʩʮ̼͐ʇʇ˦ચɺʇʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ˑ˺ͅʇͅ੮ଏ৲৵৵ੴ৶৸৸੮ɘ੮;ʇɘ̼ੴ੮ʮ͐ૄͅ੮ʇɘͅ;੮͐˺੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͸ʩ;੮ ˺͸˦ʇ̼ͅ੮ˈ͙͐ͅ੮ή͙ʮ͐ੳ৽ਁ

166

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

BOUNCING UP AND SLIDING DOWN Ĕʩʮˑʇ੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʮ˦ʁ͙̼͐ͅ;੮ʮͅ੮ʮ˦੮ʠ̼ʇʇ੮ʠɘˑˑੴ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ɘ̼ʇ੮ ͙͙ͅɘˑˑ;੮ ͸ʩʇ̼ʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ͐ͅɘɺʮˑʮΈʇઝ˺̼ੴ੮ ˑʇͅͅ੮ ʡʇ˦ʇ̼˺͙ͅˑ;ੴ੮ ͐ͅɘʡ˦ɘ͐ʇੳ੮ š˦ʇ੮ ̼ʇ̹˺̼͐੮ ʠ̼˺˚੮r˺ͅ੮˦ʡʇˑʇͅ੮̹̼˺ϲʮˑʇʁ੮ɘ˦੮ʇʮʡʩ͐;ચɺʇʁ੮ʠɘɻʮˑʮ͐;੮͸ʩʇ̼ʇ੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʩɘʁ੮ ɺʇʇ˦੮͐ʩʇ̼ʇ੮ϲʮͷʇ੮;ʇɘ̼ͅ੮˺̼੮˚˺̼ʇੳ੮îʩʮͅ੮ʮͅ੮ɘ˦੮ʮ˚̹̼ʇͅͅʮͷʇ੮͐ʇ˦͙̼ʇ੮ʠ˺̼੮ɘ੮̹˺̹͙ˑɘ͐ʮ˺˦੮͐ʩɘ͐੮ ̹̼ʇͷʮ˺͙ͅˑ;੮ ˚ʮʡʩ͐੮ ʩɘͷʇ੮ ɺʇʇ˦੮ ɻ;ɻˑʮ˦ʡ੮ ɘ˚˺˦ʡ੮ ͅʩʇˑ͐ʇ̼ͅੴ੮ ʩ˺̹ͅʮ͐ɘˑͅੴ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ̼͐ͅʇʇ͐ੳ੮ äʇͷʇ˦͐;੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ ͐ʩ˺ͅʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʇ̼ʇ੮ ̼ʇɻʇʮͷʮ˦ʡ੮ ˦˺੮ ͐ʩʇ̼ɘ̹;ੳ৽ਂ੮ š˦ɻʇ੮ ͅ˺˚ʇચ ˺˦ʇ੮ʡʇ͐ͅ੮ʮ˦͐˺੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੴ੮͐ʩʇ˦ੴ੮͐ʩʇ;੮˺ʠ͐ʇ˦੮ɺʇɻ˺˚ʇ੮͸ʩɘ͐੮‡ʇʮˑ੮I˺˦ʡ੮ɻɘˑˑͅ੮ ુˑ͙˚̹ͅૂੵ੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮͸ʩ˺˚੮ˑʮ͐͐ˑʇ੮̹̼˺ʡ̼ʇͅͅ੮ʮͅ੮ʇͽ̹ʇɻ͐ʇʁ੮ɘ˦ʁ੮ʠ˺̼੮͸ʩ˺˚੮ˑʮ͐͐ˑʇ੮ͅʇ̼ͷʮɻʇ੮ ʮͅ੮̹̼˺ͷʮʁʇʁੳ ä˺˚ʇ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ ɻɘ̼ʇͅ੮ ̼ʇɘˑˑ;੮ ʁ˺੮ ˺ʠʠʇ̼੮ ˚˺̼ʇ੮ ુɻɘ̼ʇੴૂ੮ ɺ͙͐੮ ͐ʩʮͅ੮ ͙͙ͅɘˑˑ;੮ ʁʇ̹ʇ˦ʁͅ੮ ˺˦੮͐ʩʇ੮͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮˺ʠ੮ɘ੮ɻ˺͙˦͐;੮͐˺੮͙ͅʇ੮ʮ͐ͅ੮˺͸˦੮ʠ͙˦ʁͅ੮͐˺੮̹ɘ;੮ɘ੮ʠɘɻʮˑʮ͐;੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮ ˺͐ʩʇ̼͸ʮͅʇ੮ɺʇ੮ˑʇʠ͐੮͐˺੮͙̼ͅͷʮͷʇ੮ફ˺̼੮͐ͅɘ̼ͷʇબ੮˺˦੮ʠʇʁʇ̼ɘˑ੮ääU੮ʠ͙˦ʁͅੳ੮ˑɘ˦ੴ੮͐ʩʇ੮˚ɘ˦ɘʡʇ̼੮˺ʠ੮ ͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇੴ੮ɘʡɘʮ˦੮ͷɘ͙˦͐ʇʁ੮ʩʮͅ੮ʠɘɻʮˑʮ͐;੮ɘͅ੮ɘ੮͐ͅɘ˦ʁ˺͙͐ੵ੮ુ{˺͐ͅ੮યɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅર੮ ˺̹ʇ̼ɘ͐ʇ੮ˑʮˌʇ੮ɘ੮̼ʇ͐ʮ̼ʇ˚ʇ˦͐੮ɻ˺˚˚͙˦ʮ͐;ੴ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮˺˦੮͐ʩʇʮ̼੮˺͸˦੮ɘ˦ʁ੮ɘˑˑ੮͐ͅɘʠʠ੮ʮͅ੮ʩʇˑ̹ચ ʮ˦ʡ੮͸ʮ͐ʩ੮ʮͅ੮˚ʇʁʮɻɘ͐ʮ˺˦੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੳ੮Ĕʇ੮ʁ˺˦ૄ͐੮˺̹ʇ̼ɘ͐ʇ੮͐ʩɘ͐੮͸ɘ;ੳૂ੮Pɘͷʮ˦ʡ੮͐ʩʇ̼ɘચ ̹ʮ͐ͅͅ੮ɘ˦ʁ੮ʡ̼˺͙̹ͅ੮˺˦ચͅʮ͐ʇ੮ʮͅ੮ɘ੮͸ɘ;੮ʠ˺̼੮͐ʩʇ੮ʠɘɻʮˑʮ͐;੮͐˺੮ɘͷ˺ʮʁ੮ɻ̼ʮͅʇͅੴ੮ɘͅ੮#ʮ˦ʁ;੮ʇͽ̹ˑɘʮ˦ͅੵ੮ ુĔʇ੮ʩɘͷʇ੮ή͙ɘˑʮϲʮʇʁ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͸ʩ˺੮ɘ̼ʇ੮ɘɺˑʇ੮͐˺੮̹ͅ˺͐੮͐ʩʮ˦ʡͅੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ɻɘ˦੮ͅɘ;ੴ੮ૃͅ˺੮ ɘ˦ʁ੮ͅ˺੮ͅʇʇ˚ͅ੮ɘ੮ˑʮ͐͐ˑʇ੮˺ʠʠੴૄ੮ૃͅ˺੮ɘ˦ʁ੮ͅ˺੮ʮͅ˦ૄ͐੮͐ɘˌʮ˦ʡ੮ʩʇ̼੮˚ʇʁͅੳૄ੮˦ʁ੮͸ʇ੮͸˺̼ˌ੮͐˺ʡʇ͐ʩʇ̼੮ ͐˺੮˚ɘʮ˦͐ɘʮ˦੮͐ͅɘɺʮˑʮ͐;ੳૂ੮{˺̼ʇ੮̼˺ɺ͙͐ͅ੮̼͐ʇɘ͐˚ʇ˦͐੮ʩʇˑ̹ͅ੮ɘͷ˺ʮʁ੮͐͸˺੮͸ɘ;ͅ੮͐ʩʮͅ੮͙̹̹ͅ˺ͅʇʁ੮ ʇ˦ʁ੮̹˺ʮ˦͐੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻɘ˦੮ɻʮ̼ɻˑʇ੮ɺɘɻˌੵ੮ɺʇʮ˦ʡ੮ɺ˺͙˦ɻʇʁ੮͙̹੮͐˺੮ʩʮʡʩʇ̼੮ˑʇͷʇˑͅ੮ ˺ʠ੮ɻɘ̼ʇ੮˺̼੮ʁ̼˺̹̹ʮ˦ʡ੮ʁ˺͸˦੮͐˺͸ɘ̼ʁ੮˦˺੮ɻɘ̼ʇ੮ɘ͐੮ɘˑˑੳ rʇ͐ૄͅ੮͐ͅɘ̼͐੮͸ʮ͐ʩ੮͐ʩ˺ͅʇ੮ɺ˺͙˦ɻʇʁ੮͙̹ੳ੮#˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘ̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ɘ੮ͅ˚ɘˑˑ੮̹˺̼͐ʮ˺˦੮ ˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮̼ʇͅʮʁʇ˦͐ͅੵ੮͐ʩʇ੮˺̹ʇ̼ɘ͐˺̼ͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮ʇ͐ͅʮ˚ɘ͐ʇʁ੮ɺʇ͐͸ʇʇ˦੮ৱৰ੮ɘ˦ʁ੮ ৳ৰ੮̹ʇ̼ɻʇ˦͐ੳ৽ਃ੮r͙ɻɘͅ੮ͅɘʮʁ੮͐ʩɘ͐੮ʩʇ੮̹̼ʇʠʇ̼̼ʇʁ੮ɻ˺˦ͅʇ̼ͷʇʁ੮ɻˑʮʇ˦͐ͅ੮ɺʇɻɘ͙ͅʇੴ੮ʠ˺̼੮̼ʇͅʮʁʇ˦͐ͅ੮ ͙̹ͅͅʇ˦ʁʇʁ੮ˈ͙͐ͅ੮ɘɺ˺ͷʇ੮ͅ˺ɻʮɘˑ੮ʁʇɘ͐ʩੴ੮ુʮ͐ૄͅ੮˦ʮɻʇ੮͸ʩʇ˦੮ͅ˺˚ʇ˺˦ʇ੮ʇˑͅʇ੮ʮͅ੮ʮ˦ͷ˺ˑͷʇʁੳૂ੮U͐੮ ɘˑͅ˺੮ʩʇˑ̹ʇʁ੮ʩʮ˚੮ˌʇʇ̹੮̼ʇͅʮʁʇ˦͐ͅ੮ʮ˦੮ˑʮ˦ʇੵ੮ુU੮ʩɘͷʇ੮˺˦ʇ੮̼ʇͅʮʁʇ˦͐੮͸ʩ˺੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ ͐ɘˌʇ੮ɘ˦;੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ä˺੮U੮ͅɘ;ੴ੮ૃPʇ̼ʇૄͅ੮͐ʩʇ੮˺̹͐ʮ˺˦ͅੵ੮U੮ɻɘ˦੮ɻɘˑˑ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੴ੮͐ʩʇ;ૄˑˑ੮ ͅʇ˦ʁ੮;˺͙੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮˺̼੮;˺͙੮ɻɘ˦੮͐ɘˌʇ੮;˺͙̼੮˚ʇʁͅੴ੮ɘ˦ʁ੮͸ʇૄˑˑ੮ɺʇ੮˺ˌɘ;ੳૄૂ੮îʩʮͅ੮ ʮͅੴ੮ʮ˦੮͐ʩʇ˺̼;ੴ੮˺˦ʇ੮˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ૄͅ੮˚ʮʡʩ͐ʮʇ͐ͅ੮̹˺͸ʇ̼ͅ੮˺ͷʇ̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮Ĕʇˑચ ʠɘ̼ʇ੮ɘ˦ʁ੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮#˺ʁʇ੮ͅʇɻ͐ʮ˺˦੮৵৳৵৸ੳ৵੮͐ͅɘ͐ʇͅ੮͐ʩɘ͐੮ુ͸ʩʇ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੯ੳ੯ੳ੯ੳ੮ ʁʇʇ˚ͅ੮ʮ͐੮˦ʇɻʇͅͅɘ̼;੮͐˺੮̼ʇ˚˺ͷʇ੮ʩʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮͐˺੮͐ʩʇ੮ɻ˺͙˦͐;੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ ʠɘɻʮˑʮ͐;ૂઝ͐ʩɘ͐੮ʮͅੴ੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑઝુ͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮˚ɘ;੮͐ɘˌʇ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ ʮ˦͐˺੮ɻ͙͐ͅ˺ʁ;੮ɘ˦ʁ੮̼ʇ͙̼͐˦੮ʩʮ˚੮͐˺੮͐ʩʇ੮ʠɘɻʮˑʮ͐;ੳૂ৽਄੮Ø˺͐ʇ˦͐੮͙͐ͅʠʠੳ

STEPPED DOWN

167

/ͽɻʇ̹͐੮ ͐ʩɘ͐੮ ɘ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ ˺ϲϲʮɻʮɘˑ੮ ̹˺͸ʇ̼੮ ʮͅ੮ ͅɘ̹̹ʇʁ੮ ɺ;੮ ͐ʩʇʮ̼੮ ˑɘɻˌ੮ ˺ʠ੮ ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮˺͐ʩʇ̼੮ɘɻ͐˺̼ͅੴ੮˦˺˦ʇ੮˺ʠ੮͸ʩ˺˚੮ʮͅ੮̹ˑɘ;ʮ˦ʡ੮ɺ;੮Ĕʇˑʠɘ̼ʇ੮ɘ˦ʁ੮U˦͐ͅʮ͙͐ચ ͐ʮ˺˦ͅ੮#˺ʁʇ੮ͅʇɻ͐ʮ˺˦੮৵৳৵৸ੳ৵ੳ੮Ĕʩʇ˦੮U੮ɘͅˌʇʁ੮äɘ͙ˑ੮͸ʩʇ͐ʩʇ̼੮ʩʇ੮ͅɘ͸੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ચ ͅʩʮ̹੮ ɘͅ੮ ɘ੮ ̹ˑ͙ͅ੮ ʠ˺̼੮ ʩʮͅ੮ ̼ʇͅʮʁʇ˦͐ͅੴ੮ ʩʇ੮ ʇͽɻˑɘʮ˚ʇʁੴ੮ ુU͐੮ ʁ˺ʇͅ˦ૄ͐੮ ˚ɘˌʇ੮ ɘ੮ ʁʮʠʠʇ̼ʇ˦ɻʇੳૂ੮ Pʇ੮ ̼ʇɻ˺͙˦͐ʇʁ੮ ͐ʩʇ੮ ͐ͅ˺̼;੮ ˺ʠ੮ ˺˦ʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ ͸ʩ˺੮ ુɺ̼˺ˌʇ੮ ͅʮͽ੮ ͸ʮ˦ʁ˺͸ͅૂ੮ ɺʇʠ˺̼ʇ੮ ͐ʩʇ੮ɻ˺̹ͅ੮ɻɘ˚ʇੳ੮Pʇ੮ɻ˺˚̹ˑɘʮ˦ʇʁੴ੮ુîʩʇ;੮ʁʮʁ੮˦˺͐੮͸ɘ˦͐੮͐˺੮ʁ˺੮ɘ˦;͐ʩʮ˦ʡ੮͸ʮ͐ʩ੮ʩʮ˚ੳ੮ îʩʇ੮ ʡ͙;੮ ય̼ʇͅʮʁʇ˦͐ર੮ ͅɘʮʁੴ੮ ૃUૄ˚੮ ˦˺͐੮ ʡʇ͐͐ʮ˦ʡ੮ ˺˦੮ ͐ʩʇ੮ ʡ͙̼˦ʇ;ੳૄ੮ U੮ ͅɘʮʁੴ੮ ૃØ͙͐੮ ʩʮ˚੮ ʮ˦੮ ʩɘ˦ʁɻ͙ʠʠͅੴૄ੮ɘ˦ʁ੮͐ʩʇ੮̹˺ˑʮɻʇ੮ͅɘʮʁੴ੮ૃĔʇૄ̼ʇ੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʁ˺੮ʮ͐ੳૄૂ੮Pʇੴ੮ˑʮˌʇ੮ɘ੮˦͙˚ɺʇ̼੮ ˺ʠ੮̹̼˺ͷʮʁʇ̼ͅ੮U੮͐ɘˑˌʇʁ੮͐˺ੴ੮͸ɘͅ੮˦˺͐੮˺˦੮ɺ˺ɘ̼ʁ੮͸ʮ͐ʩ੮͐ʩʇ੮̹˺ˑʮɻʇૄͅ੮ʡ̼˺͸ʮ˦ʡ੮̼ʇ͐ʮɻʇ˦ɻʇ੮ ͐˺੮͙ͅʇ੮ʠ˺̼ɻʇ੮͐˺੮ʮ˚̹˺ͅʇ੮ɘ੮৵ৱ৵ৰੳ੮Pʇ੮͸ʇ˦͐੮˺˦ੴ੮ુ)˺੮;˺͙੮ˌ˦˺͸੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ʇʁ੺੮Pʇ੮ ɺ̼˺ˌʇ੮ʠ˺͙̼੮˚˺̼ʇ੮͸ʮ˦ʁ˺͸ͅੴ੮̼ɘ˦੮ɘ̼˺͙˦ʁੴ੮ɺʇɘ͐੮ͅ˺˚ʇ˺˦ʇ੮͙̹੮ʮ˦੮͐ʩʇ੮̹ɘ̼ˌʮ˦ʡ੮ˑ˺͐ੴ੮ɘ˦ʁ੮ ͐ʩʇ˦੮ʡ˺͐੮ɘ̼̼ʇ͐ͅʇʁੳૂ /ͷʇ˦͙͐ɘˑˑ;ੴ੮͐ʩʇ੮ɻˑʮʇ˦͐੮͸ʇ˦͐੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠ˺̼੮ϲʮͷʇ੮ʁɘ;ͅੵ੮ુU͐੮͸ɘͅ੮ˈ͙͐ͅ੮ˑʮˌʇ੮ɘ੮ ͐ʮ˚ʇચ˺͙͐ੴૂ੮äɘ͙ˑ੮ɺʇ͸ɘʮˑʇʁੳ੮ુI˺ʮ˦ʡ੮ɺɘɻˌ੮͐˺੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇૂ੮ʮͅ੮ɘ˦੮ʇɘͅ;੮ʁʮͅɻʩɘ̼ʡʇ੮ ̹ˑɘ˦੮ ʠ˺̼੮ ʩ˺̹ͅʮ͐ɘˑͅੵ੮ ુU੮ ʡ˺੮ ʁ˺͸˦੮ ͐˺੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɘˑˑ੮ ͐ʩʇ੮ ͐ʮ˚ʇੳ੮ U੮ ɺ̼ʮ˦ʡ੮ યʩ˺̹ͅʮ͐ɘˑ੮ ͐ͅɘϲϲર੮ ä͐ɘ̼ɺ͙ɻˌͅੴ੮ ɺ̼ʮ˦ʡ੮ ͐ʩʇ˚੮ ɻɘˌʇͅੴ੮ ɺ̼ʮ˦ʡ੮ ͐ʩʇ˚੮ ˑ͙˦ɻʩʇͅੴ੮ U੮ ˌ˦˺͸੮ ɘˑˑ੮ ͐ʩʇ੮ ɻɘͅʇ੮ ˚ɘ˦ɘʡʇ̼ͅੳ੯ੳ੯ੳ੯ੳ੮"͙͐੮ɻʇ̼͐ɘʮ˦੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ɻɘ̼ʇ੮͸ʩɘ͐੮;˺͙੮ͅɘ;ੳ੮îʩʇ;ૄˑˑ੮ˈ͙͐ͅ੮ યʁʮͅɻʩɘ̼ʡʇ੮͐ʩʇ˚੮ɘ˦ʁર੮ʁ̼˺̹੮͐ʩʇ˚੮˺ʠʠ੮યɘ͐੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇર੮͸ʮ͐ʩ੮ɘ˦੮õɺʇ̼ੴ੮ɘ˦ʁ੮ ;˺͙ૄ̼ʇ੮ʁ˺˦ʇੳૂ {˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;ੴ੮͐ʩʇ੮̹ɘ͐ʩ͸ɘ;੮ʠ̼˺˚੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ɺɘɻˌ੮ʮ˦͐˺੮ɘ੮˚˺̼ʇ੮̼͙͐ͅɻચ ͙̼͐ʇʁ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦੮ ʩɘ̹̹ʇ˦ͅ੮ ˦˺͐੮ ʠ̼˺˚੮ ɘ˦੮ ɘɻ͙͐ʇ੮ ɻ̼ʮͅʮͅ੮ ɺ͙͐੮ ͷʮɘ੮ ɘ੮ ʁ˺͸˦͸ɘ̼ʁ੮ ͅˑʮʁʇ੮ ͐˺͸ɘ̼ʁ੮ʁʇɘ͐ʩੳ੮r͙ɻɘͅ੮̹̼˺͙ʁˑ;੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮ʩʮͅ੮ʠɘɻʮˑʮ͐;੮ʩɘʁ੮ˌʇ̹͐੮ɘˑʮͷʇ੮ɻˑʮʇ˦͐ͅ੮͸ʩ˺ੴ੮ ͙̹˺˦੮ɘ̼̼ʮͷɘˑੴ੮ͅʇʇ˚ʇʁ੮ɘͅ੮͐ʩ˺͙ʡʩ੮͐ʩʇ;੮͸˺͙ˑʁ੮ʩɘͷʇ੮ɘ੮̼͐ɘʡʮɻɘˑˑ;੮ͅʩ˺̼͐੮͐ͅɘ;ੳ੮"͙͐੮͐ʩʇ੮ ͷʇ̼;੮ʠ˺̼ɻʇͅ੮͐ʩɘ͐੮ˌʇ̹͐੮̼ʇͅʮʁʇ˦͐ͅ੮̹ͅ;ɻʩ˺ˑ˺ʡʮɻɘˑˑ;੮͐ͅɘɺˑʇ੮ɘˑͅ˺੮ˑʇʁ੮͐˺੮̹ʩ;ͅʮɻɘˑ੮ʁʇɻˑʮ˦ʇੵ੮ ુU੮͐ʩʮ˦ˌ੮͐ʩʇ੮ˑ˺˦ʡʇͷʮ͐;੮˺ʠ੮͐ɘˌʮ˦ʡ੮ɻʇ̼͐ɘʮ˦੮˚ʇʁͅ੮̼ʇɘˑˑ;੮ʩɘͅ੮ɘ˦੮ʮ˚̹ɘɻ͐੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠ੮˺˦ͅʇ͐੮ ˺ʠ੮ʁʇ˚ʇ˦͐ʮɘੴ੮ͅ˺˚ʇ੮ͅʮʁʇ੮ʇʠʠʇɻ͐ͅ੮ˑʮˌʇ੮͐ɘ̼ʁʮͷʇ੮ʁ;ͅˌʮ˦ʇͅʮɘૂઝʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮˚˺ͷʇ˚ʇ˦͐ͅ੮ ͙ͅɻʩ੮ɘͅ੮ʡ̼ʮ˚ɘɻʮ˦ʡ੮ɘ˦ʁ੮ʇ;ʇ੮ɺˑʮ˦ˌʮ˦ʡઝુɘ˦ʁ੮ˈ͙͐ͅ੮˚ɘˌʮ˦ʡ੮͐ʩʇ˚੮ɘ੮ˑ˺͐੮˚˺̼ʇ੮ʠ̼ɘʮˑੳૂ৾৻੮Pʇ੮ ̼ʇϲˑʇɻ͐ʇʁ੮͐ʩɘ͐੮ુ৵ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮˚;੮̼ʇͅʮʁʇ˦͐ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮͸ʮ͐ʩ੮˚ʇ੮˚˺̼ʇ੮͐ʩɘ˦੮͐ʇ˦੮;ʇɘ̼ͅੳ੮ îʩʇ੮̼ʇɘˑʮ͐;੮ʮͅ੮͐ʩɘ͐੮͐ʩʇ੮˺˦ˑ;੮̼ʇɘͅ˺˦੮͸ʩ;੮͐ʩʇ;ૄ̼ʇ੮˚˺ͷʮ˦ʡ੮ʮͅ੮͐ʩɘ͐੮͐ʩʇ;੮˦ʇʇʁ੮ɘ੮ʩʮʡʩʇ̼੮ ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇੴ੮ʮ˦੮͐ʇ̼˚ͅ੮˺ʠ੮˺ͽ;ʡʇ˦ੴ੮˺̼੮͐ʩʇʮ̼੮યɘɻ͐ʮͷʮ͐ʮʇͅ੮˺ʠ੮ʁɘʮˑ;੮ˑʮͷʮ˦ʡર੮ɻɘ˦ૄ͐੮ɺʇ੮ʁʇɘˑ͐੮ ͸ʮ͐ʩઝɺɘ͐ʩʮ˦ʡ੮ʇͷʇ̼;੮ʁɘ;ੴ੮ʠʇʇʁʮ˦ʡੴ੮ʇ͐ɻʇ͐ʇ̼ɘੳૂ õ˦ˑʮˌʇ੮ɺ˺͙˦ɻʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ɺɘɻˌ੮͙̹੮͐˺੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͐ʩʇ੮̼͐ɘˈʇɻ͐˺̼;੮ʮ˦͐˺੮ ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇ੮ʮͅ੮ͅ˚˺˺͐ʩੳ੮r͙ɻɘͅ੮̼ʇɻ˺͙˦͐ʇʁੴ੮ુõ͙ͅɘˑˑ;੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ͅ੮ʮͅ੮͸ʇૄˑˑ੮ͅʇ˦ʁ੮ ͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮͐˺੮͐ʩʇ੮ય˚ʇʁʮɻɘˑર੮ʩ˺̹ͅʮ͐ɘˑ੮ɘ˦ʁੴ੮ʮ˦੮ɻ˺˺̼ʁʮ˦ɘ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇ੮˚ʇʁʮɻɘˑ੮ʁ˺ɻચ ͐˺̼੮ ɘ͐੮ ͐ʩʇ੮ ʠɘɻʮˑʮ͐;ੴ੮ ͐ʩʇ;ૄˑˑ੮ ̼͙˦੮ ɘ੮ ͅʇ̼ʮʇͅ੮ ˺ʠ੮ ͐ʇ͐ͅͅ੮ ɘ˦ʁ੮ ɘ͐੮ ͐ʩɘ͐੮ ̹˺ʮ˦͐੮ ͸ʇૄˑˑ੮ ˚ɘˌʇ੮ ɘ੮ ʁʇɻʮͅʮ˺˦੮ɘɺ˺͙͐੮͸ʩʇ͐ʩʇ̼੮͐˺੮ɺ̼ʮ˦ʡ੮͐ʩʇ੮̼ʇͅʮʁʇ˦͐੮ɺɘɻˌੳ੮U੮ʩɘͷʇ੮˺˦ʇ੮ˑɘʁ;੮͸ʩ˺੮̼ʇɘˑˑ;੮

168

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ˈ͙͐ͅ੮ʁʮʁ˦ૄ͐੮ʡʇ͐੮˺͙͐੮˺ʠ੮ɺʇʁ੮ɘ˦ʁ੮͸ɘͅ˦ૄ͐੮ʁ˺ʮ˦ʡ੮͸ʇˑˑੴ੮ͅʩʇ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʇɘ͐ੴ੮ͅʩʇ੮͸ɘͅ੮ ˑ˺ͅʮ˦ʡ੮͸ʇʮʡʩ͐ੳૂ੮š˦ɻʇ੮ʩʇ̼੮ɺˑ˺˺ʁ੮̹̼ʇ͙̼ͅͅʇ੮ʁ̼˺̹̹ʇʁ੮ˑ˺͸੮ʇ˦˺͙ʡʩੴ੮͐ʩʇ;੮ͅʇ˦͐੮ʩʇ̼੮͐˺੮ ͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʡɘʮ˦͐ͅ੮ʩʇ̼੮͸ʮͅʩʇͅੳ੮îʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮ʩʇ̼੮͐˺੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇੳ੮ r͙ɻɘͅ੮͐˺ˑʁ੮͐ʩʇ˚ੴ੮ુૃUʠ੮ͅʩʇ੮ʮͅ੮ɘɺˑʇ੮͐˺੮ɻ˺˚ʇ੮ɺɘɻˌੴ੮ͅʩʇ੮ɻɘ˦੮ɻ˺˚ʇ੮ɺɘɻˌੴૄૂ੮ɺ͙͐ੴ੮ʩʇ੮ͅɘʮʁੴ੮ ુ͐ʩʇ੮̼ʇɘˑʮ͐;੮ʮͅ੮ͅʩʇ੮͸˺˦ૄ͐੮ɻ˺˚ʇ੮ɺɘɻˌੳૂ

THE END OF THE LINE? ä͐ɘ͐ʇચˑʇͷʇˑ੮ʁʮͅɻ͙ͅͅʮ˺˦ͅ੮̹ͅɘ̼ˌʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺ˑˑɘ̹ͅʇ੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮͙͙ͅɘˑˑ;੮̹ɘ;੮ˑʮ̹੮ ͅʇ̼ͷʮɻʇ੮͐˺੮͐ʩʇ੮ʮʁʇɘ੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮͐ʇ˚̹˺̼ɘ̼;੮͸ɘ;੮͐ͅɘ͐ʮ˺˦ͅ੮͐˺͸ɘ̼ʁ੮ʡ̼ʇɘ͐ʇ̼੮ʮ˦ʁʇ̹ʇ˦ચ ʁʇ˦ɻʇੳ੮"͙͐੮͙ͅɻʩ੮͐ͅʇ̹ચʁ˺͸˦ͅ੮ɘ̼ʇ੮ͷɘ˦ʮͅʩʮ˦ʡˑ;੮͙˦ɻ˺˚˚˺˦ੳ੮r͙ɻɘͅ੮͐˺ˑʁ੮˚ʇੴ੮ુU੮̼ɘ̼ʇˑ;੮ ʩɘͷʇ੮ͅ˺˚ʇ˺˦ʇ੮˚˺ͷʇ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʠɘɻʮˑʮ͐;੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮͸ʮ͐ʩ੮˚ʇ੮ɘ੮ˑ˺˦ʡ੮͐ʮ˚ʇੳ੮U੮͸˺͙ˑʁ੮ ͅɘ;੮͐ʩɘ͐੮ʮͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮͐ʩɘ͐੮ʩɘ̹̹ʇ˦ͅੴ੮˚ɘ;ɺʇੴ੮˺˦ɻʇ੮ɘ੮;ʇɘ̼ੳૂ੮Pʇ੮͸ɘͅ੮ʩɘ̹̹;੮͐˺੮̼ʇ̹˺̼͐੮ ͐ʩɘ͐੮ુU੮ʩɘʁ੮˺˦ʇ੮ˑɘʁ;੮͸ʩ˺੮ʡɘͷʇ੮˚ʇ੮͐ʩʮ̼͐;ચʁɘ;੮˦˺͐ʮɻʇੴ੮ͅʩʇૄͅ੮ˑʮͷʇʁ੮͸ʮ͐ʩ੮˚ʇ੮ʇʮʡʩ͐ʇʇ˦੮ ;ʇɘ̼ͅੴ੮ɘ˦ʁ੮ͅʩʇૄͅ੮ˈ͙͐ͅ੮ʁ˺ʮ˦ʡ੮ͅ˺੮͸ʇˑˑ੯ੳ੯ੳ੯ੳ੮͐ʩɘ͐੮ʩʇ̼੮ʠɘ˚ʮˑ;੮ʩɘͅ੮ͅɘʮʁੴ੮ૃĔʇ੮͸ɘ˦͐੮˺͙̼੮ͅʮ͐ͅʇ̼੮ ͐˺੮ɻ˺˚ʇ੮ˑʮͷʇ੮͸ʮ͐ʩ੮͙ͅੳૄ੯ੳ੯ੳ੯ੳ੮Uૄ˚੮ͅɘʁ੮͐˺੮ͅʇʇ੮ʩʇ̼੮ʡ˺ੳૂ U੮ɘͅˌʇʁ੮ˑɘ˦੮ɘɺ˺͙͐੮͸ʩʇ͐ʩʇ̼੮ʩʇ੮͐ʩ˺͙ʡʩ͐੮͐ʩʇ੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩʇ;੮̹̼˺ચ ͷʮʁʇʁ੮̼ʇͅʮʁʇ˦͐ͅ੮˚ʇɘ˦͐੮͐ʩɘ͐੮˚˺̼ʇ੮͸ʇ̼ʇ੮ɘɺˑʇ੮͐˺੮˚˺ͷʇ੮˺˦ੳ੮Pʇ੮ɘʁ˚ʮ͐͐ʇʁ੮͐ʩɘ͐੮ɘ̹ͅʮચ ̼ɘ͐ʮ˺˦੮˺ʠ͐ʇ˦੮ɻˑɘͅʩʇͅ੮͸ʮ͐ʩ੮̼ʇɘˑʮ͐;ੵ੮ુĔʇ੮ʩ˺̹ʇ੮͐˺੮ʡʇ͐੮͐ʩʇ੮ˑ˺͸੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮ય̹ʇ˺̹ˑʇર੮ ʮ˦͐˺੮˚˺ʁʇ̼ɘ͐ʇ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡੴ੮ɺ͙͐੮͸ʇ੮ɘˑˑ੮ˌ˦˺͸੮͐ʩɘ͐ૄͅ੮˦˺͐੮̼ʇɘˑʮ͐ͅʮɻੳ੮ä˺ੴ੮͸ʩɘ͐੮͸ʇ੮ʁ˺੮ ʮͅ੮̹̼˺ͷʮʁʇ੮̹̼˺ʡ̼ɘ˚˚ʮ˦ʡ੮͐ʩɘ͐੮͸ʮˑˑ੮ɘ͐੮ˑʇɘ͐ͅ੮ʡʇ͐੮͐ʩʇʮ̼੮˚ʮ˦ʁ੮ʡ˺ʮ˦ʡੳ੮îʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ ̹ʇ˺̹ˑʇ੮͐ʩɘ͐੮ʇ˦ʁ੮͙̹੮˚˺ͷʮ˦ʡ੮˺͙͐੮˺˦੮͐ʩʇʮ̼੮˺͸˦੮ʮͅ੮ͷʇ̼;ੴ੮ͷʇ̼;੮ˑ˺͸ੳ੮U˦੮͐ʩʇ੮͐͸ʇˑͷʇ੮;ʇɘ̼ͅ੮ Uૄͷʇ੮ɺʇʇ˦੮ʩʇ̼ʇ੮યʮ˦੮ɘ੮ͅʇͷʇ˦͐;ચɺʇʁੴ੮͐ʩʇ˦੮ɘ੮ϲʮʠ͐;ચʠ˺͙̼ચɺʇʁ੮ʠɘɻʮˑʮ͐;રੴ੮͸ʇૄͷʇ੮ʩɘʁ੮ͅʇͷʇ˦੮ ˺̼੮ʇʮʡʩ͐੮˚˺ͷʇ੮˺͙͐੮˺˦੮͐ʩʇʮ̼੮˺͸˦ੳૂ੮#ʮ˦ʁ;੮ɘʁʁͅੴ੮ુ˦ʁ੮͐ʩʇ;੮ʁʮʁ੮˦˺͐੮ʁ˺੮͸ʇˑˑੳૂ੮š˦ɻʇ੮ ;˺͙੮̼ʇɻ˺ʡ˦ʮΈʇ੮͐ʩɘ͐੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅ੮ɘ̼ʇ੮ʩ˺˚ʇͅੴ੮ɘ੮ˑ˺˦ʡ੮ˑʇ˦ʡ͐ʩ੮˺ʠ੮͐ͅɘ;੮˚˺ͷʇͅ੮ ʠ̼˺˚੮ɘ੮ͅʮʡ˦੮˺ʠ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ɘ੮˚ʇ̼͐ʮɻ੮˺ʠ੮͙ͅɻɻʇͅͅੳ ੮˚˺̼ʇ੮ɻ˺˚˚˺˦੮͸ɘ;੮˺͙͐੮ʮͅ੮ͷʮɘ੮ʇͷʮɻ͐ʮ˺˦ੳ੮ˑɘ˦੮ʮ˦ͅʮ͐ͅʇʁ੮͐˺੮˚ʇ੮͐ʩʮͅ੮͸ɘͅ੮̼ʇɘˑˑ;੮ ɘ੮ ˑɘ͐ͅ੮ ̼ʇͅ˺̼͐ੵ੮ ુUૄʁ੮ ̼ɘ͐ʩʇ̼੮ ˦˺͐੮ ʁ˺੮ ʇͷʮɻ͐ʮ˺˦ͅ੮ ɺʇɻɘ͙ͅʇ੮ ͐ʩɘ͐੮ ˚ʇɘ˦ͅ੮ Uૄ˚੮ ʡʮͷʮ˦ʡ੮ ͙̹ੳ੮ U੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʡʮͷʇ੮͙̹ੳ੮U͐ૄͅ੮͐ʩʇ੮ʩɘ̼ʁʇ͐ͅ੮͐ʩʮ˦ʡ੮;˺͙੮ɻ˺͙ˑʁ੮ʁ˺ੳૂ੮îʩʇ੮ˑɘ͐ͅ੮̹ʇ̼ͅ˺˦੮ʩʇ੮ ʇͷʮɻ͐ʇʁ੮͸ɘͅ੮̹̼ʇʡ˦ɘ˦͐ੳ੮"˺͐ʩ੮ʩʇ੮ɘ˦ʁ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ɘʡ̼ʇʇʁ੮͐ʩɘ͐੮͐ʩʇ੮I͙ʇ͐ͅ੮P˺˚ʇ੮ ͸ɘͅ੮˦˺੮̹ˑɘɻʇ੮ʠ˺̼੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʮ͐ʩ੮ɘ੮ɺɘɺ;ੳ੮H˺̼੮ɻˑʮʇ˦͐ͅ੮͸ʮ͐ʩ੮ɺʇʩɘͷʮ˺̼ɘˑ੮̹̼˺ɺˑʇ˚ͅ੮˺̼੮ ʁ̼͙ʡ੮ ͙ͅʇੴ੮ ʩʇ੮ ʇͽ̹ˑɘʮ˦ʇʁੴ੮ ͐ʩʇ;੮ ͸˺͙ˑʁ੮ ̼͐;੮ ͐˺੮ ʁʇͷ˺͐ʇ੮ ʇͽ̼͐ɘ੮ ͐ͅɘʠʠ੮ ͐ʮ˚ʇ੮ ͐˺੮ ͐ʩʇ˚੮ ˺̼੮ ˚ɘˌʇ੮͐ͅɘ;ʮ˦ʡ੮ɻ˺˦͐ʮ˦ʡʇ˦͐੮˺˦੮ɘ͐͐ʇ˦ʁʮ˦ʡ੮͐ʩʇʮ̼੮Ûʇɻ˺ͷʇ̼;੮˦˺˦;˚˺͙ͅ੮ʡ̼˺͙̹ੳ੮š˦ʇ੮ ˺ʠ੮ˑɘ˦ૄͅ੮ɺʇ͐ͅ੮͐˺˺ˑͅੴ੮ʩʇ੮ͅɘʮʁੴ੮͸ɘͅ੮͐˺੮ʇͽ̹˺ͅʇ੮ɻˑʮʇ˦͐ͅ੮͐˺੮͐ʩʇ੮ʇͽʇɻ̼ɘɺˑʇ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ɘ͐੮ ˺͐ʩʇ̼੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੵ੮ુU੮͐ʇˑˑ੮͐ʩʇ˚ੴ੮ૃr˺˺ˌੴ੮ʮʠ੮;˺͙੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɻ˺˚̹ˑ;੮͸ʮ͐ʩ੮͐ʩʇ੮

STEPPED DOWN

169

̼͙ˑʇͅੴ੮;˺͙̼੮ɻʩ˺ʮɻʇੴ੮;˺͙ૄ̼ʇ੮͸ʇˑɻ˺˚ʇ੮͐˺੮ʡ˺੮ʇˑͅʇ͸ʩʇ̼ʇૄ੮ɘ˦ʁ੮ʮ͐ૄͅ੮ɘ˚ɘΈʮ˦ʡ੮ʩ˺͸੮ή͙ʮɻˌˑ;੮ ͐ʩʇ;੮̼͐ͅɘʮʡʩ͐ʇ˦੮͙̹ੴ੮ɺʇɻɘ͙ͅʇ੮ɘ੮ˑ˺͐੮˺ʠ੮͐ʩʇ˚੮ʩɘͷʇ੮ɺʇʇ˦੮͐˺੮˺͐ʩʇ̼੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳૂ੮ ä˺˚ʇ͐ʮ˚ʇͅ੮ʩʇૄˑˑ੮ʇͷʇ˦੮̹̼˺̹˺ͅʇੴ੮ૃrʇ͐ૄͅ੮ʁ̼ʮͷʇ੮;˺͙੮˺ͷʇ̼ੴ੮͐ɘˌʇ੮ɘ੮ˑ˺˺ˌ੮ɘ̼˺͙˦ʁੴ੮ͅʇʇ੮ʮʠ੮ʮ͐ૄͅ੮ ɘ੮ϲʮ͐੯ੳ੯ੳ੯ੳૄૂ੮îʩʇ;੮͙͙ͅɘˑˑ;੮ʁʇɻʮʁʇ੮͐˺੮͐ͅɘ;ੳ ä͐ʮˑˑੴ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʮͅ੮˦˺͐੮ɘ੮ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੴ੮ʮ͐੮ɻɘ˦ૄ͐੮ʠ˺̼ɻʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ɻ˺˚̹ˑʮચ ɘ˦ɻʇੴ੮ɘ˦ʁ੮ʠ˺̼੮ʇͷʇ̼;੮̼ʇɻɘˑɻʮ̼͐ɘ˦͐੮̼ʇͅʮʁʇ˦͐ੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʁ˺Έʇ˦ͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ɘ੮ ɺʇʁ੮͸ʩ˺੮˚ʮʡʩ͐੮ɺʇ੮˚˺̼ʇ੮̹ˑʮɘ˦͐ੳ੮äɘ͙ˑ੮ɘʡɘʮ˦ੵ੮ુUʠ੮͸ʇ੮ʩɘͷʇ੮ͅ˺˚ʇ˺˦ʇ੮͐ʩɘ͐੮ʁ˺ʇͅ੮ʁ̼͙ʡͅੴ੮ ˺̼੮͸ʇ੮ɻɘ˦ૄ͐੮˚ʇʇ͐੮͐ʩʇʮ̼੮˦ʇʇʁͅੴ੮U੮ʡʮͷʇ੮͐ʩʇ˚੮ɘ˦੮ʇͷʮɻ͐ʮ˺˦੮˦˺͐ʮɻʇੳ੮Ĕʇ੮ʩɘͷʇ੮ɘ੮̼ʇͅʮʁʇ˦͐੮ ͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮͐˺੮̹ɘ;੮̼ʇ˦͐ੴ੮͐ʩɘ͐ૄͅ੮͐˺˺੮ʁʇ̼͙͐ͅɻ͐ʮͷʇੴ੮ʮ͐੮ʩɘ̹̹ʇ˦ͅੳ੮îʩʇ੮˦͙˚ɺʇ̼੮˺˦ʇ੮ ͐ʩʮ˦ʡ੮ʮͅઝʮʠ੮;˺͙ૄ̼ʇ੮˦˺͐੮˚ʇʁ੮ɻ˺˚̹ˑʮɘ˦͐ੴ੮;˺͙੮ɻɘ˦ૄ͐੮ɺʇ੮ʩʇ̼ʇੳ੮U੮ʁ˺˦ૄ͐੮ɻɘ̼ʇ੮ʩ˺͸੮˚͙ɻʩ੮ ̼ʇ˦͐੮;˺͙੮̹ɘ;੯ੳ੯ੳ੯ੳ੮U੮ˌ˦˺͸੮ʮ͐ૄͅ੮͐ʩʇʮ̼੮̼ʮʡʩ͐੮ય˦˺͐ર੮͐˺੮͐ɘˌʇ੮͐ʩʇʮ̼੮˚ʇʁͅੴ੮;˺͙੮ɻɘ˦ૄ͐੮ʠ˺̼ɻʇ੮ ɘ˦;˺˦ʇ੮͐˺੮͐ɘˌʇ੮˚ʇʁͅੴ੮ɘ˦ʁ੮˺͙̼੮ʩ˺͙ͅʇ੮̼͙ˑʇͅ੮͐ͅɘ͐ʇੴ੮ʮʠ੮;˺͙੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮͐ɘˌʇ੮˚ʇʁͅੴ੮ ͐ʩɘ͐ૄͅ੮˺ˌɘ;ੴ੮;˺͙੮ɻɘ˦ૄ͐੮ˑʮͷʇ੮ʩʇ̼ʇੳ੮Uʠ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮͸̼ʮ͐ʇͅ੮͐ʩʇ੮˺̼ʁʇ̼ੴ੮;˺͙੮ʩɘͷʇ੮͐˺੮͐ɘˌʇ੮ ʮ͐ੳૂ੮Øʇ˺̹ˑʇ੮ʮ˦੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ʩɘͷʇ੮̼ʮʡʩ͐ͅ੮ɘ˦ʁ੮ʠ̼ʇʇʁ˺˚ͅੴ੮ɺ͙͐੮ʇͽʇ̼ɻʮͅʮ˦ʡ੮͐ʩʇ˚੮ʩɘͅ੮ ɻ˺˦ͅʇή͙ʇ˦ɻʇͅੳ U˦੮͐ʩʇ੮ʇ˦ʁੴ੮˚˺̼ʇ੮̼ʇͅʮʁʇ˦͐ͅ੮ͅʇʇ˚੮͐˺੮ˑʇɘͷʇ੮˺ʠ੮͐ʩʇʮ̼੮˺͸˦੮ͷ˺ˑʮ͐ʮ˺˦੮͐ʩɘ˦੮ɘ̼ʇ੮̹͙ͅʩʇʁ੮ ˺͙͐ੳ੮ #ʩɘ̼ˑʮʇੴ੮ ͸ʩ˺੮ ʩʇɘʁʇʁ੮ ͙̹੮ ͐ʩʇ੮ H͙ˑˑચäʇ̼ͷʮɻʇ੮ Øɘ̼͐˦ʇ̼ͅʩʮ̹੮ ͐ʇɘ˚੮ ɘ͐੮ ͐ʩʇ੮ õ{P੮ ɻˑʮ˦ʮɻ੮̹̼˺ϲʮˑʇʁ੮ʮ˦੮ɻʩɘ̹͐ʇ̼੮ৱੴ੮˺ɺͅʇ̼ͷʇʁੴ੮ૃĔʇૄ̼ʇ੮ϲʮʡʩ͐ʮ˦ʡ੮ʩɘ̼ʁʇ̼੮ɘ˦ʁ੮ʩɘ̼ʁʇ̼੮͐˺੮ʡʇ͐੮ ˺͙̼੮ɻˑʮʇ˦͐ͅ੮ʮ˦͐˺੮͙ͅɺ͐ͅɘ˦ʁɘ̼ʁ੮ʩ˺͙ͅʮ˦ʡ੮͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮˺͙̼੮ɻˑʮʇ˦͐ͅੳૄ੮Pʇ੮̼ʇ̹˺̼͐ʇʁ੮ ɘ͐੮˺˦ʇ੮͸ʇʇˌˑ;੮˚ʇʇ͐ʮ˦ʡ੮ʩ˺͸੮ʩʇ੮ʩɘʁ੮̹ͅʇ˦͐੮˚˺˦͐ʩͅ੮ɺʇʡʡʮ˦ʡ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮͐˺੮͐ɘˌʇ੮ ɘ੮ɻˑʮʇ˦͐੮͸ʮ͐ʩ੮˚͙ˑ͐ʮ̹ˑʇ੮ʇͷʮɻ͐ʮ˺˦ͅ੮ɘ˦ʁ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੳ੮îʩʇ੮ʁɘ;੮ɘʠ͐ʇ̼੮ʩʇ੮ʡ˺͐੮ʮ˦ੴ੮ૃʩʇ੮ ʩʮʡʩચϲʮͷʇʁ੮ ͐ʩʇ੮ ˺̹ʇ̼ɘ͐˺̼੮ ɘ˦ʁ੮ ͸ɘˑˌʇʁ੮ ˺͙͐ੳૄ੮ ͅ੮ ɘˑ͸ɘ;ͅੴ੮ ͐ʩʮͅ੮ ˚ʮʡʩ͐੮ ʩɘͷʇ੮ ͐ͅʇ˚˚ʇʁ੮ ʠ̼˺˚੮ ɘ੮ ˑɘɻˌ੮ ˺ʠ੮ ʮ˦ͅʮʡʩ͐੮ ɘ˦ʁ੮ ɘ˦੮ ͙˦͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮ ͐˺੮ ɻ˺˚̹ˑ;੮ ͸ʮ͐ʩ੮ ̼͐ʇɘ͐˚ʇ˦͐ੳ੮ š̼੮ ʮ͐੮ ˚ʮʡʩ͐੮ɺʇ੮ɺʇɻɘ͙ͅʇੴ੮ʠ˺̼੮ɘ੮ʡ̼˺͸˦੮ɘʁ͙ˑ͐ੴ੮ɺʇʮ˦ʡ੮ʩ˺͙ͅʇʁ੮ɺ͙͐੮ˑʮͷʮ˦ʡ੮˺˦੮ʠ˺͙̼੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ ʁɘ;੮ˑʇʠ͐੮˺ͷʇ̼੮ʠ̼˺˚੮ɘ˦੮ääU੮ɻʩʇɻˌ੮˚ɘ;੮ͅʇʇ˚੮ˑʇͅͅ੮ʁʮʡ˦ʮϲʮʇʁ੮͐ʩɘ˦੮ʩɘͷʮ˦ʡ੮͐ʩʇ੮͸ʩ˺ˑʇ੮ ɻʩʇɻˌ੮ɘ˦ʁ੮ɺʇʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅੳ৾ৼ Uૄͷʇ੮ͅʇʇ˦੮ɘ੮̼ɘ˦ʡʇ੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅੳ੮š˦ʇ੮͐ʩɘ͐੮U੮ͷʮͅʮ͐ʇʁੴ੮͸ʩʮɻʩ੮ͅʇ̼ͷʇʁ੮̹̼ʮચ ˚ɘ̼ʮˑ;੮ͷʇ͐ʇ̼ɘ˦ͅ੮ફ͸ʩ˺੮̼ʇɻʇʮͷʇ੮˚͙ɻʩ੮ʩʮʡʩʇ̼੮ʁʮͅɘɺʮˑʮ͐;੮̹ɘ;˚ʇ˦͐ͅબੴ੮ʩɘʁ੮ɘ੮ͅ˚ɘˑˑ੮˚˺ͷʮʇ੮ ͐ʩʇɘ͐ʇ̼੮ɘ˦ʁ੮ɘ੮ʠ˺͙˦͐ɘʮ˦੮ʮ˦੮͐ʩʇ੮ɻ˺͙̼͐;ɘ̼ʁੳ੮˦˺͐ʩʇ̼੮͸ɘͅ੮ʁʇ̹̼ʇͅͅʮ˦ʡˑ;੮ʁʇɻ̼ʇ̹ʮ͐ੳ੮îʩʇ੮ ͸ɘˑˑͅ੮͸ʇ̼ʇ੮ɺɘ̼ʇ੮ɺʇɻɘ͙ͅʇੴ੮͐ʩʇ੮˺͸˦ʇ̼੮͐˺ˑʁ੮˚ʇੴ੮̼ʇͅʮʁʇ˦͐ͅ੮͸˺͙ˑʁ੮͐ʇɘ̼੮̹˺͐ͅʇ̼ͅ੮ʁ˺͸˦੮ ˺̼੮ɻ̼͙ͅʩ੮ɻʮʡɘ̼ʇ͐͐ʇͅ੮˺˦੮͐ʩʇ˚ੳ੮îʩʇ੮ɻɘʠʇ͐ʇ̼ʮɘ੮͸ɘͅ੮ͅ͸ʇˑ͐ʇ̼ʮ˦ʡੴ੮ɺ͙͐੮͐ʩʇ੮͸ʮ˦ʁ˺͸ͅ੮͸ʇ̼ʇ੮ ͐˺˺੮̼͙͐ͅʇʁ੮͐˺੮˺̹ʇ˦ੳ੮Hˑʮʇͅ੮ɺ͙ΈΈʇʁ੮ɘ̼˺͙˦ʁ੮ɘ˦੮˺̹ʇ˦੮̼͐ɘͅʩ੮ɻɘ˦੮ʮ˦੮͐ʩʇ੮̹ɘ˦̼͐;੮͙ͅʇʁ੮ ͐˺੮͐ͅ˺̼ʇ੮̼ʮɻʇੴ੮˦ʇͽ͐੮͐˺੮ɘ੮ʠʇ͸੮ɺ˺ͽʇͅ੮˺ʠ੮͸ʮˑ͐ʇʁ੮̹̼˺ʁ͙ɻʇ੮ʁ˺˦ɘ͐ʇʁ੮ɺ;੮ɘ੮ɻʩ͙̼ɻʩੳ੮îʩʇ̼ʇ੮ ͸ɘͅ੮ɘ੮ɻʇ˚ʇ˦͐੮̹ɘ͐ʮ˺੮ʮ˦੮ɺɘɻˌ੶੮ʮ͐੮͙ͅʇʁ੮͐˺੮ʩɘͷʇ੮̼͐ʇʇͅ੮̹̼˺ͷʮʁʮ˦ʡ੮ͅʩɘʁʇੴ੮ɺ͙͐੮͐ʩʇ੮˺͸˦ʇ̼੮ ͙̹̼˺˺͐ʇʁ੮͐ʩʇ˚੮͐˺੮ʡʇ͐੮̼ʮʁ੮˺ʠ੮̼ɘ͐ͅੳ੮੮ʠʇ͸੮̼ʇͅʮʁʇ˦͐ͅ੮ͅɘ͐੮ɘ̼˺͙˦ʁ੮ɘ੮˚ʇ͐ɘˑ੮ɺɘ̼̼ʇˑ੮ʮ˦੮ ɻ˺˚̹ˑʇ͐ʇ੮ͅʮˑʇ˦ɻʇੴ੮ͅ˚˺ˌʮ˦ʡੳ

170

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

/ͷʇ̼;˺˦ʇ੮ͅʇʇ˚ʇʁ੮ɺ˺̼ʇʁੳ੮"ʇ;˺˦ʁ੮͐ʩʇ੮˺͸˦ʇ̼ੴ੮ɘ੮ϲʮ̼͐ͅચʡʇ˦ʇ̼ɘ͐ʮ˺˦੮ʮ˚˚ʮʡ̼ɘ˦͐੮ʁʇͅચ ̹ʇ̼ɘ͐ʇˑ;੮̼͙͐ͅʡʡˑʮ˦ʡ੮͐˺੮͐ͅɘ;੮˺̹ʇ˦ੴ੮ɘ˦ʁ੮ͅ˺˚ʇ੮ɻ˺˚˚͙˦ʮ͐;੮˚ʇ˚ɺʇ̼ͅ੮̼͐;ʮ˦ʡ੮͐˺੮͙̼͐˦੮ ͐ʩɘ͐੮ʇ˚̹͐;੮ˑ˺͐੮ʮ˦͐˺੮ɘ੮ͅ˚ɘˑˑ੮ʡɘ̼ʁʇ˦ੴ੮Uૄ˚੮˦˺͐੮͙̼ͅʇ੮ɘ˦;˺˦ʇ੮ɻɘ̼ʇʁੳ৾৽੮rʇɘͷʮ˦ʡ੮˚ʮʡʩ͐੮ ˦˺͐੮ɺʇ੮ʡ˺˺ʁ੮ʠ˺̼੮͐ʩʇ੮̼ʇͅʮʁʇ˦͐ͅ੮ફ˺̼੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐ʩɘ͐੮̹͙͐੮͐ʩʇ˚੮͐ʩʇ̼ʇબੴ੮ɺ͙͐੮U੮ ɻ˺͙ˑʁ˦ૄ͐੮ɺˑɘ˚ʇ੮͐ʩʇ˚੮ʮʠ੮͐ʩʇ;੮ʁʇɻʮʁʇʁ੮ˈ͙͐ͅ੮͐˺੮͸ɘˑˌ੮˺͙͐ੳ

CONCLUSION: COLLAPSING CHRONIC CARE {ɘ˦;੮ˑɘ˚ʇ˦͐੮͐ʩɘ͐੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮ʩɘͅ੮˦˺੮ɻ˺˚̹̼ʇʩʇ˦ͅʮͷʇ੮˦ɘ͐ʮ˺˦ɘˑ੮̹˺ˑʮɻ;੮ʡ͙ɘ̼ચ ɘ˦͐ʇʇʮ˦ʡ੮͙˦ʮͷʇ̼ͅɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇੳ੮"͙͐੮ʮ͐੮ʩɘͅ੮˦˺੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮̹˺ˑʮɻ;੮ɘ͐੮ɘˑˑੴ੮˚͙ɻʩ੮ ˑʇͅͅ੮ɘ੮ʡ͙ɘ̼ɘ˦͐ʇʇ੮˺ʠ੮ʮ͐ੳ৾৾੮õ͙ͅɘˑˑ;੮͸ʩʇ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘɺʁʮɻɘ͐ʇͅੴ੮ʠɘ˚ʮˑʮʇͅ੮ɘ̼ʇ੮˦ʇͽ͐੮ʮ˦੮͐ʩʇ੮ ˑʮ˦ʇ੮˺ʠ੮͙ͅɻɻʇͅͅʮ˺˦ੴ੮ˑʇʠ͐੮̹ʮɻˌʮ˦ʡ੮͙̹੮͐ʩʇ੮͐ɘɺ੮ʠ˺̼੮˦͙̼ͅʮ˦ʡ੮˺̼੮ʮ˦ચʩ˺˚ʇ੮ɻɘ̼ʇ੮ʠ˺̼੮ɘʡʮ˦ʡ੮ ̼ʇˑɘ͐ʮͷʇͅੳ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʩɘͅ੮ɺʇʇ˦੮ˑ͙ɻˌ;੮͐ʩɘ͐੮͐ʩʇ੮˦˺˦̹˺ˑʮɻ;੮ʠ˺̼੮˺̼ʡɘ˦ʮΈચ ʮ˦ʡ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɻɘ̼ʇ੮ʮ͐੮ɘʁ˺̹͐ʇʁ੮ɘʠ͐ʇ̼੮ɻˑ˺ͅʮ˦ʡ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʩɘͅ੮ɺʇʇ˦੮̹ɘ̼͐ˑ;੮ɻ˺˚ચ ̹ʇ˦ͅɘ͐ʇʁ੮ ʠ˺̼੮ ɺ;੮ ̹̼ʮͷɘ͐ʇ੮ ʇ˦̼͐ʇ̹̼ʇ˦ʇ͙̼ͅʩʮ̹ੳ੮ š̹ʇ̼ɘ͐˺̼ͅૄ੮ ɘɺʮˑʮ͐;੮ ͐˺੮ ˚ɘˌʇ੮ ʁ˺੮ ͸ʮ͐ʩ੮ ͅ˚ɘˑˑ੮ ɺ͙͐੮ ͐ͅʇɘʁ;੮ ääU੮ ̹ɘ;˚ʇ˦͐ͅ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ʠʇʁʇ̼ɘˑ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ̼ʇ˦ʁʇ̼ʇʁ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ɻɘ̼ʇͅ੮̼ʇͅʮˑʮʇ˦͐ੴ੮ɻ˺˚̹ɘ̼ʇʁ੮͐˺੮˺͐ʩʇ̼੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʡ̼ɘ˚ͅ੮͐ʩɘ͐੮ʇͽ̹ɘ˦ʁ੮ʮ˦੮ ˚˺˚ʇ˦͐ͅ੮˺ʠ੮͐ͅɘ͐ʇ੮ˑɘ̼ʡʇͅͅʇ੮ɘ˦ʁ੮ͅʩ̼ʮ˦ˌ੮͸ʩʇ˦੮ɘ͙͐ͅʇ̼ʮ͐;੮̼͐ͅʮˌʇͅੳ੮îʩʇͅʇ੮ʠɘɻʮˑʮ͐ʮʇͅ੮ʩɘͷʇ੮ ɺʇʇ˦੮ ̹ˑɘɻʇͅ੮ ͸ʩʇ̼ʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ɻɘ˦੮ ɺʇ੮ ͙ͅɺˈʇɻ͐੮ ͐˺੮ ɘɺ͙ͅʇ੮ ફ͐ʩʇ੮ ͐˺̹ʮɻ੮ ˺ʠ੮ ͐ʩʇ੮ ˦ʇͽ͐੮ ɻʩɘ̹͐ʇ̼બ੮˺̼੮ͅʮ͐ʇͅ੮˺ʠ੮͐ͅɘɺʮˑʮ͐;੮˺̼੮ʇͷʇ˦੮ɘ੮͐ͅʇ̹̹ʮ˦ʡ੮͐ͅ˺˦ʇ੮͐˺੮̼ʇɻ˺ͷʇ̼;੮ફʁʮͅɻ͙ͅͅʇʁ੮ʮ˦੮ ͐ʩʇ੮ɻʩɘ̹͐ʇ̼੮ɘʠ͐ʇ̼੮͐ʩɘ͐બੳ U˦੮ɘ˦;੮ɻɘͅʇੴ੮͐ʩʮͅ੮͙ͅɺ˺̹͐ʮ˚ɘˑ੮ͅ˺ˑ͙͐ʮ˺˦੮͐˺੮ɻʩ̼˺˦ʮɻ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮˚ɘ;੮ɺʇ੮˦ʇɘ̼ʮ˦ʡ੮ ʮ͐ͅ੮ʇ˦ʁ੮̹˺ʮ˦͐ੳ੮͐੮ɘ੮৲ৰৱ৹੮ʠ˺̼͙˚੮ʩʇˑʁ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɻɘ̹ʮ͐˺ˑੴ੮U੮ʩʇɘ̼ʁ੮ɘ˦੮͙˦̹͙ɺˑʮͅʩʇʁ੮ ʇ͐ͅʮ˚ɘ͐ʇ੮͐ʩɘ͐੮˺˦ʇચʠ˺͙̼͐ʩ੮˺ʠ੮ɘʁ͙ˑ͐੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ʠɘɻʮˑʮ͐;੮ɺʇʁͅ੮યʮ˦ɻˑ͙ʁʮ˦ʡ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ ɻɘ̼ʇͅર੮ ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ʩɘʁ੮ ɻˑ˺ͅʇʁ੮ ʮ˦੮ ͐ʩʇ੮ ̹̼ʇͷʮ˺͙ͅ੮ ϲʮͷʇ੮ ;ʇɘ̼ͅੳ৾৿੮ îʩʇ੮ ͐ͅɘ͐ʇ੮ ʩɘͅ੮ ͙ͅʁચ ʁʇ˦ˑ;੮͐ɘˌʇ˦੮ʮ˦͐ʇ̼ʇ͐ͅੴ੮̹̼˺˚˺͐ʮ˦ʡ੮˦ʇ͸੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮͐˺੮ʮ˚̹̼˺ͷʇ੮̼͐ɘɻˌʮ˦ʡ੮˺ʠ੮ɻˑ˺͙̼ͅʇͅੴ੮ ϲʮ˦ɘ˦ɻʇ੮ʮ˚̹̼˺ͷʇ˚ʇ˦͐ͅ੮͐˺੮ʁʮˑɘ̹ʮʁɘ͐ʇʁ੮ɺ͙ʮˑʁʮ˦ʡͅੴ੮ʩʮˌʇ੮͐ʩʇ੮ääU੮̼ɘ͐ʇ੮͐˺੮ʠ˺̼͐;੮ʁ˺ˑˑɘ̼ͅ੮ ɘ੮ʁɘ;ੴ੮ɘ˦ʁ੮ʡʮͷʇ੮ɻ˺͙˦͐ʮʇͅ੮ϲʮ̼͐ͅ੮ʁʮɺͅ੮ʠ˺̼੮ɺ͙;ʮ˦ʡ੮͙̹੮̹̼ʮͷɘ͐ʇ੮ʠɘɻʮˑʮ͐ʮʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ɻˑ˺ͅચ ʮ˦ʡੳ৾਀੮k˺˦੮äʩʇ̼ʮ˦ੴ੮͐ʩʇ੮ʠ˺̼˚ʇ̼੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮͐ʩʇ੮r˺ͅ੮˦ʡʇˑʇͅ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩੴ੮ˑʇʁ੮rૄͅ੮ɘʡʡ̼ʇͅͅʮͷʇ੮ʇʠʠ˺̼͐ͅ੮͐˺੮ͅɘͷʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳ੮Pʇ੮͐˺ˑʁ੮˚ʇ੮ʮ͐ૄͅ੮͐ʮ˚ʇ੮͐˺੮ ̼ʇɻ˺ʡ˦ʮΈʇ੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮ુ̹ʇ̼˚ɘ˦ʇ˦͐੮ʩ˺͙ͅʮ˦ʡ੮ʠ˺̼੮ɻʇ̼͐ɘʮ˦੮̹˺̹͙ˑɘ͐ʮ˺˦ͅੳ੮ૃ#˺˦ʡ̼ʇʡɘ͐ʇ੮ ˑʮͷʮ˦ʡૄ੮ʮͅ੮˦˺͐੮ɘ੮ɺɘʁ੮͸˺̼ʁ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮̹̼˺ʠ˺͙˦ʁ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮ʠ̼ɘɻ͙̼͐ʇʁ੮ʠɘ˚ʮˑʮʇͅੴ੮ ͸ʩ˺੮ɘ̼ʇ˦ૄ͐੮ʡ˺ʮ˦ʡ੮͐˺੮ʁ˺੮˺ˌɘ;੮ʮ˦੮ɘ੮̹ʇ̼˚ɘ˦ʇ˦͐੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮͙˦ʮ͐੮͸ʮ͐ʩ੮ͅ˺˚ʇ੮ ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʩ˺੮ɻ˺˚ʇͅ੮˺˦ɻʇ੮ɘ੮͸ʇʇˌੳૂ

STEPPED DOWN

171

îʩʇͅʇ੮ʇʠʠ˺̼͐ͅ੮˚ɘ;੮ɺʇ੮͐˺˺੮ˑʮ͐͐ˑʇੴ੮͐˺˺੮ˑɘ͐ʇੳ੮äɘ͙ˑ੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐੮͸ʩʇ˦੮ʩʇ੮ʡʇ͐ͅ੮˺ʠʠ੮ ͐ʩʇ੮ʠ̼ʇʇ͸ɘ;੮ʇɘɻʩ੮˚˺̼˦ʮ˦ʡ੮ʠ˺̼੮ɘ੮͐͸ʇˑͷʇચʩ˺͙̼੮ʁɘ;ੴ੮ʩʇૄͅ੮ુͅʮɻˌ੮͐˺੮˚;੮͐ͅ˺˚ɘɻʩੳ੮U͐ૄͅ੮ ˦˺͐੮ɺʇɻɘ͙ͅʇ੮U੮ʁ˺˦ૄ͐੮ˑʮˌʇ੮˚;੮͸˺̼ˌ੯ੳ੯ੳ੯ੳ੮U੮ˑ˺ͷʇ੮˚;੮̼ʇͅʮʁʇ˦͐ͅੳ੮U੮ɻɘ˦ૄ͐੮ˑ˺˺ˌ੮ɘ͐੮͐ʩʇ˚੮ɘ˦ʁ੮ ͅɘ;ੴ੮ૃPʇ;ੴ੮;˺͙ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮˺˦ʇ੮ʁɘ;ੳૄ੮U੮ɻɘ˦ૄ͐੮͐ʇˑˑ੮͐ʩʇ˚੮͐ʩɘ͐ੳૂ੮"͙͐ੴ੮ ʩʇ੮ɘʁ˚ʮ͐ͅੴ੮ુʮ͐੮ɻ˺˚ʇͅ੮͐˺੮͐ʩʇ੮̹˺ʮ˦͐੮͸ʩʇ̼ʇ੮͐ʩʇ̼ʇૄͅ੮ʩʇˑ̹ʮ˦ʡ੮˺͐ʩʇ̼੮̹ʇ˺̹ˑʇੴ੮ɘ˦ʁ੮͐ʩʇ̼ʇૄͅ੮ ʩʇˑ̹ʮ˦ʡ੮;˺͙̼ͅʇˑʠ੯ੳ੯ੳ੯ੳૂ੮Pʇ੮ͅɘʮʁ੮͐ʩʇ੮˺͐ʩʇ̼੮˺̹ʇ̼ɘ͐˺̼ͅ੮ɘ̼ʇ੮ુʩ˺̹ʮ˦ʡੴ੮ʩ˺̹ʮ˦ʡੴ੮ʩ˺̹ʮ˦ʡૂ੮ ͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸ʮˑˑ੮ͅɘˑͷɘʡʇ੮͐ʩʇʮ̼੮ɺ͙ͅʮ˦ʇͅͅʇͅ੮˚˺ʁʇˑੴ੮ɺ͙͐ੴ੮ુUૄ˚੮͐ʇˑˑʮ˦ʡ੮;˺͙ੴ੮͐ʩʇ̼ʇ੮ʮͅ੮ ˦˺੮ʩ˺̹ʇੳૂ

CHAPTER 9

NEGLECT AND ABUSE

A

mong the people interviewed for this study who have lived through conservatorship, Florence took one of the hardest lines against it: “I don’t understand why people involuntarily commit other ̹ʇ˺̹ˑʇੳ੯ੳ੯ੳ੯ੳ੮U͐੮ʩ͙̼͐ͅ੮˺˦੮ɘˑˑ੮ʇ˦ʁͅੳ੮U͐੮ʩ͙̼͐ͅ੮͐ʩʇ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮͸ʮ͐ʩ੮͐ʩʇ੮ʠɘ˚ʮˑ;ੴ੮ʮ͐੮ʩ͙̼͐ͅ੮ the relationship with superiors, with authority. It just puts [the conservatee] deeper inside of a sinkhole that gets harder to get out of every time.” People with mental illness shouldn’t be “punished” by years under conservatorship. They “need some place to reform, as opposed to some place to rot, locked away like criminals.” Whether or not you agree with her, after hearing her story, I hope you empathize with why she says “abolish[ing] conservatorship” is the number one change she’d like to see in the mental health system. Florence, now thirty-seven, says she grew up in a “very strict, authoritarian ʩ˺͙ͅʇʩ˺ˑʁੳૂ੮äʩʇ੮ˑɘ˚ʇ˦͐ͅੴ੮ુય{;੮˚˺͐ʩʇ̼ર੮ˌʇ̹͐੮˚ʇ੮ʮͅ˺ˑɘ͐ʇʁ੯ੳ੯ੳ੯ੳ੮U੮ɻ˺͙ˑʁ˦ૄ͐੮ʩɘͷʇ੮͐ʩɘ͐੮ connection [with peers] I wanted in my early childhood and teens.” At age fourteen, she started experimenting with marijuana and alcohol until, at age sixteen, she moved to party drugs and meth. Her mom never believed in mental health treatment. When Florence told her near the end of high school that she wanted ͐˺੮ɺʇ੮ɘ੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅੴ੮ʩʇ̼੮˚˺͐ʩʇ̼੮̼ʇ̹ˑʮʇʁੴ੮ુØͅ;ɻʩ˺ˑ˺ʡ;੮ʮͅ੮ɘ੮ή͙ɘɻˌ੮̹̼˺ʠʇͅͅʮ˺˦ੳૂ When Florence was in crisis, her mother instead turned to the police. One ʇͷʇ˦ʮ˦ʡ੮͸ʩʇ˦੮Hˑ˺̼ʇ˦ɻʇ੮͸ɘͅ੮ͅʇͷʇ˦͐ʇʇ˦ੴ੮ુ{;੮˚˺˚੮ɘ˦ʁ੮U੮͸ʇ̼ʇ੮ϲʮʡʩ͐ʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇ੮͸ɘͅ੮ hitting me, and I had nowhere to go. So I grabbed a knife, I put it to my throat, and I said, ‘If you come near me, I will kill myself.’ I didn’t mean it, I just wanted her to stop hitting me.” Her mother backed off. Florence drove to her friend’s house. The police found her there, discovered she had a knife, and took her to a “suicide ward” in a private psychiatric hospital.

NEGLECT AND ABUSE

173

nɘ͐ʇੴ੮ ̹̼˺ϲʮˑʇʁ੮ ʇɘ̼ˑʮʇ̼ੴ੮ ̼ʇɻ˺͙˦͐ʇʁ੮ ʩʇ̼੮ ϲʮ̼͐ͅ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ɘͅ੮ ɘ˦੮ ɘʁ˺ˑʇͅɻʇ˦͐੮ with ambivalence, remembering both humane treatment and an ever-lurking threat of violence. Florence recalls it with horror: “I was shocked to be there. The girls were taking the screws out of the doors and cutting themselves in the stomach. Then they were offering them to me.” She stayed a couple of weeks, then they “gave me a whole bunch of suicide pamphlets and let me go.” Her mom was not helpful with aftercare: “She was like, ‘Don’t take those meds, you don’t need them, don’t go to therapy and tell all our business, you don’t talk to nobody.’” Nonetheless, Florence made it to community college and was studying ̹̼ʇˑɘ͸੮͙˦͐ʮˑੴ੮ʮ˦੮ʩʇ̼੮ˑɘ͐ͅ੮ͅʇ˚ʇ͐ͅʇ̼ੴ੮ͅʩʇ੮ʩɘʁ੮ુɘ੮˚ʇ˦͐ɘˑ੮˚ʇˑ͐ʁ˺͸˦ૂ੮ϲʮˑˑʇʁ੮͸ʮ͐ʩ੮̼ɘɻʮ˦ʡ੮ thoughts and paranoia. She was twenty-three and having a psychotic break. The next few years were a chaotic mass of hospitalizations and stints in drug rehab. 5150s were, for Florence, another weapon in her mother’s arsenal of abuse: ુš˦ʇ੮͐ʮ˚ʇੴ੮U੮ʩɘʁ੮ɘ੮ʡˑɘͅͅ੮˺ʠ੮͸ɘ͐ʇ̼੮ɘ˦ʁ੮˚;੮˚˺˚ૄͅ੮ɺ˺;ʠ̼ʮʇ˦ʁ੮ʡ̼ɘɺɺʇʁ੮˚ʇ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ I was pushing past him, and the water got everywhere, and he called the police and said, ‘She’s elder-abusing me, she threw hot water on my face.’” The police took Florence to the hospital, “and they were like, ‘Did you have a glass of water?’ and I was like ‘Yeah, I did,’ and they said, ‘Aha, so you admit it!’” Florence might as well have been describing a wrongful criminal incarceration: “I felt like they were trying to trap me” into agreeing with the “charges” against her. Her experiences taught her that “mentally ill” is a form of stigma that, as sociologist Erving Goffman put it, is “deeply discrediting.”ৼ If her mom called the police and said Florence was sick, they assumed Florence was the problem: “I could say, ‘This person hit me, here is my bruise,’ and they say, ‘She hit me!’ and Uૄ˚੮͐ʩʇ੮˺˦ʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ɺ̼͙ʮͅʇ੯ੳ੯ੳ੯ੳ੮ɺ͙͐੮Uૄ˚੮ɘˑ͸ɘ;ͅ੮͐ʩʇ੮˺˦ʇ੮ɘ͐੮ʠɘ͙ˑ͐ੳૂ੮ͅ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺ૄͅ੮ mixed race and disabled, she feels doubly at risk when anyone calls the police on her while in crisis. Other patients in the hospital taught her to “memorize a passage in case you come into contact with law enforcement: ‘Please don’t shoot, I have a mental health disability, I’m seeing things.’” Florence has been to enough hospitals to have seen okay ones and abominable ones. She wound up in a facility where the kids of celebrities could stay in wards that looked like a log cabin and had access to a coffee machine. In another for̹̼˺ϲʮ͐੮ʠɘɻʮˑʮ͐;ੴ੮͐ʩʇ੮ɻ̼͙ʇˑ͐ʮʇͅ੮͸ʇ̼ʇ੮ϲˑɘʡ̼ɘ˦͐ੵ੮ુîʩʇ੮͐ͅɘʠʠ੮͸ɘͅ੮̹ʮ͐͐ʮ˦ʡ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘʡɘʮ˦͐ͅ੮ ʇɘɻʩ੮˺͐ʩʇ̼੮ʮ˦੮ϲʮʡʩ͐ͅੳ੮U੮͸ɘͅ੮͐˺ˑʁ੮͐˺੮ϲʮʡʩ͐੮˚;੮̼˺˺˚˚ɘ͐ʇੴ੮U੮ʁʮʁ੮ʮ͐ੴ੮U੮͸˺˦ੴ੮ɘ˦ʁ੮͐ʩʇ;੮ ʡɘͷʇ੮˚ʇ੮ɘ੮̼͐ʇɘ͐ੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮ʮ͐੮͸ɘͅ੮ˈ͙͐ͅ੮ɻ̼ɘΈ;ੴ੮͐ʩʇ;੮͸ʇ̼ʇ੮̼ʇɘˑˑ;੮˚ʇɘ˦੮͐˺੮͙ͅ੮͐ʩʇ̼ʇੳૂ੮äʩʇ੮ read in a patients’ rights pamphlet that she was allowed to make phone calls, “but

1 74

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

͐ʩʇ;੮˚˺˦ʮ͐˺̼ʇʁ੮;˺͙̼੮ɻɘˑˑͅ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͐ʩʇ;ૄʁ੮ʩɘ˦ʡ੮͙̹੮͐ʩʇ੮̹ʩ˺˦ʇ੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃäʩʇૄͅ੮˦˺͐੮ getting any calls for a week!’” Her conclusion was that “a lot of these places don’t take mental health seriously; they just see it as a business.” As Florence lived it, conservatorship is a form of punishment. People are conserved when they’ve been “hospitalized so many times within a certain period ˺ʠ੮ ͐ʮ˚ʇੴ੮ ˑʮˌʇ੮ ˦ʮ˦ʇ੮ ͐ʮ˚ʇͅ੮ ʮ˦੮ ͅʮͽ੮ ˚˺˦͐ʩͅ੮ ˺̼੮ ɘ੮ ;ʇɘ̼ੴ੮ ͐ʩʇ̼ʇૄͅ੮ ɘ੮ ή͙˺͐ɘૂ੮ ɘ˦ʁ੮ ͐ʩʇ;੮ ʡʇ͐੮ “red-lighted.” Eventually, Florence found herself in an IMD with her mother as a conservator. It’s hard to overstate, as author Esmé Weijun Wang puts it, the “absolute terror that coincides with not knowing when, or if, you will get out of such a place.”৽ It’s for that reason that some people compare the indeterminacy of conservatorship unfavorably with time-limited incarceration in the criminal justice system. Florence claims staff told her she didn’t seem like someone who “belonged on conservatorship” or in an IMD. She was locked with dozens of people with severe ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੴ੮ ɺ͙͐੮ ʠʇˑ͐੮ ͅʩʇ੮ ુɻ˺͙ˑʁ˦ૄ͐੮ ɻɘ̼̼;੮ ˺˦੮ ɘ੮ ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮ ͸ʮ͐ʩ੮ ɘ˦;˺˦ʇ੯ ੳ੯ ੳ੯ ੳ੮ I felt so alone.” Every time she talked to her mother about it, “she would threaten me, ‘If you get off this conservatorship, I’m gonna make sure you live in the streets.’” Meanwhile, though, Florence was making progress. I’ve derided IMDs so far, but to her it was much better than a hospital: “[the hospital] had really basic like, idiot groups. They give you crayons, you know?” But the groups at the IMD, which kept her busy from 7 a.m. to 8 p.m., were “very informative, very ʮ˦ͅʮʡʩ͐ʠ͙ˑੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ʡʮͷʇ੮;˺͙੮ϲʮ̼͐ͅચ̼ɘ͐ʇ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦ੴ੮ˑʮʠʇ੮ͅˌʮˑˑͅઝU੮͐ͅʮˑˑ੮ʩɘͷʇ੮ɘˑˑ੮˚;੮ ˦˺͐ʇͅ੮͐ʩɘ͐੮U੮͐˺˺ˌੳ੯ੳ੯ੳ੯ੳ੮U੮ɻ˺͙ˑʁ˦ૄ͐੮͐ʇˑˑ੮;˺͙੮ʩ˺͸੮˚͙ɻʩ੮U੮ʁʮʁ˦ૄ͐੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮ɘɺ˺͙͐੮ mental health, and what I learned in the IMD.” äʩʇ੮ϲʮ˦ʮͅʩʇʁ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚੮ɘ˦ʁ੮͸ʇ˦͐੮͐˺੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੳ੮"͙͐੮ʮ͐੮͐˺˺ˌ੮ʩʇ̼੮ϲʮͷʇ੮ years to get off conservatorship. When a forensic psychologist was interviewing Florence for one of her yearly renewals, Florence reported that her mom had been inappropriately sharing her medical information with family members and lying about whether her daughter was living with her. The court dropped her mother’s petition for renewal. Thus ended what Florence saw as a state-sanctioned extension of the domination her mother had been exerting since childhood. It’s cold comfort to say this was all Florence’s mother’s fault, because bureaucrats and clinicians throughout the mental health system enabled the abuse. One could take a small bit of solace from the fact the Florence is doing well, which must take almost unfathomable inner strength and resilience. And, for once, she feels genuinely helped by mental health professionals. Florence says her therapist

NEGLECT AND ABUSE

175

encouraged her to go back to school, but her mom was once again blocking her. “Have your mom come talk to me,” the therapist said. When they met, “I was outside the room, and I don’t know what [the therapist] said, but when my mom came out, she had her hand over her heart, and said, ‘She [the therapist] is ͅɻɘ̼;ੳૄ੯ੳ੯ੳ੯ੳ੮‡ʇͽ͐੮͐ʩʮ˦ʡ੮U੮ˌ˦˺͸ੴ੮Uૄ˚੮ʇ˦̼˺ˑˑʇʁ੮ʮ˦੮ͅɻʩ˺˺ˑ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮U੮ʩɘͷʇ੮ɘ੮৴ੳৰ੮ɘͷʇ̼ɘʡʇੳૂ î˺ʁɘ;ੴ੮Hˑ˺̼ʇ˦ɻʇ੮̼ʇͅʮʁʇͅ੮ʮ˦੮ɘ੮ή͙ʮʇ͐੮ʡ̼˺͙̹੮ʩ˺˚ʇ੮͸ʮ͐ʩ੮ɘ੮ુˑʮͷʇચʮ˦੮˚˺˚ੳૂ੮äʩʇ੮ɘˑͅ˺੮ has an FSP team and “they’re great.” As busy as they are, frantically running from one client to another, “they always get back to me in twenty-four hours” if there’s ɘ੮̹̼˺ɺˑʇ˚ੳ੮äʩʇ੮ɘʁʁͅੴ੮ુU੮ɘ˚੮̹ʩ;ͅʮɻɘˑˑ;੮ɘɻ͐ʮͷʇ੯ੳ੯ੳ੯ੳ੮ʮ͐੮ʩʇˑ̹ͅ੮˚ʇ੮͙ͅɺͅʮʁʇ੮ɘ੮ˑ˺͐੮˺ʠ੮ͅʮʁʇ੮ effects” from medication, which she takes consistently. “I’m an active student, I participate in clubs, I do volunteer work. I’ve written to women on death row for Christmastime with one of my clubs at school.” After her bachelor’s degree, ͅʩʇૄͅ੮̹ˑɘ˦˦ʮ˦ʡ੮͐˺੮ʡ˺੮͐˺੮ʡ̼ɘʁ͙ɘ͐ʇ੮ͅɻʩ˺˺ˑઝʮ˦੮ʠ˺̼ʇ˦ͅʮɻ੮̹ͅ;ɻʩ˺ˑ˺ʡ;ੴ੮˺ʠ੮ɘˑˑ੮͐ʩʮ˦ʡͅੳ U˦੮͐ʩʇ੮ϲʮ̼͐ͅ੮̹ɘ̼͐੮˺ʠ੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮U੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮͐ʩʇ੮͸ɘ;੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ɘˑˑ˺͸ͅ੮ɘʡʇ˦ɻʮʇͅ੮ all along the continuum to decline conservatorship, and thus responsibility, for individuals in dire straits. So far, in this part, I’ve emphasized how delegation creates barriers to getting people who are conserved into the facilities that cli˦ʮɻʮɘ˦ͅ੮ɘ˦ʁ੮ˈ͙ʁʡʇͅ੮ʁʇʇ˚੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ʠ˺̼੮͐ʩʇ˚ੳ੮"͙͐੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ϲˑʮ̹ͅ੮͐ʩʇ੮ͅɻ̼ʮ̹͐੮ to talk about what people face when they do get conserved and do get into “appropriate” facilities. There’s a story here about active misuses of power, of the kind that cases like Britney Spears’s have brought to light. But this chapter adds ɘ˦˺͐ʩʇ̼੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;ੵ੮͸ʩʇ̼ʇ੮ɘ੮ˑɘɻˌ੮˺ʠ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ੴ੮ʠ͙˦ʁͅੴ੮ and faith in people with mental illness leads not just to exploitation and overbearing control but also to neglect and abandonment.

PATERNALISM AND EXPLOITATION Almost as soon as LPS went into effect, some advocates sounded the alarm that declarations that someone was gravely disabled were serving as a back door to get around the law’s new limits. Dr. Francis Rigney, chairman of San Francisco’s Mental Health Advisory Board, blew the whistle in the pages of the San Francisco Chronicle in 1975, citing “evidence of widespread abuse” of conservatorship, which clinicians and judges were using as a “blanket device to sneak people into custody to enforce treatment.”৾ Notably, the highest rates were in counties with large African American populations.৿

176

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

There are, indeed, cases throughout the historical record of what looks like “wrongful conservatorship” (à la Britney Spears): people who wind up at risk of being shut away because of a concatenation of “contingencies” rather than an overriding illness.਀ In 1978, a reporter from the San Diego Union interviewed ͐͸ʇ˦͐;ચʇʮʡʩ͐ચ;ʇɘ̼ચ˺ˑʁ੮ ુ{ʮɻʩɘʇˑ੮ Øૂ੮ ͸ʩʮˑʇ੮ ʩʇ੮ ͅɘ͐੮ ુɺʇʩʮ˦ʁ੮ ϲʮͷʇ੮ ̼͐˺̹ʩʮʇͅ੮ ˚ɘ̼ˌʮ˦ʡ੮ ʩʮ˚੮ɘͅ੮ɘ˦੮˺͙͐͐ͅɘ˦ʁʮ˦ʡ੮̼ʇɘˑ੮ʇ͐ͅɘ͐ʇ੮ͅɘˑʇͅ˚ɘ˦ੴ੮͙͐ͅʁʮ˺͙ͅˑ;੮ɘ˦ͅ͸ʇ̼ʮ˦ʡ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ɘɺ˺͙͐੮ his business success, alternately straightening his tie and pushing his blackframed glasses against his nose.”ਁ Michael, although it “seem[ed] inconceivable,” had been deemed “gravely disabled” by the county public guardian, despite the ʠɘɻ͐੮͐ʩɘ͐੮ʩʇ੮͸ɘͅ੮ʇ˚̹ˑ˺;ʇʁ੮ɘ˦ʁ੮ˑʮͷʇʁ੮͸ʮ͐ʩ੮ʩʮͅ੮̹ɘ̼ʇ˦͐ͅઝ͸ʩ˺੮͐ʩʇ˚ͅʇˑͷʇͅ੮˺̹̹˺ͅʇʁ੮ the conservatorship.ਂ He seemed to be a victim of San Diego county’s “bounty system” for conservatorships, whereby the judge colluded with lax defense attor˦ʇ;ͅੴ੮ ͸ʩ˺੮ ˚ɘʁʇ੮ ͅʇͷʇ˦͐;ચϲʮͷʇ੮ ʁ˺ˑˑɘ̼ͅ੮ ̹ʇ̼੮ ͐ʩ̼ʇʇચ˚ʮ˦͙͐ʇ੮ ʩʇɘ̼ʮ˦ʡੴ੮ ɘ˦ʁ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ care homes looking for new residents.ਃ Of course, the long line of victims of guardianship are not chosen at random: ͐ʩʇ;ૄ̼ʇ੮̹ʇ˺̹ˑʇ੮͐ʩʇ੮ɻ˺͙̼͐ͅੴ੮ʁ˺ɻ͐˺̼ͅੴ੮˺̼੮ͅ˺ɻʮʇ͐;੮ɘ͐੮ˑɘ̼ʡʇ੮ϲʮ˦ʁ੮ʮ˦ɻ˺˦ͷʇ˦ʮʇ˦͐ੴ੮ɺ͙̼ʁʇ˦some, or potentially lucrative. In medieval England, the king was “entitled to pocket” the estate of an “idiot” under guardianship, while “keeping him in poverty.”਄ Early in the twentieth century, judges in Oklahoma put Native Americans under legal guardianship once oil was discovered on their lands. This “legalized ̹ˑ͙˦ʁʇ̼ૂ੮ˑʇʠ͐੮ુU˦ʁʮɘ˦੮ɻʩʮˑʁ̼ʇ˦੯ੳ੯ੳ੯ੳ੮͐˺੮ʁʮʇ੮ʠ˺̼੮ˑɘɻˌ੮˺ʠ੮˦˺͙̼ʮͅʩ˚ʇ˦͐੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇ੮ heartlessness and indifference of their professional guardians.”ৼ৻ There are more recent examples. Hillary Moss, an eighty-three-year-old woman in Simi Valley, California, dubbed “Dirty Sally,” was a “pack rat with an unrelenting determination to keep a yardful of dilapidated furniture.”ৼৼ In 1976, the city jailed her for ͙˦̹ɘʮʁ੮ϲʮ˦ʇͅ੮ʠ˺̼੮ɻ˺ʁʇ੮ͷʮ˺ˑɘ͐ʮ˺˦ͅ੮ɘ˦ʁ੮͐ʩʇ˦ੴ੮ʮ˦੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮̹͙ɺˑʮɻ੮˺͙̼͐ɘʡʇੴ੮ɻ˺˦served her. They shipped her off to a nursing home, even though a doctor determined that she “was and still is sane.” (None other than Frank Lanterman spoke up that this case seemed to violate the law.) If you’ll recall from the introduction, there are actually two conservatorship tracks in California: LPS and probate. It’s not surprising that the abuses that have received the most media attention are of probate conservatorships. The ˑʇʡɘˑ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ɘʡɘʮ˦͐ͅ੮͐ʩʇͅʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ɘ̼ʇ੮ϲˑʮ˚ͅʮʇ̼ੳ੮#˺͙̼͐ͅ੮ɻɘ˦੮ʇ͐ͅɘɺˑʮͅʩ੮ probate conservatorships based on “clear and convincing” evidence of someone’s ʮ˦ɻɘ̹ɘɻʮ͐;੮ʠ˺̼੮ͅʇˑʠચɻɘ̼ʇ੮˺̼੮ϲʮ˦ɘ˦ɻʮɘˑ੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ુɺʇ;˺˦ʁ੮ɘ੮̼ʇɘͅ˺˦able doubt,” the higher standard for grave disability (which, itself, is a narrower

NEGLECT AND ABUSE

177

ɻ̼ʮ͐ʇ̼ʮ˺˦બ੮̼ʇή͙ʮ̼ʇʁ੮ɺ;੮rØäੳ੮੮̼ʇή͙ʇ͐ͅ੮ʠ˺̼੮ɘ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻɘ˦੮ɺʇ੮ϲʮˑʇʁ੮ by any interested party, and the conservatee has to actively petition to be let out. H˺̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮͅ੮̼ʇή͙ʮ̼ʇʁ੮͐˺੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʇੴ੮ϲʮˑʇ੮ɘ੮ petition, and renew it every year (table 9.1). These two types of conservatorships are more or less open to certain kinds of misuse by the nature of the people subject to them. The statutes do not prohibit someone with mental illness from being placed on a probate conservatorship, and some public guardians told me they did so in certain circumstances (such as for a mentally ill person with a large estate). This seems to have happened to Britney Spears, whose probate proceedings started after she was hospitalized via a 5150 for mental illness.ৼ৽੮ "͙͐੮ ͐ͅʮϲˑʮ˦ʡ੮ ̹ɘ͐ʇ̼˦ɘˑʮ͐ͅʮɻ੮ ɻ˺˦̼͐˺ˑ੮ ɘ˦ʁ੮ ϲʮ˦ɘ˦ɻʮɘˑ੮

TABLE 9.1

Ĕʩ˺੮ɻɘ˦੮ϲʮˑʇ

Comparison of LPS and probate guardianship

LPS conservatorship

Probate conservatorship

Only the public guardian (with petition from inpatient/jail clinician)

Family member; state or local agency (including public guardian); “any other interested party”

Criteria for Grave disability: current inability to Lack of capacity to provide properly conservatorship provide for food, clothing, or shelter for personal needs for physical health, as a result of a mental disorder food, clothing, or shelter Evidentiary standard

Beyond a reasonable doubt (highest standard, used in criminal trials)

Clear and convincing evidence (lower standard)

Ø˺̹͙ˑɘ͐ʮ˺˦

Mental illness (can also include ‡˺͐੮̹ͅʇɻʮϲʮʇʁੵ੮ʡʇ˦ʇ̼ɘˑˑ;੮ dementia or chronic alcoholism, but developmental disability or cognitive not other substances) impairment (can also include mental illness)

Conservator

Primarily public guardian (can also be family or private professional, depending on county policy)

Primarily family and private professionals (but can be public guardian)

Key powers

Placement in a locked facility; involuntary psychiatric medication; control of disability income

{ʇʁʮɻɘˑ੮ʁʇɻʮͅʮ˺˦ͅ੶੮ϲʮ˦ɘ˦ɻʇͅ੮ɘ˦ʁ੮ʇ͐ͅɘ͐ʇ੶੮ placement in a “secured facility” (dementia only)

Review and ̼ʇ˦ʇ͸ɘˑ

Must be renewed yearly; can be recontested every six months at ̼ʇή͙ʇ͐ͅ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ

Reviewed every two years by court; conservatee must petition to terminate conservatorship

178

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦ઝ͸ʩʮɻʩ੮ʩɘͷʇ੮ɺʇɻ˺˚ʇ੮͐ʩʇ੮ʮɻ˺˦ʮɻ੮ɘɺ͙ͅʇͅ੮˺ʠ੮ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹ৼ৾ઝɘ̼ʇ੮͙͙ͅally visited on probate conservatees with intellectual/developmental disabilities and elderly people with dementia, respectively. #˺˦ͅʮʁʇ̼੮ ϲʮ˦ɘ˦ɻʮɘˑ੮ ʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦ੳ੮ U˦੮ ৲ৰৰ৵ੴ੮ ɘ੮ Los Angeles Times investigation ʠ˺͙˦ʁ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮ϲʮͷʇ੮ʩ͙˦ʁ̼ʇʁ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʮ˦੮͐ʩʇ੮͐ͅɘ͐ʇੴ੮ʩ˺ˑʁʮ˦ʡ੮ ˑʇʡɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮৴ੴ৶ৰৰ੮̹ʇ˺̹ˑʇ੮ɘ˦ʁ੮ଏৱੳ৵੮ɺʮˑˑʮ˺˦੮ʮ˦੮ɘͅͅʇ͐ͅੳৼ৿ California stepped in ͐˺੮̼ʇʡ͙ˑɘ͐ʇ੮͐ʩʇ੮ɺ͙ʁʁʮ˦ʡ੮ʮ˦ʁ͙̼͐ͅ;੮ʮ˦੮৲ৰৰ৶ੴ੮ɺ͙͐੮ʮ͐੮̼ʇ˚ɘʮ˦ͅ੮͐ʩʇ੮ɻɘͅʇ੮͐ʩɘ͐੮͙˦ͅɻ̼͙̹͙ˑ˺͙ͅ੮̹̼ʮͷɘ͐ʇ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɻɘ˦੮ϲʮˑʇ੮ɘ˦ʁ੮ɺʇ੮ʡ̼ɘ˦͐ʇʁ੮ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ɘ͐੮ુʇ˚ʇ̼ʡʇ˦ɻ;ૂ੮ʩʇɘ̼ings with their potential wards not even present. The guardian might then show up at someone’s home to announce they’ll be moving to a nursing facility, with their assets sold to cover the guardian’s “services.”ৼ਀ These cases almost always involve elderly people alleged to have cognitive impairments. Paid private guardians seldom serve as LPS conservators. People with serious mental illness rarely have time to accumulate assets that would make them of interest to exploitative professionals, since psychosis typically kicks in at the transition to adulthood.ৼਁ If a person with mental illness did have real assets, ͐ʩʇ;੮ ͸˺͙ˑʁ੮ ˑʮˌʇˑ;੮ ɺʇ੮ ʁʮͅή͙ɘˑʮϲʮʇʁ੮ ʠ̼˺˚੮ ɘ˦੮ rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ š˦ʇ੮ ɻˑʮ˦ʮɻʮɘ˦੮ involved in screening for a conservatorship program described a woman who is “incredibly dysregulated to the point where she injures herself, severely, in every ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ੮ )ʮͅˑ˺ɻɘ͐ʮ˦ʡ੮ ɘ̼˚ͅੴ੮ ͅʩʇૄͅ੮ ϲˑʮ̹̹ʇʁ੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ɺʇʁੴ੮ ͸ʮˑˑ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮ need to be medically sedated to unconsciousness. Horrendous.” Yet, the woman “has a house, she has food, and she has clothing, so we can’t do LPS.” To the clinician, making grave disability the criterion for conservatorship resulted in “missing a whole subset of people who really, really do need additional help, but have what they need.” There’s also a stark difference in the trajectories onto conservatorship between people with developmental disabilities and those with mental illness. Disability rights groups have lamented the rise of a “school-to-guardianship pipeline.” They allege that special educators encourage parents to seek guardianship to keep watch over their “forever children” when they turn eighteen.ৼਂ This denies people with developmental disabilities the “dignity of risk”: the opportunity to make ɻʩ˺ʮɻʇͅ੮ɘ˦ʁ੮ˑʮͷʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅੳৼਃ There’s virtually no way to have this kind of preemptive guardianship for people with mental illness through LPS. Rather than collaborating with concerned mothers and fathers to construct a pipeline onto conservatorship, many judges, psychiatrists, and public guardians I spoke to believed that part of their role was

NEGLECT AND ABUSE

179

blocking overeager parents. And many people living with serious mental illness have been granted the dignity of risk (without the dignity of needed support) repeatedly: released from hospitals with little follow-up after winning a probable cause hearing or evicted from supported housing because their psychotic symptoms were too disruptive to their neighbors.ৼ਄ Linda Kincaid is the head of the Coalition for Elder and Dependent Rights. She’s been monitoring guardianship abuse in California since her mother was ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇʁੴ੮ ͅʇͽ͙ɘˑˑ;੮ ɘͅͅɘ͙ˑ͐ʇʁੴ੮ ɘ˦ʁ੮ ɺʮˑˌʇʁ੮ ʠ˺̼੮ ଏ৲৵ৰੴৰৰৰ੮ ͙˦ʁʇ̼੮ ɘ੮ ̹̼˺ɺɘ͐ʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮äʩʇ੮͐˺ˑʁ੮˚ʇੴ੮ુĔʩɘ͐ʇͷʇ̼੮;˺͙੮ɻɘˑˑ੮ʮ͐ઝ̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺ʠ੮ an elderly person, or limited conservatorship [a variant of a probate conservatorship] of a young person with autism or a developmental disability, or LPS conͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮˚ɘ;੮˺̼੮˚ɘ;੮˦˺͐੮ʩɘͷʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻʩɘˑˑʇ˦ʡʇͅ੯ੳ੯ੳ੯ੳ੮ [conservatorship] takes someone’s civil rights away from them. Makes them less ˺ʠ੮ɘ੮̹ʇ̼ͅ˺˦੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮"̼ʮ͐˦ʇ;੮ä̹ʇɘ̼ͅ੮ʮˑˑ͙̼͐ͅɘ͐ʇʁ੮͐ʩɘ͐੮ɺʇɘ͙͐ʮʠ͙ˑˑ;ੳૂ੮äʩʇૄͅ੮̼ʮʡʩ͐੮͐ʩɘ͐੮ ˚ɘˈ˺̼੮ ̼ʇ̼͐ͅʮɻ͐ʮ˺˦ͅ੮ ˺ʠ੮ ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮ ̼ʮʡʩ͐ͅੴ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ʇ͐ʩʮɻɘˑ੮ ή͙ʇ͐ͅʮ˺˦ͅ੮ ͐ʩʇ;੮ ̹˺ͅʇੴ੮ occur across different types of conservatorships. But when we look at the LPS ͅ;͐ͅʇ˚੮̹ͅʇɻʮϲʮɻɘˑˑ;ੴ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ͅʇ͐੮˺ʠ੮ʩɘ̼˚ͅ੮ɻ˺˚ʇ੮͐˺੮͐ʩʇ੮ʠ˺̼ʇੳ

OVERBURDENED AND UNDERSERVING U੮ ̼ɘʮͅʇʁ੮ ͐ʩʇ੮ ή͙ʇ͐ͅʮ˺˦੮ ˺ʠ੮ ɘɺ͙ͅʮͷʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ͸ʮ͐ʩ੮ äɻɘ̼ˑʇ͐੮ P͙ʡʩʇͅ੮ ˺ʠ੮ ͐ʩʇ੮ County Public Guardians’ and Conservators’ Association (CAPAPGPC). Six ˚˺˦͐ʩͅ੮ɘʠ͐ʇ̼੮͐ʩʇ੮ä̹ʇɘ̼ͅ੮͐ͅ˺̼;੮˚ɘʁʇ੮ʩʇɘʁˑʮ˦ʇͅੴ੮P͙ʡʩʇͅ੮ʩɘʁ੮ɻˑʇɘ̼ˑ;੮ɺʇʇ˦੮ϲʮʇˑʁʮ˦ʡ੮ such concerns unceasingly. She ticked off a series of “checks-and-balances with the public guardian that don’t exist in the private sector,” like public guardians’ independent yearly investigations and oversight from patients’ rights advocates (who are paid for by behavioral health departments to provide representation and respond to complaints). These public agents’ capacity to protect conservatees, though, is sapped by ̼ɘ͸੮ϲʮͅɻɘˑ੮̼ʇɘˑʮ͐ʮʇͅੳ੮îʩʇ̼ʇ੮ʮͅ੮˦˺੮ʁʮ̼ʇɻ͐੮͐ͅɘ͐ʇ੮͙̹̹ͅ˺̼͐੮ʠ˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ˦ʁੴ੮ɘͅ੮ one report concluded, “across the board, public guardianship systems are underfunded.”৽৻ This has predictable effects on public guardians’ caseloads, their ˺ϲϲʮɻʇͅૄ੮ɘɺʮˑʮ͐;੮͐˺੮̼ʇɻ̼͙ʮ͐੮ɘ˦ʁ੮̼ʇ͐ɘʮ˦੮͐ͅɘʠʠੴ੮ɘ˦ʁ੮͐ʩʇ੮̼ʩ;͐ʩ˚੮˺ʠ੮͐ʩʇʮ̼੮ɻ˺˦͐ɘɻ͐੮͸ʮ͐ʩ੮ clients. Although some public guardians proudly describe themselves as helicopter parents, many conservatees wind up closer to latchkey kids.

180

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

You met Tod, the public guardian of a wealthy northern county, in a previous chapter. He is pleased with the intensity of supports he offers to LPS conservatees. In contrast to some counties, “we actually do everything for our clients, we ˚ɘ˦ɘʡʇ੮ϲʮ˦ɘ˦ɻʇͅੴ੮˚ʇʁʮɻɘˑੴ੮̹ͅ;ɻʩʮɘ̼͐ʮɻੴ੮ɘˑˑ੮˺ʠ੮͐ʩɘ͐ੳૂ੮Pʇ੮ʩɘͅ੮˚ɘ˦;੮ɻˑʮʇ˦͐ͅ੮ʮ˦੮ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ɻɘ̼ʇͅੴ੮͸ʩ˺੮̼ʇή͙ʮ̼ʇ੮˚˺̼ʇ੮̼ʇʡ͙ˑɘ̼੮ɻʩʇɻˌચʮ˦ͅ੮͐ʩɘ˦੮ʮʠ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʮ˦੮ɘ੮̼͙͐ͅɻ͙̼͐ʇʁ੮ ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੳ੮"͙͐੮͸ʩʇ˦੮͸ʇ੮̹ͅ˺ˌʇ੮ʮ˦੮ˑɘ͐ʇ੮৲ৰ৲ৰੴ੮ʩʇ੮͸ɘͅ੮ʁ˺͸˦੮˺˦ʇ੮ʁʇ̹͙͐;ੴ੮͸ʩ˺˚੮ he struggled to replace. Another was on maternity leave. This pushed them up to one hundred clients per conservator. Thanks to the pandemic, “we’re not doing any face-to-face contact with clients, it’s all by phone, [so] one hundred clients are more or less manageable,” but he was worried that “when we start going back to facilities, it’s not going to be manageable.” Others are more resigned to the limited level of services they can offer. I asked #ʩʇˑͅʇɘੴ੮ ʩʇɘʁ੮ ˺ʠ੮ ɘ੮ ˑɘ̼ʡʇ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ ˺ϲϲʮɻʇ੮ ʮ˦੮ ä˺͙͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ʩ˺͸੮ often deputies see their clients. She responded mournfully, “Unfortunately, it’s ˦˺͐੮ ͷʇ̼;੮ ˺ʠ͐ʇ˦ੳ੮ š͙̼੮ ˚ʮ˦ʮ˚͙˚੮ ͐ͅɘ˦ʁɘ̼ʁ੮ ʮͅ੮ ͸ʇ੮ ˦ʇʇʁ੮ ͐˺੮ ͅʇʇ੮ ͐ʩʇ˚੮ ή͙ɘ̼͐ʇ̼ˑ;ੳ੮ Ĕʇ੮ ɻɘ˦੮ͅʇʇ੮͐ʩʇ˚੮˚˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʮʠ੮͐ʩʇ̼ʇૄͅ੮ɘ˦੮ʇ˚ʇ̼ʡʇ˦ɻ;ੴ੮ʇ˦ʁ੮˺ʠ੮ˑʮʠʇੳ੮îʩ˺ͅʇ੮ͅ˺̼͐ͅ੮˺ʠ੮ ͐ʩʮ˦ʡͅ੮˺ɺͷʮ˺͙ͅˑ;੮ɺʇɻ˺˚ʇ੮ͷʇ̼;੮͙̼ʡʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮U੮͸˺͙ˑʁ੮ˑ˺ͷʇ੮͐˺੮ͅʇʇ੮˺͙̼੮ɻˑʮʇ˦͐ͅ੮˚˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐ˑ;ੴ੮ɺ͙͐੮͐ʩʇ੮ɻɘͅʇˑ˺ɘʁͅ੮ʁ˺੮˦˺͐੮ɘˑˑ˺͸੮͙ͅੳૂ৽ৼ The situation is worse for agencies with many conservatees placed out of county. One guardian lamented that her county would only reimburse the six-hour drive to visit a conservatee in a locked facility once every six months. Serge Obolensky, who spent more than a decade homeless in Hollywood until Kerry Morrison, head of Hollywood’s Business Improvement District, helped mobilize a group of private citizens to get him conserved, takes a generous attitude toward the people involved in his conservatorship. He remembers being ુ̼ʇɘˑˑ;੮͙̹ͅʇ͐ૂ੮͸ʩʇ˦੮ʩʮͅ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐ʇ͐ͅʮϲʮʇʁ੮͐ʩɘ͐੮ʩʇ੮˦ʇʇʁʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɺ͙͐੮ “now I look back, and it’s all normal.” He had never heard of a public guardian ɺʇʠ˺̼ʇ੮ ʩʇ੮ ϲʮ̼͐ͅ੮ ̹ͅ˺ˌʇ੮ ͐˺੮ ˺˦ʇ੮ ʁ͙̼ʮ˦ʡ੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ੴ੮ ɺ͙͐੮ ʩʇ੮ appreciated that “they said they were going to get my ID card, my social security card, my Medi-Cal card. They helped me out a lot.” ͐੮͐ʩɘ͐੮̹˺ʮ˦͐੮ʮ˦੮˺͙̼੮ʮ˦͐ʇ̼ͷʮʇ͸ੴ੮nʇ̼̼;੮ˈ͙˚̹ʇʁ੮ʮ˦੮͐˺੮ϲʮˑˑ੮ʮ˦੮ͅ˺˚ʇ੮ˑʇͅͅ੮̼˺ͅ;੮ʁʇ͐ɘʮˑͅੳ੮ As Serge’s conservatorship referral marched forward, one of the outreach workers who had been seeing him on the streets visited him regularly in the hospital. îʩʇ੮͸˺̼ˌʇ̼੮ʩɘʁ੮äʇ̼ʡʇ੮ͅʮʡ˦੮ɘ੮̼ʇˑʇɘͅʇ੮ͅ˺੮ͅʩʇ੮ɻ˺͙ˑʁ੮ɺʇ੮˦˺͐ʮϲʮʇʁ੮͸ʩʇ˦੮ʩʇ੮͐ͅʇ̹̹ʇʁ੮ down into an IMD. But after four months, Kerry and the worker “went up to

NEGLECT AND ABUSE

181

͐ʩʇ੮ϲˑ˺˺̼੮ય˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑરੴ੮ય͐ͅɘϲϲર੮ͅɘʮʁੴ੮ૃšʩੴ੮ʩʇૄͅ੮ʡ˺˦ʇੴૄ੮ɘ˦ʁ੮͐ʩʇ;੮͸˺͙ˑʁ੮˦˺͐੮͐ʇˑˑ੮͙ͅ੮ where [Serge] was.” Although the public guardian could consent to the release of this information, he or she was nowhere to be found. “If we did not go looking ʠ˺̼੮;˺͙ੴૂ੮nʇ̼̼;੮̼ʇϲˑʇɻ͐ʇʁੴ੮ુ˦˺ɺ˺ʁ;੮ʮ˦੮͐ʩʇ੮͸ʩ˺ˑʇ੮͸˺̼ˑʁ੮͸˺͙ˑʁ੮ʩɘͷʇ੮ˌ˦˺͸˦੮͸ʩʇ̼ʇ੮ you were. You would have been completely alone.” Kerry and her compatriot eventually found a contact in the Department of Mental Health willing to stretch privacy rules to tell them where Serge had wound up. Kerry drove out to the “far reaches” of Los Angeles County to meet him. There, she made a distressing discovery: although Serge had been conserved for months, he had not met his public guardian. Concretely, that meant the public guardian was not transferring to Serge any spending money from his social security check, which meant he couldn’t get food from the IMD’s small snack bar. Kerry raised “holy hell with the county,” and within a day or two Serge’s public guardian reached out. For Kerry, it was symbolic of a “lack of accountability” in a conservatorship system that “does not want to even acknowledge that there might be someone out there who cares, who could be the lifeline, the connector, ɻ˺͙ˑʁ੮̹̼˺ͷʮʁʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ϲʮͷʇ੮ɺ͙ɻˌͅੳૂ When Serge left the hospital for an IMD, he was placed in what anthropologist Joao Biehl, studying private institutions in Brazil where the elderly and disabled are left to die, calls a “zone of social abandonment.” Residents became ુ͙˦ˌ˦˺͸ɘɺˑʇ੯ ੳ੯ ੳ੯ ੳ੮ ͸ʮ͐ʩ੮ ˦˺੮ ˺˦ʇ੮ ɘɻɻ˺͙˦͐ɘɺˑʇ੮ ʠ˺̼੮ ͐ʩʇʮ̼੮ ɻ˺˦ʁʮ͐ʮ˺˦ੳૂ৽৽ But while Brazil’s zones were created by the failure of the state to organize any more dig˦ʮϲʮʇʁ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੴ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɺ˺͐ʩ੮ϲʮ˦ɘ˦ɻʇʁ੮͐ʩʇ੮̹ˑɘɻʇ੮͸ʩʇ̼ʇ੮äʇ̼ʡʇ੮ was relegated and used its sovereign power to place him there. It was private initiative, not engaged public authority, that brought Serge back from the brink of social death. Public guardians, like all overwhelmed street-level bureaucrats, have a range of what Lipsky describes as “coping behavior and adaptive attitudes.”৽৾ Coping ɘ˦ʁ੮ ɘʁɘ̹͐ʮ˦ʡ੮ ͸ʮ͐ʩʮ˦੮ ɺ͙ʁʡʇ͐ɘ̼;੮ ɘ˦ʁ੮ ͐ͅɘϲϲʮ˦ʡ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅ੮ ˚ʇɘ˦ͅੴ੮ ɘͅ੮ ˺˦ʇ੮ ʇͷɘˑ͙ɘtion in Los Angeles observed, that public guardians focus on keeping up with ુ̹ɘ̹ʇ̼͸˺̼ˌ੯ੳ੯ੳ੯ੳ੮͸ʩʮɻʩ੮˚͙͐ͅ੮ɺʇ੮ʁ˺˦ʇ੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮̼ʇɻʇʮͷʇͅ੮͐ʩʇ੮˚ʮ˦ʮ˚͙˚੮ ˑʇͷʇˑ੮ ˺ʠ੮ ɻɘ̼ʇੳૂ੮ îʩʇ;੮ ͐ʩ͙ͅ੮ ˑʇɘͷʇ੮ ͐˺੮ ͐ʩʇ੮ ͅʮʁʇ੮ ુૃή͙ɘˑʮ͐;੮ ˺ʠ੮ ˑʮʠʇૄ੮ ͐ɘͅˌͅ੮ ય͙ͅɻʩર੮ as personal visits and observation of living conditions.”৽৿ As the next section details, some of what guardians might see on visits to and observations of the ̹ˑɘɻʇͅ੮͸ʩʇ̼ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ˑʮͷʇ੮ɘ̼ʇ੮ή͙ʮ͐ʇ੮ʁʮ͙̼͐ͅɺʮ˦ʡੳ

182

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

LOCKED IN THE “CLOSEST THING TO HELL I’VE ENCOUNTERED” Not all of the powers that LPS gives to conservators actually get exercised. In spite of anecdotal reports documented by journalists digging into guardianships post–Britney Spears,৽਀ public guardians and judges insisted to me that LPS conservatees almost never lose their right to vote or are sterilized by court order.৽ਁ Pushing back against depictions of conservators as all-powerful, one public guardian admonished me that “many people think we have the power to do things we don’t actually have the power to do.” In that guardian’s ɻ˺͙˦͐;ੴ੮ુ̼ʇɘˑˑ;੮͐ʩʇ੮˺˦ˑ;੮͐͸˺੮̹˺͸ʇ̼ͅ੮͐ʩɘ͐੮͸ʇ੮ɘ̼ʇ੮ʡ̼ɘ˦͐ʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺͙̼͐੯ੳ੯ੳ੯ੳ੮યɘ̼ʇર੮ to place someone in a locked setting and to consent to medication.” But these are fearsome tools. Public guardians are not the one physically pinning people down to give them injections or shutting them behind locked doors. Instead, these powers are delegated to facilities that can subject people to degradation and death. îʩʇ੮ ˑɘ͐ͅચʁʮ͐ɻʩ੮ ̼ʇ͐˺̼͐੮ ͐˺੮ ɻ̼ʮ͐ʮή͙ʇͅ੮ ˺ʠ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ʮͅ੮ ͐ʩɘ͐੮ ɘ͐੮ least it keeps people safe.৽ਂ The record suggests otherwise. In-depth investigative reporting from the Los Angeles Times੮ʮ˦੮৲ৰৱ৹੮ʠ˺͙˦ʁ੮˺˦ʇ੮ʩ͙˦ʁ̼ʇʁ੮̹̼ʇͷʇ˦͐ɘɺˑʇ੮ deaths in psychiatric facilities statewide over the course of a decade.৽ਃ Government’s failure to protect people from whom courts have stripped any power to protect themselves (for example, by not allowing them to leave a facility they ϲʮ˦ʁ੮͙˦ͅɘʠʇબ੮ʮͅ੮ʩɘ̼̼˺͸ʮ˦ʡੳ੮͐੮rɘ੮#ɘͅɘੴ੮ɘ˦੮U{)੮ʮ˦੮r˺˦ʡ੮"ʇɘɻʩ੮̼͙˦੮ɺ;੮îʇˑʇɻɘ̼ʇੴ੮ two patients died by suicide over two years.৽਄ The facility was already under scrutiny for hundreds of police calls tied to patient violence and dozens of escapes per year. Staff, some of whom made a little over nine dollars an hour, argued that ̼ʇͅʮʁʇ˦͐ͅ੮ફɘˑˑ੮˺ʠ੮͸ʩ˺˚੮͸ʇ̼ʇ੮ɻ˺˦ͅʇ̼ͷʇʁબ੮͸ʇ̼ʇ੮˚˺ͷʮ˦ʡ੮͐˺˺੮ή͙ʮɻˌˑ;੮ʠ̼˺˚੮ˈɘʮˑͅ੮ɘ˦ʁ੮ acute hospitals into this less restrictive, less controlled facility. Telecare faced no ̼ʇʡ͙ˑɘ͐˺̼;੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮ʠ˺̼੮͐ʩʇ੮ʁʇɘ͐ʩͅੳ Counting deaths, however, only captures a fraction of the harm that some patients experience under involuntary psychiatric holds. Thatcher is a thirtyͅʇͷʇ˦ચ;ʇɘ̼ચ˺ˑʁ੮ ʡʇ˦ʁʇ̼ή͙ʇʇ̼ੴ੮ ˚ʮͽʇʁચ̼ɘɻʇ੮ ̹ʇ̼ͅ˺˦੶੮ ɘʠ͐ʇ̼੮ ʡ̼ɘʁ͙ɘ͐ʮ˦ʡ੮ ʠ̼˺˚੮ ɻ˺ˑˑʇʡʇੴ੮ they moved to San Francisco to become a tattoo artist. Thatcher left a bad relationship and was being stalked by their ex. They “basically developed a lot of paranoia, like a trauma response,” which “activated a manic episode.” They

NEGLECT AND ABUSE

183

pursued therapy and medication “for a really long time” via Medi-Cal but were stuck on waitlists. Thatcher only got “help” when visiting a friend in Pomona who, out of concern ʠ˺̼੮îʩɘ͐ɻʩʇ̼ੴ੮ɻɘˑˑʇʁ੮͐ʩʇ੮̹˺ˑʮɻʇੳ੮šϲϲʮɻʇ̼ͅ੮ʇͽ̼͐ɘɻ͐ʇʁ੮îʩɘ͐ɻʩʇ̼੮ʠ̼˺˚੮͐ʩʇ੮ɺɘ͐ʩ̼˺˺˚੮ and hurtled them into what I have previously described as a “state of exception” where violence and humiliation seemed routine. It started with the 5150. Thatcher was having “delusions that they were federal agents, not police.” While being strapped to a gurney, Thatcher spit on a cop’s shoes. The EMTs responded by putting Thatcher in a “pain restraint hold” (applying force to the joint of Thatcher’s jaw) and gave them an injection of sedatives and antipsychotics. Outside of emergency situations (like Thatcher’s 5150), psychiatric facilities can only forcibly medicate a person not under a conservatorship after a Riese hearing, where a judge determines if a person lacks capacity to evaluate ͐ʩʇ੮̼ʮͅˌͅ੮ɘ˦ʁ੮ɺʇ˦ʇϲʮ͐ͅ੮˺ʠ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮"͙͐੮˺˦ɻʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮͅ੮ɻ˺˦ͅʇ̼ͷʇʁੴ੮͐ʩʇ੮̹͙ɺlic guardian can consent to medication on their behalf, without going back before a judge. One public guardian, Tod, told me that this consent-by-proxy ̼ɘ̼ʇˑ;੮̼ʇή͙ʮ̼ʇʁ੮̹ʩ;ͅʮɻɘˑ੮ʠ˺̼ɻʇੳ੮Pʇ੮ʇˑɘɺ˺̼ɘ͐ʇʁੵ੮ુîʩʇ੮˚˺͐ͅ੮̹˺͸ʇ̼ʠ͙ˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮ ͸ʇ੮ʩɘͷʇ੮ʮͅ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੯ੳ੯ੳ੯ੳ੮U੮ɻɘ˦੮ͅɘ;ੴ੮ૃšʠʠ੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮;˺͙੮ʡ˺ૄ੮ɘ˦ʁ੮ͅʩ˺˺͐੮͐ʩʇ˚੮ ͙̹੮͸ʮ͐ʩ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅੳ੮U͐ૄͅ੮ɘ੮̹˺͸ʇ̼ʠ͙ˑ੮ʁʇ͐ʇ̼̼ʇ˦͐ੴ੮͸ʩʮɻʩ੮͸ʇ੮ʁ˺˦ૄ͐੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʩɘͷʇ੮ ͐˺੮͙ͅʇੳ੮{˺͐ͅ੮ɻˑʮʇ˦͐ͅ੮ɘ̼ʇ੮ʮ˦੮ͅʇ͐͐ʮ˦ʡͅ੮͸ʩʇ̼ʇ੮͐ʩʇ;੮ɻ˺˚̹ˑ;੯ੳ੯ੳ੯ੳ੮ʇʮ͐ʩʇ̼੮͸ʮˑˑʮ˦ʡˑ;੮˺̼੮ ͸ʮ͐ʩ੮ɘ੮ૃͅʩ˺͸੮˺ʠ੮ʠ˺̼ɻʇੳૄ੯ੳ੯ੳ੯ੳ੮U˦੮˺͐ʩʇ̼੮͸˺̼ʁͅੴ੮ʡʇ͐੮ɘ੮ɺ͙˦ɻʩ੮˺ʠ੮ɺ͙̼ˑ;੮˦͙̼ͅʇͅ੮ɘ̼˺͙˦ʁ੮ them and say, ‘You’re going to take that shot.’ You’re going to comply.” Beyond involuntary medication, Thatcher received little that they saw as ુ̼͐ʇɘ͐˚ʇ˦͐ૂ੮ ʁ͙̼ʮ˦ʡ੮ ˦ʮ˦ʇ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮ ɺʇ͐͸ʇʇ˦੮ ৲ৰৱ৶੮ ɘ˦ʁ੮ ৲ৰৱ৸ੳ੮ Several were in John George Psychiatric Hospital, a notorious facility in Alameda County. Thatcher remembers only “very brief encounters with doctors who seemed to have already made up their minds about where my mental health was ɘ͐ੳૂ੮îʩɘ͐ɻʩʇ̼੮ͅɘ͸੮͐ʩʇʮ̼੮̹ɘ̹ʇ̼͸˺̼ˌ੮ʇͽ͐ʇ˦ʁʮ˦ʡ੮͐ʩʇʮ̼੮৵৲৵ৰੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮ɘ˦ʁ੮͸ʇ̼ʇ੮ certain the doctors had switched their chart because it said they were “despondent and stayed in my room” even though “I was manic, staying up and talking a lot, in a high energy place and not staying in the room.” There were a few art supplies and occasional “dog therapy that everyone wanted to go to,” but that was it. One former nurse from John George concurred that it was a therapeutic ʁʇͅʇ̼͐ੵ੮ુîʩʇ̼ʇૄͅ੮ɘ੮ʡ̼ʇɘ͐੮˚;͐ʩ੮͐ʩɘ͐੮͸ʇૄ̼ʇ੮ɘɺˑʇ੮͐˺੯ੳ੯ੳ੯ੳ੮͸˺̼ˌ੮ͅ˺˚ʇ੮ˌʮ˦ʁ੮˺ʠ੮˚ɘʡʮɻ੮ɺ;੮ ͷʮ̼͙͐ʇ੮˺ʠ੮ʮ͐੮ɺʇʮ˦ʡ੮ˑɘɺʇˑʇʁ੮ɘ੮̹ͅ;ɻʩ੮યʩ˺̹ͅʮ͐ɘˑરੳ੯ੳ੯ੳ੯ੳ੮"͙͐੮͸ʇૄ̼ʇ੮ʮ˦੮͐ʩʇ੮ɺ͙ͅʮ˦ʇͅͅ੮˺ʠ੮ɻ̼˺͸ʁ੮ ɻ˺˦̼͐˺ˑੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ˈ͙͐ͅ੮ʩɘͷʇ੮͐˺੮˚ɘˌʇ੮͙̼ͅʇ੮͐ʩɘ͐੮˦˺ɺ˺ʁ;ૄͅ੮ϲʮʡʩ͐ʮ˦ʡੳૂ

184

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

They weren’t that successful. Violence was omnipresent. Thatcher said (sarcastically), “Another cool moment was when this super-young woman at John Iʇ˺̼ʡʇઝʮ͐ૄͅ੮ˑʮˌʇੴ੮ͷʇ̼;੮ͅˌʇ͸ʇʁੴ੮˚˺͐ͅˑ;੮˚ʇ˦ઝͅ˺˚ʇ੮ʁ͙ʁʇ੮̼͐ʮʇʁ੮͐˺੮͐˺͙ɻʩ੮ʩʇ̼੮͸ʩʮˑʇ੮ she was sleeping or something, and she clocked him in the face.”৾৻ Women, unsurprisingly, tend to see psychiatric hospitalizations as more traumatic and coercive than men.৾ৼ੮ r˺̼̼ɘʮ˦ʇੴ੮ ͸ʩ˺˚੮ Uૄˑˑ੮ ̹̼˺ϲʮˑʇ੮ ʮ˦੮ ͐ʩʇ੮ ˦ʇͽ͐੮ ɻʩɘ̹͐ʇ̼ੴ੮ ͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ ͸˺͙˦ʁ੮ ͙̹੮ʮ˦੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͸ʩʇ̼ʇ੮ɘͅͅɘ͙ˑ͐੮ͅʇʇ˚ʇʁ੮ɺɘ˦ɘˑੵ੮ુĚ˺͙੮ʡʇ͐੮ʩʮ͐੮ɘ੮ˑ˺͐ੳ੯ੳ੯ੳ੯ੳ੮U੮͸˺͙ˑʁ੮ just be sitting down playing cards with somebody, and then I would have my back towards [other patients], and they would come and just hit me in the back ˺ʠ੮͐ʩʇ੮ʩʇɘʁੳૂ੮U˦੮৲ৰৱ৹ੴ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ;͐ͅʇ˚੮ˑ˺ʡʡʇʁ੮৳ੴ৵ৱ৳੮ʮ˦ɻʮʁʇ˦͐ͅ੮˺ʠ੮ͷʮ˺ˑʇ˦ɻʇ੮ between patients. (In fairness, this number has gone down over the decade.)৾৽ ˑ͐ʩ˺͙ʡʩ੮̹ɘ͐ʮʇ˦͐ચ˺˦ચ̹ɘ͐ʮʇ˦͐੮ͷʮ˺ˑʇ˦ɻʇ੮ʮͅ੮˚˺̼ʇ੮ɻ˺˚˚˺˦ੴ੮ʮ˦੮৲ৰৰ৴੮ɘ੮ʁ˺ɻ͐˺̼੮͸ɘͅ੮ strangled to death in John George.৾৾ Risks to staff further down the hierarchy, who spend far more time on wards, are greater. The Bureau of Labor Statistics reports that psychiatric technicians and aides have some of the highest rates of injuries of any occupation.৾৿ A psychiatrist at a public hospital explained to me, “I tell my staff, ‘Just like we use universal precautions against infection, assume ʇͷʇ̼;˺˦ʇ੮ʮͅ੮ͷʮ˺ˑʇ˦͐੮͙˦͐ʮˑ੮̹̼˺ͷʇ˦੮˺͐ʩʇ̼͸ʮͅʇ੯ੳ੯ੳ੯ੳ੮ɺʇɻɘ͙ͅʇ੮;˺͙੮ɻɘ˦ૄ͐੮ͅ˺̼͐੮ʮ͐੮˺͙͐੮ય͸ʩ˺੮ is at risk and who isn’t].’” You can imagine how these kinds of admonitions reverɺʇ̼ɘ͐ʇ੮ɺɘɻˌ੮˺˦੮̹ɘ͐ʮʇ˦͐ͅઝʇʮ͐ʩʇ̼੮͐ʩ̼˺͙ʡʩ੮̼ʇ͐ɘˑʮɘ͐˺̼;੮ͷʮ˺ˑʇ˦ɻʇ੮˺̼੮ɘ੮͸ɘ̼ʮ˦ʇͅͅ੮͐ʩɘ͐੮ makes a supposedly healing environment feel like a battleground. Perhaps the only thing Thatcher got out of their stay at John George was ͅ˺ˑʮʁɘ̼ʮ͐;੮ ͸ʮ͐ʩ੮ ˺͐ʩʇ̼ͅ੮ ͸ʩ˺੮ ̹ʇ̼ɻʇʮͷʇʁ੮ ͐ʩʇ੮ ̹ˑɘɻʇ੮ ɘͅ੮ ʇή͙ɘˑˑ;੮ ̼͐ɘ͙˚ɘ͐ʮΈʮ˦ʡੳ੮ ુ੮ ˑ˺͐੮ of Black people in particular who had experienced incarceration at John George would be like, ‘Oh, we’re familiar with that situation,’” Thatcher reported. They ͸ʇ˦͐੮˺˦ੴ੮ુĔʩʇ˦੮U੮ˑʇʠ͐੮k˺ʩ˦੮Iʇ˺̼ʡʇ੯ੳ੯ੳ੯ੳ੮ͅ˺˚ʇ੮̼ɘ˦ʁ˺˚੮̹ʇ̼ͅ˺˦੮ʮ˦੮äɘ˦੮rʇɘ˦ʁ̼˺੮ʡɘͷʇ੮ me a cigarette. And I was like, ‘Why’d you give me a cigarette?’ and she was like, ‘I saw your sandals. [They mean] you’re either coming from Santa Rita [Jail] or John George, and I know you need a cigarette.’” Experiences like Thatcher’s capture the disparity in perceptions that polarizes ʁʇɺɘ͐ʇͅ੮ɘ̼˺͙˦ʁ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇੳ੮îʩʇ੮ુˑɘ˚ʇʁɘ੮˚˺ʁʇˑૂઝʮ˦੮͸ʩʮɻʩ੮ɘˑˑ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮ʠ͙˦˦ʇˑʇʁ੮͐˺੮ɘ੮ͅʮ˦ʡˑʇੴ੮̹ͅʇɻʮɘˑʮΈʇʁ੮ʩ˺̹ͅʮ͐ɘˑ੮ˑʮˌʇ੮k˺ʩ˦੮Iʇ˺̼ʡʇઝʩɘͅ੮ been hyped in academic journals by its founders and was even considered by legislators as a statewide model.৾਀ Meanwhile, a recent Department of Justice ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ˑɘ˚ɺɘ͐ͅʇʁ੮k˺ʩ˦੮Iʇ˺̼ʡʇੴ੮ή͙˺͐ʮ˦ʡ੮ɘ˦੮ʇͽચ̹ɘ͐ʮʇ˦͐੮͸ʩ˺੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈʇʁ੮ʮ͐੮ as the “closest thing to Hell I’ve encountered.”৾ਁ

NEGLECT AND ABUSE

185

As Esmé Weijun Wang writes, “My hope is that I’ll stay out of those cages for ͐ʩʇ੮̼ʇ͐ͅ੮˺ʠ੮˚;੮ˑʮʠʇੳ੯ੳ੯ੳ੯ੳ੮U੮ɺʇˑʮʇͷʇ੮͐ʩɘ͐੮ɺʇʮ˦ʡ੮ʩʇˑʁ੮ʮ˦੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͸ɘ̼ʁ੮ɘʡɘʮ˦͐ͅ੮˚;੮ will remains among the most scarring of my traumas.”৾ਂ To look at the experiences of people like Florence or Thatcher and assume that their skepticism of inpatient treatment is only a product of anosognosia means discounting their ʇͽ̹ʇ̼ʮʇ˦ɻʇͅઝ͸ʩʮɻʩੴ੮͐ʩʇ੮ʁɘ͐ɘ੮ɘ̼ʇ੮ɻˑʇɘ̼ੴ੮ɘ̼ʇ੮ʠɘ̼੮ʠ̼˺˚੮ɘɺʇ̼̼ɘ͐ʮ˺˦ͅੳ੮š˦ʇ੮͙͐ͅʁ;੮˺ʠ੮ public psychiatric patients found that 59 percent had been placed in seclusion, ৲৹੮̹ʇ̼ɻʇ˦͐੮ુ͐ɘˌʇ˦੮ʁ˺͸˦ૂ੮ɺ;੮͐ͅɘʠʠੴ੮৲৴੮̹ʇ̼ɻʇ˦͐੮̼͐ͅʮ̹ચͅʇɘ̼ɻʩʇʁੴ੮ৱ৴੮̹ʇ̼ɻʇ˦͐੮ɺ͙ˑˑʮʇʁ੮˺̼੮ abused, and 8 percent sexually assaulted in mental health settings.৾ਃ Conversations about increasing the number of beds should not sidestep why some people are too afraid to fall asleep in those beds.

ENDLESS INSTITUTIONALIZATION DIDN’ T END Thatcher’s repeated hospitalizations were awful. They were also short, usually ˑɘ͐ͅʮ˦ʡ੮ˈ͙͐ͅ੮ʠʇ͸੮ʁɘ;ͅੳ੮ä͙ɻʩ੮̼ɘ̹ʮʁ੮ʁʮͅɻʩɘ̼ʡʇͅ੮ɘ̹̹ʇɘ̼੮͐˺੮ɻ˺˦ϲʮ̼˚੮͐ʩʇ੮͸ʮʁʇ̹̼ͅʇɘʁ੮ narrative that LPS has made long-term institutionalization “virtually impossible.”৾਄ Yet on my visit to an IMD, I meet a woman who had been inside for twelve years. “Nobody will take her,” Simon, the director, tells me, because in addition to treatment-resistant schizophrenia, she had a stroke (despite being in her forties). “She could go to a nursing home, but she’d have no life there. She’d be with people in bed all day.” I muse in response, “Sometimes I think our society doesn’t want to believe people like her exist.” “They don’t,” Simon tells me. “She’s invisible.” Extended and expensive institutionalization is cause for bureaucratic ϲʮ˦ʡʇ̼ચ̹˺ʮ˦͐ʮ˦ʡ੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐˺̼੮U੮̹ͅ˺ˌʇ੮͐˺ੴ੮ʠ˺̼੮ example, explained that some people “live in” acute hospitals because county ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ʡʮͷʇ੮͙̹੮˺˦੮ϲʮ˦ʁʮ˦ʡ੮ɘ੮̹ˑɘɻʇ˚ʇ˦͐੮ʠ˺̼੮͐ʩʇ˚ੳ੮U{)੮ clinicians blame public guardians, who can decide that a person has “failed” in ͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮ͅ˺੮˚ɘ˦;੮͐ʮ˚ʇͅ੮͐ʩɘ͐੮ʮ͐੮ʮͅ੮ͅɘʠʇ̼੮͐˺੮ˑʇɘͷʇ੮͐ʩʇ˚੮ʮ˦ʁʇϲʮ˦ʮ͐ʇˑ;੮ʮ˦͐ʇ̼˦ʇʁੳ੮ Public guardians, for their part, accuse contracted outpatient teams of refusing ͐˺੮ɻ˺˦ͅʮʁʇ̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʠ˺̼੮͐ͅʇ̹ચʁ˺͸˦੮̹̼˺ʡ̼ɘ˚ͅੳ੮ફîʩʇ;੮ɘ̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮ʁʮϲϲʮɻ͙ˑ͐੮ clients that hurt their performance metrics.) And courts, which LPS’s boosters believed would “very effectively end the possibility of throwing people in a

186

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

mental hospital and forgetting about them,”৿৻ might mechanically sign off on renewals of conservatorship year after year. Lengthy internments can also be reinforced by dependency engendered by a loss of self those institutions themselves can cultivate. Sociologist Erving Goffman, in his 1961 exposé of state hospitals, documented the rituals that stripped ɘ͸ɘ;੮ɘˑˑ੮͐ʩʇ੮˚ɘ̼ˌʇ̼ͅ੮͐ʩɘ͐੮ɘ੮̹ɘ͐ʮʇ˦͐੮͸ɘͅ੮ɘ˦੮ુɘʁ͙ˑ͐੯ੳ੯ੳ੯ੳ੮ય͸ʮ͐ʩર੮ͅʇˑʠચʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦ੴ੮ autonomy, and freedom of action” (think of giving up all one’s personal possessions and replacing them with hospital pajamas, or losing control of with whom one’s intimate personal details are shared).৿ৼ Yet even in places where “existence ʮͅ੮ɻ͙͐੮͐˺੮͐ʩʇ੮ɺ˺˦ʇੴૂ੮I˺ʠʠ˚ɘ˦੮ɘ̼ʡ͙ʇʁੴ੮̹ʇ˺̹ˑʇ੮ϲʮ˦ʁ੮͸ɘ;ͅ੮͐˺੮ુϲˑʇͅʩ੮˺͙͐੮͐ʩʇʮ̼੮ˑʮͷʇͅੳૂ৿৽ That indomitable capacity to adapt to extreme circumstances, though, ultimately converts “inmates” into “programmed” or “built-in” creatures of these “total institutions,” unable to return to the world outside them.৿৾੮ ä͙ɺͅʇή͙ʇ˦͐੮ ̼ʇͅʇɘ̼ɻʩ੮ʩɘͅ੮ɻ˺˦ϲʮ̼˚ʇʁ੮͐ʩʇ੮ɻɘ͐ɘ̼͐ͅ˺̹ʩʮɻ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮̹̼˺ˑ˺˦ʡʇʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦alization for people’s capacity to live autonomous lives.৿৿ The story of a beloved son, who received so much institutional care yet was left with so little on the other end of it, speaks to the continued relevance of this framework six decades later. Joyce, a sprightly eighty-nine-year-old, recalled that ʩʇ̼੮ͅ˺˦੮k˺ʇੴ੮˦˺͸੮ͅʮͽ͐;ચϲʮͷʇੴ੮ɘɻ͙͐ɘˑˑ;੮ʁʮʁ੮̹̼ʇ͐͐;੮͸ʇˑˑ੮˺˦ɻʇ੮ʩʇ੮͐ͅɘ̼͐ʇʁ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ ɘʠ͐ʇ̼੮ʩʮͅ੮ϲʮ̼͐ͅ੮̹ͅ;ɻʩ˺͐ʮɻ੮ɺ̼ʇɘˌ੮ફɘ͐੮ɘʡʇ੮˦ʮ˦ʇ͐ʇʇ˦બੳ੮îʩɘ͐੮͙ͅ˚˚ʇ̼ੴ੮ʩʇੴ੮ʩʮͅ੮ɺ̼˺͐ʩʇ̼੮ Jack, and some friends went swimming in the river near their home in the Central Valley. Jack got caught in the current, and Joe went in after him. Years later, Joe still comforts Joyce, telling her she doesn’t have to feel bad about the incident. His brother Jack, Joe reports, is living happily in Los Angeles, working at a 7/11. Except that he isn’t. Jack drowned. And, Joyce told me, the experience sent Joe “clear over the cliff.” Joyce is as sharp as a tack, but she’d have to dig up her old journals to count ʩ˺͸੮˚ɘ˦;੮͐ʮ˚ʇͅ੮k˺ʇ੮͸ɘͅ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʇʁ੮˺ͷʇ̼੮͐ʩʇ੮͙ͅɺͅʇή͙ʇ˦͐੮ϲʮʠ͐ʇʇ˦੮;ʇɘ̼ͅੳ੮Pʇ੮ went onto conservatorship in 1976, in order to participate in an “orthomolecular treatment” trial at Napa State Hospital, which entailed consuming huge doses of vitamins (the approach seems not to have been effective enough to make it into psychiatry’s therapeutic arsenal).৿਀ She hoped the conservatorship would “guide him [Joe] towards rehabilitation,” but his public guardian had the mentality of “‘Well, he’s on conservatorship, so we’ll just send him here or send him there,’ not because it’s the best place, but because there’s an opening.” In the late 1980s, the place with an opening was an IMD where sixty patients were “drugged out

NEGLECT AND ABUSE

187

and walking around like zombies.” Joyce and her husband accompanied Joe to his austere room, where he sat on the bed and told her, “It’s okay Mom, I’ll stay.” But once they got to the parking lot, Joyce’s husband started sobbing, “I can’t do this. I just can’t do this.” They took him home. She did everything she could for her son. She went back to school to become a nurse. She joined the county mental health board. She found a private residential treatment program in Los Angeles whose psychiatrist called her and said “if you just have the money, I can heal your son.” She was ready to put her house up for sale to pay for it, until her friends talked her out of it. She still had to think of herself and her other children. In 1991, she nagged Joe’s conservator to put him on Clozaril, a potent new antipsychotic. When the public guardian wouldn’t, she found a doctor on her own who made the medication switch. Within six months, ͅʩʇ੮ ̼ʇɻ˺͙˦͐ʇʁੴ੮ ુ;˺͙੮ ɻ˺͙ˑʁ੮ ʩɘͷʇ੮ ɘ੮ ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮ ͸ʮ͐ʩ੮ ʩʮ˚ૂ੮ ʠ˺̼੮ ͐ʩʇ੮ ϲʮ̼͐ͅ੮ ͐ʮ˚ʇ੮ ʮ˦੮ years. By some metrics, her efforts turned Joe into a shining success: for three decades, he has stayed out of psychiatric hospitals, has not had a single arrest, and has spent zero days homeless. But he has never come home and never lived on his own. By the time Joe got effective treatment, Joyce thinks, “too much damage had been done” to his brain. “I always wanted him to get well. And it took a long time before it dawned on me that he’s probably not going to be able to function in society on his own,” she confessed. For twelve years, Joe lived at Psynergy, an unlocked residential treatment facility. Joyce said he did “really well.” Partly, that meant he adapted to insti͙͐͐ʮ˺˦ɘˑ੮ˑʮʠʇੴ੮ુɘɺˑʇ੮͐˺੮ɺɘ͐ʩʇ੮ʩʮ˚ͅʇˑʠ੮ɘ˦ʁ੮͐ɘˌʇ੮ɻɘ̼ʇ੮˺ʠ੮ʩʮ˚ͅʇˑʠઝ͸ʮ͐ʩ੮̹̼˺˚̹͐ʮ˦ʡੳ੮ Able to negotiate the facility, follow instructions.” But mostly, Joyce meant that he was “doing well” because he was happy and had friends. Those friends would ϲʮ˦ʮͅʩ੮͐ʩʇʮ̼੮͐ʩʇ̼ɘ̹ʇ͙͐ʮɻ੮̹̼˺ʡ̼ɘ˚੮ɘ͐੮Øͅ;˦ʇ̼ʡ;੮ɘ˦ʁ੮͐ͅʇ̹੮ʁ˺͸˦੮ʮ˦͐˺੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ housing. They were being given what disability rights organizations call a “right to fail,” a chance to live independently even if success is uncertain.৿ਁ Joe stayed. Joyce admitted, “I feel really guilty, because my son probably could have survived on the streets, but I just couldn’t do that.” He had failed too many times for her to want to see it again. A staff member at Psynergy had the same realization: “When I started here, one of my goals was, ‘How do we get these clients off conservatorship and make them independent?’ But I realized that ৲ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮˺͙̼੮ɻˑʮʇ˦͐ͅ੮˦ʇʇʁ੮͐ʩɘ͐੮ˑʇͷʇˑ੮˺ʠ੮͙̹̹ͅ˺̼͐੮યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ʠ˺̼ʇͷʇ̼੯ੳ੯ੳ੯ੳ੮ ͅ˺੮;˺͙੮̼ʇɘˑʮΈʇ੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮ͅʩ˺͙ˑʁ੮ɺʇੴ੮ૃP˺͸੮ʁ˺੮͸ʇ੮˚ɘˌʇ੮͙̼ͅʇ੮̹ʇ˺̹ˑʇૄͅ੮˦ʇʇʁͅ੮ are being met?’”

188

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

But Joe got older, and his needs changed. Decades of heavy medication made ʩʮ˚੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮͙˦͐ͅʇɘʁ;੮˺˦੮ʩʮͅ੮ʠʇʇ͐੮͙˦͐ʮˑੴ੮ʮ˦੮৲ৰ৲ৱੴ੮ʩʇ੮ʠʇˑˑ੮ɘ˦ʁ੮ɺ̼˺ˌʇ੮ʩʮͅ੮ɘ̼˚ੳ੮Pʇ੮ ͸ɘͅ੮ɻ˺˦ϲʮ˦ʇʁ੮͐˺੮ɘ੮͸ʩʇʇˑɻʩɘʮ̼ੳ੮Pʮͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮˚˺ͷʇʁ੮k˺ʇ੮͐˺੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇ੮ʠ˺̼੮ “rehabilitation,” without even telling Joyce beforehand. (Conveniently, the move shifted Joe from the county’s ledgers to the federal government’s, since Joe was now old enough for Medicare.) Regulations make it almost impossible to put people who have a mental illness and people who are elderly in the same board and care. The rule makers seemed to assume people like Joe would die young.৿ਂ Psynergy would like to take him back, but the public guardian told Joyce, “You’re getting old and Joe’s getting weak, so this is where he will end up the rest of his life.” It’s a sorry denouement to what Joyce insists has, all in all, been a “wonderful life.” When Joyce goes to visit Joe, “the bed isn’t clean, he’s wearing somebody else’s clothes, or he’s dressed inappropriately.” They don’t even have a dedicated phone for patients anymore, claiming COVID makes it too hazardous. Joyce doesn’t blame the staff; she, like Goffman, blames the place: “It’s the facility. It’s the way it’s governed. It’s old and crumbling. It’s dirty. It’s depressing. It’s not conducive to a person getting well.” Joyce often leaves her visits crying: “My heart is breaking. Because I don’t have the strength or ability to bring him home.” Joe would like to go home too. He tells her that if only he could go home, Joyce and ʩʮͅ੮ʠɘ͐ʩʇ̼੮͸˺͙ˑʁ੮ʡʇ͐੮ɺɘɻˌ੮͐˺ʡʇ͐ʩʇ̼ઝʇͷʇ˦੮͐ʩ˺͙ʡʩ੮͐ʩʇ;੮͸ʇ̼ʇ੮͐ͅʮˑˑ੮˚ɘ̼̼ʮʇʁ੮͸ʩʇ˦੮ʩʇ੮ died a decade ago. Joe had long been adapted to institutional life, but he wasn’t resigned to it. He used to ask for a new hearing to contest his conservatorship every six months, so he could “get my life back.” Perhaps he implicitly knew, as Goffman argued, ͐ʩɘ͐੮͸ʩʮˑʇ੮ુͅ˺˚ʇ੮̼˺ˑʇͅ੮ɻɘ˦੮ɺʇ੮̼ʇચʇ͐ͅɘɺˑʮͅʩʇʁ੯ੳ੯ੳ੯ੳ੮ʮʠ੮ɘ˦ʁ੮͸ʩʇ˦੮ʩʇ੮̼ʇ͙̼͐˦ͅ੮͐˺੮͐ʩʇ੮ world, it is plain that other losses” that people suffer from lengthening internment become “irrevocable and may be painfully experienced as such.”৿ਃ For the past year, though, Joyce recounted, he’s stopped going to court. “There are a lot of things he would have fought before,” she sighed, “but now he’s tired.” For all of this, Joyce still believes Joe has a guardian angel. Decades ago, he ̼͐ʮʇʁ੮͸ɘˑˌʮ˦ʡ੮ͅʮͽ͐;ચϲʮͷʇ੮˚ʮˑʇͅ੮ʠ̼˺˚੮ʩʮͅ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮͐˺੮ͅʇʇ੮ʩʮͅ੮ʡ̼ɘ˦ʁ˚ɘ੶੮͸ʩʇ˦੮ night fell, he rang a stranger’s doorbell, and they let him sleep on their porch. Another time, a cop picked him up off the streets of Los Angeles and called Joyce to say, “I don’t want to take him to a hospital, they are so bad.” He’s certainly ʩɘʁ੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ઝ˺̼੮˚ɘ˦;ઝ˺ͷʇ̼੮͐ʩʇ੮ɻ˺͙̼ͅʇ੮˺ʠ੮ʠ˺̼͐;ચͅʮͽ੮;ʇɘ̼ͅੴ੮ɺ͙͐੮̼ʇɻʇ˦͐ˑ;੮ they’ve been as distant as an angel and less magnanimous. Mostly, though, Joe has

NEGLECT AND ABUSE

189

a mom, which is why Joyce is so afraid of what will happen when she’s not there ɘ˦;˚˺̼ʇੳ੮ુU੮͸ʮˑˑ੮ʁ˺੮ʇͷʇ̼;͐ʩʮ˦ʡ੮U੮ɻɘ˦੮ʠ˺̼੮ʩʮ˚੮͙˦͐ʮˑ੮˚;੮ʁ;ʮ˦ʡ੮ʁɘ;ੴૂ੮ͅʩʇ੮ɻ˺˦ϲʮʁʇʁੴ੮ ɺ͙͐੮ુUૄ˚੮ɘʠ̼ɘʮʁ੮Uૄ˚੮ʡ˺ʮ˦ʡ੮͐˺੮ʁʮʇ੮ɺʇʠ˺̼ʇ੮ʩʮ˚ੳૂ੮‡˺͐ʩʮ˦ʡ੮ʮ˦੮ϲʮͷʇ੮ʁʇɻɘʁʇͅ੮˺ʠ੮ɘʁͷ˺ɻɘɻ;੮ throughout the mental health system gives her, a deeply religious woman, faith that it can provide her son a life worth living when she’s gone. Joe received what many parents desperately want: a stabilizing conservatorship and consistent treatment. Thanks to that, he has avoided the worst abuses described in this chapter, be it handcuffs, mechanical restraints, or a forced ʮ˦ˈʇɻ͐ʮ˺˦ੳ੮Ěʇ͐੮ʁʇɻɘʁʇͅ੮̹ͅʇ˦͐੮ʮ˦ͅʮʁʇ੮ʩʮʡʩˑ;੮̼͙͐ͅɻ͙̼͐ʇʁ੮ͅʇ͐͐ʮ˦ʡͅੴ੮ɘ͐੮͐ʩʇ੮ɻ˺͐ͅ੮˺ʠ੮ή͙ʮ͐ʇ੮ ˑʮ͐ʇ̼ɘˑˑ;੮˚ʮˑˑʮ˺˦ͅ੮˺ʠ੮ʁ˺ˑˑɘ̼ͅੴ੮ɻ˺͙ˑʁ੮˦˺͐੮ʇή͙ʮ̹੮ʩʮ˚੮͸ʮ͐ʩ੮͐ʩʇ੮ͅˌʮˑˑͅ੮ɘ˦ʁ੮͙̹̹ͅ˺̼͐ͅ੮ʩʇ੮ needed to successfully leave. Sixty years of deinstitutionalization, which commentators like Goffman helped spark, has left most families afraid of seeing their loved ones abandoned outside of institutions. But it hasn’t entirely eliminated the fear of seeing them abandoned inside, very much alone.

CONCLUSION: NO ONE CARES ENOUGH What’s missing in many of the stories in this chapter is any clarity about who is accountable for these multiple failures and who has the authority to correct ͐ʩʇ˚ੳ੮Ø͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̼͐ͅʇͅͅ੮ʩ˺͸੮˺ͷʇ̼͐ͅɘ͐ʇʁ੮͐ʩʇʮ̼੮̹˺͸ʇ̼ͅ੮ɘ̼ʇੵ੮͐ʩʇ;੮ can’t make someone stop taking meth, for example, or force an IMD to accept an assaultive patient. But if they don’t have the regulatory authority, capacity, or incentive to tightly surveil the facilities they depend on to intern and medicate conservatees, who does? As coercion gets delegated, responsibility gets dissipated. The examples in this chapter suggest it is not just scarcity that explains why clinicians use their negative discretion to pull even very sick people off the conservatorship continuum. It’s also a weighing of the relative risks of being abandoned into autonomy versus coerced into institutions that cannot be depended upon to heal. One county hospital psychiatrist admitted, “I know what our hospital is like. It’s a really horrible place. It’s really scary. I would not want my relative up there. It might be more traumatizing for the patient [than being released]. If there’s any other way to help them, if they’re on the border, then I really have to try that [alternative].” This chapter contributes to a burgeoning body of investigations into the mistreatment of people on conservatorships. But the harms faced by people

190

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

with mental illness with public guardians may be, in aggregate, different than ͐ʩ˺ͅʇ੮˺ʠ੮˺͐ʩʇ̼੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮Uʠ੮͐ʩʇ੮ɻ̼ʮ͐ʮή͙ʇͅ੮˺ʠ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ ̹̼˺ɺɘ͐ʇ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɘ̼ʇ੮͸ʇˑˑ੮͙ͅ˚˚ʇʁ੮͙̹੮ɺ;੮͐ʩʇ੮ʮ̼˺˦ʮɻ੮͐ʮ͐ˑʇ੮˺ʠ੮͐ʩʇ੮‡ʇ͐ϲˑʮͽ੮ϲʮˑ˚੮ I Care a Lotઝʮੳʇੳੴ੮˺ͷʇ̼ɺʇɘ̼ʮ˦ʡ੮ɻ˺˦̼͐˺ˑ੮ɘ˦ʁ੮ʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦ઝ͐ʩʇ੮̹̼˺ɺˑʇ˚੮ʠ˺̼੮˚ɘ˦;੮ LPS conservatees is that no one cares enough.৿਄ The abuses of sovereign power over conservatees are compounded by the absence of external authority overseeing its use. î˺੮ɻˑ˺ͅʇੴ੮Uૄˑˑ੮̼ʇ͙̼͐˦੮͐˺੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮͸ʮ͐ʩ੮͸ʩʮɻʩ੮U੮ɺʇʡɘ˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੳ੮Øʇ˺̹ˑʇ੮ like Florence think that we should abolish conservatorship. Can you blame them?

CHAPTER 10

STABILIZATION AND RECOVERY

I

’ve never heard someone say they grew up wanting to be a conservator. Debby might have been born to be one without knowing it. She comes from three generations of college professors and got her degree in English literature. She spent a lot of the 1970s on spiritual pilgrimages in India. “I was kind of at loose ends, and one thing led to another, and just to pay the bills, U੮͐˺˺ˌ੮ɘ੮ˈ˺ɺ੮ɘ͐੮ɘ੮̹̼ʮͷɘ͐ʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑੴૂ੮ͅʩʇ੮ʇͽ̹ˑɘʮ˦ͅੳ੮äʩʇ੮͸ɘͅ੮ુˑʮ˦ʇ੮͐ͅɘϲϲૂੵ੮ ુĔʩʇ˦੮ɻˑʮʇ˦͐ͅ੮͸˺͙ˑʁ੮ɺʇ੮ɺ̼˺͙ʡʩ͐੮ʮ˦੮˺˦੮ɘ੮৵ৱ৵ৰੴ੮ʩɘ͙ˑʇʁ੮ʮ˦੮ɺ;੮͐ʩʇ੮̹˺ˑʮɻʇ੯ੳ੯ੳ੯ੳ੮;˺͙੮ ͐˺˺ˌ੮ɻɘ̼ʇ੮˺ʠ੮͐ʩʇ˚ੴ੮;˺͙੮ʁʮʁ੮͐ʩʇ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮̹ɘ̹ʇ̼͸˺̼ˌੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮̹͙͐੮̹ʇ˺̹ˑʇ੮ʮ˦੮ɘ੮͙͐ɺ੮ ͐ʩɘ͐੮͸ʇ੮ʩɘʁ੮ʮ˦੮ɘ੮˦͙̼ͅʇૄͅ੮͐ͅɘ͐ʮ˺˦ੴ੮ɺʇɻɘ͙ͅʇ੮˺ʠ͐ʇ˦͐ʮ˚ʇͅ੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ɺʇ੮ϲʮˑ͐ʩ;੮˺̼੮ɻ˺ͷered with lice.” She learned “what it’s like to deal with a schizophrenic coming in off his meds and putting him back on the street.” It was the “very front-line work” of a street-level bureaucrat people-processing in a shriveling public mental health system. She went back to school to be a marriage and family therapist but was “not really feeling it.” She applied for a job as a public guardian in Marin County, with no idea what it entailed. She caught a “bug” for the job. She’s convinced that what made her a good conservator is probably what would have made her a bad ͐ʩʇ̼ɘ̹ʮ͐ͅੵ੮ુĚ˺͙੮ʩɘͷʇ੮͐˺੮̼ʇɘˑʮΈʇ੮;˺͙ૄ̼ʇ੮ʠ˺ˑˑ˺͸ʮ˦ʡ੮ɘ੮ˑʇʡɘˑ੮ɻ˺ʁʇੳ੯ੳ੯ੳ੯ੳ੮U͐ૄͅ੮˦˺͐੮ʠ˺̼੮ʇͷʇ̼;body that is working on mental health, you need a more directive, assertive kind ˺ʠ੮̹ʇ̼ͅ˺˦ɘˑʮ͐;ੳૂ੮Pʇ̼੮˺ϲϲʮɻʇ੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮ɺ̼˺͙ʡʩ͐੮ʮ˦੮̹ͅ;ɻʩ˺ˑ˺ʡʮ͐ͅͅ੮͸ʮ͐ʩ੮ʁ˺ɻ͐˺̼ɘ͐ʇͅੴ੮ ɺ͙͐੮͐ʩʇ;੮ુɘ̼ʇ੮˦˺͐੮ʡ˺˺ʁ੮ɘ͐੮ʮ͐੮ɺʇɻɘ͙ͅʇ੮ʮ͐ૄͅ੮ʁʮ̼͐;੮͸˺̼ˌੳ੮îʩʮͅ੮ʮͅ੮˦˺͐੮ͅʇͽ;ੳ੮Ě˺͙ૄ̼ʇ੮͸ʮ͐ʩ੮ people who are not well. That’s why there’s a lot of turnover in public guardians, ɘ੮ˑ˺͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮ɻ˺˚ʇ੮ʮ˦੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃîʩʮͅ੮ʮͅ੮˦˺͐੮͸ʩɘ͐੮U੮̹ͅʇ˦͐੮ϲʮͷʇ੮;ʇɘ̼ͅ੮ʮ˦੮ʡ̼ɘʁ͙ɘ͐ʇ੮ school for.’” Except for a brief hiatus in the 1990s, Debby stayed in the profession until retiring a few months after I talked to her in 2021.

192

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

U˦੮͐ͅɘ͐ʇͅ੮ˑʮˌʇ੮‡ʇ͸੮Ě˺̼ˌੴ੮ɘ੮̹ʇ̼ͅ˺˦੮ɻɘ˦੮ɺʇ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ɻ˺˚˚ʮ͐͐ʇʁ੮͐˺੮ɘ੮̹ͅ;chiatric facility for a long period without a court ever appointing a legal guardʮɘ˦ੳ੮U˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ˑ˺˦ʡʇ̼ચ͐ʇ̼˚੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮̼ʇή͙ʮ̼ʇͅ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੴ੮͸ʩ˺੮ is yet another player in the professional mélange of psychiatrists, case managers, ̹˺ˑʮɻʇੴ੮̹̼˺ɺɘ͐ʮ˺˦੮˺ϲϲʮɻʇ̼ͅੴ੮ɘ˦ʁ੮ˈ͙ʁʡʇͅ੮ʮ˦͐ʇ̼ͷʇ˦ʮ˦ʡ੮ʮ˦੮ɘ੮̹ʇ̼ͅ˺˦ૄͅ੮ˑʮʠʇੳ੮U੮͸˺˦ʁʇ̼ʇʁੴ੮ what value do conservators actually add? In some cases, not much. Public guardʮɘ˦ͅ੮ ͅʮʡ˦੮ ˺ʠʠ੮ ˺˦੮ ̹ˑɘɻʇ˚ʇ˦͐੮ ɻʩɘ˦ʡʇͅ੮ ɘ˦ʁ੮ ʇ˦͙̼ͅʇ੮ ͐ʩɘ͐੮ ̹ɘ̹ʇ̼ͅ੮ ɘ̼ʇ੮ ϲʮˑʇʁ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ court. But Debby shows how the key contribution of a conservator comes from acting as an engaged authority within the mental health system, rather than from exerting power over conservatees themselves. U˦੮ʩʇ̼੮ϲʮ̼͐ͅ੮̹˺ͅʮ͐ʮ˺˦ੴ੮ͅʩʇ੮ʩɘʁ੮ɘ੮ɻɘͅʇˑ˺ɘʁ੮˺ʠ੮ৱ৶ৰ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੴ੮͸ʩʮɻʩ੮͸ɘͅ੮˚ɘ˦ageable only because 90 percent of them were in nearby Napa State Hospital. Back then, it was still the era when, as the Los Angeles Times put it, conservators appeared to have “total power” to decide “when they [conservatees] get to see the sunshine again.”ৼ Even though Debby had realized she was a “more practical person” than her academic parents, she was nonetheless keeping up with the science of serious mental illness. In 1989, she learned about Clozaril, a new “magic bullet” antipsychotic for people with treatment-resistant psychosis that was being marketed as “bring[ing] patients back to life.”৽ She had a client at Napa State who was in restraint and seclusion 24/7 because “everything they devised to keep him ʠ̼˺˚੮ʩ͙̼͐ʮ˦ʡ੮ʩʮ˚ͅʇˑʠੴ੮ʩʇૄʁ੮˺˦ʇ੮͙̹੮͐ʩʇ˚੮યɺ;੮ϲʮ˦ʁʮ˦ʡ੮ɘ੮˦ʇ͸੮͸ɘ;੮͐˺੮ͅʇˑʠચʩɘ̼˚રੳૂ੮äʩʇ੮ went to her boss at the county mental health department and said, “We should try getting this guy on Clozaril.” He said there was no protocol for procuring such an expensive drug in the public system. So she drove to Sacramento to meet with the head of the then-existent State Department of Mental Health. “Long story short, I got a protocol [to purchase and use the drug],” she recounts, “and I got everyone in county management mad at me, they threatened me, and I had to go to the union to defend myself, ɺʇɻɘ͙ͅʇ੮ʮ͐ੴ੮ή͙˺͐ʇੴ੮ૃPɘʁ੮˦ʇͷʇ̼੮ɺʇʇ˦੮ʁ˺˦ʇ੮ɺʇʠ˺̼ʇੳૄૂ੮ફÛ˺ʁ੮äʩɘ˦ʇ̼ੴ੮ʠ̼˺˚੮r੮){Pੴ੮ told me the barriers to using Clozaril at the time also included liability concerns, since it can lead to seizures and a potentially fatal decline in white blood cells.) In any case, her client went on Clozaril and was out of Napa in six months. ુšʠ੮ɻ˺͙̼ͅʇ੮ʩʇૄͅ੮˦˺͐੮ɻ͙̼ʇʁੴૂ੮ͅʩʇ੮ɻɘ͙͐ʮ˺˦ʇʁੴ੮ɺ͙͐੮͐ʩʮ̼͐;ચϲʮͷʇ੮;ʇɘ̼ͅ੮ˑɘ͐ʇ̼ੴ੮ુʩʇૄͅ੮ʁ˺ʮ˦ʡ੮ ˺ˌɘ;੯ੳ੯ੳ੯ੳ੮ɘ͐੮͐ʩʇ੮ɺɘͅʇˑʮ˦ʇ੮͐ʩɘ͐੮ʩʇ੮͸ɘͅ੮̹̼˺ɺɘɺˑ;੮˚ʇɘ˦͐੮͐˺੮ɺʇ੮ɘ͐ੳૂ੮äʩʇ੮ɺʇˑʮʇͷʇͅ੮ʩʇ̼੮ advocacy helped open the door for other conservatees to gain access to Clozaril in the state hospital system.

S TA B I L I Z AT I O N A N D R E C OV E RY

193

)ʇɺɺ;੮ͅɘ͸੮ɘ˦੮ʇ˦ʡɘʡʇʁ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ɘͅ੮͸ʇɘ̼ʮ˦ʡ੮ɘ˦˺͐ʩʇ̼੮ʩɘ͐ੵ੮ુ͸ʩʇ˦੮ˈ͙ʁʡʇͅ੮ ask me, ‘How do you see your job?’ I say, ‘good parent,’ a parent that will help ͐ʩʇ੮̹ʇ̼ͅ˺˦੮ϲʮ˦ʁ੮͐ʩʇʮ̼੮ʩʮʡʩʇ͐ͅ੮ˑʇͷʇˑ੮˺ʠ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡੳૂ੮U˦੮ʩʮͅ੮ʇ͐ʩ˦˺ʡ̼ɘ̹ʩ;੮˺ʠ੮͙̹ͅʇ̼੮ high-end mental health services for the children of the rich and famous, Neil I˺˦ʡ੮ ʁʇͅɻ̼ʮɺʇͅ੮ ʩ˺͸੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ͙ͅʇ੮ ુɻ˺˦ɻʇ̼͐ʇʁ੮ ɻ˺˦̼͐ͅɘʮ˦͐ૂੵ੮ ɘ˦੮ ʮ˦͐ʇ˦͐ʮ˺˦ɘˑ੮ ɘ˦ʁ੮ deliberate application of psychiatric coercion to develop people’s capabilities.৾ #˺˦ͅʇ̼ͷɘ͐˺̼ͅ੮ˑʮˌʇ੮)ʇɺɺ;੮˚ʮʡʩ͐੮ɺʇ੮˺ʠʠʇ̼ʮ˦ʡ੮͐ʩʇ੮ɻʩʇɘ̹ੴ੮̹͙ɺˑʮɻ੮ʇή͙ʮͷɘˑʇ˦͐ੳ Debby told me about Laura, who was one of those “famous street people” that everyone wants managed but for whom no one wants responsibility. She was “bipolar with a bad meth problem,” a long sheet of 5150s, and many arrests. )ʇɺɺ;੮͸˺͙ˑʁ੮ͅʇʇ੮ʩʇ̼੮ʮ˦੮͐ʩʇ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁ੮͸ʩʇ̼ʇ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇ੮͸ɘͅ੮ located. Eventually, she asked her boss, “Why hasn’t anyone ever tried to get her on conservatorship?” They concluded that the local hospitals, with their “treat ’em and street ’em” approach, would never do it on their own. So the next time Laura was 5150ed, Debby called her outpatient case manager and said, “Let’s see if we can get her kept in the hospital.” )ʇɺɺ;ઝɘɻ͐ʮ˦ʡ੮ɘ੮ɺʮ͐੮ˑʮˌʇ੮ɘ˦੮˺ϲϲʮɻʮɘˑ੮ͷʇ̼ͅʮ˺˦੮˺ʠ੮nʇ̼̼;੮{˺̼̼ʮͅ˺˦ੴ੮͐ʩʇ੮"͙ͅʮ˦ʇͅͅ੮ Improvement District head who served as a “mission controller” for the conservatorship process—shepherded Laura onto conservatorship. It wasn’t a panɘɻʇɘੵ੮ુH˺̼੮ʇʮʡʩ͐੮;ʇɘ̼ͅੴ੮ͅʩʇ੮͸ɘͅ੮ͷ˺ˑɘ͐ʮˑʇੴ੮˚ʇ˦ɘɻʮ˦ʡੴ੮ˌʮɻˌʇʁ੮˺͙͐੮˺ʠ੮˺˦ʇ੮̹̼˺ʡ̼ɘ˚੮˺̼੮ ɘ˦˺͐ʩʇ̼ੳ੯ੳ੯ੳ੯ੳ੮äʩʇૄʁ੮̼͙˦੮ɘ͸ɘ;੮ʠ̼˺˚੮̹̼˺ʡ̼ɘ˚ͅੳ੯ੳ੯ੳ੯ੳ੮Uૄʁ੮ʡ˺੮˺ͷʇ̼੮ɘ˦ʁ੮ɻʩɘͅʇ੮ʩʇ̼੮ʁ˺͸˦ੴ੮ bring her back.” Debby recalls that Laura showed up at one conservatorship ̼ʇ˦ʇ͸ɘˑ੮ʩʇɘ̼ʮ˦ʡ੮ʩɘͷʮ˦ʡ੮ʇͅɻɘ̹ʇʁ੮ʠ̼˺˚੮ɘ੮ʠɘɻʮˑʮ͐;ੴ੮ʩʮʡʩ੮˺˦੮˚ʇ͐ʩੵ੮ુäʩʇ੮͸ɘͅ੮ͅʮ͐͐ʮ˦ʡ੮ɘ͐੮ the table with her attorney, screaming obscenities at the doctor who was trying to testify.” The judge declared, “Enough, I’m ruling this grave disability.” Debby and another deputy guarded her on a bench until law enforcement showed up to take her to the hospital. “She was sitting there screaming at the top of her ˑ͙˦ʡͅੴ੮ૃU੮ʩɘ͐ʇ੮;˺͙੮ɘˑˑੴ੮;˺͙੮ɘ̼ʇ੮ɻ˺˦ɻʇ˦̼͐ɘ͐ʮ˺˦੮ɻɘ˚̹੮̼ʇˈʇɻ͐ͅੳૄૂ੮)ʇɺɺ;੮ˑɘ͙ʡʩʇʁੵ੮ુU੮͸ɘͅ੮ thinking, ‘Not only are you in a concentration camp, but you’re so bad, they don’t even want you there!’” Most programs wouldn’t try Laura on Clozaril, because she was too unstaɺˑʇ੮ ɘ˦ʁ੮ ϲˑʮʡʩ͐;੮ ͐˺੮ ˚˺˦ʮ͐˺̼੮ ʠ˺̼੮ ͐ʩʇ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ૄͅ੮ ͅʮʁʇ੮ ʇʠʠʇɻ͐ͅੳ੮ "͙͐੮ )ʇɺɺ;੮ ˌʇ̹͐੮ searching until she found a psychiatrist willing to take the risk. “It helped her ʮ˚˚ʇ˦ͅʇˑ;ੴૂ੮ͅʩʇ੮̼ʇɻɘˑˑͅੳ੮ુU͐੮͸ɘͅ੮͐ʩʇ੮ϲʮ̼͐ͅ੮˦˺͐ɻʩ੮ʮ˦੮ʡʇ͐͐ʮ˦ʡ੮ʩʇ̼੮ɘ੮ˑʮ͐͐ˑʇ੮˚˺̼ʇ੮ɻ˺˺̹ʇ̼ɘ͐ʮͷʇੳૂ੮ʠ͐ʇ̼੮ϲʮʠ͐ʇʇ˦੮;ʇɘ̼ͅ੮˺ʠ੮͙˦͐ͅɘɺˑʇ੮̹ˑɘɻʇ˚ʇ˦͐ͅੴ੮)ʇɺɺ;੮ʠ˺͙ʡʩ͐੮ʩɘ̼ʁ੮͐˺੮ʡʇ͐੮ʩʇ̼੮ into a Crestwood-run board and care. She didn’t want to give too much credit to

194

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

̹̼ʮͷɘ͐ʇ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮̹̼˺ͷʮʁʇ̼ͅઝુUૄʁ੮˚ɘ;ɺʇ੮ʡʮͷʇ੮#̼ʇ͐ͅ͸˺˺ʁ੮ɘ੮#଱ૂઝɺ͙͐੮)ʇɺɺ;੮ˑʮˌʇʁ੮ the staff there, and so did Laura. ુäʩʇૄͅ੮ ʮ˦੮ ʩʇ̼੮ ͅʮͽ͐ʮʇͅ੮ ˦˺͸ੴૂ੮ )ʇɺɺ;੮ ̼ʇϲˑʇɻ͐ͅੴ੮ ુɘ˦ʁ੮ ɘ੮ ʠʇ͸੮ ;ʇɘ̼ͅ੮ ɘʡ˺ੴ੮ ͅʩʇ੮ ̼ʇɘˑˑ;੮ started to settle down.” Debby confesses that she “just got a call about her this ˚˺̼˦ʮ˦ʡੴ੮ͅʩʇૄͅ੮ɘɻ͐ʮ˦ʡ੮˺͙͐ੳૂ੮"͙͐੮ͅʩʇ੮ʮͅ੮˦˺੮ˑ˺˦ʡʇ̼੮ɘ੮̹ʇ̼ͅ˺˦੮ʁʇϲʮ˦ʇʁ੮ͅ˺ˑʇˑ;੮ɺ;੮ʩʇ̼੮ problems. Laura even reconnected with her one remaining family member and ͐ͅɘ̼͐ʇʁ੮͸̼ʮ͐ʮ˦ʡ੮̹˺ʇ̼͐;ੳ੮੮ʠʇ͸੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ɘ͐੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ assembled the poems into a book, “and in the title, front page of the book, she ͸̼˺͐ʇੴ੮ૃîʩʮͅ੮ʮͅ੮ʠ˺̼੮˚;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͸ʩ˺੮̼ʇɘˑˑ;੮ʩʇˑ̹ʇʁ੮˚ʇ੮ϲʮ˦ʁ੮˺͙͐੮͐ʩɘ͐੮U੮ɻ˺͙ˑʁ੮ be me, in a good way.’” The handful of studies on the outcomes of conservatorship mostly show where ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ͸ʮ˦ʁ੮ ͙̹ੵ੮ ʮ˦੮ ̹ˑɘɻʇ˚ʇ˦͐ͅ੮ ˑʮˌʇ੮ ˑ˺ɻˌʇʁ੮ U{)ͅ੮ ˺̼੮ ͙˦ˑ˺ɻˌʇʁ੮ ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ cares.৿ But as you’ll see in this chapter, conservatorship can achieve a range of other outcomes beyond simply keeping people out of jails or off the streets. Individual ̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੴ੮ ʠɘɻʮ˦ʡ੮ ˑʮ͐͐ˑʇ੮ ͐ͅɘ͐ʇ੮ ˺ͷʇ̼ͅʮʡʩ͐ੴ੮ ʁʇϲʮ˦ʇ੮ ɘ੮ ̹˺ͅʮ͐ʮͷʇ੮ ˺͙͐ɻ˺˚ʇ੮ in radically different ways. Some professionals aim for bare stabilization. Others pursue choice, independence, or recovery. The tactics they deploy to get there range from litigating over graph paper to haggling over medication compliance. What these uplifting stories at the end of the conservatorship continuum share is that they do not emerge from the exercise of legally anointed authority ɘ˦ʁ੮͐ʩʇ੮ʁʇˑʮɺʇ̼ɘ͐ʇ੮ʁʇͅʮʡ˦੮˺ʠ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇੳ੮U˦͐ͅʇɘʁੴ੮͐ʩʇ;੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ depend on the scrappy resourcefulness of professionals like Debby and the resilience of conservatees, working against and around the system.

CYCLES OF STABILIZATION Most people who go onto LPS conservatorships get off of them alive. This may surprise you. The widespread depiction is that “It’s nearly impossible to escape ɘ੮ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ʇͽɻʇ̹͐੮ʮ˦੮ɘ੮ɻ˺ϲϲʮ˦ੳૂ਀ Guardianship really may be a life sentence for many elderly people with dementia and might have been the case for Britney Spears had she not had an international movement agitating for her freedom.ਁ Ěʇ͐੮ɺ˺͐ʩ੮͐ʩʇ੮ˑʮ˚ʮ͐ʇʁ੮ή͙ɘ˦͐ʮ͐ɘ͐ʮͷʇ੮ʁɘ͐ɘ੮ɘͷɘʮˑɘɺˑʇ੮ɘ˦ʁ੮˚;੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮͸ʮ͐ʩ੮̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅ੮̹ɘʮ˦͐੮ɘ੮ɺʮʠ͙̼ɻɘ͐ʇʁ੮̹ʮɻ͙̼͐ʇੳ੮U˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʮ˦੮৲ৰৱ৸ੴ੮৶ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ʩɘʁ੮ ɺʇʇ˦੮ ˺˦੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʠ˺̼੮ ɘ͐੮ ˑʇɘ͐ͅ੮ ϲʮͷʇ੮ ;ʇɘ̼ͅੳ੮ ˚˺˦ʡ੮ ˦ʇ͸੮ referrals, though, two-thirds remained for less than a year.ਂ

S TA B I L I Z AT I O N A N D R E C OV E RY

195

These latter cases capture that, for some public guardians, the point of a conservatorship is to pull professionals together and buy them some time to address a crisis.ਃ੮)ɘ̼̼ʇˑˑੴ੮͸ʩ˺੮˚ɘ˦ɘʡʇͅ੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇ੮ʮ˦੮͐ʩʇ੮#ʇ˦̼͐ɘˑ੮ Valley, has a libertarian streak well-adapted to his county’s more limited social service infrastructure. So I wasn’t surprised that, when I asked for a “proud moment” in his long career, he reached for a case that suggested his ability not to promote lasting personal transformation but to alleviate immediate sufferʮ˦ʡੵ੮ુU੮˚ɘʁʇ੮ɘ੮̼ʇɘˑˑ;੮̼͐ͅ˺˦ʡ੮ɻɘͅʇ੮˚ɘ˦;੮;ʇɘ̼ͅ੮ɘʡ˺੮ɘɺ˺͙͐੮ɘ੮ɻˑʮʇ˦͐੮͸ʩ˺੮͸ɘͅ੮ૃ͙ͅɻcessfully homeless,’ she loved being on the street, she was thrilled to get pocket change from people, that was a rush for her,” he recounted. The public guardian stepped in because “she broke her ankle trying to get into a dumpster [looking for edible discarded food], [and] it wound up healing badly, holding at like a 40-degree angle from her foot.” We’ll talk in chapter 12 about how challenging it is to get medical and psychiatric services to work together. In this case, having a public guardian brokering ɺʇ͐͸ʇʇ˦੮˚͙ˑ͐ʮ̹ˑʇ੮ͅ;͐ͅʇ˚ͅ੮͸ɘͅ੮ɻ̼͙ɻʮɘˑੳ੮)ɘ̼̼ʇˑˑૄͅ੮˺ϲϲʮɻʇ੮̹̼˺ͷʮʁʇʁ੮ʇͷʮʁʇ˦ɻʇ੮͐˺੮͐ʩʇ੮ ˈ͙ʁʡʇ੮͐ʩɘ͐੮͐ʩʇ੮͸˺˚ɘ˦੮͸ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ફ;˺͙੮ɻɘ˦ૄ͐੮ʁ͙˚̹͐ͅʇ̼੮ʁʮͷʇ੮͸ʮ͐ʩ੮ɘ੮ɺ̼˺ˌʇ˦੮ʠ˺˺͐੸બੴ੮˺ͷʇ̼̼˺ʁʇ੮ʩʇ̼੮˺ɺˈʇɻ͐ʮ˺˦੮͐˺੮ʮ˦ͷɘͅʮͷʇ੮͙̼ͅʡʇ̼;੮ફɺ;੮ͅʩ˺͸ʮ˦ʡ੮ʩʇ̼੮˚ʇ˦͐ɘˑ੮ʮˑˑness interfered with her capacity to understand her medical condition), and used its placement power to keep her in a medical facility long enough for her foot to ʠ͙ˑˑ;੮ʩʇɘˑੳ੮îʩʇ੮˺͙͐ɻ˺˚ʇ੮͸ɘͅ੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮ુɺɘɻˌ੮˺˦੮ʩʇ̼੮ʠʇʇ͐ૂ੮ફˑʮ͐ʇ̼ɘˑˑ;બ੮ɘ˦ʁ੮ુɘɺˑʇ੮ ͐˺੮ˑʮͷʇ੮͐ʩʇ੮ˑʮʠʇ͐ͅ;ˑʇ੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮͙ͅʇʁ੮͐˺ૂ੮ફɺʇʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ੮ɘ˦ʁ੮ʁ͙˚̹͐ͅʇ̼੮ʁʮͷʮ˦ʡ੮ʠ˺̼੮ food). He’s convinced it’s an outcome that neither law nor medicine could have achieved on its own. This narrow aspiration can be frustrating to some people who fought hard to ʡʇ͐੮ͅ˺˚ʇ˺˦ʇ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮U੮ɻʩʇɻˌʇʁ੮ɺɘɻˌ੮ʮ˦੮͸ʮ͐ʩ੮nʮˑʇ;੮ફ͸ʩ˺ੴ੮ɘʠ͐ʇ̼੮;ʇɘ̼ͅ੮ ˺ʠ੮̼͐;ʮ˦ʡ੮͐˺੮ϲʮ˦ʁ੮ʡ˺˺ʁ੮ɻɘ̼ʇ੮ʠ˺̼੮ʩʇ̼੮ʁɘ͙ʡʩ͐ʇ̼੮#ˑɘ̼ʮͅͅɘੴ੮ɻ˺˦ɻˑ͙ʁʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ ͸ɘͅ੮ુɻˑʇɘ̼੮ɘͅ੮˚͙ʁૂબੳ੮nʮˑʇ;੮͸ɘͅ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺˦͐ͅɘ˦͐੮ુ˺ʩચͅʩʮ͐ੴ੮#ˑɘ̼ʮͅͅɘ੮ʮͅ੮ ɺɘɻˌ੮ʮ˦੮ˈɘʮˑૂ੮ˑʇ͐͐ʇ̼ͅ੮ͅʩʇ੮ͅʇ˦͐੮ɘɻ̼˺ͅͅ੮ɻ˺͙˦͐;੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ϲʮ˦ɘˑˑ;੮ʡ˺͐੮͐ʩʇ˚੮͐˺੮ુɘˑˑ੮ look around the room and say, ‘Oh my God, who’s in charge? This is embarrassʮ˦ʡੴ੮͐ʩʮͅ੮ʮͅ੮̼ʮʁʮɻ͙ˑ˺͙ͅੳૄૂ੮੮ɻ˺͙˦͐;੮͙̹ͅʇ̼ͷʮͅ˺̼੮ˑʇɘ˦ʇʁ੮˺˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮ˌʇʇ̹੮#ˑɘ̼ʮͅͅɘ੮ˑ˺˦ʡʇ̼੮ɘ˦ʁ੮ɘ̹̹ˑ;੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮nʮˑʇ;੮͸˺͙ˑʁ੮ુ̹͙͐੮ʩʇ̼੮ˑʮʠʇ੮˺˦੮ʮ͐ૂ੮͐ʩɘ͐੮ if they hadn’t “gotten [Clarissa] conserved when we did, by the end of that year [2020] she would have been dead. There’s no other way. She was so close.” Clarissa’s public guardian did what he arguably was supposed to do and tried to place her in a less restrictive, unlocked residential program. But “she kept

196

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

Ĕšrʮ˦ʡੴ੮ɘ˦ʁ੮͐ʩʇ;੮͸˺͙ˑʁ੮ϲʮ˦ʁ੮ʩʇ̼੮ʁ̼͙˦ˌੴ੮ͅ˺˚ʇ͸ʩʇ̼ʇ੮ʇˑͅʇੴ੮˺͙͐੮˺ʠ੮ʮ͐ੳૂ੮/ͷʇ˦͙͐ally, the public guardian sent her to an IMD and ordered her to take medication. H˺̼੮nʮˑʇ;ੴ੮͐ʩʇ੮̼ʇ͙ͅˑ͐ͅ੮͸ʇ̼ʇ੮ɘ੮͙ͅʁʁʇ˦੮̼ɘ;੮˺ʠ੮ʩ˺̹ʇੵ੮ુØ̼˺ɺɘɺˑ;੮͸ʮ͐ʩʮ˦੮͐ʩ̼ʇʇ੮͸ʇʇˌͅੴ੮ ;˺͙੮ɻ˺͙ˑʁ੮͐ͅɘ̼͐੮ʠʇʇˑʮ˦ʡ੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮͙̼͐˦ʮ˦ʡ੮ɘ̼˺͙˦ʁੳ੮Ě˺͙੮ɻ˺͙ˑʁ੮͐ͅɘ̼͐੮ɻ˺˦ͷʇ̼ͅɘtions with her, she was lucid. [Clarissa] was coming back. It was amazing.” ʠ͐ʇ̼੮ɘ੮ʠʇ͸੮˚˺˦͐ʩͅੴ੮͐ʩʇ੮U{)੮ʁʮͅɻʩɘ̼ʡʇʁ੮ʩʇ̼੮͐˺੮ɘ˦˺͐ʩʇ̼੮͙˦ˑ˺ɻˌʇʁ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ treatment program that her public guardian lined up. The cycle seemed to be ̼ʇ͐ͅɘ̼͐ʮ˦ʡੳ੮nʮˑʇ;੮͐˺ˑʁ੮˚ʇੴ੮ુU͐੮͸ɘͅ੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੳ੮˦ʁ੮͙̹̹ͅ˺ͅʇʁˑ;੮͐ʩʇ;੮ʩɘʁ੮ ɻ˺˦̼͐˺ˑੴ੮ɺ͙͐੮͐ʩʇ;੮ʁʮʁ˦ૄ͐ੳ੮îʩʇ̼ʇ੮͸ɘͅ੮˦˺੮͙̹̹ͅ˺̼͐ੳ੯ੳ੯ੳ੯ੳ੮îʩʇ੮͐ͅɘʠʠ੮͸ʇ̼ʇ੮ɘˑˑ੮͸ɘ͐ɻʩʮ˦ʡ੮îē੮ ͐˺ʡʇ͐ʩʇ̼ੴ੮ɘ˦ʁ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮͸ʇ̼ʇ੮͸ɘˑˌʮ˦ʡ੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ੮îʩʇ̼ʇ੮͸ɘͅ੮˦˺੮̼͙͐ͅɻ͙̼͐ʇ੯ੳ੯ੳ੯ੳ੮ યɘ˦ʁર੮ɘ੮ˑʮή͙˺̼੮͐ͅ˺̼ʇ੮યɘɻ̼˺ͅͅ੮͐ʩʇ੮̼͐ͅʇʇ͐રੳૂ੮nʮˑʇ;੮̹̼ʇ͙̼ͅͅʇʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺੮ transfer her daughter to a different program, which was still unlocked but had ͐ʮʡʩ͐ʇ̼੮̼͙ˑʇͅ੮ɘ˦ʁ੮˦˺੮ɘʁˈɘɻʇ˦͐੮ˑʮή͙˺̼੮͐ͅ˺̼ʇੳ੮#ˑɘ̼ʮͅͅɘੴ੮ɘʡɘʮ˦ੴ੮ͅʇʇ˚ʇʁ੮͐˺੮͐ͅɘɺʮˑʮΈʇੳ õ˦ʠ˺̼͙͐˦ɘ͐ʇˑ;੮ʠ˺̼੮nʮˑʇ;ੴ੮#ˑɘ̼ʮͅͅɘૄͅ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ˈ˺ʮ˦ʇʁ੮͐ʩʇ੮ુI̼ʇɘ͐੮Ûʇͅʮʡnation” of 2021, which gutted social service bureaucracies around the state, and ή͙ʮ͐ੳ੮îʩʇ੮˦ʇ͸੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ɻɘˑˑʇʁ੮#ˑɘ̼ʮͅͅɘ੮ɘ˦ʁੴ੮ɘʠ͐ʇ̼੮ɘ੮ͅʩ˺̼͐੮ɻ˺˦ͅʇ̼ͷɘ͐ʮ˺˦ੴ੮ɻ˺˦cluded that she was no longer gravely disabled. He would let the conservatorship ʇͽ̹ʮ̼ʇ੮ɘ͐੮͐ʩʇ੮˺˦ʇચ;ʇɘ̼੮˚ɘ̼ˌੳ੮ફÛʇ˚ʇ˚ɺʇ̼੮͐ʩɘ͐੮rØä੮ɻɘͅʇ੮ˑɘ͸੮̼ʇή͙ʮ̼ʇͅ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ ɺʇ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ʮ˦੮͐ʩʇ੮̹̼ʇͅʇ˦͐ੴ੮˦˺͐੮ˈ͙͐ͅ੮͐ʩʇ੮̹ɘ͐ͅ੮˺̼੮͐ʩʇ੮ʠ͙͙̼͐ʇੳબ੮nʮˑʇ;੮̹ˑʇɘʁʇʁ੮ ͸ʮ͐ʩ੮ʩʇ̼੮ʁɘ͙ʡʩ͐ʇ̼੮͐˺੮͐ͅɘ;੮ʮ˦੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚ੴ੮͐ʇˑˑʮ˦ʡ੮ʩʇ̼ੴ੮ુĚ˺͙ૄ̼ʇ੮˦˺͐੮̼ʇɘʁ;ੴ੮;˺͙ૄ̼ʇ੮ close, you’re starting to get some insight.” Clarissa was insistent, though, that ͸ʩʇ˦੮ͅʩʇ੮ʡ˺͐੮˺͙͐ੴ੮ͅʩʇૄʁ੮ʡ˺੮͐˺੮ɘ੮ʩ˺˚ʇˑʇͅͅ੮ͅʩʇˑ͐ʇ̼੮ʮ˦੮͐ʩʇ੮˦˺̼͐ʩ੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮nʮˑʇ;੮ hoped for a rainy winter so she would reconsider. ુĔʇૄͷʇ੮ʡ˺˦ʇ੮͐ʩ̼˺͙ʡʩ੮͐ʩʮͅ੮˚ɘ̼ɘ͐ʩ˺˦ੴ੮ɘ˦ʁ੮͸ʇૄ̼ʇ੮ͅ˺੮ɻˑ˺ͅʇ੮͐˺੮͐ʩʇ੮ϲʮ˦ʮͅʩ੮ˑʮ˦ʇੴ੮ɘ˦ʁ੮ ʮ͐ૄͅ੮ɺʇʮ˦ʡ੮̼ʮ̹̹ʇʁ੮˺͙͐ੴૂ੮nʮˑʇ;੮ˑɘ˚ʇ˦͐ʇʁੳ੮ͅ੮͐ʩʇ੮ʇ˦ʁ੮ʁɘ͐ʇ੮ʠ˺̼੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ approached, she forwarded me a new “oh-shit” letter. She wrote, “Is it responsible or even legal to basically go from ‘taking care of someone’ to releasing them into ɘ੮ʩ˺˚ʇˑʇͅͅ੮ͅʮ͙͐ɘ͐ʮ˺˦੺੯ੳ੯ੳ੯ੳ੮‡˺͐੮͙̼ͅʇ੮ʩ˺͸੮ʮ˦੮ʡ˺˺ʁ੮˚ʮ˦ʁ੮˺̼੮ɻ˺˦ͅɻʮʇ˦ɻʇ੮;˺͙੮ɻɘ˦੮ͅʇ˦tence her to a life on the street. She has come close on several occasions to killing ʩʇ̼ͅʇˑʠ੮ɘ˦ʁ੮˺͐ʩʇ̼ͅੳ੯ੳ੯ੳ੯ੳ੮äʩʇ੮ʩɘͅ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੴ੮ɺ͙͐੮ͅʩʇ੮ͅʩ˺͙ˑʁ੮ɘˑͅ˺੮ʩɘͷʇ੮ʩ͙˚ɘ˦੮̼ʮʡʩ͐ͅੳૂ੮ nʮˑʇ;ૄͅ੮̹ˑʇɘ੮͸ɘͅ੮͙˦͙ͅɻɻʇͅͅʠ͙ˑੳ੮Ĕʩʇ˦੮nʮˑʇ;੮ɘ˦ʁ੮U੮̹ͅ˺ˌʇ੮͐ʇ˦੮˚˺˦͐ʩͅ੮ɘʠ͐ʇ̼੮#ˑɘ̼ʮͅͅɘ੮ left conservatorship, she had been to four hospitals and eight detox facilities and had been arrested four times. ੮৲ৰ৲ৰ੮͐ͅɘ͐ʇ੮ɘ͙ʁʮ͐੮ʠ˺͙˦ʁ੮͐ʩɘ͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ɘͅ੮ɘ੮̼ʇͷ˺ˑͷʮ˦ʡ੮ʁ˺˺̼੮ʠ˺̼੮˚ɘ˦;ੳ੮ Of the sixty cases auditors reviewed, eighteen had already been on a conservatorship before their current one.਄੮ʁͷ˺ɻɘ͐ʇͅ੮ʠ˺̼੮ɘ੮̼˺ɺ͙͐ͅੴ੮̹ɘ͐ʇ̼˦ɘˑʮ͐ͅʮɻ੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮

S TA B I L I Z AT I O N A N D R E C OV E RY

197

serious mental illness might take this as a sign that the conservatorship system is failing. Indeed, for some family members, the fact that conditions like schizo̹ʩ̼ʇ˦ʮɘ੮ɘ̼ʇ੮ɻʩ̼˺˦ʮɻ੮ʮͅ੮̹̼ʇɻʮͅʇˑ;੮͸ʩ;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅʩ˺͙ˑʁ੮ɺʇ੮ʮ˦ʁʇϲʮ˦ʮ͐ʇੴ੮ɘͅ੮ʮͅ੮ ͐ʩʇ੮ɻɘͅʇ੮͸ʮ͐ʩ੮̹̼˺ɺɘ͐ʇ੮ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹ͅੳ੮ફnʮˑʇ;੮ˈ͙͐ͅ੮͸ʮͅʩʇͅ੮#ˑɘ̼ʮͅͅɘૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ had lasted two years instead of one.) Some counties, on the other hand, treat conservatorship like the governmental responses to wars or natural disasters. Conservatorship suspends normal rules and rights in a state of exception that, ideally, should be as short as possible.ৼ৻ One public guardian told me, “The goal of conservatorship is to have ͅ˺˚ʇ˺˦ʇ੮ ɻ˺˚ʇ੮ ˺ʠʠ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੯ ੳ੯ ੳ੯ ੳ੮ Uʠ੮ ͐ʩʇ;ૄ̼ʇ੮ ͐ͅɘɺˑʇੴ੮ ˚ʇʁ੮ ɻ˺˚̹ˑʮɘ˦͐ੴ੮ ɘ˦ʁ੮ have housing, we should be thinking about terminating conservatorship.” Some people would stop their medication, get hospitalized, and have a new conservatorship petition, and “we understand that. We in a way, expect it, because this is a chronic condition.” H˺ɻ͙ͅʮ˦ʡ੮ ˺˦੮ ɘ੮ ˚ʮ˦ʮ˚ɘˑ੮ ʁʇʡ̼ʇʇ੮ ˺ʠ੮ ͐ʇ˚̹˺̼ɘ̼;੮ ͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦੮ ɘͅ੮ ͐ʩʇ੮ ˚ʇ̼͐ʮɻ੮ ʠ˺̼੮ conservatorship’s success is one coherent if controversial way to balance law and medicine, in a way that leans toward civil rights. Whether that’s the right objec͐ʮͷʇ੮ʮͅ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ɘ੮̹ʩʮˑ˺ͅ˺̹ʩʮɻɘˑੴ੮˦˺͐੮ɘ੮ɻˑʮ˦ʮɻɘˑੴ੮ή͙ʇ͐ͅʮ˺˦ੳ

CHOICE AND DIGNITY AMID CONSTRAINT Other conservatees, far from revolving in and out of conservatorship, remain stuck in institutions, sometimes for decades. But even people facing ongoing ̼ʇ̼͐ͅʮɻ͐ʮ˺˦ͅ੮͐˺੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅ੮ɻɘ˦੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮ʡʮͷʇ˦੮ʁʮʡ˦ʮ͐;ੴ੮ɻʩ˺ʮɻʇੴ੮ɘ˦ʁ੮ɘ˦੮ attentive ear. The conservatees I interviewed often depicted conservatorship hearings as a ˦ʮʡʩ͐˚ɘ̼ʮͅʩ੮˚ʇʁʮɻɘˑચˑʇʡɘˑ੮ɻ˺˦̹ͅʮ̼ɘɻ;੮͐˺੮̼͐ͅʮ̹੮͐ʩʇ˚੮˺ʠ੮͐ʩʇʮ̼੮ɘ͙͐˺˦˺˚;ੳ੮ˑʇͽɘ˦ʁʇ̼ੴ੮ who had been conserved twice and hospitalized more times than he could count, ʠʇˑ͐੮͐ʩɘ͐੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅ੮ુ̼ʇ̹ʇɘ͐੮ɺɘͅʮɻɘˑˑ;੮͸ʩɘ͐੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ɘ̼ʇ੮ͅɘ;ʮ˦ʡੳ੯ੳ੯ੳ੯ੳ੮ îʩʇ;ૄ̼ʇ੮ɻˑɘʮ˚ʮ˦ʡ੮͐ʩʇ;ૄ̼ʇ੮ʁʇʠʇ˦ʁʮ˦ʡ੮;˺͙੮ɺ͙͐੮͐ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮˺˦੮͐ʩʇ੮˺͐ʩʇ̼੮͐ʇɘ˚ੳૂ੮ͅ੮ ʠ˺̼੮͐ʩʇ੮ˈ͙ʁʡʇͅੴ੮ુʮ͐ૄͅ੮ˑʮˌʇ੮ʩʇૄͅ੮ʡ˺ʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮ɘ੮̼ʇʩʇɘ̼ͅɘˑੴ੮ˑʮˌʇ੮ʮ͐ૄͅ੮͐ͅɘʡʇʁੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ˈ͙͐ͅ੮ ͸ɘ˦͐੮͐˺੮ϲʮ˦ʁ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮͐ʩɘ͐੮ˈ͙͐ͅʮϲʮʇͅ੮͐ʩʇ੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦ੴ੮͐ʩʇ੮ʮ˦͐ʇ̼˦˚ʇ˦͐ੴ੮͸ʩɘ͐ever.” He pointed out that “legally, you’re innocent until proven guilty,” but from talking to peers, he believed that “99 percent of conservatorships are awarded,” which suggested to him that maybe he didn’t have a right to have that right.

198

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

I wonder how he would have felt had he been represented by someone like ˑʮੳ੮Pʇ̼੮̼͐ɘˈʇɻ͐˺̼;੮ʮ˦͐˺੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮rØä੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʠ˺̼੮ɘ੮͙ͅɺ͙̼ɺɘ˦੮‡˺̼͐ʩʇ̼˦੮ California county wasn’t a deliberate one. ‘I decided to go part time because I had twins,’ she explained, ‘and I wound up on conservatorship because it tends to be something that’s seen as easier. They call it the “mommy track.’’ ’ Operating on her ˺͸˦ੴ੮ͅʩʇ੮˦˺˦ʇ͐ʩʇˑʇͅͅ੮ɘ͙ͅͅ˚ʇʁ੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮Έʇɘˑ˺͙ͅ੮ɘʁͷ˺ɻɘ͐ʇੳ੮Ĕʩʇ˦੮͸ʇ੮ϲʮ̼͐ͅ੮̹ͅ˺ˌʇ੮ʮ˦੮ 2018, she had defeated a surprising number of conservatorship petitions by insistʮ˦ʡ੮˺˦੮ɘ੮ɻˑʮʇ˦͐ૄͅ੮̼ʮʡʩ͐੮͐˺੮ɘ੮ˈ͙̼;੮̼͐ʮɘˑ੮ફ͸ʩʮɻʩ੮U੮ɻɘ˦੮˺˦ˑ;੮ɘ͙ͅͅ˚ʇ੮ɻɘ͙ͅʇʁ੮ɘˑˑ੮ͅ˺̼͐ͅ੮˺ʠ੮ ɻ˺˦͐ͅʇ̼˦ɘ͐ʮ˺˦੮ʠ˺̼੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ˑ˺˺ˌʮ˦ʡ੮͐˺੮̹ʇ˺̹ˑʇચ̹̼˺ɻʇͅͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ή͙ʮɻˌˑ;બੳ੮ ‘We are a more conservative county, and on the jury, I want that white male who voted for Trump who says, “He’s allowed to mumble to himself on the street. Why are we going to spend our tax dollars on someone who doesn’t want to be housed? Ĕʩ;੮ʮͅ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮͐ʩʮͅ੺੮rʇɘͷʇ੮ʩʮ˚੮ɘˑ˺˦ʇੴૄૄੰૄ੮ͅʩʇ੮ʇˑɘɺ˺̼ɘ͐ʇʁੳ ˑʮ੮ʮͅ੮˦˺͐ੴ੮ʮ˦੮̹̼ʮ˦ɻʮ̹ˑʇੴ੮˺̹̹˺ͅʇʁ੮͐˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮Uʠ੮ɘ˦;͐ʩʮ˦ʡੴ੮ͅʩʇૄʁ੮ ˑʮˌʇ੮͐˺੮ͅʇʇ੮rØä੮̼ʇʠ˺̼˚ʇʁ੮ુͅ˺੮͐ʩʇ;੮ɻɘ˦੮ϲʮˑʇ੮યʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ɺɘͅʇʁ੮˺˦੮˚ʇ͐ʩੳૂ੮ She knows that “it sounds so harsh, but the reality is they [her clients] are going to end up in jail. It’s not like conservatorship or nothing, it’s conservatorship or ˈɘʮˑੳૂ੮Ĕʩɘ͐੮U੮̼ʇɘˑˑ;੮ʠ˺͙˦ʁ੮ʁʮ͐ͅʮ˦ɻ͐ʮͷʇ੮ɘɺ˺͙͐੮ˑʮૄͅ੮ɘʁͷ˺ɻɘɻ;੮͸ɘͅ੮˦˺͐੮ʩ˺͸੮ʠ˺̼ɻʇʠ͙ˑˑ;੮ she wielded law against medicine, but the extent to which she wanted both of them to pay attention to the desires and preferences of the people they were supposed to serve. U੮ϲʮ̼͐ͅ੮̹ͅ˺ˌʇ੮͐˺੮ˑʮ੮ʮ˦੮৲ৰৱ৸ੴ੮ɘ˦ʁ੮ʠ˺ˑˑ˺͸ʇʁ੮͙̹੮͸ʮ͐ʩ੮ʩʇ̼੮ʮ˦੮৲ৰ৲ৱ੮̹ɘ̼͐ˑ;੮ɺʇɻɘ͙ͅʇ੮ U੮͸ɘ˦͐ʇʁ੮͐ʩʇ੮ʠ͙ˑˑ੮͐ͅ˺̼;੮˺ʠ੮͐ʩʇ੮ુʡ̼ɘ̹ʩ੮̹ɘ̹ʇ̼੮ʡ͙;ੳૂ੮ͅ੮ͅʩʇ੮̼ʇɻ˺͙˦͐ʇʁੴ੮ɘʠ͐ʇ̼੮ɘ੮ˑ˺˦ʡ੮ conversation with her client, she went before the judge to make an unconven͐ʮ˺˦ɘˑ੮̼ʇή͙ʇ͐ͅੵ੮ુU੮͐˺ˑʁ੮ʩʮ˚ੴ੮ૃ{;੮ɻˑʮʇ˦͐੮͸ʮˑˑ੮ɘɻɻʇ̹͐੮યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮͸ʮ͐ʩ੮͐ʩʇ੮˺˦ʇ੮ ɻ˺˦ʁʮ͐ʮ˺˦੮͐ʩɘ͐੮ʩʇ੮ɺʇ੮̹̼˺ͷʮʁʇʁ੮ʡ̼ɘ̹ʩ੮̹ɘ̹ʇ̼ੳૄ੮˦ʁ੮͐ʩʇ੮ˈ͙ʁʡʇੴ੮͸ʩ˺੮̼͙͐ͅɻˌ੮˚ʇ੮ˑʮˌʇ੮ ɘ˦੮ʇ˦ʡʮ˦ʇʇ̼੮̹ʇ̼ͅ˺˦ɘˑʮ͐;੮ʩʮ˚ͅʇˑʠ੯ੳ੯ੳ੯ੳ੮ˑʇɘ˦ʇʁ੮ʮ˦੮ɘ˦ʁ੮ͅɘʮʁੴ੮ૃĔʩɘ͐੮ͅʮΈʇ੮ʡ̼ɘ̹ʩ੮̹ɘ̹ʇ̼੺ૄ੮ ˦ʁ੮U੮ͅɘʮʁੴ੮ૃšʩੴ੮U੮ʩɘʁ˦ૄ͐੮͐ʩ˺͙ʡʩ͐੮͐˺੮ɘͅˌૄ੮ɘ˦ʁ੮ʩʇ੮ͅɘʮʁੴ੮ૃU͐੮˚ɘ͐͐ʇ̼ͅੳ੮Ĕʩ;੮ʁ˺˦ૄ͐੮;˺͙੮ ɘͅˌ੮ ɘ˦ʁ੮ ɻ˺˚ʇ੮ ɺɘɻˌ੺ૄૂ੮ äʩʇ੮ ή͙ʇ̼ʮʇʁ੮ ʩʇ̼੮ ɻˑʮʇ˦͐ੴ੮ ͸ʩ˺੮ ʩɘʁ੮ ɘ˦੮ ʮ˚˚ʇʁʮɘ͐ʇ੮ ɘ˦ͅ͸ʇ̼ੵ੮ one-eighth of an inch. She reported to the judge, who replied, “That’s what I thought.” The judge brought in the public guardian, and lectured, “‘I can’t technically order you to provide him with graph paper, but I’m going to strongly suggest as the judge in this case that he be provided with graph paper one-eighth ˺ʠ੮ɘ˦੮ʮ˦ɻʩ੮ͅή͙ɘ̼ʇੳૄ੮ä˺੮͐ʩʇ;੮ʁʮʁੳૂ I wanted to know why he wasn’t getting graph paper before then. She replied, ુU੮͐ʩʮ˦ˌ੮˚ɘ;ɺʇ੮ʩʇ੮͸ɘͅ੮ʡʇ͐͐ʮ˦ʡ੮ͅ˺˚ʇੴ੮ɺ͙͐੮ʩʇ੮͸ɘͅ੮ʡ˺ʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮ʮ͐੮ɘ͐੮ɘ੮ή͙ʮɻˌ੮ɻˑʮ̹ੳ੮

S TA B I L I Z AT I O N A N D R E C OV E RY

199

U͐੮ˈ͙͐ͅ੮͸ɘͅ˦ૄ͐੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ϲˑ˺͸੮˺ʠ੮͐ʩʮ˦ʡͅ੯ੳ੯ੳ੯ੳ੮યɘ͐੮ʩʮͅર੮ˑ˺ɻˌʇʁ੮યU{)રੳૂ੮U͐੮ʮͅੴ੮͐ʩʇ੮͐ͅ˺̼;੮ suggests, easy for facilities to assume everyone needs the same things, namely medication and some coping skills. “Other than that, he wasn’t contesting [his conservatorship]?” I asked, a bit incredulous. She insisted, “That was the reason he wanted out of there. They didn’t have graph paper.” ˑʮ੮ ʩɘͅ੮ ɘ˦੮ ʮ˦ɻ̼ʇʁʮɺˑʇ੮ ɺɘͅˌʇ͐੮ ˺ʠ੮ ͐ͅ˺̼ʮʇͅ੮ ˑʮˌʇ੮ ͐ʩʮͅੵ੮ ૃäʇ̼ʮ˺͙ͅˑ;ੴ੮ ͸ʇ੮ ʩɘʁ੮ ɘ੮ ʡ͙;੮ who just said he wanted Doritos. He was diabetic and the doctor put him on a restricted diet. But we got the judge to say, “Doctor, this person has no control ˺ͷʇ̼੮ʩʮͅ੮ˑʮʠʇੴ੮ʩʇ੮ʁ˺ʇͅ˦ૄ͐੮ɻ˺˦̼͐˺ˑ੮ʩʮͅ੮˚ʇʁͅੴ੮ʩʇ੮ʁ˺ʇͅ˦ૄ͐੮ɻ˺˦̼͐˺ˑ੮͸ʩʇ̼ʇ੮ʩʇ੮ˑʮͷʇͅ੯ੳ੯ੳ੯ੳ੮ Just give him some Doritos!’’ ’ One conservatee would agree to be conserved if he could leave his facility to go to a jazz concert; another wanted a green dress. š͐ʩʇ̼ͅ੮ ͸˺͙ˑʁ੮ ɘɻɻʇ̹͐੮ ɺʇʮ˦ʡ੮ ʮ˦੮ ɘ੮ ˑ˺ɻˌʇʁ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ઝʮʠ੮ ˺˦ˑ;੮ ͐ʩʇ;੮ ɻ˺͙ˑʁ੮ ͅ˚˺ˌʇੵ੮ ૃĚ˺͙ૄͷʇ੮͐ɘˌʇ˦੮ɘ͸ɘ;੮͐ʩʇʮ̼੮ɘˑɻ˺ʩ˺ˑੴ੮;˺͙ૄͷʇ੮͐ɘˌʇ˦੮ɘ͸ɘ;੮͐ʩʇʮ̼੮˚ʇ͐ʩੴ੮͐ʩʇ;ૄ̼ʇ੮ɺʇʮ˦ʡ੮̹͙͐੮ in a crappy place, they’re taking meds that make them feel terrible, make them fat, spaced out, no sex drive, sometimes they’re not allowed caffeine, and it’s like, “Just let them have this cigarette.’’ ’ In a debate over conservatorship that pits fundamental civil liberties against a risk of death from grave disability, it’s easy to lose sight of the constant indignities imposed on psychiatric patients. Thatcher recounted a host of abuses in psychiatric settings, a few of which were covered in the previous chapter. They ɘˑͅ˺੮ʩɘʁ੮͐ͅ˺̼ʮʇͅ੮ˑʮˌʇ੮͐ʩʮͅ੮˺˦ʇੵ੮ુĔʩʇ˦੮U੮͸ɘͅ੮ʮ˦੮યʩ˺̹ͅʮ͐ɘˑરੴ੮͸ʇ੮ɻɘ˚̹ɘʮʡ˦ʇʁ੮͐˺੮ɺʇ੮ able to watch a DVD, ’cause there were sports on the TV all day, and not a lot ˺ʠ੮͙ͅ੮͸ʇ̼ʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁੳ੮ä˺੮͐ʩʇ;੮͸ʇ̼ʇ੮ˑʮˌʇੴ੮ૃHʮ˦ʇੴ੮;˺͙੮ɻɘ˦੮͸ɘ͐ɻʩ੮ɘ੮)ē)ੳૄૂ੮îʩɘ͐ɻʩʇ̼੮ and a few other eager residents “cracked open the case, and there was no DVD ʮ˦ͅʮʁʇੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮͸ʇ̼ʇ੮ɘˑˑ੮ʇ˚̹͐;ੳૂ੮U੮ʩ˺̹ʇ੮͐ʩʮͅ੮͸ɘͅ੮ˈ͙͐ͅ੮ɘ੮ɻɘ̼ʇˑʇͅͅ੮˚ʮ͐ͅɘˌʇ੮ɺ;੮͐ͅɘʠʠੴ੮ not a malicious act, but the effect for patients like Thatcher was the same either ͸ɘ;ੵ੮ʠʇʇˑʮ˦ʡ੮ʮʡ˦˺̼ʇʁ੮ɘ˦ʁ੮ʮ˦ͷʮͅʮɺˑʇੳৼৼ੮ફͅ੮ɘ˦੮ɘͅʮʁʇੴ੮îʩɘ͐ɻʩʇ̼੮̼ʇɻɘˑˑͅ੮͐ʩɘ͐੮͐ʩʇ੮ʇ˚̹͐;੮ case was for A Beautiful Mind, the story of a math professor who lived with schizophrenia, which, they pointed out, was “super ironic for a psych ward.”) I’d like to ʮ˚ɘʡʮ˦ʇ੮ˑʮ੮͸˺͙ˑʁ੮̹ʇ͐ʮ͐ʮ˺˦੮ɘ੮ˈ͙ʁʡʇ੮͐˺੮˺̼ʁʇ̼੮ɘ੮ɺʇ͐͐ʇ̼੮˚˺ͷʮʇ੮ͅʇˑʇɻ͐ʮ˺˦ੳ Conservatees’ views on conservatorship are usually on a continuum between ˺͙̼͐ʮʡʩ͐੮˺̹̹˺ͅʮ͐ʮ˺˦੮ɘ˦ʁ੮̹ɘͅͅʮͷʇ੮ɘɻɻʇ̹͐ɘ˦ɻʇੳ੮ˑʮ੮̹ͅʇɻ͙ˑɘ͐ʇʁੴ੮ૃUૄʁ੮ͅɘ;੮ʠ˺̼੮ৱৰજৱ৵੮̹ʇ̼cent of the clients, they simply think they have no mental illness. The doctors ˑ˺ͷʇ੮͐ʇ͐ͅʮʠ;ʮ˦ʡ੮ɘɺ˺͙͐੮ʮ͐ੴ੮ુɘ˦˺ͅ˺ʡ˦˺ͅʮɘੳૂ੯ੳ੯ੳ੯ੳ੮îʩ˺ͅʇ੮ય̹ɘ͐ʮʇ˦͐ͅર੮ɘ̼ʇ੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ say, “Why is this happening to me? This is a travesty. If I am conserved, why ɘ̼ʇ˦ૄ͐੮;˺͙੮ɘˑˑ੮ɺʇʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷʇʁ੺ૄૄ੮ૄ੮H˺̼੮ɻˑʮʇ˦͐ͅ੮ʮ˦੮͐ʩʇ੮ʡ̼ɘ;੮˚ʮʁʁˑʇ੮ʡ̼˺͙˦ʁੴ੮͐ʩ˺͙ʡʩੴ੮

200

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

there are windows of opportunity—if only someone takes the time to listen. ˑʮ੮ʡ˺ʇͅ੮˺˦ੵ੮ૃH˺̼੮͐ʩʇ੮ˑɘ̼ʡʇ͐ͅ੮̹ʇ̼ɻʇ˦͐ɘʡʇੴ੮͐ʩʇ;੮ͅʮ˚̹ˑ;੮ʁ˺˦ૄ͐੮ˑʮˌʇ੮͐ʩʇʮ̼੮̹ˑɘɻʇ˚ʇ˦͐ੳ੮ I think 70 percent of them would stay under conservatorship if they could go to an open board and care [rather than a locked facility]. Most people don’t want to ɺʇ੮ʩ˺˚ʇˑʇͅͅ੶੮͐ʩʇ;੮͸ɘ˦͐੮ɘ੮̹ˑɘɻʇ੮͐˺੮ͅˑʇʇ̹੮ɘ˦ʁ੮͐ʩʇ;੮͸ɘ˦͐੮ʠ˺˺ʁੳૄ੮˦ʁ੮͐ʩʇ˦ੴ੮ૃ৵੮̹ʇ̼ɻʇ˦͐੮ of my clients go to trial [contesting a conservatorship petition] for completely random reasons.’ Like graph paper. These kinds of interventions may be less about getting people off conservatorͅʩʮ̹੮˺̼੮˺͙͐੮˺ʠ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ɘ˦ʁ੮˚˺̼ʇ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮͐ʩʇʮ̼੮ή͙ɘˑʮ͐;੮˺ʠ੮ˑʮʠʇ੮͸ʮ͐ʩʮ˦੮͐ʩʇ˚ੳ੮ Ûʇͅʇɘ̼ɻʩ੮ʩɘͅ੮ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮ʠ˺͙˦ʁ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇૄͅ੮ˑʇʡɘˑ੮͐ͅɘ͙͐ͅ੮˚ɘ͐͐ʇ̼ͅ੮ˑʇͅͅ੮ʠ˺̼੮ʩ˺͸੮ they experience involuntary hospitalization than whether they feel listened to and respected in the process.ৼ৽੮Ĕʮ͐ʩ੮ɘ͐͐ʇ˦͐ʮͷʇ੮ˈ͙ʁʡʇͅ੮˺̼੮ɘ͐͐˺̼˦ʇ;ͅ੮ˑʮˌʇ੮ˑʮੴ੮ɻ˺˦servatorship procedures can become sites of “therapeutic justice” that reinforce that conservatees are rights-bearing individuals with preferences that matter.ৼ৾ ͅ੮͸ʇૄˑˑ੮ͅʇʇ੮ʮ˦੮͐ʩʇ੮˦ʇͽ͐੮ͅʇɻ͐ʮ˺˦ੴ੮͐ʩ˺͙ʡʩੴ੮ͅ˺˚ʇ੮̹̼˺ʡ̼ɘ˚ͅ੮ɘ͙ͅͅ˚ʇ੮͐ʩɘ͐੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ really can live outside of institutions so long as we override just one of those ̹̼ʇʠʇ̼ʇ˦ɻʇͅੵ੮͐ʩʇ੮ɻʩ˺ʮɻʇ੮͐˺੮̼ʇʠ͙ͅʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ

FORCING MEDS FOR FREEDOM îʩʇ੮˺̼ʮʡʮ˦ɘˑ੮ુ)ʮˑʇ˚˚ɘ੮˺ʠ੮{ʇ˦͐ɘˑ੮#˺˚˚ʮ͐˚ʇ˦͐ͅૂ੮̼ʇ̹˺̼͐੮ʮ˦੮ৱ৹৶৶੮ʇ˦ͷʮͅʮ˺˦ʇʁ੮͐ʩɘ͐੮ ͐ʩʇ੮ɻ˺͙̼͐ͅ੮͸˺͙ˑʁ੮ʡ̼ɘ˦͐੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮̹˺͸ʇ̼ͅ੮ુʮ˦ʁʮͷʮʁ͙ɘˑયˑ;ર੯ੳ੯ੳ੯ੳ੮͐ɘʮˑ˺̼ʇʁ੮͐˺੮͐ʩʇ੮ disabilities of the ward.”ৼ৿ Conservatorship would be carefully calibrated to the ɘ̼ʇɘͅ੮ʮ˦੮͸ʩʮɻʩ੮ɘ੮̹ʇ̼ͅ˺˦ૄͅ੮ˈ͙ʁʡ˚ʇ˦͐੮͸ɘͅ੮ɘϲϲˑʮɻ͐ʇʁ੮ɘ˦ʁ੮˺͐ʩʇ̼͸ʮͅʇ੮ˑʇɘͷʇ੮͐ʩʇʮ̼੮ɘ͙͐˺˦omy intact. In practice, most conservatorship courts nationwide default to granting “plenary” guardianships, which give conservators the whole range of powers allowed by the law.ৼ਀ Judge Davis, for example, did a bit of tweaking but generally ticked off the same list of powers granted to the public guardian, including the ̼ʮʡʩ͐੮͐˺੮̹ˑɘɻʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮ɘ੮ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੴ੮̼ʇ̼͐ͅʮɻ͐੮ʁ̼ʮͷʮ˦ʡ੮ɘ˦ʁ੮ϲʮ̼ʇɘ̼˚੮˺͸˦ʇ̼ͅʩʮ̹ੴ੮ ɘ˦ʁ੮ ʮ˚̹˺ͅʇ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ ફU੮ ˦ʇͷʇ̼੮ ͅɘ͸੮ ʩʇ̼੮ ʡ̼ɘ˦͐੮ ̹˺͸ʇ̼੮ ৱৱફɘબੴ੮ ͸ʮ͐ʩʁ̼ɘ͸ʮ˦ʡ੮ someone’s right to vote.) By contrast, some pilot initiatives are working to titrate the coercion public guardians exercise in order to maximize client independence. I saw one such example when I attended court hearings for a “community conservatorship” ̹̼˺ʡ̼ɘ˚੮ ફ͐ʩʇͅʇ੮ ̹̼˺ʡ̼ɘ˚ͅ੮ ʇͽʮ͐ͅ੮ ʮ˦੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺੮ ɘ˦ʁ੮ ˑɘ˚ʇʁɘ੮ #˺͙˦͐ʮʇͅબੳ੮ îʩʇ੮

S TA B I L I Z AT I O N A N D R E C OV E RY

201

conservatees—all of whom were coming in from unlocked placements in the community, rather than locked facilities—were here for a monthly check-in with the court. They told the judge about a recent family reunion, a dispute with other residents in their board and care home, and a new volunteering gig at an animal shelter. The judge responded to nearly every report with copious praise and a ɻ˺˚˚˺˦੮̼ʇʠ̼ɘʮ˦ੵ੮ૃnʇʇ̹੮͙̹੮͐ʩʇ੮ʡ˺˺ʁ੮͸˺̼ˌੳ੮˦ʁ੮ˌʇʇ̹੮͐ɘˌʮ˦ʡ੮;˺͙̼੮˚ʇʁͅੳૄ੮੮ʁʇ̹͙͐;੮ public guardian was waiting in the wings with a goodie bag of snacks to give the conservatees on their way out. îʩʇ̼ʇૄͅ੮ɘ੮ͅʮ˚̹ˑʇ੮͐ʩʇ˺̼;੮͙˦ʁʇ̼ˑ;ʮ˦ʡ੮ɻ˺˚˚͙˦ʮ͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੵ੮˚ɘ˦;੮ɻ˺˦servatees could live safely outside locked institutions if only they were medica͐ʮ˺˦੮ɻ˺˚̹ˑʮɘ˦͐੮ફ͙͙ͅɘˑˑ;੮˚ʇɘ˦ʮ˦ʡ੮͐ʩʇ;੮ɘɻɻʇ̹͐੮ɘ੮˚˺˦͐ʩˑ;੮ͅʩ˺͐੮˺ʠ੮ɘ੮ˑ˺˦ʡચɘɻ͐ʮ˦ʡ੮ ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻબੳ੮ͅ੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮˺˦ʇ੮ɻ˺˚˚͙˦ʮ͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚੮ʇͽ̹ˑɘʮ˦ʇʁੴ੮ʩʇ̼੮˺ϲϲʮɻʇ੮ˑ˺˺ˌͅ੮ʠ˺̼੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮ are gravely disabled but have a low risk of violence. The individual’s public defender then meets with the candidate and explains the public guardian’s barʡɘʮ˦ੵ੮ʮʠ੮͐ʩʇ;੮ɘʡ̼ʇʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ફ͐ʩɘ͐੮ʮͅੴ੮ʁ˺˦ૄ͐੮ɻ˺˦͐ʇ͐ͅ੮͐ʩʇʮ̼੮ʩʇɘ̼ʮ˦ʡબੴ੮͐ʩʇ;੮ can live in the community on the condition they “consent to being involuntarily medicated if needed.” ʁ˚ʮ͐͐ʇʁˑ;ੴ੮U੮͐ʩʮ˦ˌ੮ʮ͐ૄͅ੮ɘ੮˚ʮ̼ͅʇ̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦੮͐˺੮ͅɘ;ੴ੮ɘͅ੮͐ʩʇ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺ˑʁ੮˚ʇੴ੮ that community conservatorship programs are “100 percent voluntary” with “no coercion.” These individuals are still subject to the sovereign power of a standard LPS conservatorship, which means that if they refuse, they’re likely to go to an IMD. Still, there’s some truth to the somewhat Orwellian framing that, under community conservatorship, ‘if you take your meds, your rights won’t be taken away.’ îʩʇ੮ ̹̼˺ʡ̼ɘ˚੮ ʩɘͅ੮ ɺʇ˦ʇϲʮ͐ͅ੮ ʠ˺̼੮ ɺ˺͐ʩ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ɘ˦ʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅ੮ ફɘ˦ʁ੮ ͐ʩʇ੮ counties that pay for them). It enables conservatees who otherwise would be lingering in a hospital waiting for a locked placement to leave faster, freeing up that bed for someone who might actually need inpatient care. While many counties won’t place conservatees in any level of care less structured than a board ɘ˦ʁ੮ɻɘ̼ʇੴ੮ৱৱ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ˑʮͷʇ੮ɘ͐੮ʩ˺˚ʇ੮˺̼੮ʮ˦੮͐ʩʇʮ̼੮˺͸˦੮ apartment.ৼਁ੮ H˺̼੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ˺˦੮ ɻ˺˚˚͙˦ʮ͐;੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ɘʡ̼ʇʇʮ˦ʡ੮ ͐˺੮ ɘ˦੮ injectable antipsychotic one day a month might be a good trade to be largely left alone the other twenty-nine. Luke, a social worker whose outpatient team works with clients on community conservatorship, described a client with autism and psychosis who had a

202

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

compulsion to continually trespass in the same places. This earned him the sad distinction of being the “most arrested person” in his city. While he agreed to go on community conservatorship, the client resisted his monthly shot. Typically, in cases of noncompliance, the public guardian coordinates a “show of support,” ͸ʩʮɻʩ੮˚ʇɘ˦ͅ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ʩʇ੮ɻˑʮʇ˦͐ૄͅ੮ʩ˺͙ͅʇ੮͸ʮ͐ʩ੮ɘ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮̹ɘ̼ɘ˚ʇʁʮɻ੮ɘ˦ʁ੮ ɘ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼੮ʮ˦੮͐˺͸ੳ੮੮̹˺ˑʮɻʇ੮ͅʇ̼ʡʇɘ˦͐੮͸ʩ˺੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʇʁ੮ʮ˦੮͐ʩʇͅʇ੮ ˚ʮͅͅʮ˺˦ͅ੮̼ʇɻ˺͙˦͐ʇʁੴ੮ુUૄˑˑ੮ˈ͙͐ͅ੮ͅɘ;ੴ੮ૃĚ˺͙ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮˦ʇʇʁ੮͐˺੮ʁ˺੮͐ʩʮͅੴ੮͐ʩʇ̼ʇૄͅ੮ɘ੮ɻ˺͙̼͐੮ order, the judge says it needs to happen.’ Nine times out of ten, I can coax them into rolling up their sleeve.” Luke’s client, though, continued to refuse. Ultimately, the power of a community conservatorship is predicated on the ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʡʇ͐੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ɺɘɻˌ੮͐˺੮ɘ੮ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;੮˺̼੮/Ûੳ੮ There, a client’s “voluntary” agreement to involuntary medication can be translated into being physically forced to take it. The problem, Luke told me, was that this individual, who lived with his parents, “locked himself in his room” during the shows of support. The police declared, “We’re not going to go out there and drag him out.” Like most clinicians I talked to, Luke would like to see police less involved in handling mental health crises in principle but was well aware how their increasingly hands-off approach enfeebled the coercion on which the conservatorship system rests. /ͷʇ˦͙͐ɘˑˑ;ੴ੮ ͐ʩʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮ ͸ɘͅ੮ ̼ʇɘ̼̼ʇ͐ͅʇʁ੮ ɘ˦ʁ੮ ̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮ ͐˺੮ ͐ʩʇ੮ ̹ͅ;ɻʩ੮ /Ûੴ੮ where he was given his shot. Luke explained that there is often this kind of “learning curve” whereby someone might have to have a few such interventions before they realize that “the shot isn’t as bad as I expected, it is helping me reach ˚;੮ʡ˺ɘˑͅੴ੮ɘ˦ʁ੮ʮ͐੮ʮͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮U੮ʩɘͷʇ੮͐˺੮ʁ˺ੳૂ੮H˺̼੮˺͐ʩʇ̼ͅੴ੮͐ʩʇ੮ુɺˑɘɻˌ੮̼˺ɺʇ੮ʇʠʠʇɻ͐ૂ੮ ફ͐ʩɘ͐੮ʮͅੴ੮ɺʇʮ˦ʡ੮̹̼ʇ͙̼ͅͅʇʁ੮ɘ˦ʁ੮̹̼ɘʮͅʇʁ੮ɺ;੮͐ʩʇ੮ˈ͙ʁʡʇ੮˺ͷʇ̼ͅʇʇʮ˦ʡ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚બ੮̹̼˺vides an authoritative push toward medication compliance. Luke’s client went back home, and “we don’t tell him what to do during the day, we don’t force him to wear certain clothes, or any of the other things people are afraid conserved clients will have to do. He can do his own thing.” He hasn’t been back to jail in three years on the program. U˦ͅ˺ʠɘ̼੮ɘͅ੮͸ʇ੮ʁʇϲʮ˦ʇ੮ુʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇૂ੮ɘͅ੮ુ͐ͅɘ;ʮ˦ʡ੮˺͙͐੮˺ʠ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅੴૂ੮ɻ˺˚˚͙˦ʮ͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚ͅ੮ʩɘͷʇ੮ͅʩ˺͸˦੮͐ʩʇʮ̼੮̹˺͐ʇ˦͐ʮɘˑੳ੮U˦੮ˑɘ˚ʇʁɘ੮#˺͙˦͐;ੴ੮ ɘ˦੮ʇ˦͐ʮ̼ʇ੮ɻ˺ʩ˺̼͐੮˺ʠ੮͐͸ʇ˦͐;ચϲʮͷʇ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ˌʇ̹͐੮˺͙͐੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮ˈɘʮˑͅ੮˺ͷʇ̼੮ two years.ৼਂ੮H˺̼੮͐ʩʇ˚ੴ੮ʠ˺̼ɻʇʁ੮˚ʇʁͅઝɘ˦ʁ੮ʮ˦͐ʇ˦ͅʮͷʇ੮ɻ˺˚˚͙˦ʮ͐;੮ͅʇ̼ͷʮɻʇͅ੮ɻ˺˺̼ʁʮ˦ɘ͐ʇʁ੮ɺ;੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ૄͅ੮˺ϲϲʮɻʇઝ̼ʇɘˑˑ;੮͸ʇ̼ʇ੮ɘ੮͐ʮɻˌʇ͐੮͐˺੮ʡ̼ʇɘ͐ʇ̼੮ʠ̼ʇʇʁ˺˚ੳ

S TA B I L I Z AT I O N A N D R E C OV E RY

203

THE REALITY OF RECOVERY îʩʇ̼ʇૄͅ੮ ɘ੮ ͙ɺʮή͙ʮ͐˺͙ͅ੮ ɺ͙ΈΈ͸˺̼ʁ੮ ʮ˦੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ੵ੮ ુ̼ʇɻ˺ͷʇ̼;ੳૂ੮ îʩʇ੮ ä͙ɺ͐ͅɘ˦ɻʇ੮ɺ͙ͅʇ੮ɘ˦ʁ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ʡʇ˦ɻ;ੴ੮ɘ੮ʠʇʁʇ̼ɘˑ੮ʇ˦͐ʮ͐;੮͐ʩɘ͐੮̹̼˺ͷʮʁʇͅ੮ ʡ͙ʮʁɘ˦ɻʇ੮ ɘ˦ʁ੮ ʡ̼ɘ˦͐ͅ੮ ʠ˺̼੮ ͐ͅɘ͐ʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ͅ੮ ફɺ͙͐੮ ʇͽʇ̼ɻʮͅʇͅ੮ ˑʮ͐͐ˑʇ੮ regulatory authority over them), describes it as a “process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”ৼਃ੮Ûʇɻ˺ͷʇ̼;੮͸ɘͅ੮ɘ੮ˌʇ;੮̹̼ʮ˦ɻʮ̹ˑʇ੮ɺʇʩʮ˦ʁ੮͐ʩʇ੮ ৲ৰৰ৴੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ɻ͐੮ɘ˦ʁ੮ʩɘͅ੮ɺʇɻ˺˚ʇ੮͐ʩʇ੮ʁʇʠɘ͙ˑ͐੮͐ͅɘ͐ʇʁ੮ʡ˺ɘˑ੮˺ʠ੮˚ɘ˦;੮ ɻ˺͙˦͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ͅੳ੮H˺̼੮ͅ˺˚ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅੴ੮͐ʩ˺͙ʡʩੴ੮ʮ͐ૄͅ੮ʮ̼̼ʇˑʇͷɘ˦͐੮ ͐˺੮͐ʩʇʮ̼੮͸˺̼ˌੳ੮š˦ʇ੮͐˺ˑʁ੮˚ʇੵ੮ુĔʩʇ˦੮͸ʇ੮ʡʇ͐੮ɘ੮̼ʇʠʇ̼̼ɘˑ੮ͅɘ;ʮ˦ʡੴ੮ૃʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੴૄ੮͸ʇ੮ ͸ɘ˦͐੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐˺੮ɻ˺˦ϲʮ̼˚੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺ʡ˦˺ͅʮͅ੮ʮͅ੮˦˺͐੮ʠ˺̼੮ɘ˦;੮ͅ˺̼͐੮˺ʠ੮̼ʇɻ˺ͷery, no chance of participating in normal life activities.”ৼ਄ Then there are the people who prove that recovery is a real but painstakingly gradual process—one facilitated when conservators are patient enough to take small steps by a conservatee’s side. Lorraine, now thirty-two, believes that she’s “always been bipolar,” but her story is as much about overcoming trauma and the substances she used to dull it. Lorraine “grew up fast.” She had to serve as a ̹ɘ̼ʇ˦͐੮͐˺੮ʩʇ̼੮ϲʮͷʇ੮ͅʮɺˑʮ˦ʡͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇʮ̼੮ɘʁ˺̹͐ʮͷʇ੮˚˺͐ʩʇ̼੮ુ͸ɘͅ੮ɘ੮ʁ̼͙ʡ੮ɘʁʁʮɻ͐੯ੳ੯ੳ੯ੳ੮ had a lot of men over, and didn’t really pay attention to her children.” There was “abuse in the home, hitting us with belts and spoons, and sticks.” When she was thirteen, she was “fed up” and pushed her mom in a dispute. By this point, she was touching all sorts of government agencies, but “I just felt I wasn’t ready to tell them [child welfare workers, police, or her therapist] what was going on. ૄ#ɘ͙ͅʇੴ੮Uૄ˚੮ˑʮˌʇੴ੮ૃĔʩ;੮ʁ˺੮U੮ʩɘͷʇ੮͐˺੮ʡ˺੮͐˺੮͐ʩʮͅ੮͙̹͐ͅʮʁ੮ʁ˺ɻ͐˺̼੺੮˚੮U੮͐ʩɘ͐੮ɻ̼ɘΈ;੺ૄૂ੮ Instead of getting support, she got sent to juvenile hall. She later found inner stability in a residence for transitional-age youth coming out of the foster system, but fell victim to the external instability of Califor˦ʮɘૄͅ੮͸ʇˑʠɘ̼ʇ੮ͅ;͐ͅʇ˚ੳ੮îʩʇ੮ʠɘɻʮˑʮ͐;੮ુɻˑ˺ͅʇʁ੮ʁ˺͸˦੯ੳ੯ੳ੯ੳ੮યɘ˦ʁર੮͐ʩʇ;੮ʁʮʁ˦ૄ͐੮ʡʮͷʇ੮͙ͅ੮͐˺˺੮ ˚͙ɻʩ੮͐ʮ˚ʇ੮͐˺੮ϲʮ˦ʁ੮ɘ੮̹ˑɘɻʇੳૂ੮îʩʇ੮˦ʇͽ͐੮̹ʇ̼ʮ˺ʁ੮˺ʠ੮ʩʇ̼੮ˑʮʠʇ੮͸ɘͅ੮ુʠ˺ʡʡ;ੳૂ੮r˺̼̼ɘʮ˦ʇ੮͸ɘͅ੮ in and out of shelters. She started smoking crack and meth. She married a much ˺ˑʁʇ̼੮˚ɘ˦ੴ੮͸ʩ˺੮ુʩɘʁ੮˚ʇ੮ʩɘͷʮ˦ʡ੮ͅʇͽ੮͸ʮ͐ʩ੮̹ʇ˺̹ˑʇ੮ʠ˺̼੮˚˺˦ʇ;ੳ੮˦ʁ੮U੮͸˺͙ˑʁ੮ɻ̼;੮ɘ˦ʁ੮ be like, ‘I don’t want to do this,’ and he didn’t care, he was like, ‘We need the ˚˺˦ʇ;ੴ੮ͅ˺੮;˺͙ૄ̼ʇ੮ʡ˺˦˦ɘ੮ʁ˺੮ʮ͐ੳૄ੯ੳ੯ੳ੯ੳ੮U੮ʠʇˑ͐੮ˑʮˌʇ੮̼͐ͅɘʮʡʩ͐ચ͙̹੮ͅʩʮ͐ੳૂ

204

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

Conservatorship was one more blow to her sense of self-worth. She was visiting her outpatient case manager and, after a dispute, hid in the bathroom and tried to self-injure. They 5150ed her, and “told me that because I continually kept ʡ˺ʮ˦ʡ੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͙ͅʮ˦ʡ੮ʁ̼͙ʡͅ੯ੳ੯ੳ੯ੳ੮͐ʩʇ;੮ʩɘʁ੮ʡʮͷʇ˦੮˚ʇ੮ɘˑˑ੮͐ʩʇ੮ɻʩɘ˦ɻʇͅ੮U੮ɻ˺͙ˑʁ੮ get, and I did not listen, so they put me on conservatorship.” It “sucked, because I like to be independent” but, she told herself, “I had been warned many times.” The hospital set her up with an interview to go to a board and care, but “I kept hurting myself.” She instead went to Metropolitan State Hospital. Lorraine was a long, long way from the “hope, healing, connection, and empowerment” that people in recovery are supposed to be reaching for.৽৻ I spoke to Dr. Howie, a psychiatrist in the state hospital, about what people like Lorraine get there that they couldn’t get in a regular acute hospital. There’s a high staff-to-patient ratio to contain at risk patients, of course, and the ability to combine multiple, complex treatments, like Clozaril and electroconvulsive therapy. But what seemed really distinctive, in a system where hospitalizations are usually focused on achieving the bare minimum of stability necessary for discharge, is the focus on helping people progress along multiple ʁʮ˚ʇ˦ͅʮ˺˦ͅੵ੮ુĔʇ੮˚ʇʇ͐੮ʇͷʇ̼;੮ͅʮ˦ʡˑʇ੮˚˺˦͐ʩ੮͐˺੮ͅɘ;ੴ੮ૃPʇ̼ʇ੮ɘ̼ʇ੮;˺͙̼੮ʡ˺ɘˑͅੴ੮ʩʇ̼ʇૄͅ੮ what you need to do.’” Lorraine reported that the state hospital’s arrivals unit was terrifying and ̼ʮͷʇ˦੮ ͸ʮ͐ʩ੮ ͷʮ˺ˑʇ˦ɻʇੳ੮ "͙͐੮ ͅʩʇ੮ ή͙ʮɻˌˑ;੮ ˚˺ͷʇʁ੮ ͐˺੮ ɘ੮ ͸ɘ̼ʁ੮ ͐ʩɘ͐੮ ˺ʠʠʇ̼ʇʁ੮ ʁʮɘˑʇɻ͐ʮɻɘˑ੮ behavioral therapy, an approach designed to help people with severe trauma build skills to regulate emotions and manage interpersonal relations. Dr. Howie explained that when patients like Lorraine start following through with attending groups and taking care of hygiene, they move to level 2, where they gain access ͐˺੮ɘ੮ુ̹ɘ͐ʮʇ˦͐ͅૄ੮˺˦ˑ;੮ˑ˺͙˦ʡʇૂ੮ɘ˦ʁ੮ુͅ˚ɘˑˑ੮ˈ˺ɺͅ੮ɺɘͅʇʁ੮˺˦੮͐ʩʇʮ̼੮ɘɺʮˑʮ͐;ੳૂ੮Pʇ੮ή͙ɘˑʮϲʮʇʁੴ੮ ુä˺˚ʇ੮̹ɘ͐ʮʇ˦͐ͅ੮˚ʮʡʩ͐੮˦˺͐੮ʩɘͷʇ੮͐ʩʇ੮ɻɘ̹ɘɺʮˑʮ͐;੮˺ʠ੮˚˺̹̹ʮ˦ʡ੮ɘ੮ϲˑ˺˺̼ੴૂ੮ͅ˺੮͐ʩʇ;੮˚ʮʡʩ͐੮ just end up “wiping door knobs or picking up trash.” Menial though that might ͅ˺͙˦ʁੴ੮r˺̼̼ɘʮ˦ʇ੮ɘ̹̹̼ʇɻʮɘ͐ʇʁ੮ʮ͐ੵ੮ુU੮ʡ˺͐੮͐ʩʇ੮˺̹̹˺̼͙͐˦ʮ͐;੮͐˺੮͸˺̼ˌ੮યʠ˺̼੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑરੴ੮ they gave us money for cleaning, and you could buy stuff from a catalog.” Level 3, P˺͸ʮʇ੮ͅɘʮʁੴ੮͸ɘͅ੮ʠ˺̼੮͐ʩ˺ͅʇ੮ુ˺˦੮͐ʩʇʮ̼੮͸ɘ;੮˺͙͐ૂ੮͸ʩ˺੮˚ʮʡʩ͐੮ɺʇ੮ɘɺˑʇ੮͐˺੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ the hospital’s GED program. r˺̼̼ɘʮ˦ʇ੮͸˺̼ˌʇʁ੮ʩʇ̼੮͸ɘ;੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ˑʇͷʇˑͅੳ੮ʠ͐ʇ̼੮ͅʮͽ੮˚˺˦͐ʩͅੴ੮ͅʩʇ੮͐ͅʇ̹̹ʇʁ੮ ʁ˺͸˦੮͐˺੮#ɘˑʮʠ˺̼˦ʮɘ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮î̼ɘ˦ͅʮ͐ʮ˺˦ͅ੮ફ#Øîબੴ੮ɘ˦੮U{)੮͐ʩɘ͐੮˦͙˚ʇ̼˺͙ͅ੮̹ʇ˺̹ˑʇ੮ described to me as the gold standard for locked subacute care. So far, I’ve painted ɘ੮̹̼ʇ͐͐;੮ʁʮ̹ͅɘ̼ɘʡʮ˦ʡ੮̹˺̼̼͐ɘʮ͐੮˺ʠ੮U{)ͅੳ੮ˑʇͽɘ˦ʁʇ̼ੴ੮͸ʩ˺੮ˑʮͷʇͅ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮

S TA B I L I Z AT I O N A N D R E C OV E RY

205

and has been conserved twice, described being sent to an IMD one hundred miles from his hometown. It was “like a really bad prison” where he had no visits, no ɻʮʡɘ̼ʇ͐͐ʇͅੴ੮ɘ˦ʁ੮˦˺੮îēੳ੮ુ{ɘ;ɺʇ੮͐ʩʇ;੮ɻˑʇɘ˦ʇʁ੮͐ʩʇ੮ϲˑ˺˺̼ͅੴૂ੮ʩʇ੮˺ʠʠʇ̼ʇʁੳ੮ુUʠ੮U੮ʩɘʁ੮͐˺੮ͅɘ;੮ something good about it, it’s that you weren’t slipping on human waste on the ϲˑ˺˺̼ͅੳૂ੮͐੮ɘ˦˺͐ʩʇ̼੮U{)ੴ੮͐ʩ˺͙ʡʩੴ੮ʩʮͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮͸ɘͅ੮ʁʮʠʠʇ̼ʇ˦͐ੵ੮ુ͐੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ everything seems like it’s behind closed doors. They’re more transparent at the U{)ੳ੮U͐ૄͅ੮ˑʇͅͅ੮ɘ˚ɺʮʡ͙˺͙ͅੵ੮͐ʩʇ;੮ʩɘͷʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮યʠ˺̼੮̹̼˺ʡ̼ʇͅͅʮ˺˦੮ɘ˦ʁ੮ʁʮͅɻʩɘ̼ʡʇર੮ɘ˦ʁ੮ ͐ʩʇ;੮͸ɘ͐ɻʩ੮;˺͙̼੮̹̼˺ʡ̼ʇͅͅੳ੮ˑˑ੮˺ʠ੮͐ʩʇ੮͙ͅʁʁʇ˦੮͐ʩʇ̼ʇૄͅ੮ɘ੮ˑ˺͐੮ˑʇͅͅ੮ʠʇɘ̼ੳ੮Ě˺͙ૄ̼ʇ੮˦˺͐੮ͅʮ͐ting on the edge of your seat [wondering when you’ll get out].” H˺̼੮ r˺̼̼ɘʮ˦ʇੴ੮ ̹̼˺ʡ̼ʇͅͅ੮ ͸ɘͅ੮ ˚ʇɘ͙̼ͅʇʁ੮ ʮ˦੮ {Ø৳੮ ϲʮˑʇͅੳ੮ #Øî੮ ˌʇ̹͐੮ ʮ͐ͅ੮ ̼ʇͅʮʁʇ˦͐ͅ੮ on a relentless schedule of group therapy, and “every week, if you did good, ;˺͙੮͸˺͙ˑʁ੮ʡʇ͐੮͐˺੮ɻʩ˺˺ͅʇ੮ͅʮͽ͐ʇʇ˦੮ͅ˺˦ʡͅ੮͐˺੮ʁ˺͸˦ˑ˺ɘʁੳ੯ੳ੯ੳ੯ੳ੮˦ʁ੮͐ʩɘ͐੮͸ɘͅ੮˺˦ʇ੮˺ʠ੮ ͐ʩʇ੮͐ʩʮ˦ʡͅ੮͐ʩɘ͐੮ʩʇˑ̹ʇʁ੮˚ʇ੮ʡʇ͐੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮;ʇɘ̼ੳ੯ੳ੯ੳ੯ੳ੮îʩɘ͐੮͸ɘͅ੮ɘ˦੮ʮ˦ɻʇ˦͐ʮͷʇ੮ʠ˺̼੮ ˚ʇੳૂ੮ફUʠ੮;˺͙ૄ̼ʇ੮ɻ͙̼ʮ˺͙ͅੴ੮ʩʇ̼੮ɻʩ˺ʮɻʇͅ੮̼ɘ˦ʡʇʁ੮ʠ̼˺˚੮ɻ˺͙˦̼͐;੮ͅʮ˦ʡʇ̼੮#ɘ̼̼ʮʇ੮õ˦ʁʇ̼wood to the death metal band Slipknot.) There was also a cooking group that motivated her to get up early and a walking group that allowed her to escape from behind locked doors. She appreciated the “token economy” that gave her tickets for showering or attendance, which allowed her to buy hygiene products or candies and chips from the IMD’s commissary. She was seeing a doctor, but ͐ʩʇ੮˚˺͐ͅ੮ʮ˚̹ɘɻ͐ʠ͙ˑ੮̹ʇ˺̹ˑʇ੮ɘ͐੮#Øî੮͸ʇ̼ʇ੮͐ʩʇ੮˺͐ʩʇ̼੮̼ʇͅʮʁʇ˦͐ͅੵ੮ુØ̼˺ɻʇͅͅʮ˦ʡ੮͸ʮ͐ʩ੮ ˺͐ʩʇ̼੮̹ʇ˺̹ˑʇ੮ʮͅ੮ɘ੮ɺʇ˦ʇϲʮ͐ੴ੮ɺʇɻɘ͙ͅʇ੮˺͐ʩʇ̼੮̹ʇ˺̹ˑʇ੮͸ʮˑˑ੮ˈ͙˚̹੮ʮ˦੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃšʩ੮Uૄͷʇ੮ been through that, too.’” She graduated to Psynergy, an unlocked residential treatment program in Morgan Hill, south of San Jose.৽ৼ The facility is nestled in the back of a cul-desac, near an elementary school and surrounded by private residences. It has some of the features of a mental institution—the wide hallways are a holdover from the building’s previous life as a nursing home—and some that make it pretty ʁʮ͐ͅʮ˦ɻ͐ʮͷʇઝˑʮˌʇ੮ʇή͙ʮ˦ʇ੮͐ʩʇ̼ɘ̹;੮͸ʮ͐ʩ੮ʩ˺̼ͅʇͅੳ In deciding whom to admit, Psynergy is willing to overlook assaultive behavʮ˺̼ͅ੮˺̼੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮Ĕšrʮ˦ʡੴ੮˺˦ʇ੮͐ͅɘʠʠ੮˚ʇ˚ɺʇ̼੮͐˺ˑʁ੮˚ʇੴ੮ʮʠ੮ͅ˺˚ʇ˺˦ʇ੮ʮͅ੮ુ͸˺̼ˌʮ˦ʡ੮ ͐ʩʇʮ̼੮ɘͅͅ੮˺ʠʠ੮ʮ˦੮ɘ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡ੮યɺ;ર੮ʁ˺ʮ˦ʡ੮ɘˑˑ੮͐ʩʇʮ̼੮ʡ̼˺͙̹ͅੳૂ੮ͅ੮͸ʮ͐ʩ੮#Øîੴ੮Øͅ;˦ergy is built around different “statuses” that give clients concrete objectives and intermediate steps to get there. The staff member insisted that a patient’s identiϲʮɻɘ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇʮ̼੮ʁʮɘʡ˦˺ͅʮͅ੮ʮͅ੮˦˺͐੮͐ʩʇ੮ˌʇ;੮ʠɘɻ͐˺̼੮ʮ˦੮͐ʩɘ͐੮̹̼˺ʡ̼ʇͅͅʮ˺˦ੵ੮ુU੮ʁ˺˦ૄ͐੮ʡʮͷʇ੮ a shit if you have insight. I want you to be nice, get along with others, participate in our therapy.” On my tour, we walk through a room with yoga mats set up for

206

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ɘ˦੮͙̹ɻ˺˚ʮ˦ʡ੮˚ʮ˦ʁʠ͙ˑ˦ʇͅͅ੮ɻˑɘͅͅੵ੮ૃš͙̼੮ʡ˺ɘˑ੮ʮͅ੮͐˺੮ʩɘͷʇ੮͐ʩʇ˚੮̹ͅʇ˦ʁ੮ɘͅ੮ˑʮ͐͐ˑʇ੮͐ʮ˚ʇ੮ watching TV as possible,’ my guide tells me. Psynergy allows people to experiment, in a structured way, with the freedoms denied to them in other settings. The program prefers that people sign in and out, but it can’t stop anyone from leaving. They care more about whether ̹ʇ˺̹ˑʇ੮ͅʩ˺͸ʇ̼੮ϲʮ̼͐ͅੴ੮ɺʇɻɘ͙ͅʇੴ੮˚;੮ʡ͙ʮʁʇ੮ʇͽ̹ˑɘʮ˦ͅੴ੮ુĔʇ੮͸ɘ˦͐੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮ʡ˺੮˺͙͐੮ and just look like a person, because we’re trying to reduce stigma in everything we do.” They’d also like clients to use their paltry funds left over from SSI to ɺ͙;੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮˺͐ʩʇ̼੮͐ʩɘ˦੮ɘ੮H̼ɘ̹̹͙ɻɻʮ˦˺੮ɘ͐੮͐ʩʇ੮ˑ˺ɻɘˑ੮ä͐ɘ̼ɺ͙ɻˌͅੴ੮ɺ͙͐੮͐ʩʇ;੮ɘ̼ʇ˦ૄ͐੮ going to stop them. The program can’t even prevent residents from using drugs on the outside. ʠ͐ʇ̼੮;ʇɘ̼ͅ੮˺ʠ੮ʇ˦ʠ˺̼ɻʇʁ੮ͅ˺ɺ̼ʮʇ͐;੮ɘ˦ʁ੮͙˦̼ʇˑʇ˦͐ʮ˦ʡ੮ͅʇˑʠચ͸˺̼ˌੴ੮͐ʩ˺͙ʡʩੴ੮r˺̼̼ɘʮ˦ʇ੮ ͙ͅʇʁ੮ʩʇ̼੮ʠ̼ʇʇʁ˺˚੮ʮ˦੮ɘ੮˦ʇ͸੮͸ɘ;ੵ੮ુĚ˺͙੮ʡʇ͐੮ʠ̼ʇʇʁ˺˚੯ੳ੯ੳ੯ੳ੮͐˺੮ʁ˺੮͸ʩɘ͐੮;˺͙੮͸ɘ˦͐ੳ੮˦ʁ੮ the thing was that once I had that freedom, I didn’t go and do drugs a single ͐ʮ˚ʇੳ੯ੳ੯ੳ੯ੳ੮U͐੮̼ʇɘˑˑ;੮ʩʇˑ̹ʇʁ੮˚ʇ੮͐˺੮ˌ˦˺͸੮͐ʩɘ͐੮;˺͙੮ɻ˺͙ˑʁ੮ˑʮͷʇ੮ˑʮʠʇ੮ʁ̼͙ʡ੮ʠ̼ʇʇੴ੮͐ʩɘ͐੮;˺͙੮ don’t have to go and smoke dope to have a good time, be more social.” Lorraine ʇͷʇ˦੮ ͐ͅɘ̼͐ʇʁ੮ ̼͙˦˦ʮ˦ʡ੮ ͐ʩʇ੮ ˑɻ˺ʩ˺ˑʮɻͅઃ‡ɘ̼ɻ˺͐ʮɻͅ੮ ˦˺˦;˚˺͙ͅ੮ ˚ʇʇ͐ʮ˦ʡͅ੮ ɘ͐੮ Øͅ;˦ʇ̼ʡ;ੴ੮ʠ˺̼੮͸ʩʮɻʩ੮ͅʩʇ੮ʡ˺͐੮̹ɘʮʁ੮ʮ˦੮ʡʮʠ͐੮ɻɘ̼ʁͅ੮ફ˦˺͐੮ɻɘͅʩੴ੮ɺʇɻɘ͙ͅʇ੮Øͅ;˦ʇ̼ʡ;ੴ੮ˑʮˌʇ੮#Øî੮˺̼੮ ͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮̹ʇ˺̹ˑʇ੮͐˺੮ˑ˺ͅʇ੮͐ʩʇʮ̼੮ʁʮͅɘɺʮˑʮ͐;੮ɺʇ˦ʇϲʮ͐ͅબੳ੮ä͙ʁʁʇ˦ˑ;ੴ੮ “I felt like a lot of people really looked up to me and told me that they liked my group.” Being at Psynergy, Lorraine says, was “the biggest blessing of all.” She moved into Psynergy’s on-site step-down apartments, and then, a month before her interview, into cooperative housing back in her hometown. Staff come in occasionally to offer support, but most of her contacts are with her house˚ɘ͐ʇͅੴ੮͸ʩ˺੮ɘˑͅ˺੮ˑʮͷʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ੮äʩʇૄͅ੮͐ʩ̼ʮͷʮ˦ʡੳ੮ʠ͐ʇ̼੮ͅʇͷʇ˦੮;ʇɘ̼ͅੴ੮ͅʩʇૄͅ੮ also looking to get off of conservatorship. It’s a big change. Her conservator has been the behind-the-scenes coordinator for her trajectory between institutions. “I talk to my conservator all the time,” she offers, “he sends me money, we just talk about different things.” Conservatorship serves as an insurance policy for programs like Psynergy, which is more willing to accept someone with a checkered history knowing that a conservator can help move a client back up a level of care if things go wrong. Lorraine’s story is inspiring. It’s a testament to the important work being ʁ˺˦ʇ੮ɺ;੮ʠɘɻʮˑʮ͐ʮʇͅ੮ˑʮˌʇ੮#Øî੮ɘ˦ʁ੮Øͅ;˦ʇ̼ʡ;ੴ੮͸ʩʮɻʩ੮ɻ˺˚ɺʮ˦ʇ੮ɘ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮͐ͅɘ͙͐ͅ੮͸ʮ͐ʩ੮ a zeal for doing right by their residents. The story is also, from the perspective of some approaches to disability rights, all wrong. Lorraine’s gradual transition

S TA B I L I Z AT I O N A N D R E C OV E RY

207

from acute hospital to state hospital to IMD to residential treatment to cooperative apartment is indicative of a “step-down philosophy,” which the Department ˺ʠ੮k͙͐ͅʮɻʇ੮ʩɘͅ੮˺ɺͅʇ̼ͷʇʁ੮ુʁ˺ʇͅ੮˦˺͐੮ɻ˺˚̹˺̼͐੮͸ʮ͐ʩ੮͐ʩʇ੮ય˚ʇ̼ʮɻɘ˦ͅ੮͸ʮ͐ʩ੮)ʮͅɘɺʮˑʮ͐ʮʇͅ੮ ɻ͐ૄͅર੮ ̼ʇή͙ʮ̼ʇ˚ʇ˦͐੮ ͐ʩɘ͐੮ ̹ʇ˺̹ˑʇ੮ ̼ʇɻʇʮͷʇ੮ ɻ˺˚˚͙˦ʮ͐;ચɺɘͅʇʁ੮ ͅʇ̼ͷʮɻʇͅੳૂ৽৽੮ îʩʇ੮ )šĩ੮ has moved aggressively to shut down “sheltered employment” that pays below minimum wage.৽৾੮H̼˺˚੮͐ʩʇ੮˺͙͐ͅʮʁʇੴ੮ʮ͐੮ˑ˺˺ˌͅ੮ʁʇʡ̼ɘʁʮ˦ʡ੮͐˺੮˚ʇ͐ʇ̼੮˺͙͐੮{Ø৳੮ϲʮˑʇͅ੮ based on good behavior or offer tokens in exchange for polishing doorknobs so a person can buy a bag of chips. But perhaps the right approach in general for people with disabilities might ˦˺͐੮ɺʇ੮͐ʩʇ੮̼ʮʡʩ͐੮ɘ̹̹̼˺ɘɻʩ੮ʠ˺̼੮ɘ੮ͅ˚ɘˑˑ੮͙ͅɺͅʇ͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮ɘͅ੮ʩɘͷʮ˦ʡ੮grave disabilities. Critics argue that recovery-oriented mental health programs embrace ɘ੮ͷʇ̼;੮˚ʇ̼ʮɻɘ˦੮ɻ˺˦ɻʇ̹͐ʮ˺˦੮͐ʩɘ͐੮ʇή͙ɘ͐ʇͅ੮ɻʮ͐ʮΈʇ˦ͅʩʮ̹੮͸ʮ͐ʩ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇੳ৽৿ This ʇ˚̹ʩɘͅʮͅ੮ʇ˚ɺ˺ʁʮʇͅ੮͐ʩʇ੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅ੮˺ʠ੮ɘ੮̼ʇͅʮʁ͙ɘˑ੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇ੮͐ʩɘ͐੮˺ʠ͐ʇ˦੮ʁ˺ʇͅ੮ not want to provide enduring, and expensive, support. It thus “places heightened and potentially stressful expectations on patients.”৽਀ What should we say to people like Lorraine, for whom independence so often looked like vulnerability to mistreatment? Is it a mistake to have put her in “segregated” contexts with other people facing similar challenges, in which she at last found solidarity and understanding? I don’t have an easy answer. Certainly, Lorraine should not have needed conservatorship to get housing, care, and com̹ɘ˦ʮ˺˦ͅʩʮ̹ੳ੮"͙͐੮͐ʩʇ੮̼ʇɘˑʮ͐;੮ʮͅ੮͐ʩɘ͐੮ͅʩʇ੮ʁʮʁ੮ʡʇ͐੮ʮ͐੮͐ʩ̼˺͙ʡʩ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮˦ʁੴ੮ʮ˦੮ her words, it was “the best thing that has ever happened.”

CONCLUSION: AMBIGUOUS OUTCOMES The past two chapters present two diametrically opposed visions of what happens to conservatees. Depending on where you stand, you might read stories of neglect ɘ˦ʁ੮ɘɺ͙ͅʇ੮ɘͅ੮̼ʇϲˑʇɻ͐ʮ˦ʡ੮͐ʩʇ੮̼ʇɘˑ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮˺ʠ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚੮ɘ˦ʁ੮ tales of recovery and stabilization as a jumble of unrepresentative anecdotes—or ͷʮɻʇ੮ͷʇ̼ͅɘੳ੮Hˑ˺̼ʇ˦ɻʇ੮˚ʮʡʩ͐੮ͅʇʇ˚੮͐˺੮ɺʇ੮ɘ੮͸ʩʮ͐ͅˑʇɺˑ˺͸ʇ̼੮ɻɘˑˑʮ˦ʡ੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮͸ʮʁʇ̹̼ͅʇɘʁ੮̹̼˺ɺˑʇ˚ͅઝ˺̼੮ફɘͅ੮˺˦ʇ੮̼ʇͷʮʇ͸ʇ̼੮͙ͅʡʡʇ͐ͅʇʁબ੮ˈ͙͐ͅ੮ͷ˺ʮɻʮ˦ʡ੮ʩʇ̼੮ʁʇˑ͙ͅʮ˺˦ͅ੮ɘɺ˺͙͐੮ her mother. Debby could be a paragon of public guardians’ dedication to their clients or a self-serving bureaucrat telling me what I wanted to hear. U੮ʩʮʡʩˑʮʡʩ͐੮ɺ˺͐ʩ੮˦ʇʡɘ͐ʮͷʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ફʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦ੴ੮˦ʇʡˑʇɻ͐ੴ੮˚ɘˑ̼͐ʇɘ͐˚ʇ˦͐ੴ੮ɘ˦ʁ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦બ੮ɘ˦ʁ੮̹˺ͅʮ͐ʮͷʇ੮˺͙͐ɻ˺˚ʇͅ੮ફ͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦ੴ੮ʁʮʡ˦ʮ͐;ੴ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇੴ੮

208

C A R E A N D C O E R C I O N U N D E R C O N S E RVATO R S H I P

ɘ˦ʁ੮̼ʇɻ˺ͷʇ̼;બ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐ʩɘ͐੮˚;੮̼ʇͅʇɘ̼ɻʩ੮ϲʮ˦ʁͅ੮ɘ̼ʇ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮͐ʩ̼˺͙ʡʩout the state. What remains to be done is to weigh the prevalence of one versus the other. Disturbingly, the agencies that should be doing this kind of analysis aren’t. There is no statewide reporting or, in most cases, countywide data. We ʁ˺˦ૄ͐੮ˌ˦˺͸੮ʇͷʇ˦੮͐ʩʇ੮˚˺͐ͅ੮ɺɘͅʮɻ੮˺͙͐ˑʮ˦ʇͅ੮˺ʠ੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ͅ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੵ੮͸ʩʇ̼ʇ੮ they are, how long they stay there, what services they are receiving from their conservators, and, perhaps most important, whether those conservatees are satʮͅϲʮʇʁ੮͸ʮ͐ʩ੮ɘ˦;੮˺ʠ੮͐ʩʇ੮ɘɺ˺ͷʇੳ The conservatorship system is lacking not just in authority, then, but also in ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;ੳ੮ͅ੮;˺͙ૄˑˑ੮ͅʇʇ੮ʮ˦੮͐ʩʇ੮ɻʩɘ̹͐ʇ̼ͅ੮͐ʩɘ͐੮ʠ˺ˑˑ˺͸ੴ੮͐ʩʮͅ੮ʩɘͅ˦ૄ͐੮͐ͅ˺̹̹ʇʁ੮̹˺ˑʮɻ;੮ makers from pushing to widen conservatorship’s net. These reforms seek to bring more people into a black box producing everything from abuse to recovery in uncertain measure.

PART III

REFORM

CHAPTER 11

PAVING A NEW PATHWAY

T

he June 2018 hearing was, staff of the California Assembly Judiciary Committee told me, the most emotional one they had ever seen. Four years later, the bill that provoked all that sentiment had led to the conservatorship of just three people.ৼ äʇ˦ɘ͐ʇ੮"ʮˑˑ੮ৱৰ৴৵੮͐ɘ̼ʡʇ͐ʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ુʮ˦ɻɘ̹ɘɺˑʇ੮˺ʠ੮ɻɘ̼ʮ˦ʡ੮ʠ˺̼੮͐ʩʇયʮ̼ર੯ੳ੯ੳ੯ੳ੮ʩʇɘˑ͐ʩ੮ and well-being due to a serious mental illness and substance use disorder, as ʇͷʮʁʇ˦ɻʇʁ੮ɺ;੮ʠ̼ʇή͙ʇ˦͐੮ʁʇ͐ʇ˦͐ʮ˺˦੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ɘ˦ʁ੮̼͐ʇɘ͐˚ʇ˦͐੮̹͙̼͙ͅɘ˦͐੮͐˺੮ͅʇɻtion 5150.”৽੮ુH̼ʇή͙ʇ˦͐ૂ੮͸ɘͅ੮ʁʇϲʮ˦ʇʁ੮ɘͅ੮ʇʮʡʩ͐੮৵ৱ৵ৰͅ੮ʮ˦੮͐ʩʇ੮̹ɘ͐ͅ੮;ʇɘ̼ੳ੮Ě˺͙੮ɻ˺͙ˑʁ੮ͅɘ;੮ its target was people like Professor Jolie, whose near-constant crises in public attract endless community attention but who are nonetheless cast out by ERs ʩ˺͙̼ͅ੮ɘʠ͐ʇ̼੮̹˺ˑʮɻʇ੮̹ˑɘɻʇ੮ɘ੮ʩ˺ˑʁੳ੮U˦੮̹̼ʇͅʇ˦͐ʮ˦ʡ੮͐ʩʇ੮ɺʮˑˑ੮ʠ˺̼੮ɘ੮ϲʮ˦ɘˑ੮ͷ˺͐ʇ੮ɘ͐੮͐ʩʇ੮k͙˦ʇ੮ 2018 hearing, SB 1045’s author, State Senator Scott Wiener from San Francisco, ˺ɺˑʮή͙ʇˑ;੮ɻ̼ʮ͐ʮή͙ʇʁ੮rØäੵ੮ુĔʩʇ˦੮͸ʇ੮ͅʇʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ͅˑʇʇ̹ʮ˦ʡ੮ʮ˦੮͐ʩʇʮ̼੮ʠʇɻʇͅ੯ੳ੯ੳ੯ੳ੮̹ʇ˺̹ˑʇ੮͸ɘˑˌ੮ɺ;੮ɘ˦ʁ੮͐ʩʇ;੮͸˺˦ʁʇ̼੮ɘ˦ʁ੮͐ʩʇ;੮ get angry, ‘Why is no one doing anything about this?’ And the reason is our current conservatorship laws.” He noted that the expansion was something we “need to handle with great care, because these are civil liberties we’re talking about.” But, he riposted, many of these individuals were “currently being conserved in a place called ‘jail.’” äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ ˚ɘ;˺̼ચʇˑʇɻ͐੮ r˺˦ʁ˺˦੮ "̼ʇʇʁઝ˺˦੮ ʩʇ̼੮ ϲʮ̼͐ͅ੮ ˑ˺ɺɺ;ʮ˦ʡ੮ ͷʮͅʮ͐੮ ͐˺੮ äɘɻ̼ɘ˚ʇ˦͐˺ઝ̼ʇ̹ʇɘ͐ʇʁ੮͐ʩʇ੮˚ɘ˦̼͐ɘੵ੮͐ʩʇ੮ɺʮˑˑ੮ુ˺ʠʠʇ̼ͅ੮͙ͅ੮ɘ੮͸ɘ;੮͐˺੮ʩʇˑ̹੮ͅ˺˚ʇ੮˺ʠ੮˺͙̼੮ ˚˺͐ͅ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮̼ʇͅʮʁʇ˦͐ͅੴ੮͸ʩ˺੮ɘ̼ʇ੮˦˺͐੮ˈ͙͐ͅ੮͙ͅʠʠʇ̼ʮ˦ʡ੮˺˦੮˺͙̼੮̼͐ͅʇʇ͐ͅ੯ੳ੯ੳ੯ੳ੮યɺ͙͐ર੮ɘˑͅ˺੮ ʁ;ʮ˦ʡ੮˺˦੮˺͙̼੮̼͐ͅʇʇ͐ͅੳૂ੮äʩʇ੮ʇɻʩ˺ʇʁ੮Ĕʮʇ˦ʇ̼ૄͅ੮̼ʇʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ɻ˺ʇ̼ɻʮͷʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘͅ੮ɘ੮ ̹̼˺ʡ̼ʇͅͅʮͷʇ੮ɘɻ͐੮˺ʠ੮˚ʇ̼ɻ;ੵ੮ુU੮͸ɘ˦͐੮͐˺੮˚ɘˌʇ੮͙̼ͅʇ੮͸ʇૄ̼ʇ੮˦˺͐੮ˈ͙͐ͅ੮ɘˑˑ˺͸ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ ɻɘ˦ૄ͐੮ɻɘ̼ʇ੮ʠ˺̼੮͐ʩʇ˚ͅʇˑͷʇͅ੮͐˺੮ɺʇ੮ˑʇʠ͐੮˺˦੮͐ʩʇʮ̼੮˺͸˦੯ੳ੯ੳ੯ੳ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ʩɘͷʇ੮ૃ̼ʮʡʩ͐ͅੳૄ੯ੳ੯ੳ੯ੳ੮

212

REFORM

What we’re doing [currently] is not humane. It’s not compassion.” Raphael Mandelman, newly elected to the County Board of Supervisors, declared that “no issue is more frustrating for my constituents, and no public policy failure is more obvious, ̹ɘʮ˦ʠ͙ˑੴ੮ɘ˦ʁ੮ʇ˚ɺɘ̼̼ɘͅͅʮ˦ʡ੯ੳ੯ੳ੯ੳ੮ય͐ʩɘ˦ર੮˺͙̼੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ɻɘ̼ʇ੮ʠ˺̼੮ͅ˺੮˚ɘ˦;੮˺ɺͷʮously sick people.” Their chaotic trajectories were, he said, a “relentless and costly merry-go-round that carries them from the streets, to the hospital, to jail, and around and around and around. It is inhuman, it is expensive, and it has to stop.” The chair of the committee then called for statements from the opposition, and a familiar litany of groups offered a familiar litany of arguments against involuntary treatment (arguments that, to be fair, have had validity for decades). ੮̹ͅ˺ˌʇͅ͸˺˚ɘ˦੮ʠ˺̼੮ɘ˦੮ɘʁͷ˺ɻɘɻ;੮ʡ̼˺͙̹ੴ੮͐ʩʇ੮Ĕʇ͐ͅʇ̼˦੮#ʇ˦͐ʇ̼੮˺˦੮rɘ͸੮ɘ˦ʁ੮Ø˺ͷʇ̼͐;ੴ੮ blasted SB 1045 as a distraction from the “complete failure” to fund “upstream solutions” like “supported housing with wraparound services [or] early mental health or drug treatment.” She hammered that a “failure to control the real estate market, a lack of affordable housing, [and] the criminalization of poverty” were the real culprits for the “extreme human rights violations” happening on the streets, not a “lack of conservatorships.” Curtis Child, the lobbyist for Disability Rights California, declared that his group was adamantly opposed because ુ͸ʇૄͷʇ੮̹ͅʇ˦͐੮ʁʇɻɘʁʇͅ੯ੳ੯ੳ੯ੳ੮͸˺̼ˌʮ˦ʡ੮ɘ͐੮ʁʇચʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈʮ˦ʡ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴૂ੮͸ʩʮɻʩ੮͐ʩʇ੮ bill (despite Wiener’s promise that “our goal here is housing and services, not locked facilities”) threatened to reverse. This implacable opposition was met by committee members’ torn, emotional, and ultimately unanimous support for the bill. David Chu, a Democrat from San H̼ɘ˦ɻʮͅɻ˺ੴ੮͸ɘͅ੮͐ʩʇ੮˚˺͐ͅ੮͙˦ʇή͙ʮͷ˺ɻɘˑੴ੮͐ͅɘ͐ʮ˦ʡੴ੮ુĔʇૄͷʇ੮˺ʠ͐ʇ˦੮ʇͽ̹̼ʇͅͅʇʁ੮͐ʩʇ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇ੮͐ʩɘ͐੮͐ʩʇ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ʮ˦ͅɘ˦ʮ͐;੮ʮͅ੮ʁ˺ʮ˦ʡ੮͐ʩʇ੮ͅɘ˚ʇ੮͐ʩʮ˦ʡ੮˺ͷʇ̼੮ɘ˦ʁ੮˺ͷʇ̼੮ɘʡɘʮ˦ੳ੮ U੮͙̹̹ͅ˺̼͐੮͐ʩʮͅ੮ɺʇɻɘ͙ͅʇੴ੮͸ʮ͐ʩ੮ʠ˺ˑˌͅ੮͸ʩ˺੮ɘ̼ʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੯ੳ੯ੳ੯ੳ੮U੮ʁ˺੮͐ʩʮ˦ˌ੮͸ʇ੮ have to try different things.” The vote from Jordan Cunningham, a Republican ʠ̼˺˚੮äɘ˦੮r͙ʮͅ੮šɺʮ̹ͅ˺ੴ੮͸ɘͅ੮ɻˑʇɘ̼ˑ;੮ʩɘ̼ʁʇ̼ੳ੮ુîʩʮͅ੮ʮͅ੮ɘ੮͐˺͙ʡʩ੮ͷ˺͐ʇੴૂ੮ʩʇ੮͐ͅɘ˚˚ʇ̼ʇʁੴ੮ haltingly. When he was an attorney, he defended a woman who was sued when her son with “severe schizophrenia,” who had been 5150ed “numerous times,” ͐ͅ˺ˑʇ੮ɘ੮ϲʮ̼ʇɘ̼˚੮ʠ̼˺˚੮ʩʇ̼੮ʡɘ̼ɘʡʇ੮ɘ˦ʁ੮ુ˚͙̼ʁʇ̼ʇʁ੮ʩʮͅ੮˦ʇͽ͐ચʁ˺˺̼੮˦ʇʮʡʩɺ˺̼੮ɺʇɻɘ͙ͅʇ੮ ʩʇ੮͐ʩ˺͙ʡʩ͐੮ͅʩʇ੮͸ɘͅ੮ɘ੮ͷɘ˚̹ʮ̼ʇੳૂ੮Pʇ੮ϲʮʁʡʇ͐ʇʁ੮͙˦ɻ˺˚ʠ˺̼͐ɘɺˑ;ੴ੮ુĚ˺͙੮ˌ˦˺͸੯ੳ੯ੳ੯ੳ੮Ĕʩʇ˦੮ ͸ʇ੮͐ɘˑˌ੮ɘɺ˺͙͐੮̹ʇ˺̹ˑʇ੮ʠɘˑˑʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ɻ̼ɘɻˌͅ੯ੳ੯ੳ੯ੳૂ੮Pʇ੮͸ɘͅ੮ϲʮʡʩ͐ʮ˦ʡ੮ɺɘɻˌ੮͐ʇɘ̼ͅੴ੮ “That’s real. So let’s do this.” U͐ૄͅ੮̼ɘ̼ʇ੮ʠ˺̼੮ʇͷʇ̼;੮˚ʇ˚ɺʇ̼੮˺ʠ੮ɘ੮ɻ˺˚˚ʮ͐͐ʇʇ੮͐˺੮ʇͽ̹ˑɘʮ˦੮͐ʩʇʮ̼੮ͷ˺͐ʇੴ੮ɺ͙͐੮͐ʩʇ੮˺ϲϲʮcial displays of angst continued. Ash Kalra, a Democrat from San Jose, noted

PAV I N G A N E W PAT H WAY

213

that the eight-5150s-in-one-year criterion for the new conservatorships “really speaks to the degree that someone is struggling to stay alive.” As a former public defender who worked years in a drug treatment court, he remarked, “I have a visɻʇ̼ɘˑ੮̼ʇɘɻ͐ʮ˺˦੮͐˺੮ɘ˦;੮ˌʮ˦ʁ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʁʇ͐ʇ˦͐ʮ˺˦ੳૂ੮"͙͐੮ʩʇ੮ͅʩ˺˺ˌ੮ʩʮͅ੮ʩʇɘʁ੮ͅɘʁˑ;ੵ੮ “There are many occasions, heartbreaking occasions, where I wanted to do more, ɘ˦ʁ੮U੮ɻ˺͙ˑʁ˦ૄ͐ੳ੮{ɘ˦;੮ɻˑʮʇ˦͐ͅ੯ੳ੯ੳ੯ੳ੮͸ʇ੮ɻˑ˺ͅʇʁ੮͐ʩʇʮ̼੮ɻɘͅʇͅ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇʮ̼੮ʁʇɘ͐ʩͅੳૂ Ĕʮʇ˦ʇ̼੮ʡɘͷʇ੮ʩʮͅ੮ϲʮ˦ɘˑ੮͐ͅɘ͐ʇ˚ʇ˦͐ੴ੮͙ͅ˚˚ɘ̼ʮΈʮ˦ʡ੮͐ʩɘ͐੮͐ʩʮͅ੮ʁʮͅɻ͙ͅͅʮ˺˦੮͸ɘͅ੮ુ̹ʇ̼ͅ˺˦ɘˑੴ੮ɺʇɻɘ͙ͅʇ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮͐ʩʮͅ੮ʮͅ੮ɘɺ˺͙͐੮̹ʇ˺̹ˑʇੳ੯ੳ੯ੳ੯ੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮̹ʇ˺̹ˑʇ੮U੮ͅʇʇ੮ʮ˦੮˚;੮ neighborhood, in the Castro, who over years I see them decline, decline, decline, ɘ˦ʁ੮͐ʩʇ˦੮˺˦ʇ੮ʁɘ;੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮͐ʩʇ̼ʇ੮ɘ˦;˚˺̼ʇੳ੯ੳ੯ੳ੯ੳ੮îʩʮͅ੮ʮͅ੮ɘ੮ʩ͙˚ɘ˦੮̼͐ɘʡʇʁ;੮͐ʩɘ͐੮ ̹ˑɘ;ͅ੮˺͙͐੯ੳ੯ੳ੯ੳ੮ʇͷʇ̼;͸ʩʇ̼ʇ੮ʮ˦੮˺͙̼੮͐ͅɘ͐ʇੳૂ੮îʩʇ˦੮͐ʩʇ੮ɻʩɘʮ̼੮ɻɘˑˑʇʁ੮͐ʩʇ੮̼˺ˑˑੴ੮ɘ˦ʁ੮ʇͷʇ̼;੮ member voted in favor of the bill. This chapter follows the torturous, costly, and ineffectual implementation of SB 1045. It’s a story about the public’s and policy makers’ growing intolerance for homeless substance users, balanced against their ongoing uneasiness with forced treatment. In the case of SB 1045, legislators salved their discomfort by adding protections that granted negative discretion to even more actors than the ̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ̹ɘ͐ʩ͸ɘ;ੳ੮ Ĕʩɘ͐੮ ʩɘ̹̹ʇ˦ʇʁ੮ ʮ˦੮ ͐ʩʇ੮ ʇ˦͙ͅʮ˦ʡ੮ ʠ˺͙̼੮ years is a warning about the massive amount of passion, effort, and acrimony ͐ʩɘ͐੮ɻɘ˦੮ʡ˺੮ʮ˦͐˺੮ʩʇˑ̹ʮ˦ʡઝ˺̼੮ʩɘ̼˚ʮ˦ʡઝɘ੮ͅ˚ɘˑˑ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ʇ˺̹ˑʇੴ੮ͅ˺੮ˑ˺˦ʡ੮ɘͅ੮͐ʩʇ੮ system remains so fragmented and delegated that no one has clear authority for ʩʇˑ̹ʮ˦ʡઝ˺̼੮ʩɘ̼˚ʮ˦ʡઝ͐ʩʇ˚ੳ

THE “METH CONSERVATORSHIP ” BILL San Francisco is experiencing, in microcosm, a particularly acute version of California’s more general crisis of drug use and homelessness, collapse of a private system of residential care,৾ and gaps in the public voluntary outpatient system. It’s easy to understand how politicians might conclude that desperate times call for desperate measures. How that measure wound up being the expansion of conservatorship is less apparent. Governor Newsom mooted the idea in 2008 when he was San Francisco’s mayor.৿ The effort didn’t go anywhere. Then, in late 2017, Heather Knight, a San Francisco Chronicle columnist and advocate for taking a harder line on homeˑʇͅͅ˦ʇͅͅੴ੮̼ʇ̹˺̼͐ʇʁ੮˺˦੮ˑʮɻʇੴ੮ɘ੮ુ˦ʇʮʡʩɺ˺̼ʩ˺˺ʁ੮ϲʮͽ͙̼͐ʇૂ੮͸ʩ˺੮ˑʮͷʇʁ੮˺͙͐ͅʮʁʇ੮ɘ੮"͙̼ʡʇ̼੮

214

REFORM

King at Sixteenth and Mission, “her belongings piled high in shopping carts and stuffed into suitcases spread all around her.”਀ Alice believed it was 2006 and had such bad back pain that sometimes “she can’t walk and other homeless people have to carry her to nearby bushes to relieve herself.” City workers offered her ʩ˺͙ͅʮ˦ʡ੮ͅʮͽ͐;੮͐ʮ˚ʇͅੴ੮ɺ͙͐੮ͅʩʇ੮̼ʇʠ͙ͅʇʁੳ੮n˦ʮʡʩ͐੮ɻ̼ʮ͐ʮή͙ʇʁ੮rØäૄͅ੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅੴ੮ʇͽ̹ˑɘʮ˦ʮ˦ʡ੮͐ʩɘ͐੮ુʮ˦੮͐ʩʇ੮˦ɘ˚ʇ੮˺ʠ੮ɻ˺˚̹ɘͅͅʮ˺˦੯ੳ੯ੳ੯ੳ੮ય͐ʩʇ;ર੮ɻɘ˦˦˺͐੮ɻ˺˚̹ʇˑ੮ her to move inside, where she would be warm, and have a bed and bathroom.” äʩʇ੮ɘͅˌʇʁ੮{ɘ;˺̼੮/ʁ੮rʇʇ੮ɘɺ˺͙͐੮ˑʮɻʇੴ੮͸ʩ˺੮̼ʇ̹ˑʮʇʁੴ੮ુU੮ʁ˺˦ૄ͐੮͐ʩʮ˦ˌ੮͸ʇ੮ʩɘͷʇ੮̼͐ͅ˺˦ʡ੮ enough conservatorship programs.” Alice ultimately accepted an offer of housing but passed away shortly thereafter.ਁ {ɘ;˺̼੮rʇʇ੮ʩʮ˚ͅʇˑʠ੮ʁʮʇʁ੮ɘɺ̼͙̹͐ˑ;੮ɘ੮ʠʇ͸੮͸ʇʇˌͅ੮ˑɘ͐ʇ̼ੴ੮ɺ͙͐੮˺͐ʩʇ̼ͅ੮̹ʮɻˌʇʁ੮͙̹੮͐ʩʇ੮ baton. In February 2018, Scott Wiener declared at a press conference that the city ͸ɘͅ੮ʮ˦੮ɘ੮ુ˚ʮʁ͐ͅ੮˺ʠ੮ɘ੮ɻ̼ʮͅʮͅ੯ੳ੯ੳ੯ੳ੮ɘ੮ˑʮʠʇચ˺̼ચʁʇɘ͐ʩ੮ͅʮ͙͐ɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮ʮ͐੮ʮͅ੮ɺʇ;˺˦ʁ੮ʮ˦ʩ͙˚ɘ˦ʇ੮ to sit back and watch as these people die.”ਂ He announced that “current conserͷɘ͐˺̼ͅʩʮ̹੮ˑɘ͸੮ʮͅ੮ʮ˦ɘʁʇή͙ɘ͐ʇ੮͐˺੮˚ʇʇ͐੮˺͙̼੮ɻ˺͙˦͐ʮʇͅૄ੮˦ʇʇʁͅ੮ɘ̼˺͙˦ʁ੮ɻʩ̼˺˦ʮɻ੮ʩ˺˚ʇˑʇͅͅ੮ people with severe mental illness or drug addiction” and promised to “craft a bold and comprehensive bill that will save lives.” /ˑʇɻ͐ʇʁ੮ ˺ϲϲʮɻʮɘˑͅ੮ ͙͐ͅ˚ɺˑʇʁ੮ ˺ͷʇ̼੮ ͐ʩʇ˚ͅʇˑͷʇͅ੮ ʮ˦੮ ͙̹̹ͅ˺̼͐ੳ੮ r˺˦ʁ˺˦੮ "̼ʇʇʁੴ੮ ͸ʩ˺੮ appeared at Wiener’s press conference, touted her efforts to ramp up conserͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮͐ʩʇ੮˚ɘ;˺̼ɘˑ੮ʇˑʇɻ͐ʮ˺˦ઝɺ͙͐੮ͅ˺੮ʁʮʁ੮ʩʇ̼੮˺̹̹˺˦ʇ˦͐ੳਃ The San Francisco Chronicle pronounced in an editorial that while “concerns” about civil rights “merit consideration, they’re dwarfed by the human toll that every onlooker ͅʇʇͅੳ੯ੳ੯ੳ੯ੳ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ͅʩ˺͙ˑʁ੮̹ˑɘ;੮ɘ੮̼˺ˑʇ੮ʮ˦੮ʇ˦ʁʮ˦ʡ੮ɘ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮ɘ˦ʁ੮ʁʮ͙̼͐ͅɺing side of homelessness.”਄ The discourse was emblematic of what the anthro̹˺ˑ˺ʡʮ͐ͅ੮˦ʁ̼ʇɘ੮r̹̕ʇΈ੮ɻɘˑˑͅ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮̼ʇʡʮ˚ʇ੮˺ʠ੮ુɺ̼͙͐ɘˑ੮ɻ˺˚̹ɘͅͅʮ˺˦ૂੵ੮ʮ˦੮ɘ੮ ɻ˺˦͐ʇͽ͐੮͸ʩʇ̼ʇ੮ʩ˺͙ͅʮ˦ʡ੮ɘ˦ʁ੮̼͐ʇɘ͐˚ʇ˦͐੮̼ʇͅ˺͙̼ɻʇͅ੮ɘ̼ʇ੮ʠɘ̼੮ʠ̼˺˚੮͙ͅϲϲʮɻʮʇ˦͐੮͐˺੮ɘʁʁ̼ʇͅͅ੮ the scale of suffering, aggressive last-ditch interventions are prioritized based on individuals’ “proximity to [their] own death[s].”ৼ৻ While Wiener et al.’s mantra was that the bill was necessary to stop people from “dying on the streets,” the bill’s design suggested a target population dis͐ʮ˦ɻ͐ʮͷʇ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ̹ʇ˺̹ˑʇ੮ ̼͐ɘʁʮ͐ʮ˺˦ɘˑˑ;੮ ͙ͅɺˈʇɻ͐ʇʁ੮ ͐˺੮ rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮ îʩʇ੮ draft legislation would allow conservatorships for people who were chronically ʩ˺˚ʇˑʇͅͅ੮ ɘ˦ʁ੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮ ͙ͅʇ̼ͅઝ˦˺੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ̼ʇή͙ʮ̼ʇʁੳ੮ îʩʇ੮ ˚ɘ;˺̼ૄͅ੮ ˺ϲϲʮɻʇ੮ ͸̼˺͐ʇ੮͐˺੮͐ʩʇ੮ͅͅʇ˚ɺˑ;ੴ੮ુîʩʇ੮rØä੮ɻ͐੮ʠɘˑˑͅ੮ͅʩ˺̼͐੮ʮ˦੮ͅʇ̼ͷʮ˦ʡ੮˚˺ʁʇ̼˦੮˦ʇʇʁͅ੯ੳ੯ੳ੯ੳ੮ [because] substance use disorder is not considered [for conservatorship]” even though 67 percent of users of the city’s Psychiatric Emergency Services had such

PAV I N G A N E W PAT H WAY

215

a diagnosis.ৼৼ੮îʩʇ੮ɺʮˑˑ੮ʮ˦ʮ͐ʮɘˑˑ;੮̹̼˺̹˺ͅʇʁ੮ή͙ɘˑʮʠ;ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ based on four 5150s in the past year, which would hypothetically nab those individuals being rapidly dumped from an ER once they came down from a high. Although advocates described it as a “housing conservatorship” bill to emphasize that it was geared toward getting homeless people into supported housing, one ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮̹͙͐੮ʮ͐੮ɺˑ͙˦͐ˑ;ੵ੮ુä"੮ৱৰ৴৵੮ʮͅ੮˦˺͐੮͐ʩʇ੮ૃʩ˺͙ͅʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ૄ੮ɺʮˑˑੴ੮ʮ͐ૄͅ੮ the ‘meth conservatorship’ bill.”ৼ৽ Given the overwhelming public support for forced treatment of homeless drug users,ৼ৾ sources in the legislature told me that by the time Wiener’s draft reached the Assembly, its passage was certain. I asked one legislative aide if the bill’s authors came armed with any research about the effectiveness of conserͷɘ͐˺̼ͅʩʮ̹੮ɘͅ੮ɘ੮ͅ˺ˑ͙͐ʮ˺˦੮͐˺੮ʁ̼͙ʡ੮͙ͅʇ੮ɘ˦ʁ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੳ੮ફU͐੮͸ɘͅ੮ɘ੮̼͐ʮɻˌ੮ή͙ʇ͐ͅʮ˺˦ੴ੮ because at this point I knew the evidence was scant at best.ৼ৿) The aide told me, ુU͐ૄͅ੮˦˺͐੮ɻˑʇɘ̼੮ɻ͙͐੮͐ʩɘ͐੮યʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐ર੮ʮͅ੮ɘ੮ʩʮʡʩˑ;੮ʇʠʠʇɻ͐ʮͷʇ੮ͅ˺ˑ͙͐ʮ˺˦੯ੳ੯ੳ੯ੳ੮ but for the folks in the legislature who are voting on this, their constituents with ̹˺ˑʮ͐ʮɻɘˑ੮ɻɘ̹ʮ͐ɘˑ੮͐˺੮̹ͅʇ˦ʁ੯ੳ੯ੳ੯ੳ੮ɘ̼ʇ੮˺ʠ੮͐ʩʇ੮˚ʮ˦ʁͅʇ͐੮͐ʩɘ͐੮͐ʩʮͅ੮ʮͅ੮ɘ˦੮ʇʠʠʇɻ͐ʮͷʇ੮͸ɘ;੯ੳ੯ੳ੯ੳ੮˺ʠ੮ dealing with homelessness that they view as problematic to their communities.” The staff of the Assembly Judiciary Committee, where negotiations took place, were unwaveringly opposed to the bill. They wrote in their analysis that the “danger is evident” in moving away from a standard of grave disability toward one based on the number of times someone was 5150ed.ৼ਀ It was “unclear,” they argued, “why seeking medical care in an emergency room would provide a basis to hold a person involuntarily for at least one year.” Moreover, including only people who were “chronically homeless” would “create a different standard of ̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮͐ʩɘ͐੮ʮͅ੮ɺɘͅʇʁ੮ͅ˺ˑʇˑ;੮˺˦੮˺˦ʇૄͅ੮ʇɻ˺˦˺˚ʮɻ੮ status.” The optics were not great, given Breed and Wiener’s support for sweeps of homeless encampments and opposition to Prop C, a 2018 ballot initiative that imposed a surcharge on wealthy corporations to fund homelessness services.ৼਁ With the tacit support of the committee chair and the help of opponents of ͐ʩʇ੮ɺʮˑˑ੮ˑʮˌʇ੮)ʮͅɘɺʮˑʮ͐;੮Ûʮʡʩ͐ͅ੮#ɘˑʮʠ˺̼˦ʮɘ੮ɘ˦ʁ੮͐ʩʇ੮#rõੴ੮͐ͅɘʠʠ੮ુɻʩʇ͸ʇʁ੮ય͐ʩʇ੮ɺʮˑˑર੮ ͐˺੮ɺʮ͐ͅૂ੮ફɘͅ੮˺˦ʇ੮ˑ˺ɺɺ;ʮ͐ͅ੮̹͙͐੮ʮ͐બੳ੮îʩʇ੮ϲʮ˦ɘˑ੮ͷʇ̼ͅʮ˺˦੮̼ʇή͙ʮ̼ʇʁ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ʩɘͷʇ੮ eight, not four, 5150s in the past year. Potential conservatees needed to be diagnosed with both a substance use disorder and mental illness by the ER during each of those 5150s (chronic homelessness disappeared as a criterion entirely). ˚ʇ˦ʁ˚ʇ˦͐ͅ੮̼͐ɘ˦ͅʠ˺̼˚ʇʁ੮͐ʩʇ੮ɺʮˑˑ੮ʮ˦͐˺੮ɘ੮ϲʮͷʇચ;ʇɘ̼੮̹ʮˑ˺͐੮̹̼˺ʡ̼ɘ˚੮ʠ˺̼੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮r˺ͅ੮˦ʡʇˑʇͅੴ੮ɘ˦ʁ੮äɘ˦੮)ʮʇʡ˺੮˺˦ˑ;ੴ੮͸ʮ͐ʩ੮˺˦ʇ̼˺͙ͅ੮̼ʇ̹˺̼͐ʮ˦ʡ੮ɘ˦ʁ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮

216

REFORM

̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅੳ੮{˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐ˑ;ੴ੮͐ʩʇ੮ɺʮˑˑ੮̼ʇή͙ʮ̼ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮̼͐;੮ɘ੮ˑʇͅͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮˺̹͐ʮ˺˦ੴ੮ɘͅͅʮ͐ͅʇʁ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̼͐ʇɘ͐˚ʇ˦͐੮ફšîબੴ੮ before applying for conservatorship. The bill then passed the Assembly 61–0 and the Senate 39–0. At a press conference, Mayor Breed recounted, “I probably harassed Governor Brown every single day until he signed it,” which he did on September 27, 2018. Although civil rights advocates had been publicly defeated, in a practical sense their mobilization against SB 1045 had been successful. With the amendments, one disability rights lobbyist told me, “we knew that they’d have a really hard time actually putting the program together and getting anyone in it.” Wiener had initially told the Assembly in June 2018 that “approximately 1 percent of the homeless population [which was about eight thousand in San Francisco] meets the criteria in the bill.” But when it came time for the San Francisco Board of Supervisors to consider its implementation early the next year, the city was ʇ͐ͅʮ˚ɘ͐ʮ˦ʡ੮͐ʩɘ͐ੴ੮͸ʩʮˑʇ੮ϲʮʠ͐;ચϲʮͷʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˚ʇ͐੮͐ʩʇ੮ʇʮʡʩ͐ચ৵ৱ৵ৰͅ੮ɻ̼ʮ͐ʇ̼ʮ˺˦ੴ੮˺˦ˑ;੮ ϲʮͷʇ੮ ʩɘʁ੮ ɘˑ̼ʇɘʁ;੮ ુʠɘʮˑʇʁૂ੮ šîੳ੮ ુUૄ˚੮ ˦˺͐੮ ͸ʮˑˑʮ˦ʡ੮ ͐˺੮ ɺɘɻˌ੮ ʁ˺͸˦ੳ੯ ੳ੯ ੳ੯ ੳ੮ Uʠ੮ ʮ͐ૄͅ੮ ʠ˺͙̼੮ [people], it’s still worth doing. If it’s one, it’s still worth doing,” Supervisor Mandelman insisted.ৼਂ In a rare move for a bill that had not yet been implemented, Wiener returned in early 2019 with new legislation, SB 40. The revision would allow the county mental health department to apply directly for a conservatorship once a person ʩʮ͐੮ʇʮʡʩ͐੮৵ৱ৵ৰͅ੮ʮʠ੮ʮ͐੮͸ɘͅ੮ʁʇ͐ʇ̼˚ʮ˦ʇʁ੮͐ʩɘ͐੮̼͐;ʮ˦ʡ੮šî੮ુ͸˺͙ˑʁ੮ɺʇ੮ʮ˦͙ͅϲϲʮɻʮʇ˦͐੮͐˺੮ treat the person.”ৼਃ Civil rights advocates once again extracted their pound of ϲˑʇͅʩੴ੮ͅʩ˺̼͐ʇ˦ʮ˦ʡ੮͐ʩʇ੮ʁ͙̼ɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮˦ʇ͸੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʠ̼˺˚੮˺˦ʇ੮;ʇɘ̼੮͐˺੮ͅʮͽ੮ months.ৼ਄੮îʩɘ͐੮ɺʮˑˑ੮ɘˑͅ˺੮̹ɘͅͅʇʁ੮͙˦ɘ˦ʮ˚˺͙ͅˑ;ੳ੮U͐੮͐ʇ͐ͅʮϲʮʇʁ੮͐˺੮ˑʇʡʮͅˑɘ͐˺̼ͅૄ੮ʁʇͅʮ̼ʇ੮͐˺੮ be seen as “doing something” about the nexus of mental illness and substance use (and, implicitly, homelessness). But it was indicative of the hesitation about how ʠɘ̼੮ɺʇ;˺˦ʁ੮͐ʩʇ੮̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ɺ˺͙˦ʁɘ̼ʮʇͅ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ͅʇ͐੮ɺ;੮rØä੮͐ʩɘ͐੮ “something” should be.

COMPLAINT-DRIVEN REFORM ä"੮ৱৰ৴৵੮ɘ˦ʁ੮ä"੮৴ৰ੮̼ʇή͙ʮ̼ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͐ʩ̼ʇʇ੮ɻ˺͙˦͐ʮʇͅ੮ɘ͙͐ʩ˺̼ʮΈʇʁ੮͐˺੮ʮ˚̹ˑʇ˚ʇ˦͐੮͐ʩʇ੮ program meet a series of stringent criteria. The board of supervisors needed to ϲʮ˦ʁ੮͐ʩɘ͐੮ɘ੮ʩ˺͐ͅ੮˺ʠ੮ͅʇ̼ͷʮɻʇͅੴ੮ʠ̼˺˚੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮͐˺੮˚ʇʁʮɻɘ͐ʮ˺˦੮˚ɘ˦ɘʡʇ˚ʇ˦͐੮

PAV I N G A N E W PAT H WAY

217

͐˺੮ʠɘ˚ʮˑ;੮͙̹̹ͅ˺̼͐ੴ੮͸ʇ̼ʇ੮ɘͷɘʮˑɘɺˑʇ੮ʮ˦੮ુ͙ͅϲϲʮɻʮʇ˦͐੮ή͙ɘ˦͐ʮ͐;ੴ੮̼ʇͅ˺͙̼ɻʇͅੴ੮ɘ˦ʁ੮ʠ͙˦ʁʮ˦ʡ੮ ˑʇͷʇˑͅ੮͐˺੮ͅʇ̼ͷʇ੮͐ʩʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮̹˺̹͙ˑɘ͐ʮ˺˦ੳૂ৽৻੮U͐੮ʠ͙̼͐ʩʇ̼੮ʩɘʁ੮͐˺੮ɻ˺˦ϲʮ̼˚੮͐ʩɘ͐੮ુ˦˺੮ ͷ˺ˑ͙˦͐ɘ̼;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅૂ੮͸˺͙ˑʁ੮ɺʇ੮ુ̼ʇʁ͙ɻʇʁ੮ɘͅ੮ɘ੮̼ʇ͙ͅˑ͐੮˺ʠ੯ੳ੯ੳ੯ੳ੮ʮ˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦ੳૂ੮ rʇʡʮͅˑɘ͐˺̼ͅ੮ ɘ˦ʁ੮ ɻ˺͙˦͐;੮ ͙̹ͅʇ̼ͷʮͅ˺̼ͅ੮ ʮ˦੮ r˺ͅ੮ ˦ʡʇˑʇͅ੮ ɘ˦ʁ੮ äɘ˦੮ )ʮʇʡ˺੮ ʩɘʁ੮ initially indicated their enthusiasm for the bill.৽ৼ੮"͙͐੮͐ʩʇ;੮ή͙ʮɻˌˑ;੮̼ʇɘˑʮΈʇʁ੮͐ʩʇ̼ʇ੮ was no plausible way to claim that both of these were true.৽৽ The City of San Francisco, which had always been the motor behind the bill, pressed on. In December 2018, I attended an event in San Francisco City Hall to discuss the mayor’s Draft Implementation Report. A reader of the report could be forgiven if they forgot that the housing conservatorship program was about involuntary treatment. The program would “provide the most appropriate care in the ˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ͅʇ͐͐ʮ˦ʡૂ੮ɺ;੮ુ̼ʇή͙ʮ̼યʮ˦ʡર੮͐ʩʇ੮̹̼˺ͷʮͅʮ˺˦੮˺ʠ੮Øʇ̼˚ɘ˦ʇ˦͐੮ä͙̹̹˺̼͐ʮͷʇ੮ P˺͙ͅʮ˦ʡੴૂ੮ ɘ੮ ʠ˺ɻ͙ͅ੮ ͸ʩʮɻʩ੮ ͸ɘͅ੮ ુ˦˺ͷʇˑૂ੮ ̼ʇˑɘ͐ʮͷʇ੮ ͐˺੮ ̼ʇʡ͙ˑɘ̼੮ rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮ Clients in the program would be “engaged to participate actively, and whenever possible, to direct their own service and recovery process.” At the event, repreͅʇ˦͐ɘ͐ʮͷʇͅ੮ʠ̼˺˚੮͐ʩʇ੮˚ɘ;˺̼ૄͅ੮˺ϲϲʮɻʇ੮ɘ˦ʁ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Ø͙ɺˑʮɻ੮Pʇɘˑ͐ʩ੮˺̹ʇ˦ʇʁ੮ by explaining that their focus was on ‘trying to offer them [people targeted by the law] coordinated and better services.’ The law would provide ‘more time to hear what they are saying to work with them’ to get onto a ‘pathway to wellness.’ At the end of the presentation, the organizers called for public comment. A sharply dressed, middle-aged white woman stood up and declared that she was a representative of the neighborhood association in a wealthy area. ‘I get what everyone is saying about voluntary services and people with trauma, but we’ve had it up to here!’ she declared, waving her hand above her head, the pearls ɘ̼˺͙˦ʁ੮ʩʇ̼੮˦ʇɻˌ੮ˈɘ˦ʡˑʮ˦ʡੳ੮ૃĚ˺͙੮͸ɘˑˌ੮ʁ˺͸˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɘ˦ʁ੮;˺͙ૄ̼ʇ੮͸˺̼̼ʮʇʁ੮ͅ˺˚ʇ˺˦ʇ੮ is going to bop you on the head. My assistant was threatened, seriously, twice this ͸ʇʇˌੳ੮î͸ʮɻʇ੸ૄ੮äʩʇ੮ɻˑ˺ͅʇʁੵ੮ૃîʩ̼ʇʇ੮̹ʇ˺̹ˑʇ੮͸ʇ̼ʇ੮ˌʮˑˑʇʁ੮ʮ˦੮͐ʩʇ੮#ɘ̼͐ͅ˺੮͐ʩʮͅ੮;ʇɘ̼ੳ੮îʩʇ̼ʇ੮ are homeless people who just shouldn’t be there. Period!’ An activist from the Coalition on Homelessness, which was steadfastly opposed to the bill, called out ‘How many homeless people died during that time?’ I could see the person from ͐ʩʇ੮˚ɘ;˺̼ૄͅ੮˺ϲϲʮɻʇ੮ʡ̼ʮ˚ɘɻʮ˦ʡੳ Supervisor Mandelman, who remained the bill’s most consistent champion, ͸ɘͅ੮ʁʮ̼ʇɻ͐੮͸ʩʇ˦੮U੮ɘͅˌʇʁ੮ʩʮ˚੮ʩ˺͸੮˚͙ɻʩ੮̹̼ʇ͙̼ͅͅʇ੮ʩʮͅ੮˺ϲϲʮɻʇ੮͸ɘͅ੮̼ʇɻʇʮͷʮ˦ʡੵ੮ુ#˺˦stant. Constant. Daily. A mixture of fury, sadness, angst, [and] concern” about ̹ͅʇɻʮϲʮɻ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮ʮ˦੮͐ʩʇ੮ʁʮ̼͐ͅʮɻ͐ੳ੮ͅ੮ʩʇ੮ʇͽ̹ˑɘʮ˦ʇʁ੮ʮ˦੮͐ʩɘ͐੮)ʇɻʇ˚ɺʇ̼੮৲ৰৱ৸੮ meeting, what he saw in his own district were ‘people the city already coerces a

218

REFORM

ˑ˺͐ੴ੮˺˦੮͐ʩʇ੮˚ɘ̼ʡʮ˦ͅ੮˺ʠ੮ˑɘ͸੮યrØäરੳ੮Ĕʇ੮ʡʇ͐੮ɘ੮ɺ͙˦ɻʩ੮˺ʠ੮ɻ˺˚̹ˑɘʮ˦͐ͅੴ੮ɘ˦ʁ੮͸ʇ੮ϲʮ˦ɘˑˑ;੮ pull some resources together to get them housed or maybe some care, because the person has generated enough community outrage to have a twitter account [reporting on their behaviors].’ To Mandelman, housing conservatorships were a more coherent and consistent way to respond to community pressure. Ignoring it ͸˺͙ˑʁੴ੮ʮ˦੮˺˦ʇ੮˺ϲϲʮɻʮɘˑૄͅ੮̹ʩ̼ɘͅʮ˦ʡੴ੮˺͐ʩʇ̼͸ʮͅʇ੮ˑʇɘʁ੮͐˺੮ૃ˦ʇʮʡʩɺ˺̼ͅ੮ˑʮʡʩ͐ʮ˦ʡ੮યʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇͅૄર੮͐ʇ˦͐ͅ੮˺˦੮ϲʮ̼ʇੳૄ੮ä"੮ৱৰ৴৵੮͸ɘͅ੮͐ʩ͙ͅ੮ʇ˚ɺˑʇ˚ɘ͐ʮɻ੮˺ʠ੮͸ʩɘ͐੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮#ʩ̼ʮͅ੮ Herring calls the city’s shift to “complaint-oriented services.”৽৾ While the bill’s main proponents seemed to have mutually decided to mention in every public statement that SB 1045 focused on people “dying on the ̼͐ͅʇʇ͐ͅੴૂ੮ ͐ʩʇ੮ ɻ˺˦ɻʇ̼˦੮ ͸ɘͅ੮ ˦˺͐੮ ɘɺ˺͙͐੮ ͐ʩ˺ͅʇ੮ ͸ʩ˺੮ ͸ʇ̼ʇ੮ ʁ;ʮ˦ʡ੮ ή͙ʮʇ͐ˑ;ੳ੮ ˑʮɻʇੴ੮ ͐ʩʇ੮ ͸˺˚ɘ˦੮ ͸ʩ˺ͅʇ੮ ̼ʇʠ͙ͅɘˑ੮ ˺ʠ੮ ͅʮͽ͐;੮ ˺ʠʠʇ̼ͅ੮ ˺ʠ੮ ʩ˺͙ͅʮ˦ʡ੮ ͸ɘͅ੮ ̹̼˺ϲʮˑʇʁ੮ ʮ˦੮ ͐ʩʇ੮ Chronicle, ͸˺͙ˑʁ੮ ˦˺͐੮ ʩɘͷʇ੮ ή͙ɘˑʮϲʮʇʁੴ੮ ͅʮ˦ɻʇ੮ ͅʩʇ੮ ͸ɘͅ˦ૄ͐੮ ɺʇʮ˦ʡ੮ ৵ৱ৵ৰʇʁੳ੮ ੮ ˚˺̼ʇ੮ ˑʮˌʇˑ;੮ ͐ɘ̼ʡʇ͐੮ ͸ɘͅ੮ɘ੮͸˺˚ɘ˦੮͸ʩ˺੮ɻɘ˚ʇ੮͐˺੮ɘ˦੮ુ͙̹ͅɻɘˑʇ੮ͅɘˑ˺˦੮˦ʇɘ̼੮õ˦ʮ˺˦੮äή͙ɘ̼ʇૂ੮˺˦੮ɘ੮ʁɘʮˑ;੮ɺɘͅʮͅ੮ and “plant[ed] herself outside the front door to strip her clothes off and scratch herself violently.”৽৿ The salon owner got a TV station to cover the woman, which “prompted visits from police brass and the Mayor’s staff.” The woman was hos̹ʮ͐ɘˑʮΈʇʁ੮ɺ̼ʮʇϲˑ;੮ɘ˦ʁ੮͐ʩʇ˦੮͸ʇ˦͐੮ɺɘɻˌ੮͐˺੮ͅɻ̼ɘ͐ɻʩʮ˦ʡ੮ʩʇ̼ͅʇˑʠ੮ɘ͐੮õ˦ʮ˺˦੮äή͙ɘ̼ʇੳ੮ä˺˚ʇ੮ of the most enthusiastic proponents of the bill were the Chamber of Commerce, the Travel Association, and the Hotel Council.৽਀ This target group was the source not just of vexing complaints but of enormous expenses.৽ਁ Supervisor Mandelman, sounding exasperated at one of many hearings where SB 1045 was being discussed, focused on ‘nine people who visited PES [Psychiatric Emergency Services at San Francisco General] 168 times ˺ͷʇ̼੮ ʠ˺͙̼੮ ˚˺˦͐ʩͅੳૄ੮ Pʇ੮ ͸ʇ˦͐੮ ˺˦ੵ੮ ૃͅʮʁʇ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ʩ͙˚ɘ˦੮ ɻ˺͐ͅੴ੮ ͐ʩʇ̼ʇૄͅ੮ ɘ੮ ̹͙ɺˑʮɻ੮ ɻ˺͐ͅઝ͸ʇૄ̼ʇ੮̹ͅʇ˦ʁʮ˦ʡ੮ɘ੮ˑ˺͐੮˺ʠ੮˚˺˦ʇ;੮˺˦੮͐ʩ˺ͅʇ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ͷʮͅʮ͐ͅੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮˦ʇʇʁ੮͐˺੮ get them off this merry-go-round’ (another supervisor’s chosen description was ͐ʩʇ੮ ુʩ˺˚ʇˑʇͅͅ੮ ʩɘ˚͐ͅʇ̼੮ ͸ʩʇʇˑૂબੳ੮ #ʩʮʇʠ੮ äʮ˚˺˦੮ Øɘ˦ʡੴ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ϲʮ̼ʇ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ told the supervisors that 2.5 percent of the people about whom 911 calls were placed ate up 19 percent of their total resources. ‘We have a meth user who has an abscess in his spine and sits in his wheelchair in excrement all day,’ he told the supervisors. ‘We had 122 calls to 911 about him in the last year, and in 99 meetʮ˦ʡͅੴ੮˺ʠʠʇ̼ʇʁ੮ʩʮ˚੮ͅʩʇˑ͐ʇ̼ੴ੮ɘͅͅʮ͐ͅɘ˦ɻʇ੮ɘɻ͐ʮͷɘ͐ʮ˦ʡ੮ɺʇ˦ʇϲʮ͐ͅੴ੮ɘ˦ʁ੮ɘ˦੮U)ઝʩʇ੮̼ʇʠ͙ͅʇʁ੮ʮ͐੮ all. I’m dumbfounded how he was allowed to leave a hospital [after a 5150].’ I am disturbed but not dumbfounded. A failure to provide for one’s own medical care is not, for now, a criterion for grave disability. As soon as clinicians

PAV I N G A N E W PAT H WAY

219

deemed his problem substances rather than mental illness, there was no legal basis for holding him even if he was a danger to himself. That’s, in theory, what reformers sought to change.

COERCION WINS The bill had widespread public support but was far from unopposed. In late 2018, a coalescing Voluntary Services Coalition brought together some of the typiɻɘˑ੮ͅˌʇ̹͐ʮɻͅ੮˺ʠ੮ɘ੮ɻ˺ʇ̼ɻʮͷʇ੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅઝ͙ͅɻʩ੮ɘͅ੮ ͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮ɘ˦ʁ੮͐ʩʇ੮#˺ɘˑʮ͐ʮ˺˦੮˺˦੮P˺˚ʇˑʇͅͅ˦ʇͅͅઝ͸ʮ͐ʩ੮ʡ̼ɘ;ચ haired veterans of the civil rights movement, a self-styled Mad Mob of people who had been subjected to forced treatment, the occasional representative of the Democratic Socialists of America, and outpatient drug treatment providers who feared that funds would be diverted into involuntary programs. The group organized public protests in 2018 and 2019, including one in which activists held signs declaring “treat us, don’t beat us” and “housekeys, ˦˺͐੮ʩɘ˦ʁɻ͙ʠʠͅੳૂ੮îʩʇ;੮ʁʮ̼͐ͅʮɺ͙͐ʇʁ੮ϲˑ;ʇ̼ͅ੮ʁʇ̹ʮɻ͐ʮ˦ʡ੮͐ʩʇ੮ɻʮ͐;ૄͅ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ ɘͅ੮ɘ੮ͅʮ˦ʮ͐ͅʇ̼੮˚ɘ˦੮ʮ˦੮ɘ੮̼͐ʇ˦ɻʩ੮ɻ˺ɘ͐੮ɺ̼ɘ˦ʁʮͅʩʮ˦ʡ੮ɘ੮ʁ˺ʡɻɘ͐ɻʩʇ̼ૄͅ੮˦ʇ͐੮ફϲʮʡ͙̼ʇ੮ৱৱੳৱબੳ੮U˦੮ public events, the Voluntary Services Coalition hammered that the law was a

11.1 Flyer opposing SB 1045 “housing conservatorships” in San Francisco Sourceੵ੮äʇ˦ʮ˺̼੮ɘ˦ʁ੮)ʮͅɘɺʮˑʮ͐;੮ɻ͐ʮ˺˦

220

REFORM

“grave violation of civil rights” and that conservatorship was “the most extreme deprivation of civil liberties aside from the death penalty.”৽ਂ But what seemed ͐ʩʇ੮˚˺͐ͅ੮ɻ˺˚̹ʇˑˑʮ˦ʡ੮ɘ̼ʡ͙˚ʇ˦͐੮ɘʡɘʮ˦͐ͅ੮͐ʩʇ੮ˑɘ͸੮͸ɘͅ੮ɘˑͅ˺੮͐ʩʇ੮˚˺͐ͅ੮˺ɺͷʮ˺͙ͅ੮˺˦ʇੵ੮ it was unfair to force people into services that thousands of people in San Francisco couldn’t access voluntarily.৽ਃ The head of Senior and Disability Action stated, “There is not enough housing, in shelters or permanent housing, and people are not being offered voluntary mental health services. The City must give people the services they need before rushing to scoop them up to get them out of the public eye.”৽਄ U˦੮ɘʡʡ̼ʇʡɘ͐ʇੴ੮͐ʩʮͅ੮ɻ̼ʮ͐ʮή͙ʇ੮͸ɘͅ੮˺ɺͷʮ˺͙ͅˑ;੮˺˦੮̹˺ʮ˦͐ੳ੮/ͷʇ˦੮͐ʩʇ੮˚ɘ;˺̼ૄͅ੮ʁ̼ɘʠ͐੮̹ˑɘ˦੮ estimated that they had only two hundred apartment units in “buildings with the highest level of supportive services,” a number transparently way below overall need (given the size and acuity of the city’s homeless population). Nonetheless, ˺ϲϲʮɻʮɘˑͅ੮ɻˑɘʮ˚ʇʁ੮͐ʩɘ͐ੴ੮ʠ˺̼੮͐ʩʇ੮ͅ˚ɘˑˑ੮ʡ̼˺͙̹੮͐ɘ̼ʡʇ͐ʇʁ੮ɺ;੮ä"੮ৱৰ৴৵ੴ੮˚ʮͅʡʮͷʮ˦ʡͅ੮ɘɺ˺͙͐੮ ͐ʩʇ੮ɘͷɘʮˑɘɺʮˑʮ͐;੮˺ʠ੮ͅʇ̼ͷʮɻʇͅ੮͸ʇ̼ʇ੮ɘ੮̼ʇʁ੮ʩʇ̼̼ʮ˦ʡੳ੮îʩʇ੮ɺʮˑˑ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ɘ˦੮ʮʁʇ˦͐ʮϲʮʇʁ੮ ʡ̼˺͙̹੮˺ʠ੮ϲʮʠ͐;ચϲʮͷʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸ʇ̼ʇ੮ɘˑ̼ʇɘʁ;੮̼ʇɻʇʮͷʮ˦ʡ੮ɘ੮ʩ͙ʡʇ੮ɘ˚˺͙˦͐੮˺ʠ੮ɘ͐͐ʇ˦͐ʮ˺˦੮ (as evidenced by their eight 5150s over a year). As a vote in the Board of Supervisors neared, Senator Wiener insisted, “Clearly, we need to invest a lot more in mental health and addiction services. There’s no doubt about that. The safety net is not where it should be. But to suggest you can’t get those voluntary services in SF, it’s inaccurate in the extreme. The people most in crisis, we’re investing huge resources in them, cycling through ERs [and] jails. The voluntary services are available for this small universe of people, but they’re not capable of accessing [them] because of the condition they’re in.”৾৻ Proponents of SB 1045 attributed people’s “service resistance” to a mix of anoͅ˺ʡ˦˺ͅʮɘ੮ ɘ˦ʁ੮ ɘʁʁʮɻ͐ʮ˺˦ੳ੮ š̹̹˺˦ʇ˦͐ͅ੮ ɺˑɘ˚ʇʁ੮ ͅʇ̼ͷʮɻʇͅ੮ ͐ʩɘ͐੮ ͸ʇ̼ʇ੮ ͙˦ɘɺˑʇ੮ ͐˺੮ ̹̼˺vide them what they most wanted. A source from Health Right 360, the city’s main provider of substance use treatment, told me that 94 percent of people ʇ˦͐ʇ̼ʮ˦ʡ੮͐ʩʇʮ̼੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮͸ʇ̼ʇ੮ʩ˺˚ʇˑʇͅͅ੮͙̹˺˦੮ɘ̼̼ʮͷɘˑઝɘ˦ʁ੮৴৵੮̹ʇ̼ɻʇ˦͐੮ were discharged into homelessness months later. Dr. Zeldes from the city’s street medicine team commented on how this statistic made it harder to get people to ʇ˦ʡɘʡʇੵ੮ુU੮ɻɘ˦੮̼ʇɘɻʩ੮˺͙͐੮͐˺੮ͅ˺˚ʇ˺˦ʇ੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃPʇ;ੴ੮;˺͙੮ͅʩ˺͙ˑʁ੮ʡ˺੮ʮ˦͐˺੮ɘ੮̹̼˺ʡ̼ɘ˚ੳૄ੮ îʩʇ;੮̼ʇ̹ˑ;ੴ੮ૃĔʇˑˑੴ੮͸ʩɘ͐੮ʁ˺੮U੮ʡʇ͐੺ૄ੮ૃĚ˺͙੮ʁ˺˦ૄ͐੮͙ͅʇ੮ʁ̼͙ʡͅ੮ʠ˺̼੮ͅʮͽ੮˚˺˦͐ʩͅੴ੮ɘ˦ʁ੮͐ʩʇ˦੮ ;˺͙੮ʡʇ͐੮͐˺੮ɺʇ੮ʩ˺˚ʇˑʇͅͅੴૄ੮˺̼੮ૃĚ˺͙ૄˑˑ੮ʡ˺੮͐˺੮ɘ˦੮äۚ੮ʮ˦੮͐ʩʇ੮îʇ˦ʁʇ̼ˑ˺ʮ˦੮યɘ੮˦ʇʮʡʩɺ˺̼hood with an extremely high concentration of homelessness] where everyone will be using drugs.’ That’s not compelling.”

PAV I N G A N E W PAT H WAY

221

By May 2019, it seemed as though SB 1045 did not have enough support to pass the Board of Supervisors. But revealingly, the reasons given for skepticism toward SB 1045 suggested that the debate among policy makers had shifted from whether to coerce people to where and how. Supervisor Hillary Ronen, in a hearing before the Rules Committee, dismissed impassioned pleas, like that of one speaker from the Voluntary Services First Coalition, that ‘involuntary treatment does not work.’ Ronen riposted that ‘abandoning mentally ill people to wander the street without care and medication is morally wrong and dangerous.’ äʩʇ੮ɘʁʁʇʁੴ੮ૃͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮˦ʇʇʁ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮U͐ૄͅ੮ɘ੮˦˺ચɺ̼ɘʮ˦ʇ̼੮͐˺੮˚ʇ੮͐ʩɘ͐੮ rØä੮ͅʩ˺͙ˑʁ੮ʮ˦ɻˑ͙ʁʇ੮ʁ̼͙ʡ੮ɘʁʁʮɻ͐ʮ˺˦ੳૄ੮Ĕʩɘ͐੮ͅʩʇ੮ʁ˺͙ɺ͐ʇʁ੮͸ɘͅ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ੮ɻʮ͐;੮ʩɘʁ੮ enough dual-diagnosis mental health–substance use beds to actually send people to under housing conservatorships. Two developments shifted the political dynamic. First, the city committed ͐˺੮ ʇͽ̹ɘ˦ʁʮ˦ʡ੮ ͅʇ̼ͷʮɻʇͅઝɘˑɺʇʮ͐੮ ˦˺͐੮ ͐ʩʇ੮ ˺˦ʇͅ੮ ͐ʩʇ੮ ē˺ˑ͙˦͐ɘ̼;੮ äʇ̼ͷʮɻʇͅ੮ #˺ɘˑʮ͐ʮ˺˦੮ ͸ɘ˦͐ʇʁੳ੮U˦੮ʇɘ̼ˑ;੮৲ৰৱ৸ੴ੮͐ʩʇ੮ɻʮ͐;੮ɘ˦˦˺͙˦ɻʇʁ੮͐ʩɘ͐੮ʮ͐੮͸˺͙ˑʁ੮ɺʇ੮˺̹ʇ˦ʮ˦ʡ੮ɘ੮ϲʮʠ͐;ચʠ˺͙̼ચ bed “Healing Center” at St. Mary’s Medical Center, which was actually a locked IMD run by Crestwood.৾ৼ In the run-up to the board vote, Ronen extracted a promise from the mayor to spend $50 million the next year on another hundred beds for people with co-occurring disorders.৾৽ The second factor was a threat by Mandelman and Mayor Breed to take SB ৱৰ৴৵੮ʁʮ̼ʇɻ͐ˑ;੮͐˺੮͐ʩʇ੮ͷ˺͐ʇ̼ͅੳ੮îʩʇ;੮ʩɘʁ੮̼ʇɘͅ˺˦੮͐˺੮ɺʇ੮ɻ˺˦ϲʮʁʇ˦͐ੵ੮̹˺ˑˑͅ੮ͅʩ˺͸ʇʁ੮͐ʩɘ͐੮ 77 percent of San Franciscans supported expanding conservatorships.৾৾ The Voluntary Services Coalition, seeing the writing on the wall, released a statement that “a ballot measure on conservatorship would lead to a dehumanizing cam̹ɘʮʡ˦੮ɘʡɘʮ˦͐ͅ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇੳ੯ੳ੯ੳ੯ੳ੮Ĕʮ͐ʩ੮͐ʩʇ੮͐ʩ̼ʇɘ͐੮˺ʠ੮ɘ੮ɺɘˑˑ˺͐੮˚ʇɘ͙̼ͅʇੴ੮͐ʩʇ੮͙̹ͅʇ̼visors who supported us were not left with any good options.” A supervisor’s vote against SB 1045 would anger many constituents while likely failing to prevent the legislation from going into effect. When the legislation came up for a full vote on June 4, 2019, Mandelman ɘ˦˦˺͙˦ɻʇʁ੮͐ʩɘ͐੮ʩʇ੮ʩɘʁ੮ɘɻɻʇ̹͐ʇʁ੮ɘ੮ʠʇ͸੮ɘ˚ʇ˦ʁ˚ʇ˦͐ͅੴ੮͸ʩʮɻʩ੮͸˺͙ˑʁ੮̼ʇή͙ʮ̼ʇ੮ʇͷʇ˦੮ more offers of voluntary services before someone could go onto a housing conservatorship. In the end, only one supervisor dissented. Supervisor Shamann Walton observed that “every time we take freedoms away from people, it’s typically Black people and people of color.” He lamented that “5150s usually involve law enforcement” in a moment when his goal was to protect people of color from them. An appalling 50 percent of people with eight or more 5150s in 2020 in San Francisco

222

REFORM

were Black (5 percent of residents are Black).৾৿ Nonetheless, it appeared that, for a small group of San Franciscans, the merry-go-round of short-term holds, arrests, and the street was going to stop.

NO CONSERVATORSHIP WITHOUT COOPERATION Ø̼˺̹˺˦ʇ˦͐ͅ੮ɻˑɘʮ˚ʇʁ੮͐ʩʇ੮ɘʁ˺̹͐ʮ˺˦੮˺ʠ੮ä"੮ৱৰ৴৵੮ʩɘʁ੮ͅ;˚ɺ˺ˑʮɻ੮ͅʮʡ˦ʮϲʮɻɘ˦ɻʇ੮ɺʇ;˺˦ʁ੮ the small cohort on whom it would have a direct impact. Senator Wiener, in that emotional June 2018 hearing, declared it was part of a broader effort to reverse “our state’s retreat” from providing for people with severe mental illness. After͸ɘ̼ʁੴ੮ä͙̹ʇ̼ͷʮͅ˺̼੮{ɘ˦ʁʇˑ˚ɘ˦੮˚ɘʁʇ੮͐ʩʇ੮ͅɘ˚ʇ੮ɻˑɘʮ˚ੵ੮ુU͐ૄͅ੮͐ʩʇ੮ˈ˺ɺ੮˺ʠ੮͐ʩʇ੮ʡ˺ͷʇ̼˦ment to take care of people who cannot take care of themselves. That’s what this ˑʇʡʮͅˑɘ͐ʮ˺˦੮ʮͅ੮ɘɺ˺͙͐ੳૂ੮Ěʇ͐੮ä"੮ৱৰ৴৵ૄͅ੮̼ʇͷɘ˚̹ʮ˦ʡ੮˺ʠ੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʮ˦੮͐ʩʇ੮ conservatorship system foundered against precisely the bureaucratic discretion and private delegation it was supposed to reverse. By 2020, the city had put together a twelve-member implementation working ʡ̼˺͙̹ੴ੮ɘʁʁʇʁ੮͐ͅɘʠʠ੮͐˺੮͐ʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ૄͅ੮˺ϲϲʮɻʇੴ੮ɘ˦ʁ੮ʩʮ̼ʇʁ੮ɘ੮ɻ˺˦͙ͅˑ͐ʮ˦ʡ੮ɻ˺˚̹ɘ˦;੮͐˺੮ʇͷɘˑ͙ɘ͐ʇ੮͐ʩʇ੮̹ʮˑ˺͐ੳ੮îʩʇ੮ɻ˺˦͙ͅˑ͐ɘ˦͐ૄͅ੮ϲʮ̼͐ͅ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮̼ʇ̹˺̼͐੮͸ɘͅ੮ɻʩ˺ɻˌચʠ͙ˑˑ੮ ˺ʠ੮ ϲʮˑˑʇ̼ੴ੮ ͐ɘˌʮ˦ʡ੮ ͙˦͐ʮˑ੮ ̹ɘʡʇ੮ ͅʇͷʇ˦੮ ͐˺੮ ˦˺͐ʇ੮ ͐ʩɘ͐੮ ુɘ͐੮ ͐ʩʇ੮ ͐ʮ˚ʇ੮ ˺ʠ੮ ͐ʩʮͅ੮ ̹̼ʇˑʮ˚ʮ˦ɘ̼;੮ report’s submission, the Housing Conservatorship pilot has yet to serve any individuals.”৾਀ At a hearing in July 2020, Supervisor Mandelman grilled staff from the ̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ૄͅ੮˺ϲϲʮɻʇ੮ɘ˦ʁ੮ɘ˦˦˺͙˦ɻʇʁੴ੮ͅɘ̼ɻɘ͐ͅʮɻɘˑˑ;ੴ੮ુU੮ɘˑ͸ɘ;ͅ੮ͅɘʮʁ੮͐ʩʮͅ੮͸˺͙ˑʁ੮ be worth doing if it helped just one person. But I did think that it would help at least one person.” š˦ʇ੮ͅ˺͙̼ɻʇ੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮͐ʩʇ੮ʮ˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦੮˺ʠ੮ä"੮ৱৰ৴৵੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈʇʁ੮ʮ͐੮ɘͅ੮ ɘ੮ુ͙̼͐ʁ੮˺ʠ੮ɘ੮ˑɘ͸ૂ੮͐ʩɘ͐੮͸ɘͅ੮ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;੮˚˺̼ʇ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ʇͽʇ̼ɻʮͅʇ੮͐ʩɘ˦੮ɘ੮̼ʇʡ͙ˑɘ̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮U͐੮˚ɘ˦ʁɘ͐ʇʁ੮͐ʩɘ͐ੴ੮ɘͅ੮ɘ੮̹ʇ̼ͅ˺˦੮˚ɘ̼ɻʩʇʁ੮͐˺͸ɘ̼ʁ੮ʇʮʡʩ͐੮ ৵ৱ৵ৰͅੴ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ʁ˺ɻ͙˚ʇ˦͐੮͐ʩɘ͐੮͐ʩʇ;੮ʩɘʁ੮˦˺͐ʮϲʮʇʁ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮͐ʩɘ͐੮͐ʩʇ;੮͸ʇ̼ʇ੮ɘ͐੮ risk of a conservatorship and that they could receive voluntary services instead. U˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦੮̼ʇή͙ʮ̼ʇʁ੮ʁʇͷʇˑ˺̹ʮ˦ʡ੮ɘ˦ʁ੮ɘ̹̹̼˺ͷʮ˦ʡ੮ͅʇͷʇ˦͐ʇʇ˦੮ʁʮʠʠʇ̼ʇ˦͐੮ʠ˺̼˚ͅੳ੮ îʩ͙ͅ੮ ʠ˺ˑˑ˺͸ʇʁ੮ ˚˺˦͐ʩͅ੮ ˺ʠ੮ ϲʮ˦ʡʇ̼ચ̹˺ʮ˦͐ʮ˦ʡ੮ ɺʇ͐͸ʇʇ˦੮ ͐ʩʇ੮ ɻʮ͐;੮ ɘ͐͐˺̼˦ʇ;੮ ɘ˦ʁ੮ ͐ʩʇ੮ Superior Court about how to enact the many protections that had been tacked onto the bill.৾ਁ The real nightmare for city staff, though, was created by the hospitals. Although debates about SB 1045 centered on what was happening at the county

PAV I N G A N E W PAT H WAY

223

ʩ˺̹ͅʮ͐ɘˑੴ੮äH੮Iʇ˦ʇ̼ɘˑੴ੮ʮ͐੮ɘɻ͙͐ɘˑˑ;੮ʩ˺ˑʁͅ੮˺˦ˑ;੮ɘɺ˺͙͐੮ɘ੮͐ʩʮ̼ʁ੮˺ʠ੮͐ʩʇ੮ɻʮ͐;ૄͅ੮rØäચʁʇͅignated beds.৾ਂ Initially, data suggested that private hospitals received about 56 percent of 5150s. By 2021, the consultants had dug deeper and found that 79 percent of 5150s were passing through hospitals other than SF General.৾ਃ This is a ̹˺ʮ˦͐੮͸˺̼͐ʩ੮ʇ˚̹ʩɘͅʮΈʮ˦ʡੵ੮̹̼ʮ˺̼੮͐˺੮͐ʩʇ੮ʩ˺͙ͅʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹ʮˑ˺͐ੴ੮˦˺੮˺˦ʇ੮ʮ˦੮ city government actually knew how many people were subject to coercive psychiatric interventions in San Francisco.৾਄ If your target population is people with eight 5150s, you need someone to be counting. It turned out some hospitals just wouldn’t. A clinician who was tracking people on the housing conservatorship pathway told me dejectedly, “Some hospitals are choosing to participate, and others are choosing not to.” Even SF General’s PES apparently told the public conservator that it would accept a list of only ten names of people for whom it would provide the housing conserva͐˺̼ͅʩʮ̹੮˦˺͐ʮɻʇͅ੮ɘ˦ʁ੮ϲʮˑʇ੮͐ʩʇ੮˦ʇɻʇͅͅɘ̼;੮ʁ˺ɻ͙˚ʇ˦͐ͅ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻʮ͐;ੳ੮H˺̼੮˺͐ʩʇ̼੮ɻˑʮʇ˦͐ͅ੮ on the program’s watch list, the hospitals “don’t let us know that they’re there.”৿৻ When this clinician did learn that someone on her radar screen was at a certain private hospital (because they had been 5150ed by a city mobile crisis team, for example), she’d call and ask, “Are you thinking conservatorship?” and ER ͐ͅɘʠʠ੮͸˺͙ˑʁ੮̼ʇ̹ˑ;ੴ੮ુĔʇ੮ʁ˺˦ૄ͐੮ʁ˺੮͐ʩɘ͐੮ʩʇ̼ʇੳૂ੮š͐ʩʇ̼੮/Ûͅ੮͸ʇ̼ʇ੮͸̼ʮ͐ʮ˦ʡ੮ુ˚ɘˑʮ˦ʡʇ̼ʮ˦ʡૂ੮ or “personality disorder” as their diagnosis, which rendered that 5150 unusable (since it did not show mental illness and a substance use disorder). “The Housing Conservatorship notice [offering services and telling someone how far along they were toward eight 5150s] is one page, it’s check boxes and a signature,” she told me, adding, “it’s amazing the amount of pushback I’m getting about even that ɘʁʁʮ͐ʮ˺˦ɘˑ੮ʁ˺ɻ͙˚ʇ˦͐ɘ͐ʮ˺˦ੳૂ੮š˦ʇ੮̹ʇ͐ʮ͐ʮ˺˦੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚੮ʩɘʁ੮ϲʮˑʇʁ੮ʠɘʮˑʇʁ੮ɺʇɻɘ͙ͅʇ੮ the judge found the paperwork incomplete. “At this point it really does seem like ɘ੮͐˺͐ɘˑ੮ˈ˺ˌʇੴૂ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʩ˺੮ʩɘʁ੮ɻ˺˦͐ɘɻ͐੮͸ʮ͐ʩ੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ʠɘɺˑʇʁ੮ϲʮʠ͐;ચϲʮͷʇ੮ people initially targeted for housing conservatorship told me. Even when the city did get someone into a housing conservatorship, the ̼ʇ͙ͅˑ͐ͅ੮͸ʇ̼ʇ੮˦˺͐੮͐ͅʇˑˑɘ̼ੳ੮š˦ʇ੮̹ʇ̼ͅ˺˦੮͸ɘͅ੮̼ʇʩ˺̹ͅʮ͐ɘˑʮΈʇʁੴ੮ɘ˦ʁ੮͐ʩʇ੮ˈ͙ʁʡʇ੮ʁʇ͐ʇ̼˚ʮ˦ʇʁ੮ ͐ʩɘ͐੮͐ʩʇ;੮˚ʇ͐੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ɘ੮̼ʇʡ͙ˑɘ̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮˦˺͐ʩʇ̼੮͸ɘͅ੮̹ˑɘɻʇʁ੮˺˦੮ a housing conservatorship while in the hospital and was set to be transferred to an unlocked facility (the kind of less restrictive option the program envisioned). They jumped out of the car on the way there. Since then, they’ve been “con͐ʮ˦͙˺͙ͅˑ;੮Ĕšrૂ੮ફɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮˺˦ʇ੮ͅ˺͙̼ɻʇબੴ੮̹ʮ˦ʡʮ˦ʡ੮ʮ˦੮ɘ˦ʁ੮˺͙͐੮˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ ͅʇ̼ͷʮɻʇͅ੮ɘ˦ʁ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮͸ʮ͐ʩ੮͐ʩʇ੮̹ʇ̼ͅ˺˦ૄͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ϲʮ˦ʁʮ˦ʡ੮˺͙͐੮͸ʩʇ̼ʇ੮͐ʩʇ;੮ʩɘʁ੮

224

REFORM

ɺʇʇ˦੮˺˦ˑ;੮ɘʠ͐ʇ̼੮͐ʩʇ;੮͸ʇ̼ʇ੮̼ʇˑʇɘͅʇʁੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͙ͅɻɻʇͅͅʠ͙ˑˑ;੮ϲʮˑʇʁ੮͐˺੮ terminate the conservatorship. It’s a huge liability to have legal responsibility for a vulnerable individual, absent the authority to get other agencies to help meet that responsibility. There are some positive stories around the margins of the housing conserͷɘ͐˺̼ͅʩʮ̹੮ ʠ̼ɘɻɘͅੳ੮ ੮ ɻˑʮ˦ʮɻʮɘ˦੮ ͸ʮ͐ʩ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ šî੮ ̹̼˺ʡ̼ɘ˚੮ ʁʇͅɻ̼ʮɺʇʁ੮ ɘ੮ woman who had refused to engage despite a court order and instead racked up ͐͸˺੮ʁ˺Έʇ˦੮৵ৱ৵ৰͅ੮ʮ˦੮ɘ੮;ʇɘ̼ઝɘ͐੮ˑʇɘ͐ͅ੮ͅʇͷʇ˦੮˺ʠ੮͸ʩʮɻʩ੮ɘɻ͙͐ɘˑˑ;੮ɻ˺͙˦͐ʇʁ੮͐˺͸ɘ̼ʁ੮͐ʩʇ੮ eight-5150 criterion (because the ER diagnosed her with both a mental illness ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ʁʮͅ˺̼ʁʇ̼બੳ੮îʩʇ˦੮#šēU)੮ͅɘͷʇʁ੮ʩʇ̼ੳ੮äʩʇ੮ʩɘʁ੮̼ʇʠ͙ͅʇʁ੮ɘ੮̼˺˺˚੮ ͸ʮ͐ʩ੮ɘ੮ͅʩɘ̼ʇʁ੮ɺɘ͐ʩ̼˺˺˚੮ʮ˦੮ɘ˦੮äۚ੮ʮ˦੮͐ʩʇ੮îʇ˦ʁʇ̼ˑ˺ʮ˦ੳ੮"͙͐੮͸ʩʇ˦੮ʩʇ̼੮̹ɘ̼͐˦ʇ̼੮͸ɘͅ੮ offered a converted hotel room as part of the city’s shelter-in-place program, she ˈ˺ʮ˦ʇʁ੮ʩʮ˚ઝɘ˦ʁੴ੮ɘͅ੮ʠɘ̼੮ɘͅ੮͐ʩʇ੮ʩ˺͙ͅʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚੮͸ɘͅ੮ɻ˺˦ɻʇ̼˦ʇʁੴ੮ ʁʮͅɘ̹̹ʇɘ̼ʇʁੳ੮ુäʩʇ੮ʮͅ੮˦˺͐੮ͅ˺ɻʮʇ͐;ૄͅ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮͙ͅɻɻʇͅͅʠ͙ˑੴૂ੮͐ʩʇ੮ɻˑʮ˦ʮɻʮɘ˦੮͐˺ˑʁ੮˚ʇੴ੮ but “she’s not hanging out at one of the police stations pooping on their cars anymore.” She had made it a year without a 5150. “She’s a shining example of what consistent shelter can do for somebody,”৿ৼ the clinician summarized, before speculating that when the city wound down the hotel program, she’d likely return to ͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ੮Ě˺͙੮ɻɘ˦ૄ͐੮˚ɘˌʇ੮͐ʩʮͅ੮͙͐ͅʠʠ੮͙̹ੳ äʇ˦ɘ͐˺̼੮Ĕʮʇ˦ʇ̼੮ϲʮ˦ɘˑˑ;੮ɺ̼˺ˌʇ੮ʩʮͅ੮ͅʮˑʇ˦ɻʇ੮ɘɺ˺͙͐੮͐ʩʇ੮ɺʮˑˑ੮ʮ˦੮৲ৰ৲৲੮͐˺੮ɻ˺˦ʁʇ˚˦੮͐ʩʇ੮ city’s “uncoordinated and lackadaisical” implementation.৿৽ This might be true, ɺ͙͐੮ʮ˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦੮̼ʇή͙ʮ̼ʇʁ੮ʇ˦ʡɘʡʇ˚ʇ˦͐੮ʠ̼˺˚੮ɘ੮̼ɘ˦ʡʇ੮˺ʠ੮˺͐ʩʇ̼੮ʁʇˑʇʡɘ͐ʇʁ੮ͅʇ̼ͷʮɻʇ੮ providers, and the bill gave no authority to the city to actually force them into participating.

CONCLUSION: THE UNMET MANDATE FOR FORCED CARE I spoke to Supervisor Mandelman in April 2021 about his waning advocacy for the housing conservatorship program. “The trouble is that, maybe we go up ʠ̼˺˚੮ ˺˦ʇ੮ ɻ˺˦ͅʇ̼ͷʇʁ੮ ̹ʇ̼ͅ˺˦੮ ͐˺੮ ϲʮͷʇઝ͐ʩʇ੮ ɺɘ˦ʡ੮ ʠ˺̼੮ ͐ʩʇ੮ ɺ͙ɻˌ੮ ʮͅ੮ ̹̼ʇ͐͐;੮ ˚ʮ˦ʮ˚ɘˑੳ੮ So, I don’t know how much further to push 1045,” he admitted. It showed in his eyes, the lack of government infrastructure necessary to pave a new pathway to ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇ੮˺˦੮͐˺̹੮˺ʠ੮͐ʩʇ੮ɻ̼ʇɘˌʮ˦ʡ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੵ੮ુîʩʇͅʇ੮ reforms are predicated on an assumption that the counties can step in and take on the public health, criminal-justice, [and] involuntary detention obligations

PAV I N G A N E W PAT H WAY

225

[and] responsibilities that the state is throwing off. San Francisco is very wealthy, ɺ͙͐੯ੳ੯ੳ੯ੳ੮˺͙̼੮ͅ;͐ͅʇ˚ͅ੮યʮ˦੮͐ʩʇ੮ɻʮ͐;ર੮ʁ˺˦ૄ͐੮ɘɻ͐੮ˑʮˌʇ੮͐ʩʇ;੮ɻɘ˦੮˚ʇʇ͐੮͐ʩʇ੮˦ʇʇʁੴ੮˺̼੮ɘ̼ʇ੮ʇͷʇ˦੮ trying.” I share his doubts. ુ˦;੮ɘ͐͐ʇ˚̹͐੮͐˺੮ɘ˚ʇ˦ʁ੮rØä੮ʮͅ੮ɺ˺͙˦ʁ੮͐˺੮ɺʇ੮ɘ˦੮͙̹ʩʮˑˑ੮ͅˑ˺ʡੴૂ੮{ɘ˦ʁʇˑ˚ɘ˦੮˚͙ͅʇʁੳ੮ "͙͐੮͐˺੮ʩʮ˚ੴ੮͐ʩʇ੮ɺ̼˺ɘʁʇ̼੮ϲʮʡʩ͐੮͸ɘͅ੮ɘ੮͸˺̼͐ʩ;੮˺˦ʇੵ੮ુîʩʇ੮˦ʇʇʁ੮યʠ˺̼੮̼ʇʠ˺̼˚ર੮ʮͅ੮ͅ˺੮˺ɺͷʮous. As the state goes out of the prison business and San Francisco goes out of the jail business, we’re conveniently shutting down all of our options [for managing disorderly behavior]” outside of forced treatment. The barriers that both civil liberties groups and half-sympathetic legislators threw up to SB 1045, he insisted out, were out of sync with the general population, which was more stridently in ʠɘͷ˺̼ੵ੮ુU੮͐ʩʮ˦ˌ੮͐ʩʇ̼ʇ੮ʮͅ੮͙ͅɻʩ੮ɘ੮ʁʮͅɻ˺˦˦ʇɻ͐੮ɺʇ͐͸ʇʇ˦੮ʩ˺͸੮äɘ˦੮H̼ɘ˦ɻʮͅɻɘ˦ͅ੮ʠʇʇˑ੮ɘɺ˺͙͐੮ ͸ʩɘ͐੮ʮͅ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮͐ʩʇ੮̼ʇ̹ͅ˺˦ͅʇ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ੳ੯ੳ੯ੳ੯ੳ੮U੮˚ʇɘ˦ੴ੮ we’re a democracy, right? So you think the people are always right. But they don’t get their way.” Mandelman is certainly correct that ceding defeat on SB 1045 will not make community pressure go away. But as he himself was seeing, legislative reform matters little if no one has clear responsibility for acting on it. The next chapter considers another reform attempt that, unlike SB 1045, was not an effort to create an entirely new pathway onto conservatorship. It took aim, instead, at the “grave disability” criterion itself. SB 1045 came with the pretense that this was a gentler, less restrictive conservatorship, focused on getting people into independent housing. The reforms considered in the next chapter, ͐ʩ˺͙ʡʩੴ੮ʇ˚̹ʩɘͅʮΈʇ੮̼ʇɺ͙ʮˑʁʮ˦ʡ੮ɘ˦ʁ੮̼ʇϲʮˑˑʮ˦ʡ੮ˑ˺˦ʡʇ̼ચ͐ʇ̼˚੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅੳ

CHAPTER 12

ASYLUM FOR THE DYING

I

t’s not just rhetoric: people are dying on the streets in Los Angeles. A ͐˺͐ɘˑ੮˺ʠ੮ৱੴ৹৸৸੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮̹ʇ̼ʮͅʩʇʁ੮ʮ˦੮͐ʩʇ੮ϲʮ̼͐ͅ੮;ʇɘ̼੮˺ʠ੮͐ʩʇ੮#šēU)ચৱ৹੮ pandemic (starting March 2020), four times the tally from 2014.ৼ The mass ˚˺̼͐ɘˑʮ͐;੮ʮͅ੮ͅʮ˚ʮˑɘ̼ˑ;੮ͅ˺ɺʇ̼ʮ˦ʡ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ફϲʮʡ͙̼ʇ੮ৱ৲ੳৱબੳ But homeless people are dying when they get off the streets, too. U˦੮͐ʩʇ੮͙ͅ˚˚ʇ̼੮˺ʠ੮৲ৰ৲ৱੴ੮͸ʩʇ˦੮U੮˚ʇ͐੮Ĕɘˑˑ;੮͸ʮ͐ʩ੮)̼ੳ੮Øɘ̼͐˺ͷʮੴ੮ͅʩʇ੮ɘ͙̼ͅͅʇʁ੮˚ʇ੮ that there were hundreds of cases like his throughout the city. And, she told me, nowhere had a greater concentration of people debilitated by mental illness than äˌʮʁ੮Û˺͸ੴ੮͸ʩʇ̼ʇ੮ͅʩʇ੮ʩɘͅ੮͸˺̼ˌʇʁ੮ɘ͐੮͐ʩʇ੮P˺˚ʇˑʇͅͅ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮ɻˑʮ˦ʮɻ੮ʠ˺̼੮˚˺̼ʇ੮ than a decade. U͐ૄͅ੮ ʁʮ͙̼͐ͅɺʮ˦ʡ੮ ͐˺੮ ʁʇͅɻ̼ʮɺʇ੮ ɘ੮ ͷʮͅʮ͐੮ ͐˺੮ ͐ʩʮͅ੮ ϲʮʠ͐;ચ͐ʩ̼ʇʇચɺˑ˺ɻˌ੮ ʡɘˑˑʇ̼;੮ ˺ʠ੮ ʩ͙˚ɘ˦੮ misery as a “tour,” but the reality is that there’s no better place to see the crystalચ ˑʮΈʇʁ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮ʁʇɻɘʁʇͅ੮˺ʠ੮˦ʇʡˑʇɻ͐ੳ੮ä˺੮U੮̼ʇɘɻʩʇʁ੮˺͙͐੮͐˺੮)̼ੳ੮"˺ˑˑ˺˚ੴ੮ɘ੮̼͐ͅʇʇ͐੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʩ˺੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʇͅ੮͸ʮ͐ʩ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮˺˦੮ɘ੮̹ʮˑ˺͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚ੴ੮͐˺੮ͅʩ˺͸੮˚ʇ੮ɘ̼˺͙˦ʁੳ îʩʇ੮ʠ͙͐ʮˑʮ͐;੮˺ʠ੮ʇͽʮ͐ͅʮ˦ʡ੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ʡ˺ͷʇ̼˦੮äˌʮʁ੮Û˺͸੮ɘ̼ʇ੮ͷʮͅʮɺˑʇ੮ɘͅ੮ͅ˺˺˦੮ɘͅ੮͸ʇ੮ ˑʇɘͷʇ੮){Pૄͅ੮˺ϲϲʮɻʇ੮˺˦੮͐ʩʇ੮˺͙͐ͅˌʮ̼͐ͅੳ੮੮ʡ̼˺͙̹੮˺ʠ੮͸˺̼ˌʇ̼ͅ੮ʮͅ੮̹˺͸ʇ̼ચ̹̼ͅɘ;ʮ˦ʡ੮͐ʩʇ੮ ͅʮʁʇ͸ɘˑˌ੮˺˦੮˺˦ʇ੮ͅʮʁʇ੮˺ʠ੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮š˦੮͐ʩʇ੮˺͐ʩʇ̼ੴ੮˚˺͙˦ʁͅ੮˺ʠ੮˺ɺˈʇɻ͐ͅ੮͐ʩɘ͐੮ͅʇʇ˚੮ ͐˺੮ʮ˦͐ʇ̼˚ʮͽ੮ͷɘˑ͙ʇʁ੮̹˺ͅͅʇͅͅʮ˺˦ͅ੮ɘ˦ʁ੮̼ʇʠ͙ͅʇ੮ɘ̼ʇ੮ʩʇɘ̹ʇʁ੮ɺʇ͐͸ʇʇ˦੮̹ɘ̼͐ˑ;੮ɻ˺ˑˑɘ̹ͅʇʁ੮ tents. ‘Later today, they’ll sweep that side of the street,’ she tells me, ‘and people ͸ʮˑˑ੮ˈ͙͐ͅ੮˚˺ͷʇ੮ʇͷʇ̼;͐ʩʮ˦ʡ੮͐˺੮͐ʩʇ੮˺͐ʩʇ̼੮ͅʮʁʇੳૄ੮U˦ʁʮͅɻ̼ʮ˚ʮ˦ɘ͐ʇ੮ɻˑʇɘ˦ʮ˦ʡ੮˺̹ʇ̼ɘ͐ʮ˺˦ͅ੮ ˑʮˌʇ੮͐ʩʮͅ੮ʩɘͷʇ੮̹ɘ̼͐ˑ;੮̼ʇ̹ˑɘɻʇʁ੮ʇ˦ʁˑʇͅͅ੮ɻʮ͐ɘ͐ʮ˺˦ͅ੮ɘͅ੮ɘ੮͸ɘ;੮͐˺੮̹͙ͅʩ੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮͐ʩʇ੮ ̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮ʡ˺੯ੳ੯ੳ੯ੳ੮ͅ˺˚ʇ͸ʩʇ̼ʇੳ৽ Ĕʇ੮͐ͅʇ̹੮ʮ˦͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɺ͙͐੮ʩɘͷʇ੮͐˺੮̹ɘ͙ͅʇ੮ɘͅ੮ɘ੮˚ɘ˦੮͸ʮ͐ʩ੮˦˺੮ˑʇʡͅ੮͸ʩʇʇˑͅ੮̹ɘ͐ͅ੮ us into the center of the intersection, screaming at the sky. Next to us, another

A SY LU M F O R T H E DY I N G

227

2000 Los Angeles* San Francisco* Alameda San Diego Sacramento Orange Santa Clara Ventura

Deaths

1500

1000

500

* 21 20

20 20

19 20

18 20

17

16

20

15

20

14

20

13

20

20

20

12

0

12.1 )ʇɘ͐ʩͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ʮ˦੮ͅʇˑʇɻ͐੮ɻ˺͙˦͐ʮʇͅੴ੮৲ৰৱ৲જ৲ৰ৲ৱ Sourceੵ੮#˺͙˦͐;੮#˺̼˺˦ʇ̼ͅ੶੮#ɘ͸ˑʇ;੮ʇ͐੮ɘˑੳ੮ફ৲ৰ৲৲બ ੾੮)ɘ͐ɘ੮ʠ˺̼੮৲ৰ৲ৱ੮ɘ̼ʇ੮ʠ˺̼੮͐ʩʇ੮ϲʮ̼͐ͅ੮;ʇɘ̼੮˺ʠ੮#šēU)ચৱ৹੮̹ɘ˦ʁʇ˚ʮɻ੮ફ{ɘ̼ɻʩ੮৲ৰ৲ৰજ{ɘ̼ɻʩ੮৲ৰ৲ৱબ

man is rolling on the ground, with what looks like peanut butter coming from his ˚˺͙͐ʩੳ੮U੮ʩɘͷʇ੮˦˺੮ʁ˺͙ɺ͐੮͐ʩɘ͐੮)̼ੳ੮"˺ˑˑ˺˚੮͸ʮͅʩʇͅ੮ͅʩʇ੮ɻ˺͙ˑʁ੮ʩʇˑ̹੮͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ ɺ͙͐੮ʮʠ੮;˺͙੮͐ͅ˺̹੮ʇɘɻʩ੮͐ʮ˚ʇ੮;˺͙੮ͅʇʇ੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮ͷʮͅʮɺˑʇ੮ɻ̼ʮͅʮͅ੮˺˦੮äˌʮʁ੮Û˺͸ੴ੮;˺͙੮ʁ˺˦ૄ͐੮ ʡʇ͐੮ͷʇ̼;੮ʠɘ̼ੳ੮˦ʁ੮͐ʩʇ੮̹˺ʮ˦͐੮˺ʠ੮˺͙̼੮ͷʮͅʮ͐੮ʮͅ੮͐˺੮ʡʮͷʇ੮˚ʇ੮ɘ੮ͅʇ˦ͅʇ੮˺ʠ੮̹ͅ;ɻʩ˺ͅʮͅ੮˦˺͐੮ʮ˦੮ʮ͐ͅ੮ most jarring form but in its more subtle—and fatal—manifestations. Ĕʇૄ̼ʇ੮͸ɘˑˌʮ˦ʡ੮̹ɘ͐ͅ੮ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮͐ʇ˦͐ͅੴ੮ɘ˦ʁ੮)̼ੳ੮"˺ˑˑ˺˚੮ʇͽ̹ˑɘʮ˦ͅ੮͸ʩ;੮͐ʩʇ੮ʮ˦ʁʮͷʮʁચ ͙ɘˑͅ੮ʩʇ̼ʇ੮͸˺͙ˑʁ੮˦˺͐੮ή͙ɘˑʮʠ;੮ʠ˺̼੮rૄͅ੮P˺˚ʇˑʇͅͅ੮š͙̼͐ʇɘɻʩ੮ɘ˦ʁ੮{˺ɺʮˑʇ੮/˦ʡɘʡʇ˚ʇ˦͐੮ ફPš{/બ੮͐ʇɘ˚ੴ੮͸ʩʮɻʩ੮ʮͅ੮͸˺̼ˌʮ˦ʡ੮͐˺੮ʠɘɻʮˑʮ͐ɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʠ˺̼੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮ ˚˺͐ͅ੮ɻʩ̼˺˦ʮɻɘˑˑ;੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੳ੮ૃયPš{/ૄͅર੮ɻˑʮʇ˦͐ͅ੮͸˺͙ˑʁ੮˦˺͐੮ʩɘͷʇ੮ a tent,’ she notes. ૃ"ʇɻɘ͙ͅʇ੮ʮ͐੮ʡʇ͐ͅ੮͐ͅ˺ˑʇ˦ੴ੮˺̼੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ɻɘ˦ૄ͐੮˚ɘ˦ɘʡʇ੮͐˺੮̹ʮ͐ɻʩ੮˺˦ʇ੺ૄ੮U੮͸˺˦ʁʇ̼੮ in response. ૃ{˺͐ͅˑ;੮ ͐ʩʇ੮ ˑɘ͐͐ʇ̼ੴૄ੮ ͅʩʇ੮ ̼ʇ̹ˑʮʇͅੳ੮ îʩʇ;ૄ̼ʇ੮ ɘˑͅ˺੮ ˺ʠ͐ʇ˦੮ ૃʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ ɘ̼ʇ˦ૄ͐੮ showing up in any system’ because their failure to attend to basic needs rarely

228

REFORM

ˑʇɘʁͅ੮͐˺੮ɘ̼̼ʇ͐ͅ੮˺̼੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮͐ʩʇ;ૄ̼ʇ੮ʇɘͅʮˑ;੮˺ͷʇ̼ˑ˺˺ˌʇʁ੮ɺ;੮̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ outreach teams. H˺̼੮̹̼ʮͷɘɻ;੮̼ʇɘͅ˺˦ͅੴ੮)̼ੳ੮"˺ˑˑ˺˚੮ʁ˺ʇͅ˦ૄ͐੮ʮ˦̼͐˺ʁ͙ɻʇ੮˚ʇ੮͐˺੮ɘ˦;੮˺ʠ੮Pš{/ૄͅ੮ɻˑʮચ ents.৾ But she’s clearly on the lookout for potential referrals (and just genuinely ɻ˺˦ɻʇ̼˦ʇʁ੮ɘɺ˺͙͐੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʇ੮ͅʇʇબੳ੮Ĕʇ੮͸ɘˑˌ੮˺ͷʇ̼੮͐˺੮ɘ੮˚ɘ˦੮ˑ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮ͅʮʁʇ͸ɘˑˌ੮ ͙˦ʁʇ̼੮ɘ੮ͅɻ̼ɘʡʡˑ;੮̼͐ʇʇੳ੮Pʇૄͅ੮ɘˑ˺˦ʇੴ੮͸ʩʮɻʩ੮ͅʩʇ੮ͅɘ;ͅ੮ʮͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮͐ʩʇ੮ɻɘͅʇ੮ʠ˺̼੮Pš{/੮ ɻˑʮʇ˦͐ͅੴ੮͸ʩ˺੮˺ʠ͐ʇ˦੮ʩɘͷʇ੮ͅʇͷʇ̼ʇ੮̹ɘ̼ɘ˦˺ʮɘ੮ɘ˦ʁ੮̼͙͐ͅʡʡˑʇ੮͐˺੮͐ɘ̹੮ʮ˦͐˺੮͐ʩʇ੮͙͙ͅɘˑ੮͙̹̹ͅ˺̼͐੮ networks between people experiencing homelessness. ‘He has shoes,’ she comચ ˚ʇ˦͐ͅੴ੮ɘ˦ʁ੮ૃˌʮ˦ʁ੮˺ʠ੮ɘ੮̹ʮˑˑ˺͸ੴૄ੮͸ʩʮɻʩ੮ʮͅ੮ˈ͙͐ͅ੮ɘ੮͸ɘʁʁʇʁચ͙̹੮͐ચͅʩʮ̼͐ੴ੮ɺ˺͐ʩ੮˺ʠ੮͸ʩʮɻʩ੮ ͅʇʇ˚੮͐˺੮ʮ˦ʁʮɻɘ͐ʇ੮ͅ˺˚ʇ੮ɻɘ̹ɘɻʮ͐;੮ʠ˺̼੮ͅʇˑʠચɻɘ̼ʇੳ੮äʩʇ੮͐ʩʮ˦ˌͅ੮ʩʇૄͅ੮̹̼˺ɺɘɺˑ;੮ˈ͙͐ͅ੮ͅˑʇʇ̹ચ ʮ˦ʡ੮˺ʠʠ੮ɘ੮ʩʮʡʩੴ੮ɘ˦ʁ੮͸ʇ੮˚˺ͷʇ੮˺˦ੳ Ĕʇૄ̼ʇ੮ ͸ɘˑˌʮ˦ʡ੮ ɘˑ˺˦ʡ੮ ͐ʩʇ੮ ͅʮʁʇ੮ ˺ʠ੮ ͐ʩʇ੮ õ˦ʮ˺˦੮ Ûʇͅɻ͙ʇ੮ {ʮͅͅʮ˺˦ੴ੮ ɘ੮ ˚ʇʡɘચͅʩʇˑ͐ʇ̼੮ ͐ʩɘ͐ੴ੮)̼ੳ੮"˺ˑˑ˺˚੮ɘ͙̼ͅͅʇͅ੮˚ʇੴ੮Pš{/੮ɻˑʮʇ˦͐ͅ੮͸˺͙ˑʁ੮˦ʇͷʇ̼੮͙ͅʇ੮ɘ˦ʁ੮͸ʩ˺ͅʇ੮̼͐ͅʮɻ͐੮ ̼͙ˑʇͅ੮ɘ̼˺͙˦ʁ੮ɻ˺˦ʡ̼ʇʡɘ͐ʇ੮ˑʮͷʮ˦ʡ੮͐ʩʇ;੮ɻ˺͙ˑʁ˦ૄ͐੮ʠ˺ˑˑ˺͸੮ʇͷʇ˦੮ʮʠ੮͐ʩʇ;੮͸ɘ˦͐ʇʁ੮͐˺ੳ੮Ĕʇ੮ ͅʇʇ੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ˑ;ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇʮ̼੮ʩʇɘʁ੮ʮ˦੮˺˦ʇ੮ɻɘ̼ʁɺ˺ɘ̼ʁ੮ɺ˺ͽ੮ɘ˦ʁ੮͐ʩʇʮ̼੮ʠʇʇ͐੮ʮ˦੮ another. She’s concerned because the parts of their legs that are exposed look ͷʇ̼;੮ɻʩɘʠʇʁੴ੮ɘ˦ʁ੮ͅʩʇ੮ˌ˦ʇʇˑͅ੮ʁ˺͸˦੮͐˺੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʇੳ੮U͐ૄͅ੮ɘ੮͙̼̹̼ͅʮͅʮ˦ʡˑ;੮ɻ˺˚˚˺˦੮ʮ͙ͅͅʇ੮ ɘ˚˺˦ʡ੮Pš{/੮ɻˑʮʇ˦͐ͅੵ੮ɘɺͅɻʇͅͅʇͅ੮˺̼੮ʇʁʇ˚ɘ੮˺ʠ੮͐ʩʇ੮ˑʇʡͅੴ੮̹͙͐͐ʮ˦ʡ੮͐ʩʇ˚੮ɘ͐੮̼ʮͅˌ੮˺ʠ੮ ɘ˚̹͙͐ɘ͐ʮ˺˦ੳ੮š˦੮͐ʩʇ੮˺͐ʩʇ̼੮ʩɘ˦ʁੴ੮ͅʩʇ੮˺ɺͅʇ̼ͷʇͅੴ੮ૃ͐ʩʮͅ੮ʮͅ੮ɘ੮̹̼ʇ͐͐;੮ʡ˺˺ʁ੮ɺ˺ͽ੮ͅʇ͐੮͙̹ੳૄ੮ U੮ˌ˦˺͸੮ͅʩʇ੮ͅʇʇͅ੮͐ʩʇ੮ɘɺ͙̼ͅʁʮ͐;੮˺ʠ੮͐ʩʮͅ੮͐ͅɘ͐ʇ˚ʇ˦͐ੳ੮"͙͐੮͸ʩʇ˦੮;˺͙̼੮̹ʮˑ˺͐੮̹̼˺ʡ̼ɘ˚੮ ʮͅ੮ ͅʇ̼ͷʮ˦ʡ੮ ϲʮʠ͐;੮ ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇ੮ ˺͙͐੮ ˺ʠ੮ ͅʇͷʇ˦͐;੮ ͐ʩ˺͙ͅɘ˦ʁੴ੮ ̼͐ʮɘʡʇ੮ ʮͅ੮ ʡ˺ʮ˦ʡ੮ ͐˺੮ ɺʇ੮ brutally strict. î˺͸ɘ̼ʁ੮ ͐ʩʇ੮ ʇ˦ʁ੮ ˺ʠ੮ ˺͙̼੮ ͐˺͙̼ੴ੮ U੮ ɘʁ˚ʮ͐੮ ͐˺੮ )̼ੳ੮ "˺ˑˑ˺˚੮ ͐ʩɘ͐੮ Uૄ˚੮ ʠʇʇˑʮ˦ʡ੮ ̹̼ʇ͐͐;੮ ʇ˚˺͐ʮ˺˦ɘˑੳ੮ૃ)˺੮;˺͙੮͐ʩʮ˦ˌ੮͐ʩʮͅ੮ʇͽʮ͐ͅͅ੮ɘ˦;͸ʩʇ̼ʇ੮ʇˑͅʇ੺ૄ੮U੮̹˺˦ʁʇ̼ੳ ૃîʩʮͅ੮ʮͅ੮̹̼ʇ͐͐;੮͙˦ʮή͙ʇ੮͐˺੮rੴૄ੮ͅʩʇ੮̼ʇϲˑʇɻ͐ͅੴ੮ૃɘ˦ʁ੮͐ʩʇ੮ˑʇ˦ʡ͐ʩ੮˺ʠ੮͐ʮ˚ʇ੮͐ʩʇͅʇ੮ʮ˦ʁʮચ ͷʮʁ͙ɘˑͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ʡ˺ʮ˦ʡ੮͸ʮ͐ʩ˺͙͐੮ͅʇ̼ͷʮɻʇͅੳૄ U˦੮‡ʇ͸੮Ě˺̼ˌੴ੮ɘ͐੮ˑʇɘ͐ͅੴ੮˦ʇɘ̼ˑ;੮ɘˑˑ੮˺ʠ੮͐ʩʇ੮ɻʩ̼˺˦ʮɻ੮ʩ˺˚ʇˑʇͅͅ੮ɘ̼ʇ੮˺˦੮ͅ˺˚ʇ੮ɘʡʇ˦ɻ;ૄͅ੮ ˑʮ͐ͅੳ੮õ˦͐ʮˑ੮̼ʇɻʇ˦͐ˑ;ੴ੮ૃPš{/ૄͅ੮ɻˑʮʇ˦͐ͅ੮͸ʇ̼ʇ੮ˈ͙͐ͅ੮ʮ˦ͷʮͅʮɺˑʇੴૄ੮ͅʩʇ੮̼ʇʮ͐ʇ̼ɘ͐ʇͅੳ੮˦˺͐ʩʇ̼੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮͸ʩ˺੮͸˺̼ˌʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ͅɘ˚ʇ੮̹˺̹͙ˑɘ͐ʮ˺˦੮̹͙͐੮ʮ͐੮͐˺੮˚ʇ੮͐ʩʮͅ੮ ͸ɘ;ੵ੮ુîʩʇ੮̹ʇ˺̹ˑʇ੮U੮ɻɘ̼ʇ੮˚˺͐ͅ੮ɘɺ˺͙͐ੴ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮˚ɘˌʇ੮ɘ੮͐ͅʮ˦ˌੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ʁ˺˦ૄ͐੮ϲʮ͐੮ ɘ˦;੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘੴ੮ɘͅ੮͐ʩʇ;ૄ̼ʇ੮ɻ͙̼̼ʇ˦͐ˑ;੮ʁʇϲʮ˦ʇʁੴ੮ͅ˺੮ય͸ʇર੮ˑʇɘͷʇ੮͐ʩʇ˚੮͐ʩʇ̼ʇ੮ɘ˦ʁ੮͐ʩʇ;੮ ʁʮʇ੮͐ʩʇ̼ʇੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ʩɘͷʇ੮ˑ˺͐ͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ˑʮˌʇ੮͐ʩɘ͐ੴ੮ɘ˦ʁ੮˦˺ɺ˺ʁ;੮ʩɘͅ੮ʇͷʇ̼੮ɘͅˌʇʁ੮͐ʩʇ˚੮ɘ੮ ͅʮ˦ʡˑʇ੮ή͙ʇ͐ͅʮ˺˦ੳ੮îʩʇ;੮ɘ̼ʇ੮ˈ͙͐ͅ੮˺͙͐੮͐ʩʇ̼ʇ੮ɘˑˑ੮ɺ;੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮ˈ͙͐ͅ੮ʠ˺̼ʡ˺͐͐ʇ˦੮̹ʇ˺̹ˑʇੳૂ By this point, we’re in front of a large supported housing building. For the past two decades, the momentum in homelessness policy has been toward Housing First, or the approach of placing people immediately in permanent, independent

A SY LU M F O R T H E DY I N G

229

ʩ˺͙ͅʮ˦ʡઝ˦˺੮ ̼͐ͅʮ˦ʡͅ੮ ɘ͐͐ɘɻʩʇʁઝɘ˦ʁ੮ ˺ʠʠʇ̼ʮ˦ʡ੮ ͷ˺ˑ͙˦͐ɘ̼;੮ ͅʇ̼ͷʮɻʇͅ੮ ɘʠ͐ʇ̼͸ɘ̼ʁੳ৿ The ʇͷʮʁʇ˦ɻʇ੮͐ʩɘ͐੮͐ʩʮͅ੮ʮͅ੮ɘ˦੮ʇʠʠʇɻ͐ʮͷʇ੮͸ɘ;੮͐˺੮ʡʇ͐੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮ˌʇʇ̹੮͐ʩʇ˚੮ housed is robust.਀ "͙͐੮͸ʩɘ͐੮͸˺̼ˌͅ੮ʠ˺̼੮˚˺͐ͅ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮˚ɘ;੮˦˺͐੮͸˺̼ˌ੮ʠ˺̼੮Pš{/ૄͅ੮ɻˑʮʇ˦͐ͅੳ੮ {ɘ˦;੮ʩɘͷʇ੮̼ʇʠ͙ͅʇʁ੮ʩ˺͙ͅʮ˦ʡ੮˺ʠʠʇ̼ͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮ʩɘͷʇ੮ɘ੮ʁʇˑ͙ͅʮ˺˦੮͐ʩɘ͐੮ˌʇʇ̹ͅ੮͐ʩʇ˚੮ ϲʮͽʇʁ੮ʮ˦੮̹ˑɘɻʇੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮͙˦͸ʮˑˑʮ˦ʡ੮͐˺੮˚˺ͷʇ੮ʇͷʇ˦੮͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮ɺɘ͐ʩ̼˺˺˚ੳ੮Uʠ੮͐ʩʇ;੮ did agree to be housed, ‘most of our folks would not get a place, they would not ˚ɘˌʇ੮ ʮ͐੮ ͐ʩ̼˺͙ʡʩ੮ ɘ˦੮ ʮ˦͐ʇ̼ͷʮʇ͸ੴ੮ ͐ʩʇ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ય˚˺͐ͅˑ;੮ ̼͙˦੮ ɺ;੮ ˦˺˦̹̼˺ϲʮ͐ͅર੮ ͸˺͙ˑʁ੮ ɻʩʇ̼̼;੮̹ʮɻˌੴૄ੮)̼ੳ੮"˺ˑˑ˺˚੮͐ʇˑˑͅ੮˚ʇੳ੮U͐੮˚ʮʡʩ͐੮ɺʇ੮ʠ˺̼੮͐ʩʇ੮ɺʇ͐ͅੴ੮ɺʇɻɘ͙ͅʇ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ʩ˺͙ͅʮ˦ʡ੮ૃ͸˺͙ˑʁ˦ૄ͐੮ɺʇ੮ͅɘʠʇ੮ʠ˺̼੮͐ʩʇ˚ੳ੮îʩʇ;੮˦ʇʇʁ੮৲৴ચʩ˺͙̼੮˚˺˦ʮ͐˺̼ʮ˦ʡੳૄ ੮ʠʇ͸੮ʁɘ;ͅ੮ʇɘ̼ˑʮʇ̼ੴ੮U੮ͷʮͅʮ͐ʇʁ੮˺˦ʇ੮˺ʠ੮͐ʩ˺ͅʇ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮ɺ͙ʮˑʁʮ˦ʡͅ੮͸ʩʇ̼ʇ੮ Pš{/੮ ɻˑʮʇ˦͐ͅ੮ ͸ʩ˺੮ ͸ʮ˦੮ ͐ʩʇ੮ ʩ˺͙ͅʮ˦ʡ੮ ˑ˺͐͐ʇ̼;੮ ɘ˦ʁ੮ ɘɻɻʇ̹͐੮ ͐ʩʇʮ̼੮ ͸ʮ˦˦ʮ˦ʡͅ੮ ˚ʮʡʩ͐੮ ʡ˺ઝɘ˦ʁੴ੮̼͐ɘʡʮɻɘˑˑ;ੴ੮ʁʮʇੳ੮)ʇͷ˺˦ੴ੮˚;੮ʡ͙ʮʁʇੴ੮ʮͅ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮˚ɘ˦ɘʡʮ˦ʡ੮͙̹̹ͅ˺̼͐੮ ͅʇ̼ͷʮɻʇͅ੮ʠ˺̼੮ͅʇͷʇ̼ɘˑ੮ɻ˺˚̹ˑʇͽʇͅ੮͐ʩɘ͐੮ʇͽɻˑ͙ͅʮͷʇˑ;੮ʩ˺͙ͅʇ੮˺˦ɻʇચʩ˺˚ʇˑʇͅͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੳ੮ Uૄͷʇ੮ͅʇʇ˦੮ͅ˺˚ʇ੮̹̼ʇ͐͐;੮ɘɺ;ͅ˚ɘˑ੮ͅʮ˦ʡˑʇચ̼˺˺˚੮˺ɻɻ͙̹ɘ˦ɻ;੮ʩ˺͐ʇˑͅ੮͐ʩɘ͐੮ή͙ɘˑʮʠ;੮ɘͅ੮ુ͙̹ͅચ ̹˺̼͐ʇʁ੮ ʩ˺͙ͅʮ˦ʡૂ੮ ˺ͷʇ̼੮ ͐ʩʇ੮ ɻ˺͙̼ͅʇ੮ ˺ʠ੮ ˚;੮ ̼ʇͅʇɘ̼ɻʩੴ੮ ɺ͙͐੮ ͐ʩʮͅ੮ ɺ͙ʮˑʁʮ˦ʡ੮ ʮͅ੮ ˦ʇ͸੮ ɘ˦ʁ੮ ɻˑʇɘ˦ੳ੮îʩʇ̼ʇૄͅ੮ɘ੮͸ʇˑˑચ͐ʇ˦ʁʇʁ੮ʡɘ̼ʁʇ˦੮ɘ˦ʁ੮ɺɘ̼ɺʇή͙ʇ੮ɘ̼ʇɘੴ੮˦ʇʮ͐ʩʇ̼੮˺ʠ੮͸ʩʮɻʩ੮ͅʇʇ˚ͅ੮͐˺੮ be getting much use. Ĕʩʮˑʇ੮)ʇͷ˺˦੮ʮͅ੮ɘ੮P˺͙ͅʮ˦ʡ੮Hʮ̼͐ͅ੮ɺʇˑʮʇͷʇ̼ੴ੮ͅʩʇ੮ɘˑͅ˺੮ʩɘͅ੮ɘ੮ʠ̼˺˦͐ચ̼˺͸੮ͅʇɘ͐੮͐˺੮ʮ͐ͅ੮ failings. There was, for example, a woman who threatened repeatedly to blow up the building. She had a colostomy bag that she often did not attach. “There was ɺˑ˺˺ʁ੮ɘ˦ʁ੮̹˺˺̹੮ɘˑˑ੮˺ͷʇ̼੮ʩʇ̼੮͙˦ʮ͐ੴૂ੮)ʇͷ˺˦੮̼ʇɻ˺͙˦͐ͅੴ੮ુɻˑʇɘ̼ˑ;੮˦˺͐੮͐ɘˌʮ˦ʡ੮ɻɘ̼ʇ੮˺ʠ੮ ʩʇ̼ͅʇˑʠੴ੮ͅ˺੮ʁʇ̹̼ʇͅͅʇʁ੮ɘ˦ʁ੮ɘ˦ͽʮ˺͙ͅੴ੮ͅɘ;ʮ˦ʡੴ੮ૃU੮͸ɘ˦͐੮͐˺੮ɺ˺˚ɺ੮͐ʩʇ੮͙˦ʮ͐ੴ੮ˈ͙͐ͅ੮˚ɘˌʇ੮͐ʩʮͅ੮ ʇ˦ʁੳૄૂ੮)ʇͷ˺˦੮ɻɘˑˑʇʁ੮͐ʩʇ੮ɻ˺͙˦͐;੮˚˺ɺʮˑʇ੮ɻ̼ʮͅʮͅ੮͐ʇɘ˚ੴ੮ʮ˦ͅʮ͐ͅʮ˦ʡੴ੮ુîʩʮͅ੮̹ʇ̼ͅ˺˦੮˦ʇʇʁͅ੮ emergency medical care.” They came in a few hours, but by then she had “put ˺˦੮ɘ੮ɻˑʇɘ˦੮îચͅʩʮ̼͐੮ɘ˦ʁ੮͸ɘˑˌʇʁ੮ɺɘɻˌ੮ʇͷʇ̼;͐ʩʮ˦ʡੳૂ੮îʩʇ੮͐ʇɘ˚੮ˑʇʠ͐੮͸ʩʇ˦੮ͅʩʇ੮˚ɘʁʇ੮ɘ੮ ̹̼˺˚ʮͅʇ੮͐˺੮ͅʇʇ੮ɘ੮̹̼ʮ˚ɘ̼;ચɻɘ̼ʇ੮ʁ˺ɻ͐˺̼ੳ îʩʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮͸ɘͅ੮˺˦ʇ੮̼ʇɘͅ˺˦੮)ʇͷ˺˦੮ʁʇɻʮʁʇʁ੮͐˺੮̹͙̼͙ͅʇ੮ɻ˺͙˦͐;੮ɘ͙͐ʩ˺̼ʮΈɘ͐ʮ˺˦੮ ͐˺੮͸̼ʮ͐ʇ੮rØä੮ʩ˺ˑʁͅ੮ʩʇ̼ͅʇˑʠੳ੮ä͐ʮˑˑੴ੮৵ৱ৵ৰʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ʠ˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ુʮͅ੮ͅ˺੮ʩɘ̼ʁੴ੮ because you’re supposed to be writing a hold only when someone will immiચ ˦ʇ˦͐ˑ;੮ʁʮʇ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇʮ̼੮ɻʩ˺ʮɻʇͅੳ੮U͐ૄͅ੮ͅ˺੮͙ͅɺˈʇɻ͐ʮͷʇੳ੮îʩʇ੮ˑʮ˦ʇ੮ɺʇ͐͸ʇʇ˦੮ͅʇˑʠચʁʇ͐ʇ̼ચ mination and dignity of the person is so blurry.” That balancing act is trickiest for people refusing medical treatment for physચ ʮɻɘˑ੮ʩʇɘˑ͐ʩ੮ʮ͙ͅͅʇͅੳ੮îʩʇ੮͸ʇʇˌ੮ɺʇʠ˺̼ʇੴ੮)ʇͷ˺˦੮ʁʮʁ੮ɘ੮͸ʇˑˑ˦ʇͅͅ੮ɻʩʇɻˌ੮˺˦੮ɘ੮̼ʇͅʮʁʇ˦͐੮ɘ˦ʁ੮ ʠ˺͙˦ʁ੮ʩʮ˚੮ુɘɻ͐ʮͷʇˑ;੮ʁ;ʮ˦ʡ੯ੳ੯ੳ੯ੳ੮ʩʇ੮ͅ˚ʇˑˑʇʁ੮ˑʮˌʇ੮ʁʇɘ͐ʩ੮ɘ˦ʁ੮ʁʇɻɘ;ੳૂ੮"͙͐੮ʩʇ੮ʮ˦ͅʮ͐ͅʇʁੴ੮ુU੮ ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ʁ˺˦ૄ͐੮ɻɘˑˑ੮͐ʩʇ੮ɘ˚ɺ͙ˑɘ˦ɻʇੳૂ੮Ĕʩʇ˦੮͐ʩʇ੮̹ɘ̼ɘ˚ʇʁʮɻͅ੮

230

REFORM

ɘ̼̼ʮͷʇʁੴ੮ુîʩʇ;੮ɻɘ˚ʇ੮ɘ˦ʁ੮ͅɘʮʁੴ੮ૃU͐ૄͅ੮˦˺͐੮˺ˌɘ;੮ʠ˺̼੮;˺͙੮͐˺੮ͅɘ;੮ુ˦˺ੴૂ੮ʮʠ੮;˺͙੮͐ͅɘ;੮ʩʇ̼ʇ੮ ;˺͙੮͸ʮˑˑ੮ʁʮʇੳૄ੮˦ʁ੮ʩʇ੮ͅɘʮʁੴ੮ૃU੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʁʮʇੳૄ੮ૃĚ˺͙੮ʩɘͷʇ੮͐˺੮ɻ˺˚ʇੳૄ੮ૃU੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮ ͐˺੮ʡ˺੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳૄ੮îʩʇ˦੮͐ʩʇ;੮ɘͅˌʇʁ੮ʩʮ˚ੴ੮ૃ)˺੮;˺͙੮͸ɘ˦͐੮͐˺੮ʁʮʇ੮ɘ͐੮ʩ˺˚ʇ੺ૄ੮˦ʁ੮ ʩʇ੮ͅɘʮʁੴ੮ૃ‡˺ੴ੮U੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʁʮʇੳૄ੮˦ʁ੮͐ʩʇ੮̼ʇ̹ͅ˺˦ʁʇ̼ͅ੮ͅɘʮʁੴ੮ૃɻɻ˺̼ʁʮ˦ʡ੮͐˺੮;˺͙̼੮ ͷʮ͐ɘˑͅ੮ɘ˦ʁ੮;˺͙̼੮̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦ੴ੮;˺͙੮͸ʮˑˑ੮ʁʮʇੳૄૂ੮/ͷʇ˦͙͐ɘˑˑ;੮͐ʩʇ;੮͐˺˺ˌ੮ʩʮ˚੮ʮ˦੮˺˦੮ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;ੳ੮ )ʇͷ˺˦੮ ͅɘ;ͅ੮ ͐ʩɘ͐੮ r੮ #˺͙˦͐;੮ ){P੮ ʩɘͅ੮ ɺʇʇ˦੮ ͅʇ˦ʁʮ˦ʡ੮ ͅʮʡ˦ɘˑͅ੮ ͐˺੮ ʩ˺ͅચ ̹ʮ͐ɘˑͅ੮ ɘ˦ʁ੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ͐ʩɘ͐੮ ̹ʩ;ͅʮɻɘˑ੮ ʩʇɘˑ͐ʩ੮ ˦ʇʇʁͅ੮ ͅʩ˺͙ˑʁ੮ ɺʇ੮ ɻ˺˦ͅʮʁʇ̼ʇʁ੮ ʮ˦੮ ৵ৱ৵ৰ੮ ʇͷɘˑ͙ɘ͐ʮ˺˦ͅੳ U͐੮ʩɘͅ˦ૄ͐੮ɺʇʇ˦੮ʇ˦˺͙ʡʩੳ੮U˦੮͐ʩʇ੮̹ɘ͐ͅ੮;ʇɘ̼ੴ੮͐ʩʇ̼ʇ੮ʩɘͷʇ੮ɺʇʇ˦੮͐ʩʮ̼͐;੮ʁʇɘ͐ʩͅ੮ɘɻ̼˺ͅͅ੮ ʩʇ̼੮˦˺˦̹̼˺ϲʮ͐ૄͅ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮̹̼˺ˈʇɻ͐ͅੳ੮U͐ૄͅ੮ɘ˦੮ʇ˦ʁʇ˚ʮɻ੮̹̼˺ɺˑʇ˚ੳ੮U˦੮˺˦ʇ੮ɘ͙ʁʮ͐੮ from San Francisco, 7 percent of people placed in supported housing in 2010 were ʁʇɘʁ੮͸ʮ͐ʩʮ˦੮ϲʮͷʇ੮;ʇɘ̼ͅੳਁ੮îʩʇ੮ʁʇɘ͐ʩ੮̼ɘ͐ʇ੮ʮ˦੮ͅʩʇˑ͐ʇ̼ચʮ˦ચ̹ˑɘɻʇ੮ʩ˺͐ʇˑͅੴ੮͸ʩʇ̼ʇ੮ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇ੮͸ʇ̼ʇ੮ͅʇ˦͐੮͐˺੮̹̼˺͐ʇɻ͐੮͐ʩʇ˚੮ʠ̼˺˚੮#šēU)ੴ੮͸ɘͅ੮ʁʮ̼͐ͅʇͅͅʮ˦ʡˑ;੮ʩʮʡʩੳਂ Fentanyl, ɘ੮̹˺͐ʇ˦͐੮ͅ;˦͐ʩʇ͐ʮɻ੮˺̹ʮ˺ʮʁ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ϲʮ˦ʁʮ˦ʡ੮ʮ͐ͅ੮͸ɘ;੮ʮ˦͐˺੮͙̹̹ͅˑʮʇͅ੮˺ʠ੮ɺ˺͐ʩ੮˚ʇ͐ʩ੮ and heroin, is a lethal accelerant (Figure 12.2).ਃ Logan, a social worker in San

800 Total Involving meth Involving cocaine Involving any opioid (pre-2020) Involving fentanyl

700 600

Deaths

500 400 300 200 100

09

08

07

10 20 11 20 12 20 13 20 14 20 15 20 16 20 17 20 18 20 19 20 20 20 21

20

20

20

20

20

06

0

12.2 šͷʇ̼ʁ˺ͅʇ੮ʁʇɘ͐ʩͅ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɺ;੮͙ͅɺ͐ͅɘ˦ɻʇੴ੮৲ৰৰ৶જ৲ৰ৲ৱ Sourceੵ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮#˺͙˦͐;੮#˺̼˺˦ʇ̼

A SY LU M F O R T H E DY I N G

231

H̼ɘ˦ɻʮͅɻ˺ੴ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮˚˺͐ͅ੮˺ʠ੮ʩʮͅ੮ɻˑʮʇ˦͐ͅૄ੮ʁʇɘ͐ʩͅ੮͸ʇ̼ʇ੮ʁ͙ʇ੮͐˺੮ɘ˦੮˺ͷʇ̼ʁ˺ͅʇ੮͐ʩɘ͐੮ ͸ɘͅ੮ ʩʮʁʁʇ˦੮ ɺʇʩʮ˦ʁ੮ ɘ̹ɘ̼͐˚ʇ˦͐੮ ͸ɘˑˑͅ੮ ɘ˦ʁ੮ ͅ˺੮ ʁʮͅɻ˺ͷʇ̼ʇʁ੮ ͐˺˺੮ ˑɘ͐ʇ੮ ͐˺੮ ɺʇ੮ ̼ʇͷʇ̼ͅʇʁ੮ ͸ʮ͐ʩ੮‡ɘ̼ɻɘ˦ੴ੮ɘ੮˦ɘͅɘˑ੮̹̼ͅɘ;ੳ੮Pʇ੮͸˺˦ʁʇ̼ʇʁੴ੮ુĔʇˑˑ੮ʮʠ੮͐ʩʇ;੮ʩɘʁ੮ɺʇʇ˦੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮ ͸˺͙ˑʁ੮̹ʇ˺̹ˑʇ੮ʩɘͷʇ੮̼ʇͷʮͷʇʁ੮͐ʩʇ˚੺੮)ʮʁ੮͐ʩʇ;੮ˑ˺ͅʇ੮͐ʩʇʮ̼੮ɻ˺˚˚͙˦ʮ͐;੮͸ʩʇ˦੮͸ʇ੮ʩ˺͙ͅʇʁ੮ them?”਄੮Pʇ੮ͅʮʡʩʇʁੴ੮ુU͐ૄͅ੮ͷʇ̼;੮ͅɘʁੳ੮"͙͐੮ɘ͐੮ˑʇɘ͐ͅ੮͐ʩʇ;੮ʁʮʇʁ੮ʩ˺͙ͅʇʁੳૂ îʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ˑ˺˺ˌͅ੮ɘ͐੮̹̼˺̹˺ͅɘˑͅ੮͐ʩɘ͐੮͐ɘ̼ʡʇ͐੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ͅʇ͐੮˺ʠ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʠ̼˺˚੮ ä"੮ৱৰ৴৵ઝ˦˺͐੮͐ʩʇ੮ɘ͙ʁʮɺˑ;੮ɘʁʁʮɻ͐ʇʁ੮ɺ͙͐੮͐ʩʇ੮ͅʮˑʇ˦͐ˑ;੮ʁʇ͐ʇ̼ʮ˺̼ɘ͐ʮ˦ʡੳ੮#˺˦ɻʇ̼˦ͅ੮ʠ˺̼੮ ͐ʩʮͅ੮̹˺̹͙ˑɘ͐ʮ˺˦੮ɻ˺˦ʡʇɘˑʇʁ੮ʮ˦੮ɘ੮ͅʇ͐੮˺ʠ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮̹̼˺̹˺ͅɘˑͅ੮͐˺੮̼ʇͷʮͅʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑચ ʮ͐;੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ɘ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ɘ͐͐ʇ˦ʁ੮͐˺੮˺˦ʇૄͅ੮̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩੳ੮îʩ˺ͅʇ੮ɺʮˑˑͅ੮ʩɘͷʇ੮ͅ˺੮ʠɘ̼੮ ʠɘʮˑʇʁੳ੮"͙͐੮ʇʠʠ˺̼͐ͅ੮͐˺੮ʡʇ͐੮͐ʩʇ੮ʁ;ʮ˦ʡ੮ʮ˦͐˺੮͐͸ʇ˦͐;ચʠ˺͙̼ચʩ˺͙̼੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮ɻɘ̼ʇઝ˦˺͐੮ ˈ͙͐ͅ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ʩ˺͙ͅʮ˦ʡઝʩɘͷʇ੮ɻ˺˦͐ʮ˦͙ʇʁ੮͐˺੮ɘʁͷɘ˦ɻʇੳ੮Ĕʩʇ͐ʩʇ̼੮˦ʇ͸੮ɘ̹̹̼˺ɘɻʩʇͅ੮ ͐˺੮ʮ˚̹˺ͅʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮͸ʮˑˑ੮ɘɻ͙͐ɘˑˑ;੮̼͐ɘ˦ͅˑɘ͐ʇ੮ʮ˦͐˺੮˚˺̼ʇ੮ɻ˺ʇ̼ɻʮͷʇ੮ɻɘ̼ʇੴ੮U੮ɘ̼ʡ͙ʇੴ੮ ͸ʮˑˑ੮ʁʇ̹ʇ˦ʁ੮˺˦੮ɺ͙ʁʁʮ˦ʡ੮ʇʠʠ˺̼͐ͅ੮͐˺੮̼ʇɺ͙ʮˑʁ੮ˑ˺˦ʡચ͐ʇ̼˚੮ɺʇʁͅ੮ɘ˦ʁ੮̹ɘ̼͐ˑ;੮̼˺ˑˑ੮ɺɘɻˌ੮͐ʩʇ੮ ʁʇચʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮rØä੮ʮͅ੮ɻ̼ʇʁʮ͐ʇʁ੮͸ʮ͐ʩ੮ʩʇˑ̹ʮ˦ʡ੮̹ͅɘ̼ˌੳ

REDEFINING GRAVE DISABILITY P˺͸੮͐˺੮ʁʇϲʮ˦ʇ੮ુʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ૂ੮͸ɘͅ੮ɘ੮͐ͅʮɻˌʮ˦ʡ੮̹˺ʮ˦͐੮ʮ˦੮͐ʩʇ੮˺̼ʮʡʮ˦ɘˑ੮˦ʇʡ˺͐ʮɘ͐ʮ˺˦ͅ੮ ˺ͷʇ̼੮rØäੳ੮Ø̼˺˚ʮ˦ʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮͸ɘ˦͐ʇʁ੮ʮ͐੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ɘ˦੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮ુ˚ɘ˦ɘʡʇ੮ ય˺˦ʇૄͅર੮̹ʇ̼ͅ˺˦ɘˑ੮ɘʠʠɘʮ̼ͅૂ੮˺̼੮ʩɘͷʮ˦ʡ੮ુ̹̼˺˦˺͙˦ɻʇʁ੮ʁʮ͙̼͐ͅɺɘ˦ɻʇ੮ʮ˦੮ˈ͙ʁʡ˚ʇ˦͐ੴ੮͐ʩʮ˦ˌચ ing, or conduct.”ৼ৻੮îʩʇ੮ϲʮ˦ɘˑ੮ɺʮˑˑ੮ˌʇ̹͐੮˺˦ˑ;੮͐ʩʇ੮˦ɘ̼̼˺͸੮̼͐ʮ̹͐;ɻʩ੮˺ʠ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ ˺̼੮ͅʩʇˑ͐ʇ̼ੳ੮˦੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͸ɘͅ੮ɘ੮̹ʮʇɻʇ੮˺ʠ੮͐ʩʇ੮ʠɘʮˑʇʁ੮̹̼˺̹˺ͅɘˑͅ੮͐˺੮ ̼ʇʠ˺̼˚੮rØä੮ʮ˦੮ৱ৹৸৷੮ɘ˦ʁ੮৲ৰৰৰੳ੮˚ʇ˦ʁʮ˦ʡ੮ʮ͐੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ɻɘͅʇͅ੮ʮ˦੮͸ʩʮɻʩ੮ɘ੮˚ʇ˦͐ɘˑ੮ʮˑˑચ ˦ʇͅͅ੮ʮ˦͐ʇ̼ʠʇ̼ʇͅ੮͸ʮ͐ʩ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮͐ʩʇʮ̼੮̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩ੮ɺʇɻɘ˚ʇ੮ ͐ʩʇ੮ɻʇ˦͐ʇ̼̹ʮʇɻʇ੮˺ʠ੮ɘ੮̹͙ͅʩ੮ʠ˺̼੮̼ʇʠ˺̼˚੮͐ͅɘ̼͐ʮ˦ʡ੮ʮ˦੮৲ৰৱ৷ੳ੮U˦੮ɘ੮ˑɘ͐ʇ̼੮ͅʇɻ͐ʮ˺˦ੴ੮U੮͸ʮˑˑ੮ͅʩ˺͸੮ that the failure to address the medical needs of people with mental illness is a ˌʇ;੮ʇͽʩʮɺʮ͐੮ʠ˺̼੮͐ʩʇ੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮ɘ˦;੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮˚ɘˌʇ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ͅʮˑ˺ʇʁ੮ͅ;͐ͅʇ˚ͅ੮ ˺ʠ੮ɻɘ̼ʇ੮͸˺̼ˌ੮͐˺ʡʇ͐ʩʇ̼ੳ੮"͙͐੮ϲʮ̼͐ͅ੮ˑʇ͐ૄͅ੮ˑ˺˺ˌ੮ɘ͐੮͐ʩʇͅʇ੮̹̼˺̹˺ͅɘˑͅੳ ˚˺˦ʡ੮͐ʩ˺ͅʇ੮̹͙ͅʩʮ˦ʡ੮ʠ˺̼੮ɘ੮ʡ̼ɘͷʇચʁʮͅɘɺʮˑʮ͐;੮̼ʇ͸̼ʮ͐ʇ੮ʮͅ੮)̼ੳ੮Øɘ̼͐˺ͷʮੴ੮͐ʩʇ੮ુ̼ʇ˦ʇચ ʡɘʁʇ੮ʁ˺ɻ͐˺̼੮˺ʠ੮äˌʮʁ੮Û˺͸ੳૂ੮U˦੮৲ৰৰ৷ੴ੮ͅʩʇ੮͸̼˺͐ʇ੮ɘ˦੮˺̹ચʇʁ੮ɘɺ˺͙͐੮ુĔʮˑˑʮɘ˚ੴૂ੮ɘ੮̹ɘ͐ʮʇ˦͐੮ ͅʩʇ੮ ͅɘ͸੮ ɘ͐੮ ͐ʩʇ੮ ēʇ˦ʮɻʇ੮ Hɘ˚ʮˑ;੮ #ˑʮ˦ʮɻ੮ ɘʠ͐ʇ̼੮ ʩʇ੮ ͸ɘͅ੮ ̼ʇˑʇɘͅʇʁ੮ ʠ̼˺˚੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ʠ˺̼੮ ɻ˺˦ʡʇ͐ͅʮͷʇ੮ʩʇɘ̼͐੮ʠɘʮˑ͙̼ʇੳৼৼ੮Ĕʮˑˑʮɘ˚੮ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮̼ʇʠ͙ͅʇʁ੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮ʠ˺̼੮ ʩʮͅ੮ ʩʇɘ̼͐੮ ɻ˺˦ʁʮ͐ʮ˺˦੮ ɘ˦ʁ੮ ɘ੮ ʁʇɺʮˑʮ͐ɘ͐ʮ˦ʡ੮ ̼͐ͅ˺ˌʇ੶੮ Øɘ̼͐˺ͷʮ੮ ɘ͐੮ ͷɘ̼ʮ˺͙ͅ੮ ͐ʮ˚ʇͅ੮ ɘͅˌʇʁ੮ ʁ͙ˑ͐੮ Ø̼˺͐ʇɻ͐ʮͷʇ੮ äʇ̼ͷʮɻʇͅ੮ ɘ˦ʁ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ ͐˺੮ ʠ˺̼ɻʇ੮ ʩʮ˚੮ ͐˺ੴ੮ ɺ͙͐੮ ˺˦ʇ੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ̹̹ɘ̼ʇ˦͐ˑ;੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુU͐ૄͅ੮ʩʮͅ੮ʠ̼ʇʇ੮͸ʮˑˑ੮˦˺͐੮͐˺੮͐ɘˌʇ੮ʩʮͅ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅੳૂ੮

232

REFORM

Ĕʮ͐ʩ˺͙͐੮͐ʩʇ˚ੴ੮Ĕʮˑˑʮɘ˚੮ʁʮʇʁ੮ɘ੮ʠʇ͸੮͸ʇʇˌͅ੮ˑɘ͐ʇ̼ੳ੮Øɘ̼͐˺ͷʮ੮͙ͅʇʁ੮Ĕʮˑˑʮɘ˚੮͐˺੮ʮˑˑ͙̼͐ͅɘ͐ʇ੮ ɘ੮͐ͅɘ̼ˌ੮̼ʇɘˑʮ͐;ੵ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ʁʮʇ੮˺˦੮ɘͷʇ̼ɘʡʇ੮͐͸ʇ˦͐;ચϲʮͷʇ੮;ʇɘ̼ͅ੮ ;˺͙˦ʡʇ̼੮͐ʩɘ˦੮͐ʩʇ੮ʡʇ˦ʇ̼ɘˑ੮̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮ɘ˦ʁ੮ુ৶ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹̼ʇ˚ɘ͙̼͐ʇ੮ʁʇɘ͐ʩͅ੯ੳ੯ੳ੯ੳ੮ ɘ̼ʇ੮ʁ͙ʇ੮͐˺੮˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͙ͅɻʩ੮ɘͅ੮ɻɘ̼ʁʮ˺ͷɘͅɻ͙ˑɘ̼ੴ੮̹͙ˑ˚˺˦ɘ̼;ੴ੮ɘ˦ʁ੮ʮ˦ʠʇɻ͐ʮ˺˦੮ diseases.”ৼ৽ U˦੮৲ৰৱ৷ੴ੮Øɘ̼͐˺ͷʮ੮ɘ˦ʁ੮nʇ̼̼;੮{˺̼̼ʮͅ˺˦੮ફ͐ʩʇ੮P˺ˑˑ;͸˺˺ʁ੮"͙ͅʮ˦ʇͅͅ੮U˚̹̼˺ͷʇ˚ʇ˦͐੮ )ʮ̼͐ͅʮɻ͐੮ʁʮ̼ʇɻ͐˺̼બ੮ɻ˺˦ͷʇ˦ʇʁ੮ɘ੮͸ʩ˺ૄͅ੮͸ʩ˺੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻ˺˚˚͙˦ʮ͐;੮ʮ˦੮r˺ͅ੮ ˦ʡʇˑʇͅੳ੮͐੮˺˦ʇ੮ʇͷʇ˦͐ੴ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ʁʇˑʮͷʇ̼ʇʁ੮ɘ੮Ø˺͸ʇ̼Ø˺ʮ˦͐੮̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦੮ͅʩ˺͸ʮ˦ʡ੮ ͐ʩʇ੮ ɺ͙ˑʡʮ˦ʡੴ੮ ͙˦̼͐ʇɘ͐ʇʁ੮ ʩʇ̼˦ʮɘ੮ ˺ʠ੮ ˺˦ʇ੮ ̹ɘ͐ʮʇ˦͐੮ ͐˺੮ ʮˑˑ͙̼͐ͅɘ͐ʇ੮ ͸ʩ;੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ should be amended to include an “inability to make informed medical decisions.” By 2018, the working group had come up with a “checklist” to document factors ͙ͅʡʡʇ͐ͅʮ˦ʡ੮ɘ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴ੮͙ͅɻʩ੮ɘͅ੮ુͅʇͷʇ̼ʇ੮ɺ˺ʁʮˑ;੮ʮ˦ʠʇ͐ͅɘ͐ʮ˺˦ૂ੮ફʇੳʡੳੴ੮ˑʮɻʇੴ੮ͅɻɘɺʮʇͅੴ੮ ˚ɘʡʡ˺͐ͅબੴ੮ ુɻ˺ͷʇ̼ʇʁ੮ ʮ˦੮ ɺ˺ʁʮˑ;੮ ϲˑ͙ʮʁͅૂ੮ ફʇੳʡੳੴ੮ ɺˑ˺˺ʁੴ੮ ʠʇɻʇͅੴ੮ ͷ˺˚ʮ͐બੴ੮ ɘ˦ʁ੮ ુ͙˦̼͐ʇɘ͐ʇʁ੮ medical conditions” (e.g., unintentional substantial weight loss, serious open ͸˺͙˦ʁͅબੳ੮ͅ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ʇͽ̹ˑɘʮ˦ʇʁ੮ʮ͐੮͐˺੮˚ʇੴ੮ુ/ͷʇ̼;ɺ˺ʁ;੮ʩɘʁ੮͐ʩʇʮ̼੮˺͸˦੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ ˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੯ੳ੯ੳ੯ੳ੮ä˺੮U੮͐ʩ˺͙ʡʩ͐੮͐ʩɘ͐੮ʮʠ੮ʇͷʇ̼;˺˦ʇ੮͸ɘͅ੮˺˦੮͐ʩʇ੮ͅɘ˚ʇ੮̹ɘʡʇ੮˺ʠ੮͸ʩɘ͐੮ ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮̼ʇɘˑˑ;੮͸ɘͅੴ੮͸ʇ੮͸˺͙ˑʁ੮ɘˑˑ੮ʠ˺ˑˑ˺͸੮͐ʩʇ੮ˑɘ͸ੳૂ îʩʇ੮̹̼˺ɺˑʇ˚ੴ੮ɘͅ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮˺ʠ੮r੮̼ʇ̹ʇɘ͐ʇʁˑ;੮̼ʇ˚ʮ˦ʁʇʁ੮Øɘ̼͐˺ͷʮ੮͸ʩʇ˦੮ she pushed them to use the checklist, is that “the law” does not explicitly include ͙˦˚ʇ͐੮˚ʇʁʮɻɘˑ੮˦ʇʇʁ੮ɘͅ੮ɘ੮ɻ̼ʮ͐ʇ̼ʮ˺˦੮ʠ˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮Øɘ̼͐˺ͷʮ੮͸ɘͅ੮̹ɘ̼͐੮˺ʠ੮ɘ੮̹͙ͅʩ੮ ͐˺੮ɻʩɘ˦ʡʇ੮͐ʩɘ͐ੳ੮U˦੮৲ৰৱ৸ੴ੮͐ʩʇ੮r˺ͅ੮˦ʡʇˑʇͅ੮#˺͙˦͐;੮"˺ɘ̼ʁ੮˺ʠ੮ä͙̹ʇ̼ͷʮͅ˺̼ͅ੮ɘ̹̹̼˺ͷʇʁ੮ ɘ੮̼ʇͅ˺ˑ͙͐ʮ˺˦੮͙̼ʡʮ˦ʡ੮͐ʩʇ੮͐ͅɘ͐ʇ੮͐˺੮ુ̹ɘͅͅ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮͐ʩɘ͐੮ɺ̼˺ɘʁʇ˦ͅ੮͐ʩɘ͐੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ય˺ʠ੮ ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ર੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮̹ʇ˺̹ˑʇ੮͙˦ɘɺˑʇ੮͐˺੮ͅʇʇˌ੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇʮ̼੮ ˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳૂ੮H˺̼੮˺˦ʇ੮ɻʮ͐;੮ɻ˺͙˦ɻʮˑ˚ʇ˚ɺʇ̼ੴ੮͐ʩʮͅ੮ʇʠʠ˺̼͐੮͸ɘͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ુϲʮ˦ʁયʮ˦ʡર੮ a way to bring back institutionalization” for the permanently debilitated.ৼ৾ Ø˺ˑʮ͐ʮɻʮɘ˦ͅ੮͸ʇ̼ʇ੮ɺ͙ʮˑʁʮ˦ʡ੮˺˦੮ɘ੮ˑ˺ɻɘˑ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮̼ʇ̹˺̼͐੮͐ʩɘ͐੮ ɻʮ͐ʇʁ੮ʁɘ͐ɘ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺̼˺˦ʇ̼ੳ੮U͐੮ͅʩ˺͸ʇʁ੮͐ʩʇ੮̼ʮͅʇ੮ʮ˦੮ʁʇɘ͐ʩͅ੮ɘ˚˺˦ʡ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮ ʠ̼˺˚੮ ુ̹̼ʇͷʇ˦͐ɘɺˑʇ੮ ɘ˦ʁઃ˺̼੮ ̼͐ʇɘ͐ɘɺˑʇ੮ ˚ʇʁʮɻɘˑ੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅੳૂ੮ îʩʇ੮ ̼ʇ̹˺̼͐੮ ɘʁ˚ʮ͐͐ʇʁ੮ ͐ʩɘ͐੮ુ͸ʩʮˑʇ੮͐ʩʮͅ੮ʁɘ͐ɘ੮ʁ˺ʇͅ੮˦˺͐੮ʮ˦ʁʮɻɘ͐ʇ੮͸ʩʇ͐ʩʇ̼੮˺̼੮˦˺͐੮͐ʩʇ੮ʁʇɻʇɘͅʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ suffered from a mental illness,” more forced mental health treatment was necesચ ͅɘ̼;੮ɺʇɻɘ͙ͅʇ੮ુʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮ɻ˺˺ɻɻ͙̼̼ʮ˦ʡ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੯ੳ੯ੳ੯ੳ੮ may account disproportionately for the increased death rates.”ৼ৿ îʩʇ੮ʮ˦͐ʇ̼̹̼ʇ͐ʮͷʇ੮ˑʇɘ̹ͅ੮ʩʇ̼ʇ੮ɘ̼ʇ੮͸˺̼͐ʩ੮ɻɘˑˑʮ˦ʡ੮˺͙͐ੳ੮r˺͐ͅ੮˺ʠ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮̹ʇ˺̹ˑʇ੮ are dying young. So, too, are many homeless people. But not all dying homeચ ˑʇͅͅ੮ ̹ʇ˺̹ˑʇ੮ ɘ̼ʇ੮ ˚ʇ˦͐ɘˑˑ;੮ ʮˑˑੳ੮ ˦ʁ੮ ʇͷʇ˦੮ ʠ˺̼੮ ͐ʩ˺ͅʇ੮ ͐ʩɘ͐੮ ɘ̼ʇੴ੮ ͐ʩʇ੮ ˚ɘʮ˦੮ ɻɘ͙ͅʇͅ੮ ˺ʠ੮ ʁʇɘ͐ʩ੮ɘ̼ʇ੮˺ͷʇ̼ʁ˺ͅʇͅੴ੮ʩʇɘ̼͐੮ʁʮͅʇɘͅʇੴ੮̼͐ɘ˦̹ͅ˺̼͐ɘ͐ʮ˺˦੮ɘɻɻʮʁʇ˦͐ͅੴ੮ɘ˦ʁ੮ʩ˺˚ʮɻʮʁʇͅઝ͐˺੮

A SY LU M F O R T H E DY I N G

233

͸ʩʮɻʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮˚ɘ;੮˺̼੮˚ɘ;੮˦˺͐੮ʩɘͷʇ੮ɻ˺˦̼͐ʮɺ͙͐ʇʁੳ੮ä͙ʮɻʮʁʇͅੴ੮͸ʩʇ̼ʇ੮͐ʩʇ੮ˑʮ˦ˌચ age is clearest, accounted for only 4 percent of homeless deaths in LA in 2021.ৼ਀ îʩʇ੮ʁʇɻʮͅʮ˺˦੮˺ʠ੮̹ʇ˺̹ˑʇ੮ˑʮˌʇ੮Ĕʮˑˑʮɘ˚ੴ੮ʠ̼˺˚੮Øɘ̼͐˺ͷʮૄͅ੮˺̹ચʇʁੴ੮͐˺੮̼ʇʠ͙ͅʇ੮ˑʮʠʇͅɘͷʮ˦ʡ੮ treatment might seem irrational and inexplicable, but that doesn’t mean it’s ̹ɘ͐ʩ˺ˑ˺ʡʮɻɘˑੳ੮Ěʇ͐੮͐ʩʇͅʇ੮ɻɘͷʇɘ͐ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ˑ˺͐ͅ੮ɘͅ੮̹˺ˑʮɻ;੮˚ɘˌʇ̼ͅ੮ɘ˦ʁ੮˚ʇʁʮɘ੮ʁ̼ɘ͸੮ increasingly direct lines between limits to forced treatment and people dying on the streets.ৼਁ îʩʇ੮̹̼˺ˑʮʠʇ̼ɘ͐ʮ˺˦੮˺ʠ੮ɺʮˑˑͅ੮͐˺੮̼ʇʠ˺̼˚੮rØä੮ʮͅ੮̼ʇ˚ɘ̼ˌɘɺˑʇੳ੮੮৲ৰৱ৷੮ɺʮˑˑੴ੮"੮ৱ৵৳৹ੴ੮ ͸˺͙ˑʁ੮ʩɘͷʇ੮ɘʁʁʇʁ੮͙˦˚ʇ͐੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇ੮͐˺੮͐ʩʇ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮î͸˺੮ ͅʮ˚ʮˑɘ̼੮̹̼˺̹˺ͅɘˑͅ੮ʠ˺ˑˑ˺͸ʇʁ੮ʮ˦੮৲ৰৱ৸ੴ੮͐ʩ̼ʇʇ੮ʮ˦੮৲ৰৱ৹ੳ੮U੮ɻ˺͙˦͐ʇʁ੮˦ʇɘ̼ˑ;੮ɘ੮ʁ˺Έʇ˦੮ɺʮˑˑͅ੮͐˺੮ ʇͽ̹ɘ˦ʁ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮৲ৰ৲ৰੳ੮੮ˑ˺ɺɺ;ʮ͐ͅ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮ɘ͐͐ʇ˚̹͐ͅ੮ ͐˺੮̼ʇʠ˺̼˚੮rØä੮ʠ˺̼੮ʁʇɻɘʁʇͅ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮͐ʩʮͅ੮͸ɘͅ੮ɘ੮ʡ̼ɘ̼ͅͅ˺˺͐ͅ੮ʇʠʠ˺̼͐ੵ੮͐ʩʇ੮ુʠɘ̼˚੮ team” coming to the legislature from city councils and school boards was inunચ ʁɘ͐ʇʁ੮͸ʮ͐ʩ੮̹͙ɺˑʮɻ੮ɻ˺˦ɻʇ̼˦ͅ੮ɘɺ˺͙͐੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੳ੮Pʇ੮ʇͽ̹ˑɘʮ˦ʇʁੴ੮ુĔʇૄͷʇ੮ͅʇʇ˦੮ɘ˦੮ ͙̹͐ʮɻˌ੮ʮ˦੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ʇˑʇɻ͐ʇʁ੮ય˺ϲϲʮɻʮɘˑͅર੮ɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮ˑʇͷʇˑ੮͐ʩɘ͐੮͸ɘ˦͐੮͐˺੮ɻɘ̼̼;੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੯ੳ੯ੳ੯ੳ੮ʮ͐੮ʩɘͅ੮ɺʇɻ˺˚ʇ੮ͅʇͽ;ੳ੮/ͷʇ̼;ɺ˺ʁ;੮͸ɘ˦͐ͅ੮ɘ੮ɺʮˑˑੳૂ੮ˑˑ੮͐ʩʮͅ੮ ͸ɘͅ੮ʁ̼ʮͷʇ˦੮ɺ;੮ˑʇɘ̼˦ʮ˦ʡ੮ુʩ˺͸੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮ʠ̼˺˚੮̹̼ʇͷʇ˦͐ચ ɘɺˑʇ੮ʩʇɘˑ͐ʩ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͐ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮͐˺˺੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮͐˺੮˚ɘ˦ɘʡʇੳૂ AB 1971, which a group of legislators from around LA introduced in 2018, made it the furthest. The bill passed a series of committees and a unanimous ʮ˦ʮ͐ʮɘˑ੮ͷ˺͐ʇ੮˺˦੮͐ʩʇ੮ͅͅʇ˚ɺˑ;੮ϲˑ˺˺̼ੳ੮ͅ੮ʮ˦ʮ͐ʮɘˑˑ;੮͸̼ʮ͐͐ʇ˦ੴ੮͐ʩʇ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮͸˺͙ˑʁ੮ʩɘͷʇ੮ ɘ˚ʇ˦ʁʇʁ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ͅ˺˚ʇ˺˦ʇ੮ુ͙˦ɘɺˑʇ੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮ʩʮͅ੮˺̼੮ʩʇ̼੮ ˚ʇʁʮɻɘˑ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʮʠ੮͐ʩʇ੮ʠɘʮˑ͙̼ʇ੮͐˺੮̼ʇɻʇʮͷʇ੮˚ʇʁʮɻɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̼ʇ͙ͅˑ͐ͅ੮ʮ˦੮ɘ੮ʁʇ͐ʇ̼ʮચ orating physical condition or death.”ৼਂ Senator Henry Stern, one of the sponsors, ʁʇɻˑɘ̼ʇʁੴ੮ુĚ˺͙੮ɻɘ˦੮ʇʮ͐ʩʇ̼੮͸ɘˑˌ੮̹ɘ͐ͅ੮͐ʩʇ˚ੴ੮͸ɘ͐ɻʩ੮͐ʩʇ˚੮ʁʮʇ੮˺˦੮˺͙̼੮ʁ˺˺̼͐ͅʇ̹ͅੴ੮˺̼੮ we can do something about it.”ৼਃ ͅ੮͸ʮ͐ʩ੮ä"੮ৱৰ৴৵ੴ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮͐ͅɘʠʠ੮̹ɘ˦˦ʇʁ੮͐ʩʇͅʇ੮̹̼˺̹˺ͅɘˑͅੳ੮U˦੮˺˦ʇ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੴ੮ ͐ͅɘʠʠ੮ή͙˺͐ʇʁ੮ɘ͐੮ˑʇ˦ʡ͐ʩ੮ɘ˦੮ɘ̼ʡ͙˚ʇ˦͐੮ʠ̼˺˚੮͐ʩʇ੮ɘͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮ɻ˺͙˦͐;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʮ̼ʇɻ͐˺̼ͅ੮͐ʩɘ͐੮ુ͐ʩʇ੮ɺʮˑˑ੮ʁ˺ʇͅ੮˦˺͐੮̼͙ˑʇ੮˺͙͐੮ɘɺ͙ͅʇͅૂ੮ɺʇɻɘ͙ͅʇ੮ુʮ͐੮ɘˑˑ˺͸ͅ੮ʠ˺̼੮ͷʮ̼͙͐ɘˑˑ;੮ unfettered discretion to consider any medical condition without regard to its ͅʇͷʇ̼ʮ͐;ੴ੮ˑʮˌʇˑʮʩ˺˺ʁ੮˺ʠ੮ʩɘ̼˚ੴ੮˺̼੮͐ʩʇ੮̹ʇ̼ͅ˺˦ૄͅ੮ɻɘ̹ɘɻʮ͐;੮͐˺੮̼͐ʇɘ͐੮ʮ͐ੳૂ੮{˺̼ʇ˺ͷʇ̼ੴ੮͐ʩʇ੮ legislation would allow someone to be forcibly held in a hospital as a result of ͐ʩʇʮ̼੮˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦੮ɺ͙͐੮ુʁ˺ʇͅ੮˦˺͐੮̼ʇή͙ʮ̼ʇ੮͐ʩɘ͐੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ɘɻ͙͐ɘˑˑ;੮̼ʇɻʇʮͷʇͅ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ʁ͙̼ʮ˦ʡ੮ ͐ʩʇʮ̼੮ ʁʇ͐ʇ˦͐ʮ˺˦ੳૂ੮ H˺̼੮ ʡ˺˺ʁ੮ ˚ʇɘ͙̼ͅʇੴ੮ ͐ʩʇ;੮ ˺ɺͅʇ̼ͷʇʁ੮ ͐ʩɘ͐੮ ુ͐ʩʇ੮ ɻɘ̹ɘɻʮ͐;੮˺ʠ੮˚ʇʁચ̹ͅ;ɻʩ੮ɺʇʁͅૂઝ͐ʩʇ੮̹̼ʇ͙ͅ˚ɘɺˑ;੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ͅʇ͐͐ʮ˦ʡ੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮ with comorbid issues—“are few.”ৼ਄

234

REFORM

rʇʡʮͅˑɘ͐˺̼ͅ੮̼ʇ̹ͅ˺˦ʁʇʁ੮͐ʩʇ੮͸ɘ;੮͐ʩʇ;੮͐;̹ʮɻɘˑˑ;੮ʩɘͷʇ੮͸ʩʇ˦੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮ɻ˺˦ɻʇ̼˦ͅ੮ collide with a desire to take action: forging ahead while heaping on new protecચ ͐ʮ˺˦ͅੳ੮îʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮Øɘ͙ˑ੮̹̹ʇˑɺɘ͙˚੮ɘ̹͐ˑ;੮ɻɘˑˑͅ੮͐ʩʮͅ੮ɘ̹̹̼˺ɘɻʩ੮ુɘ˚ɺʮͷɘˑʇ˦ɻʇ੮ ɻ˺ʁʮϲʮʇʁੳૂ৽৻੮"੮ৱ৹৷ৱ੮͸ɘͅ੮ͅʩ̼͙˦ˌ੮͐˺੮ɘ੮̹ʮˑ˺͐੮ʮ˦੮rੴ੮ɘ˦ʁ੮ʮ͐੮͸˺͙ˑʁ੮̼ʇή͙ʮ̼ʇ੮͐ʩɘ͐੮ɘ੮˚ʇʁચ ical professional attest that a person’s medical condition would “lead to death within six months.” At this point, you could imagine AB 1971 leading to as many ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ɘͅ੮ ͐ʩʇ੮ ä"੮ ৱৰ৴৵੮ ʩ˺͙ͅʮ˦ʡ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ̹̼˺ʡ̼ɘ˚੮ ʁʮʁ੮ ફ̼ʇɻɘˑˑੵ੮ three). But the sponsors sensibly realized, as the lobbyist told me, that “the bill had been weakened beyond the point where it would be helpful” and pulled it.৽ৼ Reformers hit pause while waiting for a state auditor’s report on the functionચ ʮ˦ʡ੮˺ʠ੮rØä੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅੴ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮ɘ˦ʁ੮äʩɘ͐ͅɘ੮#˺͙˦͐;ੴ੮͐ʩʇ੮ϲʮ̼͐ͅ੮ͅʇ̼ʮ˺͙ͅ੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦੮ʮ˦੮ʁʇɻɘʁʇͅੳ੮ēʮ̼͙͐ɘˑˑ;੮ʇͷʇ̼;˺˦ʇ੮U੮͐ɘˑˌʇʁ੮͐˺੮ɘ͙ͅͅ˚ʇʁ੮ʮ͐੮͸˺͙ˑʁ੮̹̼˺ͷʮʁʇ੮ ɻ˺˚̹ʇˑˑʮ˦ʡ੮ɘ˚˚͙˦ʮ͐ʮ˺˦੮ʠ˺̼੮ɘ੮ɻʩɘ˦ʡʇ੮͐˺੮rØä੮ɻ̼ʮ͐ʇ̼ʮɘੳ੮ēʮ̼͙͐ɘˑˑ;੮ʇͷʇ̼;˺˦ʇ੮U੮͐ɘˑˌʇʁ੮ ͐˺੮͸ɘͅ੮͙̼̹̼ͅʮͅʇʁ੮͸ʩʇ˦੮͐ʩʇ੮̼ʇ̹˺̼͐ੴ੮̼ʇˑʇɘͅʇʁ੮ʮ˦੮͐ʩʇ੮͙ͅ˚˚ʇ̼੮˺ʠ੮৲ৰ৲ৰੴ੮ʁʮʁ˦ૄ͐ੳ੮U˦͐ͅʇɘʁੴ੮ ɘʠ͐ʇ̼੮ ̼ʇͷʮʇ͸ʮ˦ʡ੮ ʁ˺ɻ͙˚ʇ˦͐ɘ͐ʮ˺˦੮ ʠ˺̼੮ ͅʮͽ͐;੮ ৵ৱ৵ৰͅ੮ ɘ˦ʁ੮ ͅʮͽ͐;੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ ͐ʩʇ੮ ɘ͙ʁʮ͐˺̼੮ʠ˺͙˦ʁ੮ુ˦˺੮ʇͷʮʁʇ˦ɻʇ੮͐˺੮ˈ͙͐ͅʮʠ;੯ੳ੯ੳ੯ੳ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮˺̼੮̼ʇͷʮͅʮ˦ʡ੮͐ʩʇ੮rØä੮ɻ͐ૄͅ੮ criteria.”৽৽੮š̹̹˺˦ʇ˦͐ͅ੮˺ʠ੮̼ʇ͸̼ʮ͐ʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴ੮ˑʮˌʇ੮͐ʩʇ੮Los Angeles Times ediચ ͐˺̼ʮɘˑ੮ɺ˺ɘ̼ʁੴ੮ɻ̼˺͸ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɘ͙ʁʮ͐੮ͅʩ˺͸ʇʁ੮͐ʩɘ͐੮ુ͐ʩʇ੮̼ʇɘˑ੮̹̼˺ɺˑʇ˚੯ੳ੯ੳ੯ੳ੮ʮͅ੮˦˺͐੮͐ʩʇ੮ ̹ɘ͐ʮʇ˦͐ͅૄ੮̼ʮʡʩ͐੮͐˺੮ͅʇˑʠચʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦ੴ੮ɺ͙͐੮͐ʩʇ੮ʠɘʮˑ͙̼ʇ੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘ˦ʁ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ ̹̼˺ͷʮʁʇ੮͙ͅϲϲʮɻʮʇ˦͐੮˺˦ʡ˺ʮ˦ʡ੮ɻɘ̼ʇ੮ɘ˦ʁ੮ʩ˺͙ͅʮ˦ʡੳૂ৽৾ îʩʇ੮ɘ͙ʁʮ͐ੴ੮ɘ˦ʁ੮͐ʩʇ੮ɻ˺˦ɻ˺˚ʮ͐ɘ˦͐੮ɻ˺̼˺˦ɘͷʮ̼͙ͅ੮̹ɘ˦ʁʇ˚ʮɻੴ੮͐ʇ˚̹˺̼ɘ̼ʮˑ;੮͐˺˺ˌ੮͐ʩʇ੮ ͸ʮ˦ʁ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ͅɘʮˑͅ੮˺ʠ੮͐ʩʇ੮˚˺ͷʇ˚ʇ˦͐੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮"͙͐੮ʮ˦੮kɘ˦ચ ͙ɘ̼;੮৲ৰ৲৲ੴ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮͸ɘͅ੮ɘʡɘʮ˦੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮ુˑʇɘ˦યʮ˦ʡર੮ʮ˦͐˺੮ɻ˺˦ͅʇ̼ͷɘચ ͐˺̼ͅʩʮ̹ͅૂ੮ʮ˦੮͐ʩʇ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ͅʇͅͅʮ˺˦੮ˑɘ͐ʇ̼੮͐ʩɘ͐੮;ʇɘ̼ੳ৽৿ This means that it might be ɘ੮ ʡ˺˺ʁ੮ ˚˺˚ʇ˦͐੮ ͐˺੮ ɘ˦ɘˑ;Έʇ੮ ͸ʩɘ͐੮ ̼ʇʠ˺̼˚ʮ˦ʡ੮ rØäઝɘ˦ʁੴ੮ ̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;ੴ੮ ʇͽ̹ɘ˦ʁʮ˦ʡ੮ ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ͅ˺˚ʇ˺˦ʇૄͅ੮̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩઝ˚ʮʡʩ͐੮ɘɻ͙͐ɘˑˑ;੮ʁ˺ੳ

“OPERATION DIGNITY” FOR TRI-MORBIDITIES )̼ੳ੮ɘ̼˺˦੮{ʇ;ʇ̼੮ʮͅ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮̹ʇ̼ͅ˺˦੮;˺͙ૄʁ੮͐ʩʮ˦ˌ੮͸˺͙ˑʁ੮ɺʇ੮˺˦੮ɺ˺ɘ̼ʁ੮ʠ˺̼੮ʇͽ̹ɘ˦ʁચ ʮ˦ʡ੮͸ʩ˺੮ɻ˺͙˦͐ͅ੮ɘͅ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮Pʇ੮ʁʇʠʇ̼̼ʇʁ੮˚ʇʁʮɻɘˑ੮ͅɻʩ˺˺ˑ੮ʠ˺̼੮ɘ੮;ʇɘ̼੮ͅ˺੮ʩʇ੮ could work at a homeless shelter, where he encountered people with “untreated ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ ͸ʩ˺ͅʇ੮ ˚ʇʁʮɻɘˑ੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ ͸ʇ̼ʇ੮ ʮ˦ɘʁʇή͙ɘ͐ʇˑ;੮ ɘʁʁ̼ʇͅͅʇʁੳૂ੮ Pʇ੮ wanted to be a family physician but switched to psychiatry when he realized ͐ʩɘ͐੮ ˺͐ʩʇ̼͸ʮͅʇ੮ ʩʮͅ੮ ̼͐ɘʮ˦ʮ˦ʡ੮ ͸˺͙ˑʁ੮ ˦˺͐੮ ͙ͅϲϲʮɻʮʇ˦͐ˑ;੮ ɻ˺ͷʇ̼੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩੳ੮ Pʇ੮ ʮͅ੮

A SY LU M F O R T H E DY I N G

235

ɻ͙̼̼ʇ˦͐ˑ;੮͸˺̼ˌʮ˦ʡ੮͸ʮ͐ʩ੮õ#੮äɘ˦੮)ʮʇʡ˺ૄͅ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ;͐ͅʇ˚੮̹̼˺ͷʮʁʮ˦ʡ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ɻɘ̼ʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ʠ˺̼੮̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ɺˑʇ˚ͅੳ੮U˦੮৲ৰ৲ৱੴ੮ʩʇ੮̼ʮͅˌʇʁ੮ʩʮͅ੮ ɻɘ̼ʇʇ̼੮ɘͅ੮̹ɘ̼͐੮˺ʠ੮ુš̹ʇ̼ɘ͐ʮ˺˦੮)ʮʡ˦ʮ͐;ੴૂ੮ɘ੮̹̼˺ˈʇɻ͐੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺ʠ੮͙ͅɺચ ͐ͅɘ˦ɻʇ੮ ͙ͅʇੴ੮ ɻ˺ʡ˦ʮ͐ʮͷʇ੮ ʮ˚̹ɘʮ̼˚ʇ˦͐ͅੴ੮ ɘ˦ʁ੮ ̹ʩ;ͅʮɻɘˑ੮ ʁʮͅɘɺʮˑʮ͐ʮʇͅੳ੮ ä˺੮ Uૄ˚੮ ͙̼̹̼ͅʮͅʇʁ੮ ͸ʩʇ˦੮ʩʇ੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐੮̼ʇ͸̼ʮ͐ʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴ੮ɺʮˑˑʇʁ੮ɘͅ੮ʩʇˑ̹ʮ˦ʡ੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮ ̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺ʠ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅੴ੮ɘ˦ʁ੮̹ʩ;ͅʮɻɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅੴ੮ is “garbage.” rʮˌʇ੮ ͅ˺੮ ˚ɘ˦;੮ ʇʠʠ˺̼͐ͅ੮ ɘɻ̼˺ͅͅ੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ š̹ʇ̼ɘ͐ʮ˺˦੮ )ʮʡ˦ʮ͐;੮ ʇ˚ʇ̼ʡʇʁ੮ ʠ̼˺˚੮ ͸ʩɘ͐੮)̼ੳ੮{ʇ;ʇ̼੮ʁʇͅɻ̼ʮɺʇʁ੮ɘͅ੮͐ʩʇ੮ુ˚˺̼ɘˑ੮ʮ˦ˈ͙̼;ૂ੮͐ʩɘ͐੮ɻ˺˚ʇͅ੮ʠ̼˺˚੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮ɘ˦੮ /Û੮͸ʩʇ̼ʇ੮ુ͐ʮ˚ʇ੮ɘ˦ʁ੮͐ʮ˚ʇ੮ɘʡɘʮ˦੮;˺͙੮ʩɘͷʇ੮͐˺੮ɻˑʮɻˌ੮͐ʩʇ੮ʁʮͅɻʩɘ̼ʡʇ੮ɺ͙͐͐˺˦੮ɺʇɻɘ͙ͅʇ੮ there’s nowhere to send anybody.” Sam, a hospital psychologist who works with {ʇ;ʇ̼ੴ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐ੴ੮˺ͷʇ̼੮͐ʮ˚ʇੴ੮͐ʩʇ;੮ɺ˺͐ʩ੮̼ʇɘˑʮΈʇʁ੮͐ʩɘ͐੮˚ɘ˦;੮ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅ੮ʩɘʁ੮ ˦˺͐੮˺˦ˑ;੮ɻʩ̼˺˦ʮɻ੮ɘˑɻ˺ʩ˺ˑʮͅ˚੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɺ͙͐੮ɘˑͅ˺੮ͅʇ̼ʮ˺͙ͅ੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼ચ ments as a result of both being left unaddressed. He explained that “a lot of times when we saw someone coming in struggling with homelessness and a long history of substance use disorder, biases would come into play: ‘They’re not engaging ʮ˦੮͐ʩʇͅʇ੮͐ʩʮ˦ʡͅ੮ય˚ʇʁʮɻɘˑ੮ɻɘ̼ʇર੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;ૄ̼ʇ੮ɘʁʁʮɻ͐ʇʁੳ੮Uʠ੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ˌʮɻˌ੮͐ʩʇʮ̼੮ ɘʁʁʮɻ͐ʮ˺˦ੴ੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ʁ˺੮ͅʇˑʠચɻɘ̼ʇੳૄૂ੮äɘ˚੮ɺʇʡɘ˦੮ʁ˺ʮ˦ʡ੮ͅ˺˚ʇ੮̹ͅ;ɻʩ˺ˑ˺ʡʮɻɘˑ੮͐ʇ͐ͅʮ˦ʡ੮ ɘ˦ʁ੮ͅɘ͸੮͐ʩɘ͐੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅ੮ˑʮˌʇ੮ʁʇ˚ʇ˦͐ʮɘ੮͸ʇ̼ʇ੮ˌʮɻˌʮ˦ʡ੮ʮ˦੮ɘ͐੮ɘͅ੮ʇɘ̼ˑ;੮ɘͅ੮ ʠ˺̼͐;੮;ʇɘ̼ͅ੮˺ˑʁ੮ʠ˺̼੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʩʇɘͷ;੮˚ʇ͐ʩ੮˺̼੮ɘˑɻ˺ʩ˺ˑ੮͙ͅʇੳ੮îʩʮͅ੮̼ɘʮͅʇʁ੮ ͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦ੵ੮ુĔʇˑˑੴ੮ɘ̼ʇ੮͐ʩʇͅʇ੮̹ʇ˺̹ˑʇ੮ʇͷʇ˦੮capable੮˺ʠ੮ͅʇˑʠચɻɘ̼ʇ੺ૂ੮îʩʇ੮ɻ˺˦ɻˑ͙ͅʮ˺˦੮ ͸ɘͅ੮͐ʩɘ͐ੴ੮˦˺ੴ੮͐ʩʇ;੮͸ʇ̼ʇ˦ૄ͐ੳ੮îʩʇ;੮˦ʇʇʁʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ {ɘ˦;੮˺ʠ੮͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʇ̼ʇ੮ɘˑ̼ʇɘʁ;੮ɺʇʮ˦ʡ੮͐ɘ̼ʡʇ͐ʇʁ੮ɺ;੮͐ʩʇ੮Ûʇͅ˺͙̼ɻʇ੮ɻ͐ʮ˺˦੮ Ø̼˺ʡ̼ɘ˚੮ફÛØબੴ੮ɘ੮͐ʇɘ˚੮ˑʇʁ੮ɺ;੮͐ʩʇ੮äɘ˦੮)ʮʇʡ˺੮Hʮ̼ʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮͐˺੮ʁʇɘˑ੮͸ʮ͐ʩ੮͙̹ͅʇ̼ચ ʩʮʡʩ੮͙͐ʮˑʮΈʇ̼ͅ੮˺ʠ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ͅʇ̼ͷʮɻʇͅੳ੮äʮ˦ɻʇ੮ͅ˺˚ʇ੮͸ʇ̼ʇ੮ͷʮͅʮ͐ʮ˦ʡ੮͐ʩʇ੮/Û੮ʩ͙˦ʁ̼ʇʁͅ੮ ˺ʠ੮ ͐ʮ˚ʇͅ੮ ɘ੮ ;ʇɘ̼ੴ੮ )̼ੳ੮ {ʇ;ʇ̼੮ ʩɘʁ੮ ̹ˑʇ˦͐;੮ ˺ʠ੮ ˺̹̹˺̼͙͐˦ʮ͐ʮʇͅ੮ ͐˺੮ ɻɘˈ˺ˑʇ੮ ͅ;˚̹ɘ͐ʩʇ͐ʮɻ੮ ɻ˺ˑˑʇɘʡ͙ʇͅ੮ʮ˦͐˺੮ɘʁ˚ʮ͐͐ʮ˦ʡ੮͐ʩʇ˚ੳ੮š˦ɻʇ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʮ˦̹ɘ͐ʮʇ˦͐ͅੴ੮ʩʇ੮ɺɘʁʡʇ̼ʇʁ੮ʩʮͅ੮ɻ˺ˑચ ˑʇɘʡ͙ʇͅ੮˺˦੮͐ʩʇ੮˚ʇʁʮɻɘˑ੮ϲˑ˺˺̼ͅ੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͐˺੮ˌʇʇ̹੮͐ʩʇ˚ੳ੮Pʇ੮͐˺ˑʁ੮˚ʇੴ੮ુĔʇૄͷʇ੮ ɻɘˑˑʇʁ੮ʮ͐੮š̹ʇ̼ɘ͐ʮ˺˦੮)ʮʡ˦ʮ͐;ੴ੮ɺʇɻɘ͙ͅʇ੮͸ʩɘ͐੮U੮͸ɘ˦͐੮ʮͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮˦˺͐੮͐˺੮ɺʇ੮ʠ˺͙˦ʁ੮ ʁɘʮˑ;੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ɻ˺ͷʇ̼ʇʁ੮ʮ˦੮͐ʩʇʮ̼੮˺͸˦੮ʠʇɻʇͅ੮ɘ˦ʁ੮͙̼ʮ˦ʇ੮͸ʮ͐ʩ੮ͅˌʮ˦੮ɺ̼ʇɘˌʁ˺͸˦ੳ੮ õ˦͐ʮˑ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘ੮ɺʇ͐͐ʇ̼੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੯ੳ੯ੳ੯ੳ੮યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ʮͅ੮͐ʩʇ੮˺˦ˑ;੮͸ɘ;੮͐˺੮˦˺͐੮ʩɘͷʇ੮ ̹ʇ˺̹ˑʇ੮ʠ˺͙˦ʁ੮યɺ;੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ર੮ɻ˺ͷʇ̼ʇʁ੮ʮ˦੮͐ʩʇʮ̼੮˺͸˦੮ɺ˺ʁʮˑ;੮ϲˑ͙ʮʁͅੳૂ੮Pʇ੮ ϲʮˑʇʁ੮͐ʇ˦੮̹ʇ͐ʮ͐ʮ˺˦ͅ੮ʮ˦੮ɘ੮ʠʇ͸੮˚˺˦͐ʩͅੴ੮ɘˑˑ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ɘ˦ʁ੮ɻ˺ʡ˦ʮચ ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅੳ੮äʇͷʇ˦੮͸ʇ̼ʇ੮̼ʇʠ͙ͅʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺͙˦͐;੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੳ îʩʇ̼ʇ੮ɘ̼ʇ੮͐͸˺੮ʁʇʠʇ˦ͅʮɺˑʇ੮̼ʇɘͅ˺˦ͅ੮͸ʩ;੮͐ʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͸˺͙ˑʁ੮ɺʇ੮̼ʇͅʮͅચ ͐ɘ˦͐੮͐˺੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ͅ੮ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮ુ̼͐ʮચ˚˺̼ɺʮʁʮ͐ʮʇͅૂ੮ફ̹ͅ;ɻʩʮɘ̼͐ʮɻੴ੮˚ʇʁʮɻɘˑੴ੮

236

REFORM

ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ʁʮͅ˺̼ʁʇ̼ͅબੳ੮Hʮ̼͐ͅੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮͐ʩʇ̼ʇૄͅ੮˦˺͸ʩʇ̼ʇ੮͐˺੮̹͙͐੮͐ʩʇ˚ੳ੮ુU˦͐ʇચ grated care” is a policy buzzword, but the system is designed as if these were three ͅʇ̹ɘ̼ɘ͐ʇ੮̹˺̹͙ˑɘ͐ʮ˺˦ͅੳ੮õ#ä)ૄͅ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮͸ɘ̼ʁ੮̼͐ͅʮɻ͐ˑ;੮ʇͽɻˑ͙ʁʇͅ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˦ʇʇʁ੮ Uēͅੴ੮˚˺˦ʮ͐˺̼ͅੴ੮˺̼੮ɻɘ͐ʩʇ͐ʇ̼ͅੳ੮U{)ͅ੮ɘ˦ʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮͸˺˦ૄ͐੮͐ɘˌʇ੮̹ʇ˺ચ ple in wheelchairs or with colostomy bags. Medical hospitals, for their part, don’t ˑʮˌʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘͅʇͅੳ੮U͐ૄͅ੮̹ɘ̼͐ˑ;੮͐ͅʮʡ˚ɘੳ੮U͐ૄͅ੮̹ɘ̼͐ˑ;੮͐ʩɘ͐੮˚ʇʁʮɻɘˑ੮͐ʇɘ˚ͅ੮ɘ̼ʇ੮˦˺͐੮ɘͅ੮ ʇή͙ʮ̹̹ʇʁ੮ ͐˺੮ ̼ʇ̼͐ͅɘʮ˦੮ ɘ˦ʁ੮ ɻ˺˦͐ɘʮ˦੮ ʁʮϲϲʮɻ͙ˑ͐੮ ɺʇʩɘͷʮ˺̼ੳ੮ ˦ʁ੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ̹̼˺ͷʮʁʇ੮ʠʇ͸ʇ̼੮˺̹̹˺̼͙͐˦ʮ͐ʮʇͅ੮͐˺੮ɺʮˑˑ੮ʠ˺̼੮͐ʩʇ੮ʇͽ̹ʇ˦ͅʮͷʇ੮͐ʇ͐ͅͅ੮ɘ˦ʁ੮̹̼˺ɻʇʁ͙̼ʇͅ੮͐ʩɘ͐੮ ɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑͅૄ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ˑʮʠʇɺˑ˺˺ʁੳ Sam, the hospital psychologist, rounded out this sad picture by commentચ ʮ˦ʡ੮ ˺˦੮ ͐ʩʇ੮ ˑɘ͐ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ͐ʩ̼ʇʇ੮ ͅ;͐ͅʇ˚ͅ੮ ͙̹̹ͅ˺ͅʇʁ੮ ͐˺੮ ɺʇ੮ ͅʇ̼ͷʮ˦ʡ੮ ̼͐ʮચ˚˺̼ɺʮʁ੮ ɻɘͅʇͅੳ੮ ä͙ɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮ʠɘɻʮˑʮ͐ʮʇͅ੮̼͙˦˦ʮ˦ʡ੮ͷ˺ˑ͙˦͐ɘ̼;੮ͅʇˑʠચʮ˚̹̼˺ͷʇ˚ʇ˦͐੮̼ʇɻ˺ͷʇ̼;੮̹̼˺ʡ̼ɘ˚ͅ੮ ુ̼ʇή͙ʮ̼ʇ੮ͅ˺˚ʇ੮ʠɘʮ̼ˑ;੮ʁʇɻʇ˦͐੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʠ͙˦ɻ͐ʮ˺˦੮͐˺੮ʇ˦ʡɘʡʇ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇˑ;ੳૂ੮#ʩ̼˺˦ʮɻ੮ ɘˑɻ˺ʩ˺ˑʮͅ˚ੴ੮͐ʩʇ੮̹̼ʮ˚ɘ̼;੮ʁʮɘʡ˦˺ͅʮͅ੮˺ʠ੮˚ɘ˦;੮˺ʠ੮ÛØૄͅ੮ɻˑʮʇ˦͐ͅੴ੮ˑʇɘʁͅ੮͐˺੮ɺʇʩɘͷʮ˺̼ɘˑ੮ ̹̼˺ɺˑʇ˚ͅੴ੮ ̹˺͐ʇ˦͐ʮɘˑˑ;੮ ʠɘ͐ɘˑ੮ ˚ʇʁʮɻɘˑ੮ ɻ˺˚̹ˑʮɻɘ͐ʮ˺˦ͅੴ੮ ɘ˦ʁ੮ ʁʇ˚ʇ˦͐ʮɘ੶੮ ʮ͐੮ ɻɘ˦੮ ̼͙ˑʇ੮ ͅ˺˚ʇ˺˦ʇ੮˺͙͐੮ʠ˺̼੮ʇͷʇ̼;੮̹̼˺ʡ̼ɘ˚੮ɺ͙͐੮ˈɘʮˑੳ੮ુîʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮˦ʇʇʁʮ˦ʡ੮͐ʩʇ੮˚˺͐ͅ੮ʩʇˑ̹੮ɘ˦ʁ੮ ͐ʩʇ੮˺˦ʇͅ੮͸ʩ˺੮ɘ̼ʇ੮͐ʩʇ੮ʩɘ̼ʁʇ͐ͅ੮͐˺੮ͅʇ̼ͷʇ੮ɘ̼ʇ੮͐ʩʇ੮˺˦ʇͅ੮˦ʇʇʁʮ˦ʡ੮ʩʇˑ̹੮ʠ̼˺˚੮˚͙ˑ͐ʮ̹ˑʇ੮ ͅ;͐ͅʇ˚ͅੴૂ੮ɘ੮̹ɘ̼ɘ˚ʇʁʮɻ੮ʠ̼˺˚੮ÛØ੮͐˺ˑʁ੮˚ʇੳ੮ä˺੮͐ʩʇ੮ϲʮ̼͐ͅ੮̼ʇɘͅ˺˦੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ might deny these applications was that they were rightly worried about where ͐ʩʇ੮͙ͅɺˈʇɻ͐ͅ੮˺ʠ੮š̹ʇ̼ɘ͐ʮ˺˦੮)ʮʡ˦ʮ͐;੮͸ʇ̼ʇ੮ɘɻ͙͐ɘˑˑ;੮ʡ˺ʮ˦ʡ੮͐˺੮ʡ˺ੳ The second reason to refuse a petition is concern about what would happen ͸ʩʇ˦੮ ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ ʡ˺͐੮ ʮ˦͐˺੮ ɘ੮ ̹ˑɘɻʇ˚ʇ˦͐ੳ੮ #˺͙̼͐ͅ੮ ͙͙ͅɘˑˑ;੮ ʡ̼ɘ˦͐੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁચ ʮɘ˦ͅ੮ɺˑɘ˦ˌʇ͐੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ɻ˺˦ͅʇ˦͐੮͐˺੮˦˺˦ʮ˦ͷɘͅʮͷʇ੮˚ʇʁʮɻɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮˺˦੮͐ʩʇ੮ɻ˺˦ચ ͅʇ̼ͷɘ͐ʇʇૄͅ੮ ɺʇʩɘˑʠੳ੮ H˺̼੮ ɘ˦;͐ʩʮ˦ʡ੮ ˚˺̼ʇ੮ ͅʇ̼ʮ˺͙ͅઝ͙ͅɻʩ੮ ɘͅ੮ ɘ˚̹͙͐ɘ͐ʮ˦ʡ੮ ɘ੮ ˑʮ˚ɺ੮ ʠ˺̼੮ ɘ੮ ʁʮɘɺʇ͐ʮɻઝ͐ʩʇ;੮˦ʇʇʁ੮͐˺੮̼ʇ͙̼͐˦੮͐˺੮ɻ˺͙̼͐੮ɘ˦ʁ੮͐ʩʇ˦੮ϲʮ˦ʁ੮ɘ੮˚ʇʁʮɻɘˑ੮͐ʇɘ˚੮͸ʮˑˑʮ˦ʡ੮͐˺੮ ɘɻ͐੮˺˦੮͐ʩɘ͐੮ɻ˺͙̼͐੮˺̼ʁʇ̼ੳ੮k˺ͅʇ̹ʩ੮)ʇēʮɻ˺ੴ੮͸ʩ˺੮͸˺̼ˌʇʁ੮ɘͅ੮ɘ੮ʁʇ̹͙͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ʮ˦੮ äɘ˦੮)ʮʇʡ˺ੴ੮͐˺ˑʁ੮˚ʇ੮ɘ੮ͅɘʁ੮͐ͅ˺̼;੮ɘɺ˺͙͐੮˺˦ʇ੮˺ʠ੮˚ɘ˦;੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ુ͸ʩ˺੮ˑ˺͐ͅ੮͐ʩʇʮ̼੮ ̼ʮʡʩ͐੮ ͐˺੮ ̼ʇʠ͙ͅʇ੮ ˚ʇʁʮɻɘˑ੮ ̼͐ʇɘ͐˚ʇ˦͐੯ ੳ੯ ੳ੯ ੳ੮ યɘ˦ʁર੮ ʁʮʇʁ੮ ʠ̼˺˚੮ ͙˦̼͐ʇɘ͐ʇʁ੮ ͅʇͷʇ̼ʇ੮ ʮˑˑ˦ʇͅͅ੮ ɘ˦;͸ɘ;ੳૂ੮îʩʇ੮͸˺˚ɘ˦੮͸ɘͅ੮ુʡ̼͙ʠʠੴ੮͙̹ͅʇ̼੮ʮ˦͐ʇˑˑʮʡʇ˦͐ੴ੮ɻ̼ɘΈ;੮ɻ̼ʇɘ͐ʮͷʇੴ੮ʩʇɘ̼͐੮˺ʠ੮ʡ˺ˑʁੴ੮ came off like a hard chick standing in a saloon. She was amazing.” She also had ɻɘ˦ɻʇ̼੮ ɘ˦ʁ੮ ɺʇˑʮʇͷʇʁ੮ ͅʩʇ੮ ɻ˺͙ˑʁ੮ ɻ͙̼ʇ੮ ʮ͐੮ ͸ʮ͐ʩ੮ ɘ੮ ˚ʮͽ͙̼͐ʇ੮ ˺ʠ੮ ͅʇɘ͸ɘ͐ʇ̼੮ ɘ˦ʁ੮ ͷʮ˦ʇʡɘ̼ੳ੮ )ʇēʮɻ˺੮ʁʮʁ੮ʩʮͅ੮ʁ͙ʇ੮ʁʮˑʮʡʇ˦ɻʇੴ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ʩʇ̼੮ʁ˺ɻ͐˺̼ͅ੮ɘɺ˺͙͐੮͸ʩʇ͐ʩʇ̼੮ͅʩʇ੮ʩɘʁ੮͐ʩʇ੮ capacity to refuse chemotherapy. He concluded that she didn’t. But, he pointed ˺͙͐ੴ੮ુ͐ʩʇ̼ʇ੮ʮͅ੮˦˺੮˚ʇʁʮɻɘˑ੮͐ʇɘ˚੮ɘ˦;͸ʩʇ̼ʇੴ੮ɻʇ̼͐ɘʮ˦ˑ;੮˦˺͐੮ʮ˦੮äɘ˦੮)ʮʇʡ˺੯ੳ੯ੳ੯ੳ੮ય͐ʩɘ͐ર੮ʮͅ੮ ʡ˺ʮ˦ʡ੮͐˺੮ʁ˺ʡ̹ʮˑʇ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐੮ɘ˦ʁ੮ʩ˺ˑʁ੮͐ʩʇ˚੮ʁ˺͸˦੮ય͐˺੮ʡʮͷʇ੮͐ʩʇ˚੮ɻʩʇ˚˺͐ʩʇ̼ɘ̹;રੴૂ੮ ͸ʩɘ͐ʇͷʇ̼੮ɘ͙͐ʩ˺̼ʮ͐;੮ɘ੮ɻ˺͙̼͐੮ʩɘͅ੮ʡ̼ɘ˦͐ʇʁੳ੮îʩʮͅ੮ʮͅੴ੮ʮ˦੮ʠɘɻ͐ੴ੮ɘ੮ˌʇ;੮̹ɘ̼͐੮˺ʠ੮͸ʩ;੮͐ʩʇ੮

A SY LU M F O R T H E DY I N G

237

#ɘˑʮʠ˺̼˦ʮɘ੮P˺̹ͅʮ͐ɘˑ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮˺̹̹˺ͅʇʁ੮"੮ৱ৹৷ৱ੮ફ͐ʩʇ੮ɺʮˑˑ੮͐˺੮ɘʁʁ੮͙˦˚ʇ͐੮̹ʩ;ͅʮɻɘˑ੮ ʩʇɘˑ͐ʩ੮˦ʇʇʁͅ੮͐˺੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;બੵ੮ɺʇɻɘ͙ͅʇ੮ʮ͐੮͸˺͙ˑʁ੮̹˺͐ʇ˦͐ʮɘˑˑ;੮ˑʇɘʁ੮͐˺੮˚˺̼ʇ੮̹ʇ˺ચ ple being brought to the hospital for conditions that the hospital legally couldn’t, or ethically wouldn’t, forcibly treat.৽਀ )ʇ̹ͅʮ͐ʇ੮͐ʩʇ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮ɺɘ̼̼ʮʇ̼ͅੴ੮)̼ੳ੮{ʇ;ʇ̼੮͸ɘͅ੮͙˦ʁɘ͙˦͐ʇʁੳ੮Pʇ੮ϲʮˑʇʁ੮ɘ˦੮ɘ̹̹ˑʮચ ɻɘ͐ʮ˺˦੮ʠ˺̼੮kʇ͙ͅͅੴ੮ɘ੮ͅʇͷʇ˦͐;ચ˺˦ʇચ;ʇɘ̼ચ˺ˑʁ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ʩ˺˚ʇˑʇͅͅ੮ʠ˺̼੮ɘ੮ʁʇɻɘʁʇੳ੮kʇ͙ͅͅ੮ ͷʮͅʮ͐ʇʁ੮͐ʩʇ੮/Û੮ʠ˺͙̼੮ʩ͙˦ʁ̼ʇʁ੮͐ʮ˚ʇͅ੮ʮ˦੮˺˦ʇ੮;ʇɘ̼ੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ɻɘˑˑʇʁ੮৹ৱৱ੮ ̼͐;ʮ˦ʡ੮͐˺੮ʡʇ͐੮ʠ˺˺ʁੴ੮ɺ͙͐੮˺˦ɻʇ੮ɺʇɻɘ͙ͅʇ੮/{ä੮ɺ̼˺͙ʡʩ͐੮ʩʮ˚੮ʮ˦੮ɘʠ͐ʇ̼੮ɺʇʮ˦ʡ੮ʩʮ͐੮ɺ;੮ɘ੮ɻɘ̼ੴ੮ ɻɘ͙ͅʮ˦ʡ੮ɘ੮ɺ̼ɘʮ˦੮ɺˑʇʇʁ੮͐ʩɘ͐੮˦ʇɻʇͅͅʮ͐ɘ͐ʇʁ੮ʇ˚ʇ̼ʡʇ˦ɻ;੮͙̼ͅʡʇ̼;ੳ੮)̼ੳ੮{ʇ;ʇ̼੮ʠ˺͙˦ʁ੮ͅ˺˚ʇચ ͸ʩʇ̼ʇ੮ʮ˦੮kʇ͙ͅͅૄͅ੮˚ʇʁʮɻɘˑ੮̼ʇɻ˺̼ʁ੮͐ʩɘ͐੮ʩʇ੮ʩɘʁ੮˺˦ɻʇ੮ɺʇʇ˦੮ʁʮɘʡ˦˺ͅʇʁ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇચ ˦ʮɘੳ੮îʩʮͅ੮͸ɘͅ੮ʇ˦˺͙ʡʩ੮͐˺੮ɘ̹̹ˑ;੮ʠ˺̼੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ફʇͷʇ˦੮͐ʩ˺͙ʡʩ੮)̼ੳ੮{ʇ;ʇ̼੮ thinks his problem was really prolonged meth use, alcoholism, and dementia). ͅ੮ʮ˦੮ͅʇͷʇ̼ɘˑ੮˺͐ʩʇ̼੮ɻɘͅʇͅੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮͐˺ˑʁ੮͐ʩʇ੮š̹ʇ̼ɘ͐ʮ˺˦੮)ʮʡ˦ʮ͐;੮ ͐ʇɘ˚੮͐ʩɘ͐੮kʇ͙ͅͅૄͅ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮˦ʇʇʁʇʁ੮͐˺੮ʡ˺੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੴ੮͐ʩʇ੮ɘʡʇ˦ɻ;੮͐ʩɘ͐੮ ʁ˺ʇͅ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮îʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐ʩʇ˦੮͐˺ˑʁ੮͐ʩʇ˚੮ʩʇ੮ͅʩ˺͙ˑʁ੮ ʡ˺੮͐˺੮͐ʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ੴ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮)̼ੳ੮{ʇ;ʇ̼ੴ੮ ̼ʮʡʩ͐ˑ;ੴ੮ʠ˺͙˦ʁ੮͐ʩʮͅ੮ɘɺ͙̼ͅʁੳ੮ˑɻ˺ʩ˺ˑʮͅ˚੮ɘ˦ʁ੮ʁʇ˚ʇ˦͐ʮɘ੮ɻɘ˦੮ɺʇ੮͐ʩʇ੮ɺɘͅʮͅ੮ʠ˺̼੮ɘ˦੮rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ˺̼੮ ɘ੮ ̹̼˺ɺɘ͐ʇ੮ ˺˦ʇੳ৽ਁ੮ ˑ͐ʩ˺͙ʡʩ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ ɘ˦ʁ੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦੮äɘ˦੮)ʮʇʡ˺੮ɘ̼ʇ੮͙̹̹ͅ˺ͅʇʁˑ;੮ͅʇ̹ɘ̼ɘ͐ʇ੮ʇ˦͐ʮ͐ʮʇͅੴ੮͐ʩʇ;੮ʩɘͷʇ੮͐ʩʇ੮ͅɘ˚ʇ੮ address and phone number.৽ਂ੮ ફુU͐੮ ͅʇʇ˚ͅ੮ ͐ʩʇ̼ʇૄͅ੮ Έʇ̼˺੮ ɻ˺˚˚͙˦ʮɻɘ͐ʮ˺˦ૂ੮ ɺʇ͐͸ʇʇ˦੮ ͐ʩʇ˚ੴ੮äɘ˚੮ɘ͙̼ͅͅʇʁ੮˚ʇੳબ੮)̼ੳ੮{ʇ;ʇ̼੮͸ɘͅ੮ʠɘɻʮ˦ʡ੮ɘ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮̼͙˦ɘ̼˺͙˦ʁ੮ʠ˺̼੮̼͐;ચ ing to get stabilizing treatment for the person who, at least measured in 911 calls, ˚ʮʡʩ͐੮ʩɘͷʇ੮ɺʇʇ˦੮͐ʩʇ੮˦ʇʇʁʮʇ͐ͅ੮̹ʇ̼ͅ˺˦੮ʮ˦੮äɘ˦੮)ʮʇʡ˺੮#˺͙˦͐;ੳ U˦੮ kʇ͙ͅͅૄͅ੮ ɻɘͅʇੴ੮ ͐ʩʇ੮ ɘʡʇ˦ɻ;ચ˺˦ચɘʡʇ˦ɻ;੮ ɺɘ͐͐ˑʇ੮ ʡ˺͐੮ ʇͷʇ˦੮ ˚˺̼ʇ੮ ʩʇɘ͐ʇʁੳ੮ îʩʇ੮ äɘ˦੮ )ʮʇʡ˺੮ ɻʮ͐;੮ ɘ͐͐˺̼˦ʇ;ૄͅ੮ Ø͙ɺˑʮɻ੮ ‡͙ʮͅɘ˦ɻʇ੮ ɺɘ͐ʇ˚ʇ˦͐੮ õ˦ʮ͐੮ ફ̼ʇɘˑˑ;બ੮ ̼ʇɘˑʮΈʇʁ੮ ͐ʩɘ͐੮ ͸ʩʮˑʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅ੮ʩɘͷʇ੮ɘɺͅ˺ˑ͙͐ʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮˺ͷʇ̼੮͸ʩʇ͐ʩʇ̼੮͐˺੮ϲʮˑʇ੮ʠ˺̼੮ɘ˦੮ rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ੮ɻ˺͙̼͐੮ɻɘ˦੮˺̼ʁʇ̼੮͐ʩʇ˚੮͐˺੮ϲʮˑʇ੮ʠ˺̼੮ɘ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘચ torship.৽ਃ੮ä˺੮͐ʩʇ੮ɻʮ͐;੮͐˺˺ˌ੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮̹̼˺ɺɘ͐ʇ੮ɻ˺͙̼͐ੳ੮U˦੮͐ʩʇ੮ʩʇɘ̼ʮ˦ʡੴ੮͐ʩʇ੮ˈ͙ʁʡʇ੮ ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮͸ʇ̼ʇ੮̼ʇɘˑˑ;੮ʠ˺̼੮ˑʮ͐͐ˑʇ੮˺ˑʁ੮ˑɘʁʮʇͅ੮ફU੮ͅɘ͸੮͐ʩʇ੮ ɻ˺͙̼͐੮̼͐ɘ˦ͅɻ̼ʮ̹͐બੳ੮îʩʇ;੮ɺʇ̼ɘ͐ʇʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼੮ʮ˦͐˺੮ɻ˺˦ʁ͙ɻ͐ʮ˦ʡ੮ɘ˦੮rØä੮ ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ੳ੮îʩʇ੮ʩɘ̹̹;੮ʇ˦ʁʮ˦ʡ੮͐˺੮͐ʩʮͅ੮͐ͅ˺̼;ੴ੮U੮ʡ͙ʇͅͅੴ੮ʮͅ੮͐ʩɘ͐੮ɘͅ੮˺ʠ੮äʇ̹͐ʇ˚ɺʇ̼੮ ৲ৰ৲৲ੴ੮kʇ͙ͅͅ੮͸ɘͅ੮˺˦੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮Pʇ੮ʩɘʁ੮ɺʇʇ˦੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮ ;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ʩɘˑʠ੮͐˺੮͐ͅʇ̹੮ʁ˺͸˦੮͐˺੮ɘ੮˦ʇ͙̼˺̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇੳ੮äɘ˦੮)ʮʇʡ˺੮˺˦ˑ;੮ contracts with one such facility, and his wait is typical to get into it.৽਄੮š˦੮͐ʩʇ੮̹ˑ͙ͅ੮ ͅʮʁʇੴ੮͐ʩʇ੮ɻʮ͐;੮ɘ͐͐˺̼˦ʇ;੮ʁ˺˦ɘ͐ʇʁ੮ɘ੮Øˑɘ;ä͐ɘ͐ʮ˺˦੮ɘ˦ʁ੮ęɺ˺ͽ੮͐˺੮ʩʇˑ̹੮ʇ˦͐ʇ̼͐ɘʮ˦੮͐ʩʇͅʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੴ੮ʠ˺̼੮͸ʩ˺˚੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮͸ɘͅ੮˦˺͸੮ʩ˺˚ʇੳ

238

REFORM

îʩʇ̼ʇૄͅ੮ɘ˦੮ʇͅͅʇ˦͐ʮɘˑ੮̹˺ʮ˦͐੮ʩʇ̼ʇੵ੮͐ʩʇ੮rØä੮ɻ̼ʮ͐ʇ̼ʮɘ੮͸ʇ̼ʇ੮˦ʇͷʇ̼੮̼ʇɘˑˑ;੮͐ʩʇ੮ʮ͙ͅͅʇੳ੮ îʩɘ͐ૄͅ੮ ͸ʩ;੮ )̼ੳ੮ {ʇ;ʇ̼੮ ͐ʩʮ˦ˌͅ੮ ͐ʩʇ੮ ̼ʇʠ˺̼˚ͅ੮ ɘ̼ʇ੮ ુʡɘ̼ɺɘʡʇੳૂ੮ #˺͙̼͐ͅ੮ ʁʮʁ˦ૄ͐੮ ʁʇ˦;੮ ɘ੮ ͅʮ˦ʡˑʇ੮˺˦ʇ੮˺ʠ੮ʩʮͅ੮̹ʇ͐ʮ͐ʮ˺˦ͅੳ੮U˦੮ʠɘɻ͐ੴ੮̼ɘʮͅʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʁʇɻ̼ʇ̹ʮ͐੮̹ʩ;ͅʮɻɘˑ੮͐ͅɘ͐ʇ੮ʮͅ੮ʩʮͅ੮ ̼͙͐˚̹੮ɻɘ̼ʁ੮͸ʩʇ˦੮͐ʇ͐ͅʮʠ;ʮ˦ʡ੮ʮ˦੮rØä੮ʩʇɘ̼ʮ˦ʡͅੵ੮ુɘˑˑ੮U੮ʩɘͷʇ੮͐˺੮ʁ˺੮ʮͅ੮ͅʩ˺͸੮ɘ੮̹ʮɻ͙̼͐ʇ੮˺ʠ੮ ͐ʩʇʮ̼੮͸˺͙˦ʁੴ੮ɘ˦;੮ˌʮ˦ʁ੮˺ʠ੮ɘɺ˦˺̼˚ɘˑ੮ˑɘɺ੮ͷɘˑ͙ʇੴ੮ʮ͐ૄͅ੮ɘˑ˚˺͐ͅ੮ʡɘ˚ʇ੮˺ͷʇ̼ੴ੮͐ʩʇ੮ˈ͙ʁʡʇͅ੮ ͸ʮˑˑ੮̼͙ˑʇ੮ʮ͐ૄͅ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴૂ੮ʩʇ੮͐˺ˑʁ੮˚ʇੳ੮Pʇ੮˺˦ɻʇ੮ʩɘʁ੮ɘ˦੮rØä੮ʩ˺ˑʁ੮͙̹ʩʇˑʁ੮ʠ˺̼੮ a homeless person whose main problem was a lice infestation, leading to excepચ ͐ʮ˺˦ɘˑˑ;੮ˑ˺͸੮ʩʇ˚˺ʡˑ˺ɺʮ˦ੳ੮rØä੮ɻ̼ʮ͐ʇ̼ʮɘ੮ɘ̼ʇ੮ͷɘʡ͙ʇੴ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮˺˦੮ʩ˺͸੮͐˺੮ʁʇϲʮ˦ʇ੮ ͐ʩʇ˚੮ɘ̼ʇ੮˚ʮ˦ʮ˚ɘˑੴ੮ɘ˦ʁ੮˺ͷʇ̼ͅʮʡʩ͐੮ʮͅ੮ˑʮ˚ʮ͐ʇʁੳ੮"͙͐੮ɘͅ੮)̼ੳ੮{ʇ;ʇ̼੮͙ͅ˚˚ɘ̼ʮΈʇʁੴ੮ુrɘ͸ͅ੮ ɘ˦ʁ੮̹ɘ̹ʇ̼੮ʁ˺˦ૄ͐੮˚ɘ͐͐ʇ̼੮͸ʩʇ˦੮͐ʩʇ̼ʇૄͅ੮˦˺੮ɺ͙ʮˑʁʮ˦ʡͅੳ੯ੳ੯ੳ੯ੳ੮Uʠ੮;˺͙੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮̹ˑɘɻʇͅ੮ ʠ˺̼੮̹ʇ˺̹ˑʇ੮͐˺੮ʡ˺ੴ੮˦˺੮˦ʮ˚ɺˑʇ੮͐ʇɘ˚ͅ੮ય͐˺੮ɘ̹̹ˑ;੮͐ʩ˺ͅʇ੮ɻ̼ʮ͐ʇ̼ʮɘરੴ੮˦˺੮ˑɘ͸੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ successful.” îʩʇ੮ ʇ˦ʁ੮ ˺ʠ੮ )̼ੳ੮ {ʇ;ʇ̼ૄͅ੮ ͐ͅ˺̼;੮ ʮͅ੮ ɘ੮ ʁʮʠʠʇ̼ʇ˦͐੮ ɻɘ͙͐ʮ˺˦ɘ̼;੮ ͐ɘˑʇ੮ ɘɺ˺͙͐੮ ̼͐;ʮ˦ʡ੮ ͐˺੮ ʠ˺̼ɻʇ੮ʁʮ̹ͅɘ̼ɘ͐ʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ʮ˦͐˺੮ɻɘ̼ʮ˦ʡ੮ʠ˺̼੮ʮ˦ɻ˺˦ͷʇ˦ʮʇ˦͐੮̹ʇ˺̹ˑʇੳ੮ʠ͐ʇ̼੮š̹ʇ̼ɘ͐ʮ˺˦੮ )ʮʡ˦ʮ͐;ૄͅ੮ુɻ̼͙ͅɘʁʇૂ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹ʇ͐ʮ͐ʮ˺˦ͅੴ੮õ#ä)੮ɘ˦˦˺͙˦ɻʇʁ੮͐ʩʇ੮ʠ˺̼˚ɘચ ͐ʮ˺˦੮ ˺ʠ੮ ɘ੮ ુɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻ˺˚˚ʮ͐͐ʇʇੳૂ੮ {ɘ͐͐ੴ੮ ɘ੮ ̹ͅ;ɻʩʮɘ̼͐;੮ ̼ʇͅʮʁʇ˦͐ੴ੮ ʁʇͅɻ̼ʮɺʇʁ੮ ʩʮͅ੮˺͸˦੮ʩ˺̹ͅʮ͐ɘˑૄͅ੮ɻ˺˚˚ʮ͐͐ʇʇ੮ɘͅ੮ʇͽʮ͐ͅʮ˦ʡ੮͐˺੮ુʁʇ˦;੮ʇͷʇ̼;͐ʩʮ˦ʡੳૂ੮P˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ચ ʮ̼͐ͅɘ͐ʮ˺˦੮ɘʁ˚˺˦ʮͅʩʇʁ੮)̼ੳ੮{ʇ;ʇ̼੮͐˺੮͐ͅ˺̹੮̹͙͐͐ʮ˦ʡ੮ʩ˺ˑʁͅ੮˺˦੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅ੮͸ʩ˺੮ would occupy their beds for an indeterminant length of time. They transferred )̼ੳ੮{ʇ;ʇ̼੮͐ʇ˚̹˺̼ɘ̼ʮˑ;੮͐˺੮ɘ˦˺͐ʩʇ̼੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩɘ͐੮͸ɘͅ੮˦˺͐੮ʠ˺̼˚ɘˑˑ;੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮͐˺੮ ͐ɘˌʇ੮rØä੮̹ɘ͐ʮʇ˦͐ͅੳ Uʠ੮͐ʩʇ̼ʇૄͅ੮͐ʩɘ͐੮˚͙ɻʩ੮̼ʇͅʮ͐ͅɘ˦ɻʇ੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮͐˺੮ɻ˺˦ͅʇ̼ͷʮ˦ʡ੮ͅ˺˚ʇચ ˺˦ʇ੮ ɘˑ̼ʇɘʁ;੮ ɻ˺˚ʮ˦ʡ੮ ͐˺੮ ͐ʩʇ੮ /Û੮ ʠ˺͙̼੮ ʩ͙˦ʁ̼ʇʁ੮ ͐ʮ˚ʇͅ੮ ʮ˦੮ ɘ੮ ;ʇɘ̼ੴ੮ ʮ˚ɘʡʮ˦ʇ੮ ͸ʩɘ͐੮ ʮ͐੮ ͸˺͙ˑʁ੮ˑ˺˺ˌ੮ˑʮˌʇ੮ʮʠੴ੮ɘʠ͐ʇ̼੮rØä੮ʮͅ੮ˑ˺˺ͅʇ˦ʇʁੴ੮ͅ˺˚ʇ˺˦ʇ੮̼͐ʮʇʁ੮͐˺੮ʡʇ͐੮͐ʩʇ੮ͅʮˑʇ˦͐ੴ੮ʩ͙ʁʁˑʇʁ੮ masses of Skid Row inpatient care.

OUTPATIENT CONSERVATORSHIP FOR INPATIENT CARE š˦ʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮˚͙ˑ͐ʮ̹ˑʇ੮͐˺˺ˑͅ੮͸ʮ͐ʩʮ˦੮ rØä੮ ˑɘ͸੮ ͐ʩɘ͐੮ ɻ˺͙ˑʁ੮ ɺʇ੮ ͙ͅʇʁ੮ ͐˺੮ ̹͙ͅʩ੮ ˚˺̼ʇ੮ ̹ʇ˺̹ˑʇ੮ ˺˦͐˺੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ ʇͷʇ˦੮ ɘɺͅʇ˦͐੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ɻʩɘ˦ʡʇͅੴ੮ɺ͙͐੮͐ʩɘ͐੮ʩɘͷʇ੮ɺʇʇ˦੮ˑ;ʮ˦ʡ੮ʁ˺̼˚ɘ˦͐੮ʠ˺̼੮ˑɘɻˌ੮˺ʠ੮ʡ˺ͷʇ̼˦ચ ˚ʇ˦͐੮ ̼͐ͅɘ͐ʇʡ;੮ ˺̼੮ ʮ˦ʮ͐ʮɘ͐ʮͷʇੳ੮ ä˺˚ʇ੮ ʇ˦͐ʇ̼̹̼ʮͅʮ˦ʡ੮ ɘɻ͐˺̼ͅ੮ ɘ̼ʇ੮ ɻʩɘ˦ʡʮ˦ʡ੮ ͐ʩɘ͐ੳ੮ Ø͙ɺચ ˑʮɻ੮ ʁʇʠʇ˦ʁʇ̼ͅ੮ ʩɘͷʇ੮ ɺʇʇ˦੮ ϲʮʡ͙̼ʮ˦ʡ੮ ˺͙͐੮ ɘ੮ ͷɘ̼ʮʇ͐;੮ ˺ʠ੮ ͸ɘ;ͅ੮ ʠ˺̼੮ ɻ˺͙̼͐ͅ੮ ɘ˦ʁ੮ ˈɘʮˑͅ੮ ͐˺੮ ʁʮͷʇ̼͐੮̹ʇ˺̹ˑʇ੮˺˦͐˺੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੳ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʩɘͅ੮ɺʇʡ͙˦੮ ͙ͅʮ˦ʡ੮͐ʩʇ੮ʁ˺̼˚ɘ˦͐੮̹̼˺ͷʮͅʮ˺˦ͅ੮͐ʩɘ͐੮ɘˑˑ˺͸੮ʠ˺̼੮ɘ੮ʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮

A SY LU M F O R T H E DY I N G

239

based on chronic alcoholism. This section turns to another such mechanism: a ˑ˺˦ʡચʮʡ˦˺̼ʇʁ੮͐ͅɘ͙͐͐ʇ੮͐ʩɘ͐੮ɘˑˑ˺͸ͅ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ϲʮˑʇ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹ʇ͐ʮ͐ʮ˺˦੮ʠ˺̼੮ ͅ˺˚ʇ˺˦ʇ੮ˑʮͷʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮͸ʮ͐ʩ˺͙͐੮̹ɘͅͅʮ˦ʡ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮͸ʩ˺ˑʇ੮ͅʇ̼ʮʇͅ੮˺ʠ੮ͷʇ͐˺੮ ̹˺ʮ˦͐ͅઝ৵ৱ৵ৰͅੴ੮/Ûͅੴ੮ɘ˦ʁ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐ͅઝ͐ʩɘ͐੮̹ʇ˺̹ˑʇચ̹̼˺ɻʇͅͅ੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ৾৻ {˺͐ͅ੮rØä੮̼ʇʠ˺̼˚ͅ੮ͅʇʇˌ੮͐˺੮ɻ̼ɘ˚੮˚˺̼ʇ੮̹ʇ˺̹ˑʇ੮͐ʩ̼˺͙ʡʩ੮ʇͽʮ͐ͅʮ˦ʡ੮̹ɘ͐ʩ͸ɘ;ͅੳ੮Uૄ˚੮ ʮ˦̼͐ʮʡ͙ʇʁ੮ ɺ;੮ rૄͅ੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ̹̼˺ʡ̼ɘ˚੮ ɺʇɻɘ͙ͅʇੴ੮ ʮ˦੮ ɻ˺˦̼͐ɘ͐ͅੴ੮ ʮ͐੮ ͙ͅʇʁ੮͐ʩʮͅ੮ʁ˺̼˚ɘ˦͐੮ɘ͙͐ʩ˺̼ʮ͐;੮ɘͅ੮̹ɘ̼͐੮˺ʠ੮ɘ੮ʁʇˑʮɺʇ̼ɘ͐ʇੴ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ચˑʇʁ੮̼ʇϲˑʇɻ͐ʮ˺˦੮ ͐˺੮ɺʇ͐͐ʇ̼੮ʮʁʇ˦͐ʮʠ;੮͸ʩ˺੮̹ͅʇɻʮϲʮɻɘˑˑ;੮ɺʇ˦ʇϲʮ͐ͅ੮ʠ̼˺˚੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮k˺˦੮äʩʇ̼ʮ˦ੴ੮ɘ੮ ʠ˺̼˚ʇ̼੮ē੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɘ̹̹˺ʮ˦͐ʇʁ੮͐˺੮̼͙˦੮͐ʩʇ੮͐ʩ̼ʇʇચɺʮˑˑʮ˺˦ચʁ˺ˑˑɘ̼ચɘચ;ʇɘ̼੮){P੮ ʮ˦੮৲ৰৱ৶ੴ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͐˺੮˚ʇ੮͐ʩɘ͐੮͐ʩʇ੮͐;̹ʮɻɘˑ੮ɻʮ̼ɻ͙ʮ͐੮˺ʠ੮͸ɘʮ͐ʮ˦ʡ੮ʠ˺̼੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮ɺʇ੮ ʮ˦੮ɘɻ͙͐ʇ੮ɻ̼ʮͅʮͅੴ੮͐ɘˌʮ˦ʡ੮͐ʩʇ˚੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɘ˦ʁ੮˺˦ˑ;੮ɘ̹̹ˑ;ʮ˦ʡ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʮʠ੮͐ʩʇ;੮ʠɘʮˑ੮͐˺੮͐ͅɘɺʮˑʮΈʇੴ੮ʮͅ੮ɘ੮ુ͸ɘ͐ͅʇ੮˺ʠ੮͐ʮ˚ʇੳૂ੮Øʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮ʩʇ੮ͅɘʮʁੴ੮ ુʩɘͷʇ੮ɘ੮ɻʩ̼˺˦ʮɻ੮̹̼˺ɺˑʇ˚੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͸ʇ੮͐ʩ̼˺͸੮͐ʩʇ˚੮ʮ˦͐˺੮ɘ˦੮ɘɻ͙͐ʇ੮યʩ˺̹ͅʮ͐ɘˑરੴ੮ɘ͐੮ʡ̼ʇɘ͐੮ ʇͽ̹ʇ˦ͅʇ੮͐˺੮͐ʩʇ੮͐ɘͽ̹ɘ;ʇ̼ੴ੮ʮ˦͐˺੮ɺʇʁͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ɘˑ̼ʇɘʁ;੮ˑ˺ʡચˈɘ˚˚ʇʁੴ੮ʮ˦੮ɘ˦੮ʇ˦ͷʮ̼˺˦ચ ment that is toxic.” Pʮͅ੮ ʮʁʇɘੴ੮ ʮ˦͐ͅʇɘʁੴ੮ ͸ɘͅ੮ ʠ˺̼੮ ͐ʩʇ੮ P˺˚ʇˑʇͅͅ੮ š͙̼͐ʇɘɻʩ੮ ɘ˦ʁ੮ {˺ɺʮˑʇ੮ /˦ʡɘʡʇ˚ʇ˦͐੮ team, which works with those unhoused persons in the county most struggling ͐˺੮͙̼ͅͷʮͷʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮͐˺੮ɘ̹̹̼˺ɘɻʩ੮͐ɘ̼ʡʇ͐ʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮ɘ੮ુ̹ˑɘ͐͐ʇ̼ૂ੮˺ʠ੮ͅʇ̼ચ ͷʮɻʇͅੳ੮ુI͙ɘ̼ɘ˦͐ʇʇʁ੮ʩ˺͙ͅʮ˦ʡૂ੮͸ɘͅ੮ɘ੮ˌʇ;੮̹ɘ̼͐੮˺ʠ੮͐ʩɘ͐੮̹ˑɘ͐͐ʇ̼ੳ੮U͐੮ɻ˺͙ˑʁ੮ɺʇ੮ુɘ੮ͅʩʇˑ͐ʇ̼੮ ɺʇʁੴ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ɺʇʁੴ੮ɘ˦;੮͐;̹ʇ੮˺ʠ੮ɺʇʁ੮͐ʩɘ͐੮͸ʇ੮͸ʮˑˑ੮˚ɘˌʇ੮ɘͷɘʮˑɘɺˑʇ੮͐˺੮͐ʩɘ͐੮ ̹ʇ̼ͅ˺˦੮ʮ˦੮̼ʇɘˑ੮͐ʮ˚ʇ੮ʠ̼˺˚੮͐ʩʇ੮̼͐ͅʇʇ͐ੳૂ੮Pʇ੮ʮ˦ͅʮ͐ͅʇʁੴ੮ુĚ˺͙੮ʁ˺˦ૄ͐੮˚ʇͅͅ੮͸ʮ͐ʩ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ autonomy, unless you offer them resources up front.” As someone who still worked as a street psychiatrist, Sherin knew that most ̹ʇ˺̹ˑʇ੮ ʩɘͷʇ੮ ɺʇʇ˦੮ ુɺ͙̼˦ʇʁૂ੮ ɺ;੮ ͐ʩʇ੮ ͅ;͐ͅʇ˚੮ ɺʇʠ˺̼ʇੴ੮ ͅ˺੮ ુ৹৹੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ ͐ʩʇ੮ ͐ʮ˚ʇੴ੮ ͐ʩʇ;੮ ͅɘ;ੴ੮ ૃʡʇ͐੮ ˑ˺͐ͅੳૄૂ੮ Ĕʩʇ˦੮ ͐ʩʇ੮ ͐ʇɘ˚੮ ુ̼ʇɘɻʩયʇͅર੮ ͐ʩʇ੮ ̹˺ʮ˦͐੮ ͸ʩʇ̼ʇ੮ ͐ʩɘ͐੮ ̼ʇˑʇ˦͐ˑʇͅͅ੮ ʇ˦ʡɘʡʇ˚ʇ˦͐੮͸ʮ͐ʩ੮ʁʇʁʮɻɘ͐ʇʁੴ੮ɻ˺˚˚ʮ͐͐ʇʁ੮̼ʇͅ˺͙̼ɻʇͅ੮͙̹੮ʠ̼˺˦͐੮ʮͅ੮˦˺͐੮ʇʠʠʇɻ͐ʮͷʇ੯ੳ੯ੳ੯ੳ੮ ͐ʩʇ˦੮ ͸ʇ੮ ʩɘͷʇ੮ ͐˺੮ ͐ʩʮ˦ˌ੮ ɘɺ˺͙͐੮ ɻ˺˚̹ʇˑˑʮ˦ʡ੮ ʇ˦ʡɘʡʇ˚ʇ˦͐ੳૂ੮ îʩɘ͐੮ ˚ʮʡʩ͐੮ ͐ͅɘ̼͐੮ ͸ʮ͐ʩ੮ ɻ˺͙̼͐ચ˺̼ʁʇ̼ʇʁ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̼͐ʇɘ͐˚ʇ˦͐੮ફšîબ੮ɺ͙͐੮ɻ˺͙ˑʁ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ʡ̼ɘʁ͙ɘ͐ʇ੮͐˺੮ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦ઝ˚ɘʁʇ੮ɺ;੮ɘ˦੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻˑʮ˦ʮɻʮɘ˦੮͸ʩʮˑʇ੮͐ʩɘ͐੮̹ʇ̼ͅ˺˦੮ ͸ɘͅ੮͐ͅʮˑˑ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮îʩʇ੮̹˺ʮ˦͐੮͸ɘͅ੮͐ʩɘ͐੮Pš{/੮͸˺͙ˑʁ੮˺˦ˑ;੮̹͙̼͙ͅʇ੮ɻ˺˦ͅʇ̼ͷɘચ torship when a full range of resources had been offered and a placement for a ˦ʇ͸ˑ;੮ɻ˺˦ͅʇ̼ͷʇʁ੮ɻˑʮʇ˦͐੮͸ɘͅ੮ɘˑ̼ʇɘʁ;੮ˑʮ˦ʇʁ੮͙̹ੳ ä͐ɘ̼͐ʮ˦ʡ੮ ʮ˦੮ ͙ʡ͙͐ͅ੮ ৲ৰ৲ৰੴ੮ ɘ੮ ɻ˺˚˚ʮ͐͐ʇʇ੮ ʠ˺̼੮ ͐ʩʮͅ੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ̹ʮˑ˺͐੮ɺ̼˺͙ʡʩ͐੮Pš{/੮ɘ˦ʁ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮͐˺ʡʇ͐ʩʇ̼੮͸ʇʇˌˑ;੮͐˺੮ʁʮͅɻ͙ͅͅ੮̹˺͐ʇ˦ચ ͐ʮɘˑ੮ɻɘͅʇͅੳ੮U੮͸ɘ͐ɻʩʇʁ੮ɘ੮̼͐ɘʮ˦ʮ˦ʡ੮ɺ;੮)̼ੳ੮/ˑʮΈɘɺʇ͐ʩ੮"̼˺˚ˑʇ;ੴ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ʮ˦ͷ˺ˑͷʇʁ੮

240

REFORM

͸ʮ͐ʩ੮͐ʩʇ੮̹ʮˑ˺͐ੴ੮͐ʩɘ͐੮ʡɘͷʇ੮ɘ੮͸ʮ˦ʁ˺͸੮ʮ˦͐˺੮͐ʩʇ੮ɻˑʮʇ˦͐ʇˑʇ੮͐ʩʇ;੮ʇ˦ͷʮͅʮ˺˦ʇʁੳ੮U˦੮ɻ˺˦̼͐ɘ͐ͅ੮ ͐˺੮ )̼ੳ੮ Øɘ̼͐˺ͷʮૄͅ੮ ɘ̹̹̼˺ɘɻʩੴ੮ "̼˺˚ˑʇ;੮ ͅɘʮʁ੮ ͐ʩɘ͐੮ ુʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;ੴ੮ ʮ͐ૄͅ੮ ɻ˺˦ɻʇ̹͙͐ɘˑੴ੮ ͐ʩʇ̼ʇ੮ɘ̼ʇ੮ɻ̼ʮ͐ʇ̼ʮɘੴ੮ɺ͙͐੮͐ʩʇ̼ʇૄͅ੮˦˺͐੮ɘ੮ɻʩʇɻˌˑʮ͐ͅ੮͸ʩʇ̼ʇ੮;˺͙੮ɻɘ˦੮ʩɘͷʇ੮ʠ˺͙̼੮˺͙͐੮˺ʠ੮ʇʮʡʩ͐ੴ੮ ɘ˦ʁ੮ʮ͐ૄͅ੮ͅ˺˚ʇ੮ˌʮ˦ʁ੮˺ʠ੮ˑʮ˦ʇ੮˺̼੮͐ʩ̼ʇͅʩ˺ˑʁੳૂ੮äʩʇ੮ʡɘͷʇ੮ɘ੮̼ɘ˦ʡʇ੮˺ʠ੮ʇͽɘ˚̹ˑʇͅ੮ͅʩ˺͸ʮ˦ʡ੮ ͐ʩʇ੮˦ʇͽ͙ͅ੮ɺʇ͐͸ʇʇ˦੮ɘ˦੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮˺˦ʇૄͅ੮˦ʇʇʁͅ੮ɘ˦ʁ੮̹ͅ;ɻʩ˺ͅʮͅੵ੮ͅ˺˚ʇ˺˦ʇ੮ ɻ˺˦ͷʮ˦ɻʇʁ੮͐ʩʇ;੮ʩɘʁ੮ɘ੮ુͅ˺ˑɘ̼੮̹˺͸ʇ̼ʇʁ੮ʩʇɘ̼͐ૂ੮͐ʩɘ͐੮͐ʩʇ;੮˦ʇʇʁʇʁ੮͐˺੮ɺʇ੮˺͙͐ͅʮʁʇ੮͐˺੮ ɻʩɘ̼ʡʇੴ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ɺʇˑʮʇͷʇʁ੮͐ʩʇ;੮͸˺͙ˑʁ੮ɺʇ੮ʇͽʇɻ͙͐ʇʁ੮ɺ;੮͐ʩʇ੮#U੮ʮʠ੮͐ʩʇ;੮ˑʇʠ͐੮ ɘ੮̼͐ͅʇʇ͐੮ɻ˺̼˦ʇ̼ੴ੮˺̼੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮̼ʇʠ͙ͅʮ˦ʡ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ɺʇɻɘ͙ͅʇ੮͐ͅɘʠʠ੮͸ʇ̼ʇ੮ʮ˦੮ a cult torturing residents.৾ৼ੮ ˦੮ ɘɺͅʇ˦ɻʇ੮ ˺ʠ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ ɘ̼̼ʇ͐ͅͅੴ੮ ˺̼੮ /Û੮ ͷʮͅચ ʮ͐ͅ੮˚ʮʡʩ͐੮˚ɘˌʇ੮͐ʩʇʮ̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ˑʇͅͅ੮ͷʮͅʮɺˑʇ੮͐˺੮ɘ੮ˈ͙ʁʡʇੳ੮U͐੮͸ɘͅ੮͐ʩ͙ͅ੮ɻ̼͙ɻʮɘˑ੮ ʠ˺̼੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮͐˺੮ʡ̼ɘʁ͙ɘˑˑ;੮ɺ͙ʮˑʁ੮͙̹੮ɘ੮ɻɘͅʇ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺ͷʇ̼੮ repeated encounters. U˦੮ Hʇɺ̼͙ɘ̼;੮ ৲ৰ৲৲ੴ੮ ͐ʩʇ੮ ͐ʇɘ˚੮ ̼ʇˑʇɘͅʇʁ੮ ͐ʩʇ੮ ϲʮ̼͐ͅ੮ ̼ʇ͙ͅˑ͐ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ̹ʮˑ˺͐ੳ੮ îʩʇ੮ ɻ˺˚ચ ˚ʮ͐͐ʇʇ੮ʁʮͅɻ͙ͅͅʇʁ੮ʠ˺̼͐;ચ͐ʩ̼ʇʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɘ˦ʁ੮ϲʮˑʇʁ੮ɘ੮̹ʇ͐ʮ͐ʮ˺˦੮˺˦੮͐ʩʮ̼͐;ੳ੮îʩʇ੮ˈ͙ʁʡʇ੮ ̼͙ˑʇʁ੮͐˺੮ɻ˺˦ͅʇ̼ͷʇ੮͐͸ʇ˦͐;ચͅʮͽੳ৾৽ The pandemic, surprisingly, facilitated the proચ ɻʇͅͅੳ੮Ûɘ͐ʩʇ̼੮͐ʩɘ˦੮ʩɘͷʮ˦ʡ੮͐˺੮ʁ̼ɘʡ੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮͐ʩʇʮ̼੮ʩʇɘ̼ʮ˦ʡੴ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺͙ˑʁ੮ʩɘͷʇ੮ ͐ʩʇ˚੮ɘ͐͐ʇ˦ʁ੮ͷʮ̼͙͐ɘˑˑ;ੴ੮ʠ̼˺˚੮͐ʩʇ੮̼͐ͅʇʇ͐ੳ੮k͙ʁʡʇͅ੮ʡ˺͐੮͐˺੮ͅʇʇ੮͐ʩʇ˚੮ʮ˦੮͐ʩʇʮ̼੮ુ˦ɘ͙̼͐ɘˑૂ੮ ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮ ફ͸ʩʇ̼ʇ੮ ͐ʩʇ;੮ ˚ʮʡʩ͐੮ ɺʇ੮ ͐ͅɘ̼ͷʮ˦ʡੴ੮ ˦ɘˌʇʁੴ੮ ɘ˦ʁ੮ ʇͽ̹˺ͅʇʁબ੮ ɘ˦ʁ੮ ˦˺͐੮ ͐ʩʇ੮ ɘ̼͐ʮϲʮɻʮɘˑ੮̹ͅɘɻʇ੮˺ʠ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ફ͸ʩʇ̼ʇ੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼੮͸ʇ̼ʇ੮̹̼˺ͷʮʁʇʁબੳ੮ îʩʇ੮̹ʇ˺̹ˑʇ੮͐ʩʇ;੮ɻ˺˦ͅʇ̼ͷʇʁ੮͸ʇ̼ʇ੮ુʩʮʡʩˑ;੮ͷ͙ˑ˦ʇ̼ɘɺˑʇૂ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺ੴ੮ʮ˦੮ɘʁʁʮ͐ʮ˺˦੮ ͐˺੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮˺̼੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʩɘʁ੮ુ̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅૂ੮ ˑʮˌʇ੮ુPUēੴ੮ʇͽ̼͐ʇ˚ʮ͐;੮ʮ˦ʠʇɻ͐ʮ˺˦ͅੴ੮ɘ̼͐ʮɘˑ੮ϲʮɺ̼ʮˑˑɘ͐ʮ˺˦ੴ੮͸ʩʇʇˑɻʩɘʮ̼ચʁʇ̹ʇ˦ʁʇ˦ɻʇੴ੮̼͐ɘ͙ચ ˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼;ੴ੮ય˺̼ર੮̹͙ˑ˚˺˦ɘ̼;੮ʇ˚ɺ˺ˑʮͅ˚ੳૂ îʩʇ੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͐ʇɘ˚੮ ʩɘʁ੮ ʩ˺̹ʇʁ੮ ͐ʩɘ͐੮ ˚ɘ˦;੮ ̹ʇ˺̹ˑʇ੮ ɻ˺͙ˑʁ੮ ͅʩ˺̼͐ચɻʮ̼ɻ͙ʮ͐੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮ʡ˺੮ʁʮ̼ʇɻ͐ˑ;੮͐˺੮ˑ˺˦ʡચ͐ʇ̼˚੮ɻɘ̼ʇ੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮ ˦ʁ੮৲৷੮̹ʇ̼ɻʇ˦͐੮ʁʮʁ੮˚ɘˌʇ੮ʮ͐੮͐˺੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;ੴ੮ˑʮˌʇ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇੳ੮š˦ʇ੮ ̹ʇ̼ͅ˺˦੮ʮ˦ͷ˺ˑͷʇʁ੮ʮ˦੮͐ʩʇ੮̹ʮˑ˺͐੮͐˺ˑʁ੮˚ʇੴ੮ʇ˦͐ʩ͙ͅʮɘ͐ͅʮɻɘˑˑ;ੴ੮͐ʩɘ͐੮ુɘ͐੮͐ʩʇ੮ɺʇʡʮ˦˦ʮ˦ʡੴ੮U੮ ͸˺͙ˑʁ੮ʩɘͷʇ੮͐˺ˑʁ੮;˺͙੮͐ʩɘ͐੮͐ʩʇ੮˺˦ˑ;੮͸ɘ;੮͐ʩʮͅ੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ʇʠʠʇɻ͐ʮͷʇ੮ʮͅ੮͐ʩɘ͐੮͐ʩʇ;੮ɘˑˑ੮ ͸˺͙ˑʁ੮ʩɘͷʇ੮˦ʇʇʁʇʁ੮͐˺੮ʡ˺੮ʮ˦͐˺੮ͅ˺˚ʇ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡੳ੮U੮͐ʩ˺͙ʡʩ͐੮˚ɘ;ɺʇ੮͐ʩʇ੮ʁ̼ʮͷʇ੮͐˺੮ ɺʇ੮ɺɘɻˌ੮˺͙͐੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮͸˺͙ˑʁ੮̼ʇ͙ͅˑ͐੮ʮ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʇˑ˺̹ʮ˦ʡ੮ʠ̼˺˚੮͐ʩʇʮ̼੮ʠɘɻʮˑʮચ ͐ʮʇͅੳૂ੮Pɘ̹̹ʮˑ;ੴ੮͐ʩʇ;੮ʠ˺͙˦ʁ੮͐ʩɘ͐੮ુͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ɻˑʮʇ˦͐ͅੴ੮˦˺͐੮ɘˑˑੴ੮યʩɘͷʇર੮ɺʇʇ˦੮ɘɺˑʇ੮͐˺੮ ʡ˺੮ʮ˦͐˺੮ɘ˦੮˺̹ʇ˦੮ͅʇ͐͐ʮ˦ʡੴ੮ɘ˦ʁ੮͐ʩʇ;ૄ̼ʇ੮͐ͅɘ;ʮ˦ʡੴ੮͐ʩʇ;ૄ̼ʇ੮˦˺͐੮ʡʮͷʮ˦ʡ੮ɘ˦;੮ʩʮ˦͐੮͐ʩɘ͐੮͐ʩʇ;੮ want to go back on the streets.” "͙͐੮͐ʩʇ੮˺͐ʩʇ̼ͅ੮ʁʮʁ੮˦ʇʇʁ੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ੮{˺̼ʇ˺ͷʇ̼ੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮͐ʩʇ੮ ϲʮ̼͐ͅ੮̼ʇ͙ͅˑ͐ͅ੮͙ͅɺ˚ʮ͐͐ʇʁੴ੮ુ˚ʇʁʮɻɘˑ੮̹̼˺ɺˑʇ˚ͅ੮͙˦ɻ˺ͷʇ̼ʇʁ੮ɘʠ͐ʇ̼੮̼ʇʠʇ̼̼ɘˑ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ચ ͷɘ͐˺̼ͅʩʮ̹੮ ˑʇʁ੮ ͐˺੮ ˑ˺˦ʡ੮ ̹ˑɘɻʇ˚ʇ˦͐੮ ʁʇˑɘ;ͅૂ੮ ʮ˦੮ ͐ͅʇ̹̹ʮ˦ʡ੮ ʁ˺͸˦੮ ʠ̼˺˚੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ʮ˦͐˺੮

A SY LU M F O R T H E DY I N G

241

U{)ͅੳ੮/ͷʇ˦੮͐ʩʮͅ੮ɻ˺˺̼ʁʮ˦ɘ͐ʇʁ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʇʠʠ˺̼͐੮̼͙͐ͅʡʡˑʇʁ੮ɘʡɘʮ˦͐ͅ੮ɺ˺͐ʩ੮͐ʩʇ੮ɻ˺˚ચ ̹ˑʇͽ੮˦ʇʇʁͅ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅઝɘɻɻ͙˚͙ˑɘ͐ʇʁ੮͐ʩɘ˦ˌͅ੮͐˺੮ʁʇɻɘʁʇͅ੮˺ʠ੮̹̼ʮ˺̼੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ʮ˦ʁʮʠʠʇ̼ʇ˦ɻʇઝɘ˦ʁ੮ɘ੮ʁʇˑʇʡɘ͐ʇʁ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮͐ͅʮˑˑ੮ʡɘͷʇ੮̹̼ʮͷɘ͐ʇ੮̹̼˺ͷʮʁʇ̼ͅ੮ɘ˚̹ˑʇ੮ʁʮͅચ cretion to turn down those cases of most concern to public authorities. k˺˦੮äʩʇ̼ʮ˦ૄͅ੮ͷʮͅʮ˺˦੮͸ɘͅ੮˚͙ɻʩ੮ɺ̼˺ɘʁʇ̼੮͐ʩɘ˦੮ɘ੮ϲʮʠ͐;ચ̹ʇ̼ͅ˺˦੮̹̼˺ʡ̼ɘ˚ੳ੮Pʮͅ੮৲ৰৱ৸੮ ̹ʮ͐ɻʩ੮ʠ˺̼੮͐ʩʇ੮̹ʮˑ˺͐੮ɘ˦͐ʮɻʮ̹ɘ͐ʇʁ੮ુৱੴৰৰৰ੮ɘʁʁʮ͐ʮ˺˦ɘˑ੮̼ʇʠʇ̼̼ɘˑͅ੮̹ʇ̼੮;ʇɘ̼੮યʮ˦੮rર੯ੳ੯ੳ੯ੳ੮ on an outpatient basis.”৾৾੮ H˺̼੮ ͐ʩɘ͐ੴ੮ ʩʇૄͅ੮ ɻ˺˦ͷʮ˦ɻʇʁੴ੮ ʩʇ੮ ͸˺͙ˑʁ੮ ˦ʇʇʁ੮ ˚˺̼ʇ੮ ͐ʩɘ˦੮ ˈ͙͐ͅ੮ɘʁʁʮ˦ʡ੮ુ̹ʩ;ͅʮɻɘˑ੮ʩʇɘˑ͐ʩૂ੮͐˺੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳ੮U˦੮ʩʮͅ੮̼ʇɘʁʮ˦ʡੴ੮͐ʩʇ੮˺̼ʮʡʮ˦ɘˑ੮ʮʁʇɘ੮ ɺʇʩʮ˦ʁ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ુ͸ɘͅ੮ ɺɘͅʇʁ੮ ˺˦੮ ૃˑʮͷʮ˦ʡ੮ ͅɘʠʇˑ;੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺˚˚͙˦ʮ͐;ੴૄ੮ ɺ͙͐੮ ʮ͐੮ got whittled down to food, clothing, and shelter.” He was hoping to bring back ͐ʩɘ͐੮ ʇɘ̼ˑ;੮ ɻ˺˦ɻʇ̹͐ʮ˺˦ੵ੮ ુîʩʇ̼ʇ੮ ɘ̼ʇ੮ ˚ɘ˦;੮ ʮ˦ʁʮɻɘ͐˺̼ͅ੮ ય˺ʠ੮ ˦˺͐੮ ˑʮͷʮ˦ʡ੮ ͅɘʠʇˑ;રੳ੮ ‡˺͐੮ ɺʇʮ˦ʡ੮ɘɺˑʇ੮͐˺੮ɘɻɻʇͅͅ੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇ੮͸ʩʇ˦੮;˺͙ૄͷʇ੮ʡ˺͐੮ʡɘ˦ʡ̼ʇ˦ʇੳ੮ˑˑ˺͸ʮ˦ʡ੮;˺͙̼ͅʇˑʠ੮ ͐˺੮ɺʇ੮̹̼ʇ;ʇʁ੮͙̹˺˦੮ɘ˦ʁ੮ͅʇͽ͙ɘˑˑ;੮ɘͅͅɘ͙ˑ͐ʇʁੴ੮ʁɘʮˑ;ੳ੯ੳ੯ੳ੯ੳ੮Ø͙ͅʩʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮̼͐ɘϲϲʮɻੳ੮ Pɘͷʮ˦ʡ੮ɘ˦੮ʮ˦ʠʇɻ͐ʮ˺͙ͅ੮ʁʮͅʇɘͅʇ੮ɘ˦ʁ੮͐ʩ̼˺͸ʮ˦ʡ੮ʠʇɻʇͅ੮ɘ͐੮̹ʇ˺̹ˑʇੳૂ੮"͙͐ੴ੮ɘͅ੮͐ʩʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ ̹ˑɘɻʇ˚ʇ˦͐ͅ੮͙ͅʇʁ੮ɺ;੮͐ʩʇ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹ʮˑ˺͐੮ͅʩ˺͸ʇʁੴ੮͐˺੮̼͐ʇɘ͐੮͐ʩʇ੮ people meeting those criteria, you’re going to need hospital beds. That’s where we turn now.

BREAKING GROUND )ʇɻʇ˚ɺʇ̼੮৲ৱੴ੮৲ৰ৲ৱ੮͸ɘͅ੮ɘ੮˚ʮˑʇ͐ͅ˺˦ʇ੮ʠ˺̼੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ઝɘ˦ʁ੮ ɘ˦੮˺˚ʇ˦੮˺ʠ੮̹̼˺ʠ˺͙˦ʁ੮ɻʩɘ˦ʡʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮îʩɘ͐੮ʁɘ;ੴ੮͐ʩʇ੮ äɘɻ̼ɘ˚ʇ˦͐˺੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮Hɘɻʮˑʮ͐;ੴ੮ɘ੮˦ʇ͸੮ৱৱ৷ચɺʇʁ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɘɻɻʇ̹͐ʇʁ੮ʮ͐ͅ੮ϲʮ̼͐ͅ੮ ̹ɘ͐ʮʇ˦͐ੳ੮U͐੮͸ɘͅ੮͐ʩʇ੮ϲʮ̼͐ͅ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮ɺ͙ʮˑ͐੮ʠ̼˺˚੮͐ʩʇ੮ʡ̼˺͙˦ʁ੮͙̹੮ʮ˦੮#ɘˑʮચ fornia in thirty years.৾৿੮ફ੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦ʁ͙̼͐ͅ;੮͐˺ˑʁ੮˚ʇ੮ʮ͐੮ʩɘʁ੮ ɺʇʇ˦੮ͅ˺੮ˑ˺˦ʡ੮͐ʩɘ͐੮˦˺੮˺˦ʇ੮ʮ˦੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ˌ˦ʇ͸੮͐ʩʇ੮̹̼˺ɻʇʁ͙̼ʇ੮͐˺੮ˑʮɻʇ˦ͅʇ੮͙ͅɻʩ੮ ɘ੮ʠɘɻʮˑʮ͐;੮ɘ˦;˚˺̼ʇੴ੮ɻɘ͙ͅʮ˦ʡ੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮ʁʇˑɘ;ͅੳબ îʩʇ੮äɘɻ̼ɘ˚ʇ˦͐˺੮ʩ˺̹ͅʮ͐ɘˑ੮͸ɘͅ੮˺˦ʇ੮˺ʠ੮˚ɘ˦;੮ʮ˦ʮ͐ʮɘ͐ʮͷʇͅ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻɘ̹ɘɻʮ͐;੮ʮ˦੮ ˑ˺ɻˌʇʁੴ੮ɘɻ͙͐ʇચɻɘ̼ʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮U˦੮৲ৰৱ৸ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮̼͙̼ɘˑ੮äʩɘ͐ͅɘ੮#˺͙˦͐;੮ ɘ˦˦˺͙˦ɻʇʁ੮ ͐͸ʇ˦͐;੮ ˦ʇ͸੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɺʇʁͅ੮ ʮ˦੮ ʮ͐ͅ੮ Ûʇʡʮ˺˦ɘˑ੮ {ʇʁʮɻɘˑ੮ #ʇ˦͐ʇ̼ੳ੮ ુ#˺͙˦͐ˑʇͅͅ੮ɘ̼ʇɘ੮̼ʇͅʮʁʇ˦͐ͅૂ੮͐ʩɘ˦ˌʇʁ੮͐ʩʇ੮ɺ˺ɘ̼ʁ੮˺ʠ੮͙̹ͅʇ̼ͷʮͅ˺̼ͅ੮ʠ˺̼੮͐ɘˌʮ˦ʡ੮ɘɻ͐ʮ˺˦ੳ৾਀ The response was a far cry from the opprobrium typically heaped on plans to ɺ̼ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ʮ˦͐˺੮͐ʩʇ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁੳ੮੮ʠʇ͸੮˺͐ʩʇ̼੮˦˺͐ɘચ ɺˑʇ੮ ʇͽɘ˚̹ˑʇͅ੮ ʮ˦ɻˑ͙ʁʇ੮ ɘ̹̹̼˺ͷɘˑ੮ ˺ʠ੮ ɘ˦੮ ʇʮʡʩ͐;ચɺʇʁ੮ ʠɘɻʮˑʮ͐;੮ ʮ˦੮ U˦ʁʮ˺ੴ੮ ͐ʩʇ੮ ɘʁʁʮ͐ʮ˺˦੮ ˺ʠ੮ͅʮͽ͐;ચͅʮͽ੮ɺʇʁͅ੮͐˺੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦੮äɘ˦੮k˺ͅʇੴ੮ʡ̼˺͙˦ʁɺ̼ʇɘˌʮ˦ʡ੮ʠ˺̼੮͐͸˺੮ͅʮͽ͐ʇʇ˦ચɺʇʁ੮

242

REFORM

͐ͅɘ˦ʁચɘˑ˺˦ʇ੮͙˦ʮ͐ͅ੮ʮ˦੮"ɘˌʇ̼ͅϲʮʇˑʁੴ੮ɘ˦ʁ੮͐ʩʇ੮˺̹ʇ˦ʮ˦ʡ੮˺ʠ੮ɘ੮˦ʇ͸੮ͅʮͽ͐ʇʇ˦ચɺʇʁ੮ʠɘɻʮˑʮ͐;੮˺˦੮ ͐ʩʇ੮ɻɘ˚̹͙ͅ੮˺ʠ੮ɘ੮ɻ˺͙˦͐;੮Ûʇɻ˺ͷʇ̼;੮#ʇ˦͐ʇ̼੮ʮ˦੮͐ʩʇ੮#ʇ˦̼͐ɘˑ੮ēɘˑˑʇ;ੳ৾ਁ੮U੮͸ɘͅ੮̼͙͐ͅɻˌ੮ɺ;੮ ͐ʩʇ੮˦ʇɘ̼ચ͙˦ʮͷʇ̼ͅɘˑ੮͸ʇˑɻ˺˚ʮ˦ʡ੮˺ʠ੮͐ʩʮͅ੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮͐ʩʇ੮˚˺͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ʇ˦ʁ੮˺ʠ੮͐ʩʇ੮ ̹ˑɘɻʇ˚ʇ˦͐੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮੮˦͙̼ͅʇ੮͸ʮ͐ʩ੮ɘ˦੮ʮ˦͐ʇ˦ͅʮͷʇ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̼͐ʇɘ͐˚ʇ˦͐੮͐ʇɘ˚੮ʠ˺̼੮ unsheltered homeless people in San Francisco put it pithily: “100 percent of our ̹ʇ˺̹ˑʇ੮˦ʇʇʁ੮ɘ੮ʩʮʡʩʇ̼੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇੳૂ I̼ɘ̹ʩͅ੮ ɘ˦ʁ੮ ͐ͅɘ͐ʮ͐ͅʮɻͅ੮ ͅʩ˺͸ʮ˦ʡ੮ ͐ʩɘ͐੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ʩɘͅ੮ ʠʇ͸ʇ̼੮ ɘɻ͙͐ʇ੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ɺʇʁͅ੮ ͐ʩɘ˦੮ ͐ʩʇ੮ ˦ɘ͐ʮ˺˦ɘˑ੮ ɘͷʇ̼ɘʡʇ੮ ɘ˦ʁ੮ ˚˺͐ͅ੮ ʁʇͷʇˑ˺̹ʇʁ੮ ɻ˺͙˦̼͐ʮʇͅ੮ ɻʮ̼ɻ͙ˑɘ͐ʇ੮ ʇ˦ʁચ ˑʇͅͅˑ;੮ ʮ˦੮ Ø˺͸ʇ̼Ø˺ʮ˦͐ͅੴ੮ ʩʇɘ̼ʮ˦ʡͅੴ੮ ɘ˦ʁ੮ ̹ˑɘ˦˦ʮ˦ʡ੮ ̼ʇ̹˺̼͐ͅ੮ ɘ̼˺͙˦ʁ੮ ͐ʩʇ੮ ͐ͅɘ͐ʇੳ੮ îʩʇ੮ ʡɘ̹੮ʮͅ੮ˑʇͅͅ੮ʁ̼ɘ˚ɘ͐ʮɻ੮ʮʠ੮;˺͙੮ʮ˦ɻˑ͙ʁʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡͅ੮ˑʮˌʇ੮U{)ͅ੮ ફϲʮʡ͙̼ʇ੮ ৱ৲ੳ৳બੳ੮ {͙ˑ͐ʮ̹ˑʇ੮ ɘ˦ɘˑ;ͅʇͅ੮ ʩɘͷʇ੮ ɻ˺˦ɻˑ͙ʁʇʁ੮ ͐ʩɘ͐੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ͸˺͙ˑʁ੮ ʩɘͷʇ੮ ʇ˦˺͙ʡʩ੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ ɺʇʁͅ੮ ʮʠ੮ ͐ʩʇ̼ʇ੮ ͸ʇ̼ʇ੮ ͙ͅϲϲʮɻʮʇ˦͐੮ ɻ̼ʮͅʮͅ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦੮ ͅʇ̼ͷʮɻʇͅ੮ ͙̹੮ front and people were not lingering inappropriately waiting to step down to ˑ˺͸ʇ̼੮ ˑʇͷʇˑͅ੮ ˺ʠ੮ ɻɘ̼ʇੳ৾ਂ੮ Ěʇ͐੮ ͐ʩʇ੮ ɻ˺˦ͷʮɻ͐ʮ˺˦੮ ͐ʩɘ͐੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ˦ʇʇʁͅ੮ ˚˺̼ʇ੮ ɺʇʁͅ੮ ʮͅ੮

1.6

1.2 1.0 0.8 0.6 0.4

12.3 Øͅ;ɻʩʮɘ̼͐ʮɻ੮ɺʇʁͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɘ˦ʁ੮ͅʇˑʇɻ͐੮ɻ˺͙˦̼͐ʮʇͅੴ੮৲ৰ৲ৱ Sourceੵ੮š/#)ੴ੮Û‡) ੾੮)ɘ͐ɘ੮ʠ˺̼੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮ˦ɻˑ͙ʁʇ੮˺˦ˑ;੮ɘʁ͙ˑ͐੮ɺʇʁͅ

Belgium

Norway

Germany

France

Switzerland

Greece

Netherlands

Austria

OECD Average

Poland

Portugal

Finland

Denmark

Australia

California (all locked)*

Spain

Sweden

Canada

Ireland

United Kingdom

New Zealand

United States

0

Italy

0.2 California (acute hospital only)*

Beds per 1,000

1.4

A SY LU M F O R T H E DY I N G

243

̹ʇ̼ͷɘͅʮͷʇੳ੮੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʮ˦ʁ͙̼͐ͅ;੮ɻʇˑʇɺ̼ɘ͐ʇʁੴ੮ુĔʇૄͷʇ੮ͅʇʇ˦੮͐ʩʇ੮ ̹ʇ˦ʁ͙ˑ͙˚੮ͅʩʮʠ͐੮͐˺˺੮ʠɘ̼੮͐˺੮͐ʩʇ੮ͅʮʁʇ੮͐ʩɘ͐੮ͅɘ;ͅੴ੮ૃ˦˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇੴ੮ɘˑˑ੮ɻɘ̼ʇ੮ͅʩ˺͙ˑʁ੮ ɺʇ੮ ̼ʇɻ˺ͷʇ̼;ੴ੮ ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ચɺɘͅʇʁੳૄ੯ ੳ੯ ੳ੯ ੳ੮ "͙͐੮ ʮ˦੮ ͐ʩʇ੮ ˑɘ͐ͅ੮ ͐ʩ̼ʇʇ੮ ;ʇɘ̼ͅੴ੮ ʇͽɻʇ̹͐੮ ʠ˺̼੮ ͐ʩʇ੮ ʩɘ̼ʁɻ˺̼ʇ੮ ˦ɘ;ͅɘ;ʇ̼ͅੴ੮ ͸ʇ੮ ʩɘͷʇ੮ ͅʇʇ˦੮ ɘ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ͅʩʮʠ͐੮ ɺɘɻˌ੮ ʮ˦͐˺੮ ɘɻˌ˦˺͸ˑʇʁʡʮ˦ʡ੮ ͐ʩɘ͐੮͸ʇ੮ʩɘͷʇ੮ɘ੮ͅʩ˺̼͐ɘʡʇ੮˺ʠ੮ɺʇʁͅੳૂ îʩʇ੮ʮ˚̹ʇ͙͐ͅ੮ʠ˺̼੮͐ʩʇ੮äɘɻ̼ɘ˚ʇ˦͐˺੮ʩ˺̹ͅʮ͐ɘˑ੮ɻɘ˚ʇ੮ʠ̼˺˚੮ɘ੮̹̼ʮͷɘ͐ʇ੮ɻ˺˚̹ɘ˦;ੴ੮äʮʡચ ˦ɘ͙̼͐ʇ੮Pʇɘˑ͐ʩɻɘ̼ʇ੮äʇ̼ͷʮɻʇͅੴ੮͸ʩʮɻʩ੮˺̹ʇ̼ɘ͐ʇͅ੮˦ʮ˦ʇ͐ʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘɻ̼˺ͅͅ੮ʠ˺͙̼੮͐ͅɘ͐ʇͅੳ੮ îʩʮͅ੮˚ʮ̼̼˺̼ͅ੮ɘ੮˦ɘ͐ʮ˺˦ɘˑ੮̼͐ʇ˦ʁ੮͐˺͸ɘ̼ʁ੮˚˺̼ʇ੮ɺʇʁͅ੮˺͸˦ʇʁ੮ɺ;੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ɻʩɘʮ˦ͅੳ৾ਃ kʇ̼̼;੮äʇʇˑʮʡੴ੮ɘ੮ϲʮ˦ɘ˦ɻʮ˦ʡ੮ʡ͙̼͙੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅ੮͐˺੮͸ʩ˺˚੮U੮͙̼͐˦ʇʁ੮ɘ˦;੮͐ʮ˚ʇ੮U੮ɻ˺͙ˑʁ˦ૄ͐੮ ϲʮʡ͙̼ʇ੮˺͙͐੮ʩ˺͸੮ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮͸ɘͅ੮˚ɘˌʮ˦ʡ੮˚˺˦ʇ;ੴ੮ʇͽ̹ˑɘʮ˦ʇʁੴ੮ુîʩʇ̼ʇૄͅ੮ ˈ͙͐ͅ੮͙ͅɻʩ੮ɘ੮ɻ̼ʮͅʮͅ੮͐ʩɘ͐੮;˺͙੮ɻɘ˦੮ʡʇ͐੮ʮ˦͙̼ͅɘ˦ɻʇ੮̹ˑɘ˦ͅ੮ɘ˦ʁ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮͐˺੮̹ɘ;੮ ʇ˦˺͙ʡʩ੮ʠ˺̼੮;˺͙੮યɘ੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑર੮͐˺੮˚ɘˌʇ੮ʮ͐੮͸˺̼ˌੳૂ੮îʮʡʩ͐ʇ˦ʮ˦ʡ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ͅɻ̼ʇ͸ͅ੮ elsewhere in the health care industry, he told me, meant that hospitals had empty ɺʇʁͅ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮ɺʇ੮ɻʩʇɘ̹ˑ;੮ɻ˺˦ͷʇ̼͐ʇʁ੮͐˺੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˺˦ʇͅੳ੮{ʇɘ˦͸ʩʮˑʇੴ੮ʮ˦͙̼ͅʇ̼ͅੴ੮ ͐ʮ̼ʇʁ੮˺ʠ੮ɺʮʁʁʮ˦ʡ੮ʠ˺̼੮˺ͷʇ̼̹̼ʮɻʇʁ੮ɺʇʁͅ੮ʠɘ̼੮ɘ͸ɘ;ੴ੮͸ʇ̼ʇ੮͸ʮˑˑʮ˦ʡ੮͐˺੮ʮ˦ͷʇ͐ͅ੮ʮ˦੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮ capacity locally. ä͐ɘ͐ʇ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ʮͅ੮ ɘˑͅ˺੮ ͐ɘˌʮ˦ʡ੮ ɘ˦੮ ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ ɘʡʡ̼ʇͅͅʮͷʇ੮ ̼˺ˑʇੳ੮ U˦੮ ʩʮͅ੮ ৲ৰ৲ৰ੮ ä͐ɘ͐ʇ੮˺ʠ੮͐ʩʇ੮ä͐ɘ͐ʇ੮̹ͅʇʇɻʩੴ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮ˑʮ˦ˌʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇʠ˺̼˚੮ɘ˦ʁ੮ ʮ˦ͷʇ͐ͅ˚ʇ˦͐੮ʮ˦੮˦ʇ͸੮ʠɘɻʮˑʮ͐ʮʇͅੴ੮͐ͅɘ͐ʮ˦ʡ੮͐ʩɘ͐੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ɻʩɘ˦ʡʇ੮͸˺͙ˑʁ੮ɺʇ੮ɘ˦੮ુʇ˚̹͐;੮ promise” without “creating more placements.”৾਄੮îʩʮͅ੮͸ɘͅ੮˦˺͐੮ʩ˺ˑˑ˺͸੮̼ʩʇ͐˺̼ʮɻੳ੮U˦੮ ৲ৰ৲ৱੴ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼੮ɘˑˑ˺ɻɘ͐ʇʁ੮ଏ৷৵ৰ੮˚ʮˑˑʮ˺˦੮ʠ˺̼੮৵ੴৰৰৰ੮˦ʇ͸੮̼͐ʇɘ͐˚ʇ˦͐੮ɺʇʁͅ੶৿৻ after the state found itself with an unexpected budget surplus during the pandemic, ͐ʩʇ੮ ʡ˺ͷʇ̼˦˺̼੮ ɘʁʁʇʁ੮ ɘ˦˺͐ʩʇ̼੮ ଏ৲ੳ৲੮ ɺʮˑˑʮ˺˦੮ ʠ˺̼੮ ɘ੮ ̹̼˺˚ʮͅʇʁ੮ ͐͸ʇ˦͐;ચ͐͸˺੮ ͐ʩ˺͙ͅɘ˦ʁ੮ housing slots.৿ৼ੮H˺̼੮k˺˦੮äʩʇ̼ʮ˦ੴ੮ʠ˺̼˚ʇ̼ˑ;੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮r˺ͅ੮˦ʡʇˑʇͅૄͅ੮){Pੴ੮͐ʩʇ੮˦ʇ͸੮ ʠ͙˦ʁͅ੮ɘʁʁʇʁ੮͐˺੮ɘ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮͐ʩʇ੮ɻ˺͙˦͐;੮͙̹ͅʇ̼ͷʮͅ˺̼ͅ੮˚ɘʁʇ੮ʮ˦੮৲ৰৱ৹੮͐˺੮ɺ͙ʮˑʁ੮˺˦ʇ੮ ͐ʩ˺͙ͅɘ˦ʁ੮˦ʇ͸੮̹ˑɘɻʇ˚ʇ˦͐ͅੵ੮ુĔʇૄ̼ʇ੮ʮ˦੮͐ʩʇ੮̹̼˺ɻʇͅͅ੮˺ʠ੮ɘ੮˚ɘͅͅʮͷʇ੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮ɺʇʁͅઝ Uૄ˚੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮ˑ˺ɻˌʇʁ੮ɺʇʁͅੴ੮͙ͅɺɘɻ͙͐ʇ੮ɺʇʁͅੴ੮˺̹ʇ˦੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɺʇʁͅੴ੮ɘ˦ʁ੮ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ɻɘ̼ʇͅ੮͐ʩɘ͐੮ʩɘͷʇ੮ɘ੮ˑ˺͐੮˺ʠ੮ɺʇˑˑͅ੮ɘ˦ʁ੮͸ʩʮ͐ͅˑʇͅੳૂ Pʇ੮͸ɘͅ੮˦˺˦ʇ͐ʩʇˑʇͅͅ੮͸ɘ̼;੮˺ʠ੮ɘ੮ુ˺˦ʇચ͐ʮ˚ʇૂ੮͐ͅɘ͐ʇ੮ʮ˦ͷʇ͐ͅ˚ʇ˦͐ੴ੮ͅʮ˦ɻʇ੮͐ʇ˦ʁʮ˦ʡ੮͐˺੮͐ʩʇ੮ people in those beds will cost tens of millions of dollars per year. To pay for that, ʩʇ੮ʇͽ̹ˑɘʮ˦ʇʁੴ੮ુ͸ʇ੮˦ʇʇʁ੮͐ʩʇ੮U{)੮ʇͽɻˑ͙ͅʮ˺˦੮͐˺੮ʡ˺੮ɘ͸ɘ;ੳૂ੮Pʇ੮͸ɘͅ੮̼ʇʠʇ̼̼ʮ˦ʡ੮͐˺੮͐ʩʇ੮ ৱ৹৶৵੮̼͙ˑʇ੮͐ʩɘ͐੮{ʇʁʮɻɘʮʁ੮ʠ͙˦ʁͅ੮ɻɘ˦˦˺͐੮ʡ˺੮͐˺੮ɘ੮ʠɘɻʮˑʮ͐;੮͸ʮ͐ʩ੮ͅʮͽ͐ʇʇ˦੮˺̼੮˚˺̼ʇ੮ɺʇʁͅ੮ ʮʠ੮˚˺̼ʇ੮͐ʩɘ˦੮ʩɘˑʠ੮˺ʠ੮̼ʇͅʮʁʇ˦͐ͅ੮ʩɘͷʇ੮ɘ੮̹̼ʮ˚ɘ̼;੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʁʮͅ˺̼ʁʇ̼ੳ੮îʩʇ੮ˑɘ͐ʇ੮)ੳ੮kੳ੮ kɘʠʠʇ੮͸̼˺͐ʇ੮͐ʩɘ͐੮ુʇˑʮ˚ʮ˦ɘ͐યʮ˦ʡર੮͐ʩʇ੮U{)੮ʇͽɻˑ͙ͅʮ˺˦ૂ੮ʮͅ੮͐ʩʇ੮ુͅʮ˦ʡˑʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮ change” that could be made to the mental health system, since it would allow ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐˺੮͐ɘ̹੮ʮ˦͐˺੮ɘ੮˦ʇɘ̼ˑ;੮ଏ৷ৰৰચɺʮˑˑʮ˺˦ચ̹ʇ̼ચ;ʇɘ̼੮ʠ͙˦ʁʮ˦ʡ੮̼͐ͅʇɘ˚ੳ৿৽

244

REFORM

ä͐ɘ̼͐ʮ˦ʡ੮ʮ˦੮৲ৰৱ৵ੴ੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɺʇʡɘ˦੮ɘˑˑ˺͸ʮ˦ʡ੮͐ͅɘ͐ʇͅ੮͐˺੮ɘ̹̹ˑ;੮ʠ˺̼੮ɘ੮ ̹ɘ̼͐ʮɘˑ੮ુ͸ɘʮͷʇ̼ૂ੮ʠ̼˺˚੮͐ʩʮͅ੮̹̼˺ʩʮɺʮ͐ʮ˺˦ੳ৿৾ An anonymous source with knowledge ˺ʠ੮͐ʩʇ੮̹˺ˑʮɻ;ચ˚ɘˌʮ˦ʡ੮̹̼˺ɻʇͅͅ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮ɘ˦੮ʇͷʇ˦͙͐ɘˑ੮̼ʇή͙ʇ͐ͅ੮ʠ̼˺˚੮#ɘˑʮʠ˺̼˦ʮɘ੮ ʠ˺̼੮͐ʩʇͅʇ੮ʠʇʁʇ̼ɘˑ੮ʠ͙˦ʁͅ੮ʩɘʁ੮͙˦͐ͅ˺̹̹ɘɺˑʇ੮˚˺˚ʇ˦͙͐˚ੵ੮ુšɺͷʮ˺͙ͅˑ;ੴ੮ʡʮͷʇ˦੮͐ʩʇ੮ͅʩ˺̼͐ચ age of beds there is now—consensus might be too strong of a word, but growing support for expanding the capacity of facilities, so that they can take in more ʠ˺ˑˌͅ੯ੳ੯ੳ੯ੳ੮U੮ʩɘͷʇ˦ૄ͐੮ʩʇɘ̼ʁ੮ɘ˦;੮ʁʇɺɘ͐ʇ੮ɘɺ˺͙͐੮ʮ͐੮ય͐ʩʇ੮͸ɘʮͷʇ̼રੳ੮U͐੮ʮͅ੮ૃ͐ʩʇ੮͐ʩʮ˦ʡ੮͐ʩɘ͐੮ʮͅ੮ happening.’”৿৿ ‡ʇ͸੮ʮ˦͐ʇ̼ʇ͐ͅ੮ʠ̼˺˚੮̹̼ʮͷɘ͐ʇ੮ʮ˦ͷʇ͐ͅ˺̼ͅੴ੮ɘ੮͸ʮ˦ʁʠɘˑˑ੮˺ʠ੮ʠ͙˦ʁͅ੮ʠ̼˺˚੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦ચ ment, and a potential spigot of federal Medicaid money—what does this all add ͙̹੮͐˺੺੮H˺̼੮ɻ̼ʮ͐ʮɻͅੵ੮͐ʮ˚ʇ੮̼͐ɘͷʇˑ੮ɺɘɻˌ੮ɘ੮ʠʇ͸੮ʡʇ˦ʇ̼ɘ͐ʮ˺˦ͅੳ੮੮ˑ˺ɺɺ;ʮ͐ͅ੮ʠ˺̼੮ɘ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮ ʡ̼˺͙̹੮ˑɘ˚ɺɘ͐ͅʇʁ੮͐ʩʇ੮ʇʠʠ˺̼͐ͅ੮ɺ;੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼੮ɘͅ੮ુʡ˺ʮ˦ʡ੮ɺɘɻˌ੮͐˺੮͐ʩɘ͐੮ɻ˺͙̼ͅʇ੮͐ʩɘ͐੮ ͸ʇૄͷʇ੮ɺʇʇ˦੮͐ʩ̼˺͙ʡʩ੮યʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦રੴ੮͐ʩɘ͐੮͸ʇ੮ˌ˦˺͸੮͸ɘͅ੮̹̼ʇ͐͐;੮ɻ̼͙ʇˑੴ੮ɻɘ͙ͅʇʁ੮ ̹̼ʇ͐͐;੮˺͙͐͐ͅɘ˦ʁʮ˦ʡ੮̹̼˺ɺˑʇ˚ͅੳૂ੮˦˺͐ʩʇ̼੮ɘʁͷ˺ɻɘ͐ʇ੮ʇͽ̹̼ʇͅͅʇʁ੮͐˺੮˚ʇ੮ʩʇ̼੮ુʁʇʇ̹੮ʠʇɘ̼੮ ͐ʩɘ͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮̹˺ˑʮ͐ʮɻʮɘ˦ͅ੮͸ʩ˺੮͸ɘ˦͐੮͐˺੮ʡ˺੮ɺɘɻˌ੮͐˺੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮˺˦ˑ;੮̹̼ʮͷɘ͐ʇˑ;੮ ̼͙˦ੳ੮યîʩʇ;ૄ̼ʇ੮͐ʩʮ˦ˌʮ˦ʡરੴ੮ૃĔʇ੮ˈ͙͐ͅ੮˦ʇʇʁ੮͐˺੮ʡʇ͐੮͐ʩʇͅʇ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮˺ʠʠ੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮ ˑ˺ɻˌ੮͐ʩʇ˚੮͙̹ੴ੮˚ɘˌʇ੮˚˺˦ʇ;੮˺ʠʠ੮˺ʠ੮͐ʩʇ˚੯ੳ੯ੳ੯ੳૄૂ ੮ ͙̼̹̼ͅʮͅʮ˦ʡ੮ ˦͙˚ɺʇ̼੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ U੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ ʩ˺̹ʇʁੴ੮ ̹̼ʇɻʮͅʇˑ;ੴ੮ ͐ʩɘ͐੮ ͐ʩʇͅʇ੮ ʮ˦ͷʇ͐ͅ˚ʇ˦͐ͅ੮͸ʇ̼ʇ੮ɘ੮ʁ˺͸˦੮̹ɘ;˚ʇ˦͐੮˺˦੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ɺʮʡʡʇ̼ੵ੮ɺ̼ʮ˦ʡʮ˦ʡ੮ɺɘɻˌ੮͐ʩʇ੮ɘͅ;ચ lum.৿਀੮rʮʇ͙͐ʇ˦ɘ˦͐੮Ûʇʮʁ੮ʠ̼˺˚੮rØ)੮ʁʇͅɻ̼ʮɺʇʁ੮͐˺੮˚ʇ੮ɘ੮ͷʮͅʮ˺˦੮ʠ˺̼੮ɘ੮ુʩʇɘˑ͐ʩɻɘ̼ʇ੮ ɻɘ˚̹͙ͅૂੵ੮ુĔʇ੮ʩɘͷʇ੮͐ʩʮͅ੮ʮʁʇɘ੮˺ʠ੮ૃ͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ͅɻ˺˺̹੮;˺͙੮͙̹੮˺˦੮ɘ੮ʩ˺ˑʁ੮ɘ˦ʁ੮ʮ͐ૄˑˑ੮ʡʇ͐੮ ɺʇ͐͐ʇ̼ૄ੯ੳ੯ੳ੯ੳ੮યɺ͙͐੮̹ʇ˺̹ˑʇ੮˦ʇʇʁર੮ˑʮʠʇ͐ʮ˚ʇ੮˚ɘʮ˦͐ʇ˦ɘ˦ɻʇ੯ੳ੯ੳ੯ੳ੮ɘ੮̹ˑɘɻʇ੮͐˺੮ˑʮͷʇੴ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ like a senior center, with nice parks and green space.” (Many people from law ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੴ੮ʠ˺̼੮͸ʩɘ͐ʇͷʇ̼੮̼ʇɘͅ˺˦ੴ੮ͅʇʇ˚ʇʁ੮͐˺੮ʩɘͷʇ੮͐ʩʇ੮ͅɘ˚ʇ੮ʮʁʇɘੳબ੮š͐ʩʇ̼ͅ੮͸ʇ̼ʇ੮ ʩɘ̼ͅʩʇ̼ੵ੮ ɘ੮ ɻ˺ˑ͙˚˦ʮ͐ͅ੮ ʮ˦੮ {ɘ̼ʮ˦੮ ɘ̼͐ʮɻ͙ˑɘ͐ʇʁ੮ ʩʮͅ੮ ͐˺͐ɘˑʮ͐ɘ̼ʮɘ˦੮ ͷʮͅʮ˺˦੮ ˺ʠ੮ ુ̹̼˺˚̹͐ˑ;੮ ɘɺ˺ˑʮͅʩʮ˦ʡ੮ rɘ˦͐ʇ̼˚ɘ˦ચØʇ̼͐ʮͅચäʩ˺̼͐੮ ɘ˦ʁ੮ ̹̼˺̹ʇ̼ˑ;੮ ʠ͙˦ʁʮ˦ʡ੮ ͐͸ʇ˦͐;ચϲʮ̼͐ͅચɻʇ˦͙̼͐;੮ ̼ʇͅʮʁʇ˦͐ʮɘˑ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੯ੳ੯ੳ੯ੳ੮ય̹̼˺ͷʮʁʮ˦ʡર੮ˑʮʠʇચ͐ʮ˚ʇ੮˚ɘ˦ʁɘ͐˺̼;੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘ̼ʇੳૂ৿ਁ )ʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦ੴ੮ʮ͐੮ͅʇʇ˚ͅੴ੮ʮͅ੮˺ͷʇ̼ੳ੮îʩʇ੮ή͙ʇ͐ͅʮ˺˦੮ʮͅ੮ʩ˺͸੮ʠɘ̼੮͐˺੮͙̼͐˦੮ɺɘɻˌ੮ the clock.

CONCLUSION: PESSIMISM AND INSTITUTIONALIZATION ͅ੮;˺͙੮ͅɘ͸੮ʮ˦੮͐ʩʇ੮̹̼ʇͷʮ˺͙ͅ੮ɻʩɘ̹͐ʇ̼ੴ੮ɘ͐੮ˑʇɘ͐ͅ੮̼ʩʇ͐˺̼ʮɻɘˑˑ;ੴ੮͐ʩʇ੮̹˺ˑʮɻ;੮˚ɘˌʇ̼ͅ੮ɘ˦ʁ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ˺ϲϲʮɻʮɘˑͅ੮ ɺʇʩʮ˦ʁ੮ ä"੮ ৱৰ৴৵੮ ʠ̼ɘ˚ʇʁ੮ ʩ˺͙ͅʮ˦ʡ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ɘͅ੮ ˺̼ʮચ ʇ˦͐ʇʁ੮͐˺͸ɘ̼ʁ੮̼ʇɻ˺ͷʇ̼;੮ɘ˦ʁ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇੳ੮˦ʁੴ੮ɘ͐੮ˑʇɘ͐ͅ੮͐ʩʇ˺̼ʇ͐ʮɻɘˑˑ;ੴ੮͐ʩɘ͐੮˚ɘʁʇ੮

A SY LU M F O R T H E DY I N G

245

ͅʇ˦ͅʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺ͅʇ੮̹̼˺ɺˑʇ˚ɘ͐ʮɻ੮ɺʇʩɘͷʮ˺̼ͅ੮ɻ˺͙ˑʁ੮ɺʇ੮ɘ˚ʇˑʮ˺̼ɘ͐ʇʁ੮͸ʮ͐ʩ੮ɘ੮̹ʇ̼ʮ˺ʁ੮ of forced abstinence from methamphetamine. îʩʇ੮ʮ˦ʮ͐ʮɘ͐ʮͷʇͅ੮̹̼˺ϲʮˑʇʁ੮ʮ˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ઝʠ̼˺˚੮͐ʩʇ੮̹͙ͅʩ੮͐˺੮̼ʇʁʇϲʮ˦ʇ੮ʡ̼ɘͷʇ੮ʁʮͅચ ɘɺʮˑʮ͐;੮ ͐˺੮ š̹ʇ̼ɘ͐ʮ˺˦੮ )ʮʡ˦ʮ͐;੮ ͐˺੮ rૄͅ੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ̹ʮˑ˺͐ઝɘ̼ʇ੮ ɘ͐੮ once more pessimistic and paternalistic. They are focused on protecting people ͸ʩ˺੮ɘ̼ʇ੮ɘ͙ͅͅ˚ʇʁ੮͐˺੮˦ʇʇʁ੮˺˦ʡ˺ʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ˦ʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮ɻɘ̼ʇੳ੮îʩʮͅ੮ ͅʇʇ˚ͅ੮ˑʇͅͅ੮ɻ̼͙ʇˑ੮͸ʩʇ˦੮;˺͙੮ˑ˺˺ˌ੮ʩɘ̼ʁʇ̼੮ɘ͐੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮ʠ˺ɻ͙ͅ੮ˑʇͅͅ੮˺˦੮͐ʩʇ੮ person shouting in the center of an intersection and more on the person wasting away at the bus stop behind them. )˺ʇͅ੮˚ʇʇ͐ʮ˦ʡ੮͐ʩʇ੮˦ʇʇʁͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʁ;ʮ˦ʡ੮˺ʠ੮˦ʇʡˑʇɻ͐ʇʁ੮˚ʇʁʮɻɘˑ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮˺˦੮ ͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮˺̼੮˺ͷʇ̼ʁ˺ͅʮ˦ʡ੮ʮ˦੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮̼ʇή͙ʮ̼ʇ੮̼ʇʠ˺̼˚ʮ˦ʡ੮rØä੺੮îʩʇ̼ʇૄͅ੮ ˺˦ʇ੮͐ʩʮ˦ʡ੮U੮ɘ˚੮͙̼ͅʇ੮˺ʠੵ੮˦ʇ͸੮ɺʇʁͅ੮͸ʮˑˑ੮˦˺͐੮ˑʮʇ੮ʇ˚̹͐;ੳ੮îʩʇ੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅચ ɘɺʮˑʮ͐;੮͸ʮˑˑ੮ʇͽ̹ɘ˦ʁ੮͐˺੮ϲʮˑˑ੮͐ʩʇ˚ੴ੮̼ʇʡɘ̼ʁˑʇͅͅ੮˺ʠ੮ˑʇʡʮͅˑɘ͐˺̼ͅૄ੮͙ͅɻɻʇͅͅ੮ʮ˦੮˺ͷʇ̼ɻ˺˚ʮ˦ʡ੮ ʇ˦̼͐ʇ˦ɻʩʇʁ੮ ˺̹̹˺ͅʮ͐ʮ˺˦੮ ͐˺੮ rØä੮ ̼ʇʠ˺̼˚ੳ੮ Ĕʩʇ͐ʩʇ̼੮ ͐ʩɘ͐੮ ʇͽ̹ɘ˦ͅʮ˺˦੮ ͸ʮˑˑ੮ ɻɘ͐ɻʩ੮ ͐ʩʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮˚˺͐ͅ੮˦ʇʇʁ੮ɻɘ̼ʇ੮ɘ˦ʁ੮̹̼˺ͷʮʁʇ੮͐ʩʇ੮͐;̹ʇ੮˺ʠ੮ɻɘ̼ʇ੮͐ʩʇ;੮ɘɻ͙͐ɘˑˑ;੮˦ʇʇʁ੮ ʮͅ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ή͙ʇ͐ͅʮ˺˦ੳ îʩʮͅ੮˚˺˚ʇ˦͙͐˚੮ɺʇʩʮ˦ʁ੮̼ʇɺ͙ʮˑʁʮ˦ʡ੮͐ʩʇ੮ɘͅ;ˑ͙˚੮˚ɘˌʇͅ੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮ɘͅˌʇʁ੮ɺ;੮ ͐ʩʇ੮˦ʇͽ͐੮ɻʩɘ̹͐ʇ̼੮ʇͷʇ˦੮˚˺̼ʇ੮͙̼ʡʇ˦͐ੵ੮ɘ̼ʇ੮͐ʩʇ̼ʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮ɻ˺˦ͷʮ˦ɻʇ੮͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ɘ˦ʁ੮ ̹˺ˑʮɻ;੮ ˚ɘˌʇ̼ͅ੮ ͐ʩɘ͐੮ ̼ɘ˚̹ʮ˦ʡ੮ ͙̹੮ ʠ˺̼ɻʇʁ੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ͐˺੮ ͅɘͷʇ੮ ͐ʩ˺ͅʇ੮ʁ;ʮ˦ʡ੮ɘ˦ʁ੮ʁʮ̼͙̹͐ͅʮͷʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ʮͅ੮͙˦˦ʇɻʇͅͅɘ̼;੺

CHAPTER 13

SHARING AUTHORITY, RESTORING AUTONOMY

I

ϲʮ̼͐ͅ੮ ˚ʇ͐੮ /̼ʮɻ੮ Pʇ˦̼ʮή͙ʇͅ੮ ɘ͐੮ ɘ੮ ુ͐˺ͽʮɻ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ૂ੮ ʠ˺̼͙˚੮ ફˑʮˌʇ੮ ˚ɘ˦;੮ ͅʮ˚ʮˑɘ̼ˑ;੮͐ʮ͐ˑʇʁ੮ʇͷʇ˦͐ͅ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮৲ৰ৲ৱੴ੮ʮ͐੮˦˺ʁʁʇʁ੮͐˺੮͐ʩʇ੮৲ৰৰ৳੮ "̼ʮ͐˦ʇ;੮ä̹ʇɘ̼ͅ੮ͅ˺˦ʡબ੮ʩ˺͐ͅʇʁ੮ɺ;੮äʇ˦ʮ˺̼੮)ʮͅɘɺʮˑʮ͐;੮ɻ͐ʮ˺˦੮ɘ˦ʁ੮͐ʩʇ੮{ɘʁ੮{˺ɺੴ੮ ͐͸˺੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺જɺɘͅʇʁ੮ʡ̼˺͙̹ͅ੮ɘ͐੮͐ʩʇ੮ʠ˺̼ʇʠ̼˺˦͐੮˺ʠ੮˺̹̹˺ͅʮ͐ʮ˺˦੮͐˺੮ä"੮ৱৰ৴৵ੳ੮͐੮͐ʩʇ੮ ʇͷʇ˦͐ੴ੮ ɘ੮ ˑɘ͸;ʇ̼੮ ʠ̼˺˚੮ ͐ʩʇ੮ #rõ੮ ˑɘ˚ʇ˦͐ʇʁ੮ ʩ˺͸੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʁʮͅɻ̼ʮ˚ʮ˦ɘ͐ʇʁ੮ ɘʡɘʮ˦͐ͅ੮̹ʇ˺̹ˑʇੴ੮ˑʮˌʇ੮ʩʇ̼ੴ੮͸ʮ͐ʩ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅੳ੮੮͸˺˚ɘ˦੮̼ʇ̹̼ʇͅʇ˦͐ʮ˦ʡ੮͐ʩʇ੮ ʡ̼˺͙̹੮)ʇ̹̼ʇͅͅʇʁ੮Ĕʩʮˑʇ੮"ˑɘɻˌ੮ʁʇɻ̼ʮʇʁ੮ʩ˺͸੮ʠ̼ʮɻɘ˦੮˚ʇ̼ʮɻɘ˦ͅ੮͸ʇ̼ʇ੮ɘ͐੮͐ʩʇ੮ુɺ˺͐͐˺˚੮˺ʠ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮ˑɘʁʁʇ̼ੴૂ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʠ˺̼ɻʇʁ੮ʮ˦͐˺੮ˑ˺͸ચή͙ɘˑʮ͐;੮ɻɘ̼ʇੳ੮ ੮̹ɘ͐ʮʇ˦͐ͅૄ੮̼ʮʡʩ͐ͅ੮ɘʁͷ˺ɻɘ͐ʇ੮ʮ˦ͷʇʮʡʩʇʁ੮͐ʩɘ͐੮ુ˚ʇʁʮɻɘ͐ʮ˺˦੮ʮͅ੮˦˺͐੮͐ʩʇ੮ɘ˦ͅ͸ʇ̼ૂ੮ɘ˦ʁ੮ ʁʇ˦˺͙˦ɻʇʁ੮ʩ˺͸੮ુ̹ʇ˺̹ˑʇ੮ʡʇ͐੮ɻɘ͙ʡʩ͐੮͙̹੮ʮ˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɘ˦ʁ੮͐ʩʇ;੮˦ʇͷʇ̼੮ˑʇɘ̼˦੮ ʩ˺͸੮͐˺੮͐ɘˌʇ੮ɻɘ̼ʇ੮˺ʠ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮îʩʇ;੮ʩɘͷʇ੮˦˺੮ɻ˺˚˚͙˦ʮ͐;ੳ੯ੳ੯ੳ੯ੳ੮îʩʇ;੮ˑ˺ͅʇ੮ɘ˦;੮ͅˌʮˑˑͅ੮ ͐ʩʇ;੮ʩɘͷʇੳ੮îʩʇ;੮ʩɘͷʇ੮͐˺੮˺ɺʇ;ੳૂ੮˦˺͐ʩʇ̼੮̹ͅʇɘˌʇ̼੮ɺˑɘ͐ͅʇʁ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮̹̼˺ʡ̼ɘ˚੮˺ʠ੮ ʠ˺̼ɻʇʁ੮͐ͅʇ̼ʮˑʮΈɘ͐ʮ˺˦ͅ੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮͸ʩʮɻʩ੮˺˦ˑ;੮͸˺͙˦ʁ੮ʁ˺͸˦੮ʮ˦੮͐ʩʇ੮ৱ৹৷ৰͅੳৼ H˺̼੮ʩʮͅ੮̹ɘ̼͐ੴ੮/̼ʮɻ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮ʩʮ˚ͅʇˑʠ੮ɘͅ੮ɘ੮ુ̹ʇʇ̼੮ʮ˦੮̼ʇɻ˺ͷʇ̼;੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ɻʩɘˑˑʇ˦ʡʇͅੳૂ੮{˺̼ʇ੮̹ͅʇɻʮϲʮɻɘˑˑ;ੴ੮ʩʇ੮ʮʁʇ˦͐ʮϲʮʇͅ੮ɘͅ੮ʩɘͷʮ˦ʡ੮ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੳ੮Pʇૄͅ੮ɻʮ̼ɻ͙˚̹ͅʇɻ͐੮ɘɺ˺͙͐੮͐ʩɘ͐੮ˑɘɺʇˑੵ੮ɘˑ͐ʩ˺͙ʡʩ੮ʩʇ੮ɘɻˌ˦˺͸ˑʇʁʡʇʁ੮͐ʩɘ͐੮ુͅ˺˚ʇ੮ ̹ʇ˺̹ˑʇ੮ʩɘͷʇ੮ɻʩɘˑˑʇ˦ʡʇͅ੮͸ʮ͐ʩ੮͐ʩ˺ͅʇ੮͐ʇ̼˚ͅੴૂ੮ʠ˺̼੮ʩʮ˚੮͐ʩʇ੮ʁʮɘʡ˦˺ͅʮͅ੮ʮͅ੮ɘ੮ુ͙ͅʇʠ͙ˑ੮ʠ̼ɘ˚ʇ͸˺̼ˌ੮͐ʩɘ͐੮ʩʇˑ̹ͅ੮˚ʇ੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮ɘ˦ʁ੮˚ɘ˦ɘʡʇ੮͐ʩʇ੮ͅ;˚̹͐˺˚ͅ੮˺ʠ੮͐ʩɘ͐੮ʁʮͅ˺̼ʁʇ̼ૂ੮ફ˦ʇʮ͐ʩʇ̼੮ɘ੮̹͙̼ʇˑ;੮˺ɺˈʇɻ͐ʮͷʇ੮ɺʮ˺ˑ˺ʡʮɻɘˑ੮̼ʇɘˑʮ͐;੮˦˺̼੮ɘ੮˚ɘ˦͙ʠɘɻ͙̼͐ʇʁ੮ɻɘ͐ʇʡ˺̼;੮ʮ˦͐ʇ˦ʁʇʁ੮ ͐˺੮ɻ˺˦̼͐˺ˑ੮ʁʇͷʮɘ˦͐੮˺̼੮ʮ˦ɻ˺˦ͷʇ˦ʮʇ˦͐੮̹ʇ˺̹ˑʇ৽બੳ੮Pʇ੮ʩɘʁ੮ɘ੮ͅʮ˚ʮˑɘ̼੮͐ɘˌʇ੮˺˦੮˚ʇʁʮɻɘ͐ʮ˺˦ੵ੮ ુU੮ʁ˺੮̼ʇɘˑʮΈʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮ɘ̼ʇ੮͐˺̼͙̼͐ʇੴ੮ɺ͙͐੮͐ʩʇ੮̼ʮʡʩ͐੮ɻ˺˚ɺʮ˦ɘ͐ʮ˺˦ઝUૄͷʇ੮ ɺʇʇ˦੮˺˦੮͐͸˺੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻͅ੮ʠ˺̼੮ϲʮʠ͐ʇʇ˦੮;ʇɘ̼ͅઝ̹͙͐੮˚ʇ੮ʮ˦੮ɘ੮ɺʇ͐͐ʇ̼੮̹ˑɘɻʇੳૂ੮Pʇ੮ʇͷʇ˦੮ ͐˺ˑʁ੮˚ʇ੮ʮ˦੮ɘ˦੮ʮ˦͐ʇ̼ͷʮʇ͸੮ɘʠ͐ʇ̼੮͐ʩʇ੮ʇͷʇ˦͐ੴ੮ુUૄ˚੮˦˺͐੮˺˦ʇ੮˺ʠ੮͐ʩ˺ͅʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͐ʩʮ˦ˌ੮ યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ર੮ͅʩ˺͙ˑʁ੮ɺʇ੮ɻ˺˚̹ˑʇ͐ʇˑ;੮ʇˑʮ˚ʮ˦ɘ͐ʇʁੴૂ੮ʇͷʇ˦੮͐ʩ˺͙ʡʩ੮ુɘ੮ˑ˺͐੮˺ʠ੮ɘʁʁʮ͐ʮ˺˦ɘˑ੮͐ʩ˺͙ʡʩ͐੮ͅʩ˺͙ˑʁ੮ɺʇ੮̹͙͐੮ʮ˦͐˺੮યʮ͐ͅ੮͙ͅʇરੳૂ

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

2 47

îʩɘ͐ૄͅ੮ʡʇ˦ʇ̼˺͙ͅੴ੮ɺʇɻɘ͙ͅʇ੮͸ʩʇ˦੮ʩʇ੮ͅɘ;ͅ੮ʩʇ੮ˌ˦˺͸ͅ੮ુʩ˺͸੮ʩ˺̼̼ʮϲʮɻ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʮͅੴૂ੮ ʩʇૄͅ੮ ̹ͅʇɘˌʮ˦ʡ੮ ͸ʮ͐ʩ੮ ɘ͙͐ʩ˺̼ʮ͐;ੳ੮ Pʇ੮ ʡ̼ʇ͸੮ ͙̹੮ ʮ˦੮ #˺ˑ˺̼ɘʁ˺ੳ੮ Ĕʩʇ˦੮ ʩʇ੮ ͸ɘͅ੮ ͅʇͷʇ˦͐ʇʇ˦ੴ੮ʩʇ੮ɘ͐͐ʇ˚̹͐ʇʁ੮͙ͅʮɻʮʁʇ੶੮ʩʇ੮͸ʇ˦͐੮͐˺੮ɘ˦੮ɘʁ˺ˑʇͅɻʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑ੮͙˦ʮ͐੮ʠ˺̼੮͐͸˺੮ ͸ʇʇˌͅ੮ɺ͙͐੮ɻ˺˦͐ʮ˦͙ʇʁ੮͐˺੮ʇ˦ʡɘʡʇ੮ʮ˦੮ͅʇˑʠચʮ˦ˈ͙̼;ੳ੮Pʮͅ੮̹ɘ̼ʇ˦͐ͅ੮ɘʡ̼ʇʇʁ੮͸ʮ͐ʩ੮ʩʮͅ੮ʁ˺ɻ͐˺̼੮ ͐ʩɘ͐੮ʩʇ੮ɺʇˑ˺˦ʡʇʁ੮ʮ˦੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮/̼ʮɻ੮ͅɘ;ͅ੮ʩʇ੮͸ɘͅ੮ϲˑ˺͸˦੮͐˺੮͐ʩʇ੮ʠɘɻʮˑʮ͐;੮˺˦੮ɘ੮ ͅ˚ɘˑˑ੮ͅʩʇ̼ʮϲϲૄͅ੮̹ˑɘ˦ʇੴ੮ͅʩɘɻˌˑʇʁ੮ɘ͐੮͐ʩʇ੮ˑʇʡͅੳ੮îʩʮͅ੮͸ɘͅ੮ৱ৹৸ৱੴ੮ɺ͙͐੮ʩʮͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮̹ͅʇɘˌ੮ ͐˺੮ ͐ʩʇ੮ ʁ;͐ͅ˺̹ʮɘ˦੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ ̹ʇ̼ͅʮ͐ͅʇʁ੮ ʇͷʇ˦੮ ɘʠ͐ʇ̼੮ ˑɘ͸ͅ੮ ˑʮˌʇ੮ rØä੮ ͸ʇ˦͐੮ ʮ˦͐˺੮ ʇʠʠʇɻ͐੮ ˦ɘ͐ʮ˺˦͸ʮʁʇੳ੮ Pʇ੮ ̼ʇɻɘˑˑͅੴ੮ ુU੮ ͅɘ͸੮ ʠ˺ˑˌͅ੮ ͸ʩ˺੮ ͸ʇ̼ʇ੮ ̹ʩ;ͅʮɻɘˑˑ;੮ ̼ʇ̼͐ͅɘʮ˦ʇʁ੮ ɘ˦ʁ੮ ͐ɘˌʇ˦੮͐˺੮͐ʩʇ੮ͅʩ˺͸ʇ̼ͅੳ੮îʩʇ;੮ʩɘʁ੮ˑʇɘ͐ʩʇ̼੮˚ɘͅˌͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮͸ʇ̼ʇ੮ɺʮ͐ʇ̼ͅ੮ɘ˦ʁ੮̹ͅʮ͐͐ʇ̼ͅੳ੯ੳ੯ੳ੯ੳ੮{͙ɻʩ੮˺ʠ੮͐ʩʇ੮͐ʮ˚ʇ੮͸ɘͅ੮̹ͅʇ˦͐੮ʮ˦੮˚ʮ˦ʁˑʇͅͅ੮ɘɻ͐ʮͷʮ͐ʮʇͅੳ੯ੳ੯ੳ੯ੳ੮U੮ʇͽ̹ʇ̼ʮʇ˦ɻʇʁ੮ͅʇͽ͙ɘˑ੮ ɘͅͅɘ͙ˑ͐੮ɘ˦ʁ੮ͅʇͽ͙ɘˑ੮ɻ˺ʇ̼ɻʮ˺˦੮ɺ;੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ˦ʁ੮͐ͅɘʠʠੳૂ੮Pʇ੮͐ͅɘ;ʇʁ੮ɘ੮;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ʩɘˑʠੳ Ĕʩʇ˦੮ʩʇ੮͸ɘͅ੮ʁʮͅɻʩɘ̼ʡʇʁੴ੮ʩʇ੮͸ʇ˦͐੮ɺɘɻˌ੮͐˺੮ʩʮͅ੮ʩ˺˚ʇ͐˺͸˦੮͐˺੮ˑʮͷʇ੮ʮ˦੮ɘ੮ʩɘˑʠ͸ɘ;੮ ʩ˺͙ͅʇੳ੮Pʇ੮ʡ̼ʇ͸੮ʠ̼͙̼͐ͅɘ͐ʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚੮ɘ˦ʁ੮͐˺˺ˌ੮ɘ੮ɺ͙ͅ੮͐˺੮)ʇ˦ͷʇ̼ੴ੮͸ʩʇ̼ʇ੮ʩʇ੮ ͸ɘͅ੮ʡ̼ʮ̹̹ʇʁ੮ɺ;੮͸˺̼ͅʇ˦ʮ˦ʡ੮̹ͅ;ɻʩ˺͐ʮɻ੮ͅ;˚̹͐˺˚ͅੳ੮Pʇ੮͸ɘ˦ʁʇ̼ʇʁ੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮ʩ˺˚ʇˑʇͅͅੴ੮͙˦͐ʮˑ੮ʩʇ੮͸ɘͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ɘ˦ʁ੮ͅʇ˦͐੮͐˺੮ɘ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇੳ੮U͐੮͸ɘͅ੮ɘ੮ુ̹̼ʇ͐͐;ੴ੮̹̼ʇ͐͐;੮ ʁʇ̹̼ʇͅͅʮ˦ʡੴ੮ʩ˺̼̼ʮϲʮɻ੮̹ˑɘɻʇ੮͐˺੮ɺʇ੮ɘͅ੮ɘ੮˦ʮ˦ʇ͐ʇʇ˦ચ;ʇɘ̼ચ˺ˑʁੳૂ੮Pʇ੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʇʁ੮ɘ˦ʁ੮ ͸˺͙˦ʁ੮͙̹੮ɘʡɘʮ˦੮ʮ˦੮ɘ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮ʠ͐ʇ̼੮ɘ੮;ʇɘ̼੮ɘ˦ʁ੮ɘ੮ʩɘˑʠੴ੮ʩʇ੮ʡ˺͐੮ɘ੮ʁɘ;੮̹ɘͅͅ੮͐˺੮ ˑʇɘͷʇ੮͐ʩʇ੮ʠɘɻʮˑʮ͐;੮ɘ˦ʁ੮ʩ˺̹̹ʇʁ੮ɘ੮̹ˑɘ˦ʇ੮͐˺੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੳ੮îʩʇ̼ʇੴ੮͐˺˺ੴ੮ʩʇ੮͸ɘͅ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁੳ੮Pʮͅ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐˺ˑʁ੮ʩʮ˚੮ʩʇ੮˦ʇʇʁʇʁ੮ʇˑʇɻ̼͐˺ɻ˺˦ͷ͙ˑͅʮͷʇ੮͐ʩʇ̼ɘ̹;੮ફ/#îબੳ੮ Pʇ੮ ʩɘʁ੮ ʠ˺͙̼੮ ̼͐ʇɘ͐˚ʇ˦͐ͅ੶੮ ɘʠ͐ʇ̼੮ ʇɘɻʩੴ੮ ʩʇૄʁ੮ ͸ɘˌʇ੮ ͙̹੮ ͸ʮ͐ʩ੮ ુ˦˺੮ ʮʁʇɘ੮͸ʩʇ̼ʇ੮ U੮ ͸ɘͅੳૂ੮ Ĕʩʇ˦੮ʩʇ੮͐ͅɘ̼͐ʇʁ੮̼ʇʠ͙ͅʮ˦ʡ੮ʠ͙̼͐ʩʇ̼੮/#îͅੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮ɻ˺˦ͅʇ̼ͷʇʁ੮ʩʮ˚੮ɘ˦ʁ੮ͅʇ˦͐੮ʩʮ˚੮ ͐˺੮‡ɘ̹ɘ੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑੳ /̼ʮɻૄͅ੮͐ͅ˺̼;ੴ੮ʩʇ੮ͅɘʮʁ੮ɘ͐੮͐ʩʇ੮ʠ˺̼͙˚ੴ੮͸ɘͅ੮˺˦ʇ੮˺ʠ੮ɺ˺͐ʩ੮ુ̼͐ɘ͙˚ɘ੮ɘ˦ʁ੮ʩ˺̹ʇੴૂ੮ɺʇɻɘ͙ͅʇ੮ ʇͷʇ˦͙͐ɘˑˑ;੮/̼ʮɻ੮ʠ˺͙˦ʁ੮ɘ੮͐ʩʇ̼ɘ̹ʮ͐ͅ੮ɘ˦ʁ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ʩʇ੮ˑʮˌʇʁੴ੮͐ͅɘ̼͐ʇʁ੮͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅ੮͐ʩɘ͐੮͸˺̼ˌʇʁੴ੮ɘ˦ʁ੮ɺ͙ʮˑ͐੮͙̹੮ɘ੮͙̹̹ͅ˺̼͐੮˦ʇ͐͸˺̼ˌ੮ɘ˦ɻʩ˺̼ʇʁ੮ɺ;੮ʩʮͅ੮ʩ͙ͅɺɘ˦ʁ੮ ફ˦˺͸੮˺ʠ੮͐͸ʇ˦͐;ચϲʮͷʇ੮;ʇɘ̼ͅબੳ੮ʠ͐ʇ̼੮ʡ˺ʮ˦ʡ੮ɺɘɻˌ੮͐˺੮ͅɻʩ˺˺ˑੴ੮ʩʇ੮ʁʮͅɻ˺ͷʇ̼ʇʁ੮͐ʩɘ͐੮͐ʩʇ̼ʇ੮ ʮͅ੮ɘ੮ુͷʮɘɺˑʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ૂੵ੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐ੳ੮ુØʇʇ̼ͅૂ੮ɘ̼ʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ ુʇͽ̹ʇ̼͐ʮͅʇ੮ ʠ̼˺˚੮ ˑʮͷʇʁ੮ ʇͽ̹ʇ̼ʮʇ˦ɻʇૂ੮ ͸ʩ˺੮ ̹̼˺ͷʮʁʇ੮ ુͅ˺ɻʮɘˑ੮ ɘ˦ʁઃ˺̼੮ ʇ˚˺͐ʮ˺˦ɘˑ੮ ͙̹̹ͅ˺̼͐੯ ੳ੯ ੳ੯ ੳ੮ ʁʇˑʮͷʇ̼ʇʁ੮ ͸ʮ͐ʩ੮ ˚͙͙͐ɘˑ੮ ɘʡ̼ʇʇ˚ʇ˦͐੯ ੳ੯ ੳ੯ ੳ੮ ͐˺੮ ͅʇ̼ͷʮɻʇ੮ ͙ͅʇ̼ͅ੮ ͅʩɘ̼ʮ˦ʡ੮ ͅʮ˚ʮˑɘ̼੮ ɻʩɘˑˑʇ˦ʡʇͅੳૂ৾ U˦੮৲ৰৱ৴ੴ੮/̼ʮɻ੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ʠ˺̼੮ɘ੮̹˺ͅʮ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮ äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ફ{PણäHબ੮ɘͅ੮ɘ੮ુ͸ɘ̼˚ચˑʮ˦ʇૂ੮ɻ˺͙˦ͅʇˑ˺̼ੴ੮̹̼˺ͷʮʁʮ˦ʡ੮ɘ੮˦˺˦ˈ͙ʁʡ˚ʇ˦͐ɘˑ੮ ʇɘ̼੮͐˺੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɻ˺͙ˑʁ˦ૄ͐੮ϲʮ˦ʁ੮˺˦ʇ੮ɘ˚˺˦ʡ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮˺̼੮͐ʩʇ̼ɘ̹ʮ͐ͅͅੳ੮/̼ʮɻ੮͐ʩʇ˦੮ ˚˺ͷʇʁ੮ʮ˦͐˺੮ɻ̼ʮͅʮͅ੮͸˺̼ˌ੮ʮ˦੮{ɘ̼ʮ˦੮#˺͙˦͐;ੳ੮Pʇૄʁ੮ɘɻɻ˺˚̹ɘ˦;੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺˦ʁ͙ɻ͐ʮ˦ʡ੮ ৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ͅੴ੮̹̼˺ͷʮʁʮ˦ʡ੮ુɻ˺˚ʠ˺̼͐ૂ੮ɘ˦ʁ੮ુʇ˚˺͐ʮ˺˦ɘˑ੮͙̹̹ͅ˺̼͐ૂ੮͐˺੮̹ʇ˺̹ˑʇ੮ɘͅ੮͐ʩʇ;੮ ͸ʇ̼ʇ੮ɺʇʮ˦ʡ੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ

248

REFORM

";੮৲ৰ৲ৱੴ੮/̼ʮɻ੮ʩɘʁ੮ɺʇʇ˦੮̹̼˺˚˺͐ʇʁ੮͐˺੮͐ʩʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮̹ʇʇ̼੮ͅʇ̼ͷʮɻʇͅ੮ʠ˺̼੮{PણäHੳ৿੮ Pʇ੮˺ͷʇ̼ͅʇʇͅ੮ɘ੮͸ʩ˺ˑʇ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ͅʇ̼ͷʮɻʇͅੴ੮ʮ˦ɻˑ͙ʁʮ˦ʡ੮͐ʩʇ੮͸ɘ̼˚ચˑʮ˦ʇ੮ɘ˦ʁ੮ɻ˺˚˚͙˦ʮ͐;੮͙̹̹ͅ˺̼͐੮ʡ̼˺͙̹ͅੳ੮ɻ̼˺ͅͅ੮͐ʩʇͅʇ੮ͅʇ͐͐ʮ˦ʡͅੴ੮ʩʇ੮ͅɘ;ͅੴ੮̹ʇʇ̼ͅ੮̹̼˺ͷʮʁʇ੮ɘ੮ુ̹ʇ̼ͅ˺˦ɘˑʮΈʇʁੴ੮ ʩ͙˚ɘ˦ʇ੮ ɘ̹̹̼˺ɘɻʩ੯ ੳ੯ ੳ੯ ੳ੮ ɺɘͅʇʁ੮ ˺˦੮ ʇή͙ɘˑʮ͐;੮ ˦˺͐੮ ʩʮʇ̼ɘ̼ɻʩ;ੳૂ੮ ä˺˚ʇ͐ʮ˚ʇͅੴ੮ ͐ʩʇ;੮ ʩʇˑ̹੮ ͸ʮ͐ʩ੮ુʡʇ͐ય͐ʮ˦ʡર੮ʠ˺ˑˌͅ੮ɻ˺˦˦ʇɻ͐ʇʁ੮͐˺੮ͷʇ̼;੮ʩʇɘˑʮ˦ʡੴ੮͙̹̹ͅ˺̼͐ʮͷʇੴ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇ੮ͅʇ̼ͷʮɻʇͅੳૂ੮ ͐੮˺͐ʩʇ̼੮˚˺˚ʇ˦͐ͅੴ੮͐ʩʇ;੮ɘʮʁ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮͸˺̼ˌ੮͸ʮ͐ʩ੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦੮ɘ͐੮ ɘˑˑ੮ɺ͙͐੮͐ͅʮˑˑ੮͸˺͙ˑʁ੮ˑʮˌʇ੮ͅˌʮˑˑͅ੮͐˺ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮̼ʇʁ͙ɻʇ੮ʩɘ̼˚੮ʠ̼˺˚੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੳ Ĕʩʇ˦੮͸ʇ੮̹ͅ˺ˌʇੴ੮ʩʇ੮͸ɘͅ੮͐ͅɘ̼͐ʮ˦ʡ੮ɘ੮˦ʇ͸੮̹ʇʇ̼੮̹̼˺ʡ̼ɘ˚੮ʮ˦੮ä͐ੳ੮H̼ɘ˦ɻʮͅ੮P˺̹ͅʮ͐ɘˑੴ੮ ͸ʩʇ̼ʇ੮ʩʇૄʁ੮ɺʇʇ˦੮ʡʮͷʇ˦੮/#î੮ɺɘɻˌ੮ʮ˦੮͐ʩʇ੮ৱ৹৸ৰͅੳ੮õ˦ˑʮˌʇ੮ͷʮ̼͙͐ɘˑˑ;੮ʇͷʇ̼;੮˺͐ʩʇ̼੮̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮̹ɘ͐ʮʇ˦͐ͅ੮ʇ˦ɻ˺͙˦͐ʇ̼੮ʮ˦੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮͐ʩʇ੮{P੮̹ʇʇ̼ͅ੮͐ʩʇ;੮˚ʇʇ͐੮ɘͅ੮ ͐ʩʇ;੮˦ʇɘ̼੮ʁʮͅɻʩɘ̼ʡʇ੮͐ͅɘ;੮͸ʮ͐ʩ੮͐ʩʇ˚੮ɘͅ੮͐ʩʇ;੮̼ʇʇ˦͐ʇ̼੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੴ੮ʩʇˑ̹ʮ˦ʡ੮͐ʩʇ˚੮ ʡʇ͐੮ʮ˦͐˺੮ʩ˺͙ͅʮ˦ʡ੮˺̼੮˚ɘˌʇ੮ʮ͐੮͐˺੮ʠ˺ˑˑ˺͸ચ͙̹੮ɘ̹̹˺ʮ˦͐˚ʇ˦͐ͅੳ੮îʩʇ੮͙ˑ͐ʮ˚ɘ͐ʇ੮ʡ˺ɘˑ੮ʮͅ੮͐˺੮ ુ̼ʇʁ͙ɻʇ੮ʠ͙͙̼͐ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴૂ੮͸ʩʮɻʩ੮ʮͅ੮ɘ˦੮͙̼ʡʇ˦͐੮͐ɘͅˌੳ੮‡ɘ͐ʮ˺˦ɘˑˑ;ੴ੮৲ৰ੮̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ ʁʮͅɻʩɘ̼ʡʇʁ੮ ʠ̼˺˚੮ ɘɻ͙͐ʇ੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɘ̼ʇ੮ ̼ʇɘʁ˚ʮ͐͐ʇʁ੮͸ʮ͐ʩʮ˦੮͐ʩʮ̼͐;੮ʁɘ;ͅੳ਀੮îʩʇ੮ä͐ੳ੮H̼ɘ˦ɻʮͅ੮̹̼˺ʡ̼ɘ˚੮ʩɘʁ੮ɺʇʇ˦੮ʡ˺ʮ˦ʡ੮ʠ˺̼੮˺˦ˑ;੮ ʠ˺͙̼੮˚˺˦͐ʩͅੴ੮ɺ͙͐੮/̼ʮɻ੮ɘˑ̼ʇɘʁ;੮ʩɘͅ੮ͅ˺˚ʇ੮͙ͅɻɻʇͅͅ੮͐ͅ˺̼ʮʇͅੵ੮˺˦ʇ੮̹ʇ̼ͅ˺˦੮͸ɘͅ੮ુ̼ʇʠ͙ͅʮ˦ʡ੮ ͐˺੮ɻ˺˚˚͙˦ʮɻɘ͐ʇ੮͸ʮ͐ʩ੮͐ͅɘϲϲૂ੮ɘ˦ʁ੮ɘ͐੮̼ʮͅˌ੮˺ʠ੮ɺʇʮ˦ʡ੮ʇʮ͐ʩʇ̼੮ɻ˺˦ͅʇ̼ͷʇʁ੮˺̼੮ʁʮͅɻʩɘ̼ʡʇʁ੮ ͸ʮ͐ʩ˺͙͐੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻɘ̼ʇੳ੮îʩʇ੮̹ʇʇ̼ੴ੮͐ʩ˺͙ʡʩੴ੮͸ɘͅ੮ɘɺˑʇ੮͐˺੮ુʁʇͷʇˑ˺̹੮̼͙͐͐ͅ੮ɘ˦ʁ੮̼ɘ̹̹˺̼͐੯ੳ੯ੳ੯ੳ੮͸ʮ͐ʩ੮ɘ੮ˑʮ͐͐ˑʇ੮ɺʮ͐੮˺ʠ੮ͅʇˑʠચʁʮͅɻˑ˺͙̼ͅʇੳૂ੮îʩɘ͐੮̹ʇ̼ͅ˺˦ੴ੮ʩʇ੮ͅɘʮʁੴ੮ુʮͅ੮˦˺͸੮ɘɻ͙͐ɘˑˑ;੮ ͐ʩ̼ʮͷʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳૂ੮{P੮ʮͅ੮ʁʇͷʇˑ˺̹ʮ˦ʡ੮ɘ੮ͅʮ˚ʮˑɘ̼੮̹̼˺ʡ̼ɘ˚੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɺʇʮ˦ʡ੮̼ʇˑʇɘͅʇʁ੮ʠ̼˺˚੮͐ʩʇ੮ɻ˺͙˦͐;੮ˈɘʮˑੳ ͅ੮͐ʩʇ੮৲ৰ৲ৱ੮ʠ˺̼͙˚੮U੮ɘ͐͐ʇ˦ʁʇʁ੮ɘ̼͐ʮɻ͙ˑɘ͐ʇʁੴ੮ɘ͐੮ʩʇɘ̼͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ɘɺ˺͙͐੮ ͐ɘˌʮ˦ʡ੮ɘ͸ɘ;੮ɻʩ˺ʮɻʇͅੳ੮{˺̼ʇ੮̹̼ʇɻʮͅʇˑ;ੴ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮ɘ੮˚ʇɻʩɘ˦ʮͅ˚੮ʠ˺̼੮substituted੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡੴ੮ʮ˦੮͸ʩʮɻʩ੮ɘ੮͐ʩʮ̼ʁ੮̹ɘ̼͐;੮˚ɘˌʇͅ੮ɻʩ˺ʮɻʇͅ੮˺˦੮ɺʇʩɘˑʠ੮˺ʠ੮ɘ੮̹ʇ̼ͅ˺˦੮ ʁʇʇ˚ʇʁ੮ ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮ ˺̼੮ ʮ˦ɻɘ̹ɘɺˑʇ੮ ˺ʠ੮ ʁ˺ʮ˦ʡ੮ ͅ˺ੳ੮ )ʮͅɘɺʮˑʮ͐;੮ ̼ʮʡʩ͐ͅ੮ ɘʁͷ˺ɻɘ͐ʇͅ੮ ʩɘͷʇ੮ɻˑɘ˚˺̼ʇʁੴ੮ʮ˦͐ͅʇɘʁੴ੮ʠ˺̼੮͐ʩʇ੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮supported੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡੳ੮U˦੮͙ͅɻʩ੮ ɘ̼̼ɘ˦ʡʇ˚ʇ˦͐ͅੴ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʮ͐ʩ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮̼ʇˑʮʇͅ੮˺˦੮ɘ੮̼͙͐͐ͅʇʁ੮˦ʇ͐͸˺̼ˌ੮˺ʠ੮ʠ̼ʮʇ˦ʁͅੴ੮ ʠɘ˚ʮˑ;ੴ੮ɘ˦ʁ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͐˺੮ʩʇˑ̹੮͐ʩʇ˚੮˚ɘˌʇ੮ɻʩ˺ʮɻʇͅ੮͐ʩɘ͐੮ɘ̼ʇੴ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮͐ʩʇʮ̼੮ ˺͸˦ੳਁ੮š˦੮äʇ̹͐ʇ˚ɺʇ̼੮৳ৰੴ੮৲ৰ৲৲ੴ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮ͅʮʡ˦ʇʁ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮˺ɺˑʮʡɘ͐ʮ˦ʡ੮ ˈ͙ʁʡʇͅ੮ ͐˺੮ ɻ˺˦ͅʮʁʇ̼੮ ͙̹̹ͅ˺̼͐ʇʁ੮ ʁʇɻʮͅʮ˺˦੮ ˚ɘˌʮ˦ʡ੮ ʮ˦੮ ˑʮʇ͙੮ ˺ʠ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ Pʇ੮ ̼͙͐˚̹ʇ͐ʇʁ੮ ʩ˺͸੮ ͐ʩʇ੮ ˑɘ͸੮ ͸˺͙ˑʁ੮ ʇ˦͙̼ͅʇ੮ ͐ʩɘ͐੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ ુ˚ɘʮ˦͐ɘʮ˦੮ ɻ˺˦̼͐˺ˑ੮˺ͷʇ̼੮͐ʩʇʮ̼੮ˑʮͷʇͅ੮͐˺੮͐ʩʇ੮ʡ̼ʇɘ͐ʇ͐ͅ੮ʇͽ͐ʇ˦͐੮̹˺ͅͅʮɺˑʇੳૂਂ îʩɘ͐੮ˑʇʡʮͅˑɘ͐ʮ˺˦ੴ੮ʩ˺͸ʇͷʇ̼ੴ੮ɘ̹̹ˑʮʇͅ੮˺˦ˑ;੮͐˺੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮îʩʇ੮ʡ˺ͷʇ̼˦˺̼ੴ੮ɘʠ͐ʇ̼੮ɘˑˑੴ੮ʩɘʁ੮ˑ˺˦ʡ੮̹͙ͅʩʇʁ੮͐˺੮̼ɘ˚̹੮͙̹੮͐ʩʇ੮͙ͅʇ੮˺ʠ੮͙ͅɺ͐ͅʮ͙͐͐ʇʁ੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡ੮ ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮ ‡ɘ͐ʮ˺˦͸ʮʁʇੴ੮͐ʩʇ੮ͷɘ͐ͅ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮͙̹̹ͅ˺̼͐ʇʁચʁʇɻʮͅʮ˺˦ચ˚ɘˌʮ˦ʡ੮ɘ̼̼ɘ˦ʡʇ˚ʇ˦͐ͅ੮ɘ̼ʇ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

249

ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅੳਃ੮/ͽ̹ʇ̼͐ͅ੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ͅ;͐ͅʇ˚੮̼ɘʮͅʇʁ੮ʁ˺͙ɺ͐ͅ੮͐˺੮˚ʇ੮ɘɺ˺͙͐੮ʩ˺͸੮͸ʇˑˑ੮͐ʩʇͅʇ੮˚˺ʁʇˑͅ੮ɻ˺͙ˑʁ੮ ̼͐ɘ˦ͅˑɘ͐ʇ੮ʮ˦͐˺੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮îʩʇ;੮ʡ̼˺͙˦ʁʇʁ੮͐ʩ˺ͅʇ੮ɻ˺˦ɻʇ̼˦ͅ੮ʮ˦੮͐ʩʇ੮ ˺ɺͅʇ̼ͷɘ͐ʮ˺˦੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇͷʇ̼ʇ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮˚ʮʡʩ͐੮ʩɘͷʇ੮ʁʮ̼͙̹͐ͅʮͷʇ੮ɻ̼ʮͅʇͅੴ੮ ̼ʇʠ͙ͅʇ੮˦ʇʇʁʇʁ੮ɻɘ̼ʇੴ੮ʩɘͷʇ੮ˑ˺͐ͅ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮͙̼ͅͷʮͷʇ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ફͅ˺˚ʇ͐ʮ˚ʇͅ੮ɘͅ੮ ɘ੮̼ʇ͙ͅˑ͐੮˺ʠ੮̹̼˺ˑ˺˦ʡʇʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮˺̼੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇબੴ੮ɘ˦ʁ੮ʩɘͷʇ੮ʠ̼ɘ;ʇʁ੮ˑʮ˦ˌͅ੮ ͐˺੮͐ʩʇʮ̼੮ʇ̼͐ͅ͸ʩʮˑʇ੮͙̹̹ͅ˺̼͐ʇ̼ͅ੮͙ͅɻʩ੮ɘͅ੮ʠɘ˚ʮˑ;੮˺̼੮ʠ̼ʮʇ˦ʁͅੳ U˦੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੴ੮U੮ͅˌʇ͐ɻʩ੮˺͙͐੮ɘ੮continuum of collaboration੮ફϲʮʡ͙̼ʇ੮ৱ৳ੳৱબੵ੮ɘ੮ͅʇ̼ʮʇͅ੮ ˺ʠ੮ ʮ˦͐ʇ̼ˑʮ˦ˌʇʁ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ ɻ˺͙ˑʁ੮ ɘʁʁ̼ʇͅͅ੮ ͐ʩʇ੮ ̹ͅʇɻʮϲʮɻ੮ ɻʩɘˑˑʇ˦ʡʇͅ੮ ̹˺ͅʇʁ੮

Crisis

Stabilization Non-police crisis intervention (e.g. street crisis response team)

Persistent outreach (e.g. AOT) to clients remaining in the street/shelter/ independent housing

Transition to residential program via peer respites or acute diversion unit

Services

Skills

Accountable teams focused on meeting social and medical needs

Unlocked residential programs focused on coping skills and cooperative living

Support Peer-led wellness groups, clubhouses

Shared decision-making Psychiatric advanced directive used to give client authority

13.1 îʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦

250

REFORM

ɺ;੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮͸ʩʮˑʇ੮ʇ˦ɘɻ͐ʮ˦ʡ੮͐ʩʇ੮̹̼ʮ˦ɻʮ̹ˑʇͅ੮˺ʠ੮ɘ͙͐˺˦˺˚;੮ɘ˦ʁ੮ɻʩ˺ʮɻʇ੮ɘ͐੮͐ʩʇ੮ ʩʇɘ̼͐੮˺ʠ੮͙̹̹ͅ˺̼͐ʇʁ੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡੳ੮U੮ʁ̼ɘ͸੮˺˦੮͐ʩʇ੮ʇͽɘ˚̹ˑʇ੮˺ʠ੮̹̼˺ʡ̼ɘ˚ͅੴ੮ˑʮˌʇ੮ ͐ʩʇ੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐ͅ੮ʁʇͅɻ̼ʮɺʇʁ੮ɺ;੮/̼ʮɻੴ੮͐ʩɘ͐੮ɘˑ̼ʇɘʁ;੮ʇͽʮ͐ͅੴ੮ɘˑɺʇʮ͐੮˦˺͐੮ɘ͐੮ͅɻɘˑʇੴ੮ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘੳ੮ îʩʮͅ੮ ɻ˺˦͐ʮ˦͙͙˚੮ ˚͙͐ͅ੮ ̹̼˺ͷʮʁʇ੮ ϲʮͷʇ੮ ͐ʩʮ˦ʡͅੴ੮ ʇɘɻʩ੮ ˺ʠ੮ ͸ʩʮɻʩ੮ ̼ʇή͙ʮ̼ʇͅ੮ ɺ͙ʮˑʁʮ˦ʡ੮ɘ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮ɺɘͅʇʁ੮˺˦੮̼ʇ̹ͅʇɻ͐੮ɘ˦ʁ੮ɻ˺˺̹ʇ̼ɘ͐ʮ˺˦ੵ੮̎͗ȡɃɷʚɷ͑ȡ̙ɷ˃ʯ੮͐ʩɘ͐੮̹̼˺͐ʇɻ͐ͅ੮ ̹ʇ˺̹ˑʇ੮ ʠ̼˺˚੮ ɻ˺ʇ̼ɻʮ˺˦੶੮ ̹ɘ͐ʮʇ˦͐੮ ɘ˦ʁ੮ ̹ʇ̼ͅʮ͐ͅʇ˦͐੮ services੮ ͐ʩɘ͐੮ ɘʁʁ̼ʇͅͅ੮ ͐ʩʇʮ̼੮ ˚ʇʁʮɻɘˑ੮ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮˦ʇʇʁͅ੮ʮ˦੮͐ɘ˦ʁʇ˚੶੮̹̼˺ʡ̼ɘ˚ͅ੮͐ʩɘ͐੮ʩʇˑ̹੮͐ʩʇ˚੮ʁʇͷʇˑ˺̹੮skills੮͐˺੮ ͙̼ͅͷʮͷʇ੮ ʮ˦͐ʇ̼ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺˚˚͙˦ʮ͐;੶੮ supports੮ ͐ʩɘ͐੮ ˺ʠʠʇ̼੮ ʩ˺̹ʇੴ੮ ʩ͙˚ɘ˦੮ ɻ˺˦˦ʇɻ͐ʮ˺˦ੴ੮ɘ˦ʁ੮̹͙̼̹˺ͅʇ੶੮ɘ˦ʁੴ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮͐˺˺ˑͅ੮ʠ˺̼੮shared੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡ੮͐ʩɘ͐੮ ̼͐ɘ˦ͅʠʇ̼੮ɘ͙͐ʩ˺̼ʮ͐;੮ʠ˺̼੮˺̼ʡɘ˦ʮΈʮ˦ʡ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͐˺੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮ʮ͐੮ʮͅ੮ ͙̹̹ͅ˺ͅʇʁ੮͐˺੮ͅʇ̼ͷʇੳ

STABILIZATION: REDEFINING CRISIS, REDIRECTING THE POLICE Ĕʇૄˑˑ੮͐ͅɘ̼͐੮ɘ͐੮͐ʩʇ੮ͅɘ˚ʇ੮̹ˑɘɻʇ੮ɘͅ੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚ੵ੮ɻ̼ʮͅʇͅੳ੮˦ʁ੮͸ʩɘ͐੮ U੮ ˑʇɘ̼˦ʇʁ੮ ˺˦੮ ˚;੮ ̼ʮʁʇચɘˑ˺˦ʡ੮ ͸ʮ͐ʩ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ ˦ʇ͸੮ ä̼͐ʇʇ͐੮ #̼ʮͅʮͅ੮ Ûʇ̹ͅ˺˦ͅʇ੮ îʇɘ˚੮ફä#Ûîબ੮ʮͅ੮͐ʩɘ͐੮ɘʁʁ̼ʇͅͅʮ˦ʡ੮ɻ̼ʮͅʇͅ੮͐ͅɘ̼͐ͅ੮͸ʮ͐ʩ੮̼ʇɻ˺ʡ˦ʮΈʮ˦ʡ੮͐ʩɘ͐੮͐ʩʇ;੮ɘ̼ʇ੮˦˺͐੮ ɘˑ͸ɘ;ͅ੮ɻ̼ʮͅʇͅੳ ੮͸ʮʁʇ੮ͅ͸ɘ͐ʩʇ੮˺ʠ੮͐ʩʇ੮̹͙ɺˑʮɻ੮͸˺͙ˑʁ੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮˦˺͐੮ɻ˺̹ͅੴ੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮ ͐˺੮͙̼ʡʇ˦͐੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘˑˑͅੳ਄੮îʩʇ੮̹͙ͅʩ੮͐˺੮̼ʇʁ͙ɻʇ੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮̹˺ˑʮɻʇ੮ɘɻɻʇˑʇ̼ɘ͐ʇʁ੮ ɘɻ̼˺ͅͅ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮ˦੮͐ʩʇ੮͸ɘˌʇ੮˺ʠ੮̹̼˺͐ʇ͐ͅͅ੮ɘʡɘʮ˦͐ͅ੮͐ʩʇ੮˚͙̼ʁʇ̼੮˺ʠ੮Iʇ˺̼ʡʇ੮Hˑ˺;ʁੴ੮ɘ੮ "ˑɘɻˌ੮˚ɘ˦੮͙ͅʠʠ˺ɻɘ͐ʇʁ੮ɺ;੮ɘ੮{ʮ˦˦ʇɘ̹˺ˑʮͅ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ੴ੮ʮ˦੮৲ৰ৲ৰੳৼ৻੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ {ɘ;˺̼੮r˺˦ʁ˺˦੮"̼ʇʇʁ੮ʇ˚ɺ̼ɘɻʇʁ੮ä#Ûî੮ɘͅ੮̹ɘ̼͐੮˺ʠ੮ɘ੮ુɻ˺˚˚ʮ͐˚ʇ˦͐੮͐˺੯ੳ੯ੳ੯ੳ੮̼ʇʁ͙ɻʇ੮ ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮ʇ˦ɻ˺͙˦͐ʇ̼ͅ੮ɘ˦ʁ੮͙˦˦ʇɻʇͅͅɘ̼;੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮͙ͅʇ੮ɺ;੮̹̼˺ͷʮʁʮ˦ʡ੮̼ɘ̹ʮʁੴ੮̼͐ɘ͙˚ɘચʮ˦ʠ˺̼˚ʇʁ੮̼ʇ̹ͅ˺˦ͅʇયͅર੮͐˺੮ͅʇ̼ͷʮɻʇ੮ɻɘˑˑͅ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮ ɺʇʩɘͷʮ˺̼ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɻ̼ʮͅʇͅੳૂৼৼ੮ Û͙˦੮ ɺ;੮ ͐ʩʇ੮ ϲʮ̼ʇ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ ͐ʩʇ੮ ̹̼˺ʡ̼ɘ˚੮ ˈ˺ʮ˦ͅ੮ ɘ੮̹ɘ̼ɘ˚ʇʁʮɻੴ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮ˦ʮɻʮɘ˦ੴ੮ɘ˦ʁ੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐੮͸˺̼ˌʇ̼ੳ੮îʩʇ੮ˑɘ͐ͅ੮ʮͅ੮͐ʩʇ੮ ̹̼˺ʡ̼ɘ˚ૄͅ੮˚˺͐ͅ੮ʮ˦˦˺ͷɘ͐ʮͷʇ੮ʠʇɘ͙̼͐ʇੳ ";੮͐ʩʇ੮͐ʮ˚ʇ੮U੮̼˺ˑˑ੮˺͙͐੮͸ʮ͐ʩ੮͐ʩʇ˚੮ʮ˦੮ʇɘ̼ˑ;੮৲ৰ৲৲ੴ੮ä#Ûî੮ʮͅ੮˺̹ʇ̼ɘ͐ʮ˦ʡ੮৲৴ઃ৷੮ɘ˦ʁ੮ ̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮ ͐˺੮ ʩ͙˦ʁ̼ʇʁͅ੮ ˺ʠ੮ ɻɘˑˑͅ੮ ɘ੮ ˚˺˦͐ʩੳ੮ Ĕʩʇ˦੮ U੮ ɻˑʮ˚ɺ੮ ʮ˦͐˺੮ ͐ʩʇ੮ ̼ʮʡ੮ ͸ʮ͐ʩ੮ ɘ੮ ͙̹ͅʇ̼ͷʮͅ˺̼ੴ੮͐ʩʇ੮ͅɻ̼ʇʇ˦੮ʮͅ੮ɘˑ̼ʇɘʁ;੮̹˺̹̹ʮ˦ʡ੮͙̹੮͸ʮ͐ʩ੮৹ৱৱ੮ɻɘˑˑͅ੮ɺʇʮ˦ʡ੮ʁʮͷʇ̼͐ʇʁ੮ʠ̼˺˚੮ ͐ʩʇ੮̹˺ˑʮɻʇੵ੮ુ˚ɘ˦੮˦ʇͽ͐੮͐˺੮ɺ̼˺ˌʇ˦੮ʡˑɘͅͅ੮ɘ˦ʁ੮ʡɘ̼ɺɘʡʇ੮˺˦੮ͅʮʁʇ͸ɘˑˌੴૂ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮˺̼੮ ુ͸˺˚ɘ˦੮ʮ˦੮̼͐ͅʇʇ͐ੴ੮͸̼ʮ͐ʩʮ˦ʡ੮˺˦੮͐ʩʇ੮ʡ̼˺͙˦ʁੴ੮͸ʮ͐ʩ੮ʩʇɘʁ̹ʩ˺˦ʇͅੳૂ੮{˺͐ͅ੮ɻɘˑˑͅ੮͐ʩɘ͐੮ʡ˺੮ ͐˺੮ä#Ûî੮ɘ̼ʇ੮˚ɘʁʇ੮ɺ;੮͐ʩʮ̼ʁ੮̹ɘ̼͐ʮʇͅ੮ɘɺ˺͙͐੮ͅ˺˚ʇ˺˦ʇ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ˌ˦˺͸ੳ੮îʩʇ੮˚ɘˈ˺̼ʮ͐;੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

251

ɘ̼ʇ੮ϲˑɘʡʡʇʁ੮ɘͅ੮ુʮ˚̹͙ˑͅʮͷʇ੮˺̼੮ʁʮ̼͙̹͐ͅʮͷʇ੮ɺʇʩɘͷʮ˺̼ੴૂ੮͸ʮ͐ʩ੮ɘ੮ͅ˚ɘˑˑʇ̼੮˦͙˚ɺʇ̼੮ɻˑɘͅͅʮϲʮʇʁ੮ɘͅ੮ુ̹˺˺̼੮ͅʇˑʠચɻɘ̼ʇ੮˺̼੮͙̹ͅͅʇɻ͐ʇʁ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੳૂৼ৽ š͙̼੮ϲʮ̼͐ͅ੮ɻɘͅʇ੮ʠɘˑˑͅੴ੮˺˦੮ϲʮ̼͐ͅ੮ɺˑ͙ͅʩੴ੮ʮ˦͐˺੮ɺ˺͐ʩ੮ɻɘ˚̹ͅੳ੮ɻɻ˺̼ʁʮ˦ʡ੮͐˺੮͐ʩʇ੮ɻɘˑˑʇ̼ੴ੮ ͐ʩʇ੮˚ɘ˦੮ʩɘͅ੮ુ͐ʩ̼ʇʇ੮ͅʩ˺̹̹ʮ˦ʡ੮ɻɘ̼͐ͅૂ੮ɘ˦ʁ੮ુ;ʇˑˑͅ੮ɘ˦ʁ੮ͅɻ̼ʇɘ˚ͅ੮ɘˑˑ੮ʁɘ;ੳૂ੮Ĕʇ੮ϲʮ˦ʁ੮ʩʮ˚੮ ͅʮ͐͐ʮ˦ʡ੮˺͙͐ͅʮʁʇ੮͐ʩʇ੮ʁ˺˺̼੮˺ʠ੮ɘ੮ɻɘʠʋੴ੮̼˺ɻˌʮ˦ʡ੮ɺɘɻˌ੮ɘ˦ʁ੮ʠ˺̼͐ʩੴ੮͸ʇɘ̼ʮ˦ʡ੮ͅ͸ʇɘ̹͐ɘ˦͐ͅ੮ ̼˺ˑˑʇʁ੮͙̹੮ͅ˺੮͸ʇ੮ɻɘ˦੮ͅʇʇ੮ɘ੮̹ʇʇˑʮ˦ʡੴ੮ɻʩɘʠʇʁ੮ˑʇʡੳ੮Ĕʇ੮ɺ͙;੮ʩʮ˚੮ɘ੮ɻ˺ʠʠʇʇੳ੮Pʇ੮ɘͅˌͅ੮ʠ˺̼੮ ͅ˺˚ʇ੮ˑ˺͐ʮ˺˦ੴ੮͸ʩʮɻʩ੮͸ʇ੮ʁ˺˦ૄ͐੮ʩɘͷʇੳ੮îʩʇ੮͙̹ͅʇ̼ͷʮͅ˺̼੮ʮͅ੮ɻ˺˦ϲʮʁʇ˦͐੮ʩʇૄͅ੮ɘˑ̼ʇɘʁ;੮˺˦੮͐ʩʇ੮ ̼ɘʁɘ̼੮˺ʠ੮͐ʩʇ੮ɻʮ͐;ૄͅ੮ˑ˺˦ʡʇ̼ચ͐ʇ̼˚੮ʩ˺˚ʇˑʇͅͅ੮˺͙̼͐ʇɘɻʩ੮͐ʇɘ˚ੴ੮͸ʩʮɻʩ੮ʮͅ੮ɘ੮ɺʇ͐͐ʇ̼੮ϲʮ͐੮ʠ˺̼੮ ʩʮͅ੮˦˺͐ચͷʇ̼;ચɘɻ͙͐ʇ੮͐ͅɘ͐ʇੳ੮#ɘˑˑ੮ɻˑʇɘ̼ʇʁੳ îʩʇ੮˦ʇͽ͐੮ɻɘˑˑ੮ʮͅ੮ʠ˺̼੮ɘ੮͸˺˚ɘ˦੮̼ʇ̹˺̼͐ʇʁ੮ɘͅ੮ુ͐ʩ̼˺͸ʮ˦ʡ੮͐ʩʮ˦ʡͅ੮ɘ˦ʁ੮͸ɘͷʮ˦ʡ੮ɘ੮ɻ̼ɘɻˌ੮ ̹ʮ̹ʇੳૂ੮ Ĕʩʇ˦੮ ͸ʇ੮ ͅʩ˺͸੮ ͙̹ੴ੮ ͅʩʇૄͅ੮ ʁ˺ʮ˦ʡ੮ ʇͽɘɻ͐ˑ;੮ ͐ʩɘ͐੮ ફɘˑͅ˺੮ ʁɘ˦ɻʮ˦ʡ੮ ͐˺੮ ɘ੮ ɺˑɘ̼ʮ˦ʡ੮ ̹ͅʇɘˌʇ̼੮˦ʇͽ͐੮͐˺੮ʩʇ̼બੳ੮੮̹ʇʇ̼੮ʠ̼˺˚੮ɘ˦˺͐ʩʇ̼੮ä#Ûî੮͐ʇɘ˚੮ɘ˦ʁ੮ɘ˦੮˺͙̼͐ʇɘɻʩ੮͸˺̼ˌʇ̼੮ ɘ̼ʇ੮͐ɘˑˌʮ˦ʡ੮͐˺੮ʩʇ̼ੳ੮îʩʇ੮͸˺̼ˌʇ̼੮ɻ˺˚ʇͅ੮͙̹੮͐˺੮˺͙̼੮͸ʮ˦ʁ˺͸੮ɘ˦ʁ੮͐ʇˑˑͅ੮͙ͅੴ੮ૃͅʩʇૄͅ੮ˈ͙͐ͅ੮ ͙ͅʮ˦ʡ੮ય͙ͅɺ͐ͅɘ˦ɻʇͅર੮ɘ˦ʁ੮ɺʇʮ˦ʡ੮̼͙ʁʇੳ੮U͐੮ʁ˺ʇͅ˦ૄ͐੮ʇͷʇ˦੮ˑ˺˺ˌ੮ˑʮˌʇ੮ͅʩʇૄͅ੮ʩɘͷʮ˦ʡ੮ɘ੮ɺɘʁ੮ ʁɘ;ੳ੮äʩʇૄͅ੮˦˺͐੮ʡ˺ʮ˦ʡ੮ɘ˦;͸ʩʇ̼ʇੳૄ੮Ĕʇૄ̼ʇ੮ʮ˦੮͐ʩʇ੮îʇ˦ʁʇ̼ˑ˺ʮ˦ੴ੮ɘ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁ੮͸ʮ͐ʩ੮ɘ੮ ʩ;̹ʇ̼ચɻ˺˦ɻʇ˦̼͐ɘ͐ʮ˺˦੮˺ʠ੮͙˦ͅʩʇˑ͐ʇ̼ʇʁ੮ʩ˺˚ʇˑʇͅͅੳ੮U͐ૄͅ੮ʩɘ̼ʁ੮͐˺੮ˌ˦˺͸੮͸ʩ;੮͐ʩʮͅ੮ɺʇʩɘͷʮ˺̼੮͐ͅ˺˺ʁ੮˺͙͐੮ʇ˦˺͙ʡʩ੮͐˺੮˚ʇ̼ʮ͐੮ɘ੮৹ৱৱ੮ɻɘˑˑੳ Ĕʇ੮ʩʇɘʁ੮͐˺੮ɘ੮ˑʇɘʠ;੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁੴ੮ή͙ʮʇ͐੮ͅɘͷʇ੮ʠ˺̼੮ɘ˦੮˺ˑʁ੮˚ɘ˦੮ɻ͙̼ˑʇʁ੮ ͙̹੮˺˦੮ɘ੮ͅʮʁʇ੮̼͐ͅʇʇ͐ੴ੮ʩɘͷʮ˦ʡ੮ɘ੮ˑ˺͙ʁ੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮͸ʮ͐ʩ੮ʩʮ˚ͅʇˑʠੳ੮îʩʇ̼ʇૄͅ੮ɘˑ̼ʇɘʁ;੮ɘ੮ ̹ɘ̼ɘ˚ʇʁʮɻ੮ʩʇ̼ʇੴ੮ɘ˦ʁ੮ʩʇ੮͐ʇˑˑͅ੮͐ʩʇ੮͙̹ͅʇ̼ͷʮͅ˺̼੮͐ʩʇ੮˚ɘ˦੮ʮͅ੮ɘˑʇ̼͐ੴ੮˺̼ʮʇ˦͐ʇʁੴ੮ɘ̹̹̼˺̹̼ʮɘ͐ʇˑ;੮ʁ̼ʇͅͅʇʁ੮ʠ˺̼੮͐ʩʇ੮ɻˑʮ˚ɘ͐ʇੴ੮ɘ˦ʁ੮ɘɻɻʇ̹͐ʮ˦ʡ੮ʠ˺˺ʁੳ੮ફä#Ûî੮ͷɘ˦ͅ੮ʩɘͷʇ੮̹̼ʇ̹̼ʇ̹ɘ̼ʇʁ੮ ˚ʇɘˑͅ੮͐ʩʇ;੮ɻɘ˦੮ʩʇɘ͐੮ɘ˦ʁ੮ʩɘ˦ʁ੮˺͙͐ੳબ੮îʩʇ੮͙̹ͅʇ̼ͷʮͅ˺̼੮ʇ˦ɻ˺͙̼ɘʡʇͅ੮˚ʇ੮͐˺੮ʡ˺੮͐ɘˑˌ੮͐˺੮ ʩʮ˚ੳ੮ુˑʇ̼͐੮ɘ˦ʁ੮˺̼ʮʇ˦͐ʇʁૂ੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮ʁʇϲʮ˦ʇʁ੮ʇͽ̹ɘ˦ͅʮͷʇˑ;ੳ੮Pʇ੮ɻɘ˦ૄ͐੮̼ʇ˚ʇ˚ɺʇ̼੮ ʩ˺͸੮ˑ˺˦ʡ੮ʩʇૄͅ੮ɺʇʇ˦੮ʩ˺˚ʇˑʇͅͅ੮ɘ˦ʁ੮ͅɘ;ͅ੮ʩʇ੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ʡ˺੮͐˺੮ɘ੮ͅʩʇˑ͐ʇ̼੮ɺʇɻɘ͙ͅʇ੮ ʩʇ੮ʩɘͅ੮ɘ੮ʠ̼ʮʇ˦ʁ੮͸ʩ˺੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ʡʮͷʇ੮ʩʮ˚੮ɘ˦੮ɘ̹ɘ̼͐˚ʇ˦͐੮ɘ͐੮ɘ˦੮͙˦̹ͅʇɻʮϲʮʇʁ੮ʁɘ͐ʇ੮੮ ʮ˦੮͐ʩʇ੮ʠ͙͙̼͐ʇੳ੮Ĕʇ੮ʩʇɘʁ੮ɺɘɻˌ੮͐˺੮͐ʩʇ੮̼ʮʡੳ੮îʩʇ੮˚ɘ˦੮ʡ˺ʇͅ੮ɺɘɻˌ੮͐˺੮͐ɘˑˌʮ˦ʡੳ੮îʩʇ੮͙̹ͅʇ̼ͷʮͅ˺̼੮ ͐ʩʮ˦ˌͅ੮ ʩʇૄͅ੮ ˈ͙͐ͅ੮ ʩɘ̼ʁ੮ ˺ʠ੮ ʩʇɘ̼ʮ˦ʡ੮ ɘ˦ʁ੮ ʁ˺ʇͅ˦ૄ͐੮ ̼ʇɘˑʮΈʇ੮ ʩ˺͸੮ ˚͙ɻʩ੮ ˦˺ʮͅʇ੮ ʩʇૄͅ੮ ˚ɘˌʮ˦ʡੳ੮îʩʇ੮˦ʇʮʡʩɺ˺̼ͅ੮͸ʩ˺੮ɻɘˑˑʇʁ੮̹̼ʇ͙ͅ˚ɘɺˑ;੮ʁ˺ੳ îʩʇ੮ϲʮ̼͐ͅ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮̼ʇ̹˺̼͐੮˺˦੮ä#Ûî੮ɻ˺˦ϲʮ̼˚ʇʁ੮͸ʩɘ͐੮U੮ͅɘ͸੮˺˦੮˚;੮̼ʮʁʇચɘˑ˺˦ʡੵ੮ ͐ʩɘ͐ੴ੮ુʮ˦੮ˑʮ˦ʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ʩɘ̼˚ચ̼ʇʁ͙ɻ͐ʮ˺˦੮̹ʩʮˑ˺ͅ˺̹ʩ;੮͙˦ʁʇ̼̹ʮ˦˦ʮ˦ʡ੮ä#Ûîੴૂ੮৶৸੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ä#Ûî੮ɻˑʮʇ˦͐ͅ੮ɘ̼ʇ੮ˑʇʠ͐੮ʮ˦੮̹ˑɘɻʇ੮͸ʩʇ̼ʇ੮ુ͐ʩʇ;੮ʠʇʇˑ੮˚˺͐ͅ੮ɻ˺˚ʠ˺̼͐ɘɺˑʇ੮ɘ˦ʁ੮̹̼ʇʠʇ̼੮͐˺੮ɺʇੳૂ੮#ʩʮʇʠ੮äʮ˚˺˦੮Øɘ˦ʡੴ੮͸ʩ˺੮ʩʇɘʁͅ੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮̹ɘ̼ɘ˚ʇʁʮɻʮ˦ʇ੮͐ʇɘ˚੮ɘ͐੮ ͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ੴ੮˺͙͐ˑʮ˦ʇʁ੮͐ʩʇ੮͐;̹ʮɻɘˑ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ੵ੮ુä˺˚ʇ˺˦ʇ੮ʮͅ੮ʮ˦੮ɻ̼ʮͅʮͅੴ੮͐ʩʇ;੮ યɻ˺˚˚͙˦ʮ͐;੮˚ʇ˚ɺʇ̼ͅર੮ɻɘˑˑ੮͙ͅੴ੮͸ʇ੮ʡ˺ੳ੮Ĕʇ੮ʁʇચʇͅɻɘˑɘ͐ʇ੮͐ʩʇ˚ੴ੮ɺ;੮ʡʮͷʮ˦ʡ੮͐ʩʇ˚੮͐ʮ˚ʇੴ੮ ɺ;੮ˑʮ͐ͅʇ˦ʮ˦ʡ੮͐˺੮͐ʩʇ˚ੴ੮ɺ;੮ʡʮͷʮ˦ʡ੮͐ʩʇ˚੮ʠ˺˺ʁੳ੮îʩʇ;ૄ̼ʇ੮˦˺੮ˑ˺˦ʡʇ̼੮ͅʩ˺͙͐ʮ˦ʡੳ੮{ɘ;ɺʇ੮ ͐ʩʇ;ૄ̼ʇ੮˦˺੮ˑ˺˦ʡʇ̼੮˦ɘˌʇʁੴ੮ɺʇɻɘ͙ͅʇ੮͸ʇ੮ʡɘͷʇ੮͐ʩʇ˚੮ɻˑ˺͐ʩʇͅੳ੮˦ʁ੮˦˺͸੮͸ʇ੮ɘͅˌ੮͐ʩʇ˚ੴ੮

252

REFORM

ૃĔʩɘ͐੮ʁ˺੮;˺͙੮˦ʇʇʁ੮͐˺੮ʮ˚̹̼˺ͷʇ੮;˺͙̼੮ͅʮ͙͐ɘ͐ʮ˺˦੺੮#ɘ˦੮͸ʇ੮͐ɘˌʇ੮;˺͙੮ͅ˺˚ʇ͸ʩʇ̼ʇੴ੮͐˺੮ ͅʩʇˑ͐ʇ̼ੴ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ɘ੮ͅɘʠʇ੮̹ˑɘɻʇ੮͐˺੮̼ʇ͐ͅ੺ૄ੮˦ʁ੮͐ʩʇ;੮ͅɘ;੮ૃ˦˺ੳૄૂ Øɘ˦ʡ੮ ͸ʮͅʩʇͅ੮ ä#Ûî੮ ɻ˺͙ˑʁ੮ ̹͙͐੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ˺˦੮ ɘ੮ ̹ɘ͐ʩ͸ɘ;੮ ͐˺੮ ɘ੮ ɺ̼˺ɘʁʇ̼੮ ͅʇ͐੮ ˺ʠ੮ ͅʇ̼ͷʮɻʇͅੳ੮ U˦੮ ̹̼ɘɻ͐ʮɻʇੴ੮ ɘˑ͐ʩ˺͙ʡʩ੮ ä#Ûî੮ ˚ɘˌʇͅ੮ ̼ʇʠʇ̼̼ɘˑͅ੮ ͐˺੮ ͐ʩʇ੮ ɻʮ͐;ૄͅ੮ ˺͙̹͐ɘ͐ʮʇ˦͐੮ ̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅੴ੮ʠʇ͸੮͸ʮ˦ʁ੮͙̹੮ɻ˺˦˦ʇɻ͐ʮ˦ʡ੮ʮ˦੮ɘ˦੮ʇ˦ʁ͙̼ʮ˦ʡ੮͸ɘ;ੳৼ৾੮kʇ˦˦ʮʠʇ̼੮H̼ʮʇʁʇ˦ɺɘɻʩੴ੮ʠ̼˺˚੮͐ʩʇ੮ɻʮ͐;ૄͅ੮#˺ɘˑʮ͐ʮ˺˦੮˺˦੮P˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮̹˺ʮ˦͐ʇʁ੮˺͙͐੮͐ʩɘ͐੮ä#Ûî੮ુʮͅ੮ ʮ˦੮͐ʩʇ੮ʇ˦ʁ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ɘͅ੮ʇʠʠʇɻ͐ʮͷʇ੮ɘͅ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐ૄͅ੮ɺʇʩʮ˦ʁ੮͐ʩʇ˚ੴ੮ɘ˦ʁ੮͸ʩʇ͐ʩʇ̼੮ ͐ʩʇ;੮ʩɘͷʇ੮ɘ˦੮ɘɺʮˑʮ͐;੮͐˺੮̹ˑɘɻʇ੮̹ʇ˺̹ˑʇ੮ʮ˦੮ɺʇʁͅ੯ੳ੯ੳ੯ੳ੮˺͐ʩʇ̼͸ʮͅʇੴ੮ʮ͐ૄͅ੮ˈ͙͐ͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮͐ʩʇ੮ ̼ʇͷ˺ˑͷʮ˦ʡ੮ʁ˺˺̼੮͸ʩʇ̼ʇ੮યä#Ûîર੮ʮͅ੮ʡ˺ʮ˦ʡ੮˺͙͐੮͐˺੮͐ʩʇ੮̹ʇ̼ͅ˺˦ੴ੮͐ʩʇ;ૄ̼ʇ੮ʁʇચʇͅɻɘˑɘ͐ʮ˦ʡ੮ ͐ʩʇ੮ɻ̼ʮͅʇͅ੮˺ʠ੮͐ʩʇ੮˚˺˚ʇ˦͐ੴ੮˚ɘ;ɺʇ੮ʡʇ͐੮͐ʩʇ˚੮ɘɻɻʇͅͅ੮͐˺੮˚ʇʁͅੳ੯ੳ੯ੳ੯ੳ੮"͙͐੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮͅ੮ ͐ͅʮˑˑ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦ʁ੮͐ʩʇʮ̼੮˚ʇʁͅ੮ʡʇ͐੮͐ͅ˺ˑʇ˦੮˺̼੮ɻ˺˦ϲʮͅɻɘ͐ʇʁ੮ɺ;੮͐ʩʇ੮ɻʮ͐;੮યʁ͙̼ʮ˦ʡ੮ɘ੮ ʩ˺˚ʇˑʇͅͅ੮ʇ˦ɻɘ˚̹˚ʇ˦͐੮ͅ͸ʇʇ̹રੳૂ îʩʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮ʠʇɘ͙̼͐ʇ੮˺ʠ੮ä#Ûî੮ʮͅ੮͸ʩɘ͐੮ʮ͐੮ʁ˺ʇͅ˦ૄ͐੮ʁ˺ੳ੮š˦ˑ;੮৷੮̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ä#Ûî੮ɻ˺˦͐ɘɻ͐ͅ੮ˑʇɘʁ੮͐˺੮৵ৱ৵ৰͅੳৼ৿੮îʩʮͅ੮ʮͅ੮ɘ੮ͅʩɘ̼̹੮ʁʮʠʠʇ̼ʇ˦ɻʇ੮ɺʇ͐͸ʇʇ˦੮ä#Ûî੮ફɘ˦ʁ੮ ˺͐ʩʇ̼੮˦˺˦̹˺ˑʮɻʇ੮ɻ̼ʮͅʮͅ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅબ੮ɘ˦ʁ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੵ੮͐ʩʇ;੮ʩ˺̹ͅʮ͐ɘˑʮΈʇ੮̹ʇ˺̹ˑʇ੮ˑʇͅͅੳৼ਀੮îʩʇ̼ʇ੮ɘ̼ʇ੮͐ʇ˦ͅʮ˺˦ͅ੮ʩʇ̼ʇੳ੮U˦੮˚ɘ˦;੮ɻɘͅʇͅੴ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʮͅ੮ɻɘˑˑʮ˦ʡ੮৹ৱৱ੮ɺʇɻɘ͙ͅʇ੮ ͐ʩʇ;੮ ͸ɘ˦͐੮ ʇ˚ʇ̼ʡʇ˦ɻ;੮ ̼ʇ̹ͅ˺˦ʁʇ̼ͅ੮ ͐˺੮ ̼ʇ˚˺ͷʇ੮ ʩ˺˚ʇˑʇͅͅ੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ˺͙͐੮ ˺ʠ੮ ̹ˑɘɻʇੴ੮͸ɘ˦ʁʇ̼ʮ˦ʡ੮ʮ˦੮̹͙ɺˑʮɻ੮̼͐ɘ˦ͅʮ͐੮͐ͅɘ͐ʮ˺˦ͅ੮˺̼੮ʮ˦͐˺੮ʩʮʡʩʇ̼ચʮ˦ɻ˺˚ʇ੮˦ʇʮʡʩɺ˺̼ʩ˺˺ʁͅੳ੮ {˺ɺʮˑʇ੮ɻ̼ʮͅʮͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ʠ˺ɻ͙ͅੴ੮ʮ˦͐ͅʇɘʁੴ੮˺˦੮͐ͅɘɺʮˑʮΈʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦੮̹ˑɘɻʇੳ੮š˦ʇ੮˚˺ɺʮˑʇ੮ ɻ̼ʮͅʮͅ੮ɻˑʮ˦ʮɻʮɘ˦੮͐˺ˑʁ੮˚ʇੴ੮ૃĔʇ੮ɘ̼ʇ੮ɘˑ͸ɘ;ͅ੮ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼੮ɘ੮͸ɘ;੮͐˺੮͸ɘˑˌ੮ɘ͸ɘ;੮ɘ˦ʁ੮ʩɘͷʇ੮ ʮ͐੮˦˺͐੮ɺʇ੮͐˺͐ɘˑˑ;੮͙˦ʇ͐ʩʮɻɘˑੳૄ੮š˦ʇ੮ϲʮ̼͐ͅ੮̼ʇ̹ͅ˺˦ʁʇ̼ૄͅ੮͙ͅɻɻʇͅͅ੮ʮ˦੮ɘͷ˺ʮʁʮ˦ʡ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮͅ੮ɘ˦˺͐ʩʇ̼ૄͅ੮ʠɘʮˑ͙̼ʇੳ੮੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮Ø˺ˑʮɻʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ϲϲʮɻʇ̼੮ʠ͙˚ʇʁੴ੮ુU੮ ʩɘʁ੮યɘ੮ɻɘˑˑ੮ʠ˺̼ર੮ɘ੮ʡʇ˦͐ˑʇ˚ɘ˦੮͸ʮ͐ʩ੮˦˺੮̹ɘ˦͐ͅ੮ɘ˦ʁ੮͙˦ʁʇ̼͸ʇɘ̼ੴ੮ʩʇ੮͸ɘͅ੮ͷʇ̼;੮̹ͅ;ɻʩ˺͐ʮɻ੮ ɘ˦ʁ੮ͷʇ̼;੮ʇ˚ɺɘ̼̼ɘͅͅʇʁ੮ɘɺ˺͙͐੮ʮ͐ੳ੮Hʮˑ͐ʩ;ੴ੮ʁʮ̼͐;੯ੳ੯ੳ੯ੳ੮U੮ɻɘˑˑʇʁ੮યä#Ûîરੴ੮ɺ͙͐੮͸ʩʇ˦੮͐ʩʇ;੮ ɻ˺˚ʇੴ੮ ͐ʩʇ;੮ ʡʮͷʇ੮ ͐ʩʇ˚੮ ɘ੮ ͅɘ˦ʁ͸ʮɻʩ੮ ɘ˦ʁ੮ ͅɘ;੮ ͐ʩʇ;ૄ̼ʇ੮ ˦˺͐੮ ʩ˺ˑʁɘɺˑʇ੮ ͸ʩʇ˦੮ ͐ʩʇ;੮ ɘ̼ʇ੮ ʩ˺ˑʁɘɺˑʇੳ੮îʩʇ;੮યä#Ûîર੮ૃʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮͐ͅʮʡ˚ɘ͐ʮΈʇ੮ʩʮ˚ੳૄૂ ä#Ûîૄͅ੮ˑ˺͸ચˌʇ;੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮˚ʮʡʩ͐੮ͅʇʇ˚੮ʮˑˑ੮͙ͅʮ͐ʇʁ੮͐˺੮͐ʩʇ੮ʮ˦͐ʇ˦ͅʮ͐;੮˺ʠ੮͐ʩʇ੮ɻ̼ʮͅʇͅ੮̹ʇ̼ɻʇʮͷʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮˚ʇ˚ɺʇ̼ͅ੮ͅ˺ˑʮɻʮ͐ʮ˦ʡ੮͐ʩʇ˚ੳ੮"͙͐੮͐ʩʇ;੮˚ɘˌʇ੮ͅʇ˦ͅʇ੮ʮ˦੮ ɘ੮ͅ;͐ͅʇ˚੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮͸ʩʇ̼ʇ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮̼ɘ̼ʇˑ;੮ˑʇɘʁͅ੮͐˺੮ʇ˦ʁ͙̼ʮ˦ʡ੮ ɻʩɘ˦ʡʇੳ੮ ˑ͐ʩ˺͙ʡʩ੮ ͐ʩʇ̼ʇ੮ ɘ̼ʇ੮ ͅ˺˚ʇ੮ ʇͽɻʇ̹͐ʮ˺˦ͅઝ̹ʇ˺̹ˑʇ੮ ʩʮ͐͐ʮ˦ʡ੮ ̼˺ɻˌ੮ ɺ˺͐͐˺˚ੴ੮ ʡʇ͐͐ʮ˦ʡ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁੴ੮ϲʮ˦ɘˑˑ;੮ɘɻɻʇ̹͐ʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮˚˺ͷʮ˦ʡ੮ʮ˦͐˺੮ʩ˺͙ͅʮ˦ʡઝ͐ʩʇ੮ɺʇ͐ͅ੮͐ʩɘ͐੮ ˚˺͐ͅ੮৵ৱ৵ৰͅ੮ɘɻʩʮʇͷʇ੮ʮͅ੮͐ʇ˚̹˺̼ɘ̼ʮˑ;੮̼ʇ˚˺ͷʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ʠ̼˺˚੮ɘ੮ʁɘ˦ʡʇ̼˺͙ͅ੮ͅʮ͙͐ɘ͐ʮ˺˦ੳ੮ H˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɘ੮ˑ˺˦ʡચ̼͙˦˦ʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴ੮৵ৱ৵ৰͅ੮ɘ̼ʇ੮˺ʠ͐ʇ˦੮ɻ˺˚̹ˑʇ͐ʇˑ;੮̹˺ʮ˦͐ˑʇͅͅੳ੮ä͐ɘɺʮˑʮΈʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮˺˦੮͐ʩʇ੮ͅɻʇ˦ʇ੮͸ʮ͐ʩ੮ɘ੮ʩ˺͐੮˚ʇɘˑ੮ɘ˦ʁ੮ɘ੮ɻɘˑ˚੮ɻʩʇɻˌચʮ˦੮˚ʮʡʩ͐੮ ɘɻɻ˺˚̹ˑʮͅʩ੮ˈ͙͐ͅ੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅ੮ʮ˦੮ɘ˦੮/Ûੴ੮˚ʮ˦͙ͅ੮͐ʩʇ੮̹˺͐ʇ˦͐ʮɘˑ੮̼ʇ̼͐ͅɘʮ˦͐ͅ੮ɘ˦ʁ੮ ̼ʇ͙ͅˑ͐ɘ˦͐੮̼͐ɘ͙˚ɘੳ੮Iʮͷʇ˦੮͐ʩɘ͐੮৳ৱ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ä#Ûî੮ɻ˺˦͐ɘɻ͐ͅ੮ɘ̼ʇ੮͸ʮ͐ʩ੮"ˑɘɻˌ੮̹ʇ˺̹ˑʇੴ੮ ͅʮ˚̹ˑ;੮˦˺͐੮ʩɘͷʮ˦ʡ੮͐ʩʇͅʇ੮ɻɘˑˑͅ੮ʡ˺੮͐˺੮͐ʩʇ੮̹˺ˑʮɻʇ੮ʮͅ੮ɘ੮̼ʮͅˌચ̼ʇʁ͙ɻʮ˦ʡ੮ͷʮɻ͐˺̼;੮ʮ˦੮ʮ͐ͅʇˑʠੳৼਁ

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

253

îʩʇ̼ʇૄͅ੮ɘ੮˚˺̼ʇ੮ͷʇͽʮ˦ʡ੮ˑʮ˚ʮ͐੮͐˺੮˦˺˦̹˺ˑʮɻʇ੮̼ʇ̹ͅ˺˦ͅʇͅ੮ˑʮˌʇ੮ä#Ûîੳ੮îʩʇ੮̹̼˺ʡ̼ɘ˚ੴ੮ #ʩʮʇʠ੮ Øɘ˦ʡ੮ ͐˺ˑʁ੮ ˚ʇੴ੮ ʮͅ੮ ɘʮ˚ʮ˦ʡ੮ ͐˺੮ ̼ʇ̹ͅ˺˦ʁ੮ ͐˺੮ ৱৰৰ੮ ̹ʇ̼ɻʇ˦͐੮ ˺ʠ੮ "ચˑʇͷʇˑ੮ ৹ৱৱ੮ ̹˺ˑʮɻʇ੮ ɻɘˑˑͅੴ੮ʠ˺̼੮ુ˚ʇ˦͐ɘˑˑ;੮ʁʮ͙̼͐ͅɺʇʁ੮̹ʇ̼ͅ˺˦ͅૂ੮͸ʩ˺੮ɘ̼ʇ੮˦˺͐੮ͷʮ˺ˑʇ˦͐੮ɘ˦ʁ੮ʩɘͷʇ੮˦˺੮̼ʇ̹˺̼͐੮ ˺ʠ੮ɘ੮͸ʇɘ̹˺˦ੳ੮îʩʇ;ૄ̼ʇ੮˦˺͐ੴ੮ʠ˺̼੮͐ʩʇ੮˚˺˚ʇ˦͐ੴ੮ʩʇɘʁʮ˦ʡ੮͐˺੮ચˑʇͷʇˑ੮ɻɘˑˑͅੴ੮͸ʩʮɻʩ੮ɘ̼ʇ੮ ʠ˺̼੮ુ˚ʇ˦͐ɘˑˑ;੮ʁʮ͙̼͐ͅɺʇʁ੮̹ʇ̼ͅ˺˦ͅૂ੮͸ʩ˺੮ɘ̼ʇ੮ɘ̼˚ʇʁ੮˺̼੮ʁʇʇ˚ʇʁ੮̹˺͐ʇ˦͐ʮɘˑˑ;੮ʁɘ˦ʡʇ̼˺͙ͅੳ੮ Øʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ͅʇͷʇ̼ʇ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ɘ̼ʇ੮ ˺ͷʇ̼͸ʩʇˑ˚ʮ˦ʡˑ;੮ ˦˺͐੮ ͷʮ˺ˑʇ˦͐੮ ɘ˦ʁ੮ ʠɘ̼੮ ˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮ͷʮɻ͐ʮ˚ͅ੮͐ʩɘ˦੮̹ʇ̼̹ʇ̼͐ɘ͐˺̼ͅੳৼਂ੮Ěʇ͐੮ɘ˦;˺˦ʇ੮ˑ˺˺ˌʮ˦ʡ੮͐˺੮ɺ͙ʮˑʁ੮ɘ੮˚˺̼ʇ੮ ʩ͙˚ɘ˦ʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮˦ʇʇʁͅ੮͐˺੮ʡ̼ɘ̹̹ˑʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ʠɘɻ͐੮͐ʩɘ͐੮̹ͅ;ɻʩ˺ͅʮͅੴ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮͸ʩʇ˦੮ɻ˺͙̹ˑʇʁ੮͸ʮ͐ʩ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮ɻɘ˦੮ɺʇ੮ɘͅͅ˺ɻʮɘ͐ʇʁ੮͸ʮ͐ʩ੮ɘ˦੮ʇˑʇͷɘ͐ʇʁ੮ ̼ʮͅˌ੮˺ʠ੮ɻ˺˚˚ʮ͐͐ʮ˦ʡ੮ͷʮ˺ˑʇ˦͐੮ɘɻ͐ͅੳৼਃ {ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ɘ̼ʇ੮͙˦ʁʇ̼͐ͅɘ˦ʁɘɺˑ;੮̼ʇˑ͙ɻ͐ɘ˦͐੮͐˺੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮ɻ̼ʮͅʇͅ੮ ͐ʩɘ͐੮ͅʇʇ˚੮͐˺੮̹˺ͅʇ੮ɘ੮̼ʇɘˑ੮͐ʩ̼ʇɘ͐ੳ੮Ĕʩʇ˦੮U੮ͅʩɘʁ˺͸ʇʁ੮šϲϲʮɻʇ̼ͅ੮"̼ʮʡʡͅ੮ɘ˦ʁ੮Pɘ̼ʁʇ˦੮ ʮ˦੮ ˑɘ˚ʇʁɘ੮ #˺͙˦͐;ੴ੮ U੮ ˑʮ͐ͅʇ˦ʇʁ੮ ͐˺੮ ͐ʩʇ˚੮ ̹ˑʇɘʁ੮ ͙˦͙ͅɻɻʇͅͅʠ͙ˑˑ;੮ ʠ˺̼੮ ɘ੮ ɻˑʮ˦ʮɻʮɘ˦੮ ͐˺੮ ˈ˺ʮ˦੮͐ʩʇ˚੮ʮ˦੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮͐˺੮ɘ੮̹ʇ̼ͅ˺˦੮͸ɘͷʮ˦ʡ੮ˌ˦ʮͷʇͅ੮͐˺੮̹̼˺͐ʇɻ͐੮ʩʮ˚ͅʇˑʠ੮ʠ̼˺˚੮͐ʩʇ੮ ʁʇ˚˺˦ͅ੮ʮ˦੮ʩʮͅ੮ʩʇɘʁੳ੮)͙̼ʮ˦ʡ੮˚;੮ͷʮͅʮ͐੮͐˺੮)ʇͷ˺˦ૄͅ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮ɻ˺˚̹ˑʇͽੴ੮ͅʩʇ੮ ʩɘʁ੮ ɺʇʇ˦੮ ̹ʇ̼ͅʮ͐ͅʇ˦͐ˑ;੮ ̹ˑʇɘʁʮ˦ʡ੮ ʠ˺̼੮ ɘ੮ ˚˺ɺʮˑʇ੮ ɻ̼ʮͅʮͅ੮ ͐ʇɘ˚੮ ͐˺੮ ɻ˺˚ʇ੮ ˺͙͐੮ ɘ˦ʁ੮ ʩʇˑ̹੮ ͸ʮ͐ʩ੮ɘ੮̼ʇͅʮʁʇ˦͐੮͸ʩ˺ͅʇ੮̹ɘ̼ɘ˦˺ʮɘ੮ʁ̼˺ͷʇ੮ʩʮ˚੮͐˺੮ɺɘ̼̼ʮɻɘʁʇ੮ʩʮ˚ͅʇˑʠ੮ʮ˦੮ʩʮͅ੮͙˦ʮ͐੮͸ʮ͐ʩ੮ɘ੮ ɻ̼˺ͅͅɺ˺͸ੳ੮ͅ੮˚͙ɻʩ੮ɘͅ੮ɻ˺˚˚ʇ˦͐ɘ͐˺̼ͅ੮͸˺͙ˑʁ੮ˑʮˌʇ੮͐˺੮͐ɘˌʇ੮ɻ˺̹ͅ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʇή͙ɘ͐ʮ˺˦੮ ʇ˦͐ʮ̼ʇˑ;ੴ੮ʮ͐੮͐ͅʮˑˑ੮ͅʇʇ˚ͅੴ੮ɘͅ੮˺˦ʇ੮ͅʩʇ̼ʮʠʠ੮͐˺ˑʁ੮˚ʇੴ੮͐ʩɘ͐੮ુʠ˺̼੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇͅʇ੮ɻɘˑˑͅੴ੮;˺͙੮ ɻ˺͙ˑʁ੮ͅʇ˦ʁ੮˺͙͐੮äʮʡ˚͙˦ʁ੮H̼ʇ͙ʁ੮ɘ˦ʁ੮ʩʇૄʁ੮˦ʇʇʁ੮̹˺ˑʮɻʇ੮ɺɘɻˌચ͙̹ੳૂ îʩʇ̼ʇ੮ɘ̼ʇ੮͐͸˺੮̹˺ʮ˦͐ͅ੮͐˺੮˚ɘˌʇ੮ʩʇ̼ʇੳ੮š˦ʇ੮ʮͅ੮͐ʩɘ͐੮˦˺͐੮ɘˑˑ੮̹̼˺ɺˑʇ˚ɘ͐ʮɻ੮ɺʇʩɘͷʮ˺̼ͅ੮ ɘ̼ʇ੮ɺʇ͐ͅ੮ʁʇɘˑ͐੮͸ʮ͐ʩ੮ɺ;੮̹˺ˑʮɻʇ੮˺̼੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ફʇͷʇ˦੮äʮʡ˚͙˦ʁ੮H̼ʇ͙ʁબੳ੮ä˺˚ʇ੮˚ʮʡʩ͐੮ ɺʇ੮ɺʇ͐͐ʇ̼੮ɘʁʁ̼ʇͅͅʇʁ੮ɺ;੮ͅˌʮˑˑʇʁ੮ુͷʮ˺ˑʇ˦ɻʇ੮ʮ˦͐ʇ̼̼͙̹͐ʇ̼ͅૂ੮ફ̹ʮˑ˺͐ʇʁ੮ʮ˦੮#ʩʮɻɘʡ˺੮ʮ˦੮͐ʩʇ੮ ৱ৹৹ৰͅબ੮˺̼੮ɻ˺˚˚͙˦ʮ͐;ચˑʇʁ੮˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦ͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ɻ˺ˑˑʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੴ੮˦˺͐੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮̹ɘ͐ʩ˺ˑ˺ʡ;ੳৼ਄੮äʇɻ˺˦ʁੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮͙˦ʁʇ˦ʮɘɺˑʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ɻʩɘˑˑʇ˦ʡʇͅ੮ ͸ʩ˺੮ ɘ̼ʇ੮ ͅ˺੮ ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮ ͐ʩɘ͐੮ ͐ʇɘ˚ͅ੮ ˑʮˌʇ੮ ä#Ûî੮ ɻɘ˦˦˺͐੮ ʇ͐ʩʮɻɘˑˑ;੮ ͸ɘˑˌ੮ ɘ͸ɘ;ੴ੮ʇͷʇ˦੮ɘʠ͐ʇ̼੮ʡʮͷʮ˦ʡ੮ɘ੮ʩ˺͐੮˚ʇɘˑ੮ɘ˦ʁ੮ɘ੮ˑʮ͐ͅ੮˺ʠ੮ફʁʇɻˑʮ˦ʇʁબ੮̼ʇͅ˺͙̼ɻʇͅੳ੮H˺̼੮͐ʩ˺ͅʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ͅʩ˺̼͐ચ͐ʇ̼˚੮͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦੮͐ʩɘ͐੮ɘͷ˺ʮʁͅ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮͅ੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ͅʇ̹੮ ͐˺੮ɺ͙ʮˑʁʮ˦ʡ੮ɘ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮͷʇ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹ੳ੮"͙͐੮ʮ͐੮ɻɘ˦ૄ͐੮͐ͅ˺̹੮͐ʩʇ̼ʇੵ੮͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ˦ʇʇʁ੮͐˺੮ɺʇ੮ɻ˺˦ͷʮ˦ɻʇʁ੮͐˺੮ɘɻɻʇ̹͐੮ͅʇ̼ͷʮɻʇͅੳ

SERVICES: SNACKS, CIGARETTES, AND PSYCHOTROPIC MEDICATIONS "ʇɻɻɘ੮ͅʇʇ˚ͅ੮ˑʮˌʇ੮ɘ˦੮͙˦ˑʮˌʇˑ;੮ɻɘ˦ʁʮʁɘ͐ʇ੮͐˺੮ɺʇ੮ɘ੮ɻˑʮ˦ʮɻʮɘ˦੮ʮ˦੮ɘ˦੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̹̼˺ʡ̼ɘ˚ੳ੮äʩʇ੮ʡ̼ʇ͸੮͙̹੮ʮ˦੮{ɘ̼ʮ˦੮#˺͙˦͐;੮ɘ˦ʁ੮˚˺ͷʇʁ੮͐˺੮Ø˺̼͐ˑɘ˦ʁ੮ʠ˺̼੮ɻ˺ˑˑʇʡʇੴ੮͸ʩʇ̼ʇ੮

254

REFORM

ͅʩʇ੮͸ɘͅ੮ɘ˦੮ɘͷ˺͸ʇʁ੮ɘ˦ɘ̼ɻʩʮ͐ͅ੮ɘ˦ʁ੮ɻ˺˚˚͙˦ʮ͐;੮˺̼ʡɘ˦ʮΈʇ̼ੳ੮îʩʇ˦੮ɘʡɘʮ˦ੴ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ͅͅʮ͐ͅʇʁ੮š͙̹͐ɘ͐ʮʇ˦͐੮î̼ʇɘ͐˚ʇ˦͐੮ફšîબ੮͐ʇɘ˚ੴ੮͸ʩʇ̼ʇ੮ͅʩʇ੮˦˺͸੮͸˺̼ˌͅੴ੮ʮͅ੮˦˺͐੮ ή͙ʮ͐ʇ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;ੳ੮U͐੮ʮ˦͐ͅʇɘʁ੮˺̹ʇ̼ɘ͐ʇͅ੮ʮ˦੮ɘ੮ʡ̼ɘ;੮ɘ̼ʇɘ੮ɺʇ͐͸ʇʇ˦੮ʠ˺̼ɻʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮ ɻɘ̼ʇ੮ɘ˦ʁ੮ɘɻɻʇ̹͐ʮ˦ʡ੮͐ʩʇʮ̼੮ɻʩ˺ʮɻʇ੮͐˺੮̼ʇʠ͙ͅʇ੮ʮ͐ੳ੮Ĕʮ͐ʩ˺͙͐੮ɘ˦;੮̼ʇɘˑ੮ɻ˺ʇ̼ɻʮͷʇ੮ુ͐ʇʇ͐ʩੴૂ੮ ɘˑˑ੮ʩʇ̼੮͐ʇɘ˚੮ʩɘͅ੮ɘͷɘʮˑɘɺˑʇ੮͐˺੮̹̼ʇ͙̼ͅͅʇ੮̹ʇ˺̹ˑʇ੮͐˺੮ʇ˦ʡɘʡʇ੮ɘ̼ʇ੮ɻʮʡɘ̼ʇ͐͐ʇͅ੮ɘ˦ʁ੮ͅ˦ɘɻˌͅੳ੮ ˦ʁ੮͸ʮ͐ʩ੮ʇ˦˺͙ʡʩ੮̹ʇ̼ͅʮ͐ͅʇ˦ɻʇੴ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͐ɘˌʇ੮ͅ˦ɘɻˌͅ੮˚ʮʡʩ͐੮ʇͷʇ˦͙͐ɘˑˑ;੮ɘɻɻʇ̹͐੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮ɘ˦ʁ੮͐ʩʇ̼ɘ̹;ੳ îʩʇ੮šî੮˚˺ʁʇˑੴ੮ͅ˺˚ʇ੮ͷʇ̼ͅʮ˺˦੮˺ʠ੮͸ʩʮɻʩ੮ʇͽʮ͐ͅͅ੮ʮ˦੮ʠ˺̼͐;ચͅʇͷʇ˦੮͐ͅɘ͐ʇͅੴ੮ʮͅ੮ͅʮ˚̹ˑʇੵ੮ ɘ੮ˈ͙ʁʡʇ੮˺̼ʁʇ̼ͅ੮ɘ੮̹ʇ̼ͅ˺˦੮͐˺੮ɘɻɻʇ̹͐੮̼͐ʇɘ͐˚ʇ˦͐੮˺˦੮ɘ˦੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɺɘͅʮͅੴ੮͸ʮ͐ʩ੮ʠɘʮˑ͙̼ʇ੮ ͐˺੮ɻ˺˚̹ˑ;੮̹˺͐ʇ˦͐ʮɘˑˑ;੮ˑʇɘʁʮ˦ʡ੮͐˺੮ɺʇʮ˦ʡ੮̹ʮɻˌʇʁ੮͙̹੮ɺ;੮̹˺ˑʮɻʇ੮ʠ˺̼੮ɘ˦੮/Û੮ʇͷɘˑ͙ɘ͐ʮ˺˦ੳ৽৻੮ Ø̼˺̹˺˦ʇ˦͐ͅ੮˺ʠ੮šî੮ɻʇˑʇɺ̼ɘ͐ʇ੮ʮ͐੮ɘͅ੮ɘ੮ુˑʇͅͅચ̼ʇ̼͐ͅʮɻ͐ʮͷʇઃˑʇͅͅચʮ˦̼͙͐ͅʮͷʇૂ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ ͐˺੮ʮ˦̹ɘ͐ʮʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੶੮˺̹̹˺˦ʇ˦͐ͅ੮ͷʮʇ͸੮ʮ͐੮ɘͅ੮ɘ੮ુͅ˺ɻʮɘˑ੮ɻ˺˦̼͐˺ˑ੮˚ʇɻʩɘ˦ʮͅ˚੮ ʮ˦੮͐ʩʇ੮ʡ͙ʮͅʇ੮˺ʠ੮ɺʇ˦ʇͷ˺ˑʇ˦͐੮ɻ˺ʇ̼ɻʮ˺˦ૂ੮͐ʩɘ͐੮̼ʮͅˌͅ੮ʇ˦ʁˑʇͅͅˑ;੮͸ʮʁʇ˦ʮ˦ʡ੮̹ͅ;ɻʩʮɘ̼͐;ૄͅ੮ ˦ʇ͐ੳ৽ৼ੮U˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮̹˺ˑʮɻ;੮˚ɘˌʇ̼ͅ੮ʮ˦ɘ͙ʡ͙̼ɘ͐ʇʁ੮šî੮ʮ˦੮৲ৰৰৱ੮ɘͅ੮rɘ͙̼ɘૄͅ੮rɘ͸ੴ੮ɘʠ͐ʇ̼੮ rɘ͙̼ɘ੮Ĕʮˑɻ˺ͽੴ੮ɘ੮ɻˑʮ˦ʮɻ੮ͷ˺ˑ͙˦͐ʇʇ̼੮ˌʮˑˑʇʁ੮ɺ;੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮʇ˦͐੮͸ʩ˺੮͸ɘͅ੮˦˺͐੮ ͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮î˺੮ɘ͙ͅͅɘʡʇ੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮ɘʁͷ˺ɻɘ͐ʇͅੴ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ɺʮˑˑ੮ʮ˦ɻˑ͙ʁʇʁ੮ ˦˺੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮˚ʇɻʩɘ˦ʮͅ˚ੴ੮ɘˑˑ˺͸ʇʁ੮ˈ͙ʁʡʇͅ੮͐˺੮˺̼ʁʇ̼੮̹ʇ˺̹ˑʇ੮͐˺੮ͅʇʇ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɺ͙͐੮ ˦˺͐੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅੴ੮ɘ˦ʁ੮̹ʇ̼˚ʮ͐͐ʇʁ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ʁʇɻʮʁʇੴ੮ʮ˦ʁʮͷʮʁ͙ɘˑˑ;ੴ੮ʮʠ੮͐ʩʇ;੮ ͸ɘ˦͐ʇʁ੮ ͐˺੮ ˺̹͐੮ ʮ˦͐˺੮ ͐ʩʇ੮ ̹̼˺ʡ̼ɘ˚ੳ৽৽੮ U͐੮ ˺ʠʠʇ̼ʇʁ੮ ˦˺੮ ˦ʇ͸੮ ʠ͙˦ʁͅ੮ ʠ˺̼੮ ʁ˺ʮ˦ʡ੮ ͅ˺ੳ੮ š˦ʇ੮ ̹̼˺˚ʮ˦ʇ˦͐੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈʇʁ੮ʮ͐੮ɘͅ੮ɘ੮ુͅʩɘ˚੮ͅ;͐ͅʇ˚ੳૂ৽৾ äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ʮ˚̹ˑʇ˚ʇ˦͐ʇʁ੮šî੮ʮ˦੮৲ৰৱ৴੮˺˦ˑ;੮ɘ͐੮͐ʩʇ੮ʮ˦ͅʮ͐ͅʇ˦ɻʇ੮˺ʠ੮{ɘ;˺̼੮rʇʇੴ੮ ͸ʩ˺੮ͅɘʮʁ੮ʩʇ੮ુ̼ʇʠ͙ͅʇયʁર੮͐˺੮ˑʇ͐੮̹ʇ˺̹ˑʇ੮ʁʮʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘ˦;੮ˑ˺˦ʡʇ̼ૂ੮ફ͐ʩʮͅ੮͸ɘͅ੮ɺʇʠ˺̼ʇ੮ ʩʇ੮ ʁʇɻˑɘ̼ʇʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͸ɘͅ੮ ͐ʩʇ੮ ͅ˺ˑ͙͐ʮ˺˦੮ ͐˺੮ ͐ʩʇ੮ ͅɘ˚ʇ੮ ɻ˺˦ɻʇ̼˦બੳ৽৿੮ îʩʇ੮ ɻʮ͐;੮ ʩɘͅ੮ ɘ੮ ʁʇʁʮɻɘ͐ʇʁ੮ ͐ʇɘ˚੮ ͐ʩɘ͐੮ ͅʇ̼ͷʇͅ੮ ɻˑʮʇ˦͐ͅ੮ ̼ʇʠʇ̼̼ʇʁ੮ ͐˺੮ šîੴ੮ ɺ͙͐੮ ʮ͐੮ ̼ɘ̼ʇˑ;੮ ̹ˑɘɻʇͅ੮ ͐ʩʇ˚੮ ͙˦ʁʇ̼੮ ɘ੮ ɻ˺͙̼͐੮ ˺̼ʁʇ̼ੳ৽਀੮ {˺͐ͅ੮ ˺ʠ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ šî੮ ɻˑʮʇ˦͐ͅੴ੮ ͐ʩʇ˦ੴ੮ ˦ʇͷʇ̼੮ ʡʇ͐੮ɺʇ̼ɘ͐ʇʁ੮ɺ;੮ɘ੮ˈ͙ʁʡʇ੮͐ʇˑˑʮ˦ʡ੮͐ʩʇ˚੮͐˺੮ɻ˺˚̹ˑ;੮͸ʮ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮ɘ̼ʇ੮͐ʩ͙ͅ੮˦˺͐੮ ʇͷʇ˦੮͙ͅɺˈʇɻ͐ʇʁ੮͐˺੮͐ʩʇ੮˚͙ɻʩચʁʮ̹͙͐ͅʇʁ੮ુɺˑɘɻˌ੮̼˺ɺʇૂ੮ʇʠʠʇɻ͐੮ફ͸ʩʮɻʩ੮ʮͅ੮ɘ̹̹ˑʮʇʁ੮˚˺̼ʇ੮ ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮ʮ˦੮͐ʩʇ੮ɻʮ͐;ૄͅ੮#˺˚˚͙˦ʮ͐;੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚બੳ Øʇ˺̹ˑʇ੮ɘ̼ʇ੮ͅʇ˦͐੮͐˺੮šî੮͸ʩʇ˦੮͐ʩʇ;ૄͷʇ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮˚͙ˑ͐ʮ̹ˑʇ੮͐ʮ˚ʇͅ੮ɘͅ੮ɘ੮ ̼ʇ͙ͅˑ͐੮˺ʠ੮˦˺˦ɻ˺˚̹ˑʮɘ˦ɻʇ੮͸ʮ͐ʩ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮H˺̼੮ͅ˺˚ʇੴ੮ʮ͐ૄͅ੮͐ʩʇ੮ˑɘ͐ͅ੮ɻ˺˚˚͙˦ʮ͐;ચɺɘͅʇʁ੮ ͸ɘ;੮͐ͅɘ͐ʮ˺˦੮ɺʇʠ˺̼ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮"ʇɻɻɘ੮͐˺ˑʁ੮˚ʇ੮͐ʩɘ͐੮˺ʠ͐ʇ˦੮͐ʩʇ੮͐ʇɘ˚ૄͅ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʮˑˑ੮̹˺̹੮ʮ˦͐˺੮͐ʩʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮͙˦ʮ͐੮͸ʩʮˑʇ੮͐ʩʇ੮˦ʇ͸੮̼ʇʠʇ̼̼ɘˑ੮ʮͅ੮͐ͅʮˑˑ੮͐ʩʇ̼ʇ੮͐˺੮ͅʇʇ੮ʮʠ੮ ͐ʩʇ;ૄ̼ʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ʮ˦੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ુĔʇ੮ʩɘͷʇ੮ɘ੮̼ʇɘˑˑ;ੴ੮̼ʇɘˑˑ;੮ɘ˚ɘΈʮ˦ʡ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅੴૂ੮ ͅʩʇ੮ʇͽ̹ˑɘʮ˦ʇʁੴ੮ɺʇʠ˺̼ʇ੮ɘʁʁʮ˦ʡੴ੮ુɺ͙͐੮˚˺͐ͅ੮˺ʠ੮͐ʩʇ੮͐ʮ˚ʇ੮͐ʩʇ;੮યɻˑʮʇ˦͐ͅર੮ͅɘ;ੴ੮ૃH͙ɻˌ੮;˺͙ੴ੮ ˺˦ɻʇ੮U੮ʡʇ͐੮˺͙͐੮˺ʠ੮ʩʇ̼ʇੴ੮Uૄ˚੮˦˺͐੮͐ɘˌʮ˦ʡ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳૄૂ੮ä˺੮͸ʩʇ˦੮"ʇɻɻɘ੮˚ʇʇ͐ͅ੮͐ʩʇ˚ੴ੮ ͅʩʇ੮ ɘͷ˺ʮʁͅ੮ ͐ɘˑˌʮ˦ʡ੮ ɘɺ˺͙͐੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɘˑ͐˺ʡʇ͐ʩʇ̼ੳ੮ Pʇ̼੮ ̼͐ͅɘ͐ʇʡ;ੴ੮ ͅʩʇ੮ ή͙ʮ̹̹ʇʁੴ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

255

͐ͅɘ̼͐ͅ੮͸ʮ͐ʩ੮ુͅ˦ɘɻˌͅ੮ɘ˦ʁ੮ɻʮʡɘ̼ʇ͐͐ʇͅੳૂ੮Pʇ̼੮ɻˑʮʇ˦͐ͅ੮ʩɘͷʇ੮ુ;ʇɘ̼ͅ੮ɘ˦ʁ੮;ʇɘ̼ͅ੮ɘ˦ʁ੮;ʇɘ̼ͅ੮ ˺ʠ੮ɺʇʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ͅ;͐ͅʇ˚ੴ੮ɘ˦ʁ੮͐ʩʇ;੮ʁ˺˦ૄ͐੮ͅʇʇ੮ɘ˦;੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮ʮ͐ੳૂ੮ä˺੮ͅʩʇ੮ʡ̼ɘ̹ͅͅ੮ɘ͐੮ ɘ˦;͐ʩʮ˦ʡੵ੮ુrʇ͐੮˚ʇ੮͐ɘˌʇ੮;˺͙੮͐˺੮îɘ̼ʡʇ͐ੴ੮ˑʮ͐ͅʇ˦੮͐˺੮ɘ੮ͅ˺˦ʡੴ੮ɘ੮Ě˺͙î͙ɺʇ੮ͷʮʁʇ˺ੳ੯ੳ੯ੳ੯ੳ੮)˺੮ ;˺͙੮͸ɘ˦͐੮͐˺੮ʡʇ͐੮̼ʇɻ˺˦˦ʇɻ͐ʇʁ੮͐˺੮ɘ੮̹̼ʮ˚ɘ̼;੮ɻɘ̼ʇ੮ʁ˺ɻ͐˺̼੺ૂ ä˺˚ʇ੮ ˺ʠ੮ ͐ʩʇͅʇ੮ ɘ͐͐ʇ˚̹͐ͅ੮ ͐˺੮ ુ˚ʇʇ͐੮ ɻˑʮʇ˦͐ͅ੮ ͸ʩʇ̼ʇ੮ ͐ʩʇ;ૄ̼ʇ੮ ɘ͐ૂ੮ ͅ˺͙˦ʁ੮ ˑʮˌʇ੮ ͐ʩʇ੮ ɘ̹̹̼˺ɘɻʩ੮˺ʠ੮ɘ੮̼ʇʡ͙ˑɘ̼੮H͙ˑˑચäʇ̼ͷʮɻʇ੮Øɘ̼͐˦ʇ̼ͅʩʮ̹੮͐ʇɘ˚ੳ੮U͐ૄͅ੮̼͙͐ʇ੮͐ʩɘ͐੮šî੮˺̹ʇ̼ɘ͐ʇͅ੮ ˺˦੮ʇͅͅʇ˦͐ʮɘˑˑ;੮͐ʩʇ੮ͅɘ˚ʇ੮˚˺ʁʇˑ੮ફɘˑɺʇʮ͐੮͸ʮ͐ʩ੮ˑ˺͸ʇ̼੮ɻɘͅʇˑ˺ɘʁͅઝ"ʇɻɻɘ੮ʩɘͅ੮˺˦ˑ;੮ʇˑʇͷʇ˦੮ ɻˑʮʇ˦͐ͅબੳ੮ îʩʇ̼ʇૄͅ੮ ɘ੮ ˌʇ;੮ ʁʮʠʠʇ̼ʇ˦ɻʇੴ੮ ͐ʩ˺͙ʡʩੳ੮ ͅ੮ U੮ ͅɘ͸੮ ʮ˦੮ ˚;੮ ˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅ੮ ɘ͐੮ ͐ʩʇ੮ õ{P੮ɻˑʮ˦ʮɻੴ੮ɘ˦੮HäØ੮͸ʮˑˑ੮ɻˑ˺ͅʇ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ϲʮˑʇ੮˺˦ɻʇ੮͐ʩʇ;ૄͷʇ੮ͅɘʮʁ੮ુ˦˺ૂ੮͐˺੮̼͐ʇɘ͐˚ʇ˦͐੮ ɘ੮ʠʇ͸੮͐ʮ˚ʇͅ੮ફ͐ʩ̼ʇʇ੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮͐ʩʇ੮͐ͅɘ˦ʁɘ̼ʁ੮˦͙˚ɺʇ̼બੳ੮îʩʇ̼ʇૄͅ੮˦˺੮͸ɘ;੮ɘ̼˺͙˦ʁ੮ʮ͐ੵ੮ ;˺͙੮ɻɘ˦ૄ͐੮ɺʮˑˑ੮{ʇʁʮચ#ɘˑ੮ʠ˺̼੮˚ʇʁʮɻɘˑ੮ͅʇ̼ͷʮɻʇͅ੮;˺͙੮ɻɘ˦ૄ͐੮̹̼˺ͷʮʁʇੳ੮"͙͐੮͐˺੮ͅʇ̼ͷʇ੮͐ʩʇ੮ ͷʇ̼;੮ͅ˚ɘˑˑ੮˦͙˚ɺʇ̼੮˺ʠ੮ɻˑʮʇ˦͐ͅ੮˺˦੮šîੴ੮ɻ˺͙˦͐ʮʇͅ੮ʩɘͷʇ੮̹͙͐੮͙̹੮͐ʩʇʮ̼੮˺͸˦੮ʠ͙˦ʁͅ੮ફͷʮɘ੮ {Pä੮˺̼੮̼ʇɘˑʮʡ˦˚ʇ˦͐બੴ੮͸ʩʮɻʩ੮ɘˑˑ˺͸ͅ੮͐ʇɘ˚ͅ੮͐˺੮̹̼ʇͅͅ੮˺˦ੳ੮"ʇɻɻɘ੮̼ʇɻ˺͙˦͐ʇʁੴ੮ુä˺˚ʇ੮ ͐ʇɘ˚ͅ੮͸ʮˑˑ੮ɻˑ˺ͅʇ੮͐ʩʇ˚੮ય˺͙̼੮ɻˑʮʇ˦͐ͅર੮ɘͅ੮ͅ˺˺˦੮ɘͅ੮͐ʩʇ;੮ͅɘ;੮ૃʠ͙ɻˌ੮;˺͙ੳૄ੮ય"͙͐੮͸ʇ੮ˌ˦˺͸ર੮ ͐ʩʇ੮ɻˑʮʇ˦͐੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮͐ʇˑˑ੮;˺͙੮͐˺੮ʠ͙ɻˌ੮˺ʠʠੴ੮˚ɘ;ɺʇ੮͐ʩ̼ʇɘ͐ʇ˦੮;˺͙ੳ੮{˺ͷʇ੮˺˦ੳ੮Hʮʡ͙̼ʇ੮ ˺͙͐੮ʩ˺͸੮͐˺੮ʡʇ͐੮͐ʩ̼˺͙ʡʩ੮ʮ͐ੳ੯ੳ੯ੳ੯ੳ੮U͐ૄͅ੮˦˺͐੮ɘ੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮͐˺੮̹͙͐੮;˺͙̼੮ʩɘ˦ʁͅ੮͙̹੮ɘ˦ʁ੮˦˺͐੮ ʩɘͷʇ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;ੳૂ੮î˺੮ɺʇ੮ɻˑʇɘ̼ੴ੮šî੮͐ʇɘ˚ͅ੮ɻɘ˦ૄ͐੮ʡʮͷʇ੮ͅ˺˚ʇ˺˦ʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮˺̼੮ ͐ʩʇ̼ɘ̹;੮͙˦ˑʇͅͅ੮͐ʩɘ͐੮̹ʇ̼ͅ˺˦੮ͅɘ;ͅ੮ુ;ʇͅૂ੮͐˺੮͐ʩʇ˚ੳ੮U͐ૄͅ੮ˈ͙͐ͅ੮͐ʩɘ͐੮͐ʩʇ;੮ʁ˺˦ૄ͐੮͐ɘˌʇ੮ુ˦˺ૂ੮ ʠ˺̼੮ɘ˦੮ɘ˦ͅ͸ʇ̼ੳ੮ુU੮ɻɘˑˑ੮͙ͅ੮͐ͅɘˑˌʇ̼ͅੴ੮͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ɻ˺˚ʇ੮ϲʮ˦ʁ੮;˺͙੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮ ɘ˦ʁ੮ɺ͙;੮;˺͙੮ɻ˺ʠʠʇʇੳ੮Ĕʇૄ̼ʇ੮˦ʮɻʇ੮͐ͅɘˑˌʇ̼ͅੴ੮ɺ͙͐੮͸ʇૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ˌʇʇ̹੮ʡ˺ʮ˦ʡੴૂ੮ɘʁ˚ʮ͐͐ʇʁ੮ ɘ˦˺͐ʩʇ̼੮šî੮ɻˑʮ˦ʮɻʮɘ˦ੳ îʩʮͅ੮̼ʇˑʇ˦͐ˑʇͅͅੴ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮˺͙̼͐ʇɘɻʩ੮ʩɘͅ੮ͅʩ˺͸˦੮̼ʇ͙ͅˑ͐ͅੳ੮ä͐ɘ͐ʇ੮ʁɘ͐ɘ੮ͅʩ˺͸੮͐ʩɘ͐੮ ̹ɘ̼͐ʮɻʮ̹ɘ˦͐ͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮rɘ͙̼ɘૄͅ੮rɘ͸੮̹̼˺ʡ̼ɘ˚ͅ੮ʇͽʩʮɺʮ͐੮͙ͅɺ͐ͅɘ˦͐ʮɘˑ੮ʁʇɻ̼ʇɘͅʇͅ੮ʮ˦੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੴ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮ɘ˦ʁ੮ʇ˦ɻ˺͙˦͐ʇ̼ͅ੮͸ʮ͐ʩ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮ફɘˑ͐ʩ˺͙ʡʩ੮ ɘɻɘʁʇ˚ʮɻ੮͙͐ͅʁʮʇͅ੮ɘ̼ʇ੮˚˺̼ʇ੮ʇή͙ʮͷ˺ɻɘˑ੮˺˦੮šîૄͅ੮ʇʠʠʇɻ͐ʮͷʇ˦ʇͅͅબੳ৽ਁ੮ēʇ̼˺˦ʮɻɘ੮nʇˑˑ;ੴ੮ ͐ʩʇ੮ ʁʮ̼ʇɻ͐˺̼੮ ˺ʠ੮ äɘ˦੮ "ʇ̼˦ɘ̼ʁʮ˦˺ૄͅ੮ "ʇʩɘͷʮ˺̼ɘˑ੮ Pʇɘˑ͐ʩ੮ )ʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ ̼ʇ̹˺̼͐ʇʁ੮ ͐ʩɘ͐੮͐ʩʇʮ̼੮šî੮̹̼˺ʡ̼ɘ˚੮ɘɻʩʮʇͷʇʁ੮৹ৰ੮̹ʇ̼ɻʇ˦͐੮ુͷ˺ˑ͙˦͐ɘ̼;ૂ੮ʇ˦ʡɘʡʇ˚ʇ˦͐੮͸ʮ͐ʩ੮ʮ͐ͅ੮੮ ɻˑʮʇ˦͐ͅઝɘˑɺʇʮ͐੮ɘʠ͐ʇ̼੮ɘ੮͙˦;ʮʇˑʁʮ˦ʡ੮ɺɘ̼̼ɘʡʇ੮˺ʠ੮ʠ˺̼͐;੮ʠɘɻʇચ͐˺ચʠɘɻʇ੮˺͙̼͐ʇɘɻʩ੮ͷʮͅʮ͐ͅੳ৽ਂ੮ )ʇ̹ͅʮ͐ʇ੮šîૄͅ੮ɘ̼˚ચ͐͸ʮ͐ͅʮ˦ʡ੮ɘ̹̹̼˺ɘɻʩੴ੮U੮ʠ˺͙˦ʁ੮ͅ˺˚ʇ੮͙̼̹̼ͅʮͅʮ˦ʡ੮ɻ˺˦ͷʇ̼͐ͅੳ੮ુĔʇૄͷʇ੮ ɺʇʇ˦੮ɘͅˌʮ˦ʡ੮͐ʩʇ੮ɻ˺͙˦͐;੮͐˺੮ʇͽ̹ɘ˦ʁ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚ੴૂ੮ɘ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮͐˺ˑʁ੮˚ʇੳ੮ુH˺̼੮˺͙̼੮ɻˑʮʇ˦͐ͅੴ੮ʮ͐੮˚ʇɘ˦ͅ੮ɻ˺˚̹ˑʇ͐ʇ੮͸̼ɘ̹ɘ̼˺͙˦ʁ੮ͅʇ̼ͷʮɻʇͅ੮ɘ˦ʁ੮ʩʇˑ̹੮ ͸ʮ͐ʩ੮ʩ˺͙ͅʮ˦ʡੳ੮îʩʇ੮ɻ˺͙̼͐੮˚ʮʡʩ͐੮ͅɘ;੮;˺͙੮ʩɘͷʇ੮͐˺੮ʡ˺੮͐ʩʇ੮ɻˑʮ˦ʮɻੴ੮ɺ͙͐੮͐ʩʇ̼ʇૄͅ੮˦˺੮ʩɘ˚˚ʇ̼੮˺ʠ੮ૃUʠ੮;˺͙੮ʁ˺˦ૄ͐੮͐ɘˌʇ੮˚ʇʁͅੴ੮͸ʇૄˑˑ੮ʩ˺ˑʁ੮;˺͙੮ʁ˺͸˦੮ɘ˦ʁ੮ʮ˦ˈʇɻ͐੮;˺͙ੳૄ੮Ĕʇ੮ˑʮˌʇ੮͐ʩɘ͐ੳૂ੮ ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʮͅ੮˚͙̼ˌ;੮ɘ̼ʇɘ੮ɺʇ͐͸ʇʇ˦੮ુʠ˺̼ɻʇʁૂ੮ɘ˦ʁ੮ુͷ˺ˑ͙˦͐ɘ̼;ૂ੮ʮͅ੮͐ʩʇ੮̼ʮʡʩ͐੮̹ˑɘɻʇ੮ ͐˺੮˚ʇʇ͐੮ɻˑʮʇ˦͐ͅ੮͸ʩ˺੮ɘ̼ʇ੮͙˦ʁʇ̼͐ͅɘ˦ʁɘɺˑ;੮ʩ˺͐ͅʮˑʇ੮͐˺੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ɺ͙͐੮͸ʩ˺ͅʇ੮̼ʇʠ͙ͅɘˑ੮ʮͅ੮ ̹͙͐͐ʮ˦ʡ੮͐ʩʇ˚੮ɘ͐੮̼ʮͅˌ੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ

256

REFORM

#ˑʮ˦ʮɻʮɘ˦ͅ੮ˑʮˌʇ੮"ʇɻɻɘ੮ˌ˦˺͸੮͐ʩɘ͐੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʩʇˑ̹੮ͅʩ˺͙ˑʁ੮ʮ˦ɻˑ͙ʁʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ "͙͐੮ͅʩʇૄͅ੮͸ʇˑˑ੮ɘ͸ɘ̼ʇ੮͐ʩɘ͐੮ુ͸ʇૄˑˑ੮ʡʇ͐੮;˺͙੮ɘ੮̼ʇϲʮˑˑ੮˺ʠ੮͐ʩʇ੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻͅ੮;˺͙੮͸ʇ̼ʇ੮ ˺ɺˑʮʡɘ͐ʇʁ੮ ͐˺੮ ͐ɘˌʇ੮ ʮ˦੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑૂ੮ ʮͅ੮ ɘ੮ ɺɘʁ੮ ˺̹ʇ˦ʮ˦ʡ੮ ˺ʠʠʇ̼ੳ੮ U੮ ͸ɘͅ੮ ̼͙͐ͅɻˌ੮ ʮ˦੮ ˚;੮ ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮ʩ˺͸੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘʁ੮ˑʮͷʇʁ੮͐ʩ̼˺͙ʡʩ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʁʇͅɻ̼ʮɺʇʁ੮ ϲʮ˦ɘˑˑ;੮ ɻ˺˦˦ʇɻ͐ʮ˦ʡ੮ ͸ʮ͐ʩ੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ˺˦ɻʇ੮ ͐ʩʇ;੮ ̹̼˺ͷʮʁʇʁ੮ ͐ʩʇ˚੮ ͅʇʇ˚ʮ˦ʡˑ;੮ ɺɘ˦ɘˑ੮ ͐ʩʮ˦ʡͅੴ੮ˑʮˌʇ੮ʩʇˑ̹੮ʡʇ͐͐ʮ˦ʡ੮ɘ˦੮U)੮˺̼੮ɘ੮̼ʮʁʇ੮͐˺੮͐ʩʇ੮ʁʇ˦͐ʮ͐ͅੳ੮ä˺˚ʇ͐ʮ˚ʇͅੴ੮͐ʩ˺͙ʡʩੴ੮ɻ˺˦˦ʇɻ͐ʮ˦ʡ੮͸ʮ͐ʩ੮ɻˑʮʇ˦͐ͅ੮˚ʇɘ˦ͅ੮̼ʇˑʮ˦ή͙ʮͅʩʮ˦ʡ੮ɘ˦;੮ɘ̹ͅʮ̼ɘ͐ʮ˺˦੮͐˺੮̹̼˺ͷʮʁʇ੮ɘ˦;͐ʩʮ˦ʡ੮ɘˌʮ˦੮ ͐˺੮ͅʇ̼ͷʮɻʇͅੴ੮ɘ͐੮ˑʇɘ͐ͅ੮ʠ˺̼੮ɘ੮͸ʩʮˑʇੳ੮"ʇɻɻɘ੮ʮͅ˦ૄ͐੮ɺʮˑˑʮ˦ʡ੮{ʇʁʮચ#ɘˑ੮ɺ;੮͐ʩʇ੮˚ʮ˦͙͐ʇੴ੮͸ʩʮɻʩ੮ ˚ʇɘ˦ͅ੮ુU੮ɻɘ˦੮̹ͅʇ˦ʁ੮͐͸˺੮˚˺˦͐ʩͅ੮͸ʮ͐ʩ੮ɘ੮ɻˑʮʇ˦͐੮˦˺͐੮̹͙̼͙ͅʮ˦ʡ੮ɘ˦;੮̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ɻɘͅʇ੮ ˚ɘ˦ɘʡʇ˚ʇ˦͐੮ʡ˺ɘˑͅੴ੮ˈ͙͐ͅ੮ͅʮ͐͐ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇ˚੮˺˦੮ɘ੮ͅʮʁʇ͸ɘˑˌੴ੮ͅ˚˺ˌʮ˦ʡ੮ɘ੮ɻʮʡɘ̼ʇ͐͐ʇੴ੮ʠ˺̼੮ ɘ੮ɻ˺͙̹ˑʇ੮ʩ˺͙̼ͅ੮ɘ੮͸ʇʇˌੴ੮ʁ˺ʮ˦ʡ੮˦˺͐ʩʮ˦ʡੳૂ੮îʩʇ˦ੴ੮ɘ͐੮ͅ˺˚ʇ੮̹˺ʮ˦͐ੴ੮ુ;˺͙੮ɻɘ˦੮͐ʇˑˑ੮͐ʩʇ˚ੴ੮ ૃU੮͐ʩʮ˦ˌ੮ʮ͐ૄͅ੮͐ʮ˚ʇ੮͐˺੮̼͐;੮ɘ˦੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻૄ੮ɘ˦ʁ੮ʩɘͷʇ੮͐ʩɘ͐੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇ˚ੴ੮ ɘ˦ʁ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩɘ͐੮ɻ˺˦˦ʇɻ͐ʮ˺˦ੴ੮͐ʩɘ͐੮̼ʇˑɘ͐ʮ˺˦ɘˑ੮͸˺̼ˌੴ੮͐ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮˺̹ʇ˦੮͐˺੮ʁ˺ʮ˦ʡ੮ ͐ʩɘ͐ੳ੮U͐੮ɻɘ˦੮ɺʇ੮̼ʇɘˑˑ;੮ɺʇɘ͙͐ʮʠ͙ˑੳૂ šî੮ʩɘͅ੮̹̼˺ͷʇ˦੮ɺɘͅʮɻɘˑˑ;੮͙ͅʇˑʇͅͅ੮ʠ˺̼੮ͅʇͷʇ̼ɘˑ੮ɻʩɘ̼ɘɻ͐ʇ̼ͅ੮ʮ˦੮͐ʩʮͅ੮ɺ˺˺ˌੳ੮"͙͐੮ʮ͐ͅ੮ ʇ˚̹ʩɘͅʮͅ੮˺˦੮̹ʇ̼ͅʮ͐ͅʇ˦ɻʇ੮ɘ˦ʁ੮̹̼˺ͷʮʁʮ˦ʡ੮͐ʩʇ੮ͅʇ̼ͷʮɻʇͅ੮̹ʇ˺̹ˑʇ੮͸ɘ˦͐੮ફU)ͅ੮ɘ˦ʁ੮ɘ̹ɘ̼͐˚ʇ˦͐ͅ੮˺ͷʇ̼੮˚ʇʁͅ੮ɘ˦ʁ੮͐ʩʇ̼ɘ̹;બ੮ɘͅ੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ͅʇ̹੮ʮ˦੮ɺ͙ʮˑʁʮ˦ʡ੮ɘ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮͷʇ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮ͅʩ˺͙ˑʁ੮ɺʇ੮ʮ˦ɻ˺̼̹˺̼ɘ͐ʇʁ੮ʇͷʇ̼;͸ʩʇ̼ʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮U͐੮ʩʇˑ̹ͅ੮ʇ˦͙̼ͅʇ੮ ͐ʩɘ͐ੴ੮͸ʩʇ˦੮ɻ˺ʇ̼ɻʮ˺˦੮ʮͅ੮͙ͅʇʁੴ੮ʮ͐ૄͅ੮ͅʩ˺̼͐੮ɘ˦ʁ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ɺʇ੮͐ʩʇ੮ˑɘ͐ͅ੮͐ʮ˚ʇੳ r˺ʡɘ˦ੴ੮ɘ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮͸ʩ˺੮˺ͷʇ̼ͅʇʇͅ੮ɘ˦੮šî੮͐ʇɘ˚ੴ੮˺ʠʠʇ̼ʇʁ੮͙ͅɻʩ੮ɘ˦੮ʇͽɘ˚̹ˑʇੵ੮ ુPʇ੮ ͸ɘͅ੮ ɘ੮ ɺʮʡ੮ ʡ͙;ੴ੮ ͐ɘ͐͐˺˺ͅੴ੮ ˺ʠ͐ʇ˦੮ ͸ʮ͐ʩ˺͙͐੮ ɘ੮ ͅʩʮ̼͐ੴ੮ ̹˺˺̼ˑ;੮ ʁ̼ʇͅͅʇʁੴ੮ ͐ʩ̼ʇɘ͐ʇ˦ʮ˦ʡ੮ ̹ʇ˺̹ˑʇੴ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʇͽ̹˺ͅʮ˦ʡ੮ʩʮ˚ͅʇˑʠੴ੮ˈ͙͐ͅ੮̼ʇɘˑˑ;੮ʇ̼̼ɘ͐ʮɻੳ੮Pʇ੮͸˺͙ˑʁ੮̼͐ʇ̹ͅɘͅͅ੮ʮ˦੮ɘ੮ ɻ˺˦̼͙͐ͅɻ͐ʮ˺˦੮ͅʮ͐ʇ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ͷɘ˦ʁɘˑʮΈʇ੮ʮ͐ੳૂ੮Pʇ੮ʩɘʁ੮ુʁʇϲʮ˦ʮ͐ʇˑ;੮˦˺͐੮͐ʩʇ੮͸˺̼͐ͅ੮ɺʇʩɘͷʮ˺̼ͅ੮ Uૄͷʇ੮ͅʇʇ˦ૂઝr˺ʡɘ˦੮ʩɘʁ੮͸˺̼ˌʇʁ੮͸ʮ͐ʩ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ુ͸ʩ˺੮ˌʮˑˑʇʁ੮̹ʇ˺̹ˑʇੴ੮ʁ˺˦ʇ੮̼ʇɘˑˑ;੮ ɘ͸ʠ͙ˑ੮͐ʩʮ˦ʡͅૂઝɺ͙͐੮ʩʇ੮˦˺˦ʇ͐ʩʇˑʇͅͅ੮ુʮ˦̹ͅʮ̼ʇʁ੮͐ʩʮͅ੮˺͙͐ͅʮΈʇʁ੮ɘ˦ʡ͐ͅૂ੮ʮ˦੮͐ʩʇ੮ɘϲϲˑ͙ʇ˦͐੮ ɘ̼ʇɘ੮ʩʇ੮ʠ̼ʇή͙ʇ˦͐ʇʁੳ੮r˺ɻɘˑͅ੮ʇͷʇ˦੮͐ͅɘ̼͐ʇʁ੮ɘ੮î͸ʮ͐͐ʇ̼੮ɘɻɻ˺͙˦͐੮͐˺੮ʁ˺ɻ͙˚ʇ˦͐੮ʩʮͅ੮ɺʇʩɘͷʮ˺̼੮ɘ˦ʁ੮̹͙͐੮̹̼ʇ͙̼ͅͅʇ੮˺˦੮͐ʩʇ੮ɻʮ͐;ੳ Ĕʮ͐ʩ੮r˺ʡɘ˦ૄͅ੮ʇ˦ɻ˺͙̼ɘʡʇ˚ʇ˦͐ੴ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Ø͙ɺˑʮɻ੮Pʇɘˑ͐ʩ੮ુʡ̼ʇɘͅʇʁ੮͐ʩʇ੮ ͸ʩʇʇˑͅૂ੮͐˺੮ɻ˺˦ͷʮ˦ɻʇ੮äH੮Iʇ˦ʇ̼ɘˑ੮P˺̹ͅʮ͐ɘˑ੮͐˺੮ɘʁ˚ʮ͐੮ʩʮ˚੮˺˦੮ɘ੮৵ৱ৵ৰੳ੮Ĕʮ͐ʩʮ˦੮ɘ੮ʁɘ;ੴ੮ ͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮ʩʮͅ੮˚ɘʮ˦੮̹̼˺ɺˑʇ˚੮͸ɘͅ੮˚ʇ͐ʩੴ੮˦˺͐੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮ͅ˺੮ʩʇ੮ ͸˺͙ˑʁ੮ɺʇ੮̼ʇˑʇɘͅʇʁੳ੮r˺ʡɘ˦੮ɘ˦ʁ੮ʩʮͅ੮͐ʇɘ˚੮ુ͸ʇ˦͐੮͐ʩɘ͐੮ʁɘ;੮યɘ˦ʁર੮˺ʠʠʇ̼ʇʁ੮ʩʮ˚੮ͅʇ̼ͷʮɻʇͅੳ੮ Pʇ੮ ͸ɘͅ੮ ˌʮ˦ʁ੮ ˺ʠ੮ ɘ˚ɺʮͷɘˑʇ˦͐੮ ɺ͙͐੮ ɘʡ̼ʇʇʁ੮ ͐˺੮ ͅʮʡ˦੮ ͙̹ੳૂ੮ îʩʇ;੮ ̹͙͐੮ ʩʮ˚੮ ʮ˦੮ ɘ੮ äʮ˦ʡˑʇ੮ Û˺˺˚੮šɻɻ͙̹ɘ˦ɻ;੮ʩ˺͐ʇˑ੮ʮ˦੮͐ʩʇ੮îʇ˦ʁʇ̼ˑ˺ʮ˦ੳ੮ુPɘͷʮ˦ʡ੮͐ʩɘ͐੮̹ˑɘɻʇ੮ˑʇʁ੮͙ͅ੮͐˺੮ɺʇ੮ɘɺˑʇ੮͐˺੮ ϲʮ˦ʁ੮ʩʮ˚ੴૂ੮ʩʇ੮ʇˑɘɺ˺̼ɘ͐ʇʁੴ੮ુĔʇૄʁ੮ʡ˺੮˺͙͐੮ʇͷʇ̼;੮ʁɘ;੮͸ʮ͐ʩ੮ʡʮʠ͐ચɻɘ̼ʁͅ੮યɘ˦ʁર੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐ͅੳ੮Pʇ੮ʩɘʁ੮ͅ˺˚ʇ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ɻɘͅʇͅ੮͸ʩʇ̼ʇ੮ʩʇ੮ʩɘʁ੮͐˺੮ʁ˺੮ɻ˺˚˚͙˦ʮ͐;੮ͅʇ̼ͷʮɻʇੴ੮ɘ˦ʁ੮͸ʇ੮ ˚ɘʁʇ੮ɘ੮̹ˑɘ˦੮͸ʩʇ̼ʇ੮ʩʇૄʁ੮ʁ˺੮ʮ͐੮ɺ;੮ɻ˺˺ˌʮ˦ʡ੮ˑ͙˦ɻʩ੮ʮ˦੮͐ʩʇ੮ɻˑʮ˦ʮɻੳૂ੮Pʇ੮͸ɘͅ੮͐ͅʮˑˑ੮͙ͅʮ˦ʡ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

257

˚ʇ͐ʩੴ੮͐ʩ˺͙ʡʩੴ੮ɘ˦ʁ੮ʩʮͅ੮ɺʇʩɘͷʮ˺̼੮ʡ˺͐੮ʩʮ˚੮ˌʮɻˌʇʁ੮˺͙͐੮˺ʠ੮ʩʮͅ੮äۚੳ੮"ʇʮ˦ʡ੮ɻ˺˦˦ʇɻ͐ʇʁ੮ ͸ʮ͐ʩ੮r˺ʡɘ˦ૄͅ੮͐ʇɘ˚੮˚ʇɘ˦͐੮͐ʩɘ͐੮ʩʇ੮͸ɘͅ੮ɘ੮ʩʮʡʩ੮̹̼ʮ˺̼ʮ͐;੮ʠ˺̼੮ɘɻɻʇͅͅ੮͐˺੮ɘ੮‡ɘͷʮʡɘ͐ʮ˺˦੮ #ʇ˦͐ʇ̼੮ફ˺˦ʇ੮˺ʠ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮˦ʮɻʇ̼੮ͅʩʇˑ͐ʇ̼ͅબੳ੮/ͷʇ˦͙͐ɘˑˑ;ੴ੮͐ʩʇ;੮ɻ˺ɘͽʇʁ੮ʩʮ˚੮˺˦͐˺੮ ɘ˦੮ʮ˦ˈʇɻ͐ɘɺˑʇ੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻ੮ɘ˦ʁ੮ʡ˺͐੮ʩʮ˚੮ʮ˦͐˺੮˚˺̼ʇ੮ˑ˺˦ʡચ͐ʇ̼˚੮ʩ˺͙ͅʮ˦ʡੳ੮ુĔʇ੮ͅɘ͸੮ɘ੮ ̼ʇɘˑ੮͙̼͐˦ɘ̼˺͙˦ʁੴૂ੮r˺ʡɘ˦੮ͅɘʮʁੴ੮ɻʩʇʇ̼ʠ͙ˑˑ;ੳ U੮ ɻ˺˚˚ʇ˦͐ʇʁ੮ ͐ʩɘ͐੮ ͐ʩʮͅ੮ ͅ˺͙˦ʁʇʁ੮ ˑʮˌʇ੮ ɘ˦੮ ʇ˦ɻ˺͙̼ɘʡʮ˦ʡ੮ ͙ͅɻɻʇͅͅ੮ ͐ͅ˺̼;ੳ੮ r˺ʡɘ˦੮ ̹ɘ͙ͅʇʁੴ੮ɘ˦ʁ੮ɘʁʁʇʁੴ੮ુĔʇ੮ʩɘʁ੮͐ʩʇ੮ɺʇ͐ͅ੮˺͙͐ɻ˺˚ʇ੮͸ʇ੮ɻ˺͙ˑʁ੮ʩ˺̹ʇ੮ʠ˺̼ੴ੮ɘ˦ʁ੮͐ʩʇ˦ੴ੮̼͐ɘʡʮɻɘˑˑ;ੴ੮ˑʮˌʇ੮ʇʮʡʩ͐੮ʩ͙˦ʁ̼ʇʁ੮äɘ˦੮H̼ɘ˦ɻʮͅɻɘ˦ͅ੮ʮ˦੮͐ʩʇ੮ˑɘ͐ͅ੮;ʇɘ̼ੴ੮ʩʇ੮ʁʮʇʁ੮˺ʠ੮ʠʇ˦͐ɘ˦;ˑੳ੯ੳ੯ੳ੯ੳ੮ Ĕʇ੮ɻɘ˦ૄ͐੮̹̼ʇͷʇ˦͐੮ͅ˺˚ʇ˺˦ʇ੮ʠ̼˺˚੮ʁ˺ʮ˦ʡ੮͐ʩɘ͐ੳૂ੮U੮͐ʩʮ˦ˌ੮r˺ʡɘ˦੮ʮͅ੮̼ʮʡʩ͐੮͐˺੮ɺʇ੮ʩ͙˚ɺˑʇ੮ ɘɺ˺͙͐੮͐ʩʇ੮̹˺͸ʇ̼੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅੴ੮͸ʩʇ͐ʩʇ̼੮ʠ˺̼ɻʇʁੴ੮ͷ˺ˑ͙˦͐ɘ̼;ੴ੮˺̼੮ͅ˺˚ʇ͸ʩʇ̼ʇ੮ ʮ˦੮ ɺʇ͐͸ʇʇ˦ੳ੮ U˦ʁʇʇʁੴ੮ ͐ʩʇ੮ ʩʇɘ̼͐ɺ̼ʇɘˌʮ˦ʡ੮ ɻɘͅʇͅ੮ ˺ʠ੮ ʠ˺̼˚ʇ̼ˑ;੮ ʩ˺˚ʇˑʇͅͅ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ ͸ʮ˦੮ ͐ʩʇ੮ ʡ˺ˑʁʇ˦੮ ͐ʮɻˌʇ͐੮ ˺ʠ੮ ͙̹̹ͅ˺̼͐ʇʁ੮ ʩ˺͙ͅʮ˦ʡ੮ ɘ˦ʁ੮ ͐ʩʇ˦੮ ʁʮʇ੮ ͅʩ˺̼͐ˑ;੮ ͐ʩʇ̼ʇɘʠ͐ʇ̼੮ ͙ͅʡʡʇ͐ͅ੮ ͐ʩɘ͐੮ ͐ʩʇ;੮ ˦ʇʇʁ੮ ͅ˺˚ʇ͐ʩʮ˦ʡ੮ ˺͐ʩʇ̼੮ ͐ʩɘ˦੮ ͅʇ̼ͷʮɻʇͅੵ੮ ˦ʇ͸੮ ͅˌʮˑˑͅ੮ ͐˺੮ ʩʇˑ̹੮͐ʩʇ˚੮͙̼ͅͷʮͷʇੳ৽ਃ

SKILLS: LEARNING TO SURVIVE, TOGETHER îʩʇ̼ʇૄͅ੮ɘ੮ʡɘ̹੮ʮ˦੮͐ʩʇ੮̹ˑɘɻʇ˚ʇ˦͐੮ɻ˺˦͐ʮ˦͙͙˚ੳ੮š˦੮͐ʩʇ੮˺˦ʇ੮ʩɘ˦ʁੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ U{)ͅੴ੮ɘ˦ʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੳ੮îʩʇͅʇ੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐ͅ੮ʠʇʇʁੴ੮ɻˑ˺͐ʩʇੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮̹̼ʇ͙ͅ˚ʇʁ੮ʮ˦ɻɘ̹ɘɺˑʇ੮˺ʠ੮ʁ˺ʮ˦ʡ੮ʮ͐੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮š˦੮͐ʩʇ੮˺͐ʩʇ̼੮ʩɘ˦ʁੴ੮͐ʩʇ̼ʇૄͅ੮ ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ʩ˺͙ͅʮ˦ʡੴ੮ ͸ʩ˺ͅʇ੮ ̼ʇͅʮʁʇ˦͐ͅ੮ ɘ̼ʇ੮ ɘ͙ͅͅ˚ʇʁ੮ ͐˺੮ ɺʇ੮ ɘɺˑʇ੮ ͐˺੮ ͐ɘˌʇ੮ ɻɘ̼ʇ੮ ˺ʠ੮ ͐ʩʇͅʇ੮ɺɘͅʮɻ੮˦ʇʇʁͅ੮˺˦੮͐ʩʇʮ̼੮˺͸˦ੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ;੮ɻɘ˦ૄ͐ੳ੮/ͷʇ̼;੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼੮͸ʩ˺੮ ̹̼˺ͷʮʁʇͅ੮ ͐ʩʇ੮ ͙̹̹ͅ˺̼͐ͅ੮ ʮ˦੮ ͙̹̹ͅ˺̼͐ʇʁ੮ ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ʩ˺͙ͅʮ˦ʡ੮ ʩɘͅ੮ ͐ͅ˺̼ʮʇͅ੮ ˺ʠ੮ ͙˦ʮ͐ͅ੮ ˺ͷʇ̼̼͙˦੮͸ʮ͐ʩ੮ɻ˺ɻˌ̼˺ɘɻʩʇͅ੮ɘ˦ʁ੮ͅ˚ʇɘ̼ʇʁ੮ʮ˦੮ʠʇɻʇͅੳ৽਄੮Uૄͷʇ੮ʡɘʡʡʇʁ੮ʮ˦੮͐ʩʇ੮ʁ˺˺̼͸ɘ;੮˺ʠ੮ ɘ੮͙˦ʮ͐੮͸ʩʇ̼ʇ੮ͅ˺˚ʇ˺˦ʇ੮ɻ˺ͷʇ̼ʇʁ੮ʮ˦੮ɺʇʁͅ˺̼ʇͅ੮ɘ˦ʁ੮͙ˑɻʇ̼ͅ੮͸ɘͅ੮͙˦ɘɺˑʇ੮͐˺੮˚˺ͷʇ੮ʠ̼˺˚੮ɘ੮ ̹ʇʇચͅ˺ɘˌʇʁ੮˚ɘ̼͐͐ʇͅͅ੮ʠ˺̼੮ʁɘ;ͅੳ੮U˚ɘʡʇͅ੮ˑʮˌʇ੮͐ʩʇͅʇ੮ʩɘͷʇ੮ɺʇɻ˺˚ʇ੮ʡ̼ʮ͐ͅ੮ʠ˺̼੮ɻˑɘʮ˚ͅ੮͐ʩɘ͐੮ P˺͙ͅʮ˦ʡ੮Hʮ̼͐ͅੴ੮͸ʩʮɻʩ੮̼ɘ̹ʮʁˑ;੮̹ˑɘɻʇͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʮ˦͐˺੮ɘ̹ɘ̼͐˚ʇ˦͐ͅ੮ɘ˦ʁ੮ʠ˺ˑˑ˺͸ͅ੮͙̹੮ ͸ʮ͐ʩ੮ͷ˺ˑ͙˦͐ɘ̼;੮ͅʇ̼ͷʮɻʇͅੴ੮ʮͅ੮ϲˑɘ͸ʇʁ੮ɘ˦ʁ੮ͅʩ˺͙ˑʁ੮ɺʇ੮̼ʇ̹ˑɘɻʇʁ੮͸ʮ͐ʩ੮ʠ˺̼ɻʇʁ੮˚ʇʁͅ੮ɘ˦ʁ੮ ʩ˺̹ͅʮ͐ɘˑ੮ɺʇʁͅੳ৾৻੮"͙͐੮͸ʩɘ͐੮ʮʠ੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ʮ˦੮ɺʇ͐͸ʇʇ˦ੵ੮ʡʮͷʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ͅˌʮˑˑͅ੮ ͐ʩɘ͐੮ ʩʇˑ̹੮ ͐ʩʇ˚੮ ̼͐ɘ˦ͅʮ͐ʮ˺˦੮ ɘ͸ɘ;੮ ʠ̼˺˚੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɘ˦ʁ੮ U{)ͅੴ੮ ˺̼੮ ͅʩʇˑ͐ʇ̼ͅ੮ ɘ˦ʁ੮ ͐ʩʇ੮ ̼͐ͅʇʇ͐ੴ੮͐˺੮͙̼ͅͷʮͷʇ੮ɘ˦ʁ੮͐ʩ̼ʮͷʇ੮ʮ˦੮ɻ˺˚˚͙˦ʮ͐;੮ʩ˺͙ͅʮ˦ʡ੺ ä͐ʇͷʇ੮ Hʮʇˑʁͅ੮ ͸ɘͅ੮ ͸ʮ͐˦ʇͅͅ੮ ͐˺੮ ͐ʩʮͅ੮ ɻʩɘͅ˚੮ ʮ˦੮ ͐ʩʇ੮ ʩʇɘʁ;੮ ʁɘ;ͅ੮ ˺ʠ੮ ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦ੳ੮Pʇ੮ʡ̼ʇ͸੮͙̹੮ʮ˦੮ɘ੮ુ̹˺ˑʮ͐ʮɻɘˑੴ੮ɘɻ͐ʮͷʮ͐ͅ੮ʠɘ˚ʮˑ;ૂ੮ɘ˦ʁੴ੮ʁ͙̼ʮ˦ʡ੮͐ʩʇ੮ēʮʇ͐˦ɘ˚੮ Ĕɘ̼ੴ੮ɘ̹̹ˑʮʇʁ੮ʠ˺̼੮͐ͅɘ͙͐ͅ੮ɘͅ੮ɘ੮ɻ˺˦ͅɻʮʇ˦͐ʮ˺͙ͅ੮˺ɺˈʇɻ͐˺̼ੳ੮Pʇ੮ɘ͙ͅͅ˚ʇʁ੮͐ʩʇ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮ ͸˺͙ˑʁ੮ɺʇ੮̼ʇˈʇɻ͐ʇʁ੮ɘ˦ʁ੮ʩʇૄʁ੮͸ʮ˦ʁ੮͙̹੮ʮ˦੮̹̼ʮͅ˺˦ੳ੮U˦͐ͅʇɘʁੴ੮ʩʇ੮͸ɘͅ੮ɘͅͅʮʡ˦ʇʁ੮͐˺੮͐͸˺੮

258

REFORM

;ʇɘ̼ͅ੮˺ʠ੮ુɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ͅʇ̼ͷʮɻʇૂ੮ʮ˦੮ɘ੮ʩɘˑʠ͸ɘ;੮ʩ˺͙ͅʇ੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੳ੮U͐੮͸ɘͅ੮ৱ৹৶৹ੴ੮ɘ˦ʁ੮ ɘ੮͸ɘͷʇ੮˺ʠ੮̹ɘ͐ʮʇ˦͐ͅ੮ʠ̼˺˚੮‡ɘ̹ɘ੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑ੮͸ʇ̼ʇ੮ɺʇʮ˦ʡ੮ʁʮͅɻʩɘ̼ʡʇʁ੮͸ʮ͐ʩ੮ˑʮ͐͐ˑʇ੮ ˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮̹ɘ̹ʇ̼੮ɺɘʡ੮˺ʠ੮̹˺ͅͅʇͅͅʮ˺˦ͅ੮ɘ˦ʁ੮͐ʩʇ੮ɘʁʁ̼ʇͅͅ੮˺ʠ੮͐ʩʇ੮ʩ˺͙ͅʇ੮͸ʩʇ̼ʇ੮ä͐ʇͷʇੴ੮ ͸ʩ˺੮ʩɘʁ੮ુ˦˺੮ɺɘɻˌʡ̼˺͙˦ʁ੮˺̼੮̼͐ɘʮ˦ʮ˦ʡ੮ʮ˦੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩੴૂ੮͸ɘͅ੮͸˺̼ˌʮ˦ʡੳ੮H̼˺˚੮ ͸ʩʇ̼ʇ੮ ʩʇ੮ ͸ɘͅ੮ ͐ͅɘ˦ʁʮ˦ʡੴ੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚੮ ɘ͙ͅͅ˚ʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇͅʇ੮ ̼ʇʠ͙ʡʇʇͅ੮ ʠ̼˺˚੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮͸˺͙ˑʁ੮ʠɘʮˑ੮͐˺੮ɘʁɘ̹͐੮͐˺੮ˑʮʠʇ੮˺͙͐ͅʮʁʇ੮͐ʩʇ˚ੵ੮ુĔʇ੮ય͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ર੮͸ʇ̼ʇ˦ૄ͐੮ʮ˦ͷʇ͐ͅʮ˦ʡ੮ʮ˦੮ͷ˺ɻɘ͐ʮ˺˦ɘˑ੮ͅʇ̼ͷʮɻʇͅੴ੮͸ʇ੮͸ʇ̼ʇ˦ૄ͐੮ʮ˦ͷʇ͐ͅʮ˦ʡ੮ʮ˦੮ʩ˺͙ͅʮ˦ʡ੮ ʮ˦͐ʇʡ̼ɘ͐ʇʁ੮ʮ˦͐˺੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੴ੮યɘ˦ʁર੮͸ʇ੮͸ʇ̼ʇ˦ૄ͐੮ˑ˺˺ˌʮ˦ʡ੮ɘ͐੮̼ʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮ɘͅ੮ɘ੮ ʡ˺ɘˑੳ੯ੳ੯ੳ੯ੳ੮Ĕʇ੮ʩɘʁ੮ɘˑ̼ʇɘʁ;੮ʁʇɻʮʁʇʁ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʡ˺ʮ˦ʡ੮˦˺͸ʩʇ̼ʇੴ੮ͅ˺੮͸ʇ੮̹ɘ̼ˌʇʁ੮͐ʩʇ˚੮ʮ˦੮ ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇ੮ɘ˦ʁ੮˺ͷʇ̼˚ʇʁʮɻɘ͐ʇʁ੮͐ʩʇ˚ੴ੮ɘ˦ʁ੮͸ɘʮ͐ʇʁ੮͐͸ʇ˦͐;੮;ʇɘ̼ͅ੮͙˦͐ʮˑ੮ ͸ʇ੮͸ʇ̼ʇ੮̹̼˺ͷʇ˦੮̼ʮʡʩ͐ੴ੮͸ʩʇ˦੮͐ʩʇ;ૄ̼ʇ੮͐ͅʮˑˑ੮͙͐ͅɻˌ੮͐ʩʇ̼ʇੳૂ৾ৼ äʮ˦ɻʇ੮͐ʩʇ˦੮ʩʇੴ੮ɘͅ੮͐ʩʇ੮ʩʇɘʁ੮˺ʠ੮Ø̼˺ʡ̼ʇͅͅ੮H˺͙˦ʁɘ͐ʮ˺˦ઝ͸ʩʮɻʩ੮˺̹ʇ̼ɘ͐ʇʁ੮͐ʩɘ͐੮ϲʮ̼͐ͅ੮ ʩɘˑʠ͸ɘ;੮ʩ˺͙ͅʇઝʩɘͅ੮ɺʇʇ˦੮̼͐;ʮ˦ʡ੮͐˺੮ɺ͙ʮˑʁ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮͸˺͙ˑʁ੮̹̼˺ͷʇ੮ ͐ʩʇ੮̹ʇͅͅʮ˚ʮ͐ͅͅ੮͸̼˺˦ʡੳ੮U͐੮͐ͅɘ̼͐ͅ੮͸ʮ͐ʩ੮ˌʇʇ̹ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੴ੮ɘ˦੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮͐˺ͽʮɻ੮͐˺੮ͅʇˑʠચ͙ͅϲϲʮɻʮʇ˦ɻ;ੳ੮Ø̼˺ʡ̼ʇͅͅ੮˺̹ʇ̼ɘ͐ʇͅ੮)˺̼ʇ੮#̼ʮͅʮͅ੮#ˑʮ˦ʮɻੴ੮ɘ͐੮͸ʩʮɻʩ੮ ͐ʩʇ੮˦ʇ͸੮ä̼͐ʇʇ͐੮#̼ʮͅʮͅ੮Ûʇ̹ͅ˺˦ͅʇ੮îʇɘ˚੮ʠ̼ʇή͙ʇ˦͐ˑ;੮ʁ̼˺̹ͅ੮˺ʠʠ੮ɻˑʮʇ˦͐ͅੳ৾৽੮îʩʇ੮̹ͅɘɻʇ੮ ʮͅ੮ ̹̼ʇ͐͐;੮ ɺɘͅʮɻੵ੮ ˈ͙͐ͅ੮ ɘ੮ ʁ˺Έʇ˦੮ ̼ʇɻˑʮ˦ʮ˦ʡ੮ ɘ̼˚ɻʩɘʮ̼ͅੴ੮ ͸ʮ͐ʩ੮ ͐ͅɘʠʠ੮ ˺ʠʠʇ̼ʮ˦ʡ੮ ʩ˺͐੮ ˚ʇɘˑͅ੮ ɘ˦ʁ੮ͅʩ˺̼͐ચ͐ʇ̼˚੮˚ʇʁͅੳ੮"͙͐੮nʮ˚ɺʇ̼ˑ;੮îɘ;ˑ˺̼ੴ੮Ø̼˺ʡ̼ʇͅͅૄͅ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮ɻ̼ʮͅʮͅ੮ͅʇ̼ͷʮɻʇͅੴ੮ ̹˺ʮ˦͐ͅ੮˺͙͐੮ʩ˺͸੮ʁʮʠʠʇ̼ʇ˦͐੮ʮ͐੮ʮͅ੮ʠ̼˺˚੮ɘ˦੮/Ûੵ੮ુ#ˑʮʇ˦͐ͅ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ɻ˺˚ʮ˦ʡ੮ɘͅˌʮ˦ʡ੮ʠ˺̼੮ ʩʇˑ̹ੴ੮˦˺͐੮ʠʇʇˑʮ˦ʡ੮ɻ˺ʇ̼ɻʇʁ੮͐˺੮ɺʇ੮͐ʩʇ̼ʇੳ੮Ĕʇ੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ˦;੮̹˺ˑʮɻʇ੮̹̼ʇͅʇ˦ɻʇੴ੮͸ʇ੮ʁ˺˦ૄ͐੮ ʩɘͷʇ੮ɘ੮ͅʇɻ͙̼ʮ͐;੮ʡ͙ɘ̼ʁੴ੮͐ʩʇ̼ʇૄͅ੮˦˺ɺ˺ʁ;੮͐ʩʇ̼ʇ੮͐ʩɘ͐੮ʠʇʇˑͅ੮ˑʮˌʇ੮͸ʇૄ̼ʇ੮͸ɘ͐ɻʩʮ˦ʡ੮;˺͙੮˺̼੮ ͅɻɘ̼ʇʁ੮˺ʠ੮;˺͙ੳૂ੮ͅ੮ɘ੮̼ʇ͙ͅˑ͐ੴ੮ɻˑʮʇ˦͐ͅ੮͐ɘˌʇ੮ુ˺͸˦ʇ̼ͅʩʮ̹੮˺ʠ੮͐ʩʇ੮ʇ˦ʇ̼ʡ;੮˺ʠ੮͐ʩʇ੮̹ͅɘɻʇੳૂ੮ rʮˌʇ੮ɘˑˑ੮Ø̼˺ʡ̼ʇͅͅ੮̹̼˺ʡ̼ɘ˚ͅੴ੮)˺̼ʇ੮̹̼ʇ͙ͅ˚ʇͅ੮͐ʩɘ͐੮͐ʩʇ੮ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮ʮ˦੮͸ʩʮɻʩ੮ɻɘ̼ʇ੮ʮͅ੮ ʁʇˑʮͷʇ̼ʇʁ੮˚ɘ͐͐ʇ̼ͅ੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮͐ʩʇ੮ɻɘ̼ʇ੮ʮ͐ͅʇˑʠੳ Uʠ੮)˺̼ʇૄͅ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɘͅͅʇͅͅ੮ͅ˺˚ʇ˺˦ʇ੮ɘͅ੮͙˦ɘɺˑʇ੮͐˺੮̼ʇ͙̼͐˦੮͐˺੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮˺˦ɻʇ੮ ͐ʩʇʮ̼੮ ˚ɘͽʮ˚͙˚੮ ͐͸ʇ˦͐;ચʠ˺͙̼ચʩ˺͙̼੮ ͐ͅɘ;੮ ʮͅ੮ ͙̹ੴ੮ ͐ʩʇ;੮ ɻɘ˦੮ ʡ˺੮ ͐˺੮ ˺˦ʇ੮ ˺ʠ੮ Ø̼˺ʡ̼ʇͅͅૄͅ੮ ɻ͙͐ʇ੮)ʮͷʇ̼ͅʮ˺˦੮õ˦ʮ͐ͅ੮ફ)õબੳ੮)õͅ੮ɻɘ˦੮ɘˑͅ˺੮͐ɘˌʇ੮̹ʇ˺̹ˑʇ੮ɺ̼˺͙ʡʩ͐੮ʮ˦͐˺੮͐ʩʇ੮/Û੮ ˺˦੮ɘ੮৵ৱ৵ৰੴ੮ɘˑ͐ʩ˺͙ʡʩ੮͐ʩʇ;੮ʩɘͷʇ੮͐˺੮ɻ˺˚ʇ੮ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ੮U͐ૄͅ੮ʇɘͅ;੮͐˺੮ͅʇʇ੮͸ʩ;੮͐ʩʇ;੮˚ʮʡʩ͐੮ ɘʡ̼ʇʇੴ੮ʇ̹ͅʇɻʮɘˑˑ;੮͸ʩʇ˦੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ʮͅ੮ɘ੮͸ɘ̼ʁ੮ʮ˦੮äH੮Iʇ˦ʇ̼ɘˑੳ੮îʩʇ੮)õ੮U੮ͷʮͅʮ͐ੴ੮ rɘ੮Ø˺ͅɘʁɘੴ੮ʮͅ੮ʮ˦੮͐ʩʇ੮ͅɘ˚ʇ੮ɺ͙ʮˑʁʮ˦ʡ੮͸ʩʇ̼ʇ੮ä͐ʇͷʇ੮Hʮʇˑʁͅ੮͐ͅɘ̼͐ʇʁ੮ʮ˦੮ৱ৹৶৹ੴ੮ɘ੮ˈɘ͙˦͐ʮˑ;੮ ̹ɘʮ˦͐ʇʁ੮ēʮɻ͐˺̼ʮɘ˦੮˺˦੮ɘ੮ή͙ʮʇ͐੮ͅʮʁʇ੮̼͐ͅʇʇ͐੮ʮ˦੮͐ʩʇ੮{ʮͅͅʮ˺˦ੳ੮îʩʇ੮ʮ˦ͅʮʁʇ੮ʮͅ੮ή͙ʮ˦͐ʇͅͅʇ˦͐ʮɘˑˑ;੮ ‡˺̼͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘੵ੮ ʁɘ̼ˌ੮ ͸˺˺ʁચ̹ɘ˦ʇˑʇʁ੮ ͸ɘˑˑͅੴ੮ ʁʮ˚੮ ˑʮʡʩ͐ੴ੮ ɘ˦ʁ੮ ͅ˺˚ʇ͸ʩɘ͐੮ ͅʩɘɺɺ;੮ʠ͙̼˦ʮ͙̼͐ʇੳ੮Uૄ˚੮̼͙͐ͅɻˌ੮ɺ;੮͐ʩʇ੮ͅɻʩʇʁ͙ˑʇ੮̹˺͐ͅʇʁ੮˺˦੮͐ʩʇ੮͸ɘˑˑੳ੮)ɘ;ͅ੮ʮ˦੮rɘ੮Ø˺ͅɘʁɘ੮ ɘ̼ʇ੮̹ɘɻˌʇʁ੮͸ʮ͐ʩ੮ɻ˺˚˚͙˦ʮ͐;੮˚ʇʇ͐ʮ˦ʡͅੴ੮ɻʩ˺̼ʇͅੴ੮ɘ˦ʁ੮ʡ̼˺͙̹ͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ɻ˺̹ʮ˦ʡ੮ͅˌʮˑˑͅੳ ˦੮)õ੮ʮͅ੮ɘ੮̹ˑɘɻʇ੮˺ʠ੮̼ʇ̹ͅʮ͐ʇ੮ɺ͙͐੮˦˺͐੮ʮͅ˺ˑɘ͐ʮ˺˦ੳ੮#ˑʮʇ˦͐ͅ੮ˌʇʇ̹੮͐ʩʇʮ̼੮̹ʩ˺˦ʇͅ੮ɘ˦ʁ੮ ɻɘ˦੮ʮ˦ͷʮ͐ʇ੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅ੮ɘ˦ʁ੮ʠ̼ʮʇ˦ʁͅ੮˺ͷʇ̼੮ʠ˺̼੮ʁʮ˦˦ʇ̼੮ફʮʠ੮͐ʩʇ੮ʡ̼˺͙̹੮ɘʡ̼ʇʇͅબੳ੮îʩʮͅ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

259

˚ʇɘ˦ͅ੮͐ʩʇ;੮˚ʮʡʩ͐੮ɻ˺˦͐ʮ˦͙ʇ੮ʮ˦͐ʇ̼ɘɻ͐ʮ˦ʡ੮͸ʮ͐ʩ੮͐ʩʇ੮ͷʇ̼;੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮͸ʇ̼ʇ੮̹̼ʇɻʮ̹ʮ͐ɘ͐ʮ˦ʡ੮ɘ˦੮ʇ˚˺͐ʮ˺˦ɘˑ੮ɻ̼ʮͅʮͅ੮˺̼੮˺ʠʠʇ̼ʮ˦ʡ੮͐ʩʇ˚੮͙ͅɺ͐ͅɘ˦ɻʇͅ੮˺͙͐ͅʮʁʇੳ੮ુĔʇૄ̼ʇ੮̼͐;ʮ˦ʡ੮͐˺੮ ɻ̼ʇɘ͐ʇ੮̼ʇɘˑ੮ˑʮʠʇੴ੮͸ʮ͐ʩ੮ʇͽ̼͐ɘ੮͙̹̹ͅ˺̼͐ੴૂ੮îɘ;ˑ˺̼ੴ੮͐ʩʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮ɻ̼ʮͅʮͅ੮ͅʇ̼ͷʮɻʇͅੴ੮͐ʇˑˑͅ੮ ˚ʇੴ੮ુͅ˺੮͸ʇ੮͸ɘ˦͐੮͐ʩʇ˚੮͐˺੮ɺʇ੮ɘɺˑʇ੮͐˺੮̹̼ɘɻ͐ʮɻʇ੮͸ʩɘ͐੮͐ʩʇ;ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ʁ˺ʮ˦ʡ੮͸ʩʇ˦੮ ͐ʩʇ;ૄ̼ʇ੮˦˺͐੮ʩʇ̼ʇ੮ɘ˦;˚˺̼ʇੳૂ੮ä˺˚ʇ੮˺ʠ੮͐ʩʇͅʇ੮ʩɘɺʮ͐ͅ੮ɘ̼ʇ੮ɘ̼˺͙˦ʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮Ĕʩʇ˦੮ʮ͐੮ ɻ˺˚ʇͅ੮͐˺੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ͅʩʇ੮͐ʇˑˑͅ੮˚ʇੴ੮ુîʩʇ;ૄ̼ʇ੮͐ʩʇ੮˺˦ʇͅ੮˺̹ʇ˦ʮ˦ʡ੮͐ʩʇ੮ɺ˺͐͐ˑʇͅੴ੮͐ɘˌʮ˦ʡ੮͐ʩʇ੮ɻ˺̼̼ʇɻ͐੮ʁ˺ͅʇੳ੮Ĕʇૄ̼ʇ੮˦˺͐੮̹͙͐͐ʮ˦ʡ੮ʮ͐੮ʮ˦͐˺੮ɘ੮ɻ͙̹੮ɘ˦ʁ੮ʩɘ˦ʁʮ˦ʡ੮ʮ͐੮͐˺੮͐ʩʇ˚ੳૂ੮ äʩʇ੮ɘʁʁͅੴ੮ુĔʇૄ̼ʇ੮ʩʇˑ̹ʮ˦ʡ੮͐ʩʇ˚੮ʁʇͷʇˑ˺̹੮ɘʁͷ˺ɻɘɻ;੮ͅˌʮˑˑͅ੮ɘ̼˺͙˦ʁ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴૂ੮͙ͅɻʩ੮ ɘͅ੮˦ʇʡ˺͐ʮɘ͐ʮ˦ʡ੮͸ʮ͐ʩ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐˺੮̼͐;੮ɘ੮˦ʇ͸੮ʁ̼͙ʡ੮͸ʩʇ˦੮˺˦ʇ੮ʮͅ˦ૄ͐੮͸˺̼ˌʮ˦ʡ੮˺̼੮ ʮͅ੮ɻɘ͙ͅʮ˦ʡ੮ʮ˦͐˺ˑʇ̼ɘɺˑʇ੮ͅʮʁʇ੮ʇʠʠʇɻ͐ͅੳ੮š͐ʩʇ̼੮ʩɘɺʮ͐ͅ੮ɘ̼ʇ੮ɘ̼˺͙˦ʁ੮ɻ˺ˑˑʇɻ͐ʮͷʇ੮ˑʮʠʇੴ੮ͅʮ˦ɻʇ੮ ˚ɘ˦;੮Ø̼˺ʡ̼ʇͅͅ੮̼ʇͅʮʁʇ˦͐ͅੴ੮ɺ;੮ʁʮ˦͐੮˺ʠ੮̹˺ͷʇ̼͐;ੴ੮ɘ̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ˑʮͷʇ੮ʮ˦੮ɻ˺˦ʡ̼ʇʡɘ͐ʇ੮ͅʇ͐͐ʮ˦ʡͅ੮ફˑʮˌʇ੮äۚͅ੮˺̼੮ͅʩʇˑ͐ʇ̼ͅબ੮ʮ˦੮͐ʩʇ੮ʠ͙͙̼͐ʇੳ õˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮͐ʩʇ੮͐ʇ͐ͅ੮˺ʠ੮ɘ੮ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮͐ͅɘ;੮ʮ˦੮ɘ˦੮)õ੮ʮͅ੮͸ʩʇ͐ʩʇ̼੮ʮ͐੮ɻɘ˦੮̼ʇʮ˦੮ʮ˦੮ ͸ʩɘ͐ʇͷʇ̼੮ɺʇʩɘͷʮ˺̼੮͸ɘͅ੮̹͙͐͐ʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮˺˦੮ɘ੮̹ɘ͐ʩ͸ɘ;੮͐˺੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳ৾৾੮ä͐ʇͷʇ੮ Hʮʇˑʁͅੴ੮ɘʡɘʮ˦ੴ੮ɘ̼͐ʮɻ͙ˑɘ͐ʇͅ੮͐ʩʇ੮͐ʩʇ˺̼;੮ɺʇʩʮ˦ʁ੮͐ʩʇ੮˚˺ʁʇˑੵ੮ુU੮ˑʇɘ̼˦ʇʁ੮ય͸˺̼ˌʮ˦ʡ੮ɘ͐੮͐ʩʇ੮ ʩɘˑʠ͸ɘ;੮ ʩ˺͙ͅʇર੮ ͐ʩɘ͐੮ યʁʮ̼͙̹͐ͅʮͷʇર੮ ɺʇʩɘͷʮ˺̼੮ ͸ɘͅ˦ૄ͐੮ ͙˦ɘˑ͐ʇ̼ɘɺˑʇ੮ ʮʠ੮ ;˺͙੮ ˺ʠʠʇ̼ʇʁ੮ ɘ˦੮ ʇ˦ͷʮ̼˺˦˚ʇ˦͐੮ʮ˦੮͸ʩʮɻʩ੮ʮ͐੮͸ɘͅ˦ૄ͐੮ʮ˦ʇͷʮ͐ɘɺˑʇੳ੮Uૄʁ੮ͅʇʇ੮̹ʇ˺̹ˑʇ੮ɺʇ੮ʮ˦੮ɘ੮͐ʩ˺͙ʡʩ͐ચʁʮͅ˺̼ʁʇ̼੮ ͅʮ͙͐ɘ͐ʮ˺˦੮ʮ˦੮͐ʩʇ੮˚˺̼˦ʮ˦ʡ੮ɘ˦ʁ੮͐ʩʇ˦੮ɻ˺˺ˌ੮ʁʮ˦˦ʇ̼੮ɘ͐੮˦ʮʡʩ͐ੴ੮ʮʠ੮;˺͙੮͐ͅɘ;ʇʁ੮͸ʮ͐ʩ੮͐ʩʇ˚੮ યɘ˦ʁર੮;˺͙੮ʁʮʁ˦ૄ͐੮̹ɘ˦ʮɻ੮ɘ˦ʁ੮ʩɘͷʇ੮͐ʩʇ˚੮̹͙ˑˑʇʁ੮˺͙͐੮˺ʠ੮͐ʩʇ੮ʩ˺͙ͅʇੳૂ੮š˦੮͐ʩʇ੮ʁɘ;੮˺ʠ੮˚;੮ ͷʮͅʮ͐ੴ੮˺˦ʇ੮rɘ੮Ø˺ͅɘʁɘ੮̼ʇͅʮʁʇ˦͐੮͸ɘͅ੮ʩʇɘ̼ʮ˦ʡ੮͐ʩʇ੮ͷ˺ʮɻʇ੮˺ʠ੮ʩʇ̼੮ɺ˺;ʠ̼ʮʇ˦ʁ੮ʮ˦੮ʩʇ̼੮ʩʇɘʁ੮ ɘ˦ʁ੮ˑ˺͙ʁˑ;੮ɘ̼ʡ͙ʮ˦ʡ੮͸ʮ͐ʩ੮ʩʮ˚ੳ੮ä͐ɘʠʠ੮ʠ˺͙˦ʁ੮ɘ੮͸ɘ;੮͐˺੮ʁʮͷʇ̼͐੮ʩʇ̼ੵ੮ͅʩʇ੮͸ɘͅ੮ɘͅͅʮʡ˦ʇʁ੮ ͐˺੮ɻ˺˺ˌ੮ʁʮ˦˦ʇ̼੮͐ʩɘ͐੮˦ʮʡʩ͐੮ɘ˦ʁ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ˑʇ͐੮ʩʇ̼੮ʩ˺͙ͅʇ˚ɘ͐ʇͅ੮ʁ˺͸˦ੳ੮ુr˺˺ˌʮ˦ʡ੮ ʠ˺̼͸ɘ̼ʁ੮͐˺੮͐ʩɘ͐੮ɻ͙̼̼;੸ૂ੮nʮ˚ɺʇ̼ˑ;੮ͅɘ;ͅ੮͸ʩʇ˦੮͸ʇ੮̹˺̹੮ʮ˦͐˺੮ʩʇ̼੮̼˺˺˚ੴ੮ɘʁʁʮ˦ʡੴ੮ુUૄ˚੮ ʡˑɘʁ੮͐˺੮ͅʇʇ੮͐ʩʇ੮ɺʇʁ੮˚ɘʁʇੳૂ U੮˦ʇͽ͐੮͸ɘˑˌ੮˺ͷʇ̼੮͐˺੮rɘ੮˚ʮ͐ͅɘʁੴ੮ɘ੮˦ʮ˦ʇ͐;ચʁɘ;੮̹̼˺ʡ̼ɘ˚੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˦ʇʇʁ੮ ˚˺̼ʇ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɻɘ̼ʇ੮ɘʠ͐ʇ̼੮ɘ˦੮)õੳ੮{;੮ʡ͙ʮʁʇ੮ʮͅ੮kʮ˚੮Û˺ɺʇ̼͐ͅੴ੮͸ʩ˺੮͐ͅɘ̼͐ʇʁ੮ʩʮͅ੮ ɻɘ̼ʇʇ̼੮ʁ˺ʮ˦ʡ੮ʁ̼ɘ˚ɘ੮͐ʩʇ̼ɘ̹;੮ʮ˦੮͐ʩʇ੮õn੮ɺʇʠ˺̼ʇ੮˚˺ͷʮ˦ʡ੮͐˺੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੳ੮îʩʇ੮ɺ͙ʮˑʁʮ˦ʡ੮ʮͅ੮ɘ੮˚ɘΈʇ੮˺ʠ੮˦ɘ̼̼˺͸੮ʩɘˑˑ͸ɘ;ͅ੮ɘ˦ʁ੮ͅʩɘ̼ʇʁ੮ɺʇʁ̼˺˺˚ͅੴ੮ή͙ʮʇ͐੮͙˦͐ʮˑ੮U੮̼ʇɘɻʩ੮ɘ੮ˌʮ͐ɻʩʇ˦੮ ʮ˦੮͐ʩʇ੮ɺɘɻˌੳ੮੮ɻ˺͙̹ˑʇ੮˺ʠ੮̼ʇͅʮʁʇ˦͐ͅ੮ɘ̼ʇ੮ɻ˺˺ˌʮ˦ʡ੮͸ʩʮˑʇ੮̼ʇʡʡɘʇ͐˺˦੮ɺˑɘ̼ʇͅੳ੮ä˺˚ʇ˺˦ʇ੮ ʩɘͅ੮ˑʇʠ͐੮ɘ੮ɺ͙̼˦ʇ̼੮˺˦ੴ੮ɺ͙͐੮kʮ˚੮ͅ˦ʇɘˌͅ੮ɺʇʩʮ˦ʁ੮ɘ੮ɻˑʮʇ˦͐੮ͅɻ˺˺̹ʮ˦ʡ੮ʇʡʡͅ੮˺˦͐˺੮ɘ˦˺͐ʩʇ̼੮ ɻˑʮʇ˦͐ૄͅ੮̹ˑɘ͐ʇ੮͐˺੮͙̼͐˦੮ʮ͐੮˺ʠʠੳ੮Ĕʇ੮ʡ˺੮͐˺੮͐ʩʇ੮ɺɘɻˌ੮̹ɘ͐ʮ˺ੴ੮ʠ͙ˑˑ;੮ͅʇ͐੮͙̹੮ʠ˺̼੮ɘ੮ɺɘ̼ɺʇή͙ʇ੮ ફ͸ʩʮɻʩੴ੮U੮ɘ˚੮͐˺ˑʁੴ੮ʮͅ੮ɘ੮ʠ̼ʇή͙ʇ˦͐੮ɘɻ͐ʮͷʮ͐;બੳ੮îʩʮͅ੮ͅɻʇ˦ʇ੮ʮͅ੮ɘ੮͐ͅɘ̼ˌ੮ɻ˺˦̼͐ɘ͐ͅ੮͐˺੮ɘ੮ɺ˺ɘ̼ʁ੮ ɘ˦ʁ੮ɻɘ̼ʇੴ੮͸ʩʇ̼ʇ੮ɺ;੮̼ʇʡ͙ˑɘ͐ʮ˺˦੮˺̹ʇ̼ɘ͐˺̼ͅ੮ɘ̼ʇ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮̹̼˺ͷʮʁʇ੮͐ʩ̼ʇʇ੮˚ʇɘˑͅ੮ɘ˦ʁ੮ ͐͸˺੮ͅ˦ɘɻˌͅੴ੮ɘ˦ʁ੮̼ʇͅʮʁʇ˦͐ͅ੮ɘ̼ʇ˦ૄ͐੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮̹̼˺ͷʮʁʇ੮ɘ˦;͐ʩʮ˦ʡ੮ɺ͙͐੮͐ʩʇʮ̼੮ɻʩʇɻˌੳ kʮ˚੮ ͐ʇˑˑͅ੮ ˚ʇ੮ ͐ʩɘ͐੮ ͸ʩʇ˦੮ ʩʇ੮ ϲʮ̼͐ͅ੮ ɻɘ˚ʇ੮ ͐˺੮ rɘ੮ ˚ʮ͐ͅɘʁੴ੮ ુU੮ ɻ˺͙ˑʁ੮ ˦˺͐੮ ͙˦ʁʇ̼͐ͅɘ˦ʁ੮ ͸ʩɘ͐੮ ͸ɘͅ੮ ʡ˺ʮ˦ʡ੮ ˺˦ੴૂ੮ ͅʮ˦ɻʇ੮ ͅ˺੮ ˑʮ͐͐ˑʇ੮ ͐ʮ˚ʇ੮ ʮͅ੮ ̹ͅʇ˦͐੮ ˺˦੮ ˺˦ʇચ˺˦ચ˺˦ʇ੮ ͐ʩʇ̼ɘ̹;੮

260

REFORM

˺̼੮˚ʇʁʮɻɘ͐ʮ˺˦੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੳ੮îʩʇ੮̼ʇɘˑ੮ʮ˚̹ɘɻ͐੮˺ʠ੮ɺʇʮ˦ʡ੮ʮ˦੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮ ɻ˺˚ʇͅੴ੮ʩʇ੮͐ʩʮ˦ˌͅੴ੮ʠ̼˺˚੮ˈ͙͐ͅ੮ɺʇʮ˦ʡ੮͐ʩʇ̼ʇੳ੮/̹ͅʇɻʮɘˑˑ;੮ʠ˺̼੮ɻˑʮʇ˦͐ͅ੮͸ʩ˺੮ʩɘͷʇ੮ɺʇʇ˦੮ˑʮͷʮ˦ʡ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੴ੮ુ͸ʇૄ̼ʇ੮̼ɘʮͅʮ˦ʡ੮̹ʇ˺̹ˑʇૄͅ੮ɺɘ̼ੳ੮Øʇ˺̹ˑʇ੮͐ʩʮ˦ˌ੮͐ʩɘ͐੮͸ʩʇ̼ʇ੮͐ʩʇ;ૄ̼ʇ੮ɘ͐੮ ʮͅ੮ɘˑˑ੮͐ʩʇ̼ʇ੮ʮͅ੮ʠ˺̼੮͐ʩʇ˚ੳ੯ੳ੯ੳ੯ੳ੮H˺̼੮˚ɘ˦;ੴ੮ʮ͐ૄͅ੮ɘ੮ˑ˺˦ʡ੮͐ʮ˚ʇ੮ͅʮ˦ɻʇ੮͐ʩʇ;੮ˑɘ͐ͅ੮ʩɘʁ੮͐ʩʇʮ̼੮˺͸˦੮ ɺɘ͐ʩ̼˺˺˚ੴ੮ʩɘʁ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮ɻ˺˺ˌ੮ɘ੮˚ʇɘˑ੮ʠ˺̼੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮˺̼੮ʩɘʁ੮ɘɻɻʇͅͅ੮͐˺੮ɘ੮̼ʇʠ̼ʮʡʇ̼ɘ͐˺̼ੳૂ੮kʮ˚੮ɘˑͅ˺੮̼͙˦ͅ੮ɘ੮;ʇɘ̼ˑ˺˦ʡ੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮͐ɘˌʇͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮͸ʩ˺੮ʩɘͷʇ੮ɺʇʇ˦੮ ˑɘ˦ʡ͙ʮͅʩʮ˦ʡ੮ʮ˦੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇͅ੮ʠ˺̼੮;ʇɘ̼ͅ੮ɘ˦ʁ੮ͅʇʇˌͅ੮͐˺੮̼ʇɻ͙ˑ͐ʮͷɘ͐ʇ੮͐ʩʇʮ̼੮ɻɘ̹ɘɺʮˑʮ͐ʮʇͅੳ੮ Ø̼˺ʡ̼ʇͅͅ੮ʩɘͅ੮ɘˑ͸ɘ;ͅ੮ɘɻɻʇ̹͐ʇʁ੮ɻˑʮʇ˦͐ͅ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮î͸˺੮˺ʠ੮͐ʇ˦੮ɻˑʮʇ˦͐ͅ੮ɘ͐੮ rɘ੮˚ʮ͐ͅɘʁ੮ɘ̼ʇ੮ɻ˺˦ͅʇ̼ͷʇʁੳ੮"͙͐੮ʠ˺̼੮ä͐ʇͷʇ੮Hʮʇˑʁͅੴ੮ʮ͐ૄͅ੮ɘ੮ુ̼ʇʁ੮ʩʇ̼̼ʮ˦ʡੴૂ੮ɺʇɻɘ͙ͅʇ੮ુ͸ʇ੮ ʁ˺˦ૄ͐੮˺̹ʇ̼ɘ͐ʇ੮ɘ˦;੮ʁʮʠʠʇ̼ʇ˦͐ˑ;੮͸ʮ͐ʩ੮͐ʩʇ˚ੳૂ੮Ě˺͙੮ɻɘ˦ૄ͐੮ɻ˺˚̹ʇˑ੮̹ʇ˺̹ˑʇ੮͐˺੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʇ੮ ʮ˦੮ɘ੮̹̼˺ʡ̼ɘ˚੮ʁʇͅʮʡ˦ʇʁ੮͐˺੮ɻ͙ˑ͐ʮͷɘ͐ʇ੮ͅʇˑʠચ̼ʇ̹ͅʇɻ͐੮ɘ˦ʁ੮ɻ˺˚˚͙˦ʮ͐;੶੮;˺͙੮ʩɘͷʇ੮͐˺੮ɻ˺˦ͷʮ˦ɻʇ੮͐ʩʇ˚੮ʮ͐ૄͅ੮͸˺̼͐ʩ੮͐ʩʇ੮ͅ͸ʇɘ͐੮ɘ˦ʁ੮̼͙͐ͅʡʡˑʇੳ Ĕʩʇ˦੮U੮ɘͅˌ੮ʩ˺͸੮ɘ੮͐ͅɘ;੮ɘ͐੮rɘ੮˚ʮ͐ͅɘʁ੮ɻɘ˦੮ɻʩɘ˦ʡʇ੮ͅ˺˚ʇ˺˦ʇૄͅ੮̼͐ɘˈʇɻ͐˺̼;ੴ੮ɘ੮͐ͅɘʠʠ੮ ɻ˺͙˦ͅʇˑ˺̼ઝ͸ʮ͐ʩ੮ɘ੮ʩɘˑʠચͅʩɘͷʇʁ੮ʩʇɘʁ੮ɘ˦ʁ੮ɘ੮ϲˑɘ˦˦ʇˑ੮ͅʩʮ̼͐ੴ੮͐ʩʇ੮͙˦˺ϲϲʮɻʮɘˑ੮͙˦ʮʠ˺̼˚੮˺ʠ੮ "ɘ;੮̼ʇɘ੮ɻ˺͙˦͐ʇ̼ɻ͙ˑ͙̼͐ʇઝʁʇͅɻ̼ʮɺʇͅ੮ɘ˦੮͙˦ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ʮ˚˚ʮʡ̼ɘ˦͐੮ʠ̼˺˚੮/ˑ੮äɘˑͷɘʁ˺̼੮͸ʩ˺੮̼ʇɻʇ˦͐ˑ;੮̹ɘͅͅʇʁ੮͐ʩ̼˺͙ʡʩੳ੮Pʇ੮ɻɘ˚ʇੴ੮ͅʩʇ੮ͅɘʮʁੴ੮ʮ˦੮ɘ੮ુʁʇʇ̹੮ʁʇ̹ͅɘʮ̼ੴૂ੮͐ʮʇʁ੮͐˺੮ ͐ʩʇ੮̼͐ɘ͙˚ɘ੮˺ʠ੮ϲˑʇʇʮ˦ʡ੮ʩʮͅ੮ʩ˺˚ʇ੮ɻ˺͙˦̼͐;ੴ੮͐ʩʇ੮ʇɻ˺˦˺˚ʮɻ੮̹̼ʇɻɘ̼ʮ͐;੮ɻ̼ʇɘ͐ʇʁ੮ɺ;੮͐ʩʇ੮ ̹ɘ˦ʁʇ˚ʮɻੴ੮ɘ˦ʁ੮͐ʩʇ੮͙ͅɺ͐ͅɘ˦ɻʇͅ੮ʩʇ੮͙ͅʇʁ੮͐˺੮ɻ˺̹ʇ੮͸ʮ͐ʩ੮ɺ˺͐ʩੳ੮Ĕʩʇ˦੮ͅʩʇ੮͸ʇ˦͐੮͐˺੮˚ʇʇ͐੮ ʩʮ˚੮ɘ͐੮ɘ˦੮)õੴ੮ʩʮͅ੮ʁ˺͸˦͸ɘ̼ʁ੮ͅˑʮʁʇ੮ʩɘʁ੮͐ͅɘɺʮˑʮΈʇʁੴ੮ɺ͙͐੮͐ͅʮˑˑ੮ʩʇ੮ુɻ˺͙ˑʁ੮ɺɘ̼ʇˑ;੮ʡʇ͐੮ ˺͙͐੮˺ʠ੮ɺʇʁ੮͐˺੮ϲʮͽ੮ɺ̼ʇɘˌʠɘ͐ͅੳ੮U͐੮͸ɘͅ੮͐ʩʇ੮ˌʮ˦ʁ੮˺ʠ੮ʁʇ̹̼ʇͅͅʮ˺˦੮͸ʩʇ̼ʇ੮ʇͷʇ̼;͐ʩʮ˦ʡ੮ɘɻʩʇͅੴ੮ ʮ͐੮ˑʮͷʇͅ੮ʮ˦੮;˺͙̼੮ɺ˺˦ʇͅੴ੮ʇͷʇ̼;͐ʩʮ˦ʡ੮ʮͅ੮̹ɘʮ˦ʠ͙ˑੳૂ "˺͐ʩ੮ rɘ੮ ˚ʮ͐ͅɘʁ੮ ɘ˦ʁ੮ rɘ੮ Ø˺ͅɘʁɘ੮ ɘ̼ʇ੮ ˺̼ʮʇ˦͐ʇʁ੮ ͐˺͸ɘ̼ʁ੮ ͐ʩʇ੮ Pʮ̹ͅɘ˦ʮɻઃrɘ͐ʮ˦ͽ੮ ɻ˺˚˚͙˦ʮ͐;ੴ੮ ͸ʩʮɻʩ੮ ͐ʩʇ੮ ɻ˺͙˦ͅʇˑ˺̼੮ ͐ʩʮ˦ˌͅ੮ ʮͅ੮ ɻ̼͙ɻʮɘˑੵ੮ ુ#͙ˑ͙̼͐ɘˑˑ;ੴ੮ ʠ˺̼੮ ͙ͅ੮ rɘ͐ʮ˦˺ͅੴ੮ ʮ͐੮ ય˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩર੮ ʮͅ੮ ͅ˺˚ʇ͐ʩʮ˦ʡ੮ ;˺͙੮ ʁ˺˦ૄ͐੮ ͐ɘˑˌ੮ ɘɺ˺͙͐ੳ੮ îʩʇ੮ ͐ͅʮʡ˚ɘੴ੮ ʮ͐੮ ʁʇ̹̼ʮͷʇͅੳૂ੮ "͙͐੮˺ͷʇ̼੮͐ʮ˚ʇੴ੮ુ;˺͙੮ɻ˺͙ˑʁ੮ʩʇɘ̼੮ʩʮ˚੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ʩʮͅ੮ʇ˚˺͐ʮ˺˦ɘˑ੮ͷ˺ɻɘɺ͙ˑɘ̼;ੴ੮͐ɘˑˌʮ˦ʡ੮ ɘɺ˺͙͐੮ɻ˺̹ʮ˦ʡ੮ͅˌʮˑˑͅੴ੮ˑʇɘ̼˦ʮ˦ʡ੮ʩʮͅ੮˚ʇʁͅੴ੮ʮ˦͐ʇ̼˦ɘˑʮΈʮ˦ʡ੮ʮ͐੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮͐ͅɘ̼͐ʇʁ੮͐˺੮ɻɘ̼ʇ੮ ɘɺ˺͙͐੮ʩʮ˚ͅʇˑʠੳૂ੮"ʇɻɘ͙ͅʇ੮ʩʇ੮͸ɘͅ੮͙˦ʁ˺ɻ͙˚ʇ˦͐ʇʁੴ੮̼͐ʇɘ͐˚ʇ˦͐੮˺̹͐ʮ˺˦ͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮͸ʇ̼ʇ੮ˑʮ˚ʮ͐ʇʁ੮ફ͙˦͐ʮˑ੮ɘ੮৲ৰ৲৲੮̼ʇʠ˺̼˚ੴ੮ʩʇ੮ɻ˺͙ˑʁ˦ૄ͐੮ʡʇ͐੮{ʇʁʮચ#ɘˑબੳ੮ä˺੮͐ʩʇ੮͐ʇɘ˚੮ ʠ˺ɻ͙ͅʇʁ੮˺˦੮ɻ˺˦˦ʇɻ͐ʮ˦ʡ੮ʩʮ˚੮͸ʮ͐ʩ੮̹ʇʇ̼ચˑʇʁ੮͙̹̹ͅ˺̼͐੮ʡ̼˺͙̹ͅੳ੮ુPʇ੮ˑʇʠ͐੮ʩʇ̼ʇੴ੮ʁ̼˺ͷʇ੮ ɘ͸ɘ;੮ʮ˦੮ʩʮͅ੮ɻɘ̼ੴ੮͸ʇ˦͐੮ɺɘɻˌ੮͐˺੮͸˺̼ˌੴૂ੮ͅʩʇ੮͐ʇˑˑͅ੮˚ʇੴ੮ુɺ͙͐੮ɻɘ˚ʇ੮ɺɘɻˌ੮͐˺੮ʁ̼˺̹੮˺ʠʠ੮ͅ˺˚ʇ੮ ̼͐ʇɘ͐ͅ੮ʠ˺̼੮ʩʮͅ੮ʠ̼ʮʇ˦ʁͅੳૂ Ø̼˺ʡ̼ʇͅͅૄͅ੮ɘ̹̹̼˺ɘɻʩ੮͸ɘͅ੮ɘˑ˚˺͐ͅ੮ɘ੮͐ʇ˚̹ˑɘ͐ʇ੮ʠ˺̼੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ʇ˦͐ʮ̼ʇ੮͐͸ʇ˦͐;ચʠ˺͙̼ચ ʩ˺͙̼੮̼͐ʇɘ͐˚ʇ˦͐੮ͅ;͐ͅʇ˚ੳ੮U˦੮ৱ৹৷৸ੴ੮ä͐ʇͷʇ੮Hʮʇˑʁͅ੮ʩʇˑ̹ʇʁ੮̹ɘͅͅ੮͐ʩʇ੮#˺˚˚͙˦ʮ͐;੮Ûʇͅʮʁʇ˦͐ʮɘˑ੮î̼ʇɘ͐˚ʇ˦͐੮ɻ͐ੴ੮͸ʩʮɻʩ੮ʮ˦੮ʮ͐ͅ੮̹̼ʇɘ˚ɺˑʇ੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ુɻ͙̼̼ʇ˦͐੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮̹̼˺ͷʮʁʇͅ੮ʮ˦͙ͅϲϲʮɻʮʇ˦͐੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮͐˺੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ੳૂ৾৿੮îʩʇ੮ɻ͐੮˺ʠʠʇ̼ʇʁ੮ʡ̼ɘ˦͐ͅ੮͐˺੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮͐ͅɘ̼͐੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

261

͸ʮ͐ʩ੮ɘ੮ુ̼ʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮ʠ˺ɻ͙ͅ੮͸ʩʮɻʩ੮ʇ˦ɻ˺͙̼ɘʡʇͅ੮͐ʩʇ੮ɻˑʮʇ˦͐੮͐˺੮ʁʇͷʇˑ˺̹੮͐ʩʇ੮ͅˌʮˑˑͅ੮͐˺੮ ɺʇɻ˺˚ʇ੮ͅʇˑʠચ͙ͅϲϲʮɻʮʇ˦͐ੳૂ੮ä͐ʇͷʇ੮ɻˑɘʮ˚ͅ੮͐ʩɘ͐੮͐ʩʇ੮ɻ͐੮ʁʮʁ˦ૄ͐੮ʠɘʮˑ੮ʠ˺̼੮ˑɘɻˌ੮˺ʠ੮˚˺˦ʇ;ੳ੮ ુĔʇ੮͸ʇ̼ʇ੮̼˺ˑˑʮ˦ʡ੮ʮ˦੮˚˺˦ʇ;ੴૂ੮ʩʇ੮ʮ˦ͅʮ͐ͅͅੴ੮͸ʮ͐ʩ੮͐ʩʇ੮৹ৰજৱৰ੮͐ͅɘ͐ʇ੮˚ɘ͐ɻʩ੮ʠ˺̼੮ɻ˺͙˦͐;੮ ̹̼˺ʡ̼ɘ˚ͅ੮˺ʠʠʇ̼ʇʁ੮ɺ;੮rØäੴ੮ʠʇʁʇ̼ɘˑ੮ʡ̼ɘ˦͐ͅੴ੮ɘ˦ʁ੮͐ʩʇ੮ɺ͙ʁʡʇ͐੮ʠ˺̼੮͐ʩʇ੮ɻ͐੮ʮ͐ͅʇˑʠੳ੮Ĕʩɘ͐੮ #ɘˑʮʠ˺̼˦ʮɘ੮ˑɘɻˌʇʁੴ੮ʩʇ੮̹˺ͅʮ͐ͅੴ੮͸ɘͅ੮ુ̹˺ˑʮ͐ʮɻɘˑ੮͸ʮˑˑ੮ɘ˦ʁ੮ʮ˚ɘʡʮ˦ɘ͐ʮ˺˦ੳૂ੮#˺͙˦͐ʮʇͅ੮ʩɘʁ੮͐˺੮ ɘɻ͐ʮͷʇˑ;੮ɘ̹̹ˑ;੮ʠ˺̼੮͐ʩʇͅʇ੮˦ʇ͸੮ʠ͙˦ʁͅ੮ɘ˦ʁ੮ͅʩ˺͸੮ʩ˺͸੮͐ʩʇʮ̼੮̹̼˺ʡ̼ɘ˚ͅ੮͸˺͙ˑʁ੮˚ʇʇ͐੮͐ʩʇ੮ ɻ͐ૄͅ੮̼ʇʩɘɺʮˑʮ͐ɘ͐ʮͷʇ੮˚ɘ˦ʁɘ͐ʇੳ੮îʩʇ;੮ʮ˦͐ͅʇɘʁ੮̼ʇˑʮʇʁ੮˺˦੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅ੮ɘ˦ʁ੮U{)ͅੴ੮ ͐ʩʇ੮̹̼ʮͷɘ͐ʇ੮ͅʇɻ͐˺̼ૄͅ੮̼ʇɘʁ;ચ˚ɘʁʇ੮ુͅ˺ˑ͙͐ʮ˺˦ૂ੮͐˺੮ɻɘͅʇͅ੮͐ʩʇ;੮ɘ͙ͅͅ˚ʇʁ੮͸ʇ̼ʇ੮ʩ˺̹ʇˑʇͅͅˑ;੮ ɻʩ̼˺˦ʮɻੳ ͅ੮ ɘ੮ ̼ʇ͙ͅˑ͐ੴ੮ Ø̼˺ʡ̼ʇͅͅૄͅ੮ ɻ˺˦͐ʮ˦͙͙˚੮ ˺ʠ੮ ɻ̼ʮͅʮͅ੮ ɻˑʮ˦ʮɻͅ੮ ˑʮˌʇ੮ )˺̼ʇੴ੮ )õͅ੮ ˑʮˌʇ੮ rɘ੮ Ø˺ͅɘʁɘੴ੮ɘ˦ʁ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅ੮ˑʮˌʇ੮rɘ੮˚ʮ͐ͅɘʁ੮ͅʇ̼ͷʇ੮˺˦ˑ;੮ɘͅ੮͐ʇ˚̹˺̼ɘ̼;੮˺ɘͅʇͅੳ੮îʩʇ੮ͅˌʮˑˑͅ੮̹ʇ˺̹ˑʇ੮ˑʇɘ̼˦੮͐ʩʇ̼ʇੴ੮͐ʩ˺͙ʡʩੴ੮ɘ̼ʇ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮͐ͅɘ;੮͸ʮ͐ʩ੮͐ʩʇ˚ੳ੮ Ø̼˺ʡ̼ʇͅͅ੮ ͸˺͙ˑʁ੮ ˑʮˌʇ੮ ͐˺੮ ͅʇʇ੮ ɻˑʮʇ˦͐ͅ੮ ʡ˺੮ ʮ˦͐˺੮ ɻ˺˺̹ʇ̼ɘ͐ʮͷʇ੮ ʩ˺͙ͅʮ˦ʡੵ੮ ͅʩɘ̼ʇʁ੮ ɘ̹ɘ̼͐˚ʇ˦͐ͅ੮ͅɻɘ͐͐ʇ̼ʇʁ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳ੮îʩʇ̼ʇੴ੮̼ʇͅʮʁʇ˦͐ͅ੮ɻ˺͙ˑʁ੮ɻ˺ˑˑʇɻ͐ʮͷʇˑ;੮ʁʇɻʮʁʇ੮͐˺੮ ɺʇ੮ͅ˺ɺʇ̼੮˺̼ੴ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇˑ;ੴ੮͐˺੮͙ͅʇ੮ʁ̼͙ʡͅ੮͐˺ʡʇ͐ʩʇ̼ੴ੮͸ʮ͐ʩ੮‡ɘ̼ɻɘ˦੮˺˦੮ʩɘ˦ʁ੮͐˺੮̼ʇͷʮͷʇ੮ ɘ੮ʩ˺͙ͅʇ˚ɘ͐ʇ੮ʠ̼˺˚੮ɘ˦੮˺ͷʇ̼ʁ˺ͅʇੳ੮Ø̼˺ʡ̼ʇͅͅ੮ʮ˚̹ˑʮɻʮ͐ˑ;੮˺̹ʇ̼ɘ͐ʇͅ੮˺˦੮͐ʩʇ੮ɘ͙ͅͅ˚̹͐ʮ˺˦੮ ͐ʩɘ͐੮͐ʩʇ੮˺̹̹˺ͅʮ͐ʇ੮˺ʠ੮ʁʇ̹ʇ˦ʁʇ˦ɻʇ੮˺˦੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʮͅ੮˦˺͐੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇ੮ɺ͙͐ੴ੮ɘͅ੮ʁʮͅɘɺʮˑʮ͐;੮͐ʩʇ˺̼ʮ͐ͅͅ੮ɘ̼ʡ͙ʇੴ੮interdependenceੳ৾਀ U˦੮̹̼ɘɻ͐ʮɻʇੴ੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮ʁʮͅɻʩɘ̼ʡʇ੮ʠ̼˺˚੮Ø̼˺ʡ̼ʇͅͅૄͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ʮ˦͐˺੮äۚͅੳ੮îʩʇ;੮ ɘ̼ʇ੮ɘ͸ɘͅʩ੮ʮ˦੮ʠʇ˦͐ɘ˦;ˑ੮ɘ˦ʁ੮˺ͷʇ̼ɻ̼˺͸ʁʇʁੳ੮Ěʇ͐੮̼ʇͅʮʁʇ˦͐ͅੴ੮ɻ͙͐੮˺ʠʠ੮ʠ̼˺˚੮͐ʩʇ੮ʠ̼ʮʇ˦ʁͅ੮ ͐ʩʇ;੮ʩɘʁ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮˺̼੮ʮ˦੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ɘ̼ʇ੮ͷʇ̼;੮˚͙ɻʩ੮ɘˑ˺˦ʇੳ੮U˦͐ʇ̼ʁʇ̹ʇ˦ʁʇ˦ɻʇੴ੮ ͐ʩʇ˦ੴ੮̼ʇή͙ʮ̼ʇͅ੮ɺ͙ʮˑʁʮ˦ʡ੮˦ʇ͸੮˦ʇ͐͸˺̼ˌͅ੮˺ʠ੮͙̹̹ͅ˺̼͐ੴ੮͐˺੮͸ʩʮɻʩ੮͸ʇ੮˦˺͸੮͙̼͐˦ੳ

SUPPORT: THE POWER OF PEERS îʩʇ̼ʇ੮ɘ̼ʇ੮͐͸˺੮͸ɘ;ͅ੮͐˺੮͐ʩʮ˦ˌ੮ɘɺ˺͙͐੮͐ʩʇ੮̹˺͸ʇ̼੮˺ʠ੮̹ʇʇ̼ͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦ੳ੮Hʮ̼͐ͅੴ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ˑʮͷʇʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮˺ʠ੮ɺʇʮ˦ʡ੮̼͐ʇɘ͐ʇʁ੮ફɘ˦ʁ੮˚ʮ̼͐ͅʇɘ͐ʇʁબ੮ ɺ;੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚੮ ˚ɘˌʇ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ ͐˺੮ ̹̼˺ͷʮʁʇ੮ ͐ͅɘɺʮˑʮ͐;ੴ੮ ͅʇ̼ͷʮɻʇͅੴ੮ ɘ˦ʁ੮ͅˌʮˑˑͅ੮˚˺̼ʇ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ɘ˦ʁ੮ʇʠʠʇɻ͐ʮͷʇੳ੮äʇɻ˺˦ʁੴ੮̹ʇʇ̼ͅ੮ɻɘ˦੮̹̼˺ͷʮʁʇ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮͐ʩ˺ͅʇ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ʁ˺˦ૄ͐ੵ੮ɻ˺˦˦ʇɻ͐ʮ˺˦੮ɘ˦ʁ੮̹͙̼̹˺ͅʇੳ ä͐ɘ̼͐੮ ͸ʮ͐ʩ੮ ͐ͅɘɺʮˑʮΈɘ͐ʮ˺˦ੳ੮ #ʩʮʇʠ੮ Øɘ˦ʡੴ੮ ʠ̼˺˚੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ ä̼͐ʇʇ͐੮ #̼ʮͅʮͅ੮ Ûʇ̹ͅ˺˦ͅʇ੮îʇɘ˚ੴ੮ʩɘʁ੮ʠ˺͙˦ʁ੮͐ʩɘ͐੮ɘʁʁʮ˦ʡ੮ɘ੮̹ʇʇ̼੮ɘˑ˺˦ʡͅʮʁʇ੮ɘ੮̹ɘ̼ɘ˚ʇʁʮɻ੮ɘ˦ʁ੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮ˦ʮɻʮɘ˦੮͙̹̹ʇʁ੮͐ʩʇ੮˺ʁʁͅ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮͸˺͙ˑʁ੮ʇ˦ʡɘʡʇੵ੮ુĔʩʇ˦੮͸ʇ੮ʡ˺੮͙̹੮ ͐˺੮͐ʩɘ͐੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ʮ˦੮˦ʇʇʁੴ੮͐ʩʇ;੮ɻʩ˺˺ͅʇ੮͸ʩ˺੮͐ʩʇ;੮͸ɘ˦͐੮͐˺੮̹ͅʇɘˌ੮͸ʮ͐ʩੳ੯ੳ੯ੳ੯ੳ੮îʩɘ͐੮ ɻ˺͙ˑʁ੮ɺʇ੮͐ʩʇ੮̹ʇ̼ͅ˺˦੮ʮ˦੮͙˦ʮʠ˺̼˚੮ય͐ʩʇ੮̹ɘ̼ɘ˚ʇʁʮɻરੴ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ͅʇʇ˚ͅ੮͐˺੮ɺʇ੮ɘ˦੮

262

REFORM

˺ϲϲʮɻʮɘˑੴ੮͸ʩ˺ૄͅ੮ͅɘʠʇੳ੯ੳ੯ੳ੯ੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮ʮ͐੮˚ʮʡʩ͐੮ɺʇ੮͐ʩʇ੮ɺʇʩɘͷʮ˺̼ɘˑ੮ɻˑʮ˦ʮɻʮɘ˦ੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮ʮ͐ૄͅ੮͐ʩʇ੮̹ʇʇ̼ੳ੮˦ʁ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʮ͐੮ʩɘͅ੮˦˺͐ʩʮ˦ʡ੮͐˺੮ʁ˺੮͸ʮ͐ʩ੮͸ʩɘ͐੮˺͙̼੮̼ʇ̹ͅʇɻ͐ʮͷʇ੮ ̼˺ˑʇͅ੮ɘ̼ʇੴ੮ɺ͙͐੮͸ʩ˺੮ˑ˺˺ˌͅ੮͐ʩʇ੮˚˺͐ͅ੮̹ˑʇɘͅʮ˦ʡ੮͐˺੮͐ʩʇ˚ੳ੯ੳ੯ੳ੯ੳ੮Uʠ੮͸ʇૄ̼ʇ੮ʩɘͷʮ˦ʡ੮ͅ˺˚ʇ˺˦ʇ੮ ͸ʩ˺ૄͅ੮ˈ͙͐ͅ੮ʁʮ̼͙͐͐ͅͅʮ˦ʡ੮ɘ˦ʁ੮͸ʇ੮ʩɘͷʇ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ɻɘ˦੮ͅʮ͐੮˦ʇͽ͐੮͐˺੮͐ʩʇ˚੮ɘ˦ʁ੮ͅɘ;ੴ੮ૃU੮ ʩɘͷʇ੮ɺʇʇ˦੮͐ʩ̼˺͙ʡʩ੮͸ʩɘ͐੮;˺͙ૄͷʇ੮ɺʇʇ˦੮͐ʩ̼˺͙ʡʩੴૄ੮͐ʩɘ͐ૄͅ੮ͷʇ̼;੮̹˺͸ʇ̼ʠ͙ˑੳૂ੮੮̹ʇʇ̼੮ɘˑͅ˺੮ ͅʇ̼ͷʇͅ੮ɘͅ੮ɘ੮ͅˌʇ̹͐ʮɻɘˑ੮͐ʩʮ̼ʁ੮̹ɘ̼͐;੮͸ʩ˺੮˚ʮʡʩ͐੮̼ʇͅʮ͐ͅ੮˺͐ʩʇ̼੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅૄ੮ʁʇͅʮ̼ʇ੮͐˺੮ ɻɘˑˑ੮͐ʩʇ੮̹˺ˑʮɻʇ੮˺̼੮ʮ˚̹˺ͅʇ੮ɘ੮৵ৱ৵ৰੳ îʩʇ̼ʇૄͅ੮ɘ੮̼˺ˑʇ੮ʠ˺̼੮̹ʇʇ̼ͅ੮ʮ˦੮ʡʇ͐͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮ͅʇ̼ͷʮɻʇͅੴ੮͐˺˺ੳ੮#ʩɘʁ੮#˺͐ͅʇˑˑ˺ੴ੮͐ʩʇ੮ ʇͽʇɻ͙͐ʮͷʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮ͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮ä˺ɻʮɘˑ੮Ûʇʩɘɺʮˑʮ͐ɘ͐ʮ˺˦੮ʡʇ˦ɻʮʇͅੴ੮ ɘ̼ʡ͙ʇʁ੮͐ʩɘ͐੮͸ʇ੮˦ʇʇʁ੮ɘ੮˦ʇ͸੮ʮ˦͐ʇ̼̹̼ʇ͐ɘ͐ʮ˺˦੮˺ʠ੮͸ʩ;੮̹ʇ˺̹ˑʇ੮̼ʇʠ͙ͅʇ੮ɻɘ̼ʇੵ੮ુĔʇ੮ʩɘͷʇ੮͐˺੮ ͐ͅ˺̹੮ɺˑɘ˚ʮ˦ʡ੮͐ʩʇ੮ɻ͙͐ͅ˺˚ʇ̼੮ʠ˺̼੮˺͙̼੮ʮ˦ɘɺʮˑʮ͐;੮͐˺੮˚ɘˌʇ੮͐ʩʇ੮ͅɘˑʇੳૂ੮";੮ʮ˦ɻ˺̼̹˺̼ɘ͐ʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ˑʮͷʇʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ʮ˦͐˺੮ɻˑʮ˦ʮɻɘˑ੮͐ʇɘ˚ͅੴ੮ુ͸ʇ੮˚ɘ;੮ɘɻ͙͐ɘˑˑ;੮ʡʇ͐੮͐ʩʇ੮̹̼˺ʁ͙ɻ͐੮ ˑʮ˦ʇ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͐ʩʇ੮ͅɘˑʇͅ੮ʠ˺̼ɻʇ੮͐ʩɘ͐੮͸ʇ੮˦ʇʇʁੳૂ৾ਁ੮/̼ʮɻ੮Pʇ˦̼ʮή͙ʇͅੴ੮ʠ̼˺˚੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ ͅͅ˺ɻʮɘ͐ʮ˺˦ੴ੮ʁʇͅɻ̼ʮɺʇʁ੮ʩ˺͸੮ʩʇ੮ɻ˺͙ˑʁ੮ɘ͙ʡ˚ʇ˦͐੮͐ʩʇ੮ʇʠʠ˺̼͐ͅ੮˺ʠ੮˚˺̼ʇ੮̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ɻˑʮ˦ʮɻʮɘ˦ͅੵ੮ુäɘ;੮ɘ੮̹ɘ̼͐ʮɻʮ̹ɘ˦͐੮ʮͅ੮̹̼ʇͅɻ̼ʮɺʇʁ੮˦ʇ͸੮ɘ˦͐ʮ̹ͅ;ɻʩ˺͐ʮɻͅੴ੮ɘ˦ʁ੮͐ʩʇ;ૄ̼ʇ੮ʩɘͷʮ˦ʡ੮ ɺɘʁ੮̼ʇɘɻ͐ʮ˺˦ͅ੮͐˺੮͐ʩɘ͐ੳ੯ੳ੯ੳ੯ੳ੮੮̹ʇʇ̼੮ʮͅ˦ૄ͐੮͐ʩʇ̼ʇ੮͐˺੮̹̼˺˚˺͐ʇ੮˺̼੮ʁʮͅɻ˺͙̼ɘʡʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮ ɺ͙͐੮͸ʇ੮ɻɘ˦੮͐ɘˑˌ੮ɘɺ˺͙͐੮˺͙̼੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅੳ੯ੳ੯ੳ੯ੳ੮Uૄ˚੮ʡ˺˺ʁ੮ɘ͐੮͸˺̼ˌʮ˦ʡ੮͸ʮ͐ʩ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʮ͐ʩ੮ͅɻʩʮΈ˺ɘʠʠʇɻ͐ʮͷʇ੮ʁʮͅ˺̼ʁʇ̼ੴ੮ɘ˦ʁ੮Uૄͷʇ੮ʩɘʁ੮ͅ˺˚ʇ੮̼͐ʮɘˑ੮ɘ˦ʁ੮ʇ̼̼˺̼ੴ੮ɺ͙͐੮ɘˑͅ˺੮͙ͅɻɻʇͅͅ੮ ય͸ʮ͐ʩ੮˚ʇʁʮɻɘ͐ʮ˺˦ͅરੴ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ʁʇɻɘʁʇͅੳ੮U੮ɻɘ˦੮ͅʩɘ̼ʇ੮˚;੮ˑʮͷʇʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇੴ੮͸ʩʇ̼ʇɘͅ੮ ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮˺̼੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ɻɘ˦ૄ͐੮ʁ˺੮͐ʩɘ͐ੴ੮ͅʩ˺͙ˑʁ˦ૄ͐੮ʁ˺੮͐ʩɘ͐ੳૂ Øʇʇ̼ͅ੮ʩʇˑ̹੮͐ͅɘʠʠ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮ˑʮˌʇ੮͐ʩ˺ͅʇ੮˺ʠ੮Ø̼˺ʡ̼ʇͅͅੳ੮U˦੮ͅ˺˚ʇ੮ɻɘͅʇͅੴ੮͐ʩʇ;੮ ˈ͙͐ͅ੮͐ɘˌʇ੮͐ʩʇ˚੮˺ͷʇ̼ੳ੮ુØʇʇ̼੮̼ʇ̹ͅʮ͐ʇͅૂ੮ɘ̼ʇ੮ɘ੮ɺʮ͐੮ˑʮˌʇ੮ɻ͙͐ʇ੮)ʮͷʮͅʮ˺˦੮õ˦ʮ͐ͅੴ੮˚ʮ˦͙ͅ੮ ͐ʩʇ੮ɻˑʮ˦ʮɻʮɘ˦ͅੳ੮I͙;͐˺˦੮#˺ˑɘ˦͙͐˺˦˺ੴ੮ʠ̼˺˚੮rૄͅ੮Ø̼˺ˈʇɻ͐੮Ûʇ͙̼͐˦੮Øʇʇ̼੮ä͙̹̹˺̼͐੮‡ʇ͐͸˺̼ˌੴ੮ ɻ̼ʮ͐ʮή͙ʇʁ੮ ુ͐ͅʇ̼ʮˑʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ʇ˦ͷʮ̼˺˦˚ʇ˦͐ͅ੮ યˑʮˌʇ੮ /Ûͅર੮ ͐ʩɘ͐੮ ʁʮͅɻ˺͙˦͐੮ ʇͷʇ̼;͐ʩʮ˦ʡ੮͐ʩɘ͐੮;˺͙ૄ̼ʇ੮ͅʩɘ̼ʮ˦ʡੴ੮ʠʇʇˑʮ˦ʡੴ੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡੳ੮îʩʇ;੮̹͙͐੮ʮ͐੮ɘˑˑ੮ʮ˦͐˺੮͐ʩʮͅ੯ੳ੯ੳ੯ੳ੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ˑʇ˦ͅ੮͐ʩɘ͐੮͸ʩɘ͐ʇͷʇ̼੮;˺͙ૄ̼ʇ੮ͅʇʇʮ˦ʡ੮˺̼੮ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡੴ੮ʮ͐ૄͅ੮ͅ;˚̹͐˺˚ͅੳૂ৾ਂ੮ Øʇʇ̼੮ ̼ʇ̹ͅʮ͐ʇͅੴ੮ ɺ;੮ ɻ˺˦̼͐ɘ͐ͅੴ੮ ͅʇ̼ͷʇ੮ ɘͅ੮ ɘ੮ ુɺʇʁ੮ ɘ˦ʁ੮ ɺ̼ʇɘˌʠɘ͐ͅ੮ ʠ˺̼੮ ̹ʇ˺̹ˑʇ੮ ʇͽ̹ʇ̼ʮʇ˦ɻʮ˦ʡ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʁʮ̼͐ͅʇͅͅੴૂ੮˺ʠʠʇ̼ʮ˦ʡ੮ુ̼ɘʁʮɻɘˑ੮ʩ˺̹ͅʮ͐ɘˑʮ͐;ૂ੮͐ʩɘ͐੮ͅɘ;ͅੴ੮ુĚ˺͙ૄ̼ʇ੮͸ʇˑɻ˺˚ʇ੮ ʩʇ̼ʇੴ੮ɘͅ੮;˺͙੮ɘ̼ʇੳૂ੮Pɘɻʮʇ˦ʁɘ੮˺ʠ੮P˺̹ʇੴ੮ɘ੮͐ʇ˦ચɺʇʁ੮̼ʇͅʮʁʇ˦ɻʇ੮ʮ˦੮r˺˦ʡ੮"ʇɘɻʩੴ੮ʩɘͅ੮˦˺੮ ˑ˺ɻˌʇʁ੮ʁ˺˺̼ͅੴ੮˦˺੮ɺ͙ΈΈʇ̼ͅੴ੮ɘ˦ʁ੮˦˺੮˚ɘ˦ʁɘ͐˺̼;੮ʡ̼˺͙̹ͅ੮ફɘˑ͐ʩ˺͙ʡʩ੮˺ʠʠʇ̼ʮ˦ʡͅ੮ʮ˦ɻˑ͙ʁʇ੮ ˚ʇʁʮ͐ɘ͐ʮ˺˦੮˺̼੮ɘ̼͐બઝˈ͙͐ͅ੮̹ʇʇ̼੮͐ͅɘʠʠ੮ɘͷɘʮˑɘɺˑʇ੮৲৴ઃ৷੮ʠ˺̼੮ɘ੮͐ͅɘ;੮˺ʠ੮͙̹੮͐˺੮˺˦ʇ੮˚˺˦͐ʩੳ੮ äʮ˦ɻʇ੮̼ʇ̹ͅʮ͐ʇͅ੮ʁʮͷʇ̼͐੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮˚ʮʡʩ͐੮˺͐ʩʇ̼͸ʮͅʇ੮ɺʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁੴ੮#˺ˑɘ˦͙͐˺˦˺੮ʮͅ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮ɘͅˌʇʁ੮ʩ˺͸੮͐ʩʇ;੮ʩɘ˦ʁˑʇ੮ɻ̼ʮͅʇͅੳ੮Pʇ੮ɻ˺͙˦͐ʇ̼ͅੴ੮ુĔʇ੮ɘˑ˚˺͐ͅ੮˦ʇͷʇ̼੮ʩɘͷʇ੮ɘ੮ ɻ̼ʮͅʮͅੳ੮Ĕʩ;੮͸˺͙ˑʁ੮̹ʇ˺̹ˑʇ੮͐ʩ̼ʇɘ͐ʇ˦੮͙ͅ੮˺̼੮ɘɻ͐੮˺͙͐ੴ੮͸ʩʇ˦੮͸ʇૄ̼ʇ੮ʡʮͷʮ˦ʡ੮͐ʩʇ˚੮ˑ˺ͷʇ੺ૂ৾ਃ੮ Ěʇ͐੮ ͐ʩʇ̼ʇ੮ ɘ̼ʇ੮ ˺˦ˑ;੮ ϲʮͷʇ੮ ̹ʇʇ̼੮ ̼ʇ̹ͅʮ͐ʇͅ੮ ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ʁʇ̹ͅʮ͐ʇ੮ ɺʮˑˑʮ˺˦ͅ੮ ˺ʠ੮ ͙˦̹ͅʇ˦͐੮ ʁ˺ˑˑɘ̼ͅ੮ʠ̼˺˚੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ɻ͐੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮̹ɘ;੮ʠ˺̼੮͐ʩʇ˚ੳ৾਄

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

263

#ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮˺˦੮͐ʩʇ੮̹̼ʇɻʮ̹ʮɻʇ੮˺ʠ੮ɘ੮˚ɘͅͅʮͷʇ੮ʇͽ̹ɘ˦ͅʮ˺˦੮ʮ˦੮͐ʩʇ੮̼˺ˑʇ੮˺ʠ੮̹ʇʇ̼ͅੳ੮U˦੮ ৲ৰ৲ৰੴ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼੮ͅʮʡ˦ʇʁ੮ä"੮৸ৰ৳ੴ੮͸ʩʮɻʩ੮ɘˑˑ˺͸ͅ੮̼͐ɘʮ˦ʇʁ੮̹ʇʇ̼੮̹ͅʇɻʮɘˑʮ͐ͅͅ੮͐˺੮ɺʇ੮ɻʇ̼͐ʮϲʮʇʁ੮ɺ;੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɘ˦ʁ੮͐˺੮ɺʮˑˑ੮{ʇʁʮચ#ɘˑੳ੮#ɘˑʮʠ˺̼˦ʮɘ੮͸ɘͅ੮͐ʩʇ੮ʠ˺̼͐;ચ˦ʮ˦͐ʩ੮͐ͅɘ͐ʇ੮͐˺੮ ʁ˺੮ͅ˺ੵ੮̹̼ʇͷʮ˺͙ͅ੮ʮ͐ʇ̼ɘ͐ʮ˺˦ͅ੮˺ʠ੮͐ʩʇ੮ɺʮˑˑ੮ʩɘʁ੮ɺʇʇ˦੮ͷʇ͐˺ʇʁ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮˺̹̹˺ͅʮ͐ʮ˺˦੮ʠ̼˺˚੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮͸ʩ˺੮ʠʇɘ̼ʇʁ੮ɻ˺˚̹ʇ͐ʮ͐ʮ˺˦੮ʠ̼˺˚੮̹ʇʇ̼ͅ੮ફ͸ʩ˺੮ɘ̼ʇ੮ʡʇ˦ʇ̼ɘˑˑ;੮˦˺͐੮͙˦ʮ˺˦ʮΈʇʁ੮ ɘ˦ʁ੮̹ɘʮʁ੮˚͙ɻʩ੮ˑʇͅͅબੳ৿৻੮ͅ੮ɘ੮ͅ˺͙̼ɻʇ੮ʮ˦੮͐ͅɘ͐ʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮͐˺ˑʁ੮˚ʇੴ੮͸ʮ͐ʩ੮͐ʩ˺ͅʇ੮̼͐ɘʁʮ͐ʮ˺˦ɘˑ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮̼ʇ͐ʮ̼ʮ˦ʡ੮ʮ˦੮ʁ̼˺ͷʇͅ੮ɘ˦ʁ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮͙˦ɘɺˑʇ੮͐˺੮˚ʇʇ͐੮͐ʩʇ੮̼ʮͅʮ˦ʡ੮ ʁʇ˚ɘ˦ʁ੮ʠ˺̼੮ɻɘ̼ʇੴ੮ɻʇ̼͐ʮʠ;ʮ˦ʡ੮̹ʇʇ̼ͅ੮͸ɘͅ੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ુɺʮʡ੮͸˺̼ˌʠ˺̼ɻʇ੮̹ˑɘ;ૂ੮͐˺੮ϲʮˑˑ੮͐ʩʇ੮ ʡɘ̹ੳ੮‡˺͐੮ʇͷʇ̼;˺˦ʇ੮ʮͅ੮͙̼ͅʇ੮͐ʩʮͅ੮ʮͅ੮ɘ˦੮͙˦ɘʁ͙ˑ͐ʇ̼ɘ͐ʇʁ੮̹˺ͅʮ͐ʮͷʇੳ੮Øʇʇ̼੮͙̹̹ͅ˺̼͐ͅ੮͐ͅɘ̼͐ʇʁ੮ ͸ʮ͐ʩʮ˦੮ ુ͙̼ͅͷʮͷ˺̼ૂ੮ ɘ˦ʁ੮ ુʇͽચ̹ɘ͐ʮʇ˦͐ૂ੮ ˚˺ͷʇ˚ʇ˦͐ͅ੮ ͐ʩɘ͐੮ ͸ɘ˦͐ʇʁ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ ͸ʇ̼ʇ੮ɺ˺͐ʩ੮ુɻɘ̼ʮ˦ʡ੮ɘ˦ʁ੯ੳ੯ੳ੯ੳ੮ʁʇϲʮɘ˦͐ૂ੮͐˺͸ɘ̼ʁ੮˚ɘʮ˦̼͐ͅʇɘ˚੮̹ͅ;ɻʩʮɘ̼͐;ੳ৿ৼ੮I͙;͐˺˦੮#˺ˑɘ˦͙͐˺˦˺ੴ੮ʠ̼˺˚੮Ø̼˺ˈʇɻ͐੮Ûʇ͙̼͐˦ੴ੮ʠʇɘ̼ͅ੮͐ʩɘ͐੮ɺʮˑˑʮ˦ʡ੮{ʇʁʮચ#ɘˑ੮ɻ˺͙ˑʁ੮ુʁʇ̼͐ͅ˺;੮ɘˑˑ੮˺ʠ੮ ͙ͅૂ੮ɺ;੮ʠ˺̼ɻʮ˦ʡ੮̹ʇʇ̼ͅ੮͐˺੮ϲʮ͐੮͸ʩɘ͐੮͐ʩʇ;੮ʁ˺੮ʮ˦͐˺੮͐ʩʇ੮ͅɘ˚ʇ੮˦ɘ̼̼˺͸ੴ੮ͅ;˚̹͐˺˚ચʠ˺ɻ͙ͅʇʁ੮ ɺ˺ͽʇͅ੮ɘͅ੮˺͐ʩʇ̼੮̼ʇʮ˚ɺ͙̼ͅɘɺˑʇ੮ͅʇ̼ͷʮɻʇͅੳ৿৽ îʩʮͅ੮ʮͅ੮͸ʩ;੮ʮ͐ૄͅ੮ʮ˚̹˺̼͐ɘ˦͐੮͐˺੮ˑ˺˺ˌ੮ɘ͐੮͸ʩɘ͐੮̹ʇʇ̼ͅ੮ɻɘ˦੮ʁ˺੮͐ʩɘ͐੮ɻˑʮ˦ʮɻɘˑ੮ͅʇ̼ͷʮɻʇͅੴ੮ ͸ʩʇ͐ʩʇ̼੮ʁʇˑʮͷʇ̼ʇʁ੮ɺ;੮̹ʇʇ̼ͅ੮˺̼੮˺͐ʩʇ̼ͅੴ੮ɻɘ˦˦˺͐ੳ੮U੮ͷʮͅʮ͐ʇʁ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮#ˑ͙ɺʩ˺͙ͅʇੴ੮ ʮ˦੮ ɘ੮ ̼͐ͅʮ̹੮ ˚ɘˑˑ੮ ʮ˦੮ äɘ˦੮ {ɘ͐ʇ˺ੴ੮ ˈ͙͐ͅ੮ ͅ˺͙͐ʩ੮ ˺ʠ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ੴ੮ ʮ˦੮ {ɘ̼ɻʩ੮ ৲ৰ৲৲ੳ੮ {;੮ ʡ͙ʮʁʇੴ੮)ɘͷʇੴ੮ɘ੮͸ʩʮ͐ʇ੮˚ɘ˦੮͸ʩ˺੮ˑ˺˺ˌͅ੮͐˺੮ɺʇ੮ʮ˦੮ʩʮͅ੮ͅʮͽ͐ʮʇͅੴ੮ʮ˦̼͐˺ʁ͙ɻʇͅ੮ʩʮ˚ͅʇˑʠ੮ɺ;੮ ͅɘ;ʮ˦ʡ੮ʩʇ੮͸ɘͅ੮˚ɘ̼̼ʮʇʁ੮ɘ˦ʁ੮͸˺̼ˌʇʁ੮ɘͅ੮ɘ੮˚ɘɻʩʮ˦ʮ͐ͅ੮͙˦͐ʮˑ੮ʩʇ੮ʩɘʁ੮ɘ੮ૃ̹ͅ;ɻʩ˺͐ʮɻ੮ɺ̼ʇɘˌੴૄ੮ ͸ʩʮɻʩੴ੮ʩʇ੮˺ɺͅʇ̼ͷʇͅ੮ɘʠ͐ʇ̼੮ɘ੮̹ɘ͙ͅʇੴ੮ૃU੮ʡ͙ʇͅͅ੮ʩɘ̹̹ʇ˦ͅ੮͐˺੮ɘˑˑ੮˺ʠ੮͙ͅ੮ɘ͐੮ͅ˺˚ʇ੮̹˺ʮ˦͐ੳૄ Ĕʩʇ͐ʩʇ̼੮˺̼੮˦˺͐੮͐ʩɘ͐੮͐ͅɘ͐ʇ˚ʇ˦͐੮ʮͅ੮̼ʇɘˑˑ;੮̼͙͐ʇੴ੮͐ʩʇ੮̹˺͸ʇ̼੮˺ʠ੮ɘ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮͐ʩɘ͐੮ ʮ͐ૄͅ੮ɘ੮̹ͅɘɻʇ੮͸ʩʇ̼ʇ੮;˺͙੮˚ʮʡʩ͐੮ɺʇ੮ɘɺˑʇ੮͐˺੮ɺʇˑʮʇͷʇ੮ʮ͐੮ʮͅੳ੮îʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮˚˺ͷʇ˚ʇ˦͐੮ ͐ͅɘ̼͐ʇʁ੮ʮ˦੮ৱ৹৴৳੮͸ʮ͐ʩ੮ɘ੮̹ɘ͐ʮʇ˦͐੮ɻˑ͙ɺ੮ɘ͐੮Û˺ɻˌˑɘ˦ʁ੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑੴ੮ɘ˦੮ɘͅ;ˑ͙˚੮ʮ˦੮‡ʇ͸੮ Ě˺̼ˌ੮͐ʩɘ͐੮ɘ͐੮ʮ͐ͅ੮ʩʇʮʡʩ͐੮ʮ˦͐ʇ̼˦ʇʁ੮˦ʮ˦ʇ੮͐ʩ˺͙ͅɘ˦ʁ੮̹ʇ˺̹ˑʇੳ৿৾੮îʩʇ੮ʡ̼˺͙̹੮ʮ˦ɻ˺̼̹˺̼ɘ͐ʇʁ੮ ʮ˦੮ৱ৹৴৹੮ɘͅ੮H˺͙˦͐ɘʮ˦੮P˺͙ͅʇੴ੮͸ʩʮɻʩ੮ʮ˦ʩɘɺʮ͐ͅ੮ɘ੮ϲʮͷʇચ͐ͅ˺̼;੮˚ɘ˦ͅʮ˺˦੮ʮ˦੮{ɘ˦ʩɘ͐͐ɘ˦ੳ੮ U͐੮ʮͅ੮͐ʩʇ੮ʇ̹ʮɻʇ˦͐ʇ̼੮˺ʠ੮ɘ੮˚˺ͷʇ˚ʇ˦͐੮͐ʩɘ͐੮ʩɘͅ੮̹̼ͅʇɘʁ੮͐˺੮͐ʩʮ̼͐;੮ɻ˺͙˦̼͐ʮʇͅ੮ɘ˦ʁ੮ʩɘͅ੮৳৲ৰ੮ ɘʁʩʇ̼ʇ˦͐ͅੴ੮ʮ˦ɻˑ͙ʁʮ˦ʡ੮͐ʇ˦੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੳ৿৿ #ˑ͙ɺʩ˺͙ͅʇ੮ ̹ɘ̼͐ʮɻʮ̹ɘ˦͐ͅੴ੮ ɘͅ੮ )ɘͷʇ੮ ʇ˚̹ʩɘͅʮΈʇͅ੮ ˺˦੮ ˚;੮ ͐˺͙̼ੴ੮ ɘ̼ʇ੮ ˚ʇ˚ɺʇ̼ͅੴ੮ ˦˺͐੮ ̹ɘ͐ʮʇ˦͐ͅੴ੮ɻˑʮʇ˦͐ͅੴ੮˺̼੮ɻ˺˦͙ͅ˚ʇ̼ͅੳ੮ɻ͐ʮͷʮ͐;੮ʮ˦੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮˺̼ʡɘ˦ʮΈʇʁ੮ɘ̼˺͙˦ʁ੮ ͅ˺˚ʇ͐ʩʮ˦ʡ੮ ˺͐ʩʇ̼੮ ͐ʩɘ˦੮ ̼͐ʇɘ͐˚ʇ˦͐ੵ੮ ͐ʩʇ੮ ͷʮɺ̼ɘ˦͐੮ ˑʮʠʇ੮ ˺ʠ੮ ͐ʩʇ੮ #ˑ͙ɺʩ˺͙ͅʇ੮ ʮ͐ͅʇˑʠੳ੮ U੮ ͅʮ͐੮ ʮ˦੮ ˺˦੮ ˺˦ʇ੮ ɻ˺˚˚͙˦ʮ͐;੮ ˚ʇʇ͐ʮ˦ʡ੮ ͸ʩʇ̼ʇੴ੮ ʁ͙̼ʮ˦ʡ੮ ɘ੮ ʁʮͅɻ͙ͅͅʮ˺˦੮ ˺ʠ੮ ͸ʩʇ͐ʩʇ̼੮ ͐˺੮ ʡʮͷʇ੮ ̼ʇɻʇʮ̹͐ͅ੮ʠ˺̼੮̹͙̼ɻʩɘͅʇͅ੮ʮ˦੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇૄͅ੮ͅ˚ɘˑˑ੮ɻɘʠʋੴ੮˺˦ʇ੮˚ʇ˚ɺʇ̼੮ɻ͙͐ͅ੮ʮ˦੮͐˺੮ͅʩʇʇ̹ʮͅʩˑ;੮ ʁʇͅɻ̼ʮɺʇ੮ ʩɘͷʮ˦ʡ੮ ˚ʮͅͅʇʁ੮ ɘ੮ ̼ʇɻʇ˦͐੮ ˚ʇʇ͐ʮ˦ʡ੮ ɺʇɻɘ͙ͅʇ੮ ʩʇ੮ ͸ɘͅ੮ ʮ˦੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑੳ੮ ˦˺͐ʩʇ̼੮˚ʇ˚ɺʇ̼੮˺ʠʠʇ̼ͅ੮ʩʇ̼੮ɻ˺˦ʁ˺ˑʇ˦ɻʇͅ੮ɘ˦ʁ੮͐ͅɘ̼͐ͅ੮͐ɘˑˌʮ˦ʡ੮ɘɺ˺͙͐੮ɘ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ ɻʩɘ˦ʡʇ੮͐ʩɘ͐੮ˑʇʠ͐੮ʩʇ̼੮͙˦ɘɺˑʇ੮͐˺੮ͅˑʇʇ̹ੳ੮îʩʇ੮˚ʇʇ͐ʮ˦ʡૄͅ੮ʠɘɻʮˑʮ͐ɘ͐˺̼੮ˑʇ͐ͅ੮͐ʩʇ੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦੮̹ˑɘ;੮˺͙͐੮ʠ˺̼੮ɘ੮ʠʇ͸੮˚ʮ˦͙͐ʇͅੴ੮ɺʇʠ˺̼ʇ੮ʡʇ˦͐ˑ;੮ʡ͙ʮʁʮ˦ʡ੮͐ʩʇ੮ʡ̼˺͙̹੮ɺɘɻˌ੮͐˺੮ɘ੮ɺ͙ͅ;੮

264

REFORM

ɘʡʇ˦ʁɘ੮͐ʩɘ͐੮ʮ˦ɻˑ͙ʁʇͅ੮̹ˑɘ˦˦ʮ˦ʡ੮ɘ˦੮͙̹ɻ˺˚ʮ˦ʡ੮ɺʮ̼͐ʩʁɘ;੮̹ɘ̼͐;੮ɘ˦ʁ੮̹̼˺ʁ͙ɻʮ˦ʡ੮˦ʇͽ͐੮ ˚˺˦͐ʩૄͅ੮˦ʇ͸ͅˑʇ͐͐ʇ̼ੳ੮îʩʇ੮͙˦ɻ˺˦ʁʮ͐ʮ˺˦ɘˑ੮ɘɻɻʇ̹͐ɘ˦ɻʇ੮˺ʠ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮͐ʩɘ͐੮͐ʩʇ੮̼ʇ͐ͅ੮˺ʠ੮ ͅ˺ɻʮʇ͐;੮ʁʇʇ˚ͅ੮ɘɺ˦˺̼˚ɘˑੴ੮͸ʩʮˑʇ੮̼ʇʠ˺ɻ͙ͅʮ˦ʡ੮˺˦੮͐ʩʇ੮˦˺̼˚ɘˑ੮˚ʮ˦͙͐ʮɘʇ੮ફͅ˺˚ʇ͐ʮ˚ʇͅ੮ ̹ɘʮ˦ʠ͙ˑˑ;੮˦˺̼˚ɘˑੴ੮͐˺੮ɘ˦;˺˦ʇ੮ɘɻɻ͙͐ͅ˺˚ʇʁ੮͐˺੮͐ʩʇ੮ʠ̼͙̼͐ͅɘ͐ʮ˺˦੮˺ʠ੮ʡʇ͐͐ʮ˦ʡ੮ɘ˦;͐ʩʮ˦ʡ੮ ʁ˺˦ʇ੮ͷʮɘ੮ɻ˺˚˚ʮ͐͐ʇʇ੮ʮ˦੮ɘ˦;੮ͷ˺ˑ͙˦͐ɘ̼;੮˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦બੴ੮ʮͅ੮͸ʩɘ͐੮˚ɘˌʇͅ੮#ˑ͙ɺʩ˺͙ͅʇͅ੮ ͅ˺੮ʁʮ͐ͅʮ˦ɻ͐ʮͷʇੳ š˦ʇ੮˺ʠ੮͐ʩʇ੮ɺ͙ͅʮʇ͐ͅ੮͙˦ʮ͐ͅ੮˺ʠ੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮͐ʩʇ੮˺˦ʇ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ ʇ˚̹ˑ˺;˚ʇ˦͐ੳ੮Ĕ˺̼ˌੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮H˺͙˦͐ɘʮ˦੮P˺͙ͅʇੴ੮ʮͅ੮ɘ੮ુʡʇ˦ʇ̼ɘ͐ʮͷʇ੮ɘ˦ʁ੮̼ʇʮ˦͐ʇʡ̼ɘ͐ʮͷʇ੮ʠ˺̼ɻʇૂ੮͸ʩʮɻʩ੮ͅʩ˺͙ˑʁ੮ુ͙˦ʁʇ̼ˑʮʇੴ੮̹ʇ̼ͷɘʁʇੴ੮ɘ˦ʁ੮ʮ˦ʠ˺̼˚੮ɘˑˑ੮͐ʩʇ੮ɘɻ͐ʮͷʮ͐ʮʇͅ੮͐ʩɘ͐੮˚ɘˌʇ੮ ͙̹੮͐ʩʇ੮ˑʮʠʇɺˑ˺˺ʁ੮˺ʠ੮͐ʩʇ੮ɻˑ͙ɺʩ˺͙ͅʇੳૂ৿਀੮੮ɺ͙ˑˑʇ͐ʮ˦੮ɺ˺ɘ̼ʁ੮ʮͅ੮ɻ˺ͷʇ̼ʇʁ੮ʮ˦੮͐͸ʇ˦͐;ચ˺̼ચͅ˺੮ ˈ˺ɺ੮̹˺͐ͅʮ˦ʡͅੳ੮˦੮ɘʁˈɘɻʇ˦͐੮͸ʩʮ͐ʇɺ˺ɘ̼ʁ੮ˑʮ͐ͅͅ੮ϲʮͷʇ੮˚ʇ˚ɺʇ̼ͅ੮͸ʩ˺੮ʩɘͷʇ੮ʠ˺͙˦ʁ੮ˈ˺ɺͅ੮ɘͅ੮ ˑʮɺ̼ɘ̼;੮ɘʮʁʇͅੴ੮̹ʇʇ̼੮̹ͅʇɻʮɘˑʮ͐ͅͅੴ੮ɘ˦ʁ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮͷʇ੮ɘͅͅʮ͐ͅɘ˦͐ͅੳ੮˚ʇ̼ʮɻɘૄͅ੮ʁʇɻ̼ʇ̹ʮ͐੮ ͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇੴ੮ɘ˦͐ʩ̼˺̹˺ˑ˺ʡʮ͐ͅ੮ä͙ʇ੮/̼͐ͅ˺ʠʠ੮˺ɺͅʇ̼ͷʇʁ੮ʮ˦੮ৱ৹৸ৱੴ੮̼ʇή͙ʮ̼ʇͅ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ɻˑʮʇ˦͐ͅ੮͐˺੮ʩʮʡʩˑʮʡʩ͐੮͐ʩʇʮ̼੮˺͸˦੮ુʁʮͅɘɺʮˑʮ͐ʮʇͅੴ੮ʁʮɘʡ˦˺ͅʇͅੴ੮ɘ˦ʁ੮ʁʇϲʮɻʮ͐ͅૂ੮ʮ˦੮˺̼ʁʇ̼੮͐˺੮ ʡʇ͐੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙̼ʮ͐;੮ʁʮͅɘɺʮˑʮ͐;੮ʮ˦ɻ˺˚ʇ੮͐ʩʇ;੮˦ʇʇʁ੮͐˺੮͙̼ͅͷʮͷʇੳ৿ਁ੮#ˑ͙ɺʩ˺͙ͅʇͅ੮ʩɘͷʇ੮ ʠ˺͙˦ʁ੮ͅ˺˚ʇ੮ɻˑʇͷʇ̼੮͸ɘ;ͅ੮͐˺੮ʩʇˑ̹੮˚ʇ˚ɺʇ̼ͅ੮ʇͅɻɘ̹ʇ੮͐ʩʮͅ੮̼͐ɘ̹ੳ੮#ˑ͙ɺʩ˺͙ͅʇͅ੮ɻɘ˦੮˺̼ʡɘ˦ʮΈʇ੮ુ̼͐ɘ˦ͅʮ͐ʮ˺˦ɘˑ੮ʇ˚̹ˑ˺;˚ʇ˦͐ૂ੮͸ʩʇ̼ʇɺ;੮͐ͅɘʠʠ੮ʡ͙ɘ̼ɘ˦͐ʇʇ੮ʇ˚̹ˑ˺;ʇ̼ͅ੮͐ʩɘ͐੮͐ʩʇ;ૄˑˑ੮ ͐ͅʇ̹੮ʮ˦੮ʮʠ੮ɘ੮˚ʇ˚ɺʇ̼੮˚ʮͅͅʇͅ੮ɘ੮ͅʩʮʠ͐੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;ૄ̼ʇ੮ͅʮɻˌ੮˺̼੮ʮ˦੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮Iʮͷʇ˦੮ ʮ͐ͅ੮ ˑ˺ɻɘ͐ʮ˺˦੮ ʮ˦੮ äʮˑʮɻ˺˦੮ ēɘˑˑʇ;ੴ੮ Uૄ˚੮ ˦˺͐੮ ͙̼̹̼ͅʮͅʇʁ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ #ˑ͙ɺʩ˺͙ͅʇ੮ ˺̼ʡɘ˦ʮΈʇͅ੮ʇͷʇ˦͐ͅ੮ͷʮɘ੮äˑɘɻˌ੮ɘ˦ʁ੮͙ͅʇͅ੮äή͙ɘ̼ʇ੮͐˺੮̹̼˺ɻʇͅͅ੮̹ɘ;˚ʇ˦͐ͅ੮ɘ͐੮͐ʩʇ੮ɻɘʠʋੴ੮ɺ˺͐ʩ੮ ˺ʠ੮͸ʩʮɻʩ੮ʡʮͷʇ੮˚ʇ˚ɺʇ̼ͅ੮ͷ˺ɻɘ͐ʮ˺˦ɘˑ੮ͅˌʮˑˑͅੳ H˺̼੮˺͐ʩʇ̼ͅੴ੮#ˑ͙ɺʩ˺͙ͅʇͅ੮˺ʠʠʇ̼੮˚ʇɘ˦ʮ˦ʡʠ͙ˑ੮ɘɻ͐ʮͷʮ͐;੮ʇͷʇ˦੮ʮʠ੮ʡʇ͐͐ʮ˦ʡ੮ɘ੮̹ɘ;ɻʩʇɻˌ੮ ʮͅ੮͙˦ɘ͐͐ɘʮ˦ɘɺˑʇ੮˺̼੮͙˦ʁʇͅʮ̼ɘɺˑʇੳ੮"ʇͷʇ̼ˑ;੮͐ʇˑˑͅ੮˚ʇ੮ͅʩʇૄͅ੮ɺʇʇ˦੮ʮ˦੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚੮ʠ˺̼੮ʠ˺̼͐;੮;ʇɘ̼ͅੴ੮ͅʮ˦ɻʇ੮ͅʩʇ੮ʩɘʁ੮ɘ੮ʁʇˑ͙ͅʮ˺˦੮͐ʩɘ͐੮ͅʩʇ੮͸ɘͅ੮ʡʇ͐͐ʮ˦ʡ੮˚ɘ̼̼ʮʇʁ੮͐˺੮ ɘ੮͸ʇɘˑ͐ʩ;੮˚ɘ˦੮ɘ˦ʁ੮ʩʇ̼੮̹ɘ̼ʇ˦͐ͅ੮˺̼ʡɘ˦ʮΈʇʁ੮ɘ੮৵ৱ৵ৰ੮͐ʩɘ͐੮͸ɘͅ੮ુͅ˺੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɘ˦ʁ੮ͅ˺੮ ɘ͸ʠ͙ˑੳૂ੮Ĕʩʇ˦੮ͅʩʇ੮ʡ˺͐੮˺͙͐ੴ੮ɘˑˑ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮̹̼˺̹˺ͅʇʁ੮͸ɘͅ੮ɘ੮ʁɘ;੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚੮͸ʩʇ̼ʇੴ੮ʮ˦੮ʩʇ̼੮ͷʮʇ͸ੴ੮͐ͅɘʠʠ੮̹ͅ˺ˌʇ੮͐˺੮ʩʇ̼੮ˑʮˌʇ੮ɘ੮ɻʩʮˑʁੳ੮ુU੮͸ɘͅ੮ͅ˺੮ͅʇͷʇ̼ʇˑ;੮ ʁʇ̹̼ʇͅͅʇʁੳ੯ੳ੯ੳ੯ੳ੮U͐੮͸ɘͅ੮ʮ˚̹˺ͅͅʮɺˑʇ੮͐˺੮˚ɘˌʇ੮ɘ੮ʠ̼ʮʇ˦ʁੳ੮ îʩʇ̼ʇ੮͸ɘͅ੮ ˦˺੮ ɻ˺˚˚͙˦ʮ͐;ੴૂ੮ ͅʩʇ੮˚˺͙̼˦ͅੳ੮îʩʇ˦ੴ੮ϲʮͷʇ੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮ͅʩʇ੮ʁʮͅɻ˺ͷʇ̼ʇʁ੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇੳ੮äʩʇ੮ˑ˺ͷʇʁ੮͐ʩɘ͐੮ ˚ʇ˚ɺʇ̼ͅ੮ʩɘʁ੮͐ʩʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʁʇɻʮʁʇ੮͸ʩ˺˚੮͐ʩʇ;੮͸˺͙ˑʁ੮ʩʮ̼ʇ੮ɘ˦ʁ੮͐ʩɘ͐੮ʇͷʇ̼;˺˦ʇ੮ ̼͐ʇɘ͐ʇʁ੮ʩʇ̼੮ɘͅ੮ɘ੮ુ͸ʩ˺ˑʇ੮̹ʇ̼ͅ˺˦ੴૂ੮˦˺͐੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮʇ˦͐ੳ੮H˺̼੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ʮ˚ʇ੮ʮ˦੮ ʩʇ̼੮ɘʁ͙ˑ͐੮ˑʮʠʇੴ੮ͅʩʇ੮͐ͅ˺̹̹ʇʁ੮ʠʇʇˑʮ˦ʡ੮͙ͅʮɻʮʁɘˑੳ Ĕʩʇ˦੮U੮ɘͅˌ੮"ʇͷʇ̼ˑ;੮ɘɺ˺͙͐੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇͅૄ੮ʇ˚̹ˑ˺;˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅੴ੮ͅʩʇ੮ɘʁ˚ʮ͐ͅੴ੮ ુUૄ˚੮ ˦˺͐੮ ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ ʮ˦੮ ʇ˚̹ˑ˺;˚ʇ˦͐ੳ੮ U੮ ʁ˺˦ૄ͐੮ ˑʮˌʇ੮ ʩ˺͸੮ Uૄ˚੮ ̼͐ʇɘ͐ʇʁ੮ ʮ˦੮ ͐ʩʇ੮ ̼ʇʡ͙ˑɘ̼੮ ɻ˺˚˚͙˦ʮ͐;ੳ੮ {;੮ ͸˺̼ˌ੮ ʮͅ੮ ɻ˺˚ʮ˦ʡ੮ ͐˺੮ ͐ʩʇ੮ #ˑ͙ɺʩ˺͙ͅʇ੮ ɘ˦ʁ੮ ɺʇʮ˦ʡ੮ ̹ɘ̼͐੮ ˺ʠ੮ ͸ʩɘ͐੮ ʩɘ̹̹ʇ˦ͅ੮͐ʩʇ̼ʇੳૂ੮îʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮˺̼ʡɘ˦ʮΈʇʁ੮ɘ̼˺͙˦ʁ੮ɘ੮ુ͸˺̼ˌચ˺̼ʁʇ̼ʇʁ੮ʁɘ;ૂੵ੮͐ʩʇ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

265

ʇͅͅʇ˦͐ʮɘˑੴ੮ɺ͙͐੮ʠ˺̼੮˚ʇ˚ɺʇ̼ͅ੮̹͙̼ʇˑ;੮ͷ˺ˑ͙˦͐ɘ̼;ੴ੮͐ɘͅˌͅ੮˦ʇɻʇͅͅɘ̼ʮˑ;੮͐˺੮ˌʇʇ̹੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʡ˺ʮ˦ʡੳ੮/̼ʮɻɘੴ੮͐ʩʇ੮ʇͽʇɻ͙͐ʮͷʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇੴ੮͐ɘˌʇͅ੮˚ʇ੮͐˺੮ͷʮͅʮ͐੮͐ʩʇ੮ ુɺ͙ͅʮ˦ʇͅͅ੮͙˦ʮ͐ૂ੮ʮ˦੮˺˦ʇ੮ɻ˺̼˦ʇ̼੮˺ʠ੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇૄͅ੮˺̹ʇ˦੮ϲˑ˺˺̼੮̹ˑɘ˦ੵ੮͐ʩʇ;ૄ̼ʇ੮ʇ˦ʡɘʡʇʁ੮ ʮ˦੮ɘ˦੮ʇ˦ʁˑʇͅͅ੮̹̼˺ʁ͙ɻ͐ʮ˺˦੮˺ʠ੮˚ɘ͐ʇ̼ʮɘˑͅ੮˺˦੮ɻˑ͙ɺ੮̹˺ˑʮɻʮʇͅ੮ફ̼ɘ˦ʡʮ˦ʡ੮ʠ̼˺˚੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ ̹̼ʇ̹ɘ̼ʇʁ˦ʇͅͅ੮͐˺੮ˑʇɘͷʮ˦ʡ੮ʁʮ̼͐;੮ʁʮͅʩʇͅ੮ʮ˦੮͐ʩʇ੮ͅʮ˦ˌબ੮ɘ˦ʁ੮ɘʁͷʇ̼͐ʮͅʇ˚ʇ˦͐ͅ੮͐˺੮̼ʇɻ̼͙ʮ͐੮ ˦ʇ͸੮˚ʇ˚ɺʇ̼ͅ੮͸ʩʇ˦੮͐ɘɺˑʮ˦ʡ੮ɘ͐੮ɻ˺˚˚͙˦ʮ͐;੮ʇͷʇ˦͐ͅੳ੮ૃĔʩɘ͐੮ʁ˺੮;˺͙੮ʡʇ͐੮ʠ̼˺˚੮˚ɘˌʮ˦ʡ੮ ɘ੮ʠ˺̼˚੺ૄ੮/̼ʮɻɘ੮˚͙ͅʇͅੴ੮ɺʇʠ˺̼ʇ੮ɘ˦ͅ͸ʇ̼ʮ˦ʡੴ੮ૃU͐੮̼ʇ͐ͅ˺̼ʇͅ੮ʁʮʡ˦ʮ͐;ੴ੮ʮ͐੮ʡʮͷʇͅ੮̹ʇ˺̹ˑʇ੮ɘ੮ͅʇ˦ͅʇ੮ ˺ʠ੮ɘɻɻ˺˚̹ˑʮͅʩ˚ʇ˦͐ੴ੮ʮ͐੮͐ɘˌʇͅ੮ɘ͸ɘ;੮̹ɘ͐ʮʇ˦͐ʩ˺˺ʁ੮ɘ˦ʁ੮̼ʇ͐ͅ˺̼ʇͅ੮̹ʇ̼ͅ˺˦ʩ˺˺ʁੳૄ "ʇͷʇ̼ˑ;੮͐ʇˑˑͅ੮˚ʇ੮͐ʩɘ͐੮̹ɘ̼͐੮˺ʠ੮͐ʩʇ੮ͷʮ͐ɘˑ੮͸˺̼ˌ੮˺ʠ੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮͐ʩ̼˺͸ʮ˦ʡ੮ɘ੮ ˑʮʠʇˑʮ˦ʇ੮͐˺੮˚ʇ˚ɺʇ̼ͅ੮͸ʩʇ˦੮͐ʩʇ;੮ʁ̼ʮʠ͐੮ɘ͸ɘ;ੵ੮ુĔʇ੮ɘ̼ʇ੮ɘ͸ɘ̼ʇ੮˺ʠ੮˺͙̼੮̹ʇʇ̼ͅ੮ɘ˦ʁ੮͸ʩ˺ૄͅ੮ ʩɘͷʮ˦ʡ੮ɘ੮ʩɘ̼ʁ੮͐ʮ˚ʇ੮ɘ˦ʁ੮͸ʩ˺ૄͅ੮˦˺͐ੳ੮ä˺੮͐ʩɘ͐ૄͅ੮̹ɘ̼͐੮˺ʠ੮˺͙̼੮͐ɘͅˌ੮ɺ˺ɘ̼ʁੵ੮̼ʇɘɻʩʮ˦ʡ੮˺͙͐੮ ͐˺੮ ͐ʩ˺ͅʇ੮ ̹ʇ˺̹ˑʇੳૂ੮ š˦ʇ੮ ˺ʠ੮ ʩʇ̼੮ ʠ̼ʮʇ˦ʁͅ੮ ʩɘͅ੮ ુ͐ʩʇ੮ ˚˺͐ͅ੮ ʩ˺̼̼ʮɺˑʇ੮ ͷ˺ʮɻʇͅ੯ ੳ੯ ੳ੯ ੳ੮ ͐ʇˑˑʮ˦ʡ੮ ʩʮ˚੮͐˺੮ˌʮˑˑ੮ʩʮ˚ͅʇˑʠੴ੮͐ʇˑˑʮ˦ʡ੮ʩʮ˚੮͐ʇ̼̼ʮɺˑʇ੮͐ʩʮ˦ʡͅੳૂ੮Uʠ੮ɘˑˑ੮ʩʇ੮ʩɘʁ੮͸ɘͅ੮͐ʩʇ੮ɻ˺͙˦͐;੮ʁɘ;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ̹̼˺ʡ̼ɘ˚ੴ੮ ͅʩʇ੮ ʮ˦ͅʮ͐ͅͅੴ੮ ુU੮ ʁ˺˦ૄ͐੮ ͐ʩʮ˦ˌ੮ ʩʇૄʁ੮ ͐ͅʮˑˑ੮ ɺʇ੮ ʩʇ̼ʇੳ੮ "͙͐੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ #ˑ͙ɺʩ˺͙ͅʇੴ੮Uૄ˚੮˦˺͐੮͸˺̼̼ʮʇʁ੮ɘɺ˺͙͐੮ˑ˺ͅʮ˦ʡ੮ʩʮ˚ੳ੮Ĕʇ੮͸˺˦ૄ͐੮ˑʇ͐੮ʩʮ˚੮ʠɘˑˑ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮ ɻ̼ɘɻˌͅੳૂ੮Ĕʩʮˑʇ੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੮ʮͅ੮˺˦ˑ;੮˺̹ʇ˦੮ʁ͙̼ʮ˦ʡ੮͐ʩʇ੮ʁɘ;ੴ੮͐ʩʇ;ૄ̼ʇ੮̼ʇɘˑˑ;੮ɘ੮৲৴ઃ৷੮ ˺̹ʇ̼ɘ͐ʮ˺˦੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮͐ʩʇ੮ɻ˺˦͐ͅɘ˦͐੮̼͐ͅʇɘ˚੮˺ʠ੮͐ʇˑʇ̹ʩ˺˦ʇ੮ɻɘˑˑͅੴ੮ˑʇ͐͐ʇ̼ͅੴ੮ɘ˦ʁ੮ͷʮͅʮ͐ͅ੮ɺ;੮ ˚ʇ˚ɺʇ̼ͅ੮͐˺੮˺͐ʩʇ̼੮˚ʇ˚ɺʇ̼ͅੳ੮"ʇͷʇ̼ˑ;੮˺ɺͅʇ̼ͷʇͅੴ੮ુîʩʇ੮͐͸˺੮͐ʮ˚ʇͅ੮Uૄͷʇ੮ͷʇʇ̼ʇʁ੮ɘ͸ɘ;੮ ʠ̼˺˚੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇੴ੮˚;੮̹ͅ;ɻʩ˺͐ʮɻ੮ͅ;˚̹͐˺˚ͅ੮͐ͅɘ̼͐ʇʁ੮͐˺੮̼ʇ͙̼͐˦ੳૂ੮"͙͐੮ʩʇ̼੮ʠ̼ʮʇ˦ʁͅ੮ ̼ʇɘɻʩʇʁ੮˺͙͐੮͐˺੮ʩʇ̼੮ɘ˦ʁ੮ɺ̼˺͙ʡʩ͐੮ʩʇ̼੮ɺɘɻˌੳ੮îʩʇ੮ͅ;˚̹͐˺˚ͅ੮͸ʇ˦͐੮ɘ͸ɘ;ੳ îʩʇ੮̼ʇͅʇɘ̼ɻʩ੮˺˦੮̹ʇʇ̼੮͙̹̹ͅ˺̼͐ͅ੮ʮͅ੮ʮ˦ɻ˺˦ɻˑ͙ͅʮͷʇੳ੮ä˺˚ʇ੮͙͐ͅʁʮʇͅ੮ͅʩ˺͸੮͐ʩɘ͐੮̹ʇʇ̼ચ ˑʇʁ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ɻ˺˦̼͐ʮɺ͙͐ʇ੮͐˺੮˚˺ʁʇ͐ͅ੮ʮ˚̹̼˺ͷʇ˚ʇ˦͐ͅ੮ʮ˦੮ͅ;˚̹͐˺˚ͅੴ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡੴ੮ɘ˦ʁ੮ͅʇˑʠચʇϲϲʮɻɘɻ;੮͸ʩʮˑʇ੮˺͐ʩʇ̼ͅ੮ʮʁʇ˦͐ʮʠ;੮ͷʇ̼;੮ˑʮ˚ʮ͐ʇʁ੮ʮ˚̹ɘɻ͐ͅੳ৿ਂ੮îʩʇ˦੮ɘʡɘʮ˦ੴ੮ ̼ʇͅʇɘ̼ɻʩ੮˺˦੮͐ʩʇ੮ʇʠʠʇɻ͐ʮͷʇ˦ʇͅͅ੮˺ʠ੮ˑ˺˦ʡચ͐ʇ̼˚੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇੴ੮͐˺੮͸ʩʮɻʩ੮̹ʇʇ̼ͅ੮ɘ̼ʇ੮ ͙̹̹ͅ˺ͅʇʁ੮͐˺੮ɺʇ੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇੴ੮ʮͅ੮ɘˑ˚˺͐ͅ੮˦˺˦ʇͽʮ͐ͅʇ˦͐ੳ੮î˺੮ɺ͙ʮˑʁ੮ɘ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦ੴ੮ ;˺͙੮ ˦ʇʇʁ੮ ͐˺੮ ͐ɘˌʇ੮ ͅʇ̼ʮ˺͙ͅˑ;੮ ͐ʩʇ੮ ͷ˺ʮɻʇͅ੮ ˺ʠ੮ ͐ʩʇ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ͸ʩ˺˚੮ ;˺͙ૄ̼ʇ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˦ʡੳ੮˦ʁ੮ʮ˦੮ʁ˺Έʇ˦ͅ੮˺ʠ੮ʮ˦͐ʇ̼ͷʮʇ͸ͅੴ੮U੮ʩʇɘ̼ʁ੮͐ʩʇ੮ͅɘ˚ʇ੮̼ʇʠ̼ɘʮ˦ੵ੮̹ʇʇ̼੮ ͙̹̹ͅ˺̼͐ͅ੮͸˺̼ˌੴ੮˦˺͐੮ˈ͙͐ͅ੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮˚ɘˌʇ੮̼͐ʇɘ͐˚ʇ˦͐੮˚˺̼ʇ੮ʩ͙˚ɘ˦ʇ੮ɘ˦ʁ੮̼ʇɻ˺ͷʇ̼;੮ ˺̼ʮʇ˦͐ʇʁ੮ɺ͙͐੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ;੮̹̼˺ͷʮʁʇ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮˚ʇɘ͙̼ͅʇੵ੮ɻ˺˚̹ɘ˦ʮ˺˦ͅʩʮ̹੮ɘ˦ʁ੮̹͙̼̹˺ͅʇੳ

SHARED DECISION MAKING: A CLIENT-DIRECTED SYSTEM Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ˑʮͷʇʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ̼ʇ੮˦˺͐੮ˈ͙͐ͅ੮˚ɘˌʮ˦ʡ੮͐ʩʇʮ̼੮͸ɘ;੮ ˺˦͐˺੮̼͐ʇɘ͐˚ʇ˦͐੮͐ʇɘ˚ͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ɺ͙͐੮ʡ̼ɘʁ͙ɘˑˑ;੮̹ʇ˦ʇ̼͐ɘ͐ʮ˦ʡ੮͐ʩʇ੮̹˺ˑʮɻ;ચ˚ɘˌʮ˦ʡ੮

266

REFORM

ɘ˦ʁ੮̹ˑɘ˦˦ʮ˦ʡ੮̹̼˺ɻʇͅͅੳ੮ä͐ɘ͐ʇ੮̼ʇʡ͙ˑɘ͐ʮ˺˦ͅ੮˚ɘ˦ʁɘ͐ʇ੮͐ʩɘ͐੮͐ʩʇʮ̼੮ͷʮʇ͸ͅ੮ɺʇ੮͐ɘˌʇ˦੮ʮ˦͐˺੮ ɘɻɻ˺͙˦͐੮ʮ˦੮͐ʩʇ੮ʁʮ̼͐ͅʮɺ͙͐ʮ˺˦੮˺ʠ੮{Pä੮˚˺˦ʇ;ੳ੮Øʇʇ̼ͅ੮ͅʮ͐੮˺˦੮ˌʇ;੮˺ͷʇ̼ͅʮʡʩ͐੮ɺ˺ʁʮʇͅ੮ ˑʮˌʇ੮ɻ˺͙˦͐;੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ɺ˺ɘ̼ʁͅੳ੮"͙͐੮ʮ͐ૄͅ੮ʩɘ̼ʁ੮͐˺੮̼͐ɘ˦ͅˑɘ͐ʇ੮ɘʁͷʮͅ˺̼;੮̼˺ˑʇͅ੮ ʮ˦͐˺੮̼ʇɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ͅʩɘ̹ʇ੮͸ʩɘ͐੮ʩɘ̹̹ʇ˦ͅ੮˺˦੮͐ʩʇ੮ʡ̼˺͙˦ʁੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮͐ʩʇ੮ʡ̼ɘ˦ʁ੮ ̹̼ʮ˦ɻʮ̹ˑʇͅ੮ ˺ʠ੮ ɘ͙͐˺˦˺˚;੮ ɘ˦ʁ੮ ̼ʇ̹ͅʇɻ͐੮ ɘ˦ʮ˚ɘ͐ʮ˦ʡ੮ ͐ʩʇ੮ ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮ ʁʮͅɻ͙ͅͅʇʁ੮ ʮ˦੮ ͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼ੳ੮îʩʇ˦੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮͐ʩʇ੮ʠ̼ɘ͙ʡʩ͐੮˚˺˚ʇ˦͐ͅ੮͸ʩʇ˦੮͐ʩʇͅʇ੮ͷɘˑ͙ʇͅ੮ɘ̼ʇ੮͐ʩ̼˺͸˦੮ ˺͙͐੮͐ʩʇ੮͸ʮ˦ʁ˺͸੮ʮ˦੮͐ʩʇ੮˦ɘ˚ʇ੮˺ʠ੮ɘʁʁ̼ʇͅͅʮ˦ʡ੮͙̼ʡʇ˦͐੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˺˦੮˺̼੮ʮ˚̹ʇ˦ʁʮ˦ʡ੮ʁʇɘ͐ʩੳ rɘ͙̼ʮʇ੮Pɘˑˑ˚ɘ̼ˌ੮ʩɘͅ੮ɘ੮ͷʮͅʮ˺˦੮ʠ˺̼੮ʩ˺͸੮͸ʇ੮ɻɘ˦੮˚ɘˌʇ੮͐ʩʇ੮̹̼ʮ˦ɻʮ̹ˑʇͅ੮˺ʠ੮͙̹̹ͅ˺̼͐ʇʁ੮ ʁʇɻʮͅʮ˺˦੮ ˚ɘˌʮ˦ʡ੮ ˚ʇɘ˦ʮ˦ʡʠ͙ˑ੮ ʮ˦੮ ˚ʮɻ̼˺ચˑʇͷʇˑ੮ ʮ˦͐ʇ̼ɘɻ͐ʮ˺˦ͅੴ੮ ͸ʩʇ̼ʇ੮ ̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮ ͸ʮʇˑʁ੮ ͅ˺ͷʇ̼ʇʮʡ˦੮ ̹˺͸ʇ̼੮ ˺ͷʇ̼੮ ͐ʩʇʮ̼੮ ɻˑʮʇ˦͐ͅੳ੮ ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ̼͐ɘ˦̹ͅˑɘ˦͐੮ ͸ʩ˺੮͸ɘͅ੮̹̼ʇͷʮ˺͙ͅˑ;੮ɘ˦੮ɘ͐͐˺̼˦ʇ;੮͸ʮ͐ʩ੮îʇͽɘͅ੮Ûʮ˺I̼ɘ˦ʁʇ੮rʇʡɘˑ੮ʮʁੴ੮rɘ͙̼ʮʇ੮ɺʇʡʮ˦ͅ੮ ˺͙̼੮ʮ˦͐ʇ̼ͷʮʇ͸੮͸ʮ͐ʩ੮ɘ੮ˑʇɘʁʮ˦ʡ੮ή͙ʇ͐ͅʮ˺˦ੵ੮ુä˺ੴ੮Uૄ˚੮ɘ͙ͅͅ˚ʮ˦ʡ੮͐ʩɘ͐੮;˺͙̼੮̹ʩʮˑ˺ͅ˺̹ʩʮɻɘˑ੮ ɘ̹̹̼˺ɘɻʩ੮ʮͅ੮ɺʇʡʮ˦˦ʮ˦ʡ੮͸ʮ͐ʩ੮͙̹̹ͅ˺̼͐੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮˚ɘʮ˦͐ɘʮ˦ʮ˦ʡ੮ɘ͙͐˺˦˺˚;੮ɘ˦ʁ੮ɺʇʮ˦ʡ੮ ɘɺˑʇ੮͐˺੮˚ɘˌʇ੮ɘͅ੮˚ɘ˦;੮ʁʇɻʮͅʮ˺˦ͅ੮ɘͅ੮̹˺ͅͅʮɺˑʇ੮˺ͷʇ̼੮͐ʩʇʮ̼੮˺͸˦੮ˑʮͷʇͅ੺ૂ੮Uʠ੮;˺͙੮͸ɘ˦͐੮ʩʇ̼੮ ͐˺੮ ʇͽ̹ˑɘʮ˦੮ ʩ˺͸੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ ʁͷɘ˦ɻʇʁ੮ )ʮ̼ʇɻ͐ʮͷʇͅ੮ ફØ)ͅબ੮ ɻɘ˦੮ ɺʇɻ˺˚ʇ੮ ɘ੮ ͷʇʩʮɻˑʇ੮ ʠ˺̼੮ʡʮͷʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ˑʮͷʮ˦ʡ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅʇͅ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮͐ʩʇ੮ͅ;͐ͅʇ˚੮̼͐ʇɘ͐ʮ˦ʡ੮ ͐ʩʇ˚ੴ੮͐ʩʇ੮ɘ˦ͅ͸ʇ̼ੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮ʩɘͅ੮͐˺੮ɺʇ੮ુ;ʇͅੳૂ î̼ɘʁʮ͐ʮ˺˦ɘˑˑ;ੴ੮ɘ੮Ø)੮ʮͅ੮ɘ੮ʁ˺ɻ͙˚ʇ˦͐੮ϲʮˑˑʇʁ੮˺͙͐੮ɺ;੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮʇ˦͐੮ɘ˦ʁ੮ ̹͙͐੮ʮ˦੮͐ʩʇʮ̼੮˚ʇʁʮɻɘˑ੮ϲʮˑʇੳ੮Ø)ͅ੮ɘ͙͐ʩ˺̼ʮΈʇ੮ɻʇ̼͐ɘʮ˦੮̼͐ʇɘ͐˚ʇ˦͐ͅ੮ફˑʮˌʇ੮̹ͅʇɻʮϲʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮˺̼੮˚ʇʁʮɻɘ͐ʮ˺˦ͅબ੮͸ʩʮˑʇ੮̼ʇʠ͙ͅʮ˦ʡ੮˺͐ʩʇ̼ͅੳ੮Ĕʇͅੴ੮ɘ੮̹ʇʇ̼੮͸ʩ˺੮͸˺̼ˌʇʁ੮͸ʮ͐ʩ੮rɘ͙̼ʮʇ੮˚ɘˌʮ˦ʡ੮Ø)ͅ੮ʮ˦੮îʇͽɘͅੴ੮ʁʇͅɻ̼ʮɺʇʁ੮ʩʮͅ੮˺͸˦੮ɘͅ੮ુˑʮˌʇ੮ɘ੮̹ɘ̼ɘɻʩ͙͐ʇૂੵ੮ુʮ͐੮̼ʇͅɻ͙ʇͅ੮ ;˺͙੮ʮ˦੮ɻɘͅʇ੮˺ʠ੮ɘ˦੮ʇ˚ʇ̼ʡʇ˦ɻ;ੳ੮îʩʇ੮ʁ˺ɻ͙˚ʇ˦͐੮ɻ˺˚ʇͅ੮ʮ˦͐˺੮ʇʠʠʇɻ͐੮͸ʩʇ˦੮;˺͙ૄͷʇ੮ˑ˺͐ͅ੮ ɻ˺˦̼͐˺ˑ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ʮ͐੮ˌʇʇ̹ͅ੮;˺͙੮ʮ˦੮ɻ˺˦̼͐˺ˑ੮ͅ˺˚ʇ͸ʩɘ͐ੳૂ੮îʩʇ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮̹ʇ˺̹ˑʇ੮Ĕʇͅ੮ ͸˺̼ˌͅ੮͸ʮ͐ʩ੮͙ͅʇ੮Ø)ͅ੮͐˺੮̹ͅʇɻʮʠ;੮˦˺˦˚ʇʁʮɻɘ͐ʮ˺˦੮ɻ˺̹ʮ˦ʡ੮̼͐ͅɘ͐ʇʡʮʇͅ੮͐ʩɘ͐੮ʩʇˑ̹੮͐ʩʇ˚੮ ʮ˦੮ɘ੮ɻ̼ʮͅʮͅ੮ફʠ˺̼੮ʩʮ˚ੴ੮ɘ̹̹ɘ̼ʇ˦͐ˑ;ੴ੮ʮ͐ૄͅ੮ͷʇ̼;੮ˑ˺͙ʁ੮˚͙ͅʮɻ੶੮ʠ˺̼੮˺͐ʩʇ̼ͅੴ੮ɻ˺ʠʠʇʇ੮ɘ˦ʁ੮ɻʮʡɘ̼ʇ͐͐ʇͅબੳ੮U͐੮͙̼͐˦ͅ੮˺͙͐੮͐ʩɘ͐੮˚˺͐ͅ੮˺ʠ੮͸ʩɘ͐੮̹ʇ˺̹ˑʇ੮̹͙͐੮ʮ˦͐˺੮Ø)ͅ੮ʮͅ੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮͸ʮ͐ʩ੮ ɻˑʮ˦ʮɻɘˑ੮ɺʇ͐ͅ੮̹̼ɘɻ͐ʮɻʇͅੴ੮ɻ˺͙̹ˑʇʁ੮͸ʮ͐ʩ੮ʠ̼ʇή͙ʇ˦͐੮̹ˑʇɘͅ੮ʠ˺̼੮ુ͙˦ʁʇ̼͐ͅɘ˦ʁʮ˦ʡੴ੮ʇ˚̹ɘ͐ʩ;ੴ੮ ɘ˦ʁ੮ ̼ʇ̹ͅʇɻ͐ੳૂ৿ਃ੮ ੮ Ø)੮ ɻɘ˦੮ ̹͙ͅʩ੮ ɘ੮ ɻˑʮ˦ʮɻʮɘ˦੮ ͸ʩ˺੮ ˚ʮʡʩ͐੮ ʇ˦ʁ˺̼ͅʇ੮ ɘˑˑ੮ ͐ʩʇͅʇ੮ ͐ʩʮ˦ʡͅ੮ʮ˦੮̹̼ʮ˦ɻʮ̹ˑʇ੮͐˺੮ɘʁʩʇ̼ʇ੮͐˺੮͐ʩʇ˚੮ʮ˦੮̹̼ɘɻ͐ʮɻʇੴ੮ʇͷʇ˦੮ʮ˦੮ɘ੮˚˺˚ʇ˦͐੮˺ʠ੮ɻ̼ʮͅʮͅ੮ ͸ʩʇ˦੮ɘ੮ɻˑʮʇ˦͐੮ʮͅ੮˦˺͐੮ɘɺˑʇ੮͐˺੮ɘʁͷ˺ɻɘ͐ʇ੮˺˦੮͐ʩʇʮ̼੮˺͸˦੮ɺʇʩɘˑʠੳ੮Ø)ͅ੮ʩɘͷʇ੮̹̼˺ͷʇ˦੮͐˺੮ ɺʇ੮ɘ˚˺˦ʡ੮͐ʩʇ੮˚˺͐ͅ੮ʇʠʠʇɻ͐ʮͷʇ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ɘͷɘʮˑɘɺˑʇ੮͐˺੮̼ʇʁ͙ɻʇ੮ɻ˺ʇ̼ɻʮ˺˦੮ʮ˦੮͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ৿਄ Ĕʩʇ˦੮rɘ͙̼ʮʇ੮ɺʇʡɘ˦੮͐˺੮͙ͅʇ੮Ø)ͅ੮ʠ˺̼੮ʩʇ̼੮ɻˑʮʇ˦͐ͅ੮ɘ͐੮rʇʡɘˑ੮ʮʁੴ੮ͅʩʇ੮͐ͅɘ̼͐ʇʁ੮͐˺੮ ͅʇʇ੮͐ʩʇ˚੮ɘͅ੮ʩɘͷʮ˦ʡ੮˚͙ɻʩ੮ɺ̼˺ɘʁʇ̼੮̹˺͐ʇ˦͐ʮɘˑੳ੮੮Ø)੮ɻ˺͙ˑʁ੮͐ɘˌʇ੮ɘ੮̹ʇ̼ͅ˺˦ૄͅ੮̹̼ʇʠʇ̼ʇ˦ɻʇͅ੮ɘ˦ʁ੮͙̼͐˦੮͐ʩʇ˚੮ʮ˦͐˺੮ɘ੮ɺʮ˦ʁʮ˦ʡੴ੮˺̼ʡɘ˦ʮΈʮ˦ʡ੮ʠ̼ɘ˚ʇ͸˺̼ˌ੮ʠ˺̼੮ɘˑˑ੮͐ʩʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

267

͐˺͙ɻʩʮ˦ʡ੮˺˦੮͐ʩʇʮ̼੮ˑʮʠʇੵ੮ુU੮̼ʇɘˑʮΈʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͙˦ʁʇ̼ˑ;ʮ˦ʡ੮̹̼˺ɺˑʇ˚੮͸ɘͅ੮ɘ˦੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮ ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;੮͐˺੮͐ʩʇ੮ʩ͙˚ɘ˦੮ɺʇʮ˦ʡͅੴ੮͐˺੮̹̼˺ͷʮʁʇ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ɺɘͅʇʁ੮˺˦੮͸ʩɘ͐੮ ʇɘɻʩ੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮͸ɘ˦͐ʇʁ੮ɘ˦ʁ੮˦ʇʇʁʇʁੴ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘ੮͐ͅɘ˦ʁɘ̼ʁʮΈʇʁ੮ૃʩʇ̼ʇૄͅ੮͸ʩɘ͐੮͸ʇૄ̼ʇ੮ ʡ˺ʮ˦ʡ੮͐˺੮ʁ˺ੴ੮͐ʩʮͅ੮ʇʮ͐ʩʇ̼੮͸˺̼ˌͅ੮ʠ˺̼੮;˺͙੮˺̼੮ʮ͐੮ʁ˺ʇͅ˦ૄ͐੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮ʮʠ੮ʮ͐੮ʁ˺ʇͅ˦ૄ͐ੴ੮ʮ͐ૄͅ੮;˺͙̼੮ ʠɘ͙ˑ͐੮ɘ˦ʁ੮͸ʇૄˑˑ੮ʁ˺੮˚˺̼ʇ੮˺ʠ੮͐ʩʇ੮ͅɘ˚ʇੳૄૂ੮äʩʇ੮ʇͽ̹ɘ˦ʁʇʁ੮͐ʩʇ੮Ø)੮͐ʇ˚̹ˑɘ͐ʇ੮͐˺੮ʮ˦ɻˑ͙ʁʇ੮ ʩ˺͙ͅʮ˦ʡੴ੮ϲʮ˦ɘ˦ɻʮɘˑ੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮̼ʇ̹̼˺ʁ͙ɻ͐ʮ˺˦ੴ੮ɘ˦ʁ੮ɻ˺˦͐ɘɻ͐੮͸ʮ͐ʩ੮ϲʮ̼͐ͅ੮̼ʇ̹ͅ˺˦ʁʇ̼ͅ੮ ˑʮˌʇ੮ˑɘ͸੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੳ U੮ ɘͅˌʇʁ੮ rɘ͙̼ʮʇ੮ ͐˺੮ ͅʩ˺͸੮ ˚ʇ੮ ͐ʩʇ੮ ˌʮ˦ʁ੮ ˺ʠ੮ ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ ͐ʩɘ͐੮ ˚ʮʡʩ͐੮ ʡ˺੮ ʮ˦͐˺੮ ͐ʩʇ੮ ુɻ̼ʮͅʮͅ੮̼ʇ̹ͅ˺˦ͅʇૂ੮ͅʇɻ͐ʮ˺˦੮˺ʠ੮ɘ੮Ø)ੳ੮{͙ɻʩ੮˺ʠ੮ʮ͐੮ʮͅ੮ɺɘͅʮɻੵ੮̼ʇή͙ʇ͐ͅͅ੮͐ʩɘ͐੮̹˺ˑʮɻʇ੮ʇͽ̹ˑɘʮ˦੮ ͸ʩ˺੮͐ʩʇ;੮ɘ̼ʇ੮˺̼੮͸ʩ;੮͐ʩʇ;ૄ̼ʇ੮͐ʩʇ̼ʇੴ੮͐ͅɘ;੮ʮ˦੮ʠ̼˺˦͐੮˺ʠ੮ɘ੮̹ʇ̼ͅ˺˦ੴ੮˺̼੮̹ͅʇɘˌ੮ʮ˦੮ɘ੮ͅ˺ʠ͐੮ ͷ˺ʮɻʇੳ੮š͐ʩʇ̼ͅ੮ɘ̼ʇ੮˚˺̼ʇ੮̹ʇ̼ͅ˺˦ɘˑੵ੮ɘ੮ͅʇͽ͙ɘˑ੮ɘͅͅɘ͙ˑ͐੮ͷʮɻ͐ʮ˚੮˚ʮʡʩ͐੮̹̼ʇʠʇ̼੮͐˺੮ʮ˦͐ʇ̼ɘɻ͐੮ ͸ʮ͐ʩ੮ɘ੮̹ʇ̼ͅ˺˦੮˺ʠ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ʡʇ˦ʁʇ̼੮ʠ̼˺˚੮͐ʩʇʮ̼੮ɘͅͅɘʮˑɘ˦͐ੳ੮ä˺˚ʇ੮̹ʇ˺̹ˑʇ੮͸ɘ˦͐੮͐˺੮ ɺʇ੮ ɘʁʁ̼ʇͅͅʇʁ੮ ɺ;੮ ɘ੮ ̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ ͸ʇɘ̼ʮ˦ʡ੮ ɻʮͷʮˑʮɘ˦੮ ɻˑ˺͐ʩʇͅ੮ ͙ͅʮ˦ʡ੮ ͐ʩʇʮ̼੮ ϲʮ̼͐ͅ੮ ˦ɘ˚ʇੴ੮ ͸ʩʮˑʇ੮˺͐ʩʇ̼ͅ੮ʠʇʇˑ੮ʁʮʡ˦ʮϲʮʇʁ੮ɺ;੮ɘ੮ુͅʮ̼ૂ੮˺̼੮ુ˚ɘʁɘ˚ૂ੮ʠ̼˺˚੮ɘ੮͙˦ʮʠ˺̼˚ʇʁ੮˺ϲϲʮɻʇ̼ੳ੮rɘ͙̼ʮʇ੮ ˺ɺͅʇ̼ͷʇͅੴ੮ુîʩɘ͐ૄͅ੮͸ʩɘ͐ૄͅ੮ͅ˺੮ʮ˦͐ʇ̼ʇ͐ͅʮ˦ʡੳ੮U͐ૄͅ੮͐ʩʇ੮͐ʮ˦ʮʇ͐ͅ੮ˑʮ͐͐ˑʇ੮͐ʩʮ˦ʡ੮͐ʩɘ͐੮ɻɘ˦੮ͅʇ˦ʁ੮ ͅ˺˚ʇ˺˦ʇ੮ʮ˦੮˺˦ʇ੮ʁʮ̼ʇɻ͐ʮ˺˦੮˺̼੮ɘ˦˺͐ʩʇ̼ૂઝɺɘɻˌ੮ʩ˺˚ʇ੮˦ʇ͸ˑ;੮ɻɘˑ˚੮˺̼੮ʮ˦੮ʁʇʇ̹ʇ˦ʮ˦ʡ੮ ɻ̼ʮͅʮͅ੮͸ʩʮˑʇ੮ɺʇʮ˦ʡ੮̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮ʮ˦੮ɘ੮̹˺ˑʮɻʇ੮ɻ̼͙ʮͅʇ̼੮͐˺੮ˈɘʮˑ੮˺̼੮ɘ੮ʩ˺̹ͅʮ͐ɘˑઝુɘ˦ʁ੮͸ʩʇ˦੮ ͐ʩʇ;੮ʠɘˑˑੴ੮ʮ͐ૄͅ੮ͅ˺੮ʩɘ̼ʁ੮͐˺੮ʡʇ͐੮͐ʩʇ˚੮ɺɘɻˌੳૂ Ĕʩʇ˦੮U੮͐ɘˑˌʇʁ੮͐˺੮ʩʇ̼ੴ੮rɘ͙̼ʮʇ੮͸ɘͅ੮ͅʇ̼ͷʮ˦ʡ੮ɘͅ੮ɘ˦੮ʇͽ̹ʇ̼͐੮ɘʁͷʮͅʇ̼੮ʠ˺̼੮ɘ੮{ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ äʇ̼ͷʮɻʇͅ੮ ɻ͐જʠ͙˦ʁʇʁ੮ ̹̼˺ˈʇɻ͐੮ ɘɻ̼˺ͅͅ੮ ϲʮͷʇ੮ ɻ˺͙˦͐ʮʇͅ੮ ͐˺੮ ʇͽ̹ɘ˦ʁ੮ ͐ʩʇ੮ ͙ͅʇ੮ ˺ʠ੮ Ø)ͅੳ਀৻੮ ʩ˚ɘʁ̼ʇΈɘ੮ "ɘʩ̼ɘ˦ʮੴ੮ ʠ̼˺˚੮ ͐ʩʇ੮ H̼ʇͅ˦˺੮ "ʇʩɘͷʮ˺̼ɘˑ੮ Pʇɘˑ͐ʩ੮ )ʇ̹ɘ̼͐˚ʇ˦͐ੴ੮ ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ʇ˚ɺ̼ɘɻʇʁ੮͐ʩʇ੮̹ʮˑ˺͐੮ɘͅ੮ɘ੮͸ɘ;੮͐˺੮ુˌʇʇ̹੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮ ʩ˺̹ͅʮ͐ɘˑͅੴ੮ˌʇʇ̹੮͐ʩʇ˚੮˺͙͐੮˺ʠ੮ˈɘʮˑͅੴ੮̼ʇʁ͙ɻʇ੮ɻ̼ʮͅʇͅ੮ɘ˦ʁ੮ʇͅɻɘˑɘ͐ʮ˺˦ͅ੯ੳ੯ੳ੯ੳ੮̼ʇɘˑˑ;੮ˌʇʇ̹੮͐ʩʇ˚੮ ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳૂ੮U˦੮̹ɘ̼͐ʮɻ͙ˑɘ̼ੴ੮"ɘʩ̼ɘ˦ʮ੮ɺʇˑʮʇͷʇʁ੮͐ʩɘ͐੮Ø)ͅ੮ɻ˺͙ˑʁ੮ʩʇˑ̹੮̼ʇʇ˦ʡɘʡʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ʩɘʁ੮ɺʇʇ˦੮ʇ̼͐ͅɘ˦ʡʇʁ੮ɺ;੮̹ɘ͐ͅ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮˺ʠ੮ɻ˺ʇ̼ɻʮ˺˦ੵ੮ુîʩʇ;ૄˑˑ੮ɺʇ੮ ʇ˚̹˺͸ʇ̼ʇʁ੮͐˺੮ͅɘ;ੴ੮ૃ‡˺͸੮U੮ʩɘͷʇ੮͐ʩʮͅ੮ˑʇʡɘˑ੮ʁ˺ɻ͙˚ʇ˦͐ੴ੮ɘ˦ʁ੮U੮ʡʇ͐੮͐˺੮ɻ˺˦̼͐˺ˑ੮ʩ˺͸੮˚;੮ ɻɘ̼ʇ੮ʮͅ੮ʁ˺˦ʇੳ੮ä˺੮Uૄˑˑ੮ʡ˺੮͐ɘˑˌ੮͐˺੮͐ʩʇ˚੮યɻˑʮ˦ʮɻʮɘ˦ͅરੳૄૂ੮îʩʇ੮ɘ͙ͅͅ˚̹͐ʮ˺˦੮ʮͅ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮ ɘ̼ʇ੮˚˺̼ʇ੮ˑʮˌʇˑ;੮͐˺੮ʁ˺੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮˦˺͐੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ̼ʇૄͅ੮ɘ੮͐ʩ̼ʇɘ͐੮͐ʩɘ͐੮͐ʩʇ;ૄˑˑ੮ɺʇ੮ʠ˺̼ɻʇʁ੮ ͐˺ੴ੮ɺ͙͐੮̹̼ʇɻʮͅʇˑ;੮ɺʇɻɘ͙ͅʇ੮͐ʩʇ̼ʇ੮ʮͅ੮˦˺੮͙ͅɻʩ੮͐ʩ̼ʇɘ͐ੵ੮ુä˺˚ʇ˺˦ʇ੮͸ʇૄ̼ʇ੮˺͙̼͐ʇɘɻʩʮ˦ʡ੮˺˦੮ ͐ʩʇ੮̼͐ͅʇʇ͐੮͸ʩ˺੮˚ʮʡʩ͐੮ͅɘ;ੴ੮ૃI˺੮ɘ͸ɘ;ੴ੮U੮ʁ˺˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɺʇ੮͐˺ˑʁੴ੮ુ͐ɘˌʇ੮;˺͙̼੮˚ʇʁͅੴૂૄ੮ ˚ʮʡʩ͐ੴ੮͸ʮ͐ʩ੮ɘ੮Ø)ੴ੮ʡ˺੮ˑʮˌʇੴ੮ૃšˌɘ;ੴ੮U੮ʩɘͷʇ੮ɘ੮̼ʮʡʩ͐੮͐˺੮̼ʇʠ͙ͅʇ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ä˺੮Uૄˑˑ੮ˈ͙͐ͅ੮ ͐ɘˌʇ੮ʮ͐ੳૄૂ #˺͙˦͐ʮʇͅ੮ɘ̼ʇ੮̹̼ʮ˺̼ʮ͐ʮΈʮ˦ʡ੮ʁʮʠʠʇ̼ʇ˦͐੮̹˺̹͙ˑɘ͐ʮ˺˦ͅ੮ʠ˺̼੮͐ʩʇʮ̼੮Ø)ͅ੮̹ʮˑ˺͐ͅੳ਀ৼ੮{ɘ˦;੮ ɘ̼ʇ੮ʮ˦͐ʇ̼ʇ͐ͅʇʁ੮ʮ˦੮ʁʮͷʇ̼͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ͅ;͐ͅʇ˚੶੮˺͐ʩʇ̼ͅ੮ɘ̼ʇ੮ ʠ˺ɻ͙ͅʇʁ੮˺˦੮̼͐ɘ˦ͅʮ͐ʮ˺˦ચɘʡʇ੮;˺͙͐ʩ੮ફ;˺͙˦ʡ੮ɘʁ͙ˑ͐ͅੴ੮ɺʇ͐͸ʇʇ˦੮ͅʮͽ͐ʇʇ˦੮ɘ˦ʁ੮͐͸ʇ˦͐;ચ੮ ϲʮͷʇੴ੮ ˚˺ͷʮ˦ʡ੮ ˺͙͐੮ ˺ʠ੮ ɻʩʮˑʁ̼ʇ˦ૄͅ੮ ͅʇ̼ͷʮɻʇͅ੮ ˑʮˌʇ੮ ʠ˺͐ͅʇ̼੮ ɻɘ̼ʇબੳ੮ H̼ʇͅ˦˺੮ ʮͅ੮ ˑ˺˺ˌʮ˦ʡ੮ ͐˺੮

268

REFORM

͙ͅʇ੮Ø)ͅ੮͸ʮ͐ʩ੮ʮ͐ͅ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮ˑˑ˺͸ʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅઝ̹ʇ˺̹ˑʇ੮ʮ˦੮ɘ੮ɻ˺͙̼͐ચʮ˚̹˺ͅʇʁ੮͙ͅɺ͐ͅʮ͙͐͐ʇʁ੮ʁʇɻʮͅʮ˺˦ચ˚ɘˌʮ˦ʡ੮ɘ̼̼ɘ˦ʡʇ˚ʇ˦͐ઝ͐˺੮ͅʩɘ̼ʇ੮ʮ˦੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡ੮ ̼ʇή͙ʮ̼ʇͅ੮ɘ੮̹ʩʮˑ˺ͅ˺̹ʩʮɻɘˑ੮ˑʇɘ̹੮˺ʠ੮ʠɘʮ͐ʩੳ੮ä͐ɘɻ;੮ēɘ˦ɺ̼͙ʡʡʇ˦ੴ੮ʩʇɘʁ੮˺ʠ੮ʁ͙ˑ͐੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ʮ˦੮H̼ʇͅ˦˺ੴ੮ʇͽ̹ˑɘʮ˦ʇʁ੮͐ʩɘ͐੮ʮ͐੮ʇ˦͐ɘʮˑͅ੮ɘɻɻʇ̹͐ʮ˦ʡ੮͐ʩɘ͐੮ુʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ʮͅ˦ૄ͐੮ˑʮˌʇ੮ɘ੮ˑʮʡʩ͐੮ͅ͸ʮ͐ɻʩੴૂ੮͸ʮ͐ʩ੮ͅ˺˚ʇ˺˦ʇૄͅ੮ɻɘ̹ɘɻʮ͐;੮˺ʠ੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʮ˦ʡ੮ ʇ˦͐ʮ̼ʇˑ;੮ͅ˦͙ʠʠʇʁ੮˺͙͐ੳ੮H˺̼੮ʩʇ̼ੴ੮ુ͐ʩʇ̼ʇ੮ɘ̼ʇ੮ʁʇɻʮͅʮ˺˦ͅ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɻɘ˦੮ɺʇ੮˚ɘˌʮ˦ʡ੮ʠ˺̼੮͐ʩʇ˚ͅʇˑͷʇͅੴ੮ɘ˦ʁ੮͐ʩʇ;੮ɘɺͅ˺ˑ͙͐ʇˑ;੮ͅʩ˺͙ˑʁ੮ɺʇ੮˚ɘˌʮ˦ʡ੮ʠ˺̼੮ ͐ʩʇ˚ͅʇˑͷʇͅੳૂ U˦੮H̼ʇͅ˦˺ੴ੮͐ʩʇ੮ʮʁʇɘ੮˺ʠ੮˚ɘˌʮ˦ʡ੮Ø)ͅ੮͸ʮ͐ʩ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ʮͅ੮ɻˑ˺ͅʇˑ;੮͐ʮʇʁ੮͐˺੮̹̼ʇͷʮ˺͙ͅ੮̼ʇʠ˺̼˚ͅ੮͐˺੮͐ʩʇʮ̼੮rØä੮̹̼˺ʡ̼ɘ˚ͅੳ੮੮ʠʇ͸੮;ʇɘ̼ͅ੮ɘʡ˺ੴ੮͐ʩʇ੮ɻ˺͙˦͐;੮̼ʇɘˑʮΈʇʁ੮͐ʩɘ͐੮ ˚ɘ˦;੮ ̹ʇ˺̹ˑʇ੮ ɘˑ̼ʇɘʁ;੮ ˺˦੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͸ʇ̼ʇ੮ ͐ͅʮˑˑ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁੴ੮ ͙˦͐ͅɘɺˑʇੴ੮ɘ˦ʁ੮ʁʮͅɻ˺˦˦ʇɻ͐ʇʁ੮ʠ̼˺˚੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮Ûɘ͐ʩʇ̼੮͐ʩɘ˦੮̼ʇ̹ͅ˺˦ʁʮ˦ʡ੮ɺ;੮ʠ͙̼͐ʩʇ̼੮ ͐ʮʡʩ͐ʇ˦ʮ˦ʡ੮͐ʩʇ੮ʡ̼ʮ̹੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͐ʩʇ;੮ˑ˺˺ͅʇ˦ʇʁ੮ʮ͐ੳ੮îʩʇ੮̹̼˺͐˺ɻ˺ˑͅ੮ʠ˺̼੮H̼ʇͅ˦˺ૄͅ੮Ûʇɻ˺ͷʇ̼;੮͸ʮ͐ʩ੮U˦̹ͅʮ̼ɘ͐ʮ˺˦ੴ੮ä͙̹̹˺̼͐ੴ੮ɘ˦ʁ੮/˚̹˺͸ʇ̼˚ʇ˦͐੮ફÛUä/બ੮Ø̼˺ʡ̼ɘ˚ੴ੮ ɘɻɻ˺̼ʁʮ˦ʡ੮͐˺੮ēɘ˦ɺ̼͙ʡʡʇ˦ੴ੮͐˺˺ˌ੮˺͙͐੮̼ʇʠʇ̼ʇ˦ɻʇͅ੮͐˺੮ુ˦˺˦ચɻ˺˚̹ˑʮɘ˦ɻʇૂ੮ɘ˚˺˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ɘ˦ʁ੮̼ʇ̹ˑɘɻʇʁ੮ʮ͐੮͸ʮ͐ʩ੮ુ̼͐ͅʇ˦ʡ͐ʩͅચɺɘͅʇʁੴ੮ɻˑʮʇ˦͐ચɻʇ˦͐ʇ̼ʇʁ੮ˑɘ˦ʡ͙ɘʡʇੳૂ੮îʩʇ;੮ ʩɘʁ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɘ˦ʁ੮ʁʇ̹͙͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅ੮͸˺̼ˌ੮ͅʮʁʇ੮ɺ;੮ͅʮʁʇ੮ͅ˺੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ʮʁʇ˦͐ʮʠ;੮ ͸ʩʇ˦੮ɘ੮ɻˑʮʇ˦͐ૄͅ੮ͅʇʇ˚ʮ˦ʡˑ;੮˺ʁʁ੮ɺʇʩɘͷʮ˺̼੮ફ˺˦ʇ੮͸ɘͅ੮͸ɘˑˌʮ˦ʡ੮˦ʇɘ̼ˑ;੮ϲʮʠ͐;੮˚ʮˑʇͅ੮ɘ੮ʁɘ;੮ ʠ̼˺˚੮ɻʮ͐;੮͐˺੮ɻʮ͐;બ੮˺̼੮̼ʇʠ͙ͅɘˑ੮˺ʠ੮ˑʮʠʇͅɘͷʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮͸ɘͅ੮ʁ̼ʮͷʇ˦੮ɺ;੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮ ͸ʩʇ˦੮ʮ͐੮͸ɘͅ੮ˈ͙͐ͅ੮ɘ੮ʩ͙˚ɘ˦੮ɺʇʮ˦ʡ੮˚ɘˌʮ˦ʡ੮ɻ˺˦ͅɻʮ˺͙ͅ੮ɻʩ˺ʮɻʇͅ੮͐ʩɘ͐੮˺͐ʩʇ̼ͅ੮˚ʮʡʩ͐੮˦˺͐੮ ɘʡ̼ʇʇ੮͸ʮ͐ʩੳ U͐੮͸ɘͅ੮ુͅɻɘ̼;੮ʠ˺̼੮͐ͅɘʠʠੴૂ੮ēɘ˦ɺ̼͙ʡʡʇ˦੮ɘʁ˚ʮ͐͐ʇʁੴ੮͐˺੮ુɘˑˑ˺͸੮̹ʇ˺̹ˑʇ੮͐˺੮˚ɘˌʇ੮˦ɘ͙̼͐ɘˑ੮˚ʮ͐ͅɘˌʇͅੳૂ੮"͙͐੮ʮ͐੮͸ɘͅ੮ɘˑͅ˺੮ુ̹ɘ̼͐੮˺ʠ੮͐ʩʇʮ̼੮યɻˑʮʇ˦͐ͅૄર੮ˑʇɘ̼˦ʮ˦ʡ੮̹̼˺ɻʇͅͅੳૂ੮rʇ͐͐ʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮͐ɘˌʇ੮̼ʮͅˌͅ੮ફʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮ɺ;੮ʮ˦ͅʮ͐ͅʮ˦ʡੴ੮ͷʮɘ੮ɘ੮Ø)ੴ੮˺˦੮ɘ੮˚ʇʁʮɻɘ͐ʮ˺˦੮͐ʩɘ͐੮ɘ੮ ɻˑʮ˦ʮɻʮɘ˦੮ ˚ʮʡʩ͐੮ ˦˺͐੮ ͐ʩʮ˦ˌ੮ ʮͅ੮ ͐ʩʇ੮ ˚˺͐ͅ੮ ʇʠʠʇɻ͐ʮͷʇબ੮ ɻ˺͙ˑʁ੮ ̹ɘ̼ɘʁ˺ͽʮɻɘˑˑ;੮ ʩʇˑ̹੮ ͅɘͷʇ੮ ͐ʩʇ˚ੳ੮)͙̼ʮ˦ʡ੮͐ʩʇ੮ɻ˺̼˺˦ɘͷʮ̼͙ͅ੮̹ɘ˦ʁʇ˚ʮɻੴ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ͅɘ͸੮ɘ੮͸ɘͷʇ੮ ˺ʠ੮͙ͅʮɻʮʁʇͅ੮ɘ˚˺˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮îʩɘ͐੮̹ʇ˺̹ˑʇ੮̼ʇˑʇʡɘ͐ʇʁ੮͐˺੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮ʁʇɘ͐ʩ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸˺͙ˑʁ੮̼͐;੮͐˺੮ʇͅɻɘ̹ʇ੮ͷʮɘ੮̹ʩ;ͅʮɻɘˑ੮ʁʇɘ͐ʩ੮ʮͅੴ੮ͅɘʁˑ;ੴ੮̹̼ʇʁʮɻ͐ɘɺˑʇੵ੮ʮ˦੮ৱ৸৹৹ੴ੮ ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮/˚ʮˑʇ੮)͙̼ˌʩʇʮ˚੮ͅʩ˺͸ʇʁ੮ʩ˺͸੮͙ͅʮɻʮʁʇ੮ɻ˺͙ˑʁ੮ɺʇ੮ʁ̼ʮͷʇ˦੮ɺ;੮ુʇͽɻʇͅͅʮͷʇ੮ ̼ʇʡ͙ˑɘ͐ʮ˺˦੯ੳ੯ੳ੯ੳ੮ʠ͙͙̼͐ʇͅ੮̹ʮ͐ʮˑʇͅͅˑ;੮ɺˑ˺ɻˌʇʁ੯ੳ੯ੳ੯ੳ੮ɺ;੮˺̹̹̼ʇͅͅʮͷʇ੮ʁʮͅɻʮ̹ˑʮ˦ʇੳૂ਀৽੮H̼ʇͅ˦˺੮ʩɘͅ੮ ˦˺͐੮ʩɘʁ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇ੮ʁʮʇ੮ɺ;੮͙ͅʮɻʮʁʇ੮ʮ˦੮ͅʇͷʇ˦੮;ʇɘ̼ͅੳ੮Ø)ͅ੮ʩɘͷʇ੮̹̼˺ͷʇ˦੮͐˺੮ɺʇ੮ɘ੮ ˑʮʠʇͅɘͷʮ˦ʡ੮̹ɘ̼ɘɻʩ͙͐ʇ੮ʮ˦੮˚˺̼ʇ੮͸ɘ;ͅ੮͐ʩɘ˦੮˺˦ʇੳ š˦ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ʮ˦ʁʮ̹ͅʇ˦ͅɘɺˑʇ੮ ʠʇɘ͙̼͐ʇͅ੮ ˺ʠ੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ Ø)ͅ੮ ̹͙ͅʩ੮ ʮͅ੮ ʠ˺̼੮ ͐ʩʇ੮ ʁ˺ɻ͙˚ʇ˦͐ͅ੮ ͐˺੮ ɺʇ੮ ϲʮˑˑʇʁ੮ ʮ˦੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ʩʇˑ̹੮ ˺ʠ੮ ̹ʇʇ̼ͅੴ੮ ˦˺͐੮ ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੳ੮ H˺̼੮ rɘ͙̼ʮʇੴ੮ ͐ʩʮͅ੮ ʮͅ੮ ʠɘʮ̼ˑ;੮ ʮ˦͙͐ʮ͐ʮͷʇੵ੮ ુʮʠ੮ ;˺͙੮ ɘ̼ʇ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ͅ;͐ͅʇ˚੮ ͐ʩɘ͐੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ ˚ʇੴ੮ ͷʮ˺ˑɘ͐ʇʁ੮ ˚;੮ ̼ʮʡʩ͐ͅੴ੮ ̼͐ʇɘ͐ʇʁ੮ ˚ʇ੮ ̹˺˺̼ˑ;ઝ͸ʩ;੮ ͸˺͙ˑʁ੮ U੮ ɻ̼ʇɘ͐ʇ੮ ɘ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

269

ͅʇˑʠચʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦ચɺɘͅʇʁ੮ʁ˺ɻ͙˚ʇ˦͐੮͸ʮ͐ʩ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʩɘͅ੮ʩɘʁ੮̹˺͸ʇ̼੮˺ͷʇ̼੮˚ʇ੮ ʮ˦੮ɘ੮ͅʮ͙͐ɘ͐ʮ˺˦੮˺ʠ੮ʠ˺̼ɻʇ੺ૂ੮#ˑɘ͙ʁʮɘ੮ēɘ̼ʡɘͅ੮͐ͅɘ̼͐ʇʁ੮ʩʇˑ̹ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ɻ̼ʇɘ͐ʇ੮Ø)ͅ੮͸ʩʇ˦੮ ͅʩʇ੮ ʩʇɘ̼ʁ੮ ɘ੮ ̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦੮ ɺ;੮ rɘ͙̼ʮʇ੮ ˺˦੮ ̹ɘ͐ʮʇ˦͐ͅૄ੮ ̼ʮʡʩ͐ͅੵ੮ ુU੮ ͸ɘͅ੮ ˑʮˌʇੴ੮ ૃ͸ʩɘ͐ੴ੮ ;˺͙੮ ˚ʇɘ˦੮ ;˺͙੮ ʩɘͷʇ੮ ̼ʮʡʩ͐ͅ੮ ͸ʩʇ˦੮ ;˺͙੮ ʡ˺੮ ͐˺੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੺੮ îʩʇ;੮ ય͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑર੮ ʁʮʁ˦ૄ͐੮ ͐ʇˑˑ੮˚ʇ੮ɘ˦;͐ʩʮ˦ʡ੮ɘɺ˺͙͐੮͐ʩɘ͐੸ૄૂ੮äʩʇ੮ˌ˦˺͸ͅ੮ɘ͐੮ʡ͙͐੮ˑʇͷʇˑ੮͐ʩɘ͐੮ુ̹ʇ˺̹ˑʇ੮ɻɘ˦੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ʩʇɘ̼ʮ˦ʡ੮ͷ˺ʮɻʇͅ੯ੳ੯ੳ੯ੳ੮ɘ˦ʁ੮͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮˚ʇɘ˦੮͐ʩʇ;੮ʩɘͷʇ੮ɘ˦;੮ˑʇͅͅ੮ʮ˦ͅʮʡʩ͐੮˺ʠ੮͸ʩɘ͐੮ ͸˺̼ˌͅ੮ʠ˺̼੮͐ʩʇ˚੮ɘ˦ʁ੮͸ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐ੳૂ਀৾੮äʩɘ̼ʮ˦ʡ੮ʩʇ̼੮˺͸˦੮͐ͅ˺̼;੮ʩʇˑ̹ͅ੮̹͙͐੮ɻˑʮʇ˦͐ͅ੮ɘ͐੮ ʇɘͅʇ੮͸ʩ˺੮˺͐ʩʇ̼͸ʮͅʇ੮ʩʇɘ̼੮ુ̹ͅ;ɻʩʮɘ̼͐ʮɻૂ੮ɘ˦ʁ੮ુˑʇʡɘˑ੮ʁ˺ɻ͙˚ʇ˦͐ૂ੮ɘ˦ʁ੮͐ʩʮ˦ˌ੮ʮ˚˚ʇʁʮɘ͐ʇˑ;੮ુʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੳૂ੮Pʇ̼੮̹ʇ̼ͅ˺˦ɘˑ੮̼͙͐ͅʡʡˑʇͅ੮ɘˑͅ˺੮˚ʇɘ˦੮͐ʩɘ͐੮ͅʩʇ੮ˌ˦˺͸ͅ੮͸ʩɘ͐੮ ή͙ʇ͐ͅʮ˺˦ͅ੮͐˺੮ɘͅˌੳ੮{ɘ˦;੮ɻˑʮʇ˦͐ͅ੮͸ʮˑˑ੮ͅɘ;ੴ੮ુૃU੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ˦;੮͸ʇˑˑ˦ʇͅͅ੮͐˺˺ˑͅ੮ʠ˺̼੮͐ʩʮͅ੮ ɘ˦ʁ੮͐ʩɘ͐ੴૄ੮ɺ͙͐੮ɘʠ͐ʇ̼੮;˺͙੮ɘͅˌ੮͐ʩʇ੮̼ʮʡʩ͐੮ή͙ʇ͐ͅʮ˺˦ͅੴ੮ʮ͐ૄͅ੮ˑʮˌʇੴ੮ૃ˺ˌɘ;ੴ੮;˺͙੮ʁ˺੮ʩɘͷʇ੮͐ʩʇͅʇ੮ ͐ʩʮ˦ʡͅੴ੮˚ɘ;ɺʇ੮;˺͙੮ˈ͙͐ͅ੮ʁʮʁ˦ૄ͐੮ʩɘͷʇ੮ɘ੮ˑɘ˦ʡ͙ɘʡʇ੮ʠ˺̼੮ʮ͐੮ɺʇʠ˺̼ʇੳૄૂ੮Ûʇͅʇɘ̼ɻʩ੮ͅʩ˺͸ͅ੮͐ʩɘ͐੮ Ø)ͅ੮ɻ̼ʇɘ͐ʇʁ੮͸ʮ͐ʩ੮̹ʇʇ̼ͅ੮ɘ̼ʇ੮˚˺̼ʇ੮ʇʠʠʇɻ͐ʮͷʇ੮ʮ˦੮̼ʇʁ͙ɻʮ˦ʡ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮͐ʩɘ˦੮ ͐ʩ˺ͅʇ੮͸ʮ͐ʩ˺͙͐ੳ਀৿ U˦੮ɘ͐͐ʇ˚̹͐ʮ˦ʡ੮͐˺੮ʡʇ͐੮ɘ੮ˑɘ̼ʡʇ੮̹̼˺̹˺̼͐ʮ˺˦੮˺ʠ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻˑʮʇ˦͐ͅ੮͐˺੮ϲʮˑˑ੮ ͐ʩʇ˚੮˺͙͐ੴ੮ʩɘͷʮ˦ʡ੮̹ʇʇ̼ͅ੮ʩʇˑ̹੮͐ʩʇ˚੮ʁ˺੮ʮ͐ੴ੮ɘ˦ʁ੮ɻ˺ͷʇ̼ʮ˦ʡ੮˚͙ˑ͐ʮ̹ˑʇ੮ʁ˺˚ɘʮ˦ͅ੮ɺʇ;˺˦ʁ੮ ˚ʇʁʮɻɘˑ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮Ø)ͅ੮̹̼˺ˈʇɻ͐੮ʮͅ੮ͅ͸ʇʇ̹ʮ˦ʡ੮ʮ˦੮ʮ͐ͅ੮ɘ˚ɺʮ͐ʮ˺˦ੳ੮š˦ʇ੮ ɻ˺˦͙ͅˑ͐ɘ˦͐੮͐˺ˑʁ੮˚ʇੴ੮ુš͐ʩʇ̼੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮͐ʩʇ੮î˺;˺͐ɘ੮˺̼੮)˺ʁʡʇ੮˺ʠ੮Ø)ͅੴ੮͸ʩʮˑʇ੮͸ʇૄ̼ʇ੮ ͅʩ˺˺͐ʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮îʇͅˑɘੴ੮͐ʩʇ੮{ʇ̼ɻʇʁʇͅ੯ੳ੯ੳ੯ੳ੮͐ɘˌʮ˦ʡ੮͐ʩɘ͐੮ɘʁͷɘ˦ɻʇʁ੮ʁʮ̼ʇɻ͐ʮͷʇ੮˺˦ʇ੮͐ͅʇ̹੮ ʠ͙̼͐ʩʇ̼ੳૂ੮ "͙͐੮ ͐ʩʇ̼ʇ੮ ɘ̼ʇ੮ ˺̹ʇ˦੮ ή͙ʇ͐ͅʮ˺˦ͅ੮ ɘɺ˺͙͐੮ ʩ˺͸੮ ͐˺੮ ɘɻ͙͐ɘˑˑ;੮ ̼͐ɘ˦ͅʠ˺̼˚੮ Ø)ͅ੮ ʮ˦͐˺੮ɘ˦੮ુʇͽ͐ʇ̼˦ɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;ૂ੮͐ʩɘ͐੮ɻɘ˦੮ʁʮ̼ʇɻ͐੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ʮ˦੮ͅʮ͐ʇͅ੮ɘͅ੮ʁʮͷʇ̼ͅʇ੮ɘͅ੮ ͅʩʇˑ͐ʇ̼ͅੴ੮ ɻˑʮ˦ʮɻͅੴ੮ ɘ̹ɘ̼͐˚ʇ˦͐ͅੴ੮ ˈɘʮˑͅੴ੮ ɘ˦ʁ੮ ʩ˺̹ͅʮ͐ɘˑͅੳ਀਀੮ îʩʇ੮ ˑ˺ʡʮ͐ͅʮɻͅ੮ ˺ʠ੮ ͙ͅʮ˦ʡ੮ Ø)ͅ੮ ɘ̼ʇ੮ɻ˺˚̹ˑʮɻɘ͐ʇʁੴ੮ɺ͙͐੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮ʁ̼ʇɘ˚ʮ˦ʡ੮ɺʮʡੵ੮ɻ˺͙˦͐ʮʇͅ੮ɘ̼ʇ੮ɻ˺˦ͅʮʁʇ̼ʮ˦ʡ੮͐ͅ˺̼ʮ˦ʡ੮ Ø)ͅ੮ ʮ˦੮ ͸ʇɘ̼ɘɺˑʇ੮ ɺ̼ɘɻʇˑʇ͐ͅੴ੮ ɘ੮ ĺÛ੮ ɻ˺ʁʇੴ੮ ˺̼੮ ɘ੮ ɻˑ˺͙ʁચɘɻɻʇͅͅʮɺˑʇ੮ ʁɘ͐ɘɺɘͅʇ੮ ɘɻ̼˺ͅͅ੮ ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅੳ੮îʩʇ੮͐ͅɘ͐ʇ੮͸ʮˑˑ੮ʇͷʇ˦͙͐ɘˑˑ;੮˦ʇʇʁ੮͐˺੮̹ɘͅͅ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮ʡʮͷʮ˦ʡ੮Ø)ͅ੮ˑʇʡɘˑ੮ ͸ʇʮʡʩ͐ੴ੮ͅʇ͐͐ʮ˦ʡ੮̼͙ˑʇͅ੮ʠ˺̼੮ʮʠ੮ɘ˦ʁ੮͸ʩʇ˦੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻɘ˦੮˺ͷʇ̼̼ʮʁʇ੮͐ʩʇ˚ੴ੮ɘ˦ʁ੮ʁʇɻʮʁʮ˦ʡ੮ ͸ʩɘ͐੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͸ʮˑˑ੮̹ɘ;੮ʠ˺̼੮ʮʡ˦˺̼ʮ˦ʡ੮͐ʩʇ˚ੳ U੮ɘ˚੮ɻˑ˺ͅʮ˦ʡ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮͸ʮ͐ʩ੮Ø)ͅ੮ɺʇɻɘ͙ͅʇ੮˺ʠ੮ʩ˺͸੮̹̼˺ʠ˺͙˦ʁˑ;੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ ͅʩʮʠ͐੮͐ʩʇ੮ɺɘˑɘ˦ɻʇ੮˺ʠ੮̹˺͸ʇ̼੮ʮ˦੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮ͅ੮rɘ͙̼ʮʇ੮̹͙͐੮ʮ͐ੴ੮ુUʠ੮;˺͙੮ ͐ʩʮ˦ˌ੮ɘɺ˺͙͐੮ʮ͐੮ʠ̼˺˚੮ɘ੮ɻ˺˦͙ͅ˚ʇ̼੮̹ʇ̼̹ͅʇɻ͐ʮͷʇੴ੮ʮϲ੮Ĕɘˑચ{ɘ̼͐੮ʮͅ੮̹͙͐͐ʮ˦ʡ੮˺͙͐੮˺˦ʇ੮͐;̹ʇ੮ ˺ʠ੮ʡ̼ʇʇ˦੮ɺʇɘ˦ͅੴ੮ɻ˺˦͙ͅ˚ʇ̼ͅ੮ʩɘ͐ʇ੮ʮ͐ੴ੮͐ʩʇ˦੮ͅɘ;ʮ˦ʡ੮͐ʩɘ͐੮ʡ̼ʇʇ˦੮ɺʇɘ˦ͅ੮ɘ̼ʇ੮ˈ͙͐ͅ੮ɘ੮͐ʇ̼̼ʮɺˑʇ੮ ̹̼˺ʁ͙ɻ͐ੴ੮ ʮ͐ૄͅ੮ ˦˺͐੮ ̼͙͐ʇੳ੮ Ě˺͙ૄ̼ʇ੮ ˈ͙͐ͅ੮ ̹̼˺ͷʮʁʮ˦ʡ੮ ɘ੮ ͐;̹ʇ੮ ˺ʠ੮ ʡ̼ʇʇ˦੮ ɺʇɘ˦੮ ͐ʩɘ͐੮ ˦˺ɺ˺ʁ;੮ ͸ɘ˦͐ͅੳૂ੮îʩʇ੮rØä੮ɻ͐ੴ੮ʮ˦੮͐ʩʇ˺̼;੮ʮʠ੮˦˺͐੮ɘˑ͸ɘ;ͅ੮ʮ˦੮̹̼ɘɻ͐ʮɻʇੴ੮͸ɘͅ੮͙̹̹ͅ˺ͅʇʁ੮͐˺੮ʡʮͷʇ੮ ̹ʇ˺̹ˑʇ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮̼ʇʠ͙ͅʇ੮͐ʩʇ੮ʡ̼ʇʇ˦੮ɺʇɘ˦ͅ੮͐ʩʇ;੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐ੳ੮Ø)ͅੴ੮͐˺੮ʩ˺̼̼ʮɺˑ;੮ ̼͐ͅɘʮ˦੮͐ʩʇ੮ɘ˦ɘˑ˺ʡ;ੴ੮ɘ̼ʇ੮ɘɺ˺͙͐੮˺ɺˑʮʡɘ͐ʮ˦ʡ੮Ĕɘˑચ{ɘ̼͐੮͐˺੮ϲʮ˦ɘˑˑ;੮̹̼˺ͷʮʁʇ੮͐ʩʇ੮ʡ̼ʇʇ˦੮ ɺʇɘ˦ͅ੮͐ʩɘ͐੮ʮ͐ͅ੮ͅʩ˺̹̹ʇ̼ͅ੮ʁ˺੮͸ɘ˦͐ੳ

270

REFORM

CONCLUSION: CONSTRUCTING COLLABORATION ä͐ʇͷʇ੮Hʮʇˑʁͅੴ੮ʠ̼˺˚੮Ø̼˺ʡ̼ʇͅͅ੮H˺͙˦ʁɘ͐ʮ˺˦ੴ੮ʩɘͅ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʠ˺̼੮͸ʩ;੮ ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ʁʮʁ੮˦˺͐੮͙ͅɻɻʇʇʁ੮ʮ˦੮ɻ̼ʇɘ͐ʮ˦ʡ੮͐ʩʇ੮ુͅʇˑʠચ̼ʇˑʮɘ˦͐ੴ੮ɘ͙͐˺˦˺˚˺͙ͅ੮ ɻʮ͐ʮΈʇ˦ͅૂ੮ɘʁͷ˺ɻɘ͐ʇͅ੮˺̼ʮʡʮ˦ɘˑˑ;੮̹̼˺˚ʮͅʇʁੳ਀ਁ੮ä͐ʇͷʇ੮̼ʇɻɘˑˑͅੴ੮ુU੮̹ͅʇ˦͐੮˚ɘ˦;੮ˑ˺˦ʡ੮ʩ˺͙̼ͅ੮ ˑʇɘ̼˦ʮ˦ʡ੮ ʠ̼˺˚੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ʩɘʁ੮ ɺʇʇ˦੮ ʮ˦੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ʠ˺̼੮ ɘ੮ ˑ˺˦ʡ੮ ͐ʮ˚ʇੳૂ੮ Ĕʩɘ͐੮ ͐ʩʇ;੮ ͐ɘ͙ʡʩ͐੮ʩʮ˚ੴ੮ʩʇ੮ͅɘ;ͅੴ੮͸ɘͅ੮͐ʩɘ͐੮ʮ͐੮͸ɘͅ੮ɘ੮ુʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮ϲˑɘ͸ૂ੮͐˺੮ɘ͙ͅͅ˚ʇ੮ુ͐ʩɘ͐੮͐ʩʇͅʇ੮ ʠ˺ˑˌͅੴ੮͸ʩʇ˦੮͐ʩʇ;੮͸ʇ̼ʇ੮ϲʮ˦ɘˑˑ;੮ˑʇ͐੮ˑ˺˺ͅʇੴ੮͸˺͙ˑʁ੮ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ɻ˺˚ʇ੮͐˺੮̹̼˺ʡ̼ɘ˚ͅ੮͐ʩʇ;੮ ʁʮʁ˦ૄ͐੮ ͐ʩʮ˦ˌ੮ ʩʇˑ̹ʇʁ੮ ͐ʩʇ˚੮ ɘ˦;ੳૂ੮ Ĕʩʇ˦੮ ͐ʩʇ;੮ ͷ˺͐ʇʁ੮ ͸ʮ͐ʩ੮ ͐ʩʇʮ̼੮ ʠʇʇ͐੮ ɘʡɘʮ˦͐ͅ੮ ͐ʩʇͅʇ੮ ̹̼˺ʡ̼ɘ˚ͅੴ੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ˚੮͸˺͙˦ʁ੮͙̹੮ɻ˺˦ͅʇ̼ͷʇʁ੮͸ʩʮˑʇ੮˺͐ʩʇ̼ͅ੮͸˺͙˦ʁ੮͙̹੮ɻ;ɻˑʮ˦ʡ੮ʮ˦੮ ɘ˦ʁ੮˺͙͐੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮ˈɘʮˑͅੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼ͅੳ ੮ɻ˺˚˚˺˦੮͐ʩ̼ʇɘʁ੮͐ʩ̼˺͙ʡʩ੮ɘˑˑ੮˺ʠ੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮ɘɻ̼˺ͅͅ੮͐ʩʮͅ੮ɻʩɘ̹͐ʇ̼੮ʮͅ੮͐ʩɘ͐੮ ͐ʩʇ;੮̼ɘʁʮɻɘˑˑ;੮ʁʇʇ˚̹ʩɘͅʮΈʇ੮ુɘ˦˺ͅ˺ʡ˦˺ͅʮɘૂ੮ફˑɘɻˌ੮˺ʠ੮ʮ˦ͅʮʡʩ͐બੳ੮੮̼͙͐ˑ;੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮͷʇ੮ ̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹੮͐ͅɘ̼͐ͅ੮͸ʮ͐ʩ੮̼ʇɻ˺ʡ˦ʮΈʮ˦ʡ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇૄͅ੮̼ʇʠ͙ͅɘˑͅ੮˺ʠ੮ͅʇ̼ͷʮɻʇͅ੮ɘ̼ʇ੮˦˺͐੮̼ɘ˦ʁ˺˚੮̼ɘͷʮ˦ʡͅ੮ɺ͙͐੮˺ʠ͐ʇ˦੮̼ʇϲˑʇɻ͐੮̼ʇɘˑ੮ɘ˦ʁ੮˺ʠ͐ʇ˦੮̼͐ɘ͙˚ɘ͐ʮɻ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇͅ੮͸ʮ͐ʩ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮"͙ʮˑʁʮ˦ʡ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ˦ૄ͐੮ˈ͙͐ͅ੮̼ʇ˦˺͙˦ɻʮ˦ʡ੮ ͐ʩʇ੮͙ͅʇ੮˺ʠ੮ɻ˺ʇ̼ɻʮ˺˦੶੮ʮ͐੮ʮͅ੮ɘˑͅ˺੮̼ʇˑʮ˦ή͙ʮͅʩʮ˦ʡ੮ɘ͙͐ʩ˺̼ʮ͐;ੴ੮͸ʩʮɻʩੴ੮ɘͅ੮͐ʩʇ੮̹˺ˑʮ͐ʮɻɘˑ੮ͅɻʮʇ˦͐ʮ͐ͅ੮Pɘ˦˦ɘʩ੮̼ʇ˦ʁ͐੮˺ɺͅʇ̼ͷʇʁੴ੮ુɘˑ͸ɘ;ͅ੮ʁʇ˚ɘ˦ʁͅ੮˺ɺʇʁʮʇ˦ɻʇੴૂ੮ʮ˦੮ʠɘͷ˺̼੮˺ʠ੮ુ̹ʇ̼͙ͅɘͅʮ˺˦ੴ੮͸ʩʮɻʩ੮̹̼ʇ͙̹̹ͅ˺ͅʇͅ੮ʇή͙ɘˑʮ͐;ੳૂ਀ਂ੮੮ͅ;͐ͅʇ˚੮ɺɘͅʇʁ੮˺˦੮̹ʇ̼͙ͅɘͅʮ˺˦੮ɻ˺͙ˑʁ੮ɺʇ੮ ̼ʇˑʇ˦͐ˑʇͅͅੴ੮ʇͷʇ˦੮ʮ˦̼͙͐ͅʮͷʇੴ੮ɺ͙͐੮͐ʩʇ੮˺˦ˑ;੮͐ʩ̼ʇɘ͐੮ɺʇʩʮ˦ʁ੮ʮ͐੮͸˺͙ˑʁ੮ɺʇ੮˺ʠ੮˚˺̼ʇੴ੮ɘ˦ʁ੮ ˚˺̼ʇ੮ɻ̼ʇɘ͐ʮͷʇੴ੮ɘ͐͐ʇ˚̹͐ͅ੮ɘ͐੮̹ʇ̼͙ͅɘͅʮ˺˦ੳ ʁ˚ʮ͐͐ʇʁˑ;ੴ੮ɘͅ੮U੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʇʁ੮͐ʩʇͅʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅੴ੮U੮ʠ˺͙˦ʁ੮͐ʇ˦ͅʮ˺˦ͅ੮ɘ˚˺˦ʡ੮͐ʩʇ˚ੳ੮ ੮ʠʇ͸੮˺ʠ੮"ʇɻɻɘૄͅ੮šî੮ɻˑʮʇ˦͐ͅ੮ʩɘͷʇ੮ɺʇʇ˦੮ɺɘ˦˦ʇʁ੮ʠ˺̼੮˚ʮͅɺʇʩɘͷʮ˺̼੮ʠ̼˺˚੮Ø̼˺ʡ̼ʇͅͅૄͅ੮ ʠɘɻʮˑʮ͐ʮʇͅੳ੮š˦ʇ੮˚˺͐ʩʇ̼੮ɺ̼˺͙ʡʩ͐੮ʩʇ̼੮ͅ˺˦੮͐˺੮ͷʮͅʮ͐੮͐ʩʇ੮#ˑ͙ɺʩ˺͙ͅʇ੶੮ʩʇ੮͐˺˺ˌ੮˺˦ʇ੮ˑ˺˺ˌ੮ ɘ˦ʁ੮ˑʇʠ͐ੴ੮ɺʇɻɘ͙ͅʇ੮ʩʇ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɺʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮͸ʮ͐ʩ੮ુ͐ʩ˺ͅʇ੮̹ʇ˺̹ˑʇੳૂ੮ä#Ûî੮̼͙˦ͅ੮ ʮ˦͐˺੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ ͸˺͙ˑʁ੮ ɺʇ੮ ͐˺˺੮ ʮ˚̹ɘʮ̼ʇʁ੮ ͐˺੮ ̹͙͐੮ ɘ˦;͐ʩʮ˦ʡ੮ ɘɺ˺͙͐੮ ͐ʩʇʮ̼੮ ̹̼ʇʠʇ̼̼ʇʁ੮ɻ̼ʮͅʮͅ੮̼ʇ̹ͅ˺˦ͅʇ੮ʮ˦੮ɘ੮Ø)ੳ੮îʩʇ੮ɘɻɻ͙˚͙ˑɘ͐ʇʁ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮ʁʇɻɘʁʇͅ੮˺ʠ੮˦˺͐੮ ʩɘͷʮ˦ʡ੮ɘ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦੮˚ʇɘ˦੮͐ʩɘ͐੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ɻ˺͙ˑʁ੮˦˺͐੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʇ੮͸ʮ͐ʩ੮͙ͅɻʩ੮ɘ੮ɻ˺˦͐ʮ˦͙͙˚੮ʇͷʇ˦੮ʮʠ੮ʮ͐੮͸ʇ̼ʇ੮ɺ͙ʮˑ͐੮͙̹੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮͐ͅɘ͐ʇੳ U͐੮ ʮͅ੮ ˦˺͐੮ ɘ੮ ͙̼̹̼ͅʮͅʇੴ੮ ͐ʩʇ˦ੴ੮ ͐ʩɘ͐੮ ˚ɘ˦;੮ ̹ʇ˺̹ˑʇ੮ U੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ ʠ˺̼੮ ͐ʩʮͅ੮ ɻʩɘ̹͐ʇ̼੮ ͐ͅʮˑˑ੮ͅʇʇ੮ɘ੮̼˺ˑʇ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮/̼ʮɻ੮Pʇ˦̼ʮή͙ʇͅੴ੮ʠ̼˺˚੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮{ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ͅͅ˺ɻʮɘ͐ʮ˺˦ੴ੮͐˺ˑʁ੮˚ʇੴ੮ુɘ੮ʠʇ͸੮˺ʠ੮͐ʩʇ੮ʠ˺ˑˌͅ੮Uૄͷʇ੮͸˺̼ˌʇʁ੮͸ʮ͐ʩઝˈ͙͐ͅ੮ɘ੮ʠʇ͸ઝʮʠ੮ ͐ʩʇ;੮ɘ̼ʇ੮˦˺͐੮̼ʇή͙ʮ̼ʇʁ੮͐˺੮ʩɘͷʇ੮ͅ˺˚ʇ੮͐;̹ʇ੮˺ʠ੮͙̹̹ͅ˺̼͐ੴ੮͐ʩʇ;੮͸ʮˑˑ੮ɺʇ੮ͷʮɻ͐ʮ˚ʮΈʇʁ੮˺̼੮ ˈ͙͐ͅ੮ʁʮʇ੮ʮ˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ʮ˦੮͐ʩʇʮ̼੮ʠʇɻʇͅੳૂ੮š͐ʩʇ̼ͅ੮ʩʇͅʮ͐ɘ˦͐ˑ;੮ɺɘɻˌʇʁ੮̼ʇʠ˺̼˚ͅ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ʮʠ੮˺˦ˑ;੮ɘͅ੮ɘ੮͐ʇ˚̹˺̼ɘ̼;੮͐ͅ˺̹ʡɘ̹ੳ੮"͙͐੮ʇͷʇ˦੮ɘ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮ʮ˚̹˺ͅʇͅ੮

S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

271

͙ͅɺ͐ͅʮ͙͐͐ʇʁ੮ ʁʇɻʮͅʮ˺˦੮ ˚ɘˌʮ˦ʡ੮ ɻɘ˦੮ ʮ˦ɻ˺̼̹˺̼ɘ͐ʇ੮ ̹̼ʮ˦ɻʮ̹ˑʇͅ੮ ˺ʠ੮ ͙̹̹ͅ˺̼͐ʇʁ੮ ʁʇɻʮͅʮ˺˦੮ ˚ɘˌʮ˦ʡ੮͙ͅɻʩ੮ɘͅ੮̼ʇ̹ͅʇɻ͐ੴ੮ɻ˺˦˦ʇɻ͐ʮ˺˦ੴ੮ɘ˦ʁ੮˚ɘͽʮ˚ʮΈʮ˦ʡ੮ɻʩ˺ʮɻʇੳ U˦੮͐ʩʇ੮ʇ˦ʁੴ੮ʁʇ̹ͅʮ͐ʇ੮͐ʩʇ੮ʮ˦˦˺ͷɘ͐ʮͷʇ੮ʡ̼ɘ̼ͅͅ˺˺͐ͅ੮ʮ˦ʮ͐ʮɘ͐ʮͷʇͅ੮˺ʠ੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ɻ˺͙˦͐ʮʇͅੴ੮ ɘ˦ʁ੮ͅʇ̼ͷʮɻʇ੮͙ͅʇ̼ͅੴ੮˦ʇʮ͐ʩʇ̼੮ɘ੮ɻ˺˚̹̼ʇʩʇ˦ͅʮͷʇ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦੮˦˺̼੮ɘ˦੮ ʇʠʠʇɻ͐ʮͷʇ੮ફʮʠ੮ʁʮ˚ʮ˦ʮͅʩʇʁબ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚੮͐˺੮ɻɘ͐ɻʩ੮̹ʇ˺̹ˑʇ੮ʠɘˑˑʮ˦ʡ੮˺ʠʠ੮ʮ͐੮͸ʮˑˑ੮ ɻ˺˚ʇ੮ʮ˦͐˺੮ɺʇʮ˦ʡ੮˺˦੮ʮ͐ͅ੮˺͸˦ੳ੮U͐੮͸ʮˑˑ੮͐ɘˌʇ੮ʇ˦ʡɘʡʇʁ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘ͙͐ʩ˺̼ʮ͐;ੴ੮͸ʩʮɻʩ੮U੮ ͸ʮˑˑ੮ʇͽ̹ˑ˺̼ʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˦ɻˑ͙ͅʮ˺˦ੳ

CONCLUSION "ʇ;˺˦ʁ੮{ʮ̼ɘɻˑʇͅ

‘I

’m hoping you have a miracle.’ Uૄ˚੮ͅʮ͐͐ʮ˦ʡ੮ʮ˦੮͐ʩʇ੮ɻɘɺ੮ɘˑ˺˦ʡͅʮʁʇ੮ɘ੮ϲʮ̼͐ͅ੮̼ʇ̹ͅ˺˦ʁʇ̼੮ફ͐ʩʇ;ૄ̼ʇ੮̹ɘ̼͐੮˺ʠ੮ɘ੮ ͐ʇɘ˚੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮͸ʮ͐ʩ੮͐ʩʇ੮˚˺ʁʇˑͅ੮˺ʠ੮#{Ø੮ʮ˦੮rੴ੮ÛØ੮ʮ˦੮äɘ˦੮)ʮʇʡ˺ੴ੮ ˺̼੮ ä#Ûî੮ ʮ˦੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ੴ੮ ͸ʩʮɻʩ੮ ͸˺̼ˌ੮ ͸ʮ͐ʩ੮ ͙ˑ̼͐ɘʩʮʡʩ੮ ͙͐ʮˑʮΈʇ̼ͅ੮ ˺ʠ੮ ʇ˚ʇ̼ʡʇ˦ɻ;੮ services who are not engaged in any ongoing treatment). We’ve just received a ɻɘˑˑ੮ʠ̼˺˚੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ɘ͐੮ɘ੮˦ʇɘ̼ɺ;੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮äʩʇૄͅ੮̼ʇɘɻʩʮ˦ʡ੮˺͙͐੮ɘɺ˺͙͐੮ ɘ੮̹ɘ͐ʮʇ˦͐੮͸ʩ˺ੴ੮ɘ͐੮͐ʩʇ੮ʮ˦ͅʮ͐ͅʇ˦ɻʇ੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦ੴ੮ʮͅ੮ɘɺ˺͙͐੮͐˺੮ʡʇ͐੮ɺ˺˺͐ʇʁ੮ ʠ̼˺˚੮ɘ˦੮/Ûઝʇͷʇ˦੮͐ʩ˺͙ʡʩ੮ͅʩʇ੮ʮͅ੮ʠ˺͙̼͐ʇʇ˦੮͸ʇʇˌͅ੮̹̼ʇʡ˦ɘ˦͐ੴ੮͙ͅʮ˦ʡ੮˚ʇ͐ʩੴ੮ɘ˦ʁ੮̼͙͐ͅʡʡˑʮ˦ʡ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘੳ੮ૃîʩʇ;੮ͅɘ;੮͐ʩʇ;ૄ̼ʇ੮ʡ˺ʮ˦ʡ੮͐˺੮ʁʮͅɻʩɘ̼ʡʇੴ੮ɺ͙͐੮Uૄ˚੮ˑʮˌʇੴ੮ુ͐˺੮ ͸ʩʇ̼ʇ੺ૂ੮Uૄ˚੮͸˺˦ʁʇ̼ʮ˦ʡ੮ʮʠ੮;˺͙੮ʩɘͷʇ੮ɘ˦;੮ʮʁʇɘͅ੺ૄ੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮̹ˑʇɘʁͅੳ੮{;੮ʡ͙ʮʁʇ੮ ˑ˺˺ˌͅ੮͐ʩʇ੮͸˺˚ɘ˦੮͙̹੮ʮ˦੮͐ʩʇ੮ɻ˺͙˦͐;ૄͅ੮ʁɘ͐ɘɺɘͅʇੵ੮ͅʩʇ੮ʩɘͅ੮ɘ੮ˑ˺˦ʡ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ͅʩ˺̼͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮͐ʩɘ͐੮ˑʇʁ੮˦˺͸ʩʇ̼ʇੴ੮˺ʠ੮ɺʇʮ˦ʡ੮̼ʇͷʮͷʇʁ੮ɺ;੮͐ʩʇ੮ϲʮ̼ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮ʮ˦੮ɘ੮̹˺˺ˑ੮ ˺ʠ੮ͷ˺˚ʮ͐੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੴ੮ɘ˦ʁ੮˺ʠ੮˺͙̼͐ʇɘɻʩ੮͸˺̼ˌʇ̼ͅ੮ϲʮ˦ʁʮ˦ʡ੮ʩʇ̼੮ͅˑʇʇ̹ʮ˦ʡ੮ʮ˦੮ʁ˺˺̼͸ɘ;ͅੳ Ĕʇ੮ʁ̼ʮͷʇ੮͐˺੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮˦˺͐ʩʇ̼੮͐ʇɘ˚੮˚ʇ˚ɺʇ̼੮ɘ˦ʁ੮ɘ੮˦͙̼ͅʇ੮ʠ̼˺˚੮͐ʩʇ੮ˑ˺ɻɘˑ੮ "ʇʩɘͷʮ˺̼ɘˑ੮ Pʇɘˑ͐ʩ੮ )ʇ̹ɘ̼͐˚ʇ˦͐੮ ɘ̼ʇ੮ ɻ˺˚ʮ˦ʡ੮ ˺͙͐੮ ͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮ ɘ˚ɺ͙ˑɘ˦ɻʇ੮ ɺɘ;ੳ੮ îʩʇ੮˦͙̼ͅʇ੮ʡʮͷʇͅ੮ɘ੮ʁʇɺ̼ʮʇʠੵ੮Ø˺ˑʮɻʇ੮ɺ̼˺͙ʡʩ͐੮͐ʩʇ੮͸˺˚ɘ˦੮ʮ˦੮ͅɻ̼ʇɘ˚ʮ˦ʡੳ੮îʩʇ੮ʁ˺ɻ͐˺̼੮ ʩʇˑʁ੮ ʩʇ̼੮ ʩɘ˦ʁ੮ ͸ʩʮˑʇ੮ ɘ੮ ʩʇɘͷ;੮ ʁ˺ͅʇ੮ ˺ʠ੮ Ĥ;̹̼ʇͽɘ੮ ɻ͙͐੮ ͐ʩ̼˺͙ʡʩ੮ ʩʇ̼੮ ̹ͅ;ɻʩ˺ͅʮͅੳ੮ îʩʇ੮ ̹ʩ;ͅʮɻʮɘ˦ઝɘ੮̼ʇʡ͙ˑɘ̼੮ʇ˚ʇ̼ʡʇ˦ɻ;੮ʁ˺ɻ͐˺̼ઝɻɘˑˑʇʁ੮ʠ˺̼੮ɘ੮̹ͅ;ɻʩ੮ʇͷɘˑੴ੮ɺ͙͐ੴ੮ɘɻɻ˺̼ʁʮ˦ʡ੮ ͐˺੮͐ʩʇ੮˦͙̼ͅʇੴ੮ૃîʩʇ;੮ય͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅર੮ɘ̼ʇ੮ˈ͙͐ͅ੮ʁ˺ʮ˦ʡ੮ય͐ʩʇ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ર੮ɘͅ੮ɘ੮ʠɘͷ˺̼ੳ੮ îʩʇ;ૄ̼ʇ੮˦˺͐੮ʡ˺ʮ˦ʡ੮͐˺੮ˌʇʇ̹੮ʩʇ̼੮ય˺˦੮ɘ੮৵ৱ৵ৰરੳ੮îʩʇ੮/Û੮ʁ˺ɻ੮ʮͅ੮ʠ͙̼ʮ˺͙ͅੳ੮äʩʇૄʁ੮ˑʮˌʇ੮͐˺੮ ͅʇʇ੮ʩʇ̼੮ʩʇˑʁੴ੮ɻ˺˦ͅʇ̼ͷʇʁੴ੮͸ʩɘ͐ʇͷʇ̼ੳૄ੮Ĕʇ੮̼͙˦੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮˺̹͐ʮ˺˦ͅ੮ɘ˦ʁ੮̼͙ˑʇ੮͐ʩʇ˚੮ɘˑˑ੮ ˺͙͐ੳ੮੮ʠɘ˚ʮˑ;੮ͅʩʇˑ͐ʇ̼੮͸˺˦ૄ͐੮͐ɘˌʇ੮ʩʇ̼੮ɺʇɻɘ͙ͅʇ੮ͅʩʇ੮ʁ˺ʇͅ˦ૄ͐੮ʩɘͷʇ੮ɘ੮ˌʮʁ੮ફ;ʇ͐બੳ੮੮ͅ˺ɺʇ̼ʮ˦ʡ੮ɻʇ˦͐ʇ̼੮ʁ˺ʇͅ˦ૄ͐੮͸ɘ˦͐੮͐ʩʇ੮ˑʮɘɺʮˑʮ͐;੮˺ʠ੮ɘ੮̹̼ʇʡ˦ɘ˦͐੮ɻˑʮʇ˦͐੮ʮ˦੮ɘ੮̹ͅɘɻʇ੮ʁʇͅʮʡ˦ʇʁ੮ʠ˺̼੮ ͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅੳ੮äʩʇ੮ͅ˺͙˦ʁͅ੮͐˺˺੮ɺʇʩɘͷʮ˺̼ɘˑˑ;੮ʁ;̼ͅʇʡ͙ˑɘ͐ʇʁ੮ʠ˺̼੮ɘ˦੮͙˦ˑ˺ɻˌʇʁ੮ɻ̼ʮͅʮͅ੮

2 74

C O N C LU S I O N

ɻˑʮ˦ʮɻੳ੮U͐ૄͅ੮ɘ੮ä͙˦ʁɘ;੮˦ʮʡʩ͐੮ʮ˦੮ɘ੮͐ͅɘ͐ʇ੮͸ʮ͐ʩ੮͐ʩʇ੮ϲʮʠ͐ʩ੮ˑɘ̼ʡʇ͐ͅ੮ʇɻ˺˦˺˚;੮ʮ˦੮͐ʩʇ੮͸˺̼ˑʁੴ੮ ɘ˦ʁ੮͸ʇ੮ɻɘ˦ૄ͐੮ϲʮ˦ʁ੮ɘ੮ɺʇʁ੮ʠ˺̼੮ɘ੮ͅʮɻˌੴ੮ʩ˺˚ʇˑʇͅͅੴ੮ɘ˦ʁ੮̹̼ʇʡ˦ɘ˦͐੮͸˺˚ɘ˦ੳ îʩʇ੮͐ʇɘ˚੮ɺ̼ɘʮ˦͐ͅ˺̼˚ͅ੮͐ʩ̼ʇʇ੮˺̹͐ʮ˺˦ͅੳ੮îʩʇ੮ϲʮ̼͐ͅ੮ʮͅ੮͐˺੮̹ˑʇɘʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ʁ˺ɻ͐˺̼੮͐˺੮ ˌʇʇ̹੮ʩʇ̼੮ɘͅ੮ɘ੮ͅ˺ɻʮɘˑ੮ɘʁ˚ʮͅͅʮ˺˦੮ફʮੳʇੳੴ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʁ˺ʇͅ˦ૄ͐੮̼ʇɘˑˑ;੮˚ʇʇ͐੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ɘ˦ʁ੮ ͸ʩ˺ͅʇ੮ ɻɘ̼ʇ੮ ͸ʮˑˑ੮ ͐ʩ͙ͅ੮ ʡ˺੮ ͙˦̼ʇʮ˚ɺ͙̼ͅʇʁબੴ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ̹̼˺˚ʮͅʇ੮͐ʩɘ͐੮͸ʇૄˑˑ੮̹ʮɻˌ੮ʩʇ̼੮͙̹੮ɘ͐੮৶੮ɘੳ˚ੳ੮͐ʩʇ੮˦ʇͽ͐੮˚˺̼˦ʮ˦ʡੳ੮îʩʇ੮ͅʇɻ˺˦ʁ੮ʮͅ੮ˑʇ͐੮ʩʇ̼੮ɺʇ੮ ̼ʇˑʇɘͅʇʁੴ੮ˑʇɘͷʇ੮ʩʇ̼੮͐˺੮͸ɘ˦ʁʇ̼੮ɘ੮ɺʮ͐ੴ੮৵ৱ৵ৰ੮ʩʇ̼੮ɘʡɘʮ˦ੴ੮ɘ˦ʁ੮ʩ˺̹ʇ੮͐ʩɘ͐੮ͅʩʇૄͅ੮ʠɘ̼੮ʇ˦˺͙ʡʩ੮ ʠ̼˺˚੮͐ʩʮͅ੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩɘ͐੮̹ɘ̼ɘ˚ʇʁʮɻͅ੮͸ʮˑˑ੮̼͐ɘ˦̹ͅ˺̼͐੮ʩʇ̼੮ʮ˦͐ͅʇɘʁ੮͐˺੮ɘ੮ɻ˺͙˦͐;੮ʠɘɻʮˑʮ͐;੮ ˚˺̼ʇ੮͸ʮˑˑʮ˦ʡ੮͐˺੮ˌʇʇ̹੮ʩʇ̼ੳ੮U͐ૄͅ੮˦˺͐੮ɘ੮ͅɘʠʇ੮ɺʇ͐ੳ੮äʩʇૄͅ੮˺˦੮ɘ੮ʩʇɘͷ;੮ɻ˺ɻˌ͐ɘʮˑ੮˺ʠ੮ͅʇʁɘ͐ʮͷʇͅ੮ ɘ˦ʁ੮˚ʮʡʩ͐੮˦˺͐੮ʇͷʇ˦੮˚ɘˌʇ੮ʮ͐੮˺ʠʠ੮ʩ˺̹ͅʮ͐ɘˑ੮ʡ̼˺͙˦ʁͅੳ੮îʩʇ੮͐ʩʮ̼ʁ੮ʮͅ੮͐˺੮̹ɘͅͅ੮͐ʩʇ੮ʩɘ͐੮ ɘ˚˺˦ʡ੮͐ʩʇ੮͐ʇɘ˚੮˚ʇ˚ɺʇ̼ͅ੮ɘ˦ʁ੮̹ɘ;੮ʠ˺̼੮ɘ੮ʩ˺͐ʇˑ੮̼˺˺˚ੳ੮îʩɘ͐ૄͅ੮͐ʩʇ੮ɻˑ˺ͅʇ͐ͅ੮͐ʩʮ˦ʡ੮͐˺੮ ɘ੮˚ʮ̼ɘɻˑʇ੮͐ʩʇ੮ʁʮͅɻʩɘ̼ʡʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼੮ɘ͐੮ɘ੮͸ʇɘˑ͐ʩ;੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ɻɘ˦੮ʩ˺̹ʇ੮ʠ˺̼ੳ š˦੮ ̼ʮʁʇચɘˑ˺˦ʡͅ੮ ˑʮˌʇ੮ ͐ʩʇͅʇੴ੮ U੮ ͅɘ͸੮ ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮ ̹ɘ̼ɘ˚ʇʁʮɻͅੴ੮ ͅ˺ɻʮɘˑ੮ ͸˺̼ˌʇ̼ͅੴ੮ ɘ˦ʁ੮ ̹˺ˑʮɻʇ੮ ˺ϲϲʮɻʇ̼ͅ੮ ɻ̼ʮͅͅɻ̼˺ͅͅʮ˦ʡ੮ ɻ˺͙˦͐ʮʇͅ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ʠ̼ʇ˦ʇ͐ʮɻ੮ ͙̼ʡʇ˦ɻ;੮ ˺ʠ੮ ɘ੮ ͸ɘ̼੮ Έ˺˦ʇੳ੮ îʇɘ˚੮˚ʇʇ͐ʮ˦ʡͅ੮ʮ˦ͷ˺ˑͷʇʁ੮ɘ੮ʡ̼͙ʇͅ˺˚ʇ੮̼͐ʮɘʡʇੵ੮͸ʩ˺੮͸ɘͅ੮ͅʮɻˌ੮ʇ˦˺͙ʡʩ੮͐˺੮˚ʇ̼ʮ͐੮ɘ˦੮ʇͽ̼͐ɘ੮ ʇʠʠ˺̼͐੮͐˺੮ɻ˺˦ͷʮ˦ɻʇ੮˺͐ʩʇ̼੮̹̼˺ͷʮʁʇ̼ͅ੮͐˺੮ʡʮͷʇ੮͐ʩʇ˚੮ͅɻɘ̼ɻʇ੮ɺʇʁͅ੺੮Ĕʩʇ˦੮͸ʇ੮ʁ̼˺̹̹ʇʁ੮ ʮ˦͐˺੮ͅʩʇˑ͐ʇ̼ͅੴ੮ʁʇ͐˺ͽ੮ɻʇ˦͐ʇ̼ͅੴ੮˺̼੮͙̼ʡʇ˦͐੮ɻɘ̼ʇ੮ɻˑʮ˦ʮɻͅੴ੮͸ʇ੮ˑʇɘ̼˦ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʇ੮ ͸ʇ̼ʇ੮ˑ˺˺ˌʮ˦ʡ੮ʠ˺̼੮ʩɘʁ੮ʁʮͅɘ̹̹ʇɘ̼ʇʁઝ˺̼ੴ੮ͅʩ˺ɻˌʮ˦ʡˑ;੮ʠ̼ʇή͙ʇ˦͐ˑ;ੴ੮ʁʮʇʁੳ੮ēʮɻ͐˺̼;੮͸ɘͅ੮ ʇ̹ʩʇ˚ʇ̼ɘˑੳ੮îʩʇ੮̼͐ʮ͙˚̹ʩͅ੮˺ʠ੮ʡʇ͐͐ʮ˦ʡ੮ɻˑʮʇ˦͐ͅ੮ʮ˦͐˺੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ ˺̼੮ɺɘɻˌ੮ʩ˺˚ʇ੮͐˺੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮͸ʇ̼ʇ੮̼ɘ̹ʮʁˑ;੮ʁɘͅʩʇʁ੮͸ʩʇ˦੮͐ʩʇ;੮̹˺̹̹ʇʁ੮͙̹੮ ɘʡɘʮ˦੮ʮ˦੮ɘ̼̼ʇ͐ͅ੮̼ʇɻ˺̼ʁͅ੮˺̼੮৹ৱৱ੮ɻɘˑˑͅੳ U੮ɘͅˌ੮rʮʇ͙͐ʇ˦ɘ˦͐੮P˺͸ˑɘ˦ʁੴ੮͸ʩ˺੮˺ͷʇ̼ͅʇʇͅ੮͐ʩʇ੮͐ʇɘ˚ੴ੮ʩ˺͸੮ɘ˦੮/Û੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ ɻ˺͙ˑʁ੮̹˺ͅͅʮɺˑ;੮ˑʇ͐੮ͅ˺˚ʇ˺˦ʇ੮ˑʮˌʇ੮͐ʩʮͅ੮;˺͙˦ʡ੮͸˺˚ɘ˦੮͐ͅɘʡʡʇ̼੮˺͙͐੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮/Û੮ ʁ˺˺̼ͅ੮ɘˑ˺˦ʇੳ੮ુäʇͷʇ̼ʇ੮ɺ͙̼˦˺͙͐ੴૂ੮ʩʇ੮͐ʇˑˑͅ੮˚ʇੴ੮ɘʁʁʮ˦ʡੴ੮ુîʩʇ̼ʇૄͅ੮ˈ͙͐ͅ੮ͅ˺੮˚ɘ˦;੮̹ʇ˺̹ˑʇੴ੮˺˦ʇ੮ɘʠ͐ʇ̼੮͐ʩʇ੮˺͐ʩʇ̼ੴ੮ɘ੮͐ʮʁɘˑ੮͸ɘͷʇ੮˺ʠ੮˦ʇʇʁੳ੮U͐ૄͅ੮ˑʮˌʇ੮ɘ੮̼͐ʇ˦ɻʩ੮˚ʇ˦͐ɘˑʮ͐;ੳૂ੮Pʇੴ੮ ˚͙ɻʩ੮ˑʮˌʇ੮ͅɻʩ˺ˑɘ̼ͅ੮U੮ɻʮ͐ʇʁ੮ʮ˦੮͐ʩʇ੮ʮ˦̼͐˺ʁ͙ɻ͐ʮ˺˦ੴ੮ͅʇʇͅ੮˚ʇʁʮɻʮ˦ʇ੮ɘ˦ʁ੮ˑɘ͸੮ɘͅ੮ˑ˺ɻˌʇʁ੮ʮ˦੮ ʮ˦̼͐ɘɻ͐ɘɺˑʇ੮ɻ˺˦ϲˑʮɻ͐ੴ੮͸ʮ͐ʩ੮ˑɘ͸ͅ੮ˑʮˌʇ੮rØä੮ʩɘͷʮ˦ʡ੮̹͙͐੮͐˺˺੮˚͙ɻʩ੮ʇ˚̹ʩɘͅʮͅ੮˺˦੮̼ʮʡʩ͐ͅ੮ ˺ͷʇ̼੮ɻɘ̼ʇੵ੮ુU੮͐ʩʮ˦ˌ੮͐ʩʇ੮̹ʇ˦ʁ͙ˑ͙˚੮ʩɘͅ੮ʡ˺˦ʇ੮͐˺˺੮ʠɘ̼ੳ੮îʩʇ̼ʇૄͅ੮ͅ˺੮˚͙ɻʩ੮̼ʇɘɻ͐ʮ˦ʡ੮͐˺੮͐ʩʇ੮ ͅʮ˦ͅ੮˺ʠ੮͐ʩʇ੮̹ɘ͐ͅ੮͸ʩʇ˦੮̹ʇ˺̹ˑʇ੮͸ʇ̼ʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੮ɘ˦ʁ੮̹͙͐੮ɘ͸ɘ;੮ʮ˦੮ɘ˦੮ʮ˦ͅɘ˦ʇ੮ɘͅ;ˑ͙˚੮ ɘ˦ʁ੮˚ʮ̼͐ͅʇɘ͐ʇʁੳ੮‡˺͸੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ˈ͙͐ͅ੮ɘˑˑ˺͸ʇʁ੮͐˺੮ʁʮʇ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ੳૂ੮rʮˌʇ੮͐ʩʇ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮ʠ̼˺˦͐ˑʮ˦ʇ੮͸˺̼ˌʇ̼ͅ੮U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁੴ੮ʩʇૄʁ੮ˑʮˌʇ੮͐˺੮ͅʇʇ੮rØä੮̼ʇʠ˺̼˚ʇʁ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅઝ͸ʩɘ͐ʇͷʇ̼੮˚ɘˌʇͅ੮͐ʩʇ੮ʁ;ʮ˦ʡ੮͐ͅ˺̹ੳ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ɻ˺ʇ̼ɻʮ˺˦੮ʮͅ੮˺˦੮͐ʩʇ੮˚ɘ̼ɻʩੳ੮U˦੮̼ʇɻʇ˦͐੮;ʇɘ̼ͅੴ੮˚ɘ˦;੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮ ˺̼੮ ̹ɘͅͅʇʁ੮ ˑɘ͸ͅ੮ ͐˺੮ ʇͽ̹ɘ˦ʁ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐ੳৼ੮ Ûɘ͐ʇͅ੮ ˺ʠ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺ˑʁͅ੮ɘ̼ʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮˦ɘ͐ʮ˺˦͸ʮʁʇ੮ફɘ˦ʁ੮ʮ˦͐ʇ̼˦ɘ͐ʮ˺˦ɘˑˑ;બੳ৽੮ä˺˚ʇ੮˺ʠ੮͐ʩʮͅ੮͐ͅʇ˚ͅ੮ʠ̼˺˚੮ ˺̹̹˺̼͙͐˦ʮ͐ͅʮɻ੮ ̹˺ˑʮ͐ʮɻʮɘ˦ͅ੮ ˑ˺˺ˌʮ˦ʡ੮ ͐˺੮ ʁʮ̼͐ͅɘɻ͐੮ ʠ̼˺˚੮ ͐ʩʇʮ̼੮ ʠɘʮˑ͙̼ʇ੮ ͐˺੮ ɘʁʁ̼ʇͅͅ੮ ͐ʩʇ੮

C O N C LU S I O N

275

̼˺˺͐੮ ɻɘ͙ͅʇͅ੮ ˺ʠ੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ˺̼੮ ʡ͙˦੮ ͷʮ˺ˑʇ˦ɻʇੴ੮ ʇͽ̹ˑ˺ʮ͐ʮ˦ʡ੮ ɘ੮ ̹͙ɺˑʮɻ੮ ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ ʠʇɘ̼ʠ͙ˑ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ৾੮ {͙ɻʩ੮ ˚˺̼ʇ੮ ̼ʇͷʇɘˑʮ˦ʡ੮ ɘ̼ʇ੮ ˺͐ʩʇ̼੮ ͅ˺͙̼ɻʇͅ੮ ˺ʠ੮͙̹̹ͅ˺̼͐੮ʠ˺̼੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੵ੮͐ʩʇ੮̹ɘ̼ɘ˚ʇʁʮɻ੮̹ʮɻˌʮ˦ʡ੮͙̹੮͐ʩʇ੮ͅɘ˚ʇ੮ ̹ʇ̼ͅ˺˦੮ɘ͐੮͐ʩʇ੮/Û੮ʇͽʮ͐੮͐ʩʇ੮͐ʩ̼ʇʇચʩ͙˦ʁ̼ʇʁ͐ʩ੮͐ʮ˚ʇ੮͐ʩʮͅ੮;ʇɘ̼੶੮͐ʩʇ੮P˺͙ͅʮ˦ʡ੮Hʮ̼͐ͅ੮ɻɘͅʇ੮ ˚ɘ˦ɘʡʇ̼੮͸ʩ˺ͅʇ੮ɺ͙ʮˑʁʮ˦ʡ੮ʮͅ੮˺ʠ͐ʇ˦੮ɘ੮˺˦ɻʇ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ̼ͅ˺˦ૄͅ੮ˑɘ͐ͅ੮͐ͅ˺̹੮ɺʇʠ˺̼ʇ੮ʁʇɘ͐ʩ੶੮ ͐ʩʇ੮˚˺͐ʩʇ̼੮͸ʩ˺੮ʠ˺͙ʡʩ͐੮͐˺੮ʡʇ͐੮ʩʇ̼੮ɻʩʮˑʁ੮ʮ˦͐˺੮ʇͷʇ̼;੮ͷ˺ˑ͙˦͐ɘ̼;੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮ʇͽʮ͐ͅͅੴ੮ ˺˦ˑ;੮͐˺੮ͅʇʇ੮͐ʩʇ˚੮̼ʇʠ͙ͅʇ੮͐˺੮ʡ˺੶੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮͸ʩ˺੮ͅʇʇͅ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘͅ੮͐ʩʇ੮ ˺˦ˑ;੮͸ɘ;੮͐˺੮ˌʇʇ̹੮ʩʇ̼੮ɻˑʮʇ˦͐ͅ੮˺͙͐੮˺ʠ੮ˈɘʮˑ੶੮͐ʩʇ੮̼ʇɻ˺ͷʇ̼ʮ˦ʡ੮̹ɘ͐ʮʇ˦͐੮͸ʩ˺੮͸ʮͅʩʇͅ੮ʩʇૄʁ੮ ɺʇʇ˦੮˺ɺˑʮʡɘ͐ʇʁ੮͐˺੮͐ɘˌʇ੮˚ʇʁʮɻɘ͐ʮ˺˦੮ͅ˺˺˦ʇ̼ੳ îʩʮͅ੮ ɺ˺˺ˌ੮ ʩɘͅ੮ ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ ͐ʩʇ੮ ̼͙͐͐ʩ੮ ˺ʠ੮ ͐ʩʇͅʇ੮ ʇͽ̹ʇ̼ʮʇ˦ɻʇͅੳ੮ rɘ͸ͅ੮ ˑʮˌʇ੮ rØä੮ ɘ˦ʁ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ˑʮˌʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɘ̼ʇ੮ɺʇʮ˦ʡ੮ʮ˦͐ʇ̼̹̼ʇ͐ʇʁ੮ͅ˺੮̼͐ͅʮɻ͐ˑ;੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ ̼͙͐ˑ;੮ɺʇʮ˦ʡ੮ˑʇʠ͐੮͐˺੮ʁʮʇੳ੮"͙͐੮ʮ͐੮ʩɘͅ੮ɘˑͅ˺੮ɻɘ͐ɘˑ˺ʡ͙ʇʁ੮ɘ˦˺͐ʩʇ̼ੴ੮ʮ˦ɻ˺˦ʡ̼͙ʇ˦͐੮̼ʇɘˑʮ͐;ੳ੮ îʩɘ͐੮ͅɘ˚ʇ੮ˑɘ͸੮ʮͅ੮ʠɘʮˑʮ˦ʡ੮͐˺੮̹̼˺͐ʇɻ͐੮̹ʇ˺̹ˑʇ੮ʠ̼˺˚੮ɘɺ͙ͅʮͷʇ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮ ͙˦ʩʇˑ̹ʠ͙ˑઝɘ˦ʁ੮ ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐ઝ̼͐ʇɘ͐˚ʇ˦͐ੳ੮ Ĕʇ੮ ˑʇɘ̼˦ʇʁ੮ ɘɺ˺͙͐੮ ͐ʩɘ͐੮ ʠ̼˺˚੮͐ʩʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮͸ʮ͐˦ʇͅͅʇͅੴ੮ͅʇ̼ͷʮɻʇ੮͙ͅʇ̼ͅ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮Ĕʇ੮ɘˑͅ˺੮ʩʇɘ̼ʁ੮ʠ̼˺˚੮ doctors who would rather discharge someone than subject them to the trauma ˺ʠ੮ˑʮͷʮ˦ʡ੮ʮ˦੮͐ʩʇʮ̼੮ʩ˺̹ͅʮ͐ɘˑ੮˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͸ʩ˺੮̼͙͐ˑ;੮ɺʇˑʮʇͷʇ੮;˺͙ૄ̼ʇ੮ɺʇ͐͐ʇ̼੮˺ʠʠ੮ ʠ̼ʇʇ੮ʮ˦੮ɘ੮͐ʇ˦͐੮͐ʩɘ˦੮͙͐ͅɻˌ੮ʮ˦੮ɘ˦੮U{)ੳ î˺੮ʇͽ̹ˑɘʮ˦੮ʩ˺͸੮#ɘˑʮʠ˺̼˦ʮɘ੮ɻɘ˦੮ɺ˺͐ʩ੮ʩɘͷʇ੮ɘ˦੮ʇͽɻʇͅͅ੮˺ʠ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮ ɘ੮ʁʇɘ̼͐ʩ੮˺ʠ੮ˑʮʠʇͅɘͷʮ˦ʡ੮ɻ˺ʇ̼ɻʮͷʇ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅੴ੮U੮ʩɘͷʇ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮͐ʩʇ੮ɻ˺˦ɻʇ̹͐੮˺ʠ੮ abdicated authorityੳ੮͐੮ʩʇɘ̼͐ੴ੮ʮ͐੮̼ʇʠʇ̼ͅ੮͐˺੮ʩ˺͸੮ʡ˺ͷʇ̼˦˚ʇ˦͐ͅ੮ʠɘʮˑ੮͐˺੮ɻ˺˺̼ʁʮ˦ɘ͐ʇ੮ɘ˦ʁ੮ ̼ʇʡ͙ˑɘ͐ʇ੮͐ʩʇ੮ʇͽʇ̼ɻʮͅʇ੮˺ʠ੮͐ʩʇʮ̼੮˺͸˦੮̹˺͸ʇ̼ੳ੮U˦੮ͅ˺੮ʁ˺ʮ˦ʡੴ੮͐ʩʇ;੮ɘͷ˺ʮʁ੮͐ʩʇ੮ɻ˺͐ͅͅ੮ɘ˦ʁ੮ ʁʮϲϲʮɻ͙ˑ͐੮ ɻʩ˺ʮɻʇͅ੮ ͐ʩɘ͐੮ ͐ʩʇ੮ ɘɻɻ˺͙˦͐ɘɺˑʇ੮ ʇͽʇ̼ɻʮͅʇ੮ ˺ʠ੮ ͐ʩɘ͐੮ ̹˺͸ʇ̼੮ ʇ˦͐ɘʮˑͅੳ੮ ɺʁʮɻɘ͐ʮ˺˦੮͐ͅɘ̼͐ͅ੮ɘ͐੮͐ʩʇ੮͐˺̹ੴ੮ɘͅ੮ˑʇʡʮͅˑɘ͐˺̼ͅ੮ɘ˦ʁ੮͐ͅɘ͐ʇ੮ɘʡʇ˦ɻʮʇͅ੮ʩɘͷʇ੮ɻ̼ʇɘ͐ʇʁ੮̹ɘ͐ʩ͸ɘ;ͅ੮ʠ˺̼੮ ̼͐ͅʮ̹̹ʮ˦ʡ੮ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮̼ʮʡʩ͐ͅ੮ફʠ̼ʇʇʁ˺˚੮ɘ˦ʁ੮ɺ˺ʁʮˑ;੮ʮ˦͐ʇʡ̼ʮ͐;બ੮ɘ͸ɘ;੮ʠ̼˺˚੮̹ʇ˺̹ˑʇ੮ ʮ˦੮͐ʩʇ੮˦ɘ˚ʇ੮˺ʠ੮ʇͷʇ˦੮˚˺̼ʇ੮ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮ɘʮ˚ͅ੮ફ͙̼ͅͷʮͷɘˑ੮ɘ˦ʁ੮ͅɘʠʇ͐;બ੮ɺ͙͐੮ʁ˺˦ʇ੮ˑʮ͐͐ˑʇ੮ ͐˺੮ʠ͙˦ʁ੮ɘ˦ʁ੮˚˺˦ʮ͐˺̼੮ʩ˺͸੮͐ʩ˺ͅʇ੮̹ɘ͐ʩ͸ɘ;ͅ੮ʡʇ͐੮͙ͅʇʁੳ੮U͐ૄͅ੮ͷʮͅʮɺˑʇ੮ɘ͐੮͐ʩʇ੮ɻ˺͙˦͐;੮ˑʇͷʇˑੴ੮ ɘͅ੮ˑ˺˦ʡચ˦ʇʡˑʇɻ͐ʇʁ੮ɘʡʇ˦ɻʮʇͅ੮ˑʮˌʇ੮͐ʩʇ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ɺɘ͐͐ˑʇ੮͸ʮ͐ʩ੮ɺʇʩɘͷʮ˺̼ɘˑ੮ʩʇɘˑ͐ʩ੮ ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮˺̼੮͐ʩʇ੮ɻ˺͙̼͐ͅ੮˺ͷʇ̼੮˦˺͐੮͐ɘˌʮ˦ʡ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅઝ͙ͅɻʩ੮ ɘͅ੮ɘʡʮ˦ʡੴ੮ʩ˺˚ʇˑʇͅͅ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅઝ͸ʩ˺੮̹̼˺ɺɘɺˑ;੮˦ʇʇʁ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ʠ̼˺˚੮ɘˑˑ੮ ͐ʩ̼ʇʇ੮˺ʠ੮͐ʩʇ˚ੳ ɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮̼ʇɘɻʩʇͅ੮ʡ̼˺͙˦ʁ੮͐ʩ̼˺͙ʡʩ੮ʁʇˑʇʡɘ͐ʮ˺˦੮ɘ˦ʁ੮ʁʮͅɻ̼ʇ͐ʮ˺˦ੳ੮)ʇˑʇʡɘ͐ʮ˺˦੮͸ʮ͐ʩ˺͙͐੮ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;੮ʩɘͅ੮ʡʮͷʇ˦੮˦˺˦̹̼˺ϲʮ͐੮ɻˑʮ˦ʮɻͅ੮ɻɘ̼͐ʇ੮ɺˑɘ˦ɻʩʇ੮͐˺੮̹ʮɻˌ੮ ɘ˦ʁ੮ɻʩ˺˺ͅʇ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅੴ੮ʁʇʠɘ͙ˑ͐ʇʁ੮͐˺੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ʩ˺̹ͅʮ͐ɘˑͅૄ੮˚˺̼ʇ੮ϲʮ˦ɘ˦ɻʮɘˑ੮͐ʩɘ˦੮ ɻˑʮ˦ʮɻɘˑ੮̼ʇɘͅ˺˦ͅ੮ʠ˺̼੮ફ˦˺͐બ੮ɘ̹̹ˑ;ʮ˦ʡ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɘ˦ʁ੮ˑʇʠ͐੮̹̼ʮͷɘ͐ʇ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ ɻɘ̼ʇͅ੮͐˺੮ͅʮˑʇ˦͐ˑ;੮ʁʮͅɘ̹̹ʇɘ̼੮ɘ͐੮ʡ̼ʇɘ͐੮ɻ˺͐ͅ੮͐˺੮͐ʩʇʮ̼੮ʮ˦ͷʮͅʮɺˑʇ੮̼ʇͅʮʁʇ˦͐ͅੳ੮ɺʁʮɻɘ͐ʇʁ੮

276

C O N C LU S I O N

ɘ͙͐ʩ˺̼ʮ͐;੮ʡ̼ɘ˦͐ͅ੮͙˦ɻ˺˺̼ʁʮ˦ɘ͐ʇʁ੮ʁʮͅɻ̼ʇ͐ʮ˺˦ੴ੮ʠ̼ʇʇʮ˦ʡ੮̹˺ˑʮɻʇ੮͐˺੮͙ͅʇ੮৵ৱ৵ৰͅ੮ɘͅ੮ɘ੮͐˺˺ˑ੮ ʠ˺̼੮ʁʮͅ˺̼ʁʇ̼੮˚ɘ˦ɘʡʇ˚ʇ˦͐ੴ੮/Û੮̹ʩ;ͅʮɻʮɘ˦ͅ੮͐˺੮̼ɘ̹ʮʁˑ;੮̹ʇ˺̹ˑʇ੮̹̼˺ɻʇͅͅ੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮ ˦ʇʇʁʇʁ੮ɻɘ̼ʇੴ੮ɘ˦ʁ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮͐˺੮ʁʇϲʮ˦ʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͐˺੮ʇͽɻˑ͙ʁʇ੮ͅ˺˚ʇ˺˦ʇ੮͸ʩ˺੮ ɻɘ˦੮ʇɘ͐੮̼˺ɘʁˌʮˑˑ੮˺̼੮˚ɘˌʇ੮͐ʩʇʮ̼੮͸ɘ;੮͐˺੮ɘ੮ɺ͙ͅ੮͐ͅ˺̹ੳ੮îʩʇ੮ˌʇ;੮̹̼˺ɺˑʇ˚੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ ʮͅ੮˦ʇʮ͐ʩʇ̼੮ɘ੮ˑɘɻˌ੮˺ʠ੮ɻ˺ʇ̼ɻʮ˺˦੮˦˺̼੮ɘ੮ɻ˺˚̹ˑʇ͐ʇ੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ɻɘ̼ʇੳ੮U͐੮ʮͅ੮ ͐ʩʇ੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮˺ͷʇ̼ɘ̼ɻʩʮ˦ʡ੮̼͐ͅɘ͐ʇʡ;੮ɘ˦ʁ੮ˑʇɘʁʇ̼ͅʩʮ̹੮͐˺੮˚ɘˌʇ੮ʇʮ͐ʩʇ̼੮ʩɘͷʇ੮ɘ੮˚ʇɘ˦ʮ˦ʡʠ͙ˑ੮ʮ˚̹ɘɻ͐ੳ U˦੮͐ʩʮͅ੮ɻ˺˦ɻˑ͙ͅʮ˺˦ੴ੮U੮̼ʇͷʮͅʮ͐੮͐ʩʮͅ੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʮ˦੮ˑʮʡʩ͐੮˺ʠ੮͐ʩʇ੮˚˺͐ͅ੮̼ʇɻʇ˦͐੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ʮ˦ʮ͐ʮɘ͐ʮͷʇͅ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ɻ˺˦ͅʮʁʇ̼੮˺͐ʩʇ̼੮ʁ˺˚ɘʮ˦ͅ੮͸ʩʇ̼ʇ੮͐ʩʇ੮ɻ˺˦ɻʇ̹͐੮˺ʠ੮ ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮˚ʮʡʩ͐੮˺ʠʠʇ̼੮ͅ˺˚ʇ੮ɘ˦ɘˑ;͐ʮɻɘˑ੮ʮ˦ͅʮʡʩ͐ͅੴ੮͙ͅʡʡʇ͐ͅ੮ʩ˺͸੮͐˺੮̼ʇ̹ˑɘɻʇ੮ ɘɺʁʮɻɘ͐ʮ˺˦੮͸ʮ͐ʩ੮ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;ੴ੮ɘ˦ʁ੮͐ɘˌʇ੮͙ͅ੮ɺɘɻˌ੮͐˺੮͐ʩʇ੮ɺ͙ͅ੮͐ͅ˺̹੮͸ʩʇ̼ʇ੮͸ʇ੮͐ͅɘ̼͐ʇʁੳ

THE END OF ABDICATION? Ĕʩʮˑʇ੮U੮͸ɘͅ੮͸̼ʮ͐ʮ˦ʡ੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮˚˺˚ʇ˦͐ͅ੮͸ʩʇ̼ʇ੮ʮ͐੮ͅʇʇ˚ʇʁ੮ɘͅ੮͐ʩ˺͙ʡʩ੮ ˑʇʡʮͅˑɘ͐˺̼ͅ੮͸ʇ̼ʇ੮˺˦੮͐ʩʇ੮ͷʇ̼ʡʇ੮˺ʠ੮ʁʮɘʡ˦˺ͅʮ˦ʡ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ˑʮˌʇ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ ɘ˦ʁ੮͐ɘˌʮ˦ʡ੮͐ͅʇ̹ͅ੮͐˺੮̼ʇɻˑɘʮ˚੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐ʮʇͅੳ੮੮)ʇɻʇ˚ɺʇ̼੮ৱ৵ੴ੮৲ৰ৲ৱ੮ʩʇɘ̼ʮ˦ʡ੮ ɺ;੮ ͐ʩʇ੮ ˑʇʡʮͅˑɘ͙̼͐ʇૄͅ੮ ʩʇɘˑ͐ʩ੮ ɘ˦ʁ੮ ˈ͙ʁʮɻʮɘ̼;੮ ɻ˺˚˚ʮ͐͐ʇʇͅ੮ ˺˦੮ ુîʩʇ੮ rɘ˦͐ʇ̼˚ɘ˦ચ Øʇ̼͐ʮͅચäʩ˺̼͐੮ɻ͐ੵ੮P˺͸੮#ɘ˦੮U͐੮"ʇ੮U˚̹̼˺ͷʇʁ੺ૂ੮͸ɘͅ੮˺˦ʇ੮͙ͅɻʩ੮˚˺˚ʇ˦͐ੳ৿ äʮ˦ɻʇ੮ ˚˺͐ͅ੮ ˺ʠ੮ ͐ʩʇ੮ ͙ͅʡʡʇ͐ͅʮ˺˦ͅ੮ ʠ˺̼੮ ુʮ˚̹̼˺ͷʇ˚ʇ˦͐ૂ੮ ʮ˦੮ ͐ʩʇ੮ ̹ɘ͐ͅ੮ ϲʮͷʇ੮ ;ʇɘ̼ͅ੮ ʩɘͷʇ੮ʩʮ˦ʡʇʁ੮˺˦੮̼ʇ͸̼ʮ͐ʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;ੴ੮U੮ʇͽ̹ʇɻ͐ʇʁ੮͐ʩʇ੮ʁ˺Έʇ˦ͅ੮˺ʠ੮̹ͅʇɘˌʇ̼ͅ੮͐˺੮ ̹ͅʇ˦ʁ੮͐ʩʇ੮ʁɘ;੮̼ʇʩɘͅʩʮ˦ʡ੮ɘ̼ʡ͙˚ʇ˦͐ͅ੮ɘɺ˺͙͐੮͐ʩʇ੮̼͐ɘʁʇચ˺ʠʠͅ੮ɺʇ͐͸ʇʇ˦੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮ ɘ˦ʁ੮ ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ ɻɘ̼ʇੳ੮ U˦ʁʇʇʁੴ੮ ͅ˺˚ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ɘ̼ʡ͙˚ʇ˦͐ͅ੮ ʠʇˑ͐੮ ʠɘ˚ʮˑʮɘ̼ઝʮʠ੮ ˦˺੮ ˑʇͅͅ੮ ʩʇɘ̼͐ચ͸̼ʇ˦ɻʩʮ˦ʡੳ੮ îʇ̼ʇͅɘ੮ Øɘͅή͙ʮ˦ʮੴ੮ ɘ੮ ˚˺͐ʩʇ̼੮ ͸ʩ˺ͅʇ੮ ͅ˺˦੮ ͸˺͙˦ʁ੮ ͙̹੮ ʮ˦੮ ͅ˺ˑʮ͐ɘ̼;੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐੮ɘʠ͐ʇ̼੮˚ɘ˦;੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮̼ʇʠ͙ͅʇʁ੮͐˺੮ɻɘ̼ʇ੮ʠ˺̼੮ʩʮ˚ੴ੮ ˑɘ˚ʇ˦͐ʇʁ੮ʩ˺͸੮˺ͷʇ̼ˑ;੮̼͐ͅʮɻ͐੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮͐ͅɘ˦ʁɘ̼ʁͅ੮ʮ˦͐ʇ˦ʁʇʁ੮͐˺੮ુ̹̼˺͐ʇɻ͐੮યʩʇ̼੮ ͅ˺˦ર੯ ੳ੯ ੳ੯ ੳ੮ ˚ɘʁʇ੮ ʩʮ˚੮ ʠɘʮˑ੮ ˺ͷʇ̼੮ ɘ˦ʁ੮ ˺ͷʇ̼੮ ɘʡɘʮ˦੮ યɺʇʠ˺̼ʇ੮ ʡʇ͐͐ʮ˦ʡ੮ ʩʇˑ̹રੳ੮ ˦ʁ੮ ͐ʩʇ̼ʇ੮ ʮͅ੮ ˦˺੮ ʁʮʡ˦ʮ͐;੮ ʮ˦੮ ɻ˺˦͐ʮ˦͙˺͙ͅ੮ ʠɘʮˑ͙̼ʇੳૂ੮ ͅͅʇ˚ɺˑ;˚ʇ˚ɺʇ̼੮ {ʮʡ͙ʇˑ੮ äɘ˦͐ʮɘʡ˺ੴ੮ ͸ʩ˺੮ ̹ͅ˺˦ͅ˺̼ʇʁ੮ ˦͙˚ʇ̼˺͙ͅ੮ ̼ʇʠ˺̼˚ͅ੮ ͐˺੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;ੴ੮ ɻʩɘˑˑʇ˦ʡʇʁ੮ ˑʮ͐ͅʇ˦ʇ̼ͅ੮ ͐˺੮ ͸ɘˑˌ੮ äˌʮʁ੮Û˺͸੮ɘ˦ʁ੮ુɘ̼ʡ͙ʇ੮͐ʩɘ͐੮ʮ͐੮ʮͅ੮˚˺̼ʇ੮ʩ͙˚ɘ˦ʇ੮͐˺੮ˑʇɘͷʇ੮ͅ˺˚ʇɺ˺ʁ;੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐੮ ͐ʩɘ˦੯ ੳ੯ ੳ੯ ੳ੮ ɺ̼ʮ˦ʡ੮ ͐ʩʇ˚੮ ʮ˦੮ ͐˺੮ ʡʮͷʇ੮ ͐ʩʇ˚੮ ͐ʩʇ੮ ʩʇˑ̹੮ ͐ʩɘ͐੮ ͐ʩʇ;੮ ˦ʇʇʁ੮ ɘ˦ʁ੮ ʁʇͅʇ̼ͷʇ੮ ɘͅ੮ ʩ͙˚ɘ˦੮ɺʇʮ˦ʡͅੳૂ੮nʇ̼ʮͅ੮{;̼ʮɻˌੴ੮ɘ੮͙̼ͅͷʮͷ˺̼੮˺ʠ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʁʇɻ̼ʮʇʁ੮ʩ˺͸੮#ɘˑʮʠ˺̼˦ʮɘ੮͸ɘͅ੮ુɻ˺˚̹ʇˑયʮ˦ʡર੮̹ʇ˺̹ˑʇ੮͐˺੮ɺ̼˺ˌʇ˦੮ͅ;͐ͅʇ˚ͅੴૂ੮ɻ˺͙˦͐ʇ̼ʮ˦ʡ੮͐ʩɘ͐੮͐ʩʇ੮ͅ˺ˑ͙͐ʮ˺˦੮͸ɘͅ੮ુ͐˺੮ɻ˺˚̹ʇˑ੮ͅ;͐ͅʇ˚ͅ੮͐˺੮˚ʇʇ͐੮͐ʩʇ੮˦ʇʇʁͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʮ˦੮͐ʩʇ੮ˑʇɘ͐ͅ੮̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ way possible.”

C O N C LU S I O N

277

îʩʇ੮ʩʇɘ̼ʮ˦ʡ੮͐˺˺ˌ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮͙̼͐˦ੴ੮͐ʩ˺͙ʡʩੴ੮͸ʩʇ˦੮ɘ˦੮˺ϲϲʮɻʮɘˑ੮ʠ̼˺˚੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ʠ੮ Pʇɘˑ͐ʩ੮ #ɘ̼ʇ੮ äʇ̼ͷʮɻʇͅ੮ ફ)P#äબ੮ ʁʮͅɻ͙ͅͅʇʁ੮ ʩʇ̼੮ ɘʡʇ˦ɻ;ૄͅ੮ ̼˺ˑʇ੮ ʮ˦੮ ͐ʩʇ੮ rØä੮ ͅ;͐ͅʇ˚ੴ੮͸ʩʮɻʩ੮ʮ˦ɻˑ͙ʁʇʁ੮ુɻ˺ˑˑʇɻ͐ʮ˦ʡ੮͐ͅɘ͐ʮ͐ͅʮɻɘˑ੮ʁɘ͐ɘ੮ɘ˦ʁ੮˚ɘˌʮ˦ʡ੮͐ʩʇ੮ʁɘ͐ɘ੮̹͙ɺˑʮɻˑ;੮ available.” ͅͅʇ˚ɺˑ;˚ʇ˚ɺʇ̼੮/ˑ˺ʮͅʇ੮Ûʇ;ʇͅ੮˺ɺͅʇ̼ͷʇʁੴ੮ુ˚˺̼ʇ੮͐ʩɘ˦੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮ɻ˺͙˦͐ʮʇͅ੮ʁ˺੮˦˺͐੮̹̼˺ͷʮʁʇ੮ɘɻɻ͙̼ɘ͐ʇ੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ɘɺ˺͙͐੮͐ʩʇʮ̼੮rØä੮ʁʇ͐ʇ˦͐ʮ˺˦ͅੳ੯ੳ੯ੳ੯ੳ੮U੮ɘ˚੮ ͙̼ͅʇ੮ ͐ʩɘ͐੮ ;˺͙੮ ͙˦ʁʇ̼͐ͅɘ˦ʁ੮ ͐ʩɘ͐੮ ʮ͐੮ ͸˺͙ˑʁ੮ ɺʇ੮ ͷʇ̼;੮ ʁʮϲϲʮɻ͙ˑ͐੮ ʠ˺̼੮ ̹˺ˑʮɻ;˚ɘˌʇ̼ͅ੮ ͐˺੮ ʁʇ͐ʇ̼˚ʮ˦ʇ੮͸ʩɘ͐੮˺͙̼੮ɻ˺˚˚͙˦ʮ͐ʮʇͅ੮˦ʇʇʁੴ੮ɘ˦ʁ੮͸ʩʇ͐ʩʇ̼੮˺͙̼੮ʇʠʠ˺̼͐ͅ੮͐˺੮ɘʁʁ̼ʇͅͅ੮͐ʩʇͅʇ੮ ˦ʇʇʁͅ੮ɘ̼ʇ੮ɘɻ͙͐ɘˑˑ;੮͸˺̼ˌʮ˦ʡ੮ય͸ʮ͐ʩ˺͙͐੮ʁɘ͐ɘરੳૂ îʩʇ੮ )P#ä੮ ̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮ ʁʇʠʇ˦ʁʇʁੴ੮ ુĔʇ੮ ʁ˺˦ૄ͐੮ ʩɘͷʇ੮ ɘ˦;੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ʠ˺̼੮ ɘ˦;੮ ɻ˺˦ͅʇή͙ʇ˦ɻʇͅੳૂ੮îʩɘ͐੮ʮͅੴ੮ͅʩʇ੮ɻˑɘʮ˚ʇʁ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʩɘʁ੮˦˺੮ɻɘ̹ɘɻʮ͐;੮͐˺੮˚ɘˌʇ੮ɻ˺͙˦͐ʮʇͅ੮ ̹̼˺ͷʮʁʇ੮͐ʩɘ͐੮˚˺͐ͅ੮ɺɘͅʮɻ੮ʇˑʇ˚ʇ˦͐੮˺ʠ੮ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;੮ʠ˺̼੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ɘ੮ count੮˺ʠ੮ʩ˺͸੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮̼ʇɻʇʮͷʮ˦ʡ੮ʮ͐ੳ ͅͅʇ˚ɺˑ;˚ʇ˚ɺʇ̼੮ kʮ˚੮ Ĕ˺˺ʁ੮ ͅʇʇ˚ʇʁ੮ ʇͷʇ˦੮ ˚˺̼ʇ੮ ʮ̼̼ʮ͐ɘ͐ʇʁੳ੮ šɺͅʇ̼ͷʮ˦ʡ੮ ͐ʩʇ੮ ˚˺˦ʇ;੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸ɘͅ੮ʠ͙˦˦ʇˑʮ˦ʡ੮ʮ˦͐˺੮ˑ˺ɻˌʇʁ੮ɺʇʁͅੴ੮ʩʇ੮˺̹ʮ˦ʇʁੵ੮ુ‡˺ɺ˺ʁ;੮ˌ˦˺͸ͅ੮͸ʩɘ͐੮ ͐ʩʇ੮ʩʇˑˑ੮ʮͅ੮ʡ˺ʮ˦ʡ੮˺˦ੳ੮Uͅ੮͐ʩɘ͐੮ɘ੮ʠɘʮ̼੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈɘ͐ʮ˺˦ੴ੮˺̼੮ʁʮʁ੮U੮˦˺͐੮ʩɘͷʇ੮ʇ˦˺͙ʡʩ੮ɻ˺ʠʠʇʇ੮ this morning?” Pʇ੮͙̼͐˦ʇʁ੮͐˺੮͐ʩʇ੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮˺ʠ੮)P#äੴ੮ɘ˦ʁ੮ɘͅˌʇʁ੮ʁʮ̼ʇɻ͐ˑ;ੴ੮ુĔʩ˺੮ʮͅ੮̼͐ͅɘ͐ʇʡʮΈʮ˦ʡ੮ɘ˦ʁ੮̹ˑɘ˦˦ʮ˦ʡ੮ɘ˦ʁ੮ɻ˺˺̼ʁʮ˦ɘ͐ʮ˦ʡ੮͐ʩʇͅʇ੮͐ʩʮ˦ʡͅ੺੯ੳ੯ੳ੯ੳ੮P˺͸੮ʁ˺੮͸ʇ੮ˌ˦˺͸੮͐ʩɘ͐੮ ͐ʩʮͅ੮ͅʩʮ̹੮યrØäર੮ʮͅ੮ʡ˺ʮ˦ʡ੮ɘ˦;͸ʩʇ̼ʇ੮ɺ͙͐੮ʮ˦੮ɘ੮ɻʮ̼ɻˑʇ੺ૂ੮U੮ʁ˺˦ૄ͐੮͐ʩʮ˦ˌ੮ʩʮͅ੮ɘ˦˦˺;ɘ˦ɻʇ੮͸ɘͅ੮ ˈ͙͐ͅ੮ɘɺ˺͙͐੮ɘ੮ˑɘɻˌ੮˺ʠ੮ɻɘʠʠʇʮ˦ʇੳ îʩʇ੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮͷʇ੮͐˺˺ˌ੮ɘ੮ˑ˺˦ʡ੮̹ɘ͙ͅʇੵ੮ુÛʮʡʩ͐ੴ੮U੮˚ʇɘ˦ੴ੮U੮͐ʩʮ˦ˌ੮U੮ɘʡ̼ʇʇ੮͐ʩɘ͐੮̹ɘ̼͐੮ ˺ʠ੮͸ʩɘ͐੮͸ʇ੮˦ʇʇʁ੮͐˺੮ʁ˺੮ʮͅ੮̼ʇɘˑˑ;੮ʮ˦ɻ̼ʇɘͅʇ੮˺͙̼੮ʁɘ͐ɘੳૂ Ĕ˺˺ʁ੮͸ɘͅ੮͙˦ͅɘ͐ʮͅϲʮʇʁੵ੮ુĔʩ˺੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮͙ͅʇ੮͐ʩɘ͐੮ʁɘ͐ɘ੺੯ੳ੯ੳ੯ੳ੮Ĕʩ˺ૄͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ɺʇ੮ʮ˦੮ ɻʩɘ̼ʡʇ੮˺ʠ੮˚ɘˌʮ˦ʡ੮ɻʩɘ˦ʡʇͅ੺੯ੳ੯ੳ੯ੳ੮#˺͙ˑʁ੮͐ʩʇ̼ʇ੮ɺʇ੮ͅ˺˚ʇɺ˺ʁ;੮ʮ˦੮ɻʩɘ̼ʡʇ੺ૂ੮Pʇ੮̹ɘ͙ͅʇʁੳ੮ ુä˺˚ʇɺ˺ʁ;੺ૂ îʩʇ੮)P#ä੮ʁʮͷʮͅʮ˺˦੮ɻʩʮʇʠ੮˺ʠʠʇ̼ʇʁ੮ɘ੮ˑɘ͐ͅ੮ʁʇʠʇ˦ͅʇੵ੮ુ)P#ä੮ʮͅ੮ɻ˺˚˚ʮ͐͐ʇʁ੮͐˺੮˚ɘˌʮ˦ʡ੮ɻʩɘ˦ʡʇͅ੮ʮ˦੮͐ʩʇ੮ɘ̼ʇɘͅ੮͐ʩɘ͐੮͸ʇ੮ʩɘͷʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼ੴૂ੮ɺ͙͐੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ુʡɘ̹ͅૂ੮͸ʩʇ̼ʇ੮ ુ)P#ä੮ʁ˺ʇͅ੮˦˺͐੮ʩɘͷʇ੮͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮˺ͷʇ̼ͅʇʇੴૂ੮ˑʮˌʇ੮ɻ˺͙̼͐ͅ੮˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੳ Ĕ˺˺ʁ੮ɻˑ˺ͅʇʁੴ੮ુUૄ˚੮ɺʇʡʡʮ˦ʡ੮ʠ˺̼ੴ੮ͅ˺˚ʇ੮̹ʇ̼ͅ˺˦੮˺̼੮ʇ˦͐ʮ͐;੯ੳ੯ੳ੯ੳ੮͐˺੮ɘͅͅʇͅͅ੮͸ʩʇ̼ʇ੮͐ʩʇ੮ ʩʇɻˌ੮͸ʇ੮ɘ̼ʇ੮ʡ˺ʮ˦ʡੳૂ îʩʇ੮ʩʇɘ̼ʮ˦ʡ੮ˑʇʠ͐੮˚ʇ੮ʩ˺̹ʇʠ͙ˑ੮ʠ˺̼੮̼ʇʠ˺̼˚ͅ੮͐ʩɘ͐੮͸˺͙ˑʁ੮ɘʁʁ̼ʇͅͅ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;ੳ੮ U˦੮ ͐ʩʇ੮ ʇ˦ʁੴ੮ ͐ʩ˺͙ʡʩੴ੮ ৲ৰ৲৲੮ ͸ɘͅ੮ ɘ੮ ̹̼ʇ͐͐;੮ ˚ʮͽʇʁ੮ ɺɘʡੳ੮ ä͙ͅɘ˦੮ /ʡʡ˚ɘ˦ੴ੮ ɘ੮ )ʇ˚˺ɻ̼ɘ͐੮ ʠ̼˺˚੮ ä͐˺ɻˌ͐˺˦੮ ફ͸ʩ˺ੴ੮ ˦˺͐ɘɺˑ;ੴ੮ ͸ɘͅ੮ ʮ˦̼͐˺ʁ͙ɻʇʁ੮ ͐˺੮ ͐ʩʇ੮ ʮ͙ͅͅʇ੮ ͸˺̼ˌʮ˦ʡ੮ ɘ͐੮ ɘ੮ #̼ʇ͐ͅ͸˺˺ʁ੮ U{)੮ ʁʮ̼͐ͅʮɺ͙͐ʮ˦ʡ੮ ˚ʇʁͅ੮ ɘ˦ʁ੮ ˑʮʡʩ͐ʮ˦ʡ੮ ɻʮʡɘ̼ʇ͐͐ʇͅ੮ ͸ʩʮˑʇ੮ ͐ͅʮˑˑ੮ ɘ੮ ʩʮʡʩ੮ ͅɻʩ˺˺ˑʇ̼બ੮ʮ˦̼͐˺ʁ͙ɻʇʁ੮ɘ੮̹ɘɻˌɘʡʇ੮˺ʠ੮ʇʮʡʩ͐੮ɺʮˑˑͅ੮͐˺੮ɺ˺͐ʩ੮ʇͽ̹ɘ˦ʁ੮ɘ˦ʁ੮ɺʇ͐͐ʇ̼੮̼ʇʡ͙ˑɘ͐ʇ੮

278

C O N C LU S I O N

conservatorships.਀੮îʩʇ੮ʡ˺ͷʇ̼˦˺̼੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ͅʮʡ˦ʇʁ੮͐͸˺੮ɺʮˑˑͅ੮ʮ˦੮৲ৰ৲৲੮͐ʩɘ͐੮ɘʁʁ̼ʇͅͅʇʁ੮ ͐ʩʇ੮ʇͽʇɻ̼ɘɺˑʇ੮͐ͅɘ͐ʇ੮˺ʠ੮ʁɘ͐ɘ੮ɘ˦ʁ੮ɻˑɘ̼ʮʠ;ʮ˦ʡ੮rØä੮ˑɘ͸੮͐˺੮ɺɘ˦੮ͅ˺˚ʇ੮ɻ˺͙˦͐ʮʇͅૄ੮ɺˑɘ͐ɘ˦͐ˑ;੮ ʮˑˑʇʡɘˑ੮̹̼ɘɻ͐ʮɻʇ੮˺ʠ੮̹ˑɘɻʮ˦ʡ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˺˦੮ɺɘɻˌચ͐˺ચɺɘɻˌ੮৵ৱ৵ৰͅ੮͐˺੮ʩ˺ˑʁ੮͐ʩʇ˚੮͸ʮ͐ʩout going to a hearing.ਁ੮š͐ʩʇ̼੮̹̼˺̹˺ͅɘˑͅ੮͐˺੮ɺʇʇʠ੮͙̹੮˺ͷʇ̼ͅʮʡʩ͐੮ɘ˦ʁ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮ɘ˦ʁ੮ ͐˺੮ɻ̼ʇɘ͐ʇ੮ɘ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ʁɘ͐ɘɺɘͅʇ੮˺ʠ੮ɺʇʁ੮ɘͷɘʮˑɘɺʮˑʮ͐;੮͸ʇ˦͐੮˦˺͸ʩʇ̼ʇੳਂ੮î͸˺੮̼ʇʠ˺̼˚ͅ੮͐˺੮ ɘˑˑ˺͸੮˚˺̼ʇ੮͐ʇ͐ͅʮ˚˺˦;੮ʮ˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩʇɘ̼ʮ˦ʡͅ੮ɘ˦ʁ੮ʇͽ̹ɘ˦ʁ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ ͐˺੮ʮ˦ɻˑ͙ʁʇ੮ુ̹ʇ̼ͅ˺˦ɘˑ੮˺̼੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇ੮˺̼੮ͅʇˑʠચ̹̼˺͐ʇɻ͐ʮ˺˦੮ɘ˦ʁ੮ͅɘʠʇ͐;ૂ੮͸ʇ̼ʇ੮͐ͅ˺̹̹ʇʁ੮ ʮ˦੮͐ʩʇʮ̼੮̼͐ɘɻˌͅ੮ɺ;੮͐ʩʇ੮ʩʇɘʁ੮˺ʠ੮͐ʩʇ੮ͅͅʇ˚ɺˑ;੮k͙ʁʮɻʮɘ̼;੮#˺˚˚ʮ͐͐ʇʇੳਃ੮ʁͷ˺ɻɘ͐ʇͅ੮ʠ˺̼੮ ˚˺̼ʇ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ˑɘ̼ʡʇˑ;੮ʁʮʁ੮˦˺͐੮ʡʇ͐੮͐ʩʇ੮ʁʇʇ̹੮ɻʩɘ˦ʡʇͅ੮͐˺੮rØä੮͐ʩʇ;੮͸ɘ˦͐ʇʁੳ਄ U˦͐ͅʇɘʁੴ੮ ͐ʩʇ;੮ ʡ˺͐੮ #Û/੮ ɻ˺͙̼͐ͅੳ੮ Ûʇɻɘˑˑ੮ ͐ʩɘ͐੮ ʮ˦੮ ʇɘ̼ˑ;੮ ৲ৰ৲৲੮ ͐ʩʇ੮ ʡ˺ͷʇ̼˦˺̼੮ ʩɘʁ੮ ͅɘʮʁ੮ʩʇ੮͸˺͙ˑʁ੮ɺʇ੮ુˑʇɘ˦ʮ˦ʡ੮ʮ˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅૂ੶੮˺˦੮{ɘ̼ɻʩ੮৳̼ʁ੮ʩʇ੮ɘ˦˦˺͙˦ɻʇʁ੮ ͐ʩɘ͐ੴ੮ ʮ˦͐ͅʇɘʁੴ੮ ʩʇૄʁ੮ ɺʇ੮ ͸˺̼ˌʮ˦ʡ੮ ɘ̼˺͙˦ʁ੮ ͐ʩʇ˚ੳৼ৻੮ #Û/੮ ફ#˺˚˚͙˦ʮ͐;੮ ͅͅʮ͐ͅɘ˦ɻʇੴ੮ Ûʇɻ˺ͷʇ̼;ੴ੮ɘ˦ʁ੮/˚̹˺͸ʇ̼˚ʇ˦͐બ੮ɻ˺͙̼͐ͅ੮͸˺͙ˑʁ੮ͅʇ̼ͷʇ੮ɘ˦੮ʇ͐ͅʮ˚ɘ͐ʇʁ੮ͅʇͷʇ˦੮͐˺੮͐͸ʇˑͷʇ੮ ͐ʩ˺͙ͅɘ˦ʁ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮̹ͅ;ɻʩ˺͐ʮɻ੮ʁʮͅ˺̼ʁʇ̼ͅ੮͸ʩ˺੮͸ʇ̼ʇ੮˦˺͐੮͐ͅɘɺʮˑʮΈʇʁ੮ʮ˦੮ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ɘ˦ʁ੮͸ʇ̼ʇ੮ુ͙˦ˑʮˌʇˑ;੮͐˺੮͙̼ͅͷʮͷʇ੮ͅɘʠʇˑ;੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳૂ੮Hɘ˚ʮˑʮʇͅੴ੮ϲʮ̼͐ͅ੮ ̼ʇ̹ͅ˺˦ʁʇ̼ͅੴ੮̼˺˺˚˚ɘ͐ʇͅੴ੮˺̼੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺͙ˑʁ੮̼ʇʠʇ̼੮̹ʇ˺̹ˑʇ੮ʠ˺̼੮ɘ˦੮ʇͷɘˑ͙ɘ͐ʮ˺˦੶੮ʮʠ੮ʠ˺͙˦ʁ੮ʇˑʮʡʮɺˑʇੴ੮ɘ੮̹ʇ̼ͅ˺˦੮͸˺͙ˑʁ੮ɺʇ੮˺̼ʁʇ̼ʇʁ੮˺˦͐˺੮ɘ੮͐͸ʇˑͷʇચ˚˺˦͐ʩ੮ુɻɘ̼ʇ੮ ̹ˑɘ˦ૂ੮ɘ˦ʁ੮ુʩ˺͙ͅʮ˦ʡ੮̹ˑɘ˦ૂ੮ફɘˑ͐ʩ˺͙ʡʩ੮#Û/੮ɻ˺͙̼͐੮ુ̹ɘ̼͐ʮɻʮ̹ɘ˦͐ͅૂ੮ʁʮʁ੮˦˺͐੮ʩɘͷʇ੮͐˺੮ ɺʇ੮ʩ˺˚ʇˑʇͅͅੴ੮ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮͸ʇ̼ʇ੮͐ʩʇ੮˺ɺͷʮ˺͙ͅ੮͐ɘ̼ʡʇ͐ͅ੮˺ʠ੮͐ʩʇ੮ɺʮˑˑબੳ੮îʩʇ੮ɺʮˑˑ੮̹ɘͅͅʇʁ੮ with only two votes in opposition.ৼৼ੮ ɻɻ˺̼ʁʮ˦ʡ੮ ͐˺੮ I˺ͷʇ̼˦˺̼੮ ‡ʇ͸ͅ˺˚ੴ੮ #Û/੮ ɻ˺͙̼͐ͅ੮ͅʩ˺͸ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸ɘͅ੮ϲʮ˦ɘˑˑ;੮ુ͐ɘˌયʮ˦ʡર੮ͅ˺˚ʇ੮ʁɘ˚˦੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ implementing our ideals.”ৼ৽ îʩʇ੮ ̹̼˺̹˺ͅɘˑ੮ ʮͅ੮ ʁʮϲϲʮɻ͙ˑ͐੮ ͐˺੮ ɻʩɘ̼ɘɻ͐ʇ̼ʮΈʇੳ੮ îʩʇ੮ ʡ˺ͷʇ̼˦˺̼੮ ̼͐ʮʇʁ੮ ͐˺੮ ͐ʩ̼ʇɘʁ੮ ͐ʩʇ੮ ̹̼˺ͷʇ̼ɺʮɘˑ੮˦ʇʇʁˑʇ੮ɺ;੮ɻˑɘʮ˚ʮ˦ʡ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚ੴ੮ʁʇ̹ͅʮ͐ʇ੮͐ʩʇ੮ɘ̹̹ɘ̼ʇ˦͐੮ɻ˺ʇ̼ɻʮ˺˦੮˺ʠ੮ ɻ˺˚̹ʇˑˑʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͐˺੮ɘ̹̹ʇɘ̼੮ɺʇʠ˺̼ʇ੮ɘ੮ɻ˺͙̼͐ੴ੮ʇ˚ɺ̼ɘɻʇʁ੮̹̼ʮ˦ɻʮ̹ˑʇͅ੮˺ʠ੮ુ͙̹̹ͅ˺̼͐ʇʁ੮ ʁʇɻʮͅʮ˺˦ચ˚ɘˌʮ˦ʡੳૂৼ৾੮ Øɘ̼͐ʮɻʮ̹ɘ˦͐ͅ੮ ͸˺͙ˑʁ੮ ɺʇ੮ ˺ʠʠʇ̼ʇʁ੮ ɘ੮ ુ͙̹̹ͅ˺̼͐ʇ̼ૂ੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺͙̼͐੮ ̹̼˺ɻʇͅͅ੮ɘ˦ʁ੮ɺʇ੮ɘͅˌʇʁ੮͐˺੮ϲʮˑˑ੮ʮ˦੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɘʁͷɘ˦ɻʇ੮ʁʮ̼ʇɻ͐ʮͷʇੳ੮U͐੮͸˺͙ˑʁ੮ʇ˦͙̼ͅʇ੮ ̼ʇˑʇ˦͐ˑʇͅͅ੮ɘ˦ʁ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ʇ˦ʡɘʡʇ੮ɘ੮̼ʇͅʮ͐ͅɘ˦͐੮̹ʇ̼ͅ˺˦੮ʠ˺̼੮ɘ੮;ʇɘ̼੮ફ͸ʮ͐ʩ੮ɘ੮ ̹˺ͅͅʮɺˑʇ੮˺˦ʇચ;ʇɘ̼੮̼ʇ˦ʇ͸ɘˑબੳ੮îʩʇ੮ʡ˺ͷʇ̼˦˺̼੮ʩ;̹ʇʁ੮͐ʩʇ੮ુ̼ʇɘˑ੮ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;ૂ੮ɻ̼ʇɘ͐ʇʁ੮ ɺ;੮͐ʩʇ੮̹̼˺̹˺ͅɘˑੴ੮ͅʮ˦ɻʇ੮ɘ੮ˈ͙ʁʡʇ੮ɻ˺͙ˑʁ੮ϲʮ˦ʇ੮ɘ੮ɻ˺͙˦͐;੮͙̹੮͐˺੮ɘ੮͐ʩ˺͙ͅɘ˦ʁ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮ʁɘ;੮ ʠ˺̼੮ʠɘʮˑʮ˦ʡ੮͐˺੮ʁʇˑʮͷʇ̼੮͐ʩʇ੮ͅʇ̼ͷʮɻʇͅ੮ʮ˦੮͐ʩʇ੮ɻɘ̼ʇ੮̹ˑɘ˦ੳ੮#Û/੮ɻ˺͙̼͐ͅੴ੮ʮ͐੮ͅʇʇ˚ʇʁੴ੮͸˺͙ˑʁ੮ ̼ʇɻˑɘʮ˚੮ͅ˺˚ʇ੮˺ʠ੮͐ʩʇ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʠ˺̼੮˺̼ʡɘ˦ʮΈʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮͐ʩɘ͐੮˺͐ʩʇ̼͸ʮͅʇ੮ʩɘʁ੮ɺʇʇ˦੮ ʁʇˑʇʡɘ͐ʇʁ੮ͅ˺੮˚͙ɻʩ੮͐ʩɘ͐੮ɘ͙͐ʩ˺̼ʮ͐;੮ͅʇʇ˚ʇʁ੮͐˺੮ʁʮͅɘ̹̹ʇɘ̼੮ɘˑ͐˺ʡʇ͐ʩʇ̼ੳ੮ͅ੮äɘɻ̼ɘ˚ʇ˦͐˺੮ ˚ɘ;˺̼੮)ɘ̼̼ʇˑˑ੮ä͐ʇʮ˦ɺʇ̼ʡ੮ɻʇˑʇɺ̼ɘ͐ʇʁੴ੮ુîʩʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮ɻ˺˚̹ʇˑˑʇʁ੮ɘɻ͐ʮ˺˦੮ʮ˦੮ #Û/੮#˺͙̼͐੮ʮͅ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ૄͅ੮˺ɺˑʮʡɘ͐ʮ˺˦੮͐˺੮̹̼˺ͷʮʁʇ੮͐ʩʇ੮ɻɘ̼ʇੴ੮˦˺͐੮͐ʩʇ੮ʮ˦ʁʮͷʮʁual’s obligation to accept it.”ৼ৿

C O N C LU S I O N

279

îʩʇ̼ʇ੮͸ʇ̼ʇ੮ɘˑͅ˺੮͸ɘ̼˦ʮ˦ʡ੮ͅʮʡ˦ͅ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺̹˺ͅɘˑ੮͸˺͙ˑʁ੮ʠɘˑˑ੮ʮ˦͐˺੮ͅ˺˚ʇ੮͸ʇˑˑચ ͸˺̼˦੮̼͙͐ͅੳ੮)ʮ̼ʇɻ͐੮ʠ͙˦ʁʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮ɻ˺͙̼͐ͅ੮͸ɘͅ੮ˑʮ˚ʮ͐ʇʁੳৼ਀੮Ĕʩʮˑʇ੮#Û/੮ɻ˺͙̼͐੮̹ɘ̼͐ʮɻʮ̹ɘ˦͐ͅ੮͸˺͙ˑʁ੮ˈ͙˚̹੮͐˺੮͐ʩʇ੮ʠ̼˺˦͐੮˺ʠ੮͐ʩʇ੮ˑʮ˦ʇ੮ʠ˺̼੮ʩ˺͙ͅʮ˦ʡ੮ɻ̼ʇɘ͐ʇʁ੮ɺ;੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼ૄͅ੮ ଏৱ৵੮ɺʮˑˑʮ˺˦੮ʮ˦ͷʇ͐ͅ˚ʇ˦͐੮ʮ˦੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੴ੮͐ʩʇ̼ʇ੮͸ɘͅ੮͐ͅʮˑˑ੮˦˺੮ʡ͙ɘ̼ɘ˦͐ʇʇ੮͐ʩɘ͐੮͐ʩʇ੮ͅʇ̼ͷʮɻʇͅ੮ʇ˦ͷʮͅʮ˺˦ʇʁ੮ʮ˦੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɻɘ̼ʇ੮̹ˑɘ˦੮͸˺͙ˑʁ੮ɻ˺ˑˑʇɻ͐ʮͷʇˑ;੮ʇͽʮ͐ͅੳ੮{˺̼ʇ˺ͷʇ̼ੴ੮ ɘˑ͐ʩ˺͙ʡʩ੮͐ʩʇ੮̹̼ʇ͙̼ͅͅʇ੮͐˺੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ʮ˦੮#Û/੮ɻ˺͙̼͐ͅ੮ɻɘ˚ʇ੮ʠ̼˺˚੮͐ʩʇ੮͐ʩ̼ʇɘ͐੮˺ʠ੮ɘ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʠ˺̼੮˦˺͐੮̹ɘ̼͐ʮɻʮ̹ɘ͐ʮ˦ʡੴ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼੮̹͙̼ͅ˦ʇʁ੮ɘ੮̼ʇή͙ʇ͐ͅ੮ɺ;੮ɻ˺͙˦͐;੮ ̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮ʠ˺̼੮͐ͅɘ͐ʇ੮ʠ͙˦ʁʮ˦ʡੳ੮îʩʇ̼ʇ੮ʮͅ੮˦˺੮˚ʇɻʩɘ˦ʮͅ˚੮͐˺੮ʠ˺̼ɻʇ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ ɻ˺˦ͅʇ̼ͷʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ુʠɘʮˑʮ˦ʡૂ੮#Û/੮ɻ˺͙̼͐ͅੴ੮ɘ˦ʁ੮˚;੮ʡ͙ʇͅͅ੮ʮͅ੮͐ʩɘ͐ੴ੮͸ʮ͐ʩ˺͙͐੮˚˺̼ʇ੮ ̼ʇͅ˺͙̼ɻʇͅੴ੮͐ʩʇ;੮͸˺˦ૄ͐ੳ੮U˦੮ͅʩ˺̼͐ੴ੮͸ʩʇ˦੮ä͐ɘ͐ʇ੮äʇ˦ɘ͐˺̼੮îʩ˺˚ɘͅ੮õ˚ɺʇ̼ʡ੮ફ͐ʩʇ੮ɺʮˑˑૄͅ੮ ̹ͅ˺˦ͅ˺̼બ੮ͅɘʮʁ੮͐ʩʇ;੮͸ʇ̼ʇ੮ʁ˺ʮ˦ʡ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ુ˦ʇ͸੮ɘ˦ʁ੮̼ʇͷ˺ˑ͙͐ʮ˺˦ɘ̼;੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴૂ੮ he wasn’t just inadvertently echoing the rhetoric that had been used to celebrate rØä੮ϲʮͷʇ੮ʁʇɻɘʁʇͅ੮ʇɘ̼ˑʮʇ̼ੳৼਁ੮Pʇ੮͸ɘͅ੮ʁʇͅɻ̼ʮɺʮ˦ʡ੮ɘ੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮͸ɘͅ੮ʠ˺͙˦ʁʇʁ੮˺˦੮ɘ੮ ͅʮ˚ʮˑɘ̼੮ ˚˺ʁʇˑ੮ ˺ʠ੮ ͅ˚ɘͅʩʮ˦ʡ੮ ˑɘ͸੮ ɘ˦ʁ੮ ˚ʇʁʮɻʮ˦ʇੴ੮ ɻ˺ʇ̼ɻʮ˺˦੮ ɘ˦ʁ੮ ɻɘ̼ʇੴ੮ ͐˺ʡʇ͐ʩʇ̼੮ ɘ˦ʁ੮ ʩ˺̹ʮ˦ʡ੮ʠ˺̼੮ʡ˺˺ʁ੮˺͙͐ɻ˺˚ʇͅ੮˺˦੮͐ʩʇ੮˺͐ʩʇ̼੮ͅʮʁʇੳ îʩʇ੮ʇ˦ʁ͙̼ɘ˦ɻʇ੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮͙˦͙̼̹̼ͅʮͅʮ˦ʡ੮ʡʮͷʇ˦੮ʩ˺͸੮ ʁʇʇ̹ˑ;੮ʇ˚ɺʇʁʁʇʁ੮ʮ͐੮ʮͅ੮ʮ˦੮͐ʩʇ੮˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮˺ʠ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮˦ɘ͐ʮ˺˦͸ʮʁʇੳ੮ U˦੮͐ʩʇ੮˚ʮʁચ͐͸ʇ˦͐ʮʇ͐ʩ੮ɻʇ˦͙̼͐;ੴ੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ੴ੮ʮ˦੮͐ʩʇ੮͸˺̼ʁͅ੮˺ʠ੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮/ੳ੮H͙ˑˑʇ̼੮î˺̼̼ʇ;ੴ੮ુʁʇ̼͐ͅ˺;ʇʁૂ੮ɘ੮ુɻ˺ʩʇ̼ʇ˦͐ੴ੮ʮʠ੮ϲˑɘ͸ʇʁૂ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ;͐ͅʇ˚ੳৼਂ îʩʮͅ੮ʩɘ̹̹ʇ˦ʇʁ੮̹ɘ̼͐ˑ;੮ʁʇˑʮɺʇ̼ɘ͐ʇˑ;ੴ੮͐ʩ̼˺͙ʡʩ੮Ø̼ʇͅʮʁʇ˦͐੮nʇ˦˦ʇʁ;ૄͅ੮ৱ৹৶৳੮#˺˚˚͙˦ʮ͐;੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ ɻ͐ੴ੮ ɘ˦ʁ੮ ̹ɘ̼͐ˑ;੮ ͙˦ʮ˦͐ʇ˦͐ʮ˺˦ɘˑˑ;ੴ੮ ɺʇɻɘ͙ͅʇ੮ ʠʇʁʇ̼ɘˑ੮ {ʇʁʮɻɘʮʁ੮ ɘ˦ʁ੮ä˺ɻʮɘˑ੮äʇɻ͙̼ʮ͐;੮ફɘͷɘʮˑɘɺˑʇ੮˺˦ˑ;੮͐˺੮̹ʇ˺̹ˑʇ੮˺͙͐ͅʮʁʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅબ੮˚ɘʁʇ੮ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ ϲʮͅɻɘˑˑ;੮ ʮ̼̼ʇͅʮ͐ͅʮɺˑʇੳ੮ îʩʇ੮ ʠʇʁʇ̼ɘˑ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ˦ʇͷʇ̼੮ ʇͽʇ̼ɻʮͅʇʁ੮ ̼ʇɘˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ɻ̼ʇɘ͐ʇ੮ɘ੮ͅ;͐ͅʇ˚੮ʮ˦੮͐ʩʇ੮ɘͅ;ˑ͙˚ͅૄ੮̹ˑɘɻʇੳ੮‡˺͐ɘɺˑ;ੴ੮ʮ͐੮ʁʮʁ੮˦˺͐੮˚ɘ˦ʁɘ͐ʇ੮͐ʩɘ͐੮ɻ˺˚˚͙˦ʮ͐;੮ɻˑʮ˦ʮɻͅ੮ͅʇ̼ͷʇ੮ʠ˺̼˚ʇ̼੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̹ɘ͐ʮʇ˦͐ͅੴ੮ɘ˦ʁ੮͐ʩʇ;੮˺ʠ͐ʇ˦੮ didn’t.ৼਃ੮੮ৱ৹৷৷੮̼ʇ̹˺̼͐੮ʠ˺͙˦ʁ੮ৱ৳৵੮ʠʇʁʇ̼ɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮͐˺͙ɻʩʮ˦ʡ੮˺˦੮͐ʩʇ੮ˑʮͷʇͅ੮˺ʠ੮̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮ɺ͙͐੮ɺʇ˦ʇϲʮɻʮɘ̼ʮʇͅ੮͸ʇ̼ʇ੮ુʮ˦ɘʁͷʇ̼͐ʇ˦͐ˑ;੮ͷʮɻ͐ʮ˚ʮΈʇʁૂ੮ɺ;੮ ɘ੮ુˑɘɻˌ੮˺ʠ੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮˦ɘ͐ʮ˺˦ɘˑ੮̹˺ˑʮɻʮʇͅૂ੮͐˺੮ɻ̼ʇɘ͐ʇ੮ɘ੮ુɻ˺ʩʇ̼ʇ˦͐੮ͅ;͐ͅʇ˚੮˺ʠ੮ɻɘ̼ʇੳૂৼ਄ In ͐ʩʇ੮ʇɘ̼ˑ;੮ৱ৹৸ৰͅੴ੮Ø̼ʇͅʮʁʇ˦͐੮Ûʇɘʡɘ˦੮ʇͷʮͅɻʇ̼ɘ͐ʇʁ੮ʠ͙˦ʁʮ˦ʡ੮ʠ˺̼੮ɻ˺˚˚͙˦ʮ͐;੮ɻɘ̼ʇੴ੮ɘͅ੮ʩʇ੮ ʩɘʁ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੳ੮ͅ੮î˺̼̼ʇ;੮̹͙͐੮ʮ͐ੴ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮͸ɘͅ੮ͷʮ̼͙͐ɘˑˑ;੮ુʁʇɻɘ̹ʮ͐ɘ͐ʇʁૂ੮ɘ˦ʁ੮ ુɘˑˑ੮ɘ͙͐ʩ˺̼ʮ͐;੮ɘ˦ʁ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮̼͐ʇɘ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ʇͅͅʇ˦͐ʮɘˑˑ;੮ disappeared.”৽৻ î˺ʁɘ;ੴ੮ ʠʇʁʇ̼ɘˑ੮ ̹̼˺ʡ̼ɘ˚ͅ੮ ̹ɘ;੮ ʠ˺̼੮ ʩɘˑʠ੮ ˺ʠ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɻɘ̼ʇੳ৽ৼ੮ Hʇʁʇ̼ɘˑ੮ ˑɘ͸ͅ੮ ˑʮˌʇ੮͐ʩʇ੮ʠʠ˺̼ʁɘɺˑʇ੮#ɘ̼ʇ੮ɻ͐੮ʩɘͷʇ੮ʇ˦͙̼ͅʇʁ੮͐ʩɘ͐੮ɘ੮͐ͅʇɘʁʮˑ;੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮˦͙˚ɺʇ̼੮˺ʠ੮ ˚ʇ̼ʮɻɘ˦ͅ੮̼ʇɻʇʮͷʇ੮ͅ˺˚ʇ੮ˌʮ˦ʁ੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̼͐ʇɘ͐˚ʇ˦͐ੳ৽৽੮Ěʇ͐੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ૄͅ੮ɘɺʁʮɻɘ͐ʮ˺˦੮˺ʠ੮ˑʇɘʁʇ̼ͅʩʮ̹੮˺˦੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ʮͅ੮͐ͅɘ̼ˌੳ੮

280

C O N C LU S I O N

îʩʇ੮ˑɘ͐ͅ੮;ʇɘ̼੮ʠ˺̼੮͸ʩʮɻʩ੮ʮ͐੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮ɘ੮˦ɘ͐ʮ˺˦ɘˑ੮ɻ˺͙˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐੮͐˺੮ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐੮͸ɘͅ੮ৱ৹৸ৰੳ৽৾੮ˑ͐ʩ˺͙ʡʩ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮̹͙ɺˑʮͅʩʇͅ੮̼ʇ̹˺̼͐ͅ੮ ˺ʠʠʇ̼ʮ˦ʡ੮ɘ੮ɺˑ͙ʇ̹̼ʮ˦͐੮ʠ˺̼੮̼ʇʠ˺̼˚ʮ˦ʡ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੴ੮͐ʩʇ੮˚˺͐ͅ੮̼ʇɻʇ˦͐੮˺˦ʇ੮ ફʮ˦੮৲ৰৰ৳બ੮˚ɘˌʇͅ੮˦˺੮˚ʇ˦͐ʮ˺˦੮˺ʠ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮˺̼੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇੳ৽৿੮Hʇʁʇ̼ɘˑ੮ ɻ˺͙̼͐ͅ੮ʩɘͷʇ੮̹ˑɘ;ʇʁ੮ɘ੮ˌʇ;੮̼˺ˑʇ੮ʮ˦੮ͅʇ͐͐ʮ˦ʡ੮ˑʮ˚ʮ͐ͅ੮ɘ̼˺͙˦ʁ੮͐ʩʇ੮ˑʇʡɘˑ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ɘ˦ʁ੮̹̼˺ɻʇʁ͙̼ʇͅ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ɺ͙͐੮͸ʮ͐ʩʮ˦੮͐ʩ˺ͅʇ੮ˑʮ˚ʮ͐ͅੴ੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮ʠ̼ʇʇ੮̼ʇʮʡ˦ੳ੮ ä͐ɘ͐ʇͅ੮ˑʮˌʇ੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ɘͅ੮Uૄͷʇ੮ͅʩ˺͸˦੮ʮ˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮ʩɘͷʇ੮ˑʇʠ͐੮ʮ˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦੮͙̹੮͐˺੮ ͐ʩʇ੮ɻ˺͙˦͐ʮʇͅੴ੮͸ʩʮɻʩ੮ʩɘͷʇ੮ʡ̼ɘ˦͐ʇʁ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮͐˺੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੴ੮͸ʩ˺੮ʩɘͷʇ੮ ͙ˑ͐ʮ˚ɘ͐ʇˑ;੮̹̼˺ʁ͙ɻʇʁ੮ɘ੮˦˺˦ͅ;͐ͅʇ˚੮˺ʠ੮ɻɘ̼ʇ੮ɘͅ੮ɻʩɘ˺͐ʮɻ੮ɘ͐੮͐ʩʇ੮ɺ˺͐͐˺˚੮ɘͅ੮ɘ͐੮͐ʩʇ੮͐˺̹ੳ

EXTENDING ABDICATION îʩʮͅ੮ɺ˺˺ˌ੮ʩɘͅ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ͅʩ˺͸ʮ˦ʡ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺˦ɻʇ̹͐੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮̹̼˺ͷʮʁʇͅ੮ɘ੮̼͐ͅ˺˦ʡʇ̼੮ʇͽ̹ˑɘ˦ɘ͐ʮ˺˦੮ʠ˺̼੮͐ʩʇ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮ɘ˦ʁ੮ʠɘʮˑʮ˦ʡͅ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮͐ʩɘ˦੮͐ʩʇ੮ʠ̼ɘ˚ʇ͸˺̼ˌͅ੮˺ʠ੮˚ʇʁʮɻɘˑચˑʇʡɘˑ੮ɻ˺˦ϲˑʮɻ͐੮ɘ˦ʁ੮ɻ˺˦̼͐˺ˑੳ੮"͙͐੮͐ʩʇ੮ɻ˺˦ɻʇ̹͐੮ ʮͅ੮ɘ੮͐ʩʇ˺̼ʇ͐ʮɻɘˑ੮͐˺˺ˑ੮͐ʩɘ͐੮ɻɘ˦੮ɺʇ੮ɘ̹̹ˑʮʇʁ੮˚˺̼ʇ੮ɺ̼˺ɘʁˑ;੮͐˺੮ɘ˦ɘˑ;Έʇ੮̹͙ɺˑʮɻ੮̹˺ˑʮɻ;ੴ੮ ̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘɻ;ੴ੮ɘ˦ʁ੮͐ͅɘ͐ʇ੮̹˺͸ʇ̼ੳ ɺʁʮɻɘ͐ʮ˺˦੮ʮͅ੮ɘ੮͸ɘ;੮˺ʠ੮̼ʇͅ˺ˑͷʮ˦ʡ੮ɻ˺˚̹ˑʇͽ੮̹˺ˑʮɻ;੮ʁʮˑʇ˚˚ɘͅ੮ɺ;੮ɘɺɘ˦ʁ˺˦ʮ˦ʡ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ૄͅ੮ ̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ ʠ˺̼੮ ̼ʇͅ˺ˑͷʮ˦ʡ੮ ͐ʩʇ˚ੳ੮ îʩʇ੮ ̹̼ʇચrØä੮ ɻ˺˚˚ʮ͐˚ʇ˦͐੮ ͅ;͐ͅʇ˚੮ ̼ʇϲˑʇɻ͐ʇʁ੮ɘ੮ʡʇ˦ʇ̼ɘˑ੮ɻ˺˦ͅʇ˦͙ͅͅ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͷɘ̼ʮ˺͙ͅ੮ˌʮ˦ʁͅ੮˺ʠ੮˚ʇ˦͐ɘˑ੮˺̼੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮͸ʇ̼ʇ੮͐ͅɘ͐ʇ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐ʮʇͅੳ੮rØä੮ˑɘ͸੮ͅʇ͐੮ʡ͙ʮʁʇˑʮ˦ʇͅ੮ʠ˺̼੮͸ʩʇ˦੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺͙ˑʁ੮ɻ˺˦͐ʮ˦͙ʇ੮͐˺੮ʩ˺̹ͅʮ͐ɘˑʮΈʇ੮ͅ˺˚ʇ੮ʮ˦੮͐ʩʮͅ੮̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮ɺ͙͐੮̼ʇʡ͙ˑɘ͐˺̼ͅ੮ ˦ʇͷʇ̼੮̼ʇɘˑˑ;੮ɻˑɘ̼ʮϲʮʇʁ੮͸ʩʇ˦੮͐ʩʇ;੮ͅʩ˺͙ˑʁ੮ʁ˺੮ͅ˺ੳ੮ēɘ̼ʮ˺͙ͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ʡɘͷʇ੮ɻ˺͙˦͐ʮʇͅ੮ ͐ʩʇ੮˺̹͐ʮ˺˦੮͐˺੮ɻ̼ʇɘ͐ʇ੮̹̼˺ʡ̼ɘ˚ͅ੮͐˺੮ͅʇ̼ͷʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ɺ͙͐੮˦ʇͷʇ̼੮ɻ˺˚̹̼ʇʩʇ˦ͅʮͷʇˑ;੮ ̹ˑɘ˦˦ʇʁઝ˺̼੮ɺ͙ʁʡʇ͐ʇʁઝʠ˺̼੮͐ʩʇʮ̼੮ɻ˺ˑˑʇɻ͐ʮͷʇ੮˦ʇʇʁͅੳ Ĕʇ੮ ɻɘ˦੮ ͅʇʇ੮ ɘ੮ ͅʮ˚ʮˑɘ̼੮ ̹̼˺ɻʇͅͅ੮ ˺ʠ੮ ɘɺʁʮɻɘ͐ʮ˺˦੮ ʮ˦੮ ͐ʩʇ੮ ͐ͅʇɘʁʮˑ;੮ ʠʇʇɺˑʇ̼੮ ʠʇʁʇ̼ɘˑ੮ ̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮͐ʩʇ੮ɻ˺̼˺˦ɘͷʮ̼͙ͅੴ੮͸ʩʮɻʩ੮ʩɘʁ੮ˌʮˑˑʇʁ੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮˚ʮˑˑʮ˺˦੮˚ʇ̼ʮɻɘ˦ͅ੮ɺ;੮ ͐ʩʇ੮͐ʮ˚ʇ੮U੮͸̼˺͐ʇ੮͐ʩʮͅ੮ફʮ˦੮ˑɘ͐ʇ੮৲ৰ৲৲બੳ੮š˦੮äʇ̹͐ʇ˚ɺʇ̼੮ৱ৸ੴ੮৲ৰ৲৲ੴ੮Ø̼ʇͅʮʁʇ˦͐੮k˺ʇ੮"ʮʁʇ˦੮ ͐˺ˑʁ੮#"ä੮‡ʇ͸ͅੴ੮ુîʩʇ੮̹ɘ˦ʁʇ˚ʮɻ੮ʮͅ੮˺ͷʇ̼ੳ੮Ĕʇ੮͐ͅʮˑˑ੮ʩɘͷʇ੮ɘ੮̹̼˺ɺˑʇ˚੮͸ʮ͐ʩ੮#šēU)ੳ੮ Ĕʇૄ̼ʇ੮͐ͅʮˑˑ੮ʁ˺ʮ˦ʡ੮ɘ੮ˑ˺͐͐ɘ੮͸˺̼ˌ੮˺˦੮ʮ͐ੳ੮"͙͐੮͐ʩʇ੮̹ɘ˦ʁʇ˚ʮɻ੮ʮͅ੮˺ͷʇ̼ੳૂ৽਀੮#̼ʮ͐ʮɻͅ੮ʩ˺͸ˑʇʁ੮ ͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ˚ʇ˦͐੮͸ɘͅ੮ુʮ̼̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ɘ˦ʁ੮ϲˑɘ͐ચ˺͙͐੮͸̼˺˦ʡੴૂ੮ɻ˺˚ʮ˦ʡ੮ʮ˦੮ɘ੮͸ʇʇˌ੮͐ʩɘ͐੮ ˚˺̼ʇ੮͐ʩɘ˦੮͐ʩ̼ʇʇ੮͐ʩ˺͙ͅɘ˦ʁ੮˚ʇ̼ʮɻɘ˦ͅ੮ʁʮʇʁ੮˺ʠ੮͐ʩʇ੮ʁʮͅʇɘͅʇੳ৽ਁ But in an important ͸ɘ;੮"ʮʁʇ˦ૄͅ੮͐ͅɘ͐ʇ˚ʇ˦͐੮͸ɘͅ੮ɻ˺̼̼ʇɻ͐ੵ੮͐ʩʇ੮͐ͅɘ͐ʇ੮͸˺͙ˑʁ੮˦˺੮ˑ˺˦ʡʇ̼੮ɺʇ੮̼͐ʇɘ͐ʮ˦ʡ੮ɻ˺̼˺˦ɘvirus as a crisis to be decisively resolved and would cease using the many levers still at the government’s disposal in a concerted way.

C O N C LU S I O N

281

ɺʁʮɻɘ͐ʮ˦ʡ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ɘͷ˺ʮʁʇʁ੮ ɘ˦ͅ͸ʇ̼ʮ˦ʡ੮ ɘ੮ ή͙ʇ͐ͅʮ˺˦੮ ͸ʮ͐ʩ੮ ˦˺੮ ʇɘͅ;੮ ɘ˦ͅ͸ʇ̼ͅੳ੮ š˦ɻʇ੮ ʮ͐੮ ͸ɘͅ੮ ɻˑʇɘ̼੮ ͐ʩɘ͐੮ ͷɘɻɻʮ˦ʇͅ੮ ͸ʇ̼ʇ੮ ˺˦ˑ;੮ ̹ɘ̼͐ʮɘˑˑ;੮ ʇʠʠʇɻ͐ʮͷʇੴ੮ ̼͙͐ˑ;੮ ʇ̼ɘʁʮɻɘ͐ʮ˦ʡ੮ ͐ʩʇ੮ͷʮ̼͙ͅ੮͸ɘͅ੮˦˺੮ˑ˺˦ʡʇ̼੮̹˺ͅͅʮɺˑʇ੮ફʇͷʇ˦੮ʮ˦੮ɘ੮͐˺͐ɘˑʮ͐ɘ̼ʮɘ˦੮ɻ˺͙˦̼͐;੮ˑʮˌʇ੮#ʩʮ˦ɘબੳ੮"͙͐੮ ˦ʇʮ͐ʩʇ̼੮͸ɘͅ੮ʮ͐੮̹˺ˑʮ͐ʮɻɘˑˑ;੮˺̼੮ʇ͐ʩʮɻɘˑˑ;੮ʠʇɘͅʮɺˑʇ੮͐˺੮ʁ˺੮˦˺͐ʩʮ˦ʡ੮͐˺੮˚ʮ͐ʮʡɘ͐ʇ੮ʮ͐ͅ੮ʮ˚̹ɘɻ͐ੳ੮ ੮ʁʇˑʮɺʇ̼ɘ͐ʇ੮̹˺ˑʮɻ;੮̼ʇ̹ͅ˺˦ͅʇ੮͸˺͙ˑʁ੮͐ʩ͙ͅ੮̼ʇή͙ʮ̼ʇੴ੮ɘ͐੮ˑʇɘ͐ͅ੮ʮ˚̹ˑʮɻʮ͐ˑ;ੴ੮ʁʇɻʮʁʮ˦ʡ੮ʩ˺͸੮ many deaths are acceptable and calibrating mitigation measures to match. It’s ˺ɺͷʮ˺͙ͅ੮͸ʩ;੮ͅʇ͐͐ʮ˦ʡ੮˦˺੮˺ɺˈʇɻ͐ʮͷʇ੮ɘ͐੮ɘˑˑ੮ʮͅ੮ʇɘͅʮʇ̼ੳ੮ʠ͐ʇ̼੮ɘˑˑੴ੮͸ʮ͐ʩ˺͙͐੮ʡ˺ɘˑͅੴ੮͐ʩʇ̼ʇ੮ ɻɘ˦੮ɺʇ੮˦˺੮ɘɻɻ˺͙˦͐ɘɺʮˑʮ͐;੮ʠ˺̼੮ʠɘʮˑʮ˦ʡ੮͐˺੮˚ʇʇ͐੮͐ʩʇ˚ੳ੮îʩɘ͐ૄͅ੮͐ʩʇ੮ʇͅͅʇ˦ɻʇ੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ ɘ͙͐ʩ˺̼ʮ͐;ੵ੮˦˺͐੮ɘ˦੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘɻ͐ʮ˺˦੮ફ͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʮͅ੮͐ͅʮˑˑ੮ ʁʮ̼͐ͅʮɺ͙͐ʮ˦ʡ੮ͷɘɻɻʮ˦ʇͅੴ੮̼͐ɘɻˌʮ˦ʡ੮ͷʮ̼͙ͅ੮ˑʇͷʇˑͅੴ੮ɘ˦ʁ੮ɘ̹̹̼˺ͷʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐ͅબ੮ɺ͙͐੮ɘ੮ͷ˺ʮʁ੮ ˺ʠ੮̹͙̼̹˺ͅʇ੮ɘ˦ʁ੮ʁʮ̼ʇɻ͐ʮ˺˦ੳ îʩʇ੮ʁ˺͸˦ͅʮΈʮ˦ʡ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ɻɘ̼ɻʇ̼ɘˑ੮ͅ;͐ͅʇ˚੮ʮͅ੮ɘ˦˺͐ʩʇ̼੮ʇͽɘ˚̹ˑʇੳ੮#ɘˑʮʠ˺̼˦ʮɘ੮ ͅʩ̼ɘ˦ˌ੮ʮ͐ͅ੮ɺ̼͙͐ɘˑˑ;੮˺ͷʇ̼͙͐ͅʠʠʇʁ੮̹̼ʮͅ˺˦੮ͅ;͐ͅʇ˚੮ɺ;੮৲৶੮̹ʇ̼ɻʇ˦͐੮ʠ̼˺˚੮৲ৰৰ৶੮͐˺੮৲ৰৱ৸ੴ੮ ʮ˦੮˦˺੮ͅ˚ɘˑˑ੮̹ɘ̼͐੮ɺ;੮ʁʇˑʇʡɘ͐ʮ˦ʡ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮˚ɘ˦;੮̹̼ʮͅ˺˦ʇ̼ͅ੮͐˺੮ɻ˺͙˦͐;੮ˈɘʮˑͅੳ৽ਂ î̼͙ʇ੮ʁʇɻɘ̼ɻʇ̼ɘ͐ʮ˺˦ੴ੮ʩ˺͸ʇͷʇ̼ੴ੮̼ʇή͙ʮ̼ʇͅ੮ɘ੮ʁʇˑʮɻɘ͐ʇ੮ɺɘˑɘ˦ɻʮ˦ʡ੮˺ʠ੮̹͙ɺˑʮɻ੮ͅɘʠʇ͐;੮͸ʮ͐ʩ੮ ʮ˦ʁʮͷʮʁ͙ɘˑ੮͸ʇˑˑચɺʇʮ˦ʡ੮ɘ˦ʁ੮ɘ੮ɻˑʇɘ̼੮̼͐ͅɘ͐ʇʡ;੮͐˺੮ɘʁʁ̼ʇͅͅ੮ɺ˺͐ʩ੮˺͙͐ͅʮʁʇ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ ˈ͙͐ͅʮɻʇ੮ͅ;͐ͅʇ˚ੳ੮ʁͷ˺ɻɘ͐ʇͅ੮ʠ˺̼੮ɘɺ˺ˑʮͅʩʮ˦ʡ੮˚ɘͅͅ੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮͙˦ʮͷʇ̼ͅɘˑˑ;੮̼ʇɻ˺ʡ˦ʮΈʇ੮ ͐ʩɘ͐੮ ˚ɘ˦;੮ ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʇʁ੮ ̹ʇ˺̹ˑʇ੮ ʩɘͷʇ੮ ɻ˺˚̹ˑʇͽ੮ ˦ʇʇʁͅ੮ ફʮ˦ɻˑ͙ʁʮ˦ʡ੮ ɘ̼˺͙˦ʁ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩબ੮͐ʩɘ͐੮͸ʮˑˑ੮˦ʇʇʁ੮͐˺੮ɺʇ੮ɘʁʁ̼ʇͅͅʇʁ੮ʠ˺̼੮͐ʩʇ˚੮͐˺੮͐ʩ̼ʮͷʇ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;ੳ U͐ૄͅ੮ ˚͙ɻʩ੮ ɻʩʇɘ̹ʇ̼ੴ੮ ʩ˺͸ʇͷʇ̼ੴ੮ ͐˺੮ ɘɺʁʮɻɘ͐ʇੳ੮ U˦੮ ৲ৰৱ৹ੴ੮ ͐ʩʇ੮ r˺ͅ੮ ˦ʡʇˑʇͅ੮ "˺ɘ̼ʁ੮ ˺ʠ੮ ä͙̹ʇ̼ͷʮͅ˺̼ͅ੮ ɘ˦˦˺͙˦ɻʇʁ੮ ɘ੮ ̹ˑɘ˦੮ ͐˺੮ ̼ʇ̹ˑɘɻʇ੮ {ʇ˦ૄͅ੮ #ʇ˦̼͐ɘˑ੮ kɘʮˑ੮ ͸ʮ͐ʩ੮ ɘ੮ ʠ˺͙̼ચ͐ʩ˺͙sand-bed hospital.৽ਃ੮ ˑ͐ʩ˺͙ʡʩ੮ ʮ˦ʮ͐ʮɘˑˑ;੮ ɻʇˑʇɺ̼ɘ͐ʇʁ੮ ɘͅ੮ ɘ੮ ˚˺ͷʇ੮ ͐˺͸ɘ̼ʁ੮ ̼ʇ̹ˑɘɻʮ˦ʡ੮ ɻ˺ʇ̼ɻʮ˺˦੮ ͸ʮ͐ʩ੮ ɻɘ̼ʇੴ੮ ɘʁͷ˺ɻɘ͐ʇͅ੮ ̼ʮ̹˺͐ͅʇʁ੮ ͐ʩɘ͐੮ ુɘ੮ ˈɘʮˑ੮ ʮͅ੮ ɘ੮ ˈɘʮˑ੮ ʮͅ੮ ɘ੮ ˈɘʮˑૂઝ͸ʩʇ͐ʩʇ̼੮ ˺̼੮ ˦˺͐੮ ʮ͐੮ ʮͅ੮ ˑɘɺʇˑʇʁ੮ ɘ੮ ʩ˺̹ͅʮ͐ɘˑઝɘ˦ʁ੮ ʁʇʠʇɘ͐ʇʁ੮ ͐ʩʇ੮ ̹̼˺̹˺ͅɘˑੳ৽਄ But the available ɻ˺˚˚͙˦ʮ͐;ચɺɘͅʇʁੴ੮˦˺˦ɻɘ̼ɻʇ̼ɘˑ੮̹̼˺ʡ̼ɘ˚ͅ੮͐˺੮͸ʩʮɻʩ੮ɻ˺͙̼͐ͅ੮ɻ˺͙ˑʁ੮ʁʮͷʇ̼͐੮ʇ̼͐ͅ͸ʩʮˑʇ੮ ʮ˦˚ɘ͐ʇͅ੮ʩɘʁ੮˦˺͸ʩʇ̼ʇ੮˦ʇɘ̼੮ʠ˺͙̼੮͐ʩ˺͙ͅɘ˦ʁ੮ɺʇʁͅੴ੮ͅ˺੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮͸ʇ̼ʇ੮ʁʮͷʇ̼͐ʇʁ੮͐˺੮ nothing.৾৻੮‡˺͐੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ͅʇ̼ͷʮɻʇͅ੮ʁʮͅͅ˺ˑͷʇʁ੮ɘ੮ɻ̼ʮͅʮͅ੮˺ʠ੮̹̼ʮͅ˺˦੮ɘ˦ʁ੮ˈɘʮˑ੮ ˺ͷʇ̼ɻ̼˺͸ʁʮ˦ʡ੮ɺ;੮˚ʇ̼ʡʮ˦ʡ੮ʮ͐੮ʮ˦͐˺੮͐ʩʇ੮ɻ̼ʮͅʮͅ੮˺ʠ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ɘ˦ʁ੮ʁʮͅ˺̼ʁʇ̼੮˺˦੮͐ʩʇ੮ streets.৾ৼ੮îʩʇ੮ˑʮˌʇˑ;੮̼ʇ͙ͅˑ͐੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮̼ɘ̼ʇˑ;੮ɘ੮ˑʮɺʇ̼͐ɘ̼ʮɘ˦੮̹ɘ̼ɘʁʮͅʇ੶੮ ʮ˦͐ͅʇɘʁੴ੮ʮ͐ૄͅ੮ͅʩ˺̼͐ચ͐ʇ̼˚੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ફ͸ʩʇ͐ʩʇ̼੮ͷʮɘ੮৵ৱ৵ৰͅ੮˺̼੮ɘ̼̼ʇ͐ͅͅબ੮ ͐ʩɘ͐੮ɘ̼ʇ੮ɘ̼ɺʮ̼͐ɘ̼;੮ɘ˦ʁ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ͷʮ˺ˑʇ˦͐ੴ੮˺̼ʮʇ˦͐ʇʁ੮͐˺͸ɘ̼ʁ੮˺˦ˑ;੮͐ʩʇ੮˚˺͐ͅ੮ʮ˦͐˺ˑʇ̼ɘɺˑʇੴ੮ɻ˺˚̹ˑɘʮ˦͐ચʡʇ˦ʇ̼ɘ͐ʮ˦ʡ੮ɻɘͅʇͅੳ U˦੮ɘ˦ɘˑ;Έʮ˦ʡ੮͐ʩʇͅʇ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅੴ੮͐ʩʮͅ੮ɺ˺˺ˌ੮ʩɘͅ੮ʁ̼ɘ͸˦੮˺˦੮ɘ੮̼ʮɻʩ੮ɺ˺ʁ;੮˺ʠ੮͙͐ͅʁʮʇͅ੮ ˺˦੮ʩ˺͸੮ˑʇʡɘˑੴ੮˚ʇʁʮɻɘˑੴ੮ɘ˦ʁ੮͸ʇˑʠɘ̼ʇ੮ɘʡʇ˦ɻʮʇͅ੮governੴ੮disciplineੴ੮˺̼੮regulate marginɘˑʮΈʇʁ੮̹ʇ˺̹ˑʇੳ৾৽੮rʮˌʇ੮˺͐ʩʇ̼੮̼ʇͅʇɘ̼ɻʩʇ̼ͅ੮ʮ˦੮͐ʩʮͅ੮ͷʇʮ˦ੴ੮U੮ʩɘͷʇ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੵ੮̹ʇ͐͐;੮̹˺͐ʇ˦͐ɘ͐ʇͅ੮͸ʩ˺੮ʩɘͷʇ੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮˺ͷʇ̼੮͸ʩʇ͐ʩʇ̼੮ɘ˦ʁ੮

282

C O N C LU S I O N

ʩ˺͸੮͐˺੮˚ʇ͐ʇ੮˺͙͐੮̹͙˦ʮͅʩ˚ʇ˦͐ੴ੮̹̼˺ͷʮʁʇ੮ɻɘ̼ʇੴ੮ɘ˦ʁ੮ʡ̼ɘ˦͐੮ɺʇ˦ʇϲʮ͐ͅੳ৾৾੮Ûʇɻʇ˦͐ˑ;ੴ੮k˺ͅʩ੮ äʇʮ˚ੴ੮ʮ˦੮ʩʮͅ੮͙͐ͅʁ;੮˺ʠ੮ɘ˚ɺ͙ˑɘ˦ɻʇ੮͸˺̼ˌʇ̼ͅੴ੮ɘ̼ʡ͙ʇʁ੮͐ʩɘ͐੮͐ʩʮͅ੮ˑʮ˦ʇ੮˺ʠ੮̼ʇͅʇɘ̼ɻʩ੮˦ʇʇʁͅ੮ ͐˺੮̹ɘ;੮ʡ̼ʇɘ͐ʇ̼੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮͐ʩʇ੮̼ʇˑɘ͐ʮ˺˦ͅ੮ɘ˚˺˦ʡ੮̼͐ͅʇʇ͐ચˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅੴ੮͙ͅʮ˦ʡ੮͐ʩʇ੮ ʇͽɘ˚̹ˑʇ੮˺ʠ੮ʩ˺͸੮̹˺ˑʮɻʇੴ੮̹ɘ̼ɘ˚ʇʁʮɻͅੴ੮ɘ˦ʁ੮̼͐ʮɘʡʇ੮˦͙̼ͅʇͅ੮ɺ͙̼ʁʇ˦੮ͅʩ͙ϲϲˑʇ੮͙˦ʁʇͅʮ̼ɘɺˑʇ੮ ͙ͅʠʠʇ̼ʮ˦ʡ੮ɺ˺ʁʮʇͅੳ৾৿੮äʮ˚ʮˑɘ̼ˑ;ੴ੮̼˚ɘ˦ʁ˺੮rɘ̼ɘચ{ʮˑˑɜ˦੮ɘ˦ɘˑ;Έʇʁ੮ɘ੮̹̼˺ɻʇͅͅ੮˺ʠ੮̼ʇʁʮ̼͐ͅʮɺ͙͐ʮ˦ʡ੮͐ʩʇ੮̹˺˺̼੮ɘͅ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ɘʁʁ̼ʇͅͅ੮͐ʩʇʮ̼੮˺͸˦੮ʠ͙˦ʁʮ˦ʡ੮ɘ˦ʁ੮ˑʇʡɘˑ੮ɻ˺˦̼͐ͅɘʮ˦͐ͅ੮ ɺ;੮˚˺ͷʮ˦ʡ੮̹ʇ˺̹ˑʇ੮ɺɘɻˌ੮ɘ˦ʁ੮ʠ˺̼͐ʩੳ৾਀ ɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʩʇˑ̹ͅ੮͙ͅ੮˚˺̼ʇ੮ɻɘ̼ʇʠ͙ˑˑ;੮̹ͅʇɻʮʠ;੮͸ʩɘ͐੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮̼͐ͅʇʇ͐ચ ˑʇͷʇˑ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮ɻɘ˦੮ɘ˦ʁ੮ɻɘ˦˦˺͐੮ʁ˺੮ʮ˦੮͐ʩʇͅʇ੮ʩ˺̼ʮΈ˺˦͐ɘˑ੮̼ʇˑɘ͐ʮ˺˦ͅʩʮ̹ͅੳ੮ͅ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅ੮ɺʇɻ˺˚ʇ੮ʇͷʇ̼੮˚˺̼ʇ੮ɻ˺˚̹ˑʇͽੴ੮ʮ˦ʁʮͷʮʁ͙ɘˑʮΈʇʁੴ੮ɘ˦ʁ੮͐ɘ̼ʡʇ͐ʇʁ੮ફ͸ʮ͐˦ʇͅͅ੮ ͐ʩʇ੮ ʇͽ̼͐ɘ˺̼ʁʮ˦ɘ̼ʮˑ;੮ ɻ˺˦ͷ˺ˑ͙͐ʇʁ੮ ̹̼˺ɻʇͅͅ੮ ʠ˺̼੮ ʩ˺˚ʇˑʇͅͅ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͐˺੮ ή͙ɘˑʮʠ;੮ ʠ˺̼੮ ̹ʇ̼˚ɘ˦ʇ˦͐੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡબੴ੮ɘɻ͙͐ɘˑˑ;੮̹̼˺ͷʮʁʮ˦ʡ੮ɻɘ̼ʇ੮˺̼੮ɻ˺˦̼͐˺ˑ੮̼ʇή͙ʮ̼ʇͅ੮͐ʩʇ੮ ɘˑʮʡ˦˚ʇ˦͐੮˺ʠ੮ɘ੮ͅʇ̼ʮʇͅ੮˺ʠ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮ʁʇɻʮͅʮ˺˦ͅੳ੮Ěʇ͐੮ʁʇˑʇʡɘ͐ʮ˺˦੮͐˺੮ɘ੮˚ʮͽ੮˺ʠ੮̹͙ɺˑʮɻੴ੮˦˺˦̹̼˺ϲʮ͐ੴ੮ɘ˦ʁ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮ɘʡʇ˦ɻʮʇͅ੮͙ͅɺˈʇɻ͐ͅ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮͐˺੮ʁʮͷʇ̼ʡʇ˦͐੮ϲʮ˦ɘ˦ɻʮɘˑ੮ ʮ˦ɻʇ˦͐ʮͷʇͅ੮ɘ˦ʁ੮ʁʮ̹ͅɘ̼ɘ͐ʇ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ʇ͐ʩ˺ͅੳ੮U͐੮ͷʮ̼͙͐ɘˑˑ;੮ʡ͙ɘ̼ɘ˦͐ʇʇͅ੮͐ʩɘ͐੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮͸ʮˑˑ੮ʁʇϲʮ˦ʇ੮ˌʇ;੮ʇˑʮʡʮɺʮˑʮ͐;੮ɻ̼ʮ͐ʇ̼ʮɘ੮ફˑʮˌʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;બ੮ʮ˦੮ʮ˦ɻ˺˦ͅʮ͐ͅʇ˦͐੮͸ɘ;ͅੳ੮ U˦੮ͅ;͐ͅʇ˚ͅ੮͸ʮ͐ʩ੮˚;̼ʮɘʁ੮ͷʇ͐˺੮̹˺ʮ˦͐ͅੴ੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮ʁʮͅɻ̼ʇ͐ʮ˺˦੮ʮͅ੮̼ʇɘˑˑ;੮˺˦ˑ;੮˦ʇʡɘ͐ʮͷʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦ઝ͐ʩʇ੮ɘɺʮˑʮ͐;੮͐˺੮̼ʇ˚˺ͷʇ੮˺̼੮ɺˑ˺ɻˌ੮ͅ˺˚ʇ˺˦ʇ੮ʠ̼˺˚੮̼ʇɻʇʮͷʮ˦ʡ੮ͅʇ̼ͷʮɻʇͅੳ੮ ˦ʁ੮͸ʩʇ˦੮ʇͷʇ̼;˺˦ʇ੮ʩɘͅ੮˺˦ˑ;੮˦ʇʡɘ͐ʮͷʇ੮ʁʮͅɻ̼ʇ͐ʮ˺˦ੴ੮͐ʩʇ੮̼ʇ͙ͅˑ͐੮ʮͅ੮˦˺͐੮˦ʇɻʇͅͅɘ̼ʮˑ;੮͐ʩʇ੮ ɺ͙̼ʁʇ˦੮ͅʩ͙ϲϲˑʮ˦ʡ੮˺ʠ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˺˦͐˺੮˺͐ʩʇ̼੮ɘʡʇ˦ɻʮʇͅ੮͐ʩɘ͐੮äʇʮ˚੮ʁ˺ɻ͙˚ʇ˦͐ͅੴ੮ɺ͙͐੮ their complete abandonment. îʩʇ੮ ʮ˚̹˺̼͐ɘ˦ɻʇ੮ ˺ʠ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ɺʇɻ˺˚ʇͅ੮ ˚˺̼ʇ੮ ͷʮͅʮɺˑʇ੮ ʮʠ੮ ͸ʇ੮ ͅʩʮʠ͐੮ ˺͙̼੮ ɘ˦ɘˑ;͐ʮɻ੮ ʠ˺ɻ͙ͅੳ੮Ø̼ʇͷʮ˺͙ͅ੮͙͐ͅʁʮʇͅ੮˺˦੮ુʩ;̹ʇ̼ચ˚ɘ̼ʡʮ˦ɘˑʮΈʇʁ੮̹˺̹͙ˑɘ͐ʮ˺˦ͅૂ੮ʩɘͷʇ੮ɻ̼ʮ͐ʮή͙ʇʁ੮ʩ˺͸੮ ɘʡʇ˦ɻʮʇͅ੮ુʩɘ˚̹ʇ̼ੴ੮ʁʮͅɻ˺͙̼ɘʡʇੴ੮˺̼੮˺̹̹̼ʇͅͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅૂ੮͸ʩ˺੮ɘ̼ʇ੮ʁʇʇ˚ʇʁ੮˚˺̼ɘˑˑ;੮ ͙˦͸˺̼͐ʩ;੮˺ʠ੮ʩʇˑ̹ੳ৾ਁ੮Øʇ̼ʩɘ̹ͅ੮͐ʩʇ੮˚˺͐ͅ੮̼ʇͷʇɘˑʮ˦ʡ੮ɻɘͅʇͅੴ੮͐ʩ˺͙ʡʩੴ੮ɘ̼ʇ੮͐ʩ˺ͅʇ੮ʮ˦੮͸ʩʮɻʩ੮ ˚ɘ˦;੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ͅ੮ɘ˦ʁ੮ɘʡʇ˦ɻʮʇͅ੮ɻˑɘʮ˚੮ɘ੮ʡʇ˦͙ʮ˦ʇ੮ʁʇͅʮ̼ʇ੮͐˺੮ɘͅͅʮ͐ͅ੮ɺ͙͐੮ʠɘʮˑ੮͐˺੮ʁ˺੮ͅ˺੮ ʇʠʠʇɻ͐ʮͷʇˑ;ੳ੮੮̼͐ɘ˦ͅʮ͐ʮ˺˦ɘˑચɘʡʇ੮;˺͙͐ʩ੮ˑʇɘͷʮ˦ʡ੮͐ʩʇ੮ʠ˺͐ͅʇ̼੮ɻɘ̼ʇ੮ͅ;͐ͅʇ˚ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮ or a pregnant woman whose substance use leads to incarceration might have a ʩɘˑʠચʁ˺Έʇ˦੮ɻɘͅʇ੮˚ɘ˦ɘʡʇ̼ͅ੮ɘ˦ʁ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ͅ੮ʠ̼˺˚੮˚͙ˑ͐ʮ̹ˑʇ੮ɘʡʇ˦ɻʮʇͅ੶੮˦˺͐੮ɘˑˑ੮˺ʠ੮ ͐ʩʇ˚੮ ɘ̼ʇ੮ ˑ˺˺ˌʮ˦ʡ੮ ͐˺੮ ɺ͙̼ʁʇ˦੮ ͅʩ͙ϲϲˑʇ੮ ˺̼੮ ̼ʇʁʮ̼͐ͅʮɺ͙͐ʇ੮ ͐ʩʇ˚੮ ʇˑͅʇ͸ʩʇ̼ʇੳ৾ਂ What is ˚ʮͅͅʮ˦ʡ੮ʮ˦੮͐ʩʇͅʇ੮ɻɘͅʇͅ੮ʮͅ੮˦˺͐੮ɺ͙̼ʇɘ͙ɻ̼ɘ͐ʮɻ੮ɻ˺˚̹ɘͅͅʮ˺˦੮ɺ͙͐੮ɘ͙͐ʩ˺̼ʮ͐;ੴ੮ʮ˦੮͐ʩʇ੮ͅʇ˦ͅʇ੮ ˺ʠ੮ɘ੮ુʁʇͷʮɻʇ੮͐˺੮ɘɻʩʮʇͷʇੴ੮˚˺̼ʇ੮̼ʇˑʮɘɺˑ;੮ɘ˦ʁ੮͙ͅɻɻʇͅͅʠ͙ˑˑ;ੴ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ʡʮͷʇ˦੮ɘ˦ʁ੮ agreed objectives that would otherwise be less easy or impossible to attain.”৾ਃ /ͽ̹ˑɘʮ˦ʮ˦ʡ੮ ͙ͅɻʩ੮ ɻɘͅʇͅ੮ ̼ʇή͙ʮ̼ʇͅ੮ ɘ͐͐ʇ˦͐ʮ˺˦੮ ͐˺੮ ʩ˺͸੮ ʁʇɻʮͅʮ˺˦ચ˚ɘˌʮ˦ʡ੮ ɻ̼ʮ͐ʇ̼ʮɘ੮ ɘ̼ʇ੮ ʁʇϲʮ˦ʇʁ੮ɘ˦ʁ੮̼ʇʡ͙ˑɘ͐ʇʁੴ੮ʩ˺͸੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ϲˑ˺͸ͅ੮ɺʇ͐͸ʇʇ˦੮ɘʡʇ˦ɻʮʇͅੴ੮ɘ˦ʁ੮͸ʩ˺੮ʩɘͅ੮ ˑʇɘʁʇ̼ͅʩʮ̹੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ͷʇ̼੮˺͐ʩʇ̼੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅੳ

C O N C LU S I O N

283

îʩʮͅ੮ʠ̼ɘ˚ʇ͸˺̼ˌ੮ɘˑͅ˺੮ʇ˦ɻ˺͙̼ɘʡʇͅ੮͙ͅ੮͐˺੮ʁ̼ɘ͸੮ʮ˦ͅʮʡʩ͐ͅ੮ʠ̼˺˚੮ʁʮʠʠʇ̼ʇ˦͐੮ʩʮ͐ͅ˺̼ʮɻɘˑ੮˚˺˚ʇ˦͐ͅ੮͐ʩɘ˦੮̹̼ʇͷʮ˺͙ͅ੮͙͐ͅʁʮʇͅੳ੮rɘ̼ɘચ{ʮˑˑɭ˦ૄͅ੮ɘ˦ɘˑ;ͅʮͅ੮˺ʠ੮̼ʇʁʮ̼͐ͅʮɺ͙͐ʮ˦ʡ੮͐ʩʇ੮ ̹˺˺̼੮ʇ˚̹ʩɘͅʮΈʇͅ੮̹ʇ̼ʮ˺ʁͅ੮˺ʠ੮ɘ͙͐ͅʇ̼ʮ͐;ੴ੮͸ʩʇ˦੮ɘʡʇ˦ɻʮʇͅ੮˚͙͐ͅ੮̼ɘ̹ʮʁˑ;੮ϲʮ˦ʁ੮͸ɘ;ͅ੮͐˺੮ ɻ͙͐੮̼˺ˑˑͅੳ੮îʩʮͅ੮ʠ˺̼ɻʇͅ੮͐ʩʇ˚੮͐˺੮ʁʇˑʮɺʇ̼ɘ͐ʇ੮ɘ˦ʁ੮ʁʇϲʮ˦ʇ੮ʇˑʮʡʮɺʮˑʮ͐;੮ɻ̼ʮ͐ʇ̼ʮɘ੮ફ͐ʩʇ੮ৱ৹৹ৱ੮ ુ̼ʇɘˑʮʡ˦˚ʇ˦͐ૂ੮ ʮ˦੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ʠ˺̼੮ ʇͽɘ˚̹ˑʇੴ੮ ͸ɘͅ੮ ˺˦ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ʠʇ͸੮ ͐ʮ˚ʇͅ੮ ͐ʩʇ੮ ͐ͅɘ͐ʇ੮ clearly articulated who should be served by the public mental health system). But ͐ʩʇ੮ͷʇ̼;੮ɻ˺˦ɻʇ̹͐੮˺ʠ੮ɘ͙͐ͅʇ̼ʮ͐;੮̹̼ʇ͙̹̹ͅ˺ͅʇͅ੮˚˺˚ʇ˦͐ͅ੮˺ʠ੮ˑɘ̼ʡʇͅͅʇੴ੮͸ʩʇ˦੮ɘɺʁʮɻɘ͐ʮ˦ʡ੮ ɘ͙͐ʩ˺̼ʮ͐;੮˚ɘ;੮ɺʇ੮ɺ˺͐ʩ੮ʇɘͅʮʇ̼੮ɘ˦ʁ੮˚˺̼ʇ੮ɻ˺˦ͅʇή͙ʇ˦͐ʮɘˑੳ੮H˺̼੮ʇͽɘ˚̹ˑʇੴ੮˺̹̹˺˦ʇ˦͐ͅ੮ ˺ʠ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʩɘͷʇ੮̹˺ʮ˦͐ʇʁ੮͐˺੮ʩ͙ʡʇ੮˦ʇ͸੮ʮ˦ͷʇ͐ͅ˚ʇ˦͐ͅ੮ʮ˦੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ɘ˦ʁ੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮ɘͅ੮ɘ੮̼ʇɘͅ˺˦੮͐˺੮ʁʇʠʇ̼੮̼ʇʠ˺̼˚ʮ˦ʡ੮rØäੳ੮Ěʇ͐੮͐ʩʮͅ੮ɻ˺˦ͷʇ˦ʮʇ˦͐ˑ;੮ɘˑˑ˺͸ͅ੮͐ʩʇ੮͐ͅɘ͐ʇ੮͐˺੮̹͙͐੮˺ʠʠ੮ή͙ʇ͐ͅʮ˺˦ͅ੮˺ʠ੮ʩ˺͸੮͐˺੮͙ͅʇ੮ʮ͐ͅ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʇ˦͙̼ͅʇ੮ that new mental health and housing services actually serve the people who need ͐ʩʇ˚ੴ੮˚͙ɻʩ੮ˑʇͅͅ੮͸ʩʇ͐ʩʇ̼੮ʮ͐ͅ੮ͅ˺ͷʇ̼ʇʮʡ˦੮̹˺͸ʇ̼੮ͅʩ˺͙ˑʁ੮ɺʇ੮͙ͅʇʁ੮͐˺੮ʠ˺̼ɻʇ੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮ accepting them when they don’t want to. Hʮ˦ɘˑˑ;ੴ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʩɘͅ੮̼ʇˑʇͷɘ˦ɻʇ੮ʠ˺̼੮ʩ˺͸੮͸ʇ੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮̹ͅ;ɻʩʮɘ̼͐;੮ ɘ˦ʁ੮˺͐ʩʇ̼੮͐˺˺ˑͅ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ɻ˺˦̼͐˺ˑੳ੮੮ˑ˺˦ʡ੮ˑʮ˦ʇɘʡʇ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ͅɻʮʇ˦͐ʮ͐ͅͅ੮ʩɘͷʇ੮ʁʇͷʇˑ˺̹ʇʁ੮͐ʩʇ੮ʮʁʇɘ੮͐ʩɘ͐੮͐ʩʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹̼˺ʠʇͅͅʮ˺˦੮ͅʇʇˌͅ੮͐˺੮ʇ˦ʁˑʇͅͅˑ;੮ʇͽ̹ɘ˦ʁ੮ʮ͐ͅ੮̹˺͸ʇ̼੮ ɺ;੮ ɻˑɘʮ˚ʮ˦ʡ੮ ˈ͙̼ʮͅʁʮɻ͐ʮ˺˦੮ ˺ͷʇ̼੮ ɘˑˑ੮ ͅ˺̼͐ͅ੮ ˺ʠ੮ ʁʇͷʮɘ˦ɻʇੴ੮ ʁʮͅ˺̼ʁʇ̼ੴ੮ ɘ˦ʁ੮ ʁʮͅɘɺʮˑʮ͐;ੳ৾਄ äɻʩ˺ˑɘ̼ͅ੮ɘˑͅ˺੮ɻˑɘʮ˚੮͐ʩɘ͐੮͐ʩʇ੮ʠ˺̼˚੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹˺͸ʇ̼੮ʩɘͅ੮ɻʩɘ˦ʡʇʁੵ੮͙˦ˑʮˌʇ੮ʮ˦੮͐ʩʇ੮ ʇ̼ɘ੮˺ʠ੮˺̹ʇ˦ચʇ˦ʁʇʁ੮ʮ˦͐ʇ̼˦˚ʇ˦͐ͅ੮ʮ˦੮ɘͅ;ˑ͙˚ͅ੮̹˺ˑʮɻʇʁ੮ɺ;੮̹ʩ;ͅʮɻɘˑ੮ʠ˺̼ɻʇੴ੮ʮ˦੮ુ˚˺ʁʇ̼˦੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹̼ɘɻ͐ʮɻʇ੯ੳ੯ੳ੯ੳ੮˺ͷʇ̼͐੮͙ͅʇ੮˺ʠ੮ɻ˺ʇ̼ɻʮ˺˦੮ʩɘͅ੮ˑʮˌʇˑ;੮ɺʇʇ˦੮̼ʇ̹ˑɘɻʇʁ੮ɺ;੮˚˺̼ʇ੮ ͙ͅɺ͐ˑʇ੮ʠ˺̼˚ͅ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ɻ˺˦̼͐˺ˑੳૂ৿৻ îʩʮͅ੮ ɺ˺˺ˌ੮ ɻʩɘˑˑʇ˦ʡʇͅ੮ ͐ʩʮͅ੮ ̹˺̼̼͐ɘ;ɘˑੳ੮ /ͷʇ˦੮ ɘͅ੮ ɘ͐͐ʇ˦͐ʮ˺˦੮ ʩɘͅ੮ ˚˺ͷʇʁ੮ ͐˺੮ ͐ʩʇ੮ ˚ɘ˦ɘʡʇ˚ʇ˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ʮ˦੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮˺̼੮͐ʩʇʮ̼੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮ʮ˦੮̹̼ʮͅ˺˦ͅ੮ɘ˦ʁ੮ˈɘʮˑͅੴ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮ɻʮͷʮˑ੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮̼ʇ˚ɘʮ˦੮ɘ͐੮͐ʩʇ੮ ɻ˺̼ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ̼͐ɘˈʇɻ͐˺̼ʮʇͅ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ͅʇ̼ʮ˺͙ͅ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੳ੮ {˺̼ʇ੮ ͙ͅɺ͐ˑʇ੮ ʠ˺̼˚ͅ੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻ˺˦̼͐˺ˑઝˑʮˌʇ੮ˈ͙ʁʡʇͅ੮ʇ˦ɻ˺͙̼ɘʡʮ˦ʡ੮̹ɘ͐ʮʇ˦͐ͅ੮͐˺੮͐ɘˌʇ੮͐ʩʇʮ̼੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮ ͸ʩʮˑʇ੮ ˑʮͷʮ˦ʡ੮ ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐ˑ;੮ ˺̼੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ˚ɘˌʮ˦ʡ੮ ɘɻɻʇͅͅ੮ ͐˺੮ ʩ˺͙ͅing contingent on compliance৿ৼઝɘ̼ʇ੮ ͅʩɘʁ˺͸ʇʁ੮ ɺ;੮ ͐ʩʇ੮ ͐ʩ̼ʇɘ͐੮ ˺ʠ੮ ɺʇʮ˦ʡ੮ ʠ˺̼ɻibly interned in settings where control includes being placed in mechanical ̼ʇ̼͐ͅɘʮ˦͐ͅ੮ɘ˦ʁ੮ʮ˦ˈʇɻ͐ʇʁ੮͸ʮ͐ʩ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮U͐੮ʮͅ੮͐˺˺੮ʠ̼ʇή͙ʇ˦͐ˑ;੮˺ͷʇ̼ˑ˺˺ˌʇʁ੮͐ʩɘ͐੮ ɘ͐͐ʇ˚̹͐ͅ੮ ͐˺੮ ʁʮͷʇ̼͐੮ ̹ʇ˺̹ˑʇ੮ ʠ̼˺˚੮ ͐ʩʇ੮ ɻ̼ʮ˚ʮ˦ɘˑ੮ ˈ͙͐ͅʮɻʇ੮ ͅ;͐ͅʇ˚੮ ʮ˦͐˺੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ˺ʠ͐ʇ˦੮ͅʮ̹ʩ˺˦੮̹ʇ˺̹ˑʇ੮ʮ˦͐˺੮ɷʯ̀˃ʚ̢ʯ͗ȡ͇̅ treatment. Our inattention to civil com˚ʮ͐˚ʇ˦͐ͅੴ੮ʠ˺̼੮ɺ˺͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇੴ੮˚ɘ;੮ˑʇɘʁ੮͙ͅ੮͐˺੮˺ͷʇ̼ˑ˺˺ˌ੮ ͐ʩɘ͐ੴ੮ɘͅ੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑચˑʇʡɘˑ੮ͅ;͐ͅʇ˚੮̼ʇɻʇʁʇͅੴ੮ɻ˺ʇ̼ɻʮͷʇ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ɻ˺͙ˑʁ੮ɺʇ੮͐ɘˌʮ˦ʡ੮ its place.৿৽

284

C O N C LU S I O N

While legally imposed psychiatric care may be more widespread than usually ʁʇ̹ʮɻ͐ʇʁੴ੮ʮ͐ͅ੮ɘ˚ɺʮ͐ʮ˺˦ͅ੮ɘ̼ʇ੮ʇɘͅʮˑ;੮˺ͷʇ̼͐ͅɘ͐ʇʁੳ੮îʩʇ˺̼ʮ͐ͅͅ੮˺ʠ੮˚ʇʁʮɻɘˑચˑʇʡɘˑ੮ɻ˺˦̼͐˺ˑ੮ ̹˺̼̼͐ɘ;੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ɘͅ੮ɘʮ˚ʮ˦ʡ੮͐˺੮̹̼˺ʁ͙ɻʇ੮ુ̹̼˺ʁ͙ɻ͐ʮͷʇੴ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇੴ੮ ɘ˦ʁ੮ͅʇˑʠચʡ˺ͷʇ̼˦ʮ˦ʡ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੳૂ৿৾੮U͐੮ʮͅ੮ʇɘͅ;੮͐˺੮ɻ˺˦ʠ͙ͅʇ੮ɘ̹ͅʮ̼ɘ͐ʮ˺˦ɘˑ੮̼ʩʇ͐˺̼ʮɻ੮ʠ˺̼੮ ̼ʇɘˑʮ͐;ੳ੮îʩʇ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ɘͅ੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅ੮‡ʇʮˑ੮I˺˦ʡ੮ ɘ̼ʡ͙ʇͅੴ੮ʮͅ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ુ͐˺ˑʇ̼ɘ˦͐੮ɻ˺˦͐ɘʮ˦˚ʇ˦͐ૂੵ੮˦˺͐੮ɻ˺̼̼ʇɻ͐ʮ˦ʡ੮̹̼˺ɺˑʇ˚ɘ͐ʮɻ੮ ɺʇʩɘͷʮ˺̼ͅੴ੮ ɺ͙͐੮ ˌʇʇ̹ʮ˦ʡ੮ ͐ʩʇ˚੮ ˺͙͐੮ ˺ʠ੮ ͅʮʡʩ͐ੳ৿৿੮ îʩʇ੮ ɻ˺˦͐ʇ˚̹˺̼ɘ̼;੮ ͙ͅʇ੮ ˺ʠ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮͅ੮̼ʇϲˑʇɻ͐ʮͷʇ੮˺ʠ੮͐ʩʮͅ੮ˑʮ˚ʮ͐ʇʁ੮ʩ˺̼ʮΈ˺˦ੳ੮੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ɻɘ˦੮̹ʮ͐ɻʩ੮ɘ੮ ͐ʇ˦͐ੴ੮ϲʮͅʩ੮ʠ˺̼੮ʠ˺˺ʁ੮ʮ˦੮ɘ੮ʁ͙˚̹͐ͅʇ̼ੴ੮˺̼੮ɺʇʡ੮ʠ˺̼੮̹ͅɘ̼ʇ੮ɻʩɘ˦ʡʇ੮ʮͅ੮ʠɘ̼੮ʇ˦˺͙ʡʩ੮ɘ͸ɘ;੮ʠ̼˺˚੮ ʮ˚˚ʮ˦ʇ˦͐੮ʁʇɘ͐ʩ੮͐˺੮ɺʇ੮ɘˑˑ˺͸ʇʁ੮͐˺੮̼ʇʠ͙ͅʇ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʇͷʇ˦੮ʮʠ੮͐ʩʇʮ̼੮͙˦̼͐ʇɘ͐ʇʁ੮˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ʮͅ੮ɻɘ͙ͅʮ˦ʡ੮˦ʇɘ̼ˑ;੮͙˦ɺʇɘ̼ɘɺˑʇ੮͙ͅʠʠʇ̼ʮ˦ʡੳ Uͅ੮ ͐ʩʮͅ੮ ̼ʇͅʮʁ͙ɘˑ੮ ̼˺ˑʇ੮ ʠ˺̼੮ ̹ͅ;ɻʩʮɘ̼͐;੮ ɘ੮ ͅʮʡ˦੮ ͐ʩɘ͐੮ ɘ˦͐ʮચ̹ͅ;ɻʩʮɘ̼͐;੮ ɻ̼ʮ͐ʮή͙ʇͅ੮ ɘ̼ʇ੮ ͐ͅɘ̼͐ʮ˦ʡ੮͐˺੮ɺʮ͐ʇ੮˺̼੮͐ʩɘ͐੮͐ʩʇ੮ͅʩɘˌ;੮ʠ˺͙˦ʁɘ͐ʮ˺˦ͅ੮˺ʠ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʇͽ̹ʇ̼͐ʮͅʇ੮ɘ̼ʇ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ʇͽ̹˺ͅʇʁ੺৿਀੮U੮ʁ˺˦ૄ͐੮͐ʩʮ˦ˌ੮ͅ˺ੳ੮#˺˦̼͐ɘ̼;੮͐˺੮ʁʇ̹ʮɻ͐ʮ˺˦ͅ੮˺ʠ੮˚ʇʁʮɻɘˑચˑʇʡɘˑ੮ɻ˺˦ϲˑʮɻ͐ੴ੮ U੮ϲʮ˦ʁ੮͐ʩɘ͐੮͐ʩʇ੮˺ɺˈʇɻ͐ʮͷʇ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ɻ˺˦̼͐˺ˑ੮˺ʠ੮͐ʩʇ੮˚ɘʁ੮ʮͅ੮͸ʮʁʇˑ;੮ʇ˦ʁ˺̼ͅʇʁੳ੮"͙͐੮ˑʇʡɘˑੴ੮ ˚ʇʁʮɻɘˑੴ੮ ɘ˦ʁ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ɘɻ͐˺̼ͅ੮ ɘ̼ʇ੮ ̹̼˺ʠ˺͙˦ʁˑ;੮ ɻ;˦ʮɻɘˑ੮ ɘɺ˺͙͐੮ ͐ʩʇʮ̼੮ ɻ˺ˑˑʇɻ͐ʮͷʇ੮ ɻɘ̹ɘɻʮ͐;੮͐˺੮ʇ˦ʠ˺̼ɻʇ੮ʁʮͅɻʮ̹ˑʮ˦ʇ੮ɘ˦ʁ੮ͅʇˑʠચ̼ʇʡ͙ˑɘ͐ʮ˺˦ੳ৿ਁ੮{;੮ʁʮʠʠʇ̼ʇ˦͐ʮɘ͐ʮ˺˦੮˺ʠ੮ʠ˺̼˚ͅ੮ ˺ʠ੮̹˺͸ʇ̼੮ʩʇˑ̹ͅ੮ɻɘ̹͙̼͐ʇ੮͐ʩʮͅ੮ʁʮͷʇ̼ʡʇ˦ɻʇੳ੮ˑ͐ʩ˺͙ʡʩ੮͐ʩʇ੮˚˺ͷʇ˚ʇ˦͐੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻʮͷʮˑ੮ commitments will increase the sovereign power wielded over those labeled as ͅʇ̼ʮ˺͙ͅˑ;੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑੴ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ͅ੮ʩɘͷʇ੮ͅʩ˺͸˦੮ˑʮ͐͐ˑʇ੮ɘ̹̹ʇ͐ʮ͐ʇ੮͐˺੮ɘ͙ͅͅ˚ʇ੮ʡ̼ʇɘ͐ʇ̼੮ ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩɘ͐੮ɻ˺ʇ̼ɻʮ˺˦੮ʩɘͅ੮ɘ˦;੮ʇ˦ʁ͙̼ʮ˦ʡ੮ʮ˚̹ɘɻ͐ੳ੮îʩʮͅ੮ʁʮͷʇ̼ʡʇ˦ɻʇ੮ʮͅ੮ ̹ɘ̼͐ˑ;੮ɘ੮̹̼˺ʁ͙ɻ͐੮˺ʠ੮ʁʇˑʇʡɘ͐ʮ˺˦ੵ੮͸ʩʮˑʇ੮̹̼ʮͷɘ͐ʇ੮ʇ˦͐ʮ͐ʮʇͅ੮ફɺʇ੮͐ʩʇ;੮̹̼ʮͅ˺˦ͅ੮˺̼੮U{)ͅબ੮ ɻɘ˦੮ɘ͙ͅͅ˚ʇ੮͐ʩʇ੮ɻ̼˺͸˦੮ɘ˦ʁ੮ʇͽʇ̼ɻʮͅʇ੮͐ʩʇ੮ɻ˺ʇ̼ɻʮͷʇ੮̹˺͸ʇ̼੮˺ʠ੮͐ʩʇ੮͐ͅɘ͐ʇੴ੮͐ʩʇ;੮ɻɘ˦˦˺͐੮ ϲʮˑˑ੮ʮ͐ͅ੮ɻ˺˺̼ʁʮ˦ɘ͐ʮ˦ʡ੮̼˺ˑʇੳ ͅ੮ ʮ˦੮ ͐ʩʇ੮ ɻɘͅʇ੮ ˺ʠ੮ ͐ʩʇ੮ ɘ˦ʇ˚ʮɻ੮ ɻ˺̼˺˦ɘͷʮ̼͙ͅ੮ ̹ɘ˦ʁʇ˚ʮɻ੮ ̼ʇ̹ͅ˺˦ͅʇੴ੮ ɘɺʁʮɻɘ͐ʇʁ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ̹ͅʇɘˌͅ੮ ͐˺੮ ʩ˺͸੮ ̹˺͸ʇ̼੮ ʮͅ੮ ʇͽʇ̼͐ʇʁ੮ ʮ˦੮ ɘ˦੮ ʇ̼ɘ੮ ˺ʠ੮ ʁʮ˚ʮ˦ʮͅʩʇʁ੮ ɘ̹ͅʮ̼ɘ͐ʮ˺˦ੳ੮ ુPɘ̼˚੮̼ʇʁ͙ɻ͐ʮ˺˦ૂ੮ʁ̼͙ʡ੮̹̼˺ʡ̼ɘ˚ͅੴ੮͙ͅɻʩ੮ɘͅ੮ુͅɘʠʇ੮ɻ˺˦͙ͅ˚̹͐ʮ˺˦ૂ੮ͅʮ͐ʇͅ੮͸ʩʇ̼ʇ੮̹ʇ˺̹ˑʇ੮ ͙ͅʇ੮ʮˑˑʮɻʮ͐੮͙ͅɺ͐ͅɘ˦ɻʇͅ੮͙˦ʁʇ̼੮͙̹ͅʇ̼ͷʮͅʮ˺˦ੴ੮̼ʇͷʇɘˑ੮ɘ੮ˌʮ˦ʁ੮˺ʠ੮ુ̹ɘˑˑʮɘ͐ʮͷʇ੮ʡ˺ͷʇ̼˦ɘ˦ɻʇੴૂ੮ ͸ʩʇ̼ʇɺ;੮ͅ˺ɻʮʇ͐;੮ʩ˺̹ʇͅ੮͐˺੮ˌʇʇ̹੮͙ͅʇ̼ͅ੮ɘˑʮͷʇ੮͸ʮ͐ʩ˺͙͐੮ͅʇʇˌʮ˦ʡ੮͐˺੮˚ɘˌʇ੮͐ʩʇ˚੮ͅ˺ɺʇ̼ੳ৿ਂ U˦੮ʮ˦͐ʇ̼˦ɘ͐ʮ˺˦ɘˑ੮ʁʇͷʇˑ˺̹˚ʇ˦͐੮ɘ˦ʁ੮ʡˑ˺ɺɘˑ੮̹͙ɺˑʮɻ੮ʩʇɘˑ͐ʩੴ੮̹ɘ͐ͅ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ʡʇɘ̼ʇʁ੮ toward building up modern health systems modeled on Western ones have been ̼ʇ̹ˑɘɻʇʁ੮ ɺ;੮ ̹̼˺ʡ̼ɘ˚ͅ੮ ͐˺੮ ʁʮ̼͐ͅʮɺ͙͐ʇ੮ ɺʇʁ੮ ˦ʇ͐ͅ੮ ˺̼੮ ʁʇ͸˺̼˚ʮ˦ʡ੮ ˚ʇʁʮɻɘ͐ʮ˺˦ੳ੮ îʩʇ;੮ measure success purely in lives saved.৿ਃ U˦੮ ɘ੮ ʩʮ͐ͅ˺̼ʮɻɘˑ੮ ˚˺˚ʇ˦͐੮ ͸ʩʇ˦੮ ͅ˺ɻʮʇ͐;੮ ʮͅ੮ ͅˌʇ̹͐ʮɻɘˑ੮ ˺ʠ੮ ̹ͅ;ɻʩʮɘ̼͐;ૄͅ੮ ɘɺʮˑʮ͐;੮ ͐˺੮ ̼ʇ͐ͅ˺̼ʇ੮ ˚ɘʁ੮ ̹ʇ˺̹ˑʇ੮ ͐˺੮ ʠ͙ˑˑ੮ ɻʮ͐ʮΈʇ˦ͅʩʮ̹੮ ɘ˦ʁ੮ ʮͅ੮ ̼ʇˑ͙ɻ͐ɘ˦͐੮ ͐˺੮ ϲʮ˦ɘ˦ɻʇ੮ ʇͷʇ˦੮ ɘ˦੮ ɘ͐͐ʇ˚̹͐ੴ੮̹̼ʇͷʇ˦͐ʮ˦ʡ੮ʁʇɘ͐ʩ੮˚ɘ;੮ɺʇ੮͐ʩʇ੮˺˦ˑ;੮ɻ˺˦ͅʇ˦͙ͅͅ੮ʡ˺ɘˑੳ੮"͙͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮

C O N C LU S I O N

285

ʮͅ੮ ɘ੮ ̼ʇ˚ʮ˦ʁʇ̼੮ ͐ʩɘ͐੮ ̹ɘˑˑʮɘ͐ʮͷʇ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ ɻɘ˦੮ ɺʇ੮ ʠ˺̼ɻʇʠ͙ˑ੮ ˺˦ʇͅੳ੮ U˦੮ ʠɘɻ͐ੴ੮ ˺͙̼੮ ̹͙ɺˑʮɻ੮ɘ͙͐ʩ˺̼ʮ͐ʮʇͅૄ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ʁ˺੮ɘ˦;͐ʩʮ˦ʡ੮˚˺̼ʇ੮͐ʩɘ˦੮ˌʇʇ̹੮̹ʇ˺̹ˑʇ੮ͅˑʮʡʩ͐ˑ;੮ɘɺ˺ͷʇ੮ ͐ʩʇ੮ʁʮͷʮʁʮ˦ʡ੮ˑʮ˦ʇ੮ɺʇ͐͸ʇʇ˦੮ˑʮʠʇ੮ɘ˦ʁ੮ʁʇɘ͐ʩ੮˚ɘ;ੴ੮ʮ˦੮̹̼ɘɻ͐ʮɻʇੴ੮ʁʇ͐ͅʮ˦ʇ੮͙ͅ੮͐˺੮͙ͅʇ੮ʠ˺̼ɻʇ੮ ˺ͷʇ̼੮ɘ˦ʁ੮˺ͷʇ̼੮ɘʡɘʮ˦ੴ੮͙˦͐ʮˑ੮͐ʩʇ੮˚˺͐ͅ੮˚ɘ̼ʡʮ˦ɘˑ੮̹ʇ˺̹ˑʇ੮ʮ˦੮ͅ˺ɻʮʇ͐;੮ʠɘˑˑੴ੮ʮ̼̼ʇ̼͐ʮʇͷɘɺˑ;ੴ੮ below that line.

MOVING PAST THE MYTHS Uʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮˺ʠʠʇ̼ͅ੮ɘ˦੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ʮ˦͐ʇ̼̹̼ʇ͐ɘ͐ʮ˺˦੮ʠ˺̼੮͐ʩʇ੮ʠɘʮˑʮ˦ʡͅ੮˺ʠ੮˺͙̼੮ ˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੴ੮ʮ͐੮ɘˑͅ˺੮˺ʠʠʇ̼ͅ੮ɘ੮ʁʮ͐ͅʮ˦ɻ͐ʮͷʇ੮ͅʇ͐੮˺ʠ੮̹̼ʇͅɻ̼ʮ̹͐ʮ˺˦ͅੳ੮îʩʇ੮˺̹̹˺ͅʮ͐ʇ੮˺ʠ੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮engaged authorityੵ੮ɘɻ͐ʮͷʇੴ੮ʮ˦͐ʇ˦͐ʮ˺˦ɘˑੴ੮ɘ˦ʁ੮ɘɻɻ˺͙˦͐ɘɺˑʇ੮ ͙ͅʇ੮ ˺ʠ੮ ͐ʩʇ੮ ͙˦ʮή͙ʇ੮ ɻ˺˺̼ʁʮ˦ɘ͐ʮ˦ʡ੮ ɘ˦ʁ੮ ̼ʇʡ͙ˑɘ͐˺̼;੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ˺ʠ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐ੳ੮ ä͙ɻʩ੮ɘ͙͐ʩ˺̼ʮ͐;੮ͅʩ˺͙ˑʁ੮ɺʇ੮ʁʮ̼ʇɻ͐ʇʁ੮͐˺͸ɘ̼ʁੴ੮ϲʮ̼͐ͅੴ੮ɻ̼ʇɘ͐ʮ˦ʡ੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ ˺̼ʡɘ˦ʮΈʇʁ੮ɘͅ੮ɘ˦੮ʇ˦͐ʮ͐ˑʇ˚ʇ˦͐੶੮ͅʇɻ˺˦ʁੴ੮ʮ˦ɻʇ˦͐ʮͷʮΈʮ˦ʡ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮ɻɘ̼ʇ੮͐ʩɘ͐੮ɘʁʁ̼ʇͅͅʇͅ੮ ͅ˺ɻʮɘˑ੮ɘͅ੮͸ʇˑˑ੮ɘͅ੮˚ʇʁʮɻɘˑ੮˦ʇʇʁͅ੶੮͐ʩʮ̼ʁੴ੮ɻ˺˦̼͙͐ͅɻ͐ʮ˦ʡ੮ɘ੮ʠ͙ˑˑ੮ɻ˺˦͐ʮ˦͙͙˚੮˺ʠ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ ̼͐ʇɘ͐˚ʇ˦͐੮͸ʮ͐ʩ੮ɘ੮̹͙ɺˑʮɻ੮ɺɘɻˌ͐ͅ˺̹੶੮ɘ˦ʁ੮ʠ˺͙̼͐ʩੴ੮̼ʇʁ͙ɻʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐˺੮ɘ˦੮ ʇͷʮʁʇ˦ɻʇચɺɘͅʇʁੴ੮͐ɘ̼ʡʇ͐ʇʁ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ੳ î˺੮ʡʇ͐੮͐ʩʇ̼ʇੴ੮͸ʇ੮˦ʇʇʁ੮͐˺੮ɻʩɘˑˑʇ˦ʡʇ੮͐͸˺੮ͅʩʮɺɺ˺ˑʇ͐ʩͅ੮͐ͅ˺ˌʮ˦ʡ੮͐ʩʇ੮ɻ˺˦ϲˑɘʡ̼ɘ͐ʮ˺˦੮ ˺ͷʇ̼੮̼ʇʠ˺̼˚ʮ˦ʡ੮rØäੳ੮Hʮ̼͐ͅ੮ʮͅ੮͐ʩʇ੮ુ˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘੳૂ੮U͐੮ʡ˺ʇͅ੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮ˑʮˌʇ੮ ͐ʩʮͅੵ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘ˦੮˺ɺˈʇɻ͐ʮͷʇˑ;੮ʮʁʇ˦͐ʮϲʮɘɺˑʇ੮ʡ̼˺͙̹੮˺ʠ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮ ˦˺͐੮ɘɺˑʇ੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮͐ʩʇʮ̼੮˺͸˦੮͙̼ͅͷʮͷɘˑ੶੮͐ʩɘ͐੮ʮ˦ɘɺʮˑʮ͐;੮ʮͅ੮ɻɘ͙ͅʇʁ੮ɺ;੮ͅʇͷʇ̼ʇ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘ˦ʁੴ੮ʇ̹ͅʇɻʮɘˑˑ;ੴ੮ɘ˦˺ͅ˺ʡ˦˺ͅʮɘ੶੮rØä੮ʁʇϲʮ˦ʇʁ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ͅ˺੮˦ɘ̼̼˺͸ˑ;੮ ͐ʩɘ͐੮ʮ͐੮ʠɘʮˑͅ੮͐˺੮ɻɘ̹͙̼͐ʇ੮˚ɘ˦;੮ʮ˦੮͐ʩɘ͐੮̹˺̹͙ˑɘ͐ʮ˺˦੶੮̼ʇʁʇϲʮ˦ʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͸ʮˑˑ੮ ʡʇ͐੮͐ʩɘ͐੮ʡ̼˺͙̹੮ʮ˦͐˺੮ˑʮʠʇͅɘͷʮ˦ʡ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇੳ৿਄੮š̹̹˺˦ʇ˦͐ͅ੮˺ʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɘ̼ʇ੮ɘ͐੮͐ʮ˚ʇͅ੮͙͐ͅɻˌ੮ʮ˦੮ɘ੮ͅʇɻ˺˦ʁ੮˚;͐ʩੴ੮͐ʩʇ੮ુ˚;͐ʩ੮˺ʠ੮Ûʇɘʡɘ˦ੳૂ੮H̼˺˚੮͐ʩʮͅ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇੴ੮ʩɘʁ੮I˺ͷʇ̼˦˺̼੮Ûʇɘʡɘ˦੮˦˺͐੮ʡ͙͐͐ʇʁ੮͐ʩʇ੮ɻ˺˚˚͙˦ʮ͐;੮ɻɘ̼ʇ੮ͅ;͐ͅʇ˚ઝɘ˦ʁ੮ˑɘ͐ʇ̼ੴ੮ ɘͅ੮ ̹̼ʇͅʮʁʇ˦͐ੴ੮ ʠ͙˦ʁʮ˦ʡ੮ ʠ˺̼੮ ɺ˺͐ʩ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɘ˦ʁ੮ ʩ˺͙ͅʮ˦ʡ਀৻ઝ͐ʩʇ੮ ̼ʇ̹ˑɘɻʇ˚ʇ˦͐੮ ˺ʠ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮͸ɘ̼ʇʩ˺͙ͅʮ˦ʡ੮͸ʮ͐ʩ੮ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚͙˦ʮ͐;ચɺɘͅʇʁ੮ͅʇ̼ͷʮɻʇͅ੮͸˺͙ˑʁ੮ ʩɘͷʇ੮͸˺̼ˌʇʁ੮˺͙͐ੳ਀ৼ੮੮ʡʇ˦ʇ̼˺͙ͅ੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇ੮ɘ˦ʁ੮ɘ੮͙˦ʮͷʇ̼ͅɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੴ੮˦˺͐੮ ɘ˦੮ʇͽ̹ɘ˦ͅʮ˺˦੮˺ʠ੮˚ʇʁʮɻɘˑચˑʇʡɘˑ੮ɻ˺˦̼͐˺ˑੴ੮ɘ̼ʇ੮͐ʩʇ੮ɘ˦͐ʮʁ˺͐ʇ੮͐˺੮͐ʩʇ੮ɻ̼ʮͅʮͅ੮˺˦੮#ɘˑʮʠ˺̼nia’s streets. îʩʇ੮ʩɘ̼ʁ੮̼͙͐͐ʩ੮ʠ˺̼੮ɘʁʩʇ̼ʇ˦͐ͅ੮͐˺੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʮͅ੮͐ʩɘ͐ੴ੮ʇͷʇ˦੮ɺ̼ɘɻˌʇ͐ʮ˦ʡ੮ɻ˺˦ɻʇ̼˦ͅ੮ɘɺ˺͙͐੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅੴ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮͙˦ˑʮˌʇˑ;੮͐˺੮ʇͽ͐ʇ˦ʁ੮ ɻ˺ʇ̼ɻʮͷʇ੮ɻɘ̼ʇ੮͐˺੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘʁͷ˺ɻɘ͐ʇͅ੮͐ʩʮ˦ˌ੮˦ʇʇʁ੮ʮ͐ੳ਀৽੮îʩʇ̼ʇ੮ɘ̼ʇ੮͐ʩ̼ʇʇ੮̹ʮʇɻʇͅ੮˺ʠ੮ ʇͷʮʁʇ˦ɻʇ੮ʠ˺̼੮͐ʩʮͅੳ੮Hʮ̼͐ͅੴ੮̹ɘ͐ͅ੮̼ʇʠ˺̼˚ͅ੮͐˺੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʮ˦੮˺͐ʩʇ̼੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮

286

C O N C LU S I O N

ʡʇ˦ʇ̼ɘˑˑ;੮ʠɘʮˑʇʁ੮͐˺੮̹̼˺ʁ͙ɻʇ੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮ɻʩɘ˦ʡʇͅ੮ʮ˦੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɘʁ˚ʮͅͅʮ˺˦ͅੳ਀৾੮äʇɻ˺˦ʁੴ੮ʮ˦͐ʇ̼˦ɘ͐ʮ˺˦ɘˑˑ;ੴ੮̼ɘ͐ʇͅ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ʁ˺੮˦˺͐੮ͷɘ̼;੮͸ʮ͐ʩ੮ˑɘ͸ͅ੶੮ɻ˺͙˦̼͐ʮʇͅ੮͸ʮ͐ʩ੮ˑ˺˺ͅʇ੮˦ʇʇʁચʠ˺̼ચ̼͐ʇɘ͐˚ʇ˦͐੮͐ͅɘ˦ʁɘ̼ʁͅ੮ʁ˺੮˦˺͐੮ͅ;͐ͅʇ˚ɘ͐ʮɻɘˑˑ;੮ʩ˺̹ͅʮ͐ɘˑʮΈʇ੮ people more than countries with tight dangerousness-based ones.਀৿੮îʩʮͅ੮͙ͅʡʡʇ͐ͅͅ੮ ɘ੮͐ʩʮ̼ʁ੮ɻˑɘʮ˚ੵ੮ɘͅ੮Uૄͷʇ੮ɘ̼ʡ͙ʇʁ੮͐ʩ̼˺͙ʡʩ˺͙͐੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ɘ̼ʇ੮ʁʇϲʮ˦ʇʁ੮˦˺͐੮ ɺ;੮ˑʇʡɘˑ੮͐ͅɘ͙͐͐ʇͅ੮ɘ˦ʁ੮ˑʇʡʮͅˑɘ͐ʮ˺˦੮ɺ͙͐੮ɺ;੮ϲʮ˦ɘ˦ɻʮɘˑ੮ʮ˦ɻʇ˦͐ʮͷʇͅੴ੮̼ʇͅ˺͙̼ɻʇ੮ɘͷɘʮˑɘɺʮˑʮ͐;ੴ੮ and local bureaucratic imperatives.਀਀੮îʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠɘˑͅʇˑ;੮ɘ͙ͅͅ˚ʇͅ੮͐ʩɘ͐੮ #ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮ͅʩ˺̼͐੮˺˦੮ɻ˺ʇ̼ɻʇʁ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘ̼ʇੴ੮͸ʩʇ̼ʇɘͅ੮U੮ʩɘͷʇ੮ɘ̼ʡ͙ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ ̹̼˺ɺˑʇ˚੮ʮͅ੮ɘ੮ʠɘʮˑ͙̼ʇ੮͐˺੮ʮ˦͐ʇʡ̼ɘ͐ʇ੮ɻ˺ʇ̼ɻʮ˺˦ੴ੮͸ʩʮɻʩ੮ʮͅ੮ɘɻ͙͐ɘˑˑ;੮ή͙ʮ͐ʇ੮ʠ̼ʇή͙ʇ˦͐ੴ੮ʮ˦͐˺੮ any concerted and coordinated system. îʩʇ̼ʇ੮ɘ̼ʇ੮ɻʇ̼͐ɘʮ˦ˑ;੮͐͸ʇɘˌͅ੮͐˺੮rØä੮̹̼˺ɻʇʁ͙̼ʇͅ੮͐ʩɘ͐੮ɻ˺͙ˑʁ੮̼͐ͅʇɘ˚ˑʮ˦ʇ੮͐ʩʇ੮̹̼˺cess without gutting protections.਀ਁ੮"͙͐੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʩɘͅ੮ˑʇʁ੮ɘʁͷ˺ɻɘ͐ʇͅ੮ ͐˺੮̹˺͙̼੮͐˺˺੮˚͙ɻʩ੮ʇʠʠ˺̼͐੮ʮ˦͐˺੮ͅʇʇˌʮ˦ʡ੮rØä੮̼ʇʠ˺̼˚ͅ੮͐ʩɘ͐੮ʩɘͷʇ੮̹̼˺ͷʇ˦ੴ੮͐ʮ˚ʇ੮ɘ˦ʁ੮ ͐ʮ˚ʇ੮ɘʡɘʮ˦ੴ੮͐˺੮ɺʇ੮ɘ੮ɺɘʁ੮͙ͅʇ੮˺ʠ੮̹˺ˑʮ͐ʮɻɘˑ੮ɻɘ̹ʮ͐ɘˑੳ੮I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮ɘɻˌ˦˺͸ˑʇʁʡʇʁ੮ ɘͅ੮˚͙ɻʩ੮͸ʩʇ˦੮ʩʮͅ੮͐ʇɘ˚੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮ɘ͐͐ʇ˚̹͐ͅ੮͐˺੮ʇͽ̹ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩɘʁ੮ ɻ̼ʇɘ͐ʇʁ੮ુ˚ɘ˦;੮ʁʇɻɘʁʇͅ੮˺ʠ੮ɺɘ͐͐ˑʇ੮ͅɻɘ̼ͅੴ੮ʩ͙̼͐੮ʠʇʇˑʮ˦ʡͅੴ੮ɘ˦ʁ੮ʇ˦̼͐ʇ˦ɻʩʇʁ੮˺̹ʮ˦ʮ˺˦ͅੴૂ੮ ͐˺੮ˑʮ͐͐ˑʇ੮ʇʠʠʇɻ͐ੳ਀ਂ੮Ěʇ͐੮͐ʩʇ੮ʮ˚˚ʇʁʮɘ͐ʇ੮ʁʮͅ˚ʮͅͅɘˑ੮˺ʠ੮‡ʇ͸ͅ˺˚ૄͅ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮̹̼˺̹˺ͅɘˑੴ੮ #Û/੮ɻ˺͙̼͐ͅੴ੮͸ɘͅ੮ɘ੮̼ʇ˚ʮ˦ʁʇ̼੮͐ʩɘ͐੮˚ɘ˦;੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮ɘʁͷ˺ɻɘ͐ʇͅੴ੮ͅʇ̼ͷʮɻʇ੮͙ͅʇ̼ͅੴ੮ ɘ˦ʁ੮ ɻ˺˚˚͙˦ʮ͐;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ̹̼˺ͷʮʁʇ̼ͅ੮ ͅʇʇ੮ ʇͽ̹ɘ˦ͅʮ˺˦ͅ੮ ˺ʠ੮ ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ɘͅ੮ ɘ˦੮ ʇͽʮ͐ͅʇ˦͐ʮɘˑ੮ ͐ʩ̼ʇɘ͐੮ ʮ˚̹ʇ̼ͷʮ˺͙ͅ੮ ͐˺੮ ɻ˺˚̹̼˺˚ʮͅʇੳ਀ਃ੮ ˑʮʇ˦ɘ͐ʮ˦ʡ੮ ͐ʩʇͅʇ੮ ʡ̼˺͙̹ͅ੮ ʮ˦੮ ɘ੮ ˌ˦˺ɻˌચʁ˺͸˦ੴ੮ʁ̼ɘʡચ˺͙͐੮ϲʮʡʩ͐੮˺ͷʇ̼੮rØä੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʮͅ੮ɘ੮̹̼˺ɺˑʇ˚੮ɺʇɻɘ͙ͅʇ੮͐ʩ˺ͅʇ੮ʡ̼˺͙̹ͅ੮ ɘ̼ʇ੮ʇͅͅʇ˦͐ʮɘˑ੮͐˺੮̼ʇʠ˺̼˚ʮ˦ʡ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮˦˺ͅ˺ʡ˦˺ͅʮɘ੮ʮ͐ͅʇˑʠ੮ʮͅ੮˦˺͐੮ɘ੮ ˚;͐ʩੳ੮"͙͐੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮͙ͅʡʡʇ͐ͅͅ੮͐ʩɘ͐੮͐ʩʇ੮̼ʇ̹ͅ˺˦ͅʇ੮͐˺੮ɘ˦˺ͅ˺ʡ˦˺ͅʮɘ੮ʩɘͅ੮ ͐˺੮ɺʇ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅઝ͸ʩʮɻʩ੮͐ʩʇͅʇ੮ʡ̼˺͙̹ͅ੮ɻɘ˦੮ʩʇˑ̹੮ ʁʇͷʇˑ˺̹ઝ͐ʩɘ͐੮ɻɘ˦੮ɺ̼ʮ˦ʡ੮˚ɘ˦;੮̹ʇ˺̹ˑʇ੮ʁʇʇ˚ʇʁ੮ˑɘɻˌʮ˦ʡ੮ʮ˦੮ʮ˦ͅʮʡʩ͐੮ʮ˦͐˺੮ɻɘ̼ʇੳ îʩʇ੮˺͐ʩʇ̼੮ͅʮʁʇ੮˺ʠ੮͐ʩʇ੮ʁʇɺɘ͐ʇ੮˦ʇʇʁͅ੮͐˺੮ɻ˺˦ʠ̼˺˦͐੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮Ûʇɘʡɘ˦ੳ੮r˺˺ˌʮ˦ʡ੮ ɘ͐੮ͅʮͽ͐;ચ̹ˑ͙ͅ੮;ʇɘ̼ͅ੮˺ʠ੮ϲʮͅɻɘˑ੮ʠʇɘ͐ͅ੮ɘ˦ʁ੮ʠɘ˚ʮ˦ʇ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮Uૄ˚੮ɻ˺˚ʠ˺̼͐ɘɺˑʇ੮ͅɘ;ʮ˦ʡ੮ ͐ʩɘ͐੮̹̼˺̹ʇ̼ˑ;੮ʠ͙˦ʁʮ˦ʡ੮͐ʩʇ੮ͷ˺ˑ͙˦͐ɘ̼;੮˺͙̹͐ɘ͐ʮʇ˦͐੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩɘ͐੮Ûʇɘʡɘ˦੮ʇͷʮͅɻʇ̼ɘ͐ʇʁ੮͸˺͙ˑʁ੮ɺʇ੮ʡ˺˺ʁ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੳ੮"͙͐੮ʮ͐੮ʮͅ˦ૄ͐੮ή͙ʮ͐ʇ੮ͅ˺੮ ͅʮ˚̹ˑʇ੮͐˺੮͐ʩ̼˺͸੮͐ʩʮ˦ʡͅ੮ʮ˦͐˺੮̼ʇͷʇ̼ͅʇੵ੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ͅ˺੮ɘˑʮʇ˦ɘ͐ʇʁ੮͐ʩɘ͐੮ˈ͙͐ͅ੮ʠ͙˦ʁʮ˦ʡ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩɘ͐੮ͅʩ˺͙ˑʁ੮ʩɘͷʇ੮ʇͽʮ͐ͅʇʁੴ੮ɘ˦ʁ੮͐ʩɘ͐੮͐ʩʇ;੮͸˺͙ˑʁ੮ʩɘͷʇ੮ɘɻɻʇ̹͐ʇʁੴ੮ʁʇɻɘʁʇͅ੮ ɘʡ˺੮͸˺˦ૄ͐੮ʇ˦͙̼ͅʇ੮͐ʩʇ;੮ʡʇ͐੮͐ʩʇ੮ɻɘ̼ʇ੮͐ʩʇ;੮˦ʇʇʁੴ੮ɺ͙͐੮ɘ̼ʇ੮̼ʇʠ͙ͅʮ˦ʡੴ੮͐˺ʁɘ;ੳ Ĕʩʇ˦੮U੮ɘͅˌʇʁ੮î˺ɺ;੮/͸ʮ˦ʡੴ੮͐ʩʇ੮ʇͽʇɻ͙͐ʮͷʇ੮ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ šͷʇ̼ͅʮʡʩ͐੮ ɘ˦ʁ੮ ɻɻ˺͙˦͐ɘɺʮˑʮ͐;੮ #˺˚˚ʮͅͅʮ˺˦੮ ફ͸ʩʮɻʩ੮ ˺ͷʇ̼ͅʇʇͅ੮ ͐ʩʇ੮ ͙ͅʇ੮ ˺ʠ੮ {Pä੮˚˺˦ʇ;બੴ੮͐˺੮ʁʇͅɻ̼ʮɺʇ੮͐ʩʇ੮͐ͅɘ͐ʇ੮˺ʠ੮͐ʩʇ੮ુͅ;͐ͅʇ˚ૂ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅੴ੮ʩʇ੮̼ʇˈʇɻ͐ʇʁ੮͐ʩʇ੮̹̼ʇ˚ʮͅʇ੮˺ʠ੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮ʮ͐ͅʇˑʠੵ੮ુĔʇ੮ʁ˺˦ૄ͐੮ʩɘͷʇ੮ɘ੮˚ʇ˦͐ɘˑ੮

C O N C LU S I O N

287

ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੴ੮͸ʇ੮ʩɘͷʇ੮৵ੴৰৰৰચ˺ʁʁ੮̹̼˺ʡ̼ɘ˚ͅੳ੮îʩʮͅ੮ʮͅ੮ɘ੮˚˺ͅɘʮɻ੮˺ʠ੮̹̼˺ʡ̼ɘ˚ͅੴ੮ɘ˦ʁ੮ɘ੮ ˚˺ͅɘʮɻ੮ɻ˺͙ˑʁ੮ɺʇ੮ɺʇɘ͙͐ʮʠ͙ˑੴ੮ɺ͙͐੮ʮ˦੮͐ʩʮͅ੮ɻɘͅʇੴ੮ʮ͐੮ʮͅ˦ૄ͐ੳૂ੮Ĕʮ͐ʩ੮͐ʇ˦੮͐ʩ˺͙ͅɘ˦ʁ੮̹̼˺ʡ̼ɘ˚ͅੴ੮ ʮ͐੮ɻ˺͙ˑʁ੮͐ͅʮˑˑ੮ɺʇ੮̼͙͐ʇ੮͐ʩɘ͐੮˦˺˦ʇ੮˺ʠ੮͐ʩʇ˚੮ʮ˦੮ɘ੮ʡʮͷʇ˦੮ɻ˺͙˦͐;੮͸˺͙ˑʁ੮ɘɻɻʇ̹͐੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʮ͐ʩ੮ɘ੮ɻʩ̼˺˦ʮɻ੮͙ͅɺ͐ͅɘ˦ɻʇ੮ɘɺ͙ͅʇ੮̹̼˺ɺˑʇ˚ੴ੮ɻ˺ʡ˦ʮ͐ʮͷʇ੮ʮ˚̹ɘʮ̼˚ʇ˦͐ͅੴ੮ɘ˦ʁ੮ʩʮ͐ͅ˺̼;੮ ˺ʠ੮ͷʮ˺ˑʇ˦͐੮ɺʇʩɘͷʮ˺̼ੳ੮îʩʇ੮˚;͐ʩ੮˺ʠ੮Ûʇɘʡɘ˦ੴ੮ͅ˺੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ʠ͙˦ʁʮ˦ʡੴ੮ͅʮʁʇ͐ͅʇ̹ͅ੮͐ʩʇ੮˦ʇʇʁ੮ʠ˺̼੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩɘ͐੮̹̼˺ͷʮʁʇ̼ͅ੮ ɘɻ͙͐ɘˑˑ;੮ͅʇ̼ͷʇ੮͐ʩʇ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ɻʩɘˑˑʇ˦ʡʮ˦ʡੴ੮ɘ˦ʁ੮˺ɻɻɘͅʮ˺˦ɘˑˑ;੮ʇͷʇ˦੮͙˦̹ˑʇɘͅɘ˦͐੮˺̼੮ ʩ˺͐ͅʮˑʇੴ੮̹ʇ˺̹ˑʇ੮ɘ͐੮̼ʮͅˌ੮˺ʠ੮ʡ˺ʮ˦ʡ੮˺˦͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ îʩʇ੮ϲʮ̼͐ͅ੮̹̼ʮ˦ɻʮ̹ˑʇ੮ʠ˺̼੮̼ʇʠ˺̼˚ੴ੮͐ʩʇ˦ੴ੮ʮͅ੮͐˺੮ɻ˺˦̼͙͐ͅɻ͐੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੴ੮˦˺͐੮ ˈ͙͐ͅ੮ɘ੮ͅ˚˺̼ʡɘͅɺ˺̼ʁ੮˺ʠ੮ͅʇ̼ͷʮɻʇͅੳ੮H˺̼͙͐˦ɘ͐ʇˑ;ੴ੮͐ʩʇ̼ʇ੮ʮͅ੮ɘˑ̼ʇɘʁ;੮ɘ੮˚˺ʁʇˑ੮˺ʠ੮͸ʩɘ͐੮͐ʩɘ͐੮ ˚ʮʡʩ͐੮ˑ˺˺ˌ੮ˑʮˌʇੵ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ͅ;͐ͅʇ˚੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅੳ੮ îʩʇ੮ৱ৹৶৹੮rɘ˦͐ʇ̼˚ɘ˦੮{ʇ˦͐ɘˑ੮Ûʇ͐ɘ̼ʁɘ͐ʮ˺˦੮ɻ͐੮ફ;ʇͅੴ੮ʮ͐ૄͅ੮͐ʩʇ੮ͅɘ˚ʇ੮H̼ɘ˦ˌ੮rɘ˦͐ʇ̼˚ɘ˦બ੮ʁʇɻˑɘ̼ʇʁ੮͐ʩɘ͐੮ુ͐ʩʇ੮͐ͅɘ͐ʇ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘ੮ɘɻɻʇ̹͐ͅ੮ɘ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮ʮ͐ͅ੮˚ʇ˦͐ɘˑˑ;੮̼ʇ͐ɘ̼ʁʇʁ੮યsicર੮ɻʮ͐ʮΈʇ˦ͅ੮ɘ˦ʁ੮ɘ˦੮˺ɺˑʮʡɘ͐ʮ˺˦੮͐˺੮͐ʩʇ˚੮͸ʩʮɻʩ੮ʮ͐੮˚͙͐ͅ੮ʁʮͅɻʩɘ̼ʡʇੳૂ਀਄ îʩʇ੮ ͐ͅɘ͐ʇ੮ ʮͅ੮ ˦˺͐੮ ɘ੮ ʁʮ̼ʇɻ͐੮ ͅʇ̼ͷʮɻʇ੮ ̹̼˺ͷʮʁʇ̼ੳ੮ U˦͐ͅʇɘʁੴ੮ ʮ͐੮ ˺̼ʡɘ˦ʮΈʇͅ੮ Ûʇʡʮ˺˦ɘˑ੮ #ʇ˦͐ʇ̼ͅ੮͐ʩɘ͐੮ɘ̼ʇ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮ʇͷɘˑ͙ɘ͐ʮ˦ʡ੮ɘ˦;˺˦ʇ੮ʮ˦੮ɘ੮ʡʇ˺ʡ̼ɘ̹ʩʮɻ੮ɻɘ͐ɻʩ˚ʇ˦͐੮ɘ̼ʇɘੴ੮ ʁʇͅʮʡ˦ʮ˦ʡ੮ɘ੮̹ʇ̼ͅ˺˦ɘˑʮΈʇʁ੮ɻɘ̼ʇ੮̹ˑɘ˦ੴ੮ɘ˦ʁ੮ɻ˺˦̼͐ɘɻ͐ʮ˦ʡ੮ʠ˺̼੮͐ʩ˺ͅʇ੮̹ͅʇɻʮϲʮɻ੮ͅʇ̼ͷʮɻʇͅੳ Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮͸ʇ̼ʇ੮ɘˑͅ˺੮˺˦ɻʇ੮ˑʇʠ͐੮͐˺੮̼˺͐੮ʮ˦੮͐ͅɘ͐ʇ੮ʠɘɻʮˑʮ͐ʮʇͅੳ੮ õ˦ˑʮˌʇ੮ ʮ˦੮ ͐ʩʇ੮ ɻɘͅʇ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅੴ੮ ͐ʩ˺͙ʡʩੴ੮ ʠʇ͸੮ ̹ʇ˺̹ˑʇ੮ ɘ̼ʇ੮ ɻɘˑˑʮ˦ʡ੮͐˺੮͙˦ʁ˺੮͐ʩʇʮ̼੮ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦ੳਁ৻੮U˦ʁʇʇʁੴ੮ʮ͐੮ʮͅ੮̼ʇͷʇɘˑʮ˦ʡ੮͐ʩɘ͐੮˚ɘ˦;੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ ɻʮ͐ʇʁ੮ ͙ͅɻɻʇͅͅ੮ ͐ͅ˺̼ʮʇͅ੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ʇͽʮ͐ʮ˦ʡ੮ ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ˺̼੮ ɘ੮ ɻ;ɻˑʇ੮ ˺ʠ੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅ੮͐ʩɘ˦ˌͅ੮͐˺੮͐ʩʇ੮ʁʮͅɻ˺ͷʇ̼;੮˺ʠ੮ɘ੮ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ʁʮͅɘɺʮˑʮ͐;੮͐ʩɘ͐੮ʡ˺͐੮ ͐ʩʇ˚੮ ˑʮ˦ˌʇʁ੮ ͐˺੮ Ûʇʡʮ˺˦ɘˑ੮ #ʇ˦͐ʇ̼ͅ੮ ફ˺̼੮ ˚ʮˑʮ͐ɘ̼;੮ ͅʇ̼ͷʮɻʇ੮ ͐ʩɘ͐੮ ή͙ɘˑʮϲʮʇʁ੮ ͐ʩʇ˚੮ ʠ˺̼੮ ͐ʩʇ੮ ēʇ͐ʇ̼ɘ˦ͅ੮ ʠʠɘʮ̼ͅ੮ ʩʇɘˑ͐ʩ੮ ɻɘ̼ʇ੮ ͅ;͐ͅʇ˚ੴ੮ ͸ʩʮɻʩ੮ ˚ɘˌʇͅ੮ ɘ੮ ͅʮ˚ʮˑɘ̼ˑ;੮ ˺̹ʇ˦ચʇ˦ʁʇʁ੮ commitment). #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ̹̼˺ͷʮͅʮ˺˦ʮ˦ʡ੮ ʠ˺̼੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ ʮͅ੮ ɘ˦੮ ʮ˚̹ʇ̼ʠʇɻ͐੮ͅ;͐ͅʇ˚੮˚ɘ̼ˌʇʁ੮ɺ;ੴ੮ɘ˚˺˦ʡ੮˺͐ʩʇ̼੮͐ʩʮ˦ʡͅੴ੮͙˦ʁʇ̼ʠ͙˦ʁʇʁ੮ͅʇ̼ͷʮɻʇͅੴ੮˺ͷʇ̼ˑ;੮ ̼ʇ̼͐ͅʮɻ͐ʮͷʇ੮ʇˑʮʡʮɺʮˑʮ͐;੮ɻ̼ʮ͐ʇ̼ʮɘੴਁৼ੮ɘ˦ʁੴ੮;ʇͅੴ੮ʮ˚ɺ̼ʮɻɘ͐ʮ˺˦੮͸ʮ͐ʩ੮͐ʩʇ੮ɘɺ͙ͅʇ੮ɘ˦ʁ੮˺ͷʇ̼͙ͅʇ੮ ˺ʠ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳਁ৽੮"͙͐੮ʮ͐ૄͅ੮ɺɘͅʇʁ੮˺˦੮͐ʩʇ੮̼ʮʡʩ͐੮̹̼ʮ˦ɻʮ̹ˑʇੵ੮ʮ˦ʁʮͷʮʁ͙ɘˑʮΈʇʁ੮ ͅʇ̼ͷʮɻʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮̹̼˺ͷʮʁʇʁ੮ɘͅ੮̹ɘ̼͐੮˺ʠ੮ɘ˦੮ʇ˦͐ʮ͐ˑʇ˚ʇ˦͐ੴ੮˦˺͐੮ુ͐˺੮͐ʩʇ੮ʇͽ͐ʇ˦͐੮̼ʇͅ˺͙̼ɻʇͅ੮ ɘ̼ʇ੮ ɘͷɘʮˑɘɺˑʇૂ੮ ફɘͅ੮ ʮ˦੮ ͐ʩʇ੮ ̹͙ɺˑʮɻ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚બੳ੮ I˺ͷʇ̼˦˺̼੮ ‡ʇ͸ͅ˺˚੮ ʩɘͅ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮͐˺͙͐ʇʁ੮͐ʩʇ੮ɺʮˑˑʮ˺˦ͅ੮ʩʇ੮ʮͅ੮̹͙˚̹ʮ˦ʡ੮ʮ˦͐˺੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ɘ˦ʁ੮ʩ˺͙ͅʮ˦ʡੴ੮ ͙̹̹ͅˑʇ˚ʇ˦͐ʇʁ੮ ɺ;੮ ɘ੮ ˦ʇ͸੮ ʠʇʁʇ̼ɘˑ੮ ͸ʮ˦ʁʠɘˑˑ੮ ʠ˺̼੮ ɻ̼ʮͅʮͅ੮ ͅʇ̼ͷʮɻʇͅ੮ ફʠ̼˺˚੮ ͐ʩʇ੮ ৲ৰ৲৲੮ Ø̼˺͐ʇɻ͐ʮ˦ʡ੮š͙̼੮nʮʁͅ੮ʡ͙˦੮ɻ˺˦̼͐˺ˑ੮ɺʮˑˑબੳ੮"͙͐੮̹ʇ̼ʮ˺ʁͅ੮˺ʠ੮ɘɺ͙˦ʁɘ˦ɻʇ੮ʩɘͷʇ੮͐˺˺੮˺ʠ͐ʇ˦੮ ɺʇʇ˦੮ʠ˺ˑˑ˺͸ʇʁ੮ɺ;੮ɺ̼͙͐ɘˑ੮ɺʇˑ͐ચ͐ʮʡʩ͐ʇ˦ʮ˦ʡੳ੮੮ˑʇʡɘˑ੮ʇ˦͐ʮ͐ˑʇ˚ʇ˦͐ੴ੮ʇ˦ʠ˺̼ɻʇɘɺˑʇ੮ɺ;੮͐ʩʇ੮ ɻ˺͙̼͐ͅੴ੮ʮͅ੮˺˦ʇ੮͐˺˺ˑ੮͐˺੮ʇ˦͙̼ͅʇ੮ɘ˦੮ʇ˦ʁ͙̼ʮ˦ʡ੮ɻ˺˚˚ʮ͐˚ʇ˦͐ੳ

288

C O N C LU S I O N

äʇɻ˺˦ʁੴ੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮˦ʇʇʁͅ੮ͅʇ̼ͷʮɻʇͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ɘɻɻ˺͙˦͐ɘɺˑʇ੮ʠ˺̼੮˺ͷʇ̼ɻ˺˚ʮ˦ʡ੮ɘ੮ͷʇ̼;੮̼ʇɘˑ੮̹̼˺ɺˑʇ˚ੵ੮̹ʇ˺̹ˑʇ੮̼ʇʠ͙ͅʮ˦ʡ੮ɻɘ̼ʇ੮͐ʩɘ͐੮ɻˑʮ˦ʮɻʮɘ˦ͅੴ੮˺̼੮ͅ˺ɻʮʇ͐;੮͸̼ʮ͐੮ ˑɘ̼ʡʇੴ੮ ɘ̼ʇ੮ ɻ˺˦ͷʮ˦ɻʇʁ੮ ͐ʩʇ;੮ ˦ʇʇʁੳ੮ Øɘ̼͐ʮͅɘ˦ͅ੮ ʠ˺̼੮ ̹͙̼ʇˑ;੮ ͷ˺ˑ͙˦͐ɘ̼;੮ ͅʇ̼ͷʮɻʇͅ੮ ͅʩ˺͙ˑʁ੮ ʡʮͷʇ੮ͅ˺˚ʇ੮ʡ̼˺͙˦ʁ੮ɘ˦ʁ੮ɘɻɻʇ̹͐੮ɘ੮˚˺ʁʇˑ੮˺ʠ੮ʁ˺ʡʡʇʁੴ੮̹ʇ̼ͅʮ͐ͅʇ˦͐੮˺͙̼͐ʇɘɻʩ੮͐ʩɘ͐੮ʁ˺ʇͅ˦ૄ͐੮ ͐ɘˌʇ੮ુ˦˺ૂ੮ʠ˺̼੮ɘ˦੮ɘ˦ͅ͸ʇ̼੮ɘ˦ʁ੮͸˺̼ˌͅ੮̼ʇˑʇ˦͐ˑʇͅͅˑ;੮͐˺੮ʡʇ͐੮͐˺੮ુ;ʇͅੳૂ੮/˦ʡɘʡʇ˚ʇ˦͐੮ͅʩ˺͙ˑʁ੮ ˑʇɘʁ੮͸ʮ͐ʩ੮͸ʩɘ͐੮̹ʇ˺̹ˑʇ੮ɘɻ͙͐ɘˑˑ;੮͸ɘ˦͐ੴ੮͸ʩʮɻʩ੮ʮͅ੮˺ʠ͐ʇ˦੮ͅ˺ɻʮɘˑ੮͙̹̹ͅ˺̼͐ͅ੮̼ɘ͐ʩʇ̼੮͐ʩɘ˦੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘ̼ʇੳ੮ˑ͐ʩ˺͙ʡʩੴ੮ʮ˦੮̹̼ʮ˦ɻʮ̹ˑʇੴ੮͐ʩʮͅ੮ʮͅ੮͸ʩɘ͐੮H͙ˑˑચäʇ̼ͷʮɻʇ੮Øɘ̼͐˦ʇ̼ͅʩʮ̹ͅੴ੮ ͅͅʮ͐ͅʇʁ੮š͙̹͐ɘ͐ʮʇ˦͐੮î̼ʇɘ͐˚ʇ˦͐ੴ੮˺̼੮/ɘ̼ˑ;੮U˦͐ʇ̼ͷʇ˦͐ʮ˺˦੮ʮ˦੮Øͅ;ɻʩ˺ͅʮͅ੮̹̼˺ʡ̼ɘ˚ͅ੮ɘ̼ʇ੮ ɘˑ̼ʇɘʁ;੮ ʁ˺ʮ˦ʡੴ੮ ɘ੮ ˑɘɻˌ੮ ˺ʠ੮ ͐ͅɘ͐ʇ͸ʮʁʇ੮ ɘ͙͐ʩ˺̼ʮ͐;੮ ʩɘͅ੮ ˚ʇɘ˦͐੮ ͐ʩɘ͐੮ ͐ʩʇͅʇ੮ ˚˺ʁʇˑͅ੮ ɘ̼ʇ੮ ʮ˚̹ˑʇ˚ʇ˦͐ʇʁ੮ ʩɘ̹ʩɘΈɘ̼ʁˑ;ੳ੮ îʩʇ;੮ ͐˺˺੮ ˺ʠ͐ʇ˦੮ ʁ˺˦ૄ͐੮ ɘʁʩʇ̼ʇ੮ ͐˺੮ ͐ʩʇ੮ ʇͷʮʁʇ˦ɻʇચɺɘͅʇʁ੮ ˚˺ʁʇˑͅ੮ʮʁʇ˦͐ʮϲʮʇʁ੮ʮ˦੮͐ʩʇ੮ˑʮ͐ʇ̼ɘ͙̼͐ʇੳਁ৾ Uʁʇ˦͐ʮʠ;ʮ˦ʡ੮ɘ੮˚˺̼ʇ੮̼˺ɺ͙͐ͅ੮ɘ̹̹̼˺ɘɻʩ੮ʮͅ੮˦˺͐੮ʩɘ̼ʁੳ੮{˺̼ʇ੮͐ʩɘ˦੮ɘ੮ʁ˺Έʇ˦੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ʩɘʁ੮̼͐ɘʮ˦ʇʁ੮ʮ˦੮‡ʇ͸੮Ě˺̼ˌੳ੮/ͷʇ̼;੮ͅʮ˦ʡˑʇ੮˺˦ʇ੮ͅɘ͸੮ʮ͐੮ɘͅ੮ʩɘͷʮ˦ʡ੮ɘ੮͙̹ͅʇ̼ʮ˺̼੮ ̹͙ɺˑʮɻ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ੳ੮ îʩʇ੮ ͐ͅɘ͐ʇૄͅ੮ šϲϲʮɻʇ੮ ˺ʠ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ ɻˑ˺ͅʇˑ;੮ ˺ͷʇ̼ͅʇʇͅ੮ ͅͅʇ̼͐ʮͷʇ੮ #˺˚˚͙˦ʮ͐;੮ î̼ʇɘ͐˚ʇ˦͐੮ ફ#îબ੮ ɘ˦ʁ੮ šî੮ ͐ʇɘ˚ͅ੮ ͐˺੮ ʇ˦͙̼ͅʇ੮ ͐ʩʇ;੮ ʩʇ͸੮ ɻˑ˺ͅʇˑ;੮ ͐˺੮ ͐ʩʇ੮ ̹̼˺ͷʇ˦੮ ˚˺ʁʇˑͅ੮ ˺˦੮ ͸ʩʮɻʩ੮ ͐ʩʇ;੮ ɘ̼ʇ੮ ɺɘͅʇʁੴ੮ ͙ͅɻʩ੮ ɘͅ੮ ̹̼˺viding truly team-based care.ਁ৿੮ ‡ʇ͸੮ Ě˺̼ˌ੮ ʠ͙ˑˑ;੮ ̼ʇʮ˚ɺ͙̼ͅʇͅ੮ #î੮ ͐ʇɘ˚ͅ੮ ˺˦ˑ;੮ ʮʠ੮ ͐ʩʇ;੮͙ͅɻɻʇͅͅʠ͙ˑˑ;੮ɻ˺˦͐ɘɻ͐੮ɻˑʮʇ˦͐ͅ੮ͅʮͽ੮͐ʮ˚ʇͅ੮̹ʇ̼੮˚˺˦͐ʩੳਁ਀੮#ɘˑʮʠ˺̼˦ʮɘ੮̼ʇˑʮʇͅ੮ʮ˦͐ͅʇɘʁ੮ ˺˦੮ɘ੮ુͅ˺͙ˑચˌʮˑˑʮ˦ʡૂ੮ͅ;͐ͅʇ˚੮˺ʠ੮˚ʮ˦͙͐ʇચɺ;ચ˚ʮ˦͙͐ʇ੮{ʇʁʮચ#ɘˑ੮ɺʮˑˑʮ˦ʡ੮͐ʩɘ͐੮̹̼ʮ˺̼ʮ͐ʮΈʇͅ੮ medication management and medical services over building relationships and meeting basic needs.ਁਁ੮ ੮ ɺʇ͐͐ʇ̼੮ ɘ̹̹̼˺ɘɻʩ੮ ͸˺͙ˑʁ੮ ʡʮͷʇ੮ ͐ʇɘ˚ͅ੮ ɻˑʇɘ̼੮ ˺ɺˈʇɻ͐ʮͷʇͅੴ੮ ɘ੮ ʁʇϲʮ˦ʇʁ੮ɺ͙ʁʡʇ͐ੴ੮ɘ˦ʁ੮ϲˑʇͽʮɺʮˑʮ͐;੮ʮ˦੮ʩ˺͸੮͐˺੮̹ͅʇ˦ʁ੮ʮ͐੮͐˺੮˚ʇʇ͐੮͐ʩ˺ͅʇ੮ʡ˺ɘˑͅੴ੮ʇͷʇ˦੮ʮʠ੮ʮ͐੮ ˚ʇɘ˦ͅ੮̹ɘ;ʮ˦ʡ੮ɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͐˺੮͐ɘˌʇ੮ͅ˺˚ʇ˺˦ʇ੮͐˺੮͐ʩʇ੮ʁʇ˦͐ʮ͐ͅੳਁਂ ੮ ͐ʩʮ̼ʁ੮ ̼ʇɻ˺˚˚ʇ˦ʁɘ͐ʮ˺˦੮ ʮͅ੮ ͐˺੮ ʠ͙˦ʁઝɘ˦ʁ੮ ̼ʇ͐ʩʮ˦ˌઝ#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ̹ˑɘɻʇ˚ʇ˦͐੮ ɻ˺˦͐ʮ˦͙͙˚ੳ੮ #ɘˑˑʮ˦ʡ੮ ͐˺੮ ુʠ͙˦ʁ੮ ˚˺̼ʇ੮ ɺʇʁͅૂ੮ ʮͅ੮ ʇɘͅ;੶੮ ˈ͙͐ͅ੮ ɘɺ˺͙͐੮ ʇͷʇ̼;˺˦ʇ੮ U੮ ͐ɘˑˌ੮ ͐˺੮ ɘʡ̼ʇʇͅ੮͸ʮ͐ʩ੮͐ʩʇ੮ͅʇ˦͐ʮ˚ʇ˦͐ੳ੮"͙͐੮ɘ੮ુɺʇʁૂ੮ʮͅ੮ˈ͙͐ͅ੮ɘ੮˚ɘ̼͐͐ʇͅͅ੶੮ϲʮʡ͙̼ʮ˦ʡ੮˺͙͐੮͸ʩʇ̼ʇ੮͐˺੮ put it is harder.ਁਃ੮ îʩʇ੮ ˚;͐ʩ੮ ˺ʠ੮ Ûʇɘʡɘ˦੮ ͙ͅʡʡʇ͐ͅͅ੮ ͸ʇ੮ ͅʩ˺͙ˑʁ੮ ̼ʇͷʇ̼ͅʇ੮ ͐ʩʇ੮ ʠ˺̼˚ʇ̼੮ ̹̼ʇͅʮʁʇ˦͐ૄͅ੮ ʁʇʠ͙˦ʁʮ˦ʡ੮ ˺ʠ੮ ̹͙ɺˑʮɻ੮ ʩ˺͙ͅʮ˦ʡ੮ ɘ˦ʁ੮ ʠ˺ɻ͙ͅ੮ ˺˦੮ ͙̹̹ͅ˺̼͐ʇʁੴ੮ ʮ˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ɘ̹ɘ̼͐˚ʇ˦͐ͅੳ੮Ěʇ͐੮͐ʩʮͅ੮ɺ˺˺ˌ੮ʩɘͅ੮ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ʩ˺͸੮ɘ੮˺˦ʇચͅʮΈʇચϲʮ͐ͅચɘˑˑ੮ɘ̹̹̼˺ɘɻʩ੮ʠɘʮˑͅ੮ ͅ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮͸ʩ˺੮͸ʮˑˑ੮˺ͷʇ̼ʁ˺ͅʇੴ੮ʡʇ͐੮ʇͷʮɻ͐ʇʁੴ੮˺̼੮ʁʮʇ੮ʮ˦੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡੳ੮੮ ʁ˺ʡ˚ɘ͐ʮɻ੮̼ʇʠ͙ͅɘˑ੮͐˺੮ʇ˚ɺ̼ɘɻʇ੮˚˺̼ʇ੮̼͙͐ͅɻ͙̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮˺̹͐ʮ˺˦ͅ੮ʠ˺̼੮ɘ੮˚ʮ˦˺̼ʮ͐;੮˺ʠ੮ ʠ˺̼˚ʇ̼ˑ;੮ʩ˺˚ʇˑʇͅͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˚ɘ;੮ɺʇ੮͙˦ʁʇ̼˚ʮ˦ʮ˦ʡ੮̹͙ɺˑʮɻ੮͙̹̹ͅ˺̼͐੮ʠ˺̼੮P˺͙ͅʮ˦ʡ੮ Hʮ̼͐ͅ੮˚˺̼ʇ੮ɺ̼˺ɘʁˑ;੶੮̹˺ˑˑͅ੮ͅʩ˺͸ʮ˦ʡ੮˚ɘͅͅʮͷʇ੮ʇ˦ʁ˺̼ͅʇ˚ʇ˦͐੮˺ʠ੮͐ʩʇ੮ʡ˺ͷʇ̼˦˺̼ૄͅ੮#Û/੮ ɻ˺͙̼͐ͅ੮̹̼˺̹˺ͅɘˑੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮̹ͅʇɘˌ੮͐˺੮ɘ੮̼ʮͅʮ˦ʡ੮ʁʇͅʮ̼ʇ੮ʠ˺̼੮ɘ੮˚˺̼ʇ੮ʠ˺̼ɻʇʠ͙ˑ੮̼ʇ̹ͅ˺˦ͅʇ੮ to homelessness.ਁ਄੮U͐੮͐ʩ͙ͅ੮ʮ˦ɘʁͷʇ̼͐ʇ˦͐ˑ;੮̼ʇʮ˦ʠ˺̼ɻʇͅ੮͐ʩʇ੮̹̼ʇʠʇ̼̼ʇʁ੮ͅ˺ˑ͙͐ʮ˺˦੮ʮ˚̹ˑʮʇʁ੮ ɺ;੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘੵ੮ˑ˺ɻˌʇʁ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘ˦ʁ੮U{)੮ɺʇʁͅੳ

C O N C LU S I O N

289

U˦੮̼͙͐͐ʩੴ੮ɘ˦੮ɘˑˑચ˺ʠચ͐ʩʇચɘɺ˺ͷʇ੮ɘ̹̹̼˺ɘɻʩ੮͐˺੮ɺ͙ʮˑʁʮ˦ʡ੮ɺʇʁͅ੮ͅʇʇ˚ͅ੮̼ʮʡʩ͐ੴ੮ʡʮͷʇ˦੮͐ʩʇ੮ ͅɻɘˑʇ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ɻ̼ʮͅʮͅ੮ફɘˑɺʇʮ͐੮͸ʮ͐ʩ੮ɘ˦੮ʇ˚̹ʩɘͅʮͅ੮˺˦੮͙̹ચʠ̼˺˦͐੮ɻ̼ʮͅʮͅ੮ͅʇ̼ͷʮɻʇͅ੮͐˺੮ ˌʇʇ̹੮̹ʇ˺̹ˑʇ੮˺͙͐੮˺ʠ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ˦ʁ੮͙˦ˑ˺ɻˌʇʁ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚ͅ੮͐˺੮͐ͅʇ̹੮ ͐ʩʇ˚੮ʮ˦͐˺બੳ੮"͙͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮ͅʩ˺͙ˑʁ੮̼ʇɻ˺˦ɻʇ̹͙͐ɘˑʮΈʇ੮ʩ˺͸੮͐ʩ˺ͅʇ੮̹ˑɘɻʇ˚ʇ˦͐ͅ੮ʠ͙˦ɻ͐ʮ˺˦ੳ੮ H˺̼੮˺˦ʇ੮͐ʩʮ˦ʡੴ੮ʮ͐੮ͅʩ˺͙ˑʁ੮ʁʇɻ˺͙̹ˑʇ੮ˑʇʡɘˑ੮͐ͅɘ͙͐ͅ੮ʠ̼˺˚੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇੳ੮‡˺੮˺˦ʇ੮ͅʩ˺͙ˑʁ੮ ɺʇ੮˺ɺˑʮʡɘ͐ʇʁ੮͐˺੮ʩɘͷʇ੮ɘ੮ʡɘ˚͙͐੮˺ʠ੮̼ʮʡʩ͐ͅ੮̼͐ͅʮ̹̹ʇʁ੮ɘ͸ɘ;੮ͷʮɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐˺੮ɘɻɻʇͅͅ੮ ʩʮʡʩˑ;੮̼͙͐ͅɻ͙̼͐ʇʁ੮˺̼੮ʮ˦͐ʇ˦ͅʮͷʇ੮ɻɘ̼ʇ੮ʮʠ੮͐ʩʇ;੮͸ɘ˦͐੮ʮ͐ੳ੮/ͷʮʁʇ˦ɻʇ੮ʠ̼˺˚੮˺͐ʩʇ̼੮ɻ˺͙˦̼͐ʮʇͅ੮ ͙ͅʡʡʇ͐ͅͅ੮͐ʩɘ͐ੴ੮ʮʠ੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮˚˺̼ʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɺʇʁͅੴ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻ˺͙ˑʁ੮̹̼˺̹˺ͅʇ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ʇɘ̼ˑʮʇ̼੮ʮ˦੮ͅ˺˚ʇ˺˦ʇૄͅ੮ʁ˺͸˦͸ɘ̼ʁ੮̼͐ɘˈʇɻ͐˺̼;੮ɘ˦ʁ੮̹̼˺˚ʮͅʇ੮͐ʩɘ͐੮͐ʩʇ;੮ɻ˺͙ˑʁ੮ ͐ͅɘ;੮ ˑ˺˦ʡ੮ ʇ˦˺͙ʡʩ੮ ͐˺੮ ɘɻ͙͐ɘˑˑ;੮ ͐ͅɘɺʮˑʮΈʇੳ੮ ͅ੮ ɘ੮ ̼ʇ͙ͅˑ͐ੴ੮ ˚˺̼ʇ੮ ̹ʇ˺̹ˑʇ੮ ʡ˺੮ ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ ફɘ˦ʁੴ੮ɘͅ੮ɻ˺˦͙ͅ˚ʇ̼ͅ੮ʠ̼ʇʇ੮͐˺੮ˑʇɘͷʇੴ੮ɘ̼ʇ੮ɺʇ͐͐ʇ̼੮̹˺ͅʮ͐ʮ˺˦ʇʁ੮͐˺੮ʁʇ˚ɘ˦ʁ੮ʮ˚̹̼˺ͷʇʁ੮ɻɘ̼ʇ੮ and nicer conditions).ਂ৻੮š˦੮͐ʩʇ੮˺͐ʩʇ̼੮ʩɘ˦ʁੴ੮˚˺ʁʇˑͅ੮ˑʮˌʇ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ɻ˺˚˚͙˦ʮ͐;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺̼੮rૄͅ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚ͅ੮ʁʇ˚˺˦̼͐ͅɘ͐ʇ੮ that some people do need an authoritative push to stay medication compliant ɺ͙͐੮ʁ˺˦ૄ͐੮˦ʇʇʁ੮͐˺੮ɺʇ੮ʮ˦੮ɘ੮ˑ˺ɻˌʇʁ੮ͅʇ͐͐ʮ˦ʡੳ੮‡˺੮ˑʇͷʇˑ੮˺ʠ੮ɻɘ̼ʇ੮ફ͙ͅɻʩ੮ɘͅ੮ɘ˦੮HäØ੮˺̼੮ɘ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮̹̼˺ʡ̼ɘ˚બ੮ͅʩ˺͙ˑʁ੮̼ʇή͙ʮ̼ʇੴ੮ɘͅ੮˚ɘ˦;੮ʁʇ੮ʠɘɻ͐˺੮ʁ˺ੴ੮͐ʩɘ͐੮ͅ˺˚ʇ˺˦ʇ੮ ̹ɘͅͅ੮͐ʩ̼˺͙ʡʩ੮ɘ˦੮ɘɻ͙͐ʇ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮͐˺੮ɘɻɻʇͅͅ੮͐ʩʇ˚ੳ îʩʮͅ੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ɻɘ̼ʇ੮ͅ;͐ͅʇ˚੮˦ʇʇʁͅ੮͐˺੮ɺʇ੮˺̼ʡɘ˦ʮΈʇʁੴ੮˦˺͐੮ˈ͙͐ͅ੮ʠ͙˦ʁʇʁੴ੮ɺ;੮ʇ˦ʡɘʡʇʁ੮ public authority. Whether county hospitals or city-run clinics actually deliver ɺʇ͐͐ʇ̼੮ɻɘ̼ʇ੮͐ʩɘ˦੮͐ʩʇʮ̼੮̹̼ʮͷɘ͐ʇ੮ɻ˺͙˦͐ʇ̼̹ɘ̼͐ͅ੮ʮͅ੮ɘ˦੮˺̹ʇ˦੮ή͙ʇ͐ͅʮ˺˦ੳਂৼ੮#ʇ̼͐ɘʮ˦ˑ;ੴ੮͐ʩʇ੮ rØä੮ɻ͐੮͐ͅʇ˚˚ʇʁ੮ʠ̼˺˚੮͐ʩʇ੮̼ʇͷʇˑɘ͐ʮ˺˦੮͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇੴ੮͸ʩʇ˦੮ʮ͐੮͸ɘͅ੮ɘ੮ʁʮ̼ʇɻ͐੮̹̼˺ͷʮʁʇ̼੮˺ʠ੮ͅʇ̼ͷʮɻʇͅੴ੮͸ɘͅ੮˦˺͐੮ʁ˺ʮ˦ʡ੮ͅ͸ʮ˚˚ʮ˦ʡˑ;ੳ੮"͙͐੮ʮʠ੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɻ˺˦͐ʮ˦͙ʇͅ੮͐˺੮ʁʇˑʇʡɘ͐ʇ੮ɻɘ̼ʇ੮͐˺੮͐ʩʇ੮̹̼ʮͷɘ͐ʇ੮ͅʇɻ͐˺̼ੴ੮ʮ͐੮˦ʇʇʁͅ੮͐˺੮ʇ˦͙̼ͅʇ੮͐ʩɘ͐੮̹̼˺ͷʮʁʇ̼ͅ੮͐ʩɘ͐੮͐ɘˌʇ੮̹͙ɺˑʮɻ੮ ˚˺˦ʇ;੮˺̹ʇ̼ɘ͐ʇ੮ɘͅ੮̹͙ɺˑʮɻ੮ͅʇ̼ͷʮɻʇͅੳ੮îʩʮͅ੮͸ʮˑˑ੮̼ʇή͙ʮ̼ʇ੮̹͙͐͐ʮ˦ʡ੮ɘ˦੮ʇ˦ʁ੮͐˺੮̹̼ɘɻ͐ʮɻʇͅ੮˺ʠ੮ ɻ̼ʇɘ˚ʮ˦ʡੴ੮ɺˑɘɻˌˑʮ͐ͅʮ˦ʡੴ੮ɘ˦ʁ੮ɻʩʇ̼̼;ચ̹ʮɻˌʮ˦ʡ੮͐ʩɘ͐੮ɘˑˑ˺ɻɘ͐ʇ੮ɻˑʮʇ˦͐ͅ੮ɘ˦ʁ੮͐ʩʇ੮̼ʇͅ˺͙̼ɻʇͅ੮ ɘ͐͐ɘɻʩʇʁ੮͐˺੮͐ʩʇ˚੮ɺɘͅʇʁ੮˺˦੮̹̼˺ϲʮ͐ચʁ̼ʮͷʇ˦੮̹̼˺ɻˑʮͷʮ͐ʮʇͅੳ੮îʩʇ̼ʇ੮ͅʩ˺͙ˑʁ੮ɺʇ੮ɘ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ ͅ;͐ͅʇ˚੮͸ʮ͐ʩ੮̼͐ɘ˦̹ͅɘ̼ʇ˦͐੮ɻ̼ʮ͐ʇ̼ʮɘ੮ʠ˺̼੮̼ɘ͐ʮ˺˦ʮ˦ʡ੮ͅɻɘ̼ɻʇ੮ɺʇʁͅ੮ʮ˦੮ʠɘɻʮˑʮ͐ʮʇͅ੮ˑʮˌʇ੮U{)ͅੳ੮ ˦੮ ʇ˦ʡɘʡʇʁ੮ ͐ͅɘ͐ʇ੮ ͸ʮˑˑ੮ ɘˑͅ˺੮ ɺʇ੮ ˺˦ʇ੮ ͐ʩɘ͐੮ ʁ˺ʇͅ੮ ͅ˺˚ʇ੮ ͐ʩʮ˦ʡͅ੮ ʮ͐ͅʇˑʠੵ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ͅʩ˺͙ˑʁ੮ɻ˺˦͐ʮ˦͙ʇ੮͐˺੮ɺʇ੮ɘ੮̹ˑɘɻʇ੮˺ʠ੮ˑɘ͐ͅ੮̼ʇͅ˺̼͐੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʩ˺੮ɘ̼ʇ੮͐˺˺੮͐ͅʮʡ˚ɘ͐ʮΈʇʁੴ੮ ͐˺˺੮ʮͅ˺ˑɘ͐ʇʁੴ੮˺̼੮͐˺˺੮ɻ˺˚̹ˑʇͽ੮͐˺੮ɺʇ੮ɻɘ̼ʇʁ੮ʠ˺̼੮ʇˑͅʇ͸ʩʇ̼ʇੳ H˺͙̼͐ʩ੮ɘ˦ʁ੮ϲʮ˦ɘˑˑ;ੴ੮ɘ˦੮ʇ˦ʡɘʡʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮͸ʮˑˑ੮̼͐ɘ˦ͅʠ˺̼˚੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦͐˺੮ ɘ੮ ˦ɘ̼̼˺͸ˑ;੮ ͐ɘ̼ʡʇ͐ʇʁੴ੮ ʇͷʮʁʇ˦ɻʇચɺɘͅʇʁ੮ ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ੳ੮ îʩʇ੮ ͐ͅɘ͐ʇ੮ ˦ʇʇʁͅ੮ ͐˺੮ ͅʇ͐੮ ˺͙͐ɻ˺˚ʇ੮˚ʇ̼͐ʮɻͅ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘˑ˺˦ʡ੮˚͙ˑ͐ʮ̹ˑʇ੮ʁʮ˚ʇ˦ͅʮ˺˦ͅ੮ફʮ˦ɻˑ͙ʁʮ˦ʡ੮ɻˑʮ˦ʮɻɘˑ੮ ͐ͅɘɺʮˑʮ͐;ੴ੮ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡੴ੮ɘ˦ʁੴ੮;ʇͅੴ੮ɻˑʮʇ˦͐੮ͅɘ͐ʮͅʠɘɻ͐ʮ˺˦બ੮ɘ˦ʁ੮͐ʩʇ˦੮͐ʇ͐ͅ੮͸ʩʮɻʩ੮˚˺ʁʇˑͅ੮ ɘɻʩʮʇͷʇ੮͐ʩʇ˚ੳ੮/ͽ̹ʇ̼ʮ˚ʇ˦͐ͅ੮ˑʮˌʇ੮H̼ʇͅ˦˺ૄͅ੮ÛUä/੮̹̼˺ʡ̼ɘ˚੮ફʠ˺ɻ͙ͅʇʁ੮˺˦੮̼ʇ̹ͅʇɻ͐ʮ˦ʡ੮ client choice and using combined clinical-conservator teams) should be studied

290

C O N C LU S I O N

ɘ˦ʁੴ੮ʮʠ੮͐ʩʇ੮̼ʇ͙ͅˑ͐ͅ੮ɘ̼ʇ੮̹˺ͅʮ͐ʮͷʇੴ੮ͅɻɘˑʇʁ੮͙̹ੳ੮Ĕʇ੮˦ʇʇʁ੮͐˺੮ˌ˦˺͸੮ʮʠ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͸˺̼ˌͅ੮ʠ˺̼੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅ੮˺̼੮̹ʇ˺̹ˑʇ੮ʁʮͷʇ̼͐ʇʁ੮ʠ̼˺˚੮͐ʩʇ੮ɻ̼ʮ˚ʮ˦ɘˑ੮ˈ͙͐ͅʮɻʇ੮ͅ;͐ͅʇ˚੮ ɺʇʠ˺̼ʇ੮ ˚˺̼ʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ʠɘɻʮ˦ʡ੮ ͐ʩʇͅʇ੮ ʁʮϲϲʮɻ͙ˑ͐ʮʇͅ੮ ɘ̼ʇ੮ ɻ̼ɘ˚˚ʇʁ੮ ʮ˦͐˺੮ ɘ˦੮ ɘˑ̼ʇɘʁ;੮ ˺ͷʇ̼͸ʩʇˑ˚ʇʁ੮ ͅ;͐ͅʇ˚ੳ੮ ˑˑ੮ ˺ʠ੮ ͐ʩʮͅ੮ ͸ʮˑˑ੮ ͐ɘˌʇੴ੮ ɘ͐੮ ɘ੮ ɺɘ̼ʇ੮ ˚ʮ˦ʮ˚͙˚ੴ੮ ɘ੮ ͐ͅɘ͐ʇ੮ ˺ϲϲʮɻʇ੮ ̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮ʡɘ͐ʩʇ̼ʮ˦ʡ੮ɘ˦ʁ੮̹͙ɺˑʮͅʩʮ˦ʡ੮ʁɘ͐ɘੴ੮ʇ͐ͅɘɺˑʮͅʩʮ˦ʡ੮ɺʇ͐ͅ੮̹̼ɘɻ͐ʮɻʇͅੴ੮ɘ˦ʁ੮ ɻʩɘ˦˦ʇˑʮ˦ʡ੮ɺɘʁˑ;੮˦ʇʇʁʇʁ੮͐ͅɘ͐ʇ੮ʠ͙˦ʁͅ੮͐˺੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮͸ʩʮɻʩ੮ɻ˺͙˦͐ʮʇͅ੮ʩɘͷʇ੮ ͐˺˺੮ˑ˺˦ʡ੮˺ͷʇ̼ˑ˺˺ˌʇʁੳ îʩ˺ͅʇ੮ɘʁʩʇ̼ʮ˦ʡ੮͐˺੮͐ʩʇ੮˚;͐ʩ੮˺ʠ੮͐ʩʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮ͅʩ˺͙ˑʁ੮ɘɻɻʇ̹͐੮͐ʩɘ͐੮ɘ੮˚˺̼ʇ੮̼˺ɺ͙͐ͅ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ͅ;͐ͅʇ˚੮ ʮͅ੮ ˺˦ˑ;੮ ̹˺ˑʮ͐ʮɻɘˑˑ;੮ ɘ˦ʁ੮ ʇ͐ʩʮɻɘˑˑ;੮ ɘɻɻʇ̹͐ɘɺˑʇ੮ ʮʠ੮ ɻ˺͙̹ˑʇʁ੮ ͸ʮ͐ʩ੮˚˺̼ʇ੮̼˺ɺ͙͐ͅ੮̹̼˺͐ʇɻ͐ʮ˺˦ͅ੮ʠ̼˺˚੮ʮ͐ੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮̼ʇɘˑ੮ɘ˦ʁ੮ͷɘˑʮʁ੮ɻ˺˦ɻʇ̼˦ͅ੮ɘɺ˺͙͐੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅૄ੮ ˺ͷʇ̼͙ͅʇ੮ ફɘͅ੮ ʩʮʡʩˑʮʡʩ͐ʇʁ੮ ɺ;੮ ˦˺˦ʇ੮ ˺͐ʩʇ̼੮ ͐ʩɘ˦੮ "̼ʮ͐˦ʇ;੮ ä̹ʇɘ̼ͅબੳ੮ îʩʇ੮͐ͅɘ͐ʇ੮ͅʩ˺͙ˑʁ੮̹ͅʇɻʮʠ;੮͸ʩʮɻʩ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇͅ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͙ͅɻʩ੮ɘͅ੮šî੮˺̼੮ Ø)ͅੴ੮˚͙͐ͅ੮ɺʇ੮̼͐ʮʇʁ੮ફ˺̼੮̼͙ˑʇʁ੮˺͙͐બ੮ɺʇʠ˺̼ʇ੮ɘ੮ˈ͙ʁʡʇ੮ɻɘ˦੮ʮ˚̹˺ͅʇ੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ ੮˚˺̼ʇ੮ɻɘ̼ʇʠ͙ˑ੮ɘ˦ɘˑ;ͅʮͅ੮˺ʠ੮ͅ˺˚ʇ˺˦ʇૄͅ੮˦ʇʇʁ੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ʮˑˑ੮̼ʇή͙ʮ̼ʇ੮ʇ˦͙̼ͅʮ˦ʡ੮ʮ˦̹͙͐੮ʠ̼˺˚੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅੴ੮˺͙̹͐ɘ͐ʮʇ˦͐੮̹̼˺ͷʮʁʇ̼ͅੴ੮ɘ˦ʁ੮̹ʇʇ̼ͅ੮ʮ˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩʇɘ̼ʮ˦ʡͅੳ੮îʩʇ੮͐ͅɘ͐ʇ੮ͅʩ˺͙ˑʁ੮ʇ˦͙̼ͅʇ੮ʇʠʠʇɻ͐ʮͷʇ੮̼ʇ̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅ੮ ͐ʩ̼˺͙ʡʩ੮ɘ੮̹ͅʇɻʮɘˑʮΈʇʁ੮ɺ˺ʁ;੮˺ʠ੮̼͐ɘʮ˦ʇʁ੮ˑɘ͸;ʇ̼ͅੴ੮˚˺ʁʇˑʇʁ੮ɘʠ͐ʇ̼੮‡ʇ͸੮Ě˺̼ˌૄͅ੮{ʇ˦͐ɘˑ੮ P;ʡʮʇ˦ʇ੮rʇʡɘˑ੮äʇ̼ͷʮɻʇͅੳਂ৽ U͐੮ ͸˺͙ˑʁ੮ ɺʇ੮ ʇɘͅ;੮ ͐˺੮ ʇˑʮ˚ʮ˦ɘ͐ʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮ îʩʇ੮ ͐ͅɘ͐ʇ੮ ɻ̼ʇɘ͐ʇʁ੮ ͐ʩʮͅ੮ ˑʇʡɘˑ੮ ͐˺˺ˑ੶੮ʮ͐੮ɻ˺͙ˑʁ੮ɘɺ˺ˑʮͅʩ੮ʮ͐ੳ੮U͐੮ʮͅ੮͙͙ͅɘˑˑ;੮ɻʩʇɘ̹ʇ̼ੴ੮ɘʠ͐ʇ̼੮ɘˑˑੴ੮͐˺੮ʡ̼ɘ˦͐੮̹ʇ˺̹ˑʇ੮ɻʮͷʮˑ੮ˑʮɺʇ̼͐ʮʇͅ੮͐ʩɘ˦੮͐˺੮ɻɘ̼ʇ੮ʠ˺̼੮͐ʩʇ˚ੳ੮îʩʇ੮̼ʮʡʩ͐੮͸ɘ;੮͐˺੮ʁ̼ʮͷʇ੮ʁ˺͸˦੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮͐ʩ˺͙ʡʩੴ੮ ʮͅ੮ɺ;੮̼ʇʁ͙ɻʮ˦ʡ੮͐ʩʇ੮˦ʇʇʁ੮ʠ˺̼੮ʮ͐ੴ੮͸ʩʮɻʩ੮̹̼ʇͷʮ˺͙ͅ੮̼ʇͅʇɘ̼ɻʩ੮ʩɘͅ੮ͅʩ˺͸˦੮ɻɘ˦੮ɺʇ੮ʁ˺˦ʇ੮ ͐ʩ̼˺͙ʡʩ੮ ʮ˦ͷʇ͐ͅ˚ʇ˦͐੮ ʮ˦੮ ɘ੮ ʠ͙ˑˑ੮ ɻ˺˦͐ʮ˦͙͙˚੮ ˺ʠ੮ ɻɘ̼ʇੳਂ৾ Once that continuum is in ̹ˑɘɻʇੴ੮͐ʩʇ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸ʮˑˑ੮˦˺੮ˑ˺˦ʡʇ̼੮ɺʇ੮ɘ੮˚ʮͽ੮˺ʠ੮ɘɺɘ˦ʁ˺˦˚ʇ˦͐੮ ɘ˦ʁ੮ͅʩ˺̼͐ચ͐ʇ̼˚ੴ੮̹͙̼̹˺ͅʇˑʇͅͅ੮ɻ˺ʇ̼ɻʮ˺˦ੳ੮͐੮͐ʩɘ͐੮̹˺ʮ˦͐ੴ੮ʁʇɻ̼ʇɘͅʮ˦ʡ੮͐ʩʇ੮˦͙˚ɺʇ̼੮˺ʠ੮ ̹ʇ˺̹ˑʇ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺͙ʡʩ͐੮͐˺੮ɺʇ੮ɘ੮ʡ˺ɘˑ੮ɺ˺͐ʩ੮ͅʮʁʇͅ੮˺ʠ੮ɘ੮˦ʇͷʇ̼ચʇ˦ʁʮ˦ʡੴ੮ɘɻ̼ʮmonious debate can get behind. ુ/ͷʇ̼;੮ʁɘ;੮યʮ˦੮#ɘˑʮʠ˺̼˦ʮɘરੴૂ੮˺˦ʇ੮ɻˑʮ˦ʮɻʮɘ˦੮̹͙͐੮ʮ͐ੴ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ ુ͸˺̼ˌ੯ੳ੯ੳ੯ੳ੮͸ʮ͐ʩ੮ʮ˦ɻ̼ʇʁʮɺˑ;੮ͅʮɻˌ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ˦ʁ੮ʮ˦ɻ̼ʇʁʮɺˑ;੮ˑʮ˚ʮ͐ʇʁ੮̼ʇͅ˺͙̼ɻʇͅੳ੮˦ʁ੮ ʇͷʇ̼;੮ʁɘ;ੴ੮͐ʩʇ;੮˚ɘˌʇ੮˚ʮ̼ɘɻˑʇͅ੮ʩɘ̹̹ʇ˦ੳૂ੮"͙͐੮ુͅ˺੮˚ɘ˦;੮˺ʠ੮͐ʩʇͅʇ੮˺͙͐ɻ˺˚ʇͅ੮͐ʩɘ͐੮ʩɘͷʇ੮ ʡ̼˺͸˦੮͐˺੮ʠʇʇˑ੮ˑʮˌʇ੮˚ʮ̼ɘɻˑʇͅઝͅ˺˚ʇ˺˦ʇ੮ʩʇˑʁ੮ʠ˺̼੮ɘ੮̹ˑɘɻʇ˚ʇ˦͐ੴ੮̹̼˺ͷʮʁʇʁ੮͸ʮ͐ʩ੮˚ʇʁʮɻɘ͐ʮ˺˦ੴ੮˺̼੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮ɘ੮̹̼˺ʡ̼ɘ˚ઝʮ˦੮ɘ˦੮ɘ̹̹̼˺̹̼ʮɘ͐ʇˑ;੮̼ʇͅ˺͙̼ɻʇʁ੮͸˺̼ˑʁ੮͸˺͙ˑʁ੮ ̼ʇɘˑˑ;੮ˈ͙͐ͅ੮ɺʇ੮͐ͅɘ˦ʁɘ̼ʁ੮˺ʠ੮ɻɘ̼ʇੳૂ੮˦੮ɘɻɻ˺͙˦͐ɘɺˑʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʁ˺ʇͅ੮˦˺͐੮ ʩ˺̹ʇ੮ʠ˺̼੮˚ʮ̼ɘɻˑʇͅੳ੮U˦͐ͅʇɘʁੴ੮ʮ͐੮̼ʇˑʮʇͅ੮˺˦੮ʇ˦ʡɘʡʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮͐˺੮ʡ͙ɘ̼ɘ˦͐ʇʇ੮ʠ͙˦ʁɘ˚ʇ˦͐ɘˑ੮̼ʮʡʩ͐ͅ੮ʠ˺̼੮͐ʩʇ੮˚˺͐ͅ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇઝ˦˺͐੮ˈ͙͐ͅ੮͐˺੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼੮ɺ͙͐੮ɘˑͅ˺੮ ͐˺੮͙̹̹ͅ˺̼͐ੴ੮ɻɘ̼ʇੴ੮ɘ˦ʁ੮ʁʮʡ˦ʮ͐;ੳ

C O N C LU S I O N

291

CODA: BACK TO THE BUS STOP U੮͸ʇ˦͐੮ʮ˦͐˺੮˚;੮৲ৰ৲ৱ੮̼ʇͅʇɘ̼ɻʩ੮̼͐ʮ̹੮͐˺੮r˺ͅ੮˦ʡʇˑʇͅ੮ʩɘͷʮ˦ʡ੮ɘˑ̼ʇɘʁ;੮ˑʮͷʇʁ੮;ʇɘ̼ͅ੮ʮ˦੮͐ʩʇ੮ "ɘ;੮̼ʇɘ੮ɘ˦ʁ੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮ʩ͙˦ʁ̼ʇʁͅ੮˺ʠ੮ʮ˦͐ʇ̼ͷʮʇ͸ͅੳ੮U੮͐ͅʮˑˑ੮ˑʇʠ͐੮ʁʇʇ̹ˑ;੮ʁʮ̼͐ͅʇͅͅʇʁ੮ɘɺ˺͙͐੮ ͸ʩɘ͐੮U੮ʩɘʁ੮ͅʇʇ˦ੳ੮U੮ʁ̼˺ͷʇ੮ʩ˺˚ʇ੮͐˺੮Hˑɘʡ͐ͅɘʠʠੴ੮̼ʮΈ˺˦ɘੴ੮͸ʩʇ̼ʇ੮U੮ʡ̼ʇ͸੮͙̹ੳ੮U੮̼ʇɻ˺͙˦͐ʇʁ੮ ˚;੮ʁɘ;੮ɻ˺˦ʁ͙ɻ͐ʮ˦ʡ੮˺͙̼͐ʇɘɻʩ੮͐˺੮Ĕɘˑˑ;੮͸ʮ͐ʩ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ɘ˦ʁ੮˚;੮ͷʮͅʮ͐੮͐˺੮äˌʮʁ੮Û˺͸੮ ͸ʮ͐ʩ੮)̼ੳ੮"˺ˑˑ˺˚੮͐˺੮˚;੮ʠɘ͐ʩʇ̼ੳ੮ુĔʩʇ̼ʇ੮ʁ˺੮;˺͙੮͐ʩʮ˦ˌ੮͐ʩ˺ͅʇ੮̹ʇ˺̹ˑʇ੮ɘ̼ʇ੮ʮ˦੮/͙̼˺̹ʇ੺ૂ੮ ʩʇ੮ɘͅˌʇʁੳ੮{;੮ʮ˦ʮ͐ʮɘˑ੮͐ʩ˺͙ʡʩ͐੮͸ɘͅ੮ુʮ˦੮ɘ੮ʩ˺̹ͅʮ͐ɘˑੳૂ੮੮˚˺̼ʇ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ͅ˺ɻʮʇ͐;੮ ͸ʮ͐ʩ੮ɘ੮̼˺ɺ͙͐ͅ੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇੴ੮U੮͐ʩ˺͙ʡʩ͐ੴ੮͸˺͙ˑʁ੮˦˺͐੮ʩʮʁʇ੮ɺʇʩʮ˦ʁ੮ɘ੮ͅ˚˺ˌʇͅɻ̼ʇʇ˦੮˺ʠ੮ ̼ʇ̹ͅʇɻ͐੮ʠ˺̼੮ɘ͙͐˺˦˺˚;੮ɘ˦ʁ੮͸˺͙ˑʁ੮̹̼˺ͷʮʁʇ੮ɻɘ̼ʇ੮ʠ˺̼੮͙ͅɻʩ੮ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੳ ˦ʁ੮͐ʩʇ˦੮U੮̼ʇɘˑʮΈʇʁੵ੮ʮ˦੮ɘ੮ɻ˺˚̹ɘͅͅʮ˺˦ɘ͐ʇ੮ͅ˺ɻʮʇ͐;੮͸ʮ͐ʩ੮ɘ੮̼˺ɺ͙͐ͅ੮͸ʇˑʠɘ̼ʇ੮͐ͅɘ͐ʇੴ੮ ͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸˺͙ˑʁ੮˦˺͐੮ʇͽʮ͐ͅੳ #ɘˑʮʠ˺̼˦ʮɘ੮ʮͅ੮˦˺͐੮ˈ͙͐ͅ੮ʠɘɻʮ˦ʡ੮͐ʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮ɘ˦੮͙˦ʁʇ̼ʠ͙˦ʁʇʁ੮ɘ˦ʁ੮ʁʮͅ˺̼ʡɘ˦ʮΈʇʁ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ੳ੮ U͐੮ ʮͅ੮ ̼ʇɘ̹ʮ˦ʡ੮ ͙ͅʠʠʇ̼ʮ˦ʡ੮ ͅ˺͸˦੮ ɺ;੮ ͐ʩʇ੮ ʩʮʡʩʇ͐ͅ੮ ̼ʇɘˑ੮ ̹˺ͷʇ̼͐;੮̼ɘ͐ʇ੮ʮ˦੮͐ʩʇ੮˦ɘ͐ʮ˺˦ੴਂ৿੮ɘ੮ʩ˺͙ͅʮ˦ʡ੮ɻ̼ʮͅʮͅ੮͐ʩɘ͐੮ʩɘͅ੮˚ɘʁʇ੮ʮ͐੮ʩ˺˚ʇ੮͐˺੮ʩɘˑʠ੮͐ʩʇ੮ ˦ɘ͐ʮ˺˦ૄͅ੮͙˦ͅʩʇˑ͐ʇ̼ʇʁ੮ʩ˺˚ʇˑʇͅͅੴਂ਀੮ɘ˦ʁ੮ɘ੮ͅ;͐ͅʇ˚੮˺ʠ੮˚ɘͅͅ੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮͐ʩɘ͐੮ˑ˺ɻˌʇʁ੮ ͙̹੮"ˑɘɻˌ੮ɘ˦ʁ੮ɺ̼˺͸˦੮̹ʇ˺̹ˑʇ੮ɘ͐੮̼ɘ͐ʇͅ੮͐ʩɘ͐੮͸˺͙ˑʁ੮˚ɘˌʇ੮͐ʩʇ੮͸˺̼͐ͅ੮ɘ͙͐˺ɻ̼ɘɻʮʇͅ੮˺ʠ੮͐ʩʇ੮ world blush.ਂਁ੮îʩʇ̼ʇ੮ɘ̼ʇ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ʮ˦੮ʇͷʇ̼;੮ɻ˺͙˦̼͐;ੴ੮ɺ͙͐੮ʮ˦੮͐ʩʇ੮ õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮͐ʩʇ;੮ɘ̼ʇ੮ɘ͐੮͐ʩʇ੮ʇ̹ʮɻʇ˦͐ʇ̼੮˺ʠ੮ɘ੮̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ʩɘ̼ͅʩ੮˚ɘʇˑ̼͐ͅ˺˚੮˺ʠ੮ુͅ;ͅtematic and unrelenting structural violence.”ਂਂ੮ îʩʮͅ੮ ʩɘͅ੮ ɻ̼ʇɘ͐ʇʁ੮ ɘ੮ ʁʮ͐ͅʮ˦ɻ͐ʮͷʇˑ;੮ ˚ʇ̼ʮɻɘ˦੮̹˺̹͙ˑɘ͐ʮ˺˦ੴ੮ɻ˺˦ʁʇ˚˦ʇʁ੮͐˺੮ʇɘ̼ˑ;੮ʁʇɘ͐ʩ੮˺̼੮ɻ˺˦ͅʮʡ˦ʇʁ੮͐˺੮ુɺɘ̼ʇ੮ˑʮʠʇૂઝ͐ʩʇ੮ ˚˺͐ͅ੮ ˚ʮ˦ʮ˚ɘˑ੮ ͐ͅɘ˦ʁɘ̼ʁ੮ ˺ʠ੮ ʇͽʮ͐ͅʇ˦ɻʇ੮ ͐ʩɘ͐੮ ɻ˺˚ʇͅ੮ ʠ̼˺˚੮ ɘ੮ ɺʇɘ͐ʮ˦ʡ੮ ʩʇɘ̼͐੮ ɘ˦ʁ੮ ˦˺͐੮ much more.ਂਃ ͐੮͐ʩʇ੮ʇ˦ʁ੮˺ʠ੮ɘ੮ɺ˺˺ˌ੮ɻ̼ʮ͐ʮή͙ʮ˦ʡ੮̹͙ɺˑʮɻ੮ɘ͙͐ʩ˺̼ʮ͐ʮʇͅૄ੮ʠɘʮˑ͙̼ʇ੮͐˺੮͐ɘˌʇ੮̼ʇ̹ͅ˺˦ͅʮɺʮˑʮ͐;੮ʠ˺̼੮͐ʩʇͅʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅੴ੮ʮ͐ૄͅ੮͐ʮ˚ʇ੮ʠ˺̼੮˚ʇ੮͐˺੮ɘ͙ͅͅ˚ʇ੮˚;੮˺͸˦੮˺ɺˑʮʡɘ͐ʮ˺˦ͅੳ੮{;੮ ͙˦ɻ˺˚ʠ˺̼͐ɘɺˑʇ੮ɻ˺˦ɻˑ͙ͅʮ˺˦੮ɘʠ͐ʇ̼੮;ʇɘ̼ͅ੮˺ʠ੮̼ʇͅʇɘ̼ɻʩ੮ʮͅ੮͐ʩɘ͐ੴ੮˺˦੮ɺɘˑɘ˦ɻʇੴ੮͐ʩʇ̼ʇ੮ɘ̼ʇ੮ ˚˺̼ʇ੮̹ʇ˺̹ˑʇ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮͸ʩ˺੮ʁʇ̹ͅʇ̼ɘ͐ʇˑ;੮˦ʇʇʁ੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐ʩɘ˦੮ɘ̼ʇ੮ ̼ʇɻʇʮͷʮ˦ʡ੮ʮ͐ੳ੮U͐ૄͅ੮ɘ੮ʁʇʇ̹ˑ;੮͙˦ʠɘʮ̼੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮˺͙̼੮ɻ˺ˑ˺ͅͅɘˑੴ੮ɻ˺ˑˑʇɻ͐ʮͷʇ੮ʠɘʮˑ͙̼ʇͅ੮ ɘͅ੮ɘ੮ͅ˺ɻʮʇ͐;੮͐ʩɘ͐ੴ੮͸ʮ͐ʩ˺͙͐੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ͅ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸˺˦ૄ͐੮͙̼ͅͷʮͷʇ੮ˑ˺˦ʡ੮ ʇ˦˺͙ʡʩ੮͐˺੮ɺʇ˦ʇϲʮ͐੮ʠ̼˺˚੮͐ʩʇ੮̼ʇʠ˺̼˚ͅ੮U੮ʩɘͷʇ੮̹̼˺̹˺ͅʇʁੳ੮ફ{ɘ̼ˌ੮Ûʮ̹̹ʇʇੴ੮̹̼˺ϲʮˑʇʁ੮ʮ˦੮ ɻʩɘ̹͐ʇ̼੮৵ੴ੮ʁʮʇʁ੮ˈ͙͐ͅ੮ɘͅ੮͐ʩʮͅ੮ɺ˺˺ˌ੮͸ʇ˦͐੮͐˺੮̹̼ʇͅͅੳ੮Pʇ੮̼ʇ˚ɘʮ˦ʇʁ੮ɺˑʮ˦ʁੴ੮̹ͅ;ɻʩ˺͐ʮɻੴ੮ɘ˦ʁ੮ ʠ̼ʇή͙ʇ˦͐ˑ;੮ͷʮɻ͐ʮ˚ʮΈʇʁ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮˺ϲ੮ēɘɻɘͷʮˑˑʇ੮ɘʠ͐ʇ̼੮ä˺ˑɘ˦˺੮#˺͙˦͐;੮̼ʇʠ͙ͅʇʁ੮͐˺੮ ɻ˺˦ͅʇ̼ͷʇ੮ʩʮ˚੮ɘ˦ʁ੮͸ʇ˦͐੮ʮ˦͐˺੮ͅʇ̹ͅʮͅ੮ʠ̼˺˚੮ɘ˦੮͙˦̼͐ʇɘ͐ʇʁ੮͙̼ʮ˦ɘ̼;੮̼͐ɘɻ͐੮ʮ˦ʠʇɻ͐ʮ˺˦੮ʠ˺̼੮ ͸ʩʮɻʩ੮ʩʇ੮̼ʇʠ͙ͅʇʁ੮ɺɘͅʮɻ੮˚ʇʁʮɻɘˑ੮ɻɘ̼ʇੳબ੮î˺੮ͅɘ;੮˺͐ʩʇ̼͸ʮͅʇੴ੮Uૄͷʇ੮̼ʇɘˑʮΈʇʁੴ੮͸˺͙ˑʁ੮ɺʇ੮͐˺੮ ɘɺʁʮɻɘ͐ʇ੮˚;੮˺͸˦੮ɘɻɻ͙˚͙ˑɘ͐ʇʁ੮ʇͽ̹ʇ̼͐ʮͅʇੳ

292

C O N C LU S I O N

Ĕʮ͐ʩ੮ ͐ʩɘ͐੮ ͅɘʮʁੴ੮ U੮ ͸ɘ˦͐੮ ͐˺੮ ʡ˺੮ ɺʇ;˺˦ʁ੮ ʁʇɺɘ͐ʇͅ੮ ˺ͷʇ̼੮ ʩ˺͸੮ ͸ʮʁʇˑ;੮ ˺̼੮ ˦ɘ̼̼˺͸ˑ;੮ ͐˺੮ʁʇϲʮ˦ʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮͸ʮ͐ʩ੮ɘ੮ɻɘˑˑ੮͐˺੮ɺʇ੮ɺ˺ˑʁੴ੮͐˺੮ɺʇ੮ʩ͙˚ɺˑʇੴ੮ɘ˦ʁ੮͐˺੮ɺʇ੮ʩ˺̹ʇʠ͙ˑੳ੮"˺ˑʁੴ੮ɺʇɻɘ͙ͅʇ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͸˺˦ૄ͐੮ɻ˺˚ʇ੮ɻˑ˺ͅʇ੮͐˺੮ɘʁʁ̼ʇͅͅʮ˦ʡ੮͐ʩʇ੮ ͅɻɘˑʇ੮ ˺ʠ੮ ͐ʩʇ੮ ̹̼˺ɺˑʇ˚ੳ੮ îʩʇ੮ ̼ʇɘˑ੮ ˚˺˺˦ͅʩ˺͐ੴ੮ ʮ˦͐ͅʇɘʁੴ੮ ˑʮʇͅ੮ ʮ˦੮ ̼ʇʠ˺̼˚ͅ੮ ˺͙͐ͅʮʁʇ੮ ͐ʩʇ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚੮ ʇ˦͐ʮ̼ʇˑ;ੳ੮ ͅ੮ ͐ʩʇ੮ ˚ʇ̼ʮɻɘ˦੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ ͅͅ˺ɻʮɘ͐ʮ˺˦੮ ʮ͐ͅʇˑʠ੮ ̼ʇɻ˺ʡ˦ʮΈʇʁ੮ʮ˦੮ɘ੮̼ʇɻʇ˦͐੮̼ʇ̹˺̼͐ੴ੮ુ̹˺ͷʇ̼͐;੮ɘ˦ʁ੮ɘͅͅ˺ɻʮɘ͐ʇʁ੮ͷɘ̼ʮɘɺˑʇͅ੮ફʮੳʇੳੴ੮͙˦ʇ˚̹ˑ˺;˚ʇ˦͐ੴ੮ʮ˦ɻ˺˚ʇੴ੮ʇʁ͙ɻɘ͐ʮ˺˦બ੮ʩɘͷʇ੮͐ʩʇ੮˚˺͐ͅ੮̼˺ɺ͙͐ͅ੮ʇʠʠʇɻ͐੮˺˦੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɘʁ˚ʮͅͅʮ˺˦ૂઝ ɘ˦ʁੴ੮ɺ;੮ʇͽ͐ʇ˦ͅʮ˺˦ੴ੮͐ʩʇ੮˦ʇʇʁ੮ʠ˺̼੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻɘ̼ʇઝુɘ˦ʁ੮ͅʩ˺͙ˑʁ੮ɺʇ੮̹̼ʮ˺̼ʮ͐ʮΈʇʁੳૂਂ਄ îʩʇ̼ʇ੮ ɘ̼ʇ੮ ɘˑ̼ʇɘʁ;੮ ʇʠʠ˺̼͐ͅ੮ ɘʠ˺˺͐੮ ͐˺੮ ɘʁʁ̼ʇͅͅ੮ ͐ʩʇͅʇ੮ ͅ˺ɻʮɘˑ੮ ʁʇ͐ʇ̼˚ʮ˦ɘ˦͐ͅੴ੮ ͸ʩʮɻʩ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɘʁͷ˺ɻɘ͐ʇͅ੮ ͸˺͙ˑʁ੮ ɺʇ੮ ͸ʮͅʇ੮ ͐˺੮ ͙̹̹ͅ˺̼͐ੳ੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ʁͷɘ˦ɻʮ˦ʡ੮ ɘ˦ʁ੮U˦˦˺ͷɘ͐ʮ˦ʡ੮{ʇʁʮચ#ɘˑ੮ફ#ɘˑU{બ੮̹̼˺̹˺ͅɘˑੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮͸˺͙ˑʁ੮ͅʩʮʠ͐੮ʠʇʁʇ̼ɘˑ੮ {ʇʁʮɻɘʮʁ੮ ʁ˺ˑˑɘ̼ͅ੮ ɘ͸ɘ;੮ ʠ̼˺˚੮ ̹ɘ;ʮ˦ʡ੮ ʠ˺̼੮ ˚ʇʁʮɻɘˑ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ɘ˦ʁ੮ ͐˺͸ɘ̼ʁ੮ ɻ˺ͷʇ̼ʮ˦ʡ੮ɘ̹ɘ̼͐˚ʇ˦͐੮ͅʇɻ͙̼ʮ͐;੮ʁʇ̹˺ͅʮ͐ͅੴ੮̼ʇ̹ͅʮ͐ʇ੮ͅʇ̼ͷʮɻʇͅ੮ʠ˺̼੮ɻɘ̼ʇʡʮͷʇ̼ͅੴ੮˺̼੮ʩʇɘˑ͐ʩ;੮˚ʇɘˑͅ੶੮ ʠ˺̼੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ʮ˚ʇੴ੮{ʇʁʮચ#ɘˑ੮͸ʮˑˑ੮ɘˑͅ˺੮ɻ˺ͷʇ̼੮͙˦ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ʮ˚˚ʮʡ̼ɘ˦͐ͅੴ੮͐˺˺੮ˑ˺˦ʡ੮ ɘ˦੮͙˦ʁʇ̼ɻˑɘͅͅ੮ʇͽɻˑ͙ʁʇʁ੮ʠ̼˺˚੮̹͙ɺˑʮɻ੮ͅʇ̼ͷʮɻʇͅੳ੮U˦੮৲ৰ৲৲ੴ੮͐ʩʇ੮ˑʇʡʮͅˑɘ͙̼͐ʇ੮ɘˑͅ˺੮˚ɘʁʇ੮ ˚˺ͷʇͅ੮͐˺੮ɻ˺˚̹ʇˑ੮ˑ˺ɻɘˑʮ͐ʮʇͅ੮͐˺੮˚ɘˌʇ੮ʮ͐੮ʇɘͅʮʇ̼੮͐˺੮ɺ͙ʮˑʁ੮ʩ˺͙ͅʮ˦ʡੴ੮ɘ੮ͅʩ˺̼͐ɘʡʇ੮˺ʠ੮͸ʩʮɻʩ੮ ફɘ˦ʁ੮ ˦˺͐੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ˺̼੮ ʁ̼͙ʡ੮ ͙ͅʇબ੮ ʮͅ੮ ͙˦ή͙ʇ͐ͅʮ˺˦ɘɺˑ;੮ ͐ʩʇ੮ ̼˺˺͐੮ ɻɘ͙ͅʇ੮ ˺ʠ੮ ˚ɘͅͅ੮ homelessness.ਃ৻੮îʩʇ੮͐ͅɘ͐ʇૄͅ੮˚˺ͷʇͅ੮͐˺੮ʁʇɻɘ̼ɻʇ̼ɘ͐ʇ੮ɘ˦ʁ੮˺˦ʡ˺ʮ˦ʡ੮ʁʮͅɻ͙ͅͅʮ˺˦ͅ੮˺ʠ੮̼ʇ̹ɘ̼ɘ͐ʮ˺˦ͅ੮͐˺੮"ˑɘɻˌ੮̼ʇͅʮʁʇ˦͐ͅ੮ɘ̼ʇ੮ɻ̼͙ɻʮɘˑ੮͐ͅʇ̹ͅ੮͐˺͸ɘ̼ʁ੮ɻʩʮ̹̹ʮ˦ʡ੮ɘ͸ɘ;੮ɘ͐੮͐ʩʇ੮̼͙͐ͅɻ͙̼͐ɘˑ੮̼ɘɻʮͅ˚੮͐ʩɘ͐੮˺̹̹̼ʇͅͅʇͅ੮͐ʩʇ੮৶৵੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘ˦ͅ੮͸ʩ˺੮ɘ̼ʇ੮˦˺˦͸ʩʮ͐ʇੳ Ěʇ͐੮ ͸ʇ੮ ͅʩ˺͙ˑʁ੮ ɺʇ੮ ʩ͙˚ɺˑʇੴ੮ ͐˺˺ੳ੮ )ʇɺɘ͐ʇͅ੮ ɘ̼˺͙˦ʁ੮ ˚ʇ˦͐ɘˑ੮ ʮˑˑ˦ʇͅͅ੮ ̹˺ˑʮɻ;੮ ɘ̼ʇ੮ ͅ˺੮ ͙͐ͅɺɺ˺̼˦ੴ੮ʮ˦੮̹ɘ̼͐ੴ੮ɺʇɻɘ͙ͅʇ੮͸ʇ੮͐ͅʮˑˑ੮ˑɘɻˌ੮ʇͷʇ˦੮ɘ੮ɺɘͅʮɻ੮ɻ˺˦ͅʇ˦͙ͅͅ੮ɘ̼˺͙˦ʁ੮͸ʩɘ͐੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɘɻ͙͐ɘˑˑ;੮ʮͅੳ੮ä˺˚ʇ੮ɘʁͷ˺ɻɘ͐ʇͅ੮ɘ˦ʁ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮̹ɘʮ˦͐੮ʮ͐੮ɘͅ੮ɘ੮ɺ̼ɘʮ˦੮ʁʮͅʇɘͅʇ੮ ̼˺˺͐ʇʁ੮ʮ˦੮ʡʇ˦ʇͅ੮ɘ˦ʁ੮˦ʇ͙̼˺̼͐ɘ˦ͅ˚ʮ͐͐ʇ̼ͅ੶੮̼ɘʁʮɻɘˑ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮ɘ˦ʁ੮ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅͅ੮ʮ˦੮ ͐ʩʇ੮ৱ৹৶ৰͅ੮ͅɘ͸੮ʮ͐੮ɘͅ੮ɘ੮̼ʇɺʇˑˑʮ˺˦੮ɘʡɘʮ˦͐ͅ੮ɻɘ̹ʮ͐ɘˑʮͅ˚੮ɘ˦ʁ੮͐ͅʮϲˑʮ˦ʡ੮ͅ˺ɻʮɘˑ੮˦˺̼˚ͅ੶੮ʁʮͅɘɺʮˑʮ͐;੮ɘɻ͐ʮͷʮ͐ͅͅ੮ʩɘͷʇ੮̼ʇʠ̼ɘ˚ʇʁ੮ʮ͐੮ɘͅ੮ɘ੮ʠ˺̼˚੮˺ʠ੮ુ˦ʇ͙̼˺ʁʮͷʇ̼ͅʮ͐;ૂ੮˺̼੮ɘ੮ુʁɘ˦ʡʇ̼˺͙ͅ੮ ʡʮʠ͐ੳૂ੮H˺̼੮˚;੮̹ɘ̼͐ੴ੮Uૄͷʇ੮ɻ˺˚ʇ੮͐˺੮ͅʇʇ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ˑʮˌʇ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɘͅ੮̹˺͐ʇ˦͐ʮɘˑˑ;੮ɘˑˑ੮ ˺ʠ੮͐ʩ˺ͅʇ੮͐ʩʮ˦ʡͅ੮ɺ͙͐ੴ੮ɘ͐੮ˑʇɘ͐ͅ੮ʠ˺̼੮͐ʩʇ੮̹ʇ˺̹ˑʇ੮̹̼˺ϲʮˑʇʁ੮ʮ˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮ɘˑͅ˺੮ɘͅ੮ɘ੮ͅ˺͙̼ɻʇ੮ ˺ʠ੮̹̼˺ʠ˺͙˦ʁ੮͙ͅʠʠʇ̼ʮ˦ʡ੮ɘ˦ʁ੮ˑ˺ͅͅઝɘɺ˺ͷʇ੮ɘˑˑ੮ʠ˺̼੮͐ʩ˺ͅʇ੮ɘϲϲˑʮɻ͐ʇʁ੮ɺ͙͐੮ɘˑͅ˺੮ʠ˺̼੮͐ʩʇʮ̼੮ ʠ̼ʮʇ˦ʁͅ੮ɘ˦ʁ੮ʠɘ˚ʮˑʮʇͅੳ îʩ˺˚ɘͅ੮ U˦ͅʇˑੴ੮ ʠ˺̼˚ʇ̼ˑ;੮ ʩʇɘʁ੮ ˺ʠ੮ ͐ʩʇ੮ ‡ɘ͐ʮ˺˦ɘˑ੮ U˦͐ͅʮ͙͐͐ʇ੮ ˺ʠ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩੴ੮ ̼ʇɻʇ˦͐ˑ;੮ ̼ʇˑʇɘͅʇʁ੮ ɘ੮ ɺ˺˺ˌ੮ ͐ʩɘ͐੮ ͅ˺͙˦ʁʇʁ੮ ͐ʩʇ੮ ˺̹͐ʮ˚ʮ͐ͅʮɻ੮ ˦˺͐ʇ੮ ͐ʩɘ͐੮ ુ̼͐ʇɘ͐˚ʇ˦͐ͅ੮ ͸˺̼ˌੴૂ੮ ɻ˺˦ɻˑ͙ʁʮ˦ʡ੮ ͐ʩɘ͐੮ ુͅ˺ˑͷʮ˦ʡ੮ ͐ʩʇ੮ ɻɘ̼ʇ੮ ɻ̼ʮͅʮͅ੮ ̼ʇή͙ʮ̼ʇͅ੮ ˦˺͐ʩʮ˦ʡ੮ ˚˺̼ʇ੮ ͐ʩɘ˦੮ ɘ੮ ͸ʮʁʇ̼੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮ɺʇ͐ͅ੮ɻɘ̼ʇ੮͸ʇ੮ɻɘ˦੮˺ʠʠʇ̼ੳૂਃৼ੮Ěʇ͐੮ɺʇʩʮ˦ʁ੮͐ʩʇ੮͸ɘˑˑͅ੮˺ʠ੮U{)ͅੴ੮ ˺˦੮͐ʩʇ੮ɺɘɻˌ੮̹ɘ͐ʮ˺ͅ੮˺ʠ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇͅੴ੮ɘ˦ʁ੮ʮ˦੮͐ʩʇ੮ɻɘͅʇ੮ϲʮˑʇͅ੮˺ʠ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮ ͸ʇ੮ɻɘ˦੮ͅʇʇ੮͸ʩʇ̼ʇ੮͐ʩʮͅ੮˦ɘ̼̼ɘ͐ʮͷʇ੮ɺ̼ʇɘˌͅ੮ʁ˺͸˦ੳ੮îʩʇ̼ʇ੮ɘ̼ʇ੮̹ɘʮ˦ʠ͙ˑ੮ˑʮ˚ʮ͐ͅ੮͐˺੮ʩ˺͸੮͸ʇˑˑ੮

C O N C LU S I O N

293

̼͐ʇɘ͐˚ʇ˦͐ͅ੮͸˺̼ˌ੮ʠ˺̼੮ͅ˺˚ʇ੮̹ʇ˺̹ˑʇੴ੮ɘ੮͐ʩʇ̼ɘ̹ʇ͙͐ʮɻ੮ʮ˚̹˺͐ʇ˦ɻʇ੮͐ʩɘ͐੮ɻ̼ʇɘ͐ʇͅ੮͙ͅʠʠʇ̼ʮ˦ʡ੮ ʠ˺̼੮͐ʩ˺ͅʇ੮̹̼˺ͷʮʁʮ˦ʡ੮ɻɘ̼ʇੴ੮͐˺˺ੳ U੮˺ʠ͐ʇ˦੮ʠʇʇˑ੮͐ʩɘ͐ੴ੮ʮ˦੮˚ʇ̼ʮɻɘੴ੮͸ʇ੮̼͙͐ͅʡʡˑʇ੮͐˺੮ϲʮ˦ʁ੮ɘ੮ˑɘ˦ʡ͙ɘʡʇ੮ʠ˺̼੮͐ʩʇ੮ʁʮͅή͙ʮʇ͐ʮ˦ʡ੮ ̼ʇɘˑʮ͐;੮˺ʠ੮ɻʩ̼˺˦ʮɻʮ͐;੮ɘ˦ʁ੮͙ͅʠʠʇ̼ʮ˦ʡੳ੮ä˺੮Uૄˑˑ੮˺ʠʠʇ̼੮ɘ੮ή͙˺͐ʇ੮ʠ̼˺˚੮ɘ੮H̼ʇ˦ɻʩ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮ U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ʮ˦੮৲ৰৱ৶ੴ੮ɘ੮ͷʇ͐ʇ̼ɘ˦੮ʁ˺ɻ͐˺̼੮͸ʩ˺੮ʩɘʁ੮̹ͅʇ˦͐੮;ʇɘ̼ͅ੮͸˺̼ˌʮ˦ʡ੮ʮ˦੮̹͙ɺˑʮɻ੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ʠ˺̼੮ˑ˺˦ʡચ͐ʇ̼˚੮̹ɘ͐ʮʇ˦͐ͅੵ੮ુĔʮ͐ʩ੮̹ͅ;ɻʩ˺ͅʮͅੴ੮ʮ͐ૄͅ੮ɘ੮ɻ˺˚ɺɘ͐੮͐ʩɘ͐੮ ʮͅ੮˺ʠ͐ʇ˦੮ͷʇ̼;੮ʁʮϲϲʮɻ͙ˑ͐ੳ੮U͐ૄͅ੮̼͐ͅ˺˦ʡʇ̼੮͐ʩɘ˦੮͸ʇ੮ɘ̼ʇੳ੮Ĕʇ੮ˌ˦˺͸੮͐ʩɘ͐੮ɘ੮̹ɘ͐ʮʇ˦͐੮ɻ˺͙ˑʁ੮ʁ˺੮ ͸ʇˑˑ੮͐˺ʁɘ;ੴ੮ɘ˦ʁ੮͐˺˚˺̼̼˺͸੮ʠɘˑˑ੮ɘ̹ɘ̼͐ੳ੯ੳ੯ੳ੯ੳ੮ä˺੮͐ʩʇ੮ʡ˺ɘˑ੮ʮͅ੮˦˺͐੮ʠ˺̼੮͐ʩʇ˚੮͐˺੮ɺʇ੮ɘʁɘ̹͐ʇʁ੮ ͐˺੮ͅ˺ɻʮʇ͐;ੴ੮˦˺͐੮͐˺੮ɺʇ੮ૃ˦˺̼˚ɘˑʮΈʇʁੳૄ੮"͙͐੮͐˺੮ɺʇ੮ɘͅ੮ʩɘ̹̹;੮ɘͅ੮̹˺ͅͅʮɺˑʇੳ੮î˺੮͙ͅʠʠʇ̼੮ˑʇͅͅੳૂ੮ î˺੮ɺʇ੮ʩ͙˚ɺˑʇ੮˚ʇɘ˦ͅ੮ɘɻɻʇ̹͐ʮ˦ʡ੮͐ʩɘ͐੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮͐ʩʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮͐ʩʮ˦ʡ੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ɻɘ˦੮˺ʠʠʇ̼੮ʮͅ੮˦ʇʮ͐ʩʇ̼੮ɻɘ̼ʇ੮˦˺̼੮ɻ˺ʇ̼ɻʮ˺˦੮ɺ͙͐੮ɻ˺˚̹ɘͅͅʮ˺˦੮ɘ˦ʁ੮ͅ˺ˑʮʁɘ̼ʮ͐;ੵ੮ɘ੮͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮͐˺੮ϲʮʡʩ͐੮ɘ˦੮˺̹ʇ˦ચʇ˦ʁʇʁੴ੮ɘ˦ʁ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ˑ˺ͅʮ˦ʡੴ੮ɺɘ͐͐ˑʇ੮ɘʡɘʮ˦͐ͅ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ɻɘ˦੮ɺʇ੮ɺ˺͐ʩ੮˚;͐ͅʇ̼ʮ˺͙ͅ੮ɘ˦ʁ੮ͅ˺ੴ੮ͅ˺੮ɻ̼͙ʇˑੳ Ěʇ͐ੴ੮ʮ˦੮͐ʩʇ੮ʇ˦ʁੴ੮͸ʇ੮ͅʩ˺͙ˑʁ੮ɺʇ੮ʩ˺̹ʇʠ͙ˑ੮͐˺˺ੳ੮"ʇɻɘ͙ͅʇ੮˺˦ɻʇ੮͸ʇ੮̼ʇˑʮ˦ή͙ʮͅʩ੮͐ʩʇ੮ʮʁʇɘ੮ ͐ʩɘ͐੮͸ʇ੮ɻɘ˦੮ɻɘ̼ʇੴ੮ɻ˺ʇ̼ɻʇੴ੮˺̼੮ɻ˺˦ͅʇ̼ͷʇ੮ʇͷʇ̼;˺˦ʇ੮ʮ˦͐˺੮̼ʇɻ˺ͷʇ̼;੮ɘ˦ʁ੮ʮ˦ʁʇ̹ʇ˦ʁʇ˦ɻʇੴ੮ ͸ʇ੮ɻɘ˦੮̼ʇɻ˺ʡ˦ʮΈʇ੮͐ʩɘ͐੮̹ʇ˺̹ˑʇ੮ɻɘ˦੮͐ͅʮˑˑ੮ˑʮͷʇ੮˚˺̼ʇ੮ʁʮʡ˦ʮϲʮʇʁ੮ˑʮͷʇͅ੮͸ʮ͐ʩ˺͙͐੮ʇʮ͐ʩʇ̼ੳ U˦੮̹̼ͅʮ˦ʡ੮৲ৰ৲৲ੴ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ͅʇ˦͐੮˚ʇ੮ɘ੮̹ʮɻ͙̼͐ʇ੮˺ʠ੮ʩʇ̼ͅʇˑʠ੮˦ʇͽ͐੮͐˺੮Ĕɘˑˑ;ੴ੮͸ʩ˺˚੮ U੮ʩɘʁ੮˚ʇ͐੮͐ʩʇ੮;ʇɘ̼੮ɺʇʠ˺̼ʇ੮ɘ͐੮͐ʩɘ͐੮ɺ͙ͅ੮͐ͅ˺̹ੴ੮̼͐ͅʮ̹̹ʇʁ੮˺ʠ੮ɘˑˑ੮ʩʮͅ੮̹˺ͅͅʇͅͅʮ˺˦੮ʇͽɻʇ̹͐੮ ɘ੮͸ʮ˦͐ʇ̼੮ɻ˺ɘ͐੮ɻ˺ͷʇ̼ʮ˦ʡ੮ʩʮ˚੮˺˦੮ɘ੮ͅ͸ʇˑ͐ʇ̼ʮ˦ʡ੮ʁɘ;ੳ੮U˦੮͐ʩʇ੮̹ʩ˺͐˺ੴ੮ʩʇ੮͸ɘͅ੮˦˺͐੮ˈ͙͐ͅ੮ ɻˑʇɘ˦ʇʁ੮͙̹ੴ੮͐ʩɘ˦ˌͅ੮͐˺੮͐ʩʇ੮˦͙̼ͅʮ˦ʡ੮ʩ˺˚ʇ੮͸ʩʇ̼ʇ੮ʩʇ੮͸ɘͅ੮˦˺͸੮ˑʮͷʮ˦ʡੴ੮ɺ͙͐੮ɺʇɘ˚ʮ˦ʡੳ U͐੮͸ɘͅ˦ૄ͐੮ɘ˦੮ʇɘͅ;੮̼˺ɘʁ੮͐˺੮ʡʇ͐੮͐ʩʇ̼ʇੳ੮੮ʠʇ͸੮˚˺˦͐ʩͅ੮ɘʠ͐ʇ̼੮U੮ͷʮͅʮ͐ʇʁ੮Ĕɘˑˑ;ੴ੮)̼ੳ੮Øɘ̼͐˺ͷʮ੮ɻ˺˦ͷʮ˦ɻʇʁ੮ʩʮ˚੮͐˺੮ʡ˺੮͐˺੮ɘ੮ͅʩʇˑ͐ʇ̼ੳ੮Ĕʩʇ˦੮ͅʩʇ੮ɺ̼˺͙ʡʩ͐੮ʩʮ˚ੴ੮͐ʩʇ;੮ͅɘʮʁ੮ʮ͐੮͸ɘͅ੮͐˺˺੮ ˑɘ͐ʇ੮ʮ˦੮͐ʩʇ੮ʁɘ;੮ʠ˺̼੮ɘ˦੮ʮ˦͐ɘˌʇੴ੮ɺ͙͐੮ʩʇ੮ɻ˺͙ˑʁ੮ɻ˺˚ʇ੮ɺɘɻˌ੮͐˺˚˺̼̼˺͸ੳ੮"͙͐੮͐˺˚˺̼̼˺͸ੴ੮ ʩʇ੮ʁʮʁ˦ૄ͐੮͸ɘ˦͐੮͐˺੮ɻ˺˚ʇ੮ɺɘɻˌੳ੮ä˺੮Øɘ̼͐˺ͷʮ੮̼͐ʮʇʁ੮͐ʩʇ੮ʠ˺̼ɻʇʠ͙ˑ੮̼˺͙͐ʇੵ੮ͅʩʇ੮ɻɘˑˑʇʁ੮͐ʩʇ੮ Pš{/੮͐ʇɘ˚੮ફ͸ʩʮɻʩ੮ˑʇɘʁͅ੮rૄͅ੮˺͙̹͐ɘ͐ʮʇ˦͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹̼˺ʡ̼ɘ˚બ੮ɘ˦ʁ੮ͅɘʮʁੴ੮ ુîʩʮͅ੮ʡ͙;੮ʮͅ੮ʡ˺ʮ˦ʡ੮͐˺੮ʁʮʇੴ੮ʩʇ੮˦ʇʇʁͅ੮͐˺੮ɺʇ੮৵ৱ৵ৰʇʁੳૂ੮îʩʮͅ੮͐ʮ˚ʇ੮͐ʩʇ;੮ɘʡ̼ʇʇʁ੮ɘ˦ʁ੮͐˺˺ˌ੮ ʩʮ˚੮͐˺੮͐ʩʇ੮ɻ˺͙˦͐;੮ʩ˺̹ͅʮ͐ɘˑੳ੮Pʇ੮͸ɘͅ੮˺˦੮̼͐ɘɻˌ੮͐˺੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁੳ /ͽɻʇ̹͐੮ʩʇ੮͸ɘͅ˦ૄ͐ੳ੮îʩʇ੮ɻ˺͙˦͐;੮̼͐ɘ˦ͅʠʇ̼̼ʇʁ੮ʩʮ˚੮͐˺੮ɘ੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑੳ੮Ĕʩʇ˦੮)̼ੳ੮ Øɘ̼͐˺ͷʮ੮ɻɘˑˑʇʁ੮͐ʩʇ˚੮͐˺੮ͅɘ;੮ͅʩʇ੮ɻ˺͙ˑʁ੮˺ʠʠʇ̼੮͐ʇ͐ͅʮ˚˺˦;੮ɘ͐੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʩʇɘ̼ʮ˦ʡੴ੮ ͐ʩʇ੮̹ʩ;ͅʮɻʮɘ˦ૄͅ੮ɘͅͅʮ͐ͅɘ˦͐੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુšʩੴ੮˦˺ੴ੮˺͙̼੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦੮ʁ˺ʇͅ˦ૄ͐੮ˑʮˌʇ੮͐ʩɘ͐੮ યɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹રੳૂ੮äʩʇ੮ʩɘ̼ɘ˦ʡ͙ʇʁ੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮͸˺̼ˌʇ̼ੴ੮͐˺˺ੴ੮͸ʩ˺੮͐˺ˑʁ੮ʩʇ̼ੴ੮ુĔʇ੮ʩɘͷʇ੮ ͐͸˺੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ˦ʇʇʁ੮ ͐˺੮ ɺʇ੮ ɻ˺˦ͅʇ̼ͷʇʁੴ੮ ɺ͙͐੮ ͸ʇ੮ ɻɘ˦੮ ˺˦ˑ;੮ ʁ˺੮ ˺˦ʇੳૂ੮ ä˺੮ ͐ʩʇ;੮ ͅʇ˦͐੮ Wally to a nursing home. ˦ʁੴ੮ʠ˺̼੮͸ʩɘ͐ʇͷʇ̼੮̼ʇɘͅ˺˦ੴ੮ʩʇ੮͐ͅɘ;ʇʁੳ੮Ĕʩʇ˦੮Øɘ̼͐˺ͷʮ੮͸ʇ˦͐੮͐˺੮ͷʮͅʮ͐੮ʩʮ˚ੴ੮ʩʇ੮͸ɘͅ੮ ુɺ̼ʮʡʩ͐੮ʇ;ʇʁ੮ɘ˦ʁ੮ɘˑʇ̼͐ੳૂ੮îʩʮͅ੮͐ʮ˚ʇ੮ʩʇ੮ͅɘʮʁ੮ʩʇ੮̼ʇ˚ʇ˚ɺʇ̼ʇʁ੮)̼ੳ੮Øɘ̼͐˺ͷʮੳ ુ)˺੮;˺͙੮ˑʮˌʇ੮ʮ͐੮ʩʇ̼ʇ੺ૂ੮ͅʩʇ੮ɘͅˌʇʁੳ

294

C O N C LU S I O N

ુĚʇɘʩ੸ૂ੮ʩʇ੮̼ʇ̹ˑʮʇʁੳ ુĔʩɘ͐੮ʁ˺੮;˺͙੮ˑʮˌʇ੺ૂ ુI˺˺ʁ੮ʠ˺˺ʁ੸ૂ੮ʩʇ੮ʇ˦͐ʩ͙ͅʇʁੳ U͐੮ˑ˺˺ˌʇʁ੮ˑʮˌʇ੮͐ʩʇ੮̹ʇ̼ʠʇɻ͐੮˺͙͐ɻ˺˚ʇੵ੮͐ʩʇ੮̹ʇ̼ͅʮ͐ͅʇ˦ɻʇ੮˺ʠ੮ɘ੮̼ɘʠ͐੮˺ʠ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮ ˚ʇɘ˦͐੮͐ʩɘ͐੮Ĕɘˑˑ;੮͸ɘͅ੮ʡʇ͐͐ʮ˦ʡ੮ɻɘ̼ʇੴ੮˦˺੮ɻ˺ʇ̼ɻʮ˺˦੮̼ʇή͙ʮ̼ʇʁੳ੮˦ʁ੮͐ʩʇ˦ੴ੮͸ʩʇ˦੮Øɘ̼͐˺ͷʮ੮͸ɘͅ੮˚˺ͷʮ˦ʡ੮͐˺੮ˑʇɘͷʇੴ੮ʩʇ੮ɘͅˌʇʁ੮ɘ੮ʁʮͅή͙ʮʇ͐ʮ˦ʡ੮ή͙ʇ͐ͅʮ˺˦ੵ੮ુ̼ʇ੮;˺͙੮͐ɘˌʮ˦ʡ੮˚ʇ੮ with you?” ુĔʩʇ̼ʇ੮ʁ˺੮;˺͙੮͸ɘ˦͐੮͐˺੮ʡ˺੺ૂ੮ͅʩʇ੮ή͙ʇ̼ʮʇʁੳ ુ"ɘɻˌ੮͐˺੮˚;੮̹ͅ˺͐ੴૂ੮ʩʇ੮̼ʇ̹ˑʮʇʁੳ੮"ɘɻˌ੮͐˺੮ʩʮͅ੮ɺ͙ͅ੮͐ͅ˺̹ੳ ુšʩ੮Ĕɘˑˑ;ੴ੮;˺͙ૄ̼ʇ੮ͅ˺੮ͅʮˑˑ;ੴૂ੮ɘ੮͐ͅɘʠʠ੮˚ʇ˚ɺʇ̼੮ʮ˦͐ʇ̼ˈʇɻ͐ʇʁੳ "͙͐੮͸ʮ͐ʩ˺͙͐੮ɘ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ʮʠ੮ʩʇ੮͸ɘ˦͐ʇʁ੮͐˺ੴ੮ʩʇ੮͸ɘͅ੮ˑʇʡɘˑˑ;੮ʠ̼ʇʇ੮͐˺੮ʡ˺ੳ

w ͅ੮ ʠ˺̼੮ ͐ʩʇ੮ ;˺͙˦ʡ੮ ̹̼ʇʡ˦ɘ˦͐੮ ͸˺˚ɘ˦੮ ʠ̼˺˚੮ ͐ʩʇ੮ ͐ͅɘ̼͐੮ ˺ʠ੮ ͐ʩʮͅ੮ ɻʩɘ̹͐ʇ̼ੴ੮ ͐ʩʇ̼ʇ੮ ̼ʇɘˑˑ;੮ ͸ɘͅ੮ɘ੮˚ʮ̼ɘɻˑʇੴ੮˺ʠ੮ͅ˺̼͐ͅੵ੮͐ʩʇ੮/Û੮̹ʩ;ͅʮɻʮɘ˦੮ɻ˺˦ͷʮ˦ɻʇʁ੮ʩ˺̹ͅʮ͐ɘˑ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦੮͐˺੮ ˑʇ͐੮ʩʇ̼੮͐ͅɘ;੮͐ʩʇ੮˦ʮʡʩ͐ੳ੮îʩʇ੮ϲʮ̼͐ͅ੮̼ʇ̹ͅ˺˦ʁʇ̼੮U੮͸ɘͅ੮ͅʩɘʁ˺͸ʮ˦ʡ੮͸ʇ˦͐੮ʮ˦੮͐˺੮ʡʇ͐੮ɘ੮ˑ˺˺ˌ੮ ɘ͐੮ʩʇ̼੮ͅ˺੮͸ʇ੮ɻ˺͙ˑʁ੮ʮʁʇ˦͐ʮʠ;੮ʩʇ̼੮ɺɘɻˌ੮˺͙͐੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅ੮ɘʠ͐ʇ̼੮ͅʩʇ੮͸ɘͅ੮ʁʮͅɻʩɘ̼ʡʇʁੳ੮ Ĕʩʇ˦੮͸ʇ੮̹ʇʇˌʇʁ੮ʮ˦ੴ੮ͅʩʇ੮͸ɘͅ੮ͅˑʇʇ̹ʮ˦ʡ੮ͅ˺͙˦ʁˑ;ੳ੮šͷʇ̼੮͐ʩʇ੮ɻ˺͙̼ͅʇ੮˺ʠ੮ɘ੮ʠʇ͸੮ʩ˺͙̼ͅ੮͐ʩɘ͐੮ ʇͷʇ˦ʮ˦ʡੴ੮ͅʩʇ੮ʩɘʁ੮ͅʇʇ˦੮͐ʩʇ੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅ੮͸ʩ˺੮̹͙͐੮ʩʇ̼੮˺˦੮ɘ੮ʩ˺ˑʁੴ੮͐ʩʇ੮̹ɘ̼ɘ˚ʇʁʮɻͅ੮ ͸ʩ˺੮̼͐ɘ˦̹ͅ˺̼͐ʇʁ੮ʩʇ̼ੴ੮͐ʩʇ੮/Û੮̹ʩ;ͅʮɻʮɘ˦੮ɘ˦ʁ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʩ˺੮ʇͷɘˑ͙ɘ͐ʇʁ੮ʩʇ̼ੴ੮ɘ੮ʩ˺͐ͅ੮ ˺ʠ੮͐ʇɻʩͅ੮ɘ˦ʁ੮˦͙̼ͅʇͅ੮͸ʩ˺੮˺ʠʠʇ̼ʇʁ੮ʩʇ̼੮ɻɘ̼ʇ੮ɘ˦ʁ੮ɻ˺˚ʠ˺̼͐ੴ੮ɘ˦ʁ੮͐ʩʇ੮ʁʮͅɻʩɘ̼ʡʇ੮ͅ˺ɻʮɘˑ੮ ͸˺̼ˌʇ̼੮͸ʩ˺੮͸ɘͅ੮̹ˑʇɘʁʮ˦ʡ੮ʠ˺̼੮ʩʇˑ̹੮ϲʮ˦ʁʮ˦ʡ੮ɘ੮ͅʩʇˑ͐ʇ̼ੳ੮îʩɘ˦ˌͅ੮͐˺੮͐ʩʇ˚ੴ੮ͅʩʇ੮ʩɘʁ੮ɘ੮ ̼͐ɘ;੮˺ʠ੮ʩɘˑʠચʇɘ͐ʇ˦੮ʠ˺˺ʁ੮ɺ;੮ʩʇ̼੮ɺʇʁੴ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮ʡ˺͸˦ੴ੮ɘ˦ʁ੮ɘ੮̼˺˺ʠ੮˺ͷʇ̼੮ʩʇ̼੮ʩʇɘʁੳ੮ H˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮ɘ˦ʁ੮ͅʩʇˑ͐ʇ̼ੳ U˦੮͐ʩʇ੮˚˺̼˦ʮ˦ʡੴ੮ͅʩʇૄʁ੮ɺʇ੮ʡ˺˦ʇੴ੮ɘ˦ʁ੮ɺɘɻˌ੮͐˺੮ɺʇʮ˦ʡ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ

METHODOLOGICAL APPENDIX

INTERVIEWING ACROSS THE CONSERVATORSHIP CONTINUUM In 2018, I was a graduate student at Berkeley interested in the state and mental health care, and a human being residing in the Bay Area, which meant I was aware of how both government and medicine seemed to be failing many people I saw on my bike ride to campus. I was intrigued when I learned about a government bureaucracy, public guardians, on which almost nothing was written but who policy makers thought ought to be doing more. With a group of research assistants, we began contacting and interviewing the public guardians and public defenders representing conservatees in as many counties as possible. We faced a ʡ̼ʇɘ͐੮ʁʇɘˑ੮˺ʠ੮ͅˌʇ̹͐ʮɻʮͅ˚੮ɘ˦ʁ੮̼͙͐ͅʡʡˑʇʁ੮ʇͷʇ˦੮͐˺੮ϲʮ˦ʁ੮ɻ˺˦͐ɘɻ͐੮ʮ˦ʠ˺̼˚ɘ͐ʮ˺˦੮ʮ˦੮˚ɘ˦;੮ smaller counties, but we ultimately spoke to seven public defenders and nine public guardians in larger counties (those with more than a million people), six and nine in medium counties (between two hundred thousand and one million), and two and four in smaller counties (less than two hundred thousand). These interviews provided a far from complete survey of how these agencies ˺̹ʇ̼ɘ͐ʇʁ੮ɘɻ̼˺ͅͅ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅੴ੮ɺ͙͐੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮̹ɘ͐͐ʇ̼˦ͅ੮ή͙ʮɻˌˑ;੮ʇ˚ʇ̼ʡʇʁੳ੮U͐੮ became clear that decisions about conservatorship that I assumed were taken by courts and public guardians had been largely decided far earlier in the conserͷɘ͐˺̼ͅʩʮ̹੮ɻ˺˦͐ʮ˦͙͙˚੮ɺ;੮̹˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅ੮͸̼ʮ͐ʮ˦ʡ੮৵ৱ৵ৰͅੴ੮/Û੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮˚ɘˌʮ˦ʡ੮ ɘʁ˚ʮͅͅʮ˺˦ͅ੮ʁʇɻʮͅʮ˺˦ͅੴ੮˺̼੮ʮ˦̹ɘ͐ʮʇ˦͐੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮ϲʮˑˑʮ˦ʡ੮˺͙͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘ̹̹ˑʮɻɘtions. I reached out to these other professional groups through a range of stratʇʡʮʇͅੴ੮ ʮ˦ɻˑ͙ʁʮ˦ʡ੮ ʁʮ̼ʇɻ͐ˑ;੮ ɻ˺˦͐ɘɻ͐ʮ˦ʡ੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ͸ʩ˺੮ ͸ʇ̼ʇ੮ ή͙˺͐ʇʁ੮ ʮ˦੮ ͐ʩʇ੮ ˚ʇʁʮɘ੮ or had published research on the topic and relying on referrals from previous

296

M E T H O D O LO G I C A L A P P E N D I X

interviewees. Following the precepts of “theoretical sampling,” my focus was not on identifying a representative sample from each set of institutions but rather enough examples to “reveal the practices, mechanisms, and relationships” shaping each point of the continuum.ৼ In 2020, my research was given an unlikely boost by two “Moms on a Mission,” îʇ̼ʇͅɘ੮Øɘͅή͙ʮ˦ʮ੮ɘ˦ʁ੮rɘ͙̼ʇ˦੮Ûʇ͐͐ɘʡˑʮɘ͐ɘੳ੮îʩʇ;੮ͅʇ˦͐੮˚ʇ੮ɘ੮ɻ˺̹;੮˺ʠ੮ɘ੮ુPʇɘ̼͐੮Øɘ̹ʇ̼ૂ੮ they had written based on visits to various providers of Housing That Heals— residential care that could have helped their sons avoid years locked in institu͐ʮ˺˦ͅ੮˺̼੮ʁʇɻ˺˚̹ʇ˦ͅɘ͐ʮ˦ʡ੮ʮ˦੮͙̹̹ͅ˺̼͐ʇʁ੮ʩ˺͙ͅʮ˦ʡ੮ફʠ˺̼੮ˑɘɻˌ੮˺ʠ੮͙ͅϲϲʮɻʮʇ˦͐੮͙̹̹ͅ˺̼͐ͅબੳ੮ îʩʇ;੮ɻˑ͙ʇʁ੮˚ʇ੮ʮ˦੮͐˺੮͸ʩɘ͐੮ͅʩ˺͙ˑʁ੮ɺʇ੮˺ɺͷʮ˺͙ͅੵ੮͐ʩ˺ͅʇ੮͸ʮ͐ʩ੮ϲʮ̼͐ͅʩɘ˦ʁ੮ʇͽ̹ʇ̼ʮʇ˦ɻʇ੮ ˦ɘͷʮʡɘ͐ʮ˦ʡ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ʩɘͷʇ੮͙˦ʮή͙ʇ੮ɘ˦ʁ੮ʮ̼̼ʇ̹ˑɘɻʇɘɺˑʇ੮ʮ˦ͅʮʡʩ͐ͅ੮ʮ˦͐˺੮ʮ͐ੳ੮îʩʇ;੮ʡʇ˦ʇ̼˺͙ͅˑ;੮ɻʮ̼ɻ͙ˑɘ͐ʇʁ੮ɘ੮̼ʇή͙ʇ͐ͅ੮ʠ˺̼੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮ɘ˚˺˦ʡ੮ɻ˺˚˚͙˦ʮ͐ʮʇͅ੮˺ʠ੮ʠɘ˚ʮˑʮʇͅ੮˺ʠ੮̹ʇ˺ple with mental illness. In 2021, I added another group that I had been hesitant to include (since my original research design was focused on professional decisions) but whose inclusion at this point seemed absolutely essential: people who had experienced forced treatment themselves. Interviews with professionals generally lasted about an hour, those with famʮˑʮʇͅ੮ ɘ˦ʁ੮ ͅʇ̼ͷʮɻʇ੮ ͙ͅʇ̼ͅ੮ ͅ˺˚ʇ͐ʮ˚ʇͅ੮ ͐͸˺ੴ੮ ˺̼੮ ͙̹੮ ͐˺੮ ϲʮͷʇੳ੮ {˺͐ͅ੮ ˺ʠ੮ ͐ʩʇ˚੮ ͸ʇ̼ʇ੮ ɻ˺˦ducted remotely: even when I lived in the Bay Area, many interviewees were a six-hour drive away. A reader might notice that few interviewees are introduced ͸ʮ͐ʩ੮ɘ੮̹ʩ;ͅʮɻɘˑ੮ʁʇͅɻ̼ʮ̹͐ʮ˺˦੮˺̼੮ɻʩɘ̼ɘɻ͐ʇ̼ʮΈɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮ͅɻʇ˦ʇੴ੮͸ʩʮɻʩ੮̼ʇϲˑʇɻ͐ͅ੮ɺ˺͐ʩ੮ my desire to preserve anonymity and the fact that I spoke to many people over the phone. The dawn of the Zoom era during the pandemic in 2020 allowed me ͐˺੮ɘʁʁ੮ɘ੮͸ʇˑɻ˺˚ʇ੮ͷʮʁʇ˺੮ɻ˺˚̹˺˦ʇ˦͐੮͐˺੮͐ʩʇ੮ʮ˦͐ʇ̼ͷʮʇ͸ͅੳ੮U੮ɘʁɘ̹͐ʇʁ੮˚;੮ή͙ʇ͐ͅʮ˺˦naire to the particular practices and pressures of people working at each point ʮ˦੮͐ʩʇ੮ͅ;͐ͅʇ˚ੳ੮P˺͸ʇͷʇ̼ੴ੮͐˺੮ɻ̼ʇɘ͐ʇ੮ͅ˺˚ʇ੮ɻ˺˚̹ɘ̼ɘɺʮˑʮ͐;ੴ੮U੮ʇ˦ʁʇʁ੮ʇɘɻʩ੮ʮ˦͐ʇ̼ͷʮʇ͸੮ ͸ʮ͐ʩ੮ɘ੮ɻ˺˚˚˺˦੮ɺɘ͐͐ʇ̼;੮˺ʠ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ɘɺ˺͙͐੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅૄ੮ͷʮʇ͸ͅ੮˺ʠ੮rØä੮̼ʇʠ˺̼˚ੴ੮ vision for improving the mental health system, and understanding of the goals of conservatorship. ˑˑ੮͐˺ˑʁੴ੮U੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮৲৶৸੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮ɘɻ̼˺ͅͅ੮͐ʩʮ̼͐;ચʠ˺͙̼੮ɻ˺͙˦͐ʮʇͅ੶੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅૄ੮ roles are summarized in table A.1. While the raw number of interviewees is above the norm for most sociological studies, the numbers within some key groups— say, mobile crisis clinicians (twelve)—are small.৽ I have no doubt I could conduct hundreds more interviews across dozens of counties and learn still more, but the ͅɘ˚̹ˑʇ੮ʮͅ੮ˑɘ̼ʡʇ੮ʇ˦˺͙ʡʩ੮͐ʩɘ͐੮U੮ɘ˚੮̼ʇɘͅ˺˦ɘɺˑ;੮ɻʇ̼͐ɘʮ˦੮U੮ʩɘͷʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮˚˺͐ͅ੮˺ʠ੮͐ʩʇ੮ main trends in the conservatorship system.

M E T H O D O LO G I C A L A P P E N D I X

TABLE A.1

297

U˦͐ʇ̼ͷʮʇ͸ʇʇ੮ϲʮʇˑʁͅ

Law enforcement / First responder

৽਀

Outpatient clinician

৽৾

ER / Hospital

৽ਁ

Public guardian

৽ਁ

Court / Public defender

৽ਃ

Housing provider

৽৾

Government

৽ਃ

Advocacy group

ৼ਄

Family

৽਄

Person receiving involuntary treatment

৾৻

Professional organization

ৼৼ

Total

৽ਁਃ

It would be easy to see the interview data on which this book is based as ɘ੮ ͅʇɻ˺˦ʁચɺʇ͐ͅ੮ ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ ͐˺੮ ͐ʩʇ੮ ˌʮ˦ʁ੮ ˺ʠ੮ ͷʮͷʮʁ੮ ɘ˦ʁ੮ ϲʮ̼͐ͅʩɘ˦ʁ੮ ʁʇͅɻ̼ʮ̹͐ʮ˺˦ͅ੮ ͐ʩɘ͐੮ longer-term ethnographic observations would provide. Nonetheless, such an ɘ̹̹̼˺ɘɻʩ੮͸˺͙ˑʁ੮˦˺͐੮ʩɘͷʇ੮ɘˑˑ˺͸ʇʁ੮˚ʇ੮͐˺੮˚ɘˌʇ੮͐ʩʮͅ੮ɺ˺˺ˌૄͅ੮˚˺͐ͅ੮ʁʮ͐ͅʮ˦ɻ͐ʮͷʇ੮ɻ˺˦tribution. There are fantastic ethnographies of outpatient clinics, hospitals, and commitment courts৾ but fewer studies that look at the host of disparate institutions that make up the public mental health system simultaneously. Getting ɘ੮ ̹˺̼̼͐ɘʮ͐੮ ˺ʠ੮ ʇɘɻʩ੮ ͐ͅʇ̹੮ ʮ˦੮ ͐ʩʇ੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ɻ˺˦͐ʮ˦͙͙˚੮ ̼ʇή͙ʮ̼ʇʁ੮ ͅɘɻ̼ʮϲʮɻʮ˦ʡ੮ ʁʇ̹͐ʩ੮ʠ˺̼੮ɺ̼ʇɘʁ͐ʩੳ੮äʩ˺͸ʮ˦ʡ੮ʩ˺͸੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮˺̹ʇ̼ɘ͐ʇͅ੮ʮ˦੮˦˺͐੮˺˦ʇ੮ɺ͙͐੮ʁ˺Έʇ˦ͅ੮ of counties entailed a similar trade-off.

FACT CHECKING U͐ૄͅ੮ ɺ˺͐ʩ੮ ̹˺̹͙ˑɘ̼੮ ͸ʮͅʁ˺˚੮ ɘ˦ʁੴ੮ ͐˺੮ ͅ˺˚ʇ੮ ͅ˺ɻʮ˺ˑ˺ʡʮ͐ͅͅੴ੮ ɘ੮ ˚ʇ͐ʩ˺ʁ˺ˑ˺ʡʮɻɘˑ੮ ̹̼ʇɻʇ̹͐੮ that “talk is cheap.”৿੮Ûʇˑ;ʮ˦ʡ੮˺˦੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮˚ʇɘ˦ͅ੮͐ʩʮͅ੮ɺ˺˺ˌ੮̼ʇ͐ͅͅ੮˺˦੮͸ʩɘ͐੮̹ʇ˺̹ˑʇ੮ ͅɘ;੮͐ʩʇ;੮ʁ˺ੳ੮îʩʇ੮ɘ̼͐ʮϲʮɻʮɘˑ੮ͅʇ͐͐ʮ˦ʡ੮˺ʠ੮ɘ˦੮ʮ˦͐ʇ̼ͷʮʇ͸੮ɻ̼ʇɘ͐ʇͅ੮ɘˑˑ੮ͅ˺̼͐ͅ੮˺ʠ੮˺̹̹˺̼͙͐˦ʮties for doctors to sugarcoat how they treat patients, families to exaggerate the

298

M E T H O D O LO G I C A L A P P E N D I X

ͅ;͐ͅʇ˚ૄͅ੮ʠɘʮˑʮ˦ʡͅੴ੮˺̼੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅ੮͐˺੮ͅʩʮʠ͐੮ɺˑɘ˚ʇ੮˺˦͐˺੮˺͐ʩʇ̼ͅੳ੮/ͷʇ˦੮͐ʩʇ੮ɺʇ͐ͅચʮ˦tentioned interviewees can have faulty recollections. U੮ʩɘͷʇ੮ɘʁ˺̹͐ʇʁ੮ʠ˺͙̼੮̼͐ͅɘ͐ʇʡʮʇͅ੮͐˺੮ʮ˦ɻ̼ʇɘͅʇ੮˚;ੴ੮ɘ˦ʁ੮ʩ˺̹ʇʠ͙ˑˑ;੮͐ʩʇ੮̼ʇɘʁʇ̼ૄͅੴ੮ɻ˺˦ϲʮʁʇ˦ɻʇ੮ʮ˦੮˚;੮ʮ˦͐ʇ̼ͷʮʇ͸੮ʁɘ͐ɘੳ੮îʩʇ੮ϲʮ̼͐ͅ੮ʮͅ੮͐ʩʇ੮ɘ̹̹̼˺ɘɻʩ੮͐˺੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮͐ʩʇ˚ͅʇˑͷʇͅੳ੮ Ûɘ͐ʩʇ̼੮͐ʩɘ˦੮ɘͅˌʮ˦ʡ੮ʡʇ˦ʇ̼ɘˑ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ફુP˺͸੮ʁ˺੮;˺͙੮ʁʇϲʮ˦ʇ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੺ૂબੴ੮ U੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ʩɘͷʮ˦ʡ੮ʁʇɻʮͅʮ˺˦੮˚ɘˌʇ̼ͅ੮͸ɘˑˌ੮˚ʇ੮͐ʩ̼˺͙ʡʩ੮̹ͅʇɻʮϲʮɻ੮ɻɘͅʇͅੳ੮îʩʇͅʇ੮ˌʮ˦ʁͅ੮ ˺ʠ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ʇˑʮɻʮ͐ʇʁ੮˦ɘ̼̼ɘ͐ʮͷʇͅ੮͸ʩ˺ͅʇ੮ɻ˺ʩʇ̼ʇ˦ɻʇ੮ɘ˦ʁ੮ɻ˺˦ͅʮ͐ͅʇ˦ɻ;੮U੮ɻ˺͙ˑʁ੮ʇͷɘˑ͙ɘ͐ʇੳ੮ Ĕʩʮˑʇ੮ U੮ ˦ʇͷʇ̼੮ ͅ˺ˑʮɻʮ͐ʇʁ੮ ʁ˺ɻ͙˚ʇ˦͐ͅ੮ ͸ʮ͐ʩ੮ ʮʁʇ˦͐ʮϲʮɘɺˑʇ੮ ˺̼੮ ̹̼ʮͷɘ͐ʇ੮ ʮ˦ʠ˺̼˚ɘtion (such as health records), many interviewees had a paper trail to back up what they told me. This included, for example, parents who had collected emails from county public guardians or inpatient psychiatrists who could show memos directing them to reduce conservatorship applications. äʇɻ˺˦ʁੴ੮ U੮ ɻ̼˺ͅͅચɻʩʇɻˌʇʁ੮ ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ ɘʡɘʮ˦͐ͅ੮ ˺˦ʇ੮ ɘ˦˺͐ʩʇ̼੮ ɘ˦ʁ੮ ̹ʇ̼ͅʮ͐ͅʇ˦͐ˑ;੮ found that even people with sharply diverging views on what should be done to change the conservatorship system largely concurred on what was happening within in. It might be self-serving for public guardians to report that they almost ɘˑ͸ɘ;ͅ੮͸ʇ̼ʇ੮͙ͅɻɻʇͅͅʠ͙ˑ੮͸ʮ͐ʩ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̹ʇ͐ʮ͐ʮ˺˦ͅ੮͐ʩʇ;੮ϲʮˑʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮ɻ˺͙̼͐ੳ੮ The claim became more credible when I spoke to public defenders who admitted, in more self-deprecating fashion, that they usually lost. In some cases, multiple interviewees were talking about the same cases or programs (such as community conservatorship in the Bay Area), creating additional opportunities for me to ɻʩɘˑˑʇ˦ʡʇ੮˺̼੮ɻ˺˦ϲʮ̼˚੮˚;੮ϲʮ˦ʁʮ˦ʡͅੳ Third, I have created ample opportunities for the people with the most knowledge of and stakes in the system I am studying to evaluate my conclusion about ʮ͐ੳ੮U˦੮ˑɘ͐ʇ੮৲ৰ৲ৰੴ੮U੮̹˺͐ͅʇʁ੮ɘ੮̹̼ʇˑʮ˚ʮ˦ɘ̼;੮̼ʇ̹˺̼͐੮͸ʮ͐ʩ੮ϲʮ˦ʁʮ˦ʡͅ੮ɘɺ˺͙͐੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘtorship continuum onto Google Drive and circulated it to a few people I had interviewed. Their feedback was enthusiastic—but critical. More importantly, they forwarded it to many other stakeholders. I ultimately gave eight public presentations in 2021 and 2022 attended by more than four hundred people. I faced ̹˺ʮ˦͐ʇʁ੮ή͙ʇ͐ͅʮ˺˦ͅ੮ʮ˦੮ɘˑˑ੮˺ʠ੮͐ʩʇ˚ੳ੮îʩʇ੮˚˺̼ʇ੮̹͙ɺˑʮɻ੮˚;੮̼ʇͅʇɘ̼ɻʩ੮͸ʇ˦͐੮ફɘͅ੮U੮̹͙ɺˑʮͅʩʇʁ੮˦ʇ͸̹ͅɘ̹ʇ̼੮˺̹ચʇʁͅ੮ɘ˦ʁ੮͸ɘͅ੮ή͙˺͐ʇʁ੮ʮ˦੮˚ʇʁʮɘ੮͐ͅ˺̼ʮʇͅબੴ੮͐ʩʇ੮˚˺̼ʇ੮͙˦ͅ˺ˑʮɻʮ͐ʇʁ੮ criticism and corrections I had to address. H˺͙̼͐ʩੴ੮U੮ʩɘͷʇ੮ʠ˺ˑˑ˺͸ʇʁ੮ɘ੮ʡ̼˺͸ʮ˦ʡ੮˚˺ͷʇ˚ʇ˦͐੮ɘ˚˺˦ʡ੮ή͙ɘˑʮ͐ɘ͐ʮͷʇ੮̼ʇͅʇɘ̼ɻʩʇ̼ͅ੮ ʮ˦੮ʡʮͷʮ˦ʡ੮˚;੮ͅ˺͙̼ɻʇͅ੮͐ʩʇ੮˺̹̹˺̼͙͐˦ʮ͐;੮͐˺੮ɺʇ੮ʮʁʇ˦͐ʮϲʮʇʁ੮ɺ;੮˦ɘ˚ʇ੮ફ͐ʩʮͅ੮ʮͅੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮ a long-established way to increase credibility in journalism).਀ Many government ˺ϲϲʮɻʮɘˑͅ੮ɻ˺͙ˑʁ੮̹ͅʇɘˌ੮˺˦ˑ;੮ʮʠ੮͐ʩʇʮ̼੮ɻ˺͙˦͐;੮͸ɘͅ੮˦˺͐੮ʮʁʇ˦͐ʮϲʮʇʁੴ੮ɘ˦ʁ੮ͅ˺˚ʇ੮ͅʇ̼ͷʮɻʇ੮

M E T H O D O LO G I C A L A P P E N D I X

299

users were understandably reticent to be named. But the willingness of at least some interviewees to go public does create a new avenue for fact checking. If you ʁ˺˦ૄ͐੮ɺʇˑʮʇͷʇ੮˚;੮ɘɻɻ˺͙˦͐੮˺ʠ੮š̹ʇ̼ɘ͐ʮ˺˦੮)ʮʡ˦ʮ͐;ੴ੮ʡ˺੮ɘͅˌ੮)̼ੳ੮{ʇ;ʇ̼੮ɘɺ˺͙͐੮ʮ͐ੳ U˦੮͐ʩʇ੮ʇ˦ʁੴ੮͐ʩʇͅʇ੮ˑɘ͐ͅ੮͐͸˺੮͐ɘɻ͐ʮɻͅ੮ʠ˺̼੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮͐ʩʇ੮͙͐ͅʁ;ૄͅ੮ɻ̼ʇʁʮɺʮˑʮ͐;੮ʩɘͷʇ੮ ̹͙ˑˑʇʁ੮˚ʇ੮ɘ͸ɘ;੮ʠ̼˺˚੮ɘ੮̹͙̼ʇˑ;੮ɘɻɘʁʇ˚ʮɻ੮ɘ̹̹̼˺ɘɻʩ੮͐˺੮ɘɻɻ͙̼ɘɻ;੮ɘ˦ʁ੮̼͙͐͐ʩੳ੮U͐ૄͅ੮˺˦ʇ੮ thing to convince a sociological reviewer with little direct knowledge of Califor˦ʮɘૄͅ੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮ɘɺʁʮɻɘ͐ʇʁ੮ɘ͙͐ʩ˺̼ʮ͐;੮ʮͅ੮ɘ੮͙ͅʇʠ͙ˑ੮ɻ˺˦ɻʇ̹͐ੳ੮U͐੮ ͸ɘͅ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ɻʩɘˑˑʇ˦ʡʇ੮͐˺੮ʁʇ˚˺˦̼͐ͅɘ͐ʇ੮͐˺੮)̼ੳ੮Û˺ʁ੮äʩɘ˦ʇ̼ੴ੮͐ʩʇ੮ʠ˺̼˚ʇ̼੮˚ʇʁʮɻɘˑ੮ ʁʮ̼ʇɻ͐˺̼੮˺ʠ੮rૄͅ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩੴ੮͸ʩ˺੮ʡ̼ɘɻʮ˺͙ͅˑ;੮̼ʇɘʁ੮͐ʩʮͅ੮˚ɘ˦͙script, that I accurately understood Medi-Cal contracting with private hospitals. I hope this book is compelling to both academic and nonacademic audiences, but ʮ͐ૄͅ੮͐ʩʇ੮ˑɘ͐͐ʇ̼੮͐ʩɘ͐੮ʩɘͅ੮̹͙ͅʩʇʁ੮˚ʇ੮͐ʩʇ੮ʩɘ̼ʁʇ͐ͅ੮͐˺੮ʡʇ͐੮͐ʩʇ੮͐ͅ˺̼;੮̼͐ͅɘʮʡʩ͐ੳ

TRIANGULATING DATA I am, in any case, not presenting the reader with data from interviews alone. I have instead triangulated੮˚;੮ϲʮ˦ʁʮ˦ʡͅ੮͸ʮ͐ʩ੮˺͐ʩʇ̼੮ͅ˺͙̼ɻʇͅੳ š˦ʇ੮ʮͅ੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ɘˑੳ੮ˑ͐ʩ˺͙ʡʩ੮˚͙ɻʩ੮˺ʠ੮͐ʩʮͅ੮̼ʇͅʇɘ̼ɻʩ੮͸ɘͅ੮ɻ˺˦ʁ͙ɻ͐ʇʁ੮̼ʇ˚˺͐ʇˑ;੮ (after I moved to New York University), it is informed by observations of a year and a half of weekly triage meetings at the clinic I identify in chapter 1 as Urban {ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩੳ੮U˦੮৲ৰৱ৸੮ɘ˦ʁ੮৲ৰৱ৹ੴ੮U੮ɘˑͅ˺੮ɘ͐͐ʇ˦ʁʇʁ੮˚˺̼ʇ੮͐ʩɘ˦੮ɘ੮ʁ˺Έʇ˦੮ʩʇɘ̼ʮ˦ʡͅ੮ɘ˦ʁ੮ ̹͙ɺˑʮɻ੮ʇͷʇ˦͐ͅ੮˺˦੮ä"੮ৱৰ৴৵੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮ɘͅ੮͸ʇˑˑ੮ɘͅ੮͐ͅɘ͐ʇ͸ʮʁʇ੮͸˺̼ˌʮ˦ʡ੮ʡ̼˺͙̹ͅ੮ on conservatorship and board and cares. In 2021 and 2022, I conducted two͸ʇʇˌ੮ ͷʮͅʮ͐ͅ੮ ͐˺੮ ä˺͙͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ɘ˦ʁ੮ ͐ʩʇ੮ "ɘ;੮ ̼ʇɘ੮ ͐ʩɘ͐੮ ʮ˦ɻˑ͙ʁʇʁ੮ ϲʮͷʇ੮ ϲʮ̼͐ͅચ ̼ʇ̹ͅ˺˦ʁʇ̼੮̼ʮʁʇચɘˑ˺˦ʡͅੴ੮ϲʮͷʇ੮ʁɘ;ͅ੮̹ͅʇ˦͐੮ͅʩɘʁ˺͸ʮ˦ʡ੮˺͙̼͐ʇɘɻʩ੮͐ʇɘ˚ͅੴ੮ϲʮͷʇ੮͐˺͙̼ͅ੮˺ʠ੮ locked facilities, and ten visits to residential care settings, supported housing complexes, and shelters. I also attended six days of conservatorship hearings in two different counties. {;੮ ͷʮͅʮ͐ͅ੮ ɘ˦ʁ੮ ̼ʮʁʇચɘˑ˺˦ʡͅ੮ ̹̼˺ͷʮʁʇʁ੮ ͅ˺˚ʇ੮ ͙̼̹̼ͅʮͅʮ˦ʡ੮ ɻ˺˦ϲʮ̼˚ɘ͐ʮ˺˦ͅ੮ ˺ʠ੮ ͸ʩɘ͐੮ U੮ʩɘʁ੮ʩʇɘ̼ʁ੮ɘɺ˺͙͐੮ʮ˦੮ʮ˦͐ʇ̼ͷʮʇ͸ͅੳ੮Ø˺ˑʮɻʇ੮˺ϲϲʮɻʇ̼ͅ੮U੮̹ͅ˺ˌʇ੮͐˺੮˺ʠ͐ʇ˦੮ɺʇ˚˺ɘ˦ʇʁ੮ʩ˺͸੮ ʩɘ̼ʁ੮ʮ͐੮͸ɘͅ੮͐˺੮ʡʇ͐੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ̼ͅ੮ʮ˦͐˺੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮͐ʩʇ੮ɺ̼ʮʇʠ੮˚˺˚ʇ˦͐ͅ੮͐ʩʇ;ૄ̼ʇ੮ willing to go. Two hours into one ride-along (recounted in chapter 2), I saw someone agree to treatment and then be turned away because no clinician was available. The number of treatment teams or care providers I visited who had ʩɘʁ੮ɘ੮ɻˑʮʇ˦͐੮ʁʮʇ੮ʮ˦੮͐ʩʇ੮͸ʇʇˌͅ੮ɺʇʠ˺̼ʇ੮U੮ͷʮͅʮ͐ʇʁ੮͸ɘͅ੮ʩʇɘ̼͐ɺ̼ʇɘˌʮ˦ʡੳ੮/ʮ͐ʩʇ̼੮U੮ʩɘʁ੮ɘ੮

300

M E T H O D O LO G I C A L A P P E N D I X

H˺̼̼ʇ͐ͅ੮I͙˚̹જˑʮˌʇ੮ɘɺʮˑʮ͐;੮͐˺੮͙͐ͅ˚ɺˑʇ੮ʮ˦͐˺੮ϲʮʇˑʁ੮ͅʮ͐ʇͅ੮˺˦੮˚˺˚ʇ˦͐˺͙ͅ੮˺ɻɻɘͅʮ˺˦ͅੴ੮ ˺̼੮͐ʩʇͅʇ੮͐ʩʮ˦ʡͅ੮͸ʇ̼ʇ੮ʩɘ̹̹ʇ˦ʮ˦ʡ੮ʠ̼ʇή͙ʇ˦͐ˑ;ੴ੮ˈ͙͐ͅ੮ɘͅ੮͐ʩʇ੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ͅɘʮʁੳ îʩʮͅ੮ɺ˺˺ˌ੮ʁ̼ɘ͸ͅ੮˺˦੮ɘ੮ͅʇ̹ɘ̼ɘ͐ʇ੮͙͐ͅʁ;੮͐ʩɘ͐੮ʠ˺ɻ͙ͅʇʁ੮̹ͅʇɻʮϲʮɻɘˑˑ;੮˺˦੮˦ʇ͸̹ͅɘ̹ʇ̼ͅૄ੮ representations of involuntary mental health care in California.ਁ੮õͅʮ˦ʡ੮͐ʩʇ੮rʇͽʮͅõ˦ʮੴ੮Ø̼˺ĺ͙ʇ͐ͅੴ੮ɘ˦ʁ੮ɻɻʇͅͅ੮Ĕ˺̼ˑʁ੮‡ʇ͸ͅ੮ʁɘ͐ɘɺɘͅʇͅੴ੮U੮ɻ˺ˑˑʇɻ͐ʇʁ੮ৱੴ৶ৱ৵੮˦ʇ͸̹ͅɘ̹ʇ̼੮ ɘ̼͐ʮɻˑʇͅ੮˺˦੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮rØäੴ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʠɘɻʮˑʮ͐ʮʇͅੴ੮ɘ˦ʁ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮̹˺ˑʮɻ;ੳ੮ These databases included the Los Angeles Times, the San Francisco Chronicle, and the San Diego Union੮ ʠ̼˺˚੮ ͐ʩʇ੮ ৱ৹৵ৰͅ੮ ͐˺੮ ͐ʩʇ੮ ̹̼ʇͅʇ˦͐ੴ੮ ͐ʩʇ੮ Orange County Register and the Sacramento Bee੮ʠ̼˺˚੮ৱ৹৸৵੮˺˦ੴ੮ɘ˦ʁ੮ʁ˺Έʇ˦ͅ੮˺ʠ੮ˑ˺ɻɘˑ੮̹ɘ̹ʇ̼ͅ੮˚˺̼ʇ੮̼ʇɻʇ˦͐ˑ;ੳ੮ îʩʇͅʇ੮ɘ̼͐ʮɻˑʇͅ੮̹̼˺ͷʮʁʇʁ੮ʩ͙˦ʁ̼ʇʁͅ੮˺ʠ੮ͅ˚ɘˑˑ੮ɻ˺˦ϲʮ̼˚ɘ͐ʮ˺˦ͅ੮͐ʩɘ͐੮͐ʩʇ੮̹̼˺ɻʇͅͅʇͅ੮˚;੮ interviewees were describing had been documented elsewhere, often for decades. U੮ʩɘͷʇ੮ɘˑͅ˺੮ɺʇʇ˦੮˚ʇ͐ʩ˺ʁʮɻɘˑˑ;੮ɻ˺˚̹ʮˑʮ˦ʡ੮ʁ˺ɻ͙˚ʇ˦͐ͅ੮˺˦੮͐ʩʇ੮rØä੮ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚ੳ੮U੮˚ʮ˦ʇʁ੮ϲʮʠ͐;੮̼ʇ̹˺̼͐ͅ੮˺˦੮͐ʩʇ੮͐ͅɘ͐ʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮ʠ˺̼੮͐ʩʇʮ̼੮ ફ˺ʠ͐ʇ˦੮ή͙ʮ͐ʇ੮ˑʮ˚ʮ͐ʇʁબ੮ɻ˺˚˚ʇ˦͐ͅ੮ɘɺ˺͙͐੮rØäੳ੮U੮ͅɻ˺͙̼ʇʁ੮ʡ̼ɘ˦ʁ੮ˈ͙̼;੮ʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ͅੴ੮ public guardian program documents, and board of supervisors resolutions at the county level. I have also tracked down transcripts of legislative hearings on the ˺̼ʮʡʮ˦ɘˑ੮ rØä੮ ˑʇʡʮͅˑɘ͐ʮ˺˦ੴ੮ ɘ͐͐ʇ˚̹͐ʇʁ੮ ̼ʇʠ˺̼˚ͅ੮ ʮ˦੮ ͐ʩʇ੮ ৱ৹৸ৰͅ੮ ɘ˦ʁ੮ ৲ৰৰৰͅੴ੮ ɘ˦ʁ੮ ˚˺̼ʇ੮ recent proposals to change grave disability. I base some of my broad claims about ̼͐ɘ˦ͅʠ˺̼˚ɘ͐ʮ˺˦ͅ੮ʮ˦੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ʠ̼˺˚੮ɻ˺˚̹ʮˑɘ͐ʮ˺˦ͅ੮˺ʠ੮ή͙ɘ˦͐ʮ͐ɘ͐ʮͷʇ੮ʁɘ͐ɘ੮˺˦੮ʩ˺̹ͅʮtal beds, lengths of stay, involuntary holds, and conservatorship from all these ͅ˺͙̼ɻʇͅੴ੮ɻ˺˚̹ɘ̼ʇʁ੮͸ʮ͐ʩ੮ʮ˦͐ʇ̼˦ɘ͐ʮ˺˦ɘˑ੮ʁɘ͐ɘ੮ʠ̼˺˚੮͐ʩʇ੮Ĕ˺̼ˑʁ੮Pʇɘˑ͐ʩ੮š̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮ ɘ˦ʁ੮š̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮ʠ˺̼੮/ɻ˺˦˺˚ʮɻ੮#˺˺̹ʇ̼ɘ͐ʮ˺˦੮ɘ˦ʁ੮)ʇͷʇˑ˺̹˚ʇ˦͐ੳ੮{;੮ɻˑɘʮ˚ͅ੮ɘɺ˺͙͐੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮̹͙ͅʩ੮͐˺੮ʮ˦ɻ̼ʇɘͅʇ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘ̼ʇ੮ɻ˺˦͐ʇͽ͙͐ɘˑʮΈʇʁ੮ɺ;੮ an ongoing project that has catalogued over 1,000 proposed laws on involuntary care nationwide since 2011. This book is also informed by three months of research on involuntary treatment I conducted in New York in 2016 and 2017. During this time, I interviewed sixty clinicians, lawyers, judges, and administrators and observed more than two hundred hearings on involuntary medication and civil commitments. These observations provide some evidence that the basic contours of abdicated authorʮ͐;੮ɘ̼ʇ੮̹̼ʇͅʇ˦͐੮ʇˑͅʇ͸ʩʇ̼ʇ੮ʮ˦੮͐ʩʇ੮õੳäੳ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚ੳ੮îʩɘ͐੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʇͅ੮ʮ˦੮ both California and New York saw the New York system as superior, however, ʮͅ੮ ̼ʇͷʇɘˑʮ˦ʡੳ੮ ‡ʇ͸੮ Ě˺̼ˌૄͅ੮ ˚˺̼ʇ੮ ̼˺ɺ͙͐ͅ੮ ͅ;͐ͅʇ˚੮ ˺ʠ੮ ̹͙ɺˑʮɻ੮ ʩ˺̹ͅʮ͐ɘˑͅੴ੮ ʡ̼ʇɘ͐ʇ̼੮ ϲʮͅɻɘˑ੮ accountability for outpatient teams, and stronger mandates on both providers and patients to adhere to court-ordered treatment plans all point to how that

M E T H O D O LO G I C A L A P P E N D I X

301

͐ͅɘ͐ʇૄͅ੮šϲϲʮɻʇ੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩੴ੮ɘ੮ʁʇʁʮɻɘ͐ʇʁ੮ɘʡʇ˦ɻ;੮˦˺͸੮˚ʮͅͅʮ˦ʡ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੴ੮ has curbed discretion and delegation to a much greater degree. U੮ ɘ˦ɘˑ;Έʇʁ੮ ͐ʩʇͅʇ੮ ʁɘ͐ɘ੮ ͐ʩ̼˺͙ʡʩ੮ ͐ʩʇ੮ ή͙ɘˑʮ͐ɘ͐ʮͷʇ੮ ͅ˺ʠ͐͸ɘ̼ʇ੮ Dedoose. There is no ͸ɘ;੮͐˺੮ɘ͙͐˺˚ɘ͐ʇ੮˺̼੮ʁʇˑʇʡɘ͐ʇ੮͐ʩʇ੮ɘ˦ɘˑ;ͅʮͅ੮˺ʠ੮ɘ੮˚ɘͅͅ੮˺ʠ੮ʁʮ̹ͅɘ̼ɘ͐ʇ੮̼͐ɘ˦ͅɻ̼ʮ̹͐ͅੴ੮ϲʮʇˑʁ੮ notes, and reports. Instead, I manually coded the data by applying to different units of texts one of six hundred different labels. All told, I coded more than ৱ৷ੴৰৰৰ੮ͅʇ̹ɘ̼ɘ͐ʇ੮͙˦ʮ͐ͅ੮˺ʠ੮͐ʇͽ͐ੳ੮îʩʮͅ੮ɘˑˑ˺͸ʇʁ੮˚ʇ੮͐˺੮ή͙ʮɻˌˑ;੮̹͙ˑˑ੮͙̹ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮ every time a media article, interviewee, or report discussed how inpatient psyɻʩʮɘ̼͐ʮ͐ͅͅ੮ ʁʇϲʮ˦ʇʁ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;ੴ੮ ˺̼੮ ˑ˺˺ˌ੮ ͅʮʁʇ੮ ɺ;੮ ͅʮʁʇ੮ ɘ͐੮ ͐ʩʇ੮ ͷʮʇ͸ͅ੮ ˺ʠ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅੴ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ͅੴ੮ɘ˦ʁ੮ɻ˺͙˦͐;੮˺ϲϲʮɻʮɘˑͅ੮˺˦੮̹ͅʇɻʮϲʮɻ੮̼ʇʠ˺̼˚੮ˑʇʡʮͅˑɘ͐ʮ˺˦ੳ Uૄͷʇ੮͸̼ʮ͐͐ʇ˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮ɘͅ੮˚͙ɻʩ੮ɘͅ੮̹˺ͅͅʮɺˑʇੴ੮ɘͅ੮ɘ੮̼͐ͅʮ˦ʡ੮˺ʠ੮̹ʇ̼ͅ˺˦ɘˑ੮˦ɘ̼̼ɘ͐ʮͷʇͅઝ the stories of individual professionals, family members, and people subjected to forced treatment. But I have chosen these narratives because they are representative of broader trends that emerged in data analysis. I thus interviewed many, many people whose voices I have ultimately not included directly but who provided the vital evidence that the cases I do highlight are not isolated anecdotes.

ETHICS, EXCLUSIONS, REFLEXIVITY /ͷʇ̼;੮̼ʇͅʇɘ̼ɻʩ੮̹̼˺ˈʇɻ͐੮ʩɘͅ੮ʮ͐ͅ੮ˑʮ˚ʮ͐ͅੳ੮/ɘ̼ˑ;੮˺˦ੴ੮U੮ʁʇɻʮʁʇʁ੮͐˺੮ʠ˺ɻ͙ͅ੮˚;੮̼ʇͅʇɘ̼ɻʩ੮˺˦੮ adults, even though children are also subjected to involuntary treatment. There ɘ̼ʇ੮˚ɘ˦;੮͐˺̹ʮɻͅ੮˺̼ɺʮ͐ʮ˦ʡ੮rØäੴ੮͙ͅɻʩ੮ɘͅ੮̹̼ʮͷɘɻ;੮ˑɘ͸ͅ੮ફPUØબੴ੮Riese hearings for involuntary medication, the shortage of mental health workers, forced treatment ʮ˦੮̹̼ʮͅ˺˦ͅ੮ɘ˦ʁ੮ˈɘʮˑͅੴ੮ɘ˦ʁ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮̹ɘ̼ɘˑˑʇˑ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ͅ;͐ͅʇ˚ੴ੮͐ʩɘ͐੮ I have nodded to in the manuscript but ultimately given short shrift. I have no better reason than an attempt to keep this book a manageable size. This book is a story about conservatees but is not always told by conservatees. There are many studies in which researchers have managed to interview large samples of people with serious mental illness, but this is not one of them.ਂ There are a number of reasons for this limitation. I started trying to interview conservatees late in the process, since the project was initially about professional decision making. By that time, I had moved to New York and thus could not ʠ˺ˑˑ˺͸੮̼͐ͅɘ͐ʇʡʮʇͅੴ੮͙ͅɻʩ੮ɘͅ੮̹˺͐ͅʮ˦ʡ੮ϲˑ;ʇ̼ͅ੮ʮ˦੮ʁ̼˺̹ચʮ˦੮ɻʇ˦͐ʇ̼ͅ੮˺̼੮ɻˑʮ˦ʮɻͅੴ੮͐ʩɘ͐੮˚ʮʡʩ͐੮ have helped me access this population. My efforts were also constrained by a

302

M E T H O D O LO G I C A L A P P E N D I X

decision not to recruit potential participants through service providers, for fear ˺ʠ੮͙˦ʁ͙ʇ੮ʮ˦ϲˑ͙ʇ˦ɻʇੳ ‡˺˦ʇ͐ʩʇˑʇͅͅੴ੮ U੮ ˚ɘʁʇ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ʇʠʠ˺̼͐ͅ੮ ͐˺੮ ̼ʇɘɻʩ੮ ̹ʇ˺̹ˑʇ੮ ͙ͅɺˈʇɻ͐ʇʁ੮ ͐˺੮ ʠ˺̼ɻʇʁ੮ treatment. With the help of research assistants, we circulated the study to dozens of organizations and across social media. We offered compensation of forty dollars for an hour-and-a-half interview. Uptake was limited. A more effective strategy might have been to collaborate directly with community-based or advocacy organizations, actively engaging them in the research project design and execution. I also wonder if, in an era when scholars have an increasingly visible online presence, some potential interviewees looked at some of my writings, concluded that I was overly sympathetic to forced treatment, and opted not to participate.ਃ The fact that much of this book leans heavily on the perspectives of people other than conservatees themselves creates ethical as well as intellectual dilemmas. To wit: I was constantly debating how much detail to give about individuals who had contact with my interviewees but no contact with me (and thus had not given their consent to be included). A book in which professionals speak only ʮ˦੮ͷɘʡ͙ʇ੮ʡʇ˦ʇ̼ɘˑʮ͐ʮʇͅੴ੮͸ʮ͐ʩ˺͙͐੮͸ɘˑˌʮ˦ʡ੮͐ʩʇ੮̼ʇɘʁʇ̼੮͐ʩ̼˺͙ʡʩ੮̹ͅʇɻʮϲʮɻ੮ɻɘͅʇͅੴ੮͸˺͙ˑʁ੮ not just be boring; it would fail to capture the concrete dilemmas stakeholders face or the human side of conservatorship. But including such details makes for a more problematic product. U˦੮ ʡʇ˦ʇ̼ɘˑੴ੮ U੮ ʩɘͷʇ੮ ͸ʮ͐ʩʩʇˑʁੴ੮ ɻʩɘ˦ʡʇʁ੮ ͅˑʮʡʩ͐ˑ;ੴ੮ ˺̼੮ ˌʇ̹͐੮ ͷɘʡ͙ʇ੮ ̹ͅʇɻʮϲʮɻ੮ ʁʇ˚˺graphic information about people who have not directly consented to be in this book. For cases discussed by professionals, I have focused on dimensions of cliʇ˦͐ͅૄ੮͐ͅɘ͐ʇ੮ફˑʮˌʇ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮˺̼੮̹ͅ;ɻʩ˺ͅʮͅબ੮͐ʩɘ͐੮ɘ̼ʇ੮ɻ˺˚˚˺˦ੴ੮͸ʩʮˑʇ੮ˑʇɘͷʮ˦ʡ੮˺͙͐੮ ˚˺̼ʇ੮̹ͅʇɻʮϲʮɻ੮ɘ̹ͅʇɻ͐ͅ੮˺ʠ੮͐ʩʇʮ̼੮ʩʮ͐ͅ˺̼ʮʇͅ੮ફ͸ʩʮɻʩੴ੮ʮ˦੮ɘ˦;੮ɻɘͅʇੴ੮̹̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͙͙ͅɘˑˑ;੮ ʁʮʁ੮˦˺͐੮ʡʮͷʇ੮˚ʇ੮˺͙͐੮˺ʠ੮̼ʇ̹ͅʇɻ͐੮ʠ˺̼੮ɻˑʮʇ˦͐ͅૄ੮̹̼ʮͷɘɻ;બੳ੮{;੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮͸ʮ͐ʩ੮̹ɘ̼ʇ˦͐ͅ੮˺̼੮ siblings of people receiving forced treatment presented an even trickier dilemma. It would be virtually impossible to capture their experiences without giving perͅ˺˦ɘˑ੮ʁʇ͐ɘʮˑͅ੮ɘɺ˺͙͐੮͐ʩʇʮ̼੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ͅੳ੮Pʇ̼ʇੴ੮U੮ʩɘͷʇ੮ʠ˺ɻ͙ͅʇʁ੮˺˦੮ˌʇʇ̹ʮ˦ʡ੮͐ʩʇ੮ presentation fuzzy enough that, even if that person read the book and might identify themselves in it, an external person could not. Ûʇͅʇɘ̼ɻʩʇ̼ͅૄ੮˺͸˦੮ʮʁʇ˦͐ʮ͐ʮʇͅ੮ͅʩɘ̹ʇ੮͐ʩʇʮ̼੮̼ʇͅʇɘ̼ɻʩੳ੮U˦੮˚;੮ɻɘͅʇੴ੮ͅ˺˚ʇ੮˺ʠ੮͐ʩ˺ͅʇ੮ impacts are obvious: being a white man opens doors with powerful institutions ɘ˦ʁ੮ ˺ʠʠʇ̼ͅ੮ ɘ˦੮ ͙˦˚ʇ̼ʮ͐ʇʁ੮ ʩɘˑ˺੮ ˺ʠ੮ ɻ̼ʇʁʮɺʮˑʮ͐;੮ ફɘˑ͐ʩ˺͙ʡʩ੮ ;˺͙ૄʁ੮ ɺʇ੮ ͙̼̹̼ͅʮͅʇʁ੮ ʩ˺͸੮ ˚ɘ˦;੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅ੮͸ʮͅʩʇʁ੮˚ʇ੮ુʡ˺˺ʁ੮ˑ͙ɻˌ੮͸ʮ͐ʩ੮˚;੮ϲʮ˦ɘˑ੮̹ɘ̹ʇ̼ੴૂ੮ɘ͙ͅͅ˚ʮ˦ʡ੮U੮͸ɘͅ੮ɘ੮ twenty-something undergrad, at the end of our interviews). Perhaps, on the other

M E T H O D O LO G I C A L A P P E N D I X

303

ʩɘ˦ʁੴ੮˚;੮ʁʮϲϲʮɻ͙ˑ͐ʮʇͅ੮̼ʇɻ̼͙ʮ͐ʮ˦ʡ੮̹ʇ˺̹ˑʇ੮͙ͅɺˈʇɻ͐ʇʁ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮̼ʇϲˑʇɻ͐੮͐ʩʇ੮ distrust created when highly marginalized people are approached by a researcher who sits on the privileged side of every axis of identity. š̼੮ɘˑ˚˺͐ͅ੮ʇͷʇ̼;੮ɘͽʮͅੳ੮šͷʇ̼੮͐ʩʇ੮ɻ˺͙̼ͅʇ੮˺ʠ੮̼ʇͅʇɘ̼ɻʩʮ˦ʡ੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮U੮ͷʮͅʮ͐ʇʁ੮ͅʇͷeral psychiatric hospitals. Multiple times, it was to visit my brother, who struggles heroically with psychiatric and developmental disabilities. As his (likely) future guardian, my personal experience makes me wary of some of the most broad-brush claims about the inherent abusiveness of conservatorships and the universal applicability of alternatives to them. If that suggests a certain bias ɘ̼˺͙˦ʁ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐ੴ੮ʩʇ̼ʇૄͅ੮ɘ˦˺͐ʩʇ̼੮ʠɘɻ͐˺̼੮͐˺੮ɻ˺˦ͅʮʁʇ̼ੳ੮Uૄͷʇ੮ɘˑͅ˺੮ɺʇʇ˦੮͐˺੮˺˦ʇ੮ ˺ʠ੮͐ʩʇ੮ͅɘ˚ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐ʩɘ͐੮ʠʇɘ͙̼͐ʇͅ੮ʮ˦੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮˺˦੮ɘ੮৵ৱ৵ৰੳ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ ʮͅ੮ ͐ʇ̼̼ʮʠ;ʮ˦ʡ੮ ɘ˦ʁ੮ ɘˑͅ˺੮ ˚ʮʡʩ͐੮ ʩɘͷʇ੮ ͅɘͷʇʁ੮ ˚;੮ ˑʮʠʇੳ੮ U੮ ʩ˺̹ʇ੮ ͐ʩʮͅ੮ ɺ˺˺ˌ੮ ̼ʇϲˑʇɻ͐ͅ੮ ͐ʩɘ͐੮ profound ambivalence.

CHRONOLOGY OF “ABDICATED AUTHORITY”

1955

ৱ৹৶৳੮

1963

1965

1967

1969 1969

Short-Doyle Act provides matching state funds for county inpatient and outpatient mental health programs, many of which counties contract out to private entities. The state begins shutting its own directly operated clinics for released state hospital patients. îʩʇ੮ͅɻɘ˦ʁɘˑ˺͙ͅ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ɘ͐੮Hɘʮ̼ͷʮʇ͸੮ä͐ɘ͐ʇ੮P˺̹ͅʮ͐ɘˑ੮̹ͅɘ̼ˌ੮ɘ˦੮ʮ˦ή͙ʮ̼;੮ɺ;੮ the legislature, which produces a report, )ɷʚɐʣʣȡ‫˃ף‬ɩ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙̎ (published in 1966), that becomes the basis for LPS. Aid to the Totally Disabled becomes available to people with mental illness. This minimum income helps pay for people’s basic needs ˺͙͐ͅʮʁʇ੮ ˺ʠ੮ ͐ͅɘ͐ʇ੮ ʩ˺̹ͅʮ͐ɘˑͅ੮ ɘ˦ʁ੮ ̹̼˺ͷʮʁʇͅ੮ ɘ੮ ˦ʇ͸੮ ϲʮ˦ɘ˦ɻʮɘˑ੮ ʮ˦ɻʇ˦͐ʮͷʇ੮ ʠ˺̼੮ deinstitutionalization. The federal government creates Medicaid (called Medi-Cal in California), which provides health insurance for the indigent. The “IMD exclusion” bars Medicaid funds from going to psychiatric hospitals with more than sixteen beds, creating further incentive for states to empty public hospitals. The Lanterman-Petris-Short Act grants new legal protections aimed to ʇ˦ʁ੮͐ʩʇ੮ુʮ˦ɘ̹̹̼˺̹̼ʮɘ͐ʇੴ੮ʮ˦ʁʇϲʮ˦ʮ͐ʇੴ੮ɘ˦ʁ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮˺ʠ੮˚ʇ˦tally disordered persons.” The state increases Short-Doyle to cover 90 percent of local program costs. Governor Reagan announces his intention to close state hospitals and turn all responsibilities over to the counties. LPS goes into effect. Short-term holds (5150s) increase dramatically while lengths of stay (especially in state hospitals) decrease. The Lanterman Mental Retardation Act creates an entitlement to services for people with developmental disabilities, organized by a network

306

C H R O N O LO GY O F “A B D I C AT E D AU T H O R I T Y ”

of regional centers. No similar commitment is ever made for people with mental illness. 1970s Nursing homes paid for with federal Medicaid dollars and board and care homes paid with Social Security Disability Income expand to receive people released from state hospitals. The state begins licensing board and care homes in 1971 but eventually closes the Bureau of Social Work, which actively worked to develop programs and place clients. ৱ৹৷ৱ੮ ੮̼ʇ̹˺̼͐੮ɺ;੮͐ʩʇ੮/‡nU੮ʮ˦͐ͅʮ͙͐͐ʇ੮ϲʮ˦ʁͅ੮͐ʩɘ͐੮͐ʩʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ͅ;͐ͅʇ˚੮ʮͅ੮ “functioning smoothly” and keeping gravely disabled individuals in treat˚ʇ˦͐੮ɘ˦ʁ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅੳ੮îʩʮͅ੮ʮͅ੮͐ʩʇ੮ˑɘ͐ͅ੮˺ϲϲʮɻʮɘˑ੮͐ͅɘ͐ʇ͸ʮʁʇ੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮ LPS conservatorship system. 1978 The Community Residential Treatment Act provides grants to create a continuum of unlocked, rehabilitation-focused facilities throughout the state. Many counties ultimately rely instead on private, locked facilities to provide twenty-four-hour care. 1980s Governor Deukmejian cuts 25 percent from state allocations for mental health care. Private psychiatric hospitals expand, taking advantage of greater coverage and more limited cost controls from private insurance. 1981 President Reagan limits federal funding that had been offered through the Community Mental Health Centers Act. Federal leadership around mental health is, according to psychiatrist E. Fuller Torrey, “decapitated.” 1987 A major attempt to reform LPS by lengthening commitments and ʇͽ̹ɘ˦ʁʮ˦ʡ੮ ͐ʩʇ੮ ʁʇϲʮ˦ʮ͐ʮ˺˦੮ ˺ʠ੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ʠɘʮˑͅੳ੮ š̹̹˺˦ʇ˦͐ͅ੮ ɘ̼ʡ͙ʇ੮ ʮ͐੮ would unsustainably increase costs for inpatient care. 1990s Private “managed care” insurance companies and county mental health departments tighten payment criteria for acute care hospitals, leading to a decline in lengths of stay and in the number of psychiatric beds statewide. 1991 Realignment assigns counties the responsibility for paying for all outpatient, inpatient, and long-term care (including in state hospitals) for people with “severe and disabling” impairments. The law creates a dedicated funding stream but states that services will be provided only “to the extent resources are available.” ৱ৹৹৲੮ H˺̼੮͐ʩʇ੮ϲʮ̼͐ͅ੮͐ʮ˚ʇੴ੮ɘ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮̹ʇ˺̹ˑʇ੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘ̼ʇ੮ʠ˺̼ʇ˦ͅʮɻ੮ɘʁ˚ʮͅsions (e.g., incompetent to stand trial or not guilty by reason of insanity) rather than LPS conservatees. By 2002, 90 percent of patients are forensic.

C H R O N O LO GY O F “A B D I C AT E D AU T H O R I T Y ”

1995

307

Regulations rechristen IMDs as Mental Health Rehabilitation Centers. Crestwood and Telecare, two private companies, ultimately control twothirds of MHRC beds. 2000 A set of bills to amend LPS to streamline the process for involuntary medication and make it easier to impose conservatorships is unsuccessful. ৲ৰৰৱ੮ rɘ͙̼ɘૄͅ੮rɘ͸੮ɘ͙͐ʩ˺̼ʮΈʇͅ੮ͅͅʮ͐ͅʇʁ੮š͙̹͐ɘ͐ʮʇ˦͐੮î̼ʇɘ͐˚ʇ˦͐੮ɘͅ੮ɘ੮̹̼˺ʡ̼ɘ˚੮͐ʩɘ͐੮ counties could opt into (it became “opt out” in 2021). The law contains no new funding for implementation and no enforcement mechanism. 2004 The Mental Health Services Act is passed by voters. It levies a 1 percent tax on incomes above one million dollars. MHSA pays for FSP teams, ̹̼ʇͷʇ˦͐ʮ˺˦੮ɘ˦ʁ੮ʇɘ̼ˑ;੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦੮ͅʇ̼ͷʮɻʇͅੴ੮ɘ˦ʁ੮šî੮ʮ˦੮ͅ˺˚ʇ੮ɻ˺͙˦͐ʮʇͅ੮ but cannot be used for inpatient treatment. ৲ৰৰ৶੮ îʩʇ੮͐ͅɘ͐ʇ੮̹ɘͅͅʇͅ੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮̼ʇʠ˺̼˚ͅ੮͐˺੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੴ੮ʮ˦ɻˑ͙ʁing new restrictions on private guardians. LPS conservatorships are not included in reform. 2009 Budget cuts during the Great Recession force as many as one-third of clients out of the public mental health system. MHSA funds, intended to expand the system, are repurposed to maintain existing county mental health services. 2012 The state Department of Mental Health is rolled into the Department of Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ͷʮɻʇͅੳ੮îʩʇ੮˺ϲϲʮɻʇ੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮rØä੮ɘ˦ʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ is closed. 2013 Legislation amends LPS to expand the range of facilities and professionals that can carry out 5150 holds and receive people subject to them. 2014 The implementation of the Affordable Care Act creates a bifurcated system in which people on Medi-Cal with “mild” or “moderate” impairment ɘ̼ʇ੮ ͅʇ̼ͷʇʁ੮ ɺ;੮ ̹̼ʮͷɘ͐ʇ੮ ˚ɘ˦ɘʡʇʁ੮ ɻɘ̼ʇ੮ ̹ˑɘ˦ͅ੮ ɘ˦ʁ੮ ͐ʩ˺ͅʇ੮ ͸ʮ͐ʩ੮ ુͅʮʡ˦ʮϲʮɻɘ˦͐ૂ੮ impairments by county “mental health plans.” 2017 From 2017 to 2022, yearly bills to modify grave disability (including AB 1971, which would have created a pilot program in Los Angeles to conserve any person “unable to provide for his or her medical treatment” if it would lead to death within six months) are unsuccessful. 2018 SB 1045 creates “housing conservatorships” for people with co-occurring substance use and mental health disorders who have been 5150ed eight times in the previous year. The bill allows for pilot programs in San

308

C H R O N O LO GY O F “A B D I C AT E D AU T H O R I T Y ”

Francisco, Los Angeles, and San Diego but is implemented only in San Francisco and conserves only three people. ৲ৰ৲ৰ੮ ੮͐ͅɘ͐ʇ੮ɘ͙ʁʮ͐੮ϲʮ˦ʁͅ੮ુ˦˺੮ʇͷʮʁʇ˦ɻʇ੮͐˺੮ˈ͙͐ͅʮʠ;੯ੳ੯ੳ੯ੳ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮˺̼੮̼ʇͷʮͅʮ˦ʡ੮͐ʩʇ੮ LPS Act’s criteria.” The audit is limited to three counties and largely ignores the role of public guardians. 2021 Governor Newsom proposes closing state hospitals to LPS conservatees in order to make more space for people found incompetent to stand trial. Resistance, especially from county behavioral health departments, blocks the plan. ৲ৰ৲৲੮ I˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮ͅʇʇˌͅ੮͐˺੮ɘͷ˺ʮʁ੮ɘ੮ϲʮʡʩ͐੮˺ͷʇ̼੮rØä੮̼ʇʠ˺̼˚੮ɺ;੮ʮ˦̼͐˺ʁ͙ɻʮ˦ʡ੮ CARE courts, a program to compel individuals to follow a court-ordered care and housing plan. People “failing” CARE courts can be referred to conͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɺ͙͐੮˦˺੮˦ʇ͸੮ʠ͙˦ʁͅ੮ɘ̼ʇ੮ɘˑˑ˺ɻɘ͐ʇʁ੮͐˺੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮˺ϲϲʮɻʇͅੳ

GLOSSARY OF TERMS, PROCEDURES, AND FACILITIES

ક੮ਊਆਊਅ੮ԬէՍԈੵ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮ʁʇ͐ʇ˦͐ʮ˺˦੮͐ʩɘ͐੮ɻɘ˦੮ɺʇ੮ʮ˚̹˺ͅʇʁ੮ɺ;੮ɘ੮̹ʇɘɻʇ੮˺ϲϲʮɻʇ̼੮˺̼੮ ɻˑʮ˦ʮɻʮɘ˦੮ ɺɘͅʇʁ੮ ˺˦੮ ɘ੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ͅʇˑʠੴ੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ˺͐ʩʇ̼ͅੴ੮ ˺̼੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ɻɘ͙ͅʇʁ੮ɺ;੮ɘ੮˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼ੳ੮õ˦ʁʇ̼੮Ĕʇˑʠɘ̼ʇ੮ɘ˦ʁ੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮#˺ʁʇ੮äʇɻ͐ʮ˺˦੮ ৵ৱ৵ৰੴ੮ɘ˦੮ʮ˦ʁʮͷʮʁ͙ɘˑ੮ɻɘ˦੮ɺʇ੮ʩʇˑʁ੮ʠ˺̼੮͙̹੮͐˺੮ͅʇͷʇ˦͐;ચ͐͸˺੮ʩ˺͙̼ͅ੮ʮ˦੮ɘ੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮ ʠɘɻʮˑʮ͐;੮͸ʮ͐ʩ˺͙͐੮ɘ˦;੮̼ʮʡʩ͐੮͐˺੮ˈ͙ʁʮɻʮɘˑ੮̼ʇͷʮʇ͸ੳ ક੮ ਊਇਊਅ੮ ԂԎև֚Ա؄ԱԂӣ֚Աէ՚ੵ੮ H˺͙̼͐ʇʇ˦ચʁɘ;੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ͐ʩɘ͐੮ ɻɘ˦੮ ɺʇ੮ ʮ˚̹˺ͅʇʁ੮ ɘ͐੮ ͐ʩʇ੮ ʇ˦ʁ੮ ˺ʠ੮ ɘ੮ ৵ৱ৵ৰ੮ ˺˦੮ ͐ʩʇ੮ ɺɘͅʮͅ੮ ˺ʠ੮ ɘ੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ͅʇˑʠੴ੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ˺͐ʩʇ̼ͅੴ੮˺̼੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɘ˦ʁ੮ɘ˦੮ʮ˦ɘɺʮˑʮ͐;੮˺̼੮͙˦͸ʮˑˑʮ˦ʡ˦ʇͅͅ੮͐˺੮ɘɻɻʇ̹͐੮̼͐ʇɘ͐ચ ˚ʇ˦͐੮ͷ˺ˑ͙˦͐ɘ̼ʮˑ;ੳ੮੮̹ʇ̼ͅ˺˦੮˺˦੮ɘ੮৵৲৵ৰ੮˚͙͐ͅ੮ʩɘͷʇ੮ɘ੮̹̼˺ɺɘɺˑʇ੮ɻɘ͙ͅʇ੮ʩʇɘ̼ʮ˦ʡ੮ ͸ʮ͐ʩʮ˦੮ʠ˺͙̼੮ʁɘ;ͅ੮ɘ˦ʁ੮ɻɘ˦੮ɘͅˌ੮ʠ˺̼੮ɘ੮͸̼ʮ͐੮͐˺੮ɺʇ੮̼ʇˑʇɘͅʇʁੳ ક੮Ԃ֣֚Ԏ੮)Ա‫־‬Ԏև֐Աէ՚੮õ՚Ա֚੮ફ)õબੵ੮ē˺ˑ͙˦͐ɘ̼;੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮ʮ˦̹ɘ͐ʮʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑચ ʮΈɘ͐ʮ˺˦੮ʠ˺̼੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʮ˦੮ɻ̼ʮͅʮͅੳ੮Ø̼˺ͷʮʁʇͅ੮ʩʇˑ̹੮͐˺੮ʁʇͷʇˑ˺̹੮ɻ˺̹ʮ˦ʡ੮ͅˌʮˑˑͅ੮ɘ˦ʁ੮ ɘ੮͐ʩʇ̼ɘ̹ʇ͙͐ʮɻ੮˚ʮˑʮʇ͙੮ʠ˺̼੮ɘ੮̹ʇ̼ʮ˺ʁ੮˺ʠ੮͙̹੮͐˺੮͐͸˺੮͸ʇʇˌͅੳ ક੮Ԉ֣Ս֚੮ÛԎ֐ԱԈԎ՚֚ԱӣՍ੮HӣԂԱՍԱ֚‫ׅ‬੮ફÛHબੵ੮‡˺˦˚ʇʁʮɻɘˑ੮ɻ˺˦ʡ̼ʇʡɘ͐ʇ੮ˑʮͷʮ˦ʡ੮ʠɘɻʮˑʮ͐;ੴ੮ ɻ˺˚˚˺˦ˑ;੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮ɘͅ੮ɘ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇੳ ક੮֐֐Ա֐֚ԎԈ੮š֣֚քӣ֚ԱԎ՚֚੮îևԎӣ֚ՖԎ՚֚੮ફšîબੵ੮ä;͐ͅʇ˚੮˺ʠ੮ɻ˺˚̹͙ˑͅ˺̼;੮˺͙̹͐ɘ͐ʮʇ˦͐੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ʠ˺̼੮ ̹ʇ˺̹ˑʇ੮ ͸ʩ˺੮ ʩɘͷʇ੮ ɺʇʇ˦੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ ˚͙ˑ͐ʮ̹ˑʇ੮ ͐ʮ˚ʇͅ੮ ͸ʩʮˑʇ੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮˦˺˦ɻ˺˚̹ˑʮɘ˦͐ੳ੮#ˑʮʇ˦͐ͅ੮˺˦੮šî੮ɘ̼ʇ੮ʇͽ̹ʇɻ͐ʇʁ੮͐˺੮̼ʇ̹˺̼͐੮̼ʇʡ͙ચ ˑɘ̼ˑ;੮ ͐˺੮ ɘ੮ ɻ˺͙̼͐੮ ɘ˦ʁ੮ ɘ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ̹̼˺ͷʮʁʇ̼ੴ੮ ɺ͙͐੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ ˑɘ͸੮ ʁ˺ʇͅ੮ ˦˺͐੮ ɘˑˑ˺͸੮ʠ˺̼੮ʠ˺̼ɻʇʁ੮˚ʇʁʮɻɘ͐ʮ˺˦੮˺̼੮ʠ˺̼੮ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐੮˺ʠ੮͐ʩʇ੮̼͐ʇɘ͐˚ʇ˦͐੮̹ˑɘ˦ੳ ક੮"էӣևԈ੮ӣ՚Ԉ੮#ӣևԎ੮PէՖԎੵ੮õ˦ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;੮͐ʩɘ͐੮̹̼˺ͷʮʁʇͅ੮˚ʇɘˑͅੴ੮ʩ˺͙ͅʮ˦ʡੴ੮ɘɻ͐ʮͷચ ʮ͐ʮʇͅੴ੮ ɘ˦ʁ੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮ ʁʮ̹ͅʇ˦ͅʮ˦ʡੳ੮ î;̹ʮɻɘˑˑ;੮ ̹ɘʮʁ੮ ʠ˺̼੮ ͐ʩ̼˺͙ʡʩ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅૄ੮ ääU੮ʮ˦ɻ˺˚ʇੳ੮õ͙ͅɘˑˑ;੮ˑʮɻʇ˦ͅʇʁ੮ɺ;੮͐ͅɘ͐ʇ੮#˺˚˚͙˦ʮ͐;੮#ɘ̼ʇ੮rʮɻʇ˦ͅʮ˦ʡ੮ɘͅ੮ʁ͙ˑ͐੮ Ûʇͅʮʁʇ˦͐ʮɘˑ੮Hɘɻʮˑʮ͐ʮʇͅੴ੮ɘˑ͐ʩ˺͙ʡʩ੮ͅ˺˚ʇ੮ɘ̼ʇ੮͙˦ˑʮɻʇ˦ͅʇʁ੮ફͅ˺˚ʇ͐ʮ˚ʇͅ੮ˌ˦˺͸˦੮ɘͅ੮ ુ̼˺˺˚੮ɘ˦ʁ੮ɺ˺ɘ̼ʁͅૂબੳ

310

G LO S S A RY O F T E R M S , P R O C E D U R E S , A N D FAC I L I T I E S

ક੮#ӣՍԱԣէև՚Աӣ੮֐֐էԂԱӣ֚Աէ՚੮էԣ੮Ø֣ԁՍԱԂ੮ԈՖԱ՚Ա֐֚ևӣ֚էև֐ੴ੮Ø֣ԁՍԱԂ੮I֣ӣևԈԱӣ՚֐ੴ੮ ӣ՚Ԉ੮ Ø֣ԁՍԱԂ੮ #է՚֐Ԏև‫־‬ӣ֚էև֐੮ ફ#ØØIØ#બੵ੮ Ø̼˺ʠʇͅͅʮ˺˦ɘˑ੮ ˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮ ̼ʇ̹̼ʇͅʇ˦͐ʮ˦ʡ੮ɻ˺͙˦͐;੮ʁʇ̹ɘ̼͐˚ʇ˦͐ͅ੮͐ʩɘ͐੮ͅʇ̼ͷʇ੮ɘͅ੮rØä੮ɘ˦ʁ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘચ ͐˺̼ͅੳ੮Ûʇɻʇʮͷʇͅ੮ʠ͙˦ʁʮ˦ʡ੮ʠ̼˺˚੮͐ʩʇ੮͐ͅɘ͐ʇੳ ક੮#Ա‫־‬ԱՍ੮#էՖՖԱ֚ՖԎ՚֚ੵ੮Ø̼˺ɻʇʁ͙̼ʇ੮ɘˑˑ˺͸ʮ˦ʡ੮͐ʩʇ੮͐ͅɘ͐ʇ੮͐˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ʩ˺̹ͅʮ͐ɘˑʮΈʇ੮ ɘ੮̹ʇ̼ͅ˺˦੮͸ʮ͐ʩ˺͙͐੮ɘɻɻ͙ͅʮ˦ʡ੮͐ʩʇ˚੮˺ʠ੮ɘ੮ɻ̼ʮ˚ʇੳ੮#˺˚˚ʮ͐˚ʇ˦͐ͅ੮ɻɘ˦੮ɺʇ੮ɺɘͅʇʁ੮˺˦੮ parens patriaeઝ͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮˺ɺˑʮʡɘ͐ʮ˺˦੮͐˺੮̹̼˺͐ʇɻ͐੮ͷ͙ˑ˦ʇ̼ɘɺˑʇ੮ɻʮ͐ʮΈʇ˦ͅઝ˺̼੮ʮ͐ͅ੮ ̹˺ˑʮɻʇ੮̹˺͸ʇ̼੮ફʁ͙͐;੮͐˺੮̹̼ʇͷʇ˦͐੮ʩɘ̼˚બੳ ક੮#է՚֐Ԏև‫־‬ӣ֚էևੵ੮Øʇ̼ͅ˺˦੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮ɺ;੮͐ʩʇ੮ɻ˺͙̼͐੮͐˺੮˚ɘˌʇ੮ʁʇɻʮͅʮ˺˦ͅ੮˺˦੮ɺʇʩɘˑʠ੮˺ʠ੮ ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʮͅ੮ʁʇʇ˚ʇʁ੮ʡ̼ɘͷʇˑ;੮ʁʮͅɘɺˑʇʁੳ੮#˺͙ˑʁ੮ɺʇ੮ɘ੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼੮˺̼੮ ɘ੮ ̹̼ʮͷɘ͐ʇ੮ ̹̼˺ʠʇͅͅʮ˺˦ɘˑ੮ ɺ͙͐੮ ʠ˺̼੮ rØä੮ ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ ʮͅ੮ ͐;̹ʮɻɘˑˑ;੮ ɘ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ੳ ક੮)Ԏքӣև֚ՖԎ՚֚੮էԣ੮{Ԏ՚֚ӣՍ੮PԎӣՍ֚Ԭ੮ફ){Pબੵ੮#ɘˑʮʠ˺̼˦ʮɘ੮͐ͅɘ͐ʇ੮ɘʡʇ˦ɻ;੮͐ʩɘ͐੮̼ɘ˦੮ ͐ʩʇ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ͅ;͐ͅʇ˚੮ɘ˦ʁ੮̹̼˺ͷʮʁʇʁ੮˺ͷʇ̼ͅʮʡʩ͐੮ʠ˺̼੮ɻ˺͙˦͐;੮̹̼˺ʡ̼ɘ˚ͅੳ੮U͐੮ ɻˑ˺ͅʇʁ੮ʮ˦੮৲ৰৱ৲੮ɘ˦ʁ੮͸ɘͅ੮˚ʇ̼ʡʇʁ੮ʮ˦͐˺੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ચ ͷʮɻʇͅ੮ફ)P#äબੳ੮){P੮ɻɘ˦੮ɘˑͅ˺੮̼ʇʠʇ̼੮͐˺੮͐ʩʇ੮ɘʡʇ˦ɻ;੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅ੮#˺͙˦͐;੮ ફ˚ɘ˦;੮˺͐ʩʇ̼੮ɻ˺͙˦͐ʮʇͅ੮ɻɘˑˑ੮͐ʩʇʮ̼੮ɘʡʇ˦ɻ;੮ɘ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩબੳ ક੮H֣ՍՍદäԎև‫־‬ԱԂԎ੮Øӣև֚՚Ԏև֐ԬԱք੮ફHäØબੵ੮Pʮʡʩʇ͐ͅ੮ˑʇͷʇˑ੮˺ʠ੮ͷ˺ˑ͙˦͐ɘ̼;੮̹͙ɺˑʮɻ੮˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ɻɘ̼ʇ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘ੮ફɻɘˑˑʇʁ੮ͅͅʇ̼͐ʮͷʇ੮#˺˚˚͙˦ʮ͐;੮î̼ʇɘ͐˚ʇ˦͐੮ય#îર੮ ʮ˦੮˺͐ʩʇ̼੮͐ͅɘ͐ʇͅબੳ੮HäØͅ੮ʩɘͷʇ੮ˑ˺͸੮ɻˑʮʇ˦͐ચ͐ͅɘʠʠ੮̼ɘ͐ʮ˺ͅੴ੮ɻɘ˦੮˚ʇʇ͐੮ɻˑʮʇ˦͐ͅ੮ુʮ˦੮͐ʩʇ੮ ϲʮʇˑʁੴૂ੮ɘ˦ʁ੮ʩɘͷʇ੮̼ʇͅ˺͙̼ɻʇͅ੮͐˺੮̹ɘ;੮ʠ˺̼੮ʩ˺͙ͅʮ˦ʡ੮ɘ˦ʁ੮˺͐ʩʇ̼੮ͅ˺ɻʮɘˑ੮˦ʇʇʁͅੳ੮îʩʇ;੮ ɘ̼ʇ੮ϲʮ˦ɘ˦ɻʇʁ੮͐ʩ̼˺͙ʡʩ੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ɻ͐੮ɘ˦ʁ੮{ʇʁʮચ#ɘˑੳ ક੮Iևӣ‫־‬Ԏ੮)Ա֐ӣԁԱՍԱ֚‫ੵׅ‬੮U˦ɘɺʮˑʮ͐;੮͐˺੮̹̼˺ͷʮʁʇ੮ʠ˺̼੮ʠ˺˺ʁੴ੮ɻˑ˺͐ʩʮ˦ʡੴ੮˺̼੮ͅʩʇˑ͐ʇ̼੮ɘͅ੮ɘ੮̼ʇ͙ͅˑ͐੮ ˺ʠ੮ɘ੮˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼੮ફ˺̼੮ɻʩ̼˺˦ʮɻ੮ɘˑɻ˺ʩ˺ˑʮͅ˚બੳ੮I̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ʮͅ੮˺˦ʇ੮ɻ̼ʮ͐ʇચ ̼ʮ˺˦੮ʠ˺̼੮ɘ੮৵ৱ৵ৰ੮˺̼੮৵৲৵ৰ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ફɘˑ˺˦ʡͅʮʁʇ੮ʁɘ˦ʡʇ̼੮͐˺੮ͅʇˑʠ੮ɘ˦ʁ੮ʁɘ˦ʡʇ̼੮ ͐˺੮˺͐ʩʇ̼ͅબੳ੮U͐੮ʮͅ੮͐ʩʇ੮˺˦ˑ;੮ɻ̼ʮ͐ʇ̼ʮ˺˦੮ʠ˺̼੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ ક੮U՚ԂէՖքԎ֚Ԏ՚֚੮֚է੮ä֚ӣ՚Ԉ੮îևԱӣՍ੮ફUäîબੵ੮Hʮ˦ʁʮ˦ʡ੮͐ʩɘ͐੮ɘ੮ʁʇʠʇ˦ʁɘ˦͐੮ʮͅ੮͙˦ɘɺˑʇ੮͐˺੮ ̹ɘ̼͐ʮɻʮ̹ɘ͐ʇ੮ʮ˦੮͐ʩʇʮ̼੮˺͸˦੮ʁʇʠʇ˦ͅʇ੮˺̼੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͐ʩʇ੮˦ɘ͙̼͐ʇ੮˺ʠ੮͐ʩʇ੮̹̼˺ɻʇʇʁચ ʮ˦ʡͅ੮ ɘʡɘʮ˦͐ͅ੮ ͐ʩʇ˚ੳ੮ Uäî੮ ʁʇʠʇ˦ʁɘ˦͐ͅ੮ ̼ʇɻʇʮͷʇ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ͐˺੮ ̼ʇ͐ͅ˺̼ʇ੮ ͐ʩʇ˚੮ ͐˺੮ ɻ˺˚̹ʇ͐ʇ˦ɻ;੮ʮ˦੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅ੮˺̼੮ˈɘʮˑͅ੮ɘ˦ʁ੮ɻɘ˦੮ɺʇ੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ચ ͅʩʮ̹੮ɘʠ͐ʇ̼੮͐͸˺੮;ʇɘ̼ͅ੮ʮʠ੮ʠ˺͙˦ʁ੮ુ͙˦̼ʇ͐ͅ˺̼ɘɺˑʇੳૂ ક੮U՚֐֚Ա֣֚֚Աէ՚੮ԣէև੮{Ԏ՚֚ӣՍ੮)Ա֐Ԏӣ֐Ԏ੮ફU{)બੵ੮r˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;੮̹̼˺ͷʮʁʮ˦ʡ੮͙ͅɺચɘɻ͙͐ʇ੮ ɻɘ̼ʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͙˦ʁʇ̼੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮îʩʇ੮ુU{)੮ʇͽɻˑ͙ͅʮ˺˦ૂ੮̼ʇʠʇ̼ͅ੮͐˺੮ɘ੮̼͙ˑʇ੮ ͐ʩɘ͐੮ɺɘ̼ͅ੮{ʇʁʮɻɘʮʁ੮ʠ͙˦ʁͅ੮ʠ̼˺˚੮ʡ˺ʮ˦ʡ੮͐˺੮ʠɘɻʮˑʮ͐ʮʇͅ੮͸ʮ͐ʩ੮˚˺̼ʇ੮͐ʩɘ˦੮ͅʮͽ͐ʇʇ˦੮ ɺʇʁͅ੮ʮ˦੮͸ʩʮɻʩ੮˚˺̼ʇ੮͐ʩɘ˦੮ʩɘˑʠ੮͐ʩʇ੮̹ɘ͐ʮʇ˦͐ͅ੮ʩɘͷʇ੮ɘ੮̹̼ʮ˚ɘ̼;੮ʁʮɘʡ˦˺ͅʮͅ੮˺ʠ੮ɘ੮ ˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼ੳ

G LO S S A RY O F T E R M S , P R O C E D U R E S , A N D FAC I L I T I E S

311

ક੮rӣ՚֚ԎևՖӣ՚દØԎ֚ևԱ֐દäԬէև֚੮Ԃ֚੮ફrØäબੵ੮rɘ͸੮ʇ˦ɘɻ͐ʇʁ੮ʮ˦੮ৱ৹৶৷੮ɘ˦ʁ੮ʇʠʠʇɻ͐ʮͷʇ੮ʮ˦੮ ৱ৹৶৹ੳ੮ U˦̼͐˺ʁ͙ɻʇʁ੮ ˦ʇ͸੮ ɻ̼ʮ͐ʇ̼ʮɘ੮ ʠ˺̼੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੴ੮ ̼͐ͅʇ˦ʡ͐ʩચ ʇ˦ʇʁ੮ ̹ɘ͐ʮʇ˦͐ͅૄ੮ ̼ʮʡʩ͐ͅੴ੮ ɘ˦ʁ੮ ̹̼˺ͷʮʁʇʁ੮ ͐ͅɘ͐ʇ੮ ʠ͙˦ʁʮ˦ʡ੮ ʠ˺̼੮ ˑ˺ɻɘˑ੮ ɻ˺˚˚͙˦ʮ͐;੮ ͅʇ̼ͷʮɻʇͅੳ ક੮rØä੮)Ԏ֐ԱԤ՚ӣ֚Աէ՚ੵ੮͙͐ʩ˺̼ʮΈɘ͐ʮ˺˦੮ʡʮͷʇ˦੮ɺ;੮ɘ੮ɻ˺͙˦͐;੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮)ʇ̹ɘ̼͐ચ ˚ʇ˦͐੮ ͐˺੮ ɻˑʮ˦ʮɻʮɘ˦ͅ੮ ɘˑˑ˺͸ʮ˦ʡ੮ ͐ʩʇ˚੮ ͐˺੮ ̹ˑɘɻʇ੮ ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ˺˦੮ ৵ৱ৵ৰ੮ ʩ˺ˑʁͅੴ੮ ˺̼੮ ɘ͙͐ʩ˺̼ʮΈɘ͐ʮ˺˦੮͐˺੮ʩ˺̹ͅʮ͐ɘˑͅ੮ɘˑˑ˺͸ʮ˦ʡ੮͐ʩʇ˚੮͐˺੮ͅʇ̼ͷʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ʩʇˑʁ੮͐ʩ̼˺͙ʡʩ੮ rØä੮̹̼˺ɻʇʁ͙̼ʇͅੳ ક੮{ԎԈԱદ#ӣՍੵ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮{ʇʁʮɻɘʮʁ੮̹̼˺ʡ̼ɘ˚ੴ੮͸ʩʮɻʩ੮̹̼˺ͷʮʁʇͅ੮̹͙ɺˑʮɻ੮ʩʇɘˑ͐ʩ੮ʮ˦͙̼ͅચ ɘ˦ɻʇ੮ʠ˺̼੮ˑ˺͸ચʮ˦ɻ˺˚ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ɘ˦ʁ੮̹ʇ˺̹ˑʇ੮̼ʇɻʇʮͷʮ˦ʡ੮ääUੳ ક੮ {Ԏ՚֚ӣՍ੮ PԎӣՍ֚Ԭ੮ ÛԎԬӣԁԱՍԱ֚ӣ֚Աէ՚੮ #Ԏ՚֚Ԏև੮ ફ{PÛ#બੵ੮ H˺̼˚ɘˑੴ੮ ̼ʇʡ͙ˑɘ͐˺̼;੮ ˦ɘ˚ʇ੮ʠ˺̼੮ɘ˦੮U{)ੳ ક੮{էԁԱՍԎ੮#ևԱ֐Ա֐੮îԎӣՖ੮ફ{#îબੵ੮#ˑʮ˦ʮɻɘˑ੮͐ʇɘ˚ͅ੮͐ʩɘ͐੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɻ̼ʮચ ͅʇͅ੮ɘ˦ʁ੮ɻ˺˦ʁ͙ɻ͐੮৵ৱ৵ৰ੮ʇͷɘˑ͙ɘ͐ʮ˺˦ͅੳ੮#ɘˑˑʇʁ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮/˚ʇ̼ʡʇ˦ɻ;੮Ûʇ̹ͅ˺˦ͅʇ੮ îʇɘ˚ͅ੮ ફØ/Ûîબ੮ ʮ˦੮ äɘ˦੮ )ʮʇʡ˺੮ ɘ˦ʁ੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ {˺ɺʮˑʇ੮ Ûʇ̹ͅ˺˦ͅʇ੮ îʇɘ˚ͅ੮ ફØ{Ûîબ੮ʮ˦੮r˺ͅ੮˦ʡʇˑʇͅੳ ક੮{էԁԱՍԎ੮/‫־‬ӣՍ֣ӣ֚Աէ՚੮õ՚Ա֚੮ફ{/õબੵ੮{ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮͙˦ʮ͐੮˺ʠ੮͐ʩʇ੮r˺ͅ੮˦ʡʇˑʇͅ੮Ø˺ˑʮɻʇ੮ )ʇ̹ɘ̼͐˚ʇ˦͐ੳ੮ {ɘ˦ɘʡʇͅ੮ ɺ˺͐ʩ੮ ä;͐ͅʇ˚͸ʮʁʇ੮ {ʇ˦͐ɘˑ੮ ͅͅʇͅͅ˚ʇ˦͐੮ Ûʇ̹ͅ˺˦ͅʇ੮ îʇɘ˚ͅ੮ફä{Ûîબ੮ɘ˦ʁ੮͐ʩʇ੮#ɘͅʇ੮ͅͅʇͅͅ˚ʇ˦͐੮{ɘ˦ɘʡʇ˚ʇ˦͐੮Ø̼˺ʡ̼ɘ˚੮ફ#{Øબ੮ ̹̼˺ʡ̼ɘ˚ੳ ક੮Øӣ֚ԱԎ՚֚֐ૄ੮ÛԱԤԬ֚֐੮Ԉ‫־‬էԂӣ֚Ԏੵ੮Ø̼˺ʠʇͅͅʮ˺˦ɘˑͅ੮͸ʩ˺੮ɘʁͷʮͅʇ੮̹ʇ˺̹ˑʇ੮ʁʇ͐ɘʮ˦ʇʁ੮͙˦ʁʇ̼੮ rØä੮ɘɺ˺͙͐੮͐ʩʇʮ̼੮̼ʮʡʩ͐ͅੴ੮̼ʇ̹̼ʇͅʇ˦͐੮͐ʩʇ˚੮ʮ˦੮̹̼˺ɺɘɺˑʇ੮ɻɘ͙ͅʇ੮ɘ˦ʁ੮Riese੮ʩʇɘ̼ચ ʮ˦ʡͅੴ੮ɘ˦ʁ੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮ɻ˺˚̹ˑɘʮ˦͐ͅੳ ક੮Øӣ‫ׅ‬ԎԎੵ੮Øʇ̼ͅ˺˦੮ʁʇͅʮʡ˦ɘ͐ʇʁ੮͐˺੮̼ʇɻʇʮͷʇ੮͐ʩʇ੮ͅ˺ɻʮɘˑ੮ͅʇɻ͙̼ʮ͐;੮ɻʩʇɻˌ੮˺ʠ੮ɘ˦˺͐ʩʇ̼੮̹ʇ̼ͅ˺˦੮ ͸ʩ˺੮ʮͅ੮ʁʇʇ˚ʇʁ੮͙˦ɘɺˑʇ੮͐˺੮˚ɘ˦ɘʡʇ੮͐ʩʇʮ̼੮˚˺˦ʇ;ੳ੮#˺͙ˑʁ੮ɺʇ੮ɘ੮ʠɘ˚ʮˑ;੮˚ʇ˚ɺʇ̼ੴ੮ ɘ੮ͅ˺ɻʮɘˑ੮ͅʇ̼ͷʮɻʇ੮̹̼˺ͷʮʁʇ̼ੴ੮˺̼੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦ੳ ક੮ ØԎևՖӣ՚Ԏ՚֚੮ ä֣քքէև֚ԎԈ੮ Pէ֣֐Ա՚Ԥੵ੮ U˦ʁʇ̹ʇ˦ʁʇ˦͐੮ ɘ̹ɘ̼͐˚ʇ˦͐ͅ੮ ͸ʮ͐ʩ੮ ͅʇ̼ͷʮɻʇͅ੮ ફ͙ͅɻʩ੮ ɘͅ੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɻ˺͙˦ͅʇˑʮ˦ʡ੮ ˺̼੮ ɻɘͅʇ੮ ˚ɘ˦ɘʡʇ˚ʇ˦͐બ੮ ɘ͐͐ɘɻʩʇʁੳ੮ šʠ͐ʇ˦੮ ɘͅͅ˺ɻʮɘ͐ʇʁ੮͸ʮ͐ʩ੮͐ʩʇ੮P˺͙ͅʮ˦ʡ੮Hʮ̼͐ͅ੮ɘ̹̹̼˺ɘɻʩੴ੮˺ʠʠʇ̼ʮ˦ʡ੮͙˦ʩ˺͙ͅʇʁ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͙˦ɻ˺˦ʁʮ͐ʮ˺˦ɘˑ੮ʩ˺͙ͅʮ˦ʡ੮ɘ˦ʁ੮ͷ˺ˑ͙˦͐ɘ̼;੮ͅʇ̼ͷʮɻʇͅੳ ક੮ØևէԁӣԁՍԎ੮#ӣ֣֐Ԏ੮PԎӣևԱ՚Ԥੵ੮Pʇɘ̼ʮ˦ʡ੮ʩʇˑʁ੮ɘ͙͐˺˚ɘ͐ʮɻɘˑˑ;੮ɘʠ͐ʇ̼੮ʠ˺͙̼੮ʁɘ;ͅ੮˺ʠ੮ɘ੮ ৵৲৵ৰ੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮͐˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮ʮʠ੮͐ʩʇ̼ʇ੮ʮͅ੮ુ̹̼˺ɺɘɺˑʇ੮ɻɘ͙ͅʇૂ੮͐˺੮ɻ˺˦͐ʮ˦͙ʇ੮ ʁʇ͐ʇ˦͐ʮ˺˦ੳ੮Øɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮̼ʇ̹̼ʇͅʇ˦͐ʇʁ੮ɺ;੮ɘ੮̹ɘ͐ʮʇ˦͐ͅૄ੮̼ʮʡʩ͐ͅ੮ɘʁͷ˺ɻɘ͐ʇ੮ɘ˦ʁ੮ʩʇɘ̼ચ ʮ˦ʡͅ੮ɘ̼ʇ੮ʩʇˑʁ੮ɺʇʠ˺̼ʇ੮ɘ੮ʩʇɘ̼ʮ˦ʡ੮˺ϲϲʮɻʇ̼੮ફ˦˺͐੮ɘ੮ˈ͙ʁʡʇબੳ ક੮Øևէԁӣ֚Ԏ੮#է՚֐Ԏև‫־‬ӣ֚էև֐ԬԱքੵ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ફɻɘˑˑʇʁ੮ɘ੮ʡ͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ʮ˦੮˺͐ʩʇ̼੮ ͐ͅɘ͐ʇͅબ੮ʠ˺̼੮ɘʁ͙ˑ͐ͅ੮ˑɘɻˌʮ˦ʡ੮͐ʩʇ੮ɻɘ̹ɘɻʮ͐;੮͐˺੮˚ɘ˦ɘʡʇ੮͐ʩʇʮ̼੮ʩʇɘˑ͐ʩ੮˺̼੮ϲʮ˦ɘ˦ɻʇͅੳ੮

312

G LO S S A RY O F T E R M S , P R O C E D U R E S , A N D FAC I L I T I E S

Iʇ˦ʇ̼ɘˑˑ;੮ ʠ˺̼੮ ˺ˑʁʇ̼੮ ɘʁ͙ˑ͐ͅ੮ ͸ʮ͐ʩ੮ ʁʇ˚ʇ˦͐ʮɘ੮ ˺̼੮ ̹ʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮ ʁʇͷʇˑ˺̹˚ʇ˦͐ɘˑ੮ ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ફͅ˺˚ʇ͐ʮ˚ʇͅ੮ɻɘˑˑʇʁ੮ɘ੮ˑʮ˚ʮ͐ʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹બੳ੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮˚ʇ˦ચ ͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ɻɘ˦੮ɘˑͅ˺੮ʡ˺੮˺˦੮ɘ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮ɺ͙͐੮ɘ੮̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ચ ͷɘ͐˺̼੮ ɻɘ˦˦˺͐੮ ̹ˑɘɻʇ੮ ͅ˺˚ʇ˺˦ʇ੮ ʮ˦੮ ɘ੮ ˑ˺ɻˌʇʁ੮ ʠɘɻʮˑʮ͐;੮ ˺̼੮ ̼ʇή͙ʮ̼ʇ੮ ͐ʩʇ˚੮ ͐˺੮ ͐ɘˌʇ੮ ̹ͅ;ɻʩʮɘ̼͐ʮɻ੮˚ʇʁʮɻɘ͐ʮ˺˦ੳ ક੮Ø֐‫ׅ‬ԂԬԱӣ֚ևԱԂ੮Ԉ‫־‬ӣ՚ԂԎ੮)ԱևԎԂ֚Ա‫־‬Ԏ੮ફØ)બੵ੮rʇʡɘˑ੮ʁ˺ɻ͙˚ʇ˦͐੮͐ʩɘ͐੮ɻɘ˦੮̼ʇʠ͙ͅʇ੮˺̼੮ ɘ͙͐ʩ˺̼ʮΈʇ੮ɻʇ̼͐ɘʮ˦੮̼͐ʇɘ͐˚ʇ˦͐ͅੴ੮ʩ˺̹ͅʮ͐ɘˑͅੴ੮˺̼੮ɻ̼ʮͅʮͅ੮ʮ˦͐ʇ̼ͷʇ˦͐ʮ˺˦ͅ੮ʮ˦੮ɘ੮˚˺˚ʇ˦͐੮ ͸ʩʇ˦੮ɘ੮̹ʇ̼ͅ˺˦੮ʮͅ੮˦˺͐੮ɘɺˑʇ੮͐˺੮ʇͽ̹̼ʇͅͅ੮͐ʩ˺ͅʇ੮̹̼ʇʠʇ̼ʇ˦ɻʇͅ੮͐ʩʇ˚ͅʇˑͷʇͅੳ ક੮ Ø֐‫ׅ‬ԂԬԱӣ֚ևԱԂ੮ /ՖԎևԤԎ՚Ԃ‫ׅ‬੮ äԎև‫־‬ԱԂԎ֐੮ ફØ/äબੵ੮ /˚ʇ̼ʡʇ˦ɻ;੮ ʁʇ̹ɘ̼͐˚ʇ˦͐੮ ͅʇ̼ͷʮ˦ʡ੮ ˺˦ˑ;੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮̹ɘ͐ʮʇ˦͐ͅੳ੮î˺੮ʡ˺੮͐˺੮Ø/äੴ੮̹ɘ͐ʮʇ˦͐ͅ੮͐;̹ʮɻɘˑˑ;੮ʩɘͷʇ੮͐˺੮ɺʇ੮ુ˚ʇʁચ ʮɻɘˑˑ;੮ɻˑʇɘ̼ʇʁૂ੮ɺ;੮ɘ੮̼ʇʡ͙ˑɘ̼੮/Ûੴ੮ͅʮ˦ɻʇ੮Ø/ä੮ɘ̼ʇ੮ʇή͙ʮ̹̹ʇʁ੮˺˦ˑ;੮͐˺੮ʩɘ˦ʁˑʇ੮˚ʇ˦ચ ͐ɘˑ੮ʩʇɘˑ͐ʩ੮ɘ˦ʁ੮͙ͅɺ͐ͅɘ˦ɻʇ੮͙ͅʇ੮̹̼˺ɺˑʇ˚ͅੳ ક੮Ø֐‫ׅ‬ԂԬԱӣ֚ևԱԂ੮PԎӣՍ֚Ԭ੮HӣԂԱՍԱ֚‫ׅ‬੮ફØPHબੵ੮ä͐ɘ˦ʁચɘˑ˺˦ʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ʠɘɻʮˑʮ͐;੮ͅʇ̼ͷચ ʮ˦ʡ੮ ̹ʇ˺̹ˑʇ੮ ʮ˦੮ ɘɻ͙͐ʇ੮ ɻ̼ʮͅʮͅ੮ ફɻ˺˚̹ɘ̼ʇʁ੮ ͐˺੮ ɘ੮ ͙ͅɺɘɻ͙͐ʇ੮ U{)બੳ੮ ØPHͅ੮ ̹̼˺ͷʮʁʇ੮ ʩ˺̹ͅʮ͐ɘˑચˑʮˌʇ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘ̼ʇ੮ɺ͙͐੮͙͙ͅɘˑˑ;੮ɻ˺͐ͅ੮ˑʇͅͅ੮͐˺੮˺̹ʇ̼ɘ͐ʇੳ ક੮Ø֣ԁՍԱԂ੮I֣ӣևԈԱӣ՚੮ઃ੮Ø֣ԁՍԱԂ੮#է՚֐Ԏև‫־‬ӣ֚էևੵ੮#˺͙˦͐;੮ʁʇ̹ɘ̼͐˚ʇ˦͐੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ ʠ˺̼੮̹̼˺ɺɘ͐ʇ੮ɘ˦ʁ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅੳ੮#ɘ˦੮ɺʇ੮ɘ͐͐ɘɻʩʇʁ੮͐˺੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ʠ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩੴ੮ä˺ɻʮɘˑ੮äʇ̼ͷʮɻʇͅੴ੮ʡʮ˦ʡ੮ɘ˦ʁ੮ʁ͙ˑ͐੮äʇ̼ͷʮɻʇͅੴ੮˺̼੮ɘ੮͐ͅɘ˦ʁચ ɘˑ˺˦ʇ੮ʁʇ̹ɘ̼͐˚ʇ˦͐ੳ ક੮ÛԱԎ֐Ԏ੮PԎӣևԱ՚Ԥੵ੮rʇʡɘˑ੮̹̼˺ɻʇʁ͙̼ʇ੮͐˺੮ʁʇ͐ʇ̼˚ʮ˦ʇ੮ʮʠ੮ɘ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ʩɘͅ੮ɺʇʇ˦੮ʩ˺ͅચ ̹ʮ͐ɘˑʮΈʇʁ੮ ʩɘͅ੮ ͐ʩʇ੮ ુɻɘ̹ɘɻʮ͐;ૂ੮ ͐˺੮ ̼ʇʠ͙ͅʇ੮ ˚ʇʁʮɻɘ͐ʮ˺˦੮ ɘ˦ʁੴ੮ ʮʠ੮ ˦˺͐ੴ੮ ͐˺੮ ɘ͙͐ʩ˺̼ʮΈʇ੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮˚ʇʁʮɻɘ͐ʮ˦ʡ੮ɘ੮̹ɘ͐ʮʇ˦͐ੳ ક੮äՈԱՍՍԎԈ੮‡֣և֐Ա՚Ԥ੮HӣԂԱՍԱ֚‫ׅ‬੮ફä‡Hબੵ੮r˺ɻˌʇʁ੮˺̼੮͙˦ˑ˺ɻˌʇʁ੮ʠɘɻʮˑʮ͐;੮̹̼˺ͷʮʁʮ˦ʡ੮˚ʇʁચ ʮɻɘˑ੮ɘ˦ʁ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ɻɘ̼ʇ੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ɻ˺˚˺̼ɺʮʁ੮ʩʇɘˑ͐ʩ੮ɘ˦ʁ੮̹ͅ;ɻʩʮɘ̼͐ʮɻ੮ ʮ͙ͅͅʇͅੳ ક੮ä֚ӣ֚Ԏ੮Pէ֐քԱ֚ӣՍઝØͅ;ɻʩʮɘ̼͐ʮɻ੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩɘ͐੮ʮͅ੮̼͙˦੮ʁʮ̼ʇɻ͐ˑ;੮ɺ;੮͐ʩʇ੮͐ͅɘ͐ʇੳ੮‡ʮ˦ʇ͐;੮ ̹ʇ̼ɻʇ˦͐੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮͐ͅɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑ੮̹ɘ͐ʮʇ˦͐ͅ੮ɘ̼ʇ੮ʠ˺̼ʇ˦ͅʮɻ੮ɘʁ˚ʮͅͅʮ˺˦ͅ੮͙ͅɻʩ੮ ɘͅ੮ ̹ʇ˺̹ˑʇ੮ ʁʇʇ˚ʇʁ੮ ʮ˦ɻ˺˚̹ʇ͐ʇ˦͐੮ ͐˺੮ ͐ͅɘ˦ʁ੮ ̼͐ʮɘˑ੮ ˺̼੮ ˦˺͐੮ ʡ͙ʮˑ͐;੮ ɺ;੮ ̼ʇɘͅ˺˦੮ ˺ʠ੮ ʮ˦ͅɘ˦ʮ͐;ੳ੮îʩʇ੮̼ʇ˚ɘʮ˦ʁʇ̼੮ɘ̼ʇ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͙˦ʁʇ̼੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴ੮͙͙ͅચ ɘˑˑ;੮͸ʮ͐ʩ੮ɻ˺˚˺̼ɺʮʁ੮˚ʇʁʮɻɘˑ੮ʮ͙ͅͅʇͅ੮˺̼੮ɘ੮ʩʮ͐ͅ˺̼;੮˺ʠ੮ͷʮ˺ˑʇ˦ɻʇੳ ક੮ä֚ևԎԎ֚੮#ևԱ֐Ա֐੮ÛԎ֐քէ՚֐Ԏ੮îԎӣՖ੮ફä#Ûîબੵ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૄͅ੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮͐˺੮̹˺ˑʮɻʇ੮ ̼ʇ̹ͅ˺˦ͅʇ੮ ͐˺੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ɻ̼ʮͅʇͅੴ੮ ʮ˚̹ˑʇ˚ʇ˦͐ʇʁ੮ ʮ˦੮ ৲ৰ৲ৰੳ੮ îʇɘ˚੮ ʮ˦ɻˑ͙ʁʇͅ੮ ɘ੮ ̹ɘ̼ɘ˚ʇʁʮɻੴ੮ ɘ੮ ɻˑʮ˦ʮɻʮɘ˦ੴ੮ ɘ˦ʁ੮ ɘ੮ ̹ʇʇ̼ੳ੮ U˦ʮ͐ʮɘˑ੮ ʇͷɘˑ͙ɘ͐ʮ˺˦੮ ͅʩ˺͸ͅ੮ ͐ʩɘ͐੮ ä#Ûî੮ ̼ʇʁ͙ɻʇͅ੮৵ৱ৵ৰͅ੮ɺ͙͐੮ɻ˺˦˦ʇɻ͐ͅ੮ʠʇ͸੮̹ʇ˺̹ˑʇ੮͐˺੮˺˦ʡ˺ʮ˦ʡ੮̼͐ʇɘ͐˚ʇ˦͐ੳ ક੮ ä֣քքՍԎՖԎ՚֚ӣՍ੮ äԎԂ֣ևԱ֚‫ׅ‬੮ U՚ԂէՖԎ੮ ફääUબઝ#˺˚ɺʮ˦ʇʁ੮ ʠʇʁʇ̼ɘˑઃ͐ͅɘ͐ʇ੮ ̹̼˺ʡ̼ɘ˚੮ ̹̼˺ͷʮʁʮ˦ʡ੮˚˺˦͐ʩˑ;੮ʮ˦ɻ˺˚ʇ੮͐˺੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮˦˺͐੮ɘɺˑʇ੮͐˺੮͸˺̼ˌ੮ɘͅ੮ɘ੮̼ʇ͙ͅˑ͐੮˺ʠ੮ɘ੮

G LO S S A RY O F T E R M S , P R O C E D U R E S , A N D FAC I L I T I E S

313

ʁʮͅɘɺʮˑʮ͐;ੳ੮õ˦ˑʮˌʇ੮ä˺ɻʮɘˑ੮äʇɻ͙̼ʮ͐;੮)ʮͅɘɺʮˑʮ͐;੮U˦ɻ˺˚ʇ੮ફää)Uબੴ੮ääU੮̹ɘ;˚ʇ˦͐ͅ੮ ɘ̼ʇ੮˦˺͐੮ɺɘͅʇʁ੮˺˦੮ͅ˺˚ʇ˺˦ʇૄͅ੮̹̼ʇͷʮ˺͙ͅ੮̹ɘ;˚ʇ˦͐ͅ੮ʮ˦͐˺੮͐ʩʇ੮ͅ;͐ͅʇ˚ੳ ક੮ ĔևԱ֚੮ էԣ੮ PӣԁԎӣ֐੮ #էևք֣֐ઝHʮˑʮ˦ʡ੮ ɺ;੮ ɘ˦੮ ʮ˦ͷ˺ˑ͙˦͐ɘ̼ʮˑ;੮ ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ ̹ɘ͐ʮʇ˦͐ੴ੮ ͙͙ͅɘˑˑ;੮͸ʮ͐ʩ੮͐ʩʇ੮ɘʮʁ੮˺ʠ੮ɘ੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼ੴ੮̼ʇή͙ʇ͐ͅʮ˦ʡ੮̼ʇˑʇɘͅʇੳ੮Ĕ̼ʮ͐੮ʩʇɘ̼ʮ˦ʡͅ੮ ɻɘ˦੮ʩɘ̹̹ʇ˦੮ʁ͙̼ʮ˦ʡ੮ɘ੮৵৲৵ৰ੮˺̼੮͐ʇ˚̹˺̼ɘ̼;੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ

ACKNOWLEDGMENTS

I

ϲʮ̼͐ͅ੮ˑʇɘ̼˦ʇʁ੮ɘɺ˺͙͐੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮͐ʩɘ˦ˌͅ੮͐˺੮)ɘ˦੮rʇ͸ʮͅੴ੮ɘ˦ʁ੮ʠ˺̼੮͐ʩɘ͐ઝ ɘͅ੮͸ʇˑˑ੮ɘͅ੮ʩʮͅ੮ʮ˦ͷɘˑ͙ɘɺˑʇ੮˚ʇ˦͐˺̼ͅʩʮ̹੮ɘ˦ʁ੮ʡ͙ʮʁɘ˦ɻʇઝ˚;੮͐ʩɘ˦ˌચ;˺͙ͅ੮͐ͅɘ̼͐੮ ͸ʮ͐ʩ੮ʩʮ˚ੳ੮{;੮ɘɻɘʁʇ˚ʮɻ੮ɻɘ̼ʇʇ̼੮͸˺͙ˑʁ੮˦˺͐੮ʩɘͷʇ੮ʡ˺͐͐ʇ˦੮ʠɘ̼੮͸ʮ͐ʩ˺͙͐੮{ɘ̼ચ ʮ˺˦੮H˺͙̼ɻɘʁʇੳ੮Pʇ̼੮ʇ˦ɻ˺͙̼ɘʡʇ˚ʇ˦͐੮ɘ˦ʁ੮ɘʁͷʮɻʇ੮͸ʇ̼ʇ੮ʮ˦̼͙͐ͅ˚ʇ˦͐ɘˑ੮ʮ˦੮ʡʇ͐͐ʮ˦ʡ੮͐ʩʮͅ੮ ̹̼˺ˈʇɻ͐੮˺ʠʠ੮͐ʩʇ੮ʡ̼˺͙˦ʁੳ੮k˺̼ʁɘ˦੮"͙ɺʮ˦ੴ੮{ʮɻʩʇˑˑʇ੮#ʇ̼ɘੴ੮)ɘͷʮʁ੮Iɘ̼ˑɘ˦ʁੴ੮‡ʇʮˑ੮I˺˦ʡੴ੮ #ʩ̼ʮͅ੮ Pʇ̼̼ʮ˦ʡੴ੮ #ɘ̼ˑ;੮ n˦ʮʡʩ͐ੴ੮ kʇ˦˦;੮ rʇʮʡʩੴ੮ {ɘ̼ʮʇ੮ {˺͙̼ɘʁੴ੮ ‡ʮɻˌ੮ Ûʇˌʇ˦͐ʩɘˑʇ̼ੴ੮ k˺ͅʩ੮äʇʮ˚ੴ੮ɘ˦ʁ੮Û˺ʁ੮äʩɘ˦ʇ̼੮̼ʇɘʁ੮̹ɘ̼͐ͅ੮˺̼੮ɘˑˑ੮˺ʠ੮͐ʩʮͅ੮˚ɘ˦͙ͅɻ̼ʮ̹͐੮ɘ˦ʁ੮˺ʠʠʇ̼ʇʁ੮ͅʩɘ̼̹੮ ɻ˺˚˚ʇ˦͐ͅੳ੮U੮ɘ˚੮ʁʇʇ̹ˑ;੮ʡ̼ɘ͐ʇʠ͙ˑ੮͐˺੮/̼ʮɻ੮äɻʩ͸ɘ̼͐Έ੮ɘ͐੮#˺ˑ͙˚ɺʮɘ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅ੮ ʠ˺̼੮ʩʮͅ੮ʇ˦͐ʩ͙ͅʮɘͅ˚੮ʠ˺̼੮ɘ੮̼ɘʁʮɻɘˑˑ;੮ʁʮʠʠʇ̼ʇ˦͐੮ɺ˺˺ˌ੮͐ʩɘ˦੮͐ʩʇ੮˺˦ʇ੮U੮ʮ˦ʮ͐ʮɘˑˑ;੮̹̼˺˚ʮͅʇʁ੮ ʩʮ˚ੴ੮ɘͅ੮͸ʇˑˑ੮ɘͅ੮ʩʮͅ੮ʡ͙ʮʁɘ˦ɻʇ੮ʮ˦੮ɻ˺˚̹ˑʇ͐ʮ˦ʡ੮ʮ͐ੳ "ʇʠ˺̼ʇ੮U੮͐ͅɘ̼͐ʇʁ੮͐ʩʮͅ੮̹̼˺ˈʇɻ͐ੴ੮U੮ʩɘʁ੮ɻ˺˦ͷʮ˦ɻʇʁ੮˚;ͅʇˑʠ੮͐ʩɘ͐੮ʁ˺ʮ˦ʡ੮ͅ˺ɻʮ˺ˑ˺ʡʮɻɘˑ੮ ̼ʇͅʇɘ̼ɻʩ੮͸ɘͅ੮ɺ˺͐ʩ੮ʮͅ˺ˑɘ͐ʮ˦ʡ੮ɘ˦ʁ੮ʮ̼̼ʇˑʇͷɘ˦͐ੳ੮Ě˺ͅʩʮ੮#˺ʩ˦ੴ੮{ʮɻʩɘʇˑ੮r˺˦ʡੴ੮äʇɺɘ͐ͅʮʇ˦੮ rʇ੮ {˺ʮ˦ʡੴ੮ nʮ˚ɺʇ̼ˑ;੮ ‡ʮʇˑͅʇ˦ੴ੮ ˚̼ʮ͐ʩɘ੮ ä˺˚ɘͅʇˌɘ̼ੴ੮ äʮʇ̼̼ɘ੮ îʮ˚˚˺˦ͅੴ੮ ɘ˦ʁ੮ )ʮʁʮ੮ Ĕ͙ੴ੮ ˚;੮ ͙˦ʁʇ̼ʡ̼ɘʁ͙ɘ͐ʇ੮ ુɘ̹̹̼ʇ˦͐ʮɻʇͅૂ੮ ɘ͐੮ "ʇ̼ˌʇˑʇ;ੴ੮ ͐ɘ͙ʡʩ͐੮ ˚ʇ੮ ͐˺੮ ˑ˺ͷʇ੮ ̼ʇͅʇɘ̼ɻʩ੮ ɘʡɘʮ˦ੳ੮îʩʇʮ̼੮ʁ˺ʡʡʇʁ੮̹͙̼͙ͅʮ͐੮˺ʠ੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮ɘ˦ʁ੮͐ʩʇʮ̼੮ʇͽɻʮ͐ʇ˚ʇ˦͐੮͸ʩʇ˦੮͸ʇ੮ʩʇɘ̼ʁ੮ ɺɘɻˌ੮ʠ̼˺˚੮ɘ੮̹͙ɺˑʮɻ੮ʡ͙ɘ̼ʁʮɘ˦੮ʮ˦੮͐ʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʩʮ˦͐ʇ̼ˑɘ˦ʁͅ੮͸ʇ̼ʇ੮ʮ˦ʠʇɻ͐ʮ˺͙ͅੳ੮˦ɘˈɘ੮ Hʇ̼̼ʇˑˑੴ੮ Ûɘɻʩʇˑ੮ I˺͙ˑ͐ͅ˺˦ੴ੮ ęɘ˦ʁʇ̼੮ {ʇ˦˺̼ੴ੮ ɘ˦ʁ੮ kɘ˚ʮʇ੮ îɘ˦ʡ੮ ̹̼˺ͷʮʁʇʁ੮ ̼ʇͅʇɘ̼ɻʩ੮ ɘͅͅʮ͐ͅɘ˦ɻʇ੮ɘ͐੮‡Ěõੳ੮îʩʮͅ੮ɺ˺˺ˌ੮͸˺͙ˑʁ੮˦˺͐੮ʩɘͷʇ੮ɺʇʇ˦੮̹˺ͅͅʮɺˑʇઝ˺̼ੴ੮ɘ͐੮͐ʩʇ੮ͷʇ̼;੮ˑʇɘ͐ͅੴ੮ ͸˺͙ˑʁ੮ʩɘͷʇ੮ɺʇʇ˦੮˚͙ɻʩ੮͸˺̼ͅʇઝ͸ʮ͐ʩ˺͙͐੮͐ʩʇ੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮͸ʮ͐ʩ੮ͅʇ̼ͷʮɻʇ੮͙ͅʇ̼ͅ੮ɻ˺˦ચ ʁ͙ɻ͐ʇʁ੮ɺ;੮kʇ˦˦;੮rʇʮʡʩੳ੮Pʇ̼੮ͅˌʮˑˑͅ੮ɘͅ੮ɘ˦੮ʮ˦͐ʇ̼ͷʮʇ͸ʇ̼੮ɘ˦ʁ੮͐ʩʇ੮ʇ˚̹ɘ͐ʩ;੮͐ʩɘ͐੮ɻ˺˚ʇͅ੮ ͐ʩ̼˺͙ʡʩ੮ʇͷʇ˦੮ʮ˦੮ɘ੮̼͐ɘ˦ͅɻ̼ʮ̹͐੮ɘ̼ʇ੮ʮ˦̹ͅʮ̼ʮ˦ʡੳ Ûʇʡ̼ʇ͐͐ɘɺˑ;ੴ੮U੮ɻɘ˦˦˺͐੮ʮ˦ʁʮͷʮʁ͙ɘˑˑ;੮͐ʩɘ˦ˌ੮˚ɘ˦;੮˺ʠ੮͐ʩʇ੮ફɘ˦˺˦;˚˺͙ͅબ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʩ˺੮ͅʩɘ̼ʇʁ੮ͅ˺੮˚͙ɻʩ੮͐ʮ˚ʇ੮ɘ˦ʁ੮ʇͽ̹ʇ̼͐ʮͅʇ੮͸ʮ͐ʩ੮˚ʇੳ੮P˺͸ʇͷʇ̼ੴ੮U੮͸˺͙ˑʁ੮ɺʇ੮̼ʇ˚ʮͅͅ੮ʮʠ੮ U੮ʁʮʁ੮˦˺͐੮˚ʇ˦͐ʮ˺˦੮/ˑʮΈɘɺʇ͐ʩ੮"̼˺˚ˑʇ;ੴ੮k˺ͅʇ̹ʩ੮)ʇēʮɻ˺ੴ੮{ʇˑʮ˦ʁɘ੮Pʇ˦˦ʮ˦ʡੴ੮r͙ɻʮˑˑʇ੮ r;˺˦ੴ੮ ɘ̼˺˦੮ {ʇ;ʇ̼ੴ੮ nʇ̼̼;੮ {˺̼̼ʮͅ˺˦ੴ੮ kʮˑˑ੮ ‡ʮʇˑͅʇ˦ੴ੮ äʮ˚˺˦੮ Øɘ˦ʡੴ੮ ä͙ͅɘ˦੮ Øɘ̼͐˺ͷʮੴ੮

316

AC K N O W L E D G M E N T S

îʇ̼ʇͅɘ੮Øɘͅή͙ʮ˦ʮੴ੮)ɘͷʮʁ੮Ø͙ʡʩੴ੮kʇ̼̼;੮äʇʇˑʮʡੴ੮{˺̼ʡɘ˦੮ä˚;͐ʩʇੴ੮äɘ˦ʁ̼ɘ੮îʇͽʇʮ̼ɘੴ੮ɘ˦ʁ੮ "ɘ̼ɺɘ̼ɘ੮Ĕʮˑͅ˺˦੮ɘͅ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮͸ʇ˦͐੮ɘɺ˺ͷʇ੮ɘ˦ʁ੮ɺʇ;˺˦ʁ੮ɘ͐੮ͷɘ̼ʮ˺͙ͅ੮͐ʮ˚ʇͅ੮ʮ˦੮ ͙̹̹ͅ˺̼͐੮˺ʠ੮͐ʩʮͅ੮ɺ˺˺ˌ੮ફ͐ʩʇ;੮ɘ̼ʇੴ੮˺ʠ੮ɻ˺͙̼ͅʇੴ੮˦˺͐੮̼ʇ̹ͅ˺˦ͅʮɺˑʇ੮ʠ˺̼੮ʮ͐ͅ੮ɻ˺˦͐ʇ˦͐ͅબੳ੮r;˦ʁɘ੮ nɘ͙ʠ˚ɘ˦˦ੴ੮͐ʩɘ˦ˌ੮;˺͙੮ʠ˺̼੮ɘ˦ͅ͸ʇ̼ʮ˦ʡ੮ͅ˺ੴ੮ͅ˺੮˚ɘ˦;੮ʇ˚ɘʮˑͅੳ੮U੮ɘ˚੮ʠ͙̼͐ʩʇ̼੮ʡ̼ɘ͐ʇʠ͙ˑ੮ʠ˺̼੮ ͐ʩʇ੮ɻʩɘ˦ɻʇ੮͐˺੮̼ʇϲʮ˦ʇ੮˚;੮ɻ˺˦ɻˑ͙ͅʮ˺˦ͅ੮͐ʩ̼˺͙ʡʩ੮̹̼ʇͅʇ˦͐ɘ͐ʮ˺˦ͅ੮˺ʠ੮͐ʩʮͅ੮͸˺̼ˌ੮͐˺੮͐ʩʇ੮ #ɘˑʮʠ˺̼˦ʮɘ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮Øˑɘ˦˦ʮ˦ʡ੮#˺͙˦ɻʮˑੴ੮͐ʩʇ੮äʇ˚ʇˑ੮U˦͐ͅʮ͙͐͐ʇ੮ɘ͐੮õ#rੴ੮ ͐ʩʇ੮I̼ɘͷʇ੮)ʮͅɘɺʮˑʮ͐;੮Ĕ˺̼ˌʮ˦ʡ੮I̼˺͙̹ੴ੮#ɘˑʮʠ˺̼˦ʮɘ੮ʁͷ˺ɻɘ͐ʇͅੴ੮ɘ˦ʁ੮͐ʩʇ੮#˺ɘˑʮ͐ʮ˺˦੮ ʠ˺̼੮/ˑʁʇ̼੮k͙͐ͅʮɻʇੳ U੮͸ɘͅ੮ʠ˺̼͙͐˦ɘ͐ʇ੮͐˺੮͸ʇˑɻ˺˚ʇ੮ʮ˦͐˺੮͐ʩʇ੮͸˺̼ˑʁ੮͐͸˺੮ɻʩʮˑʁ̼ʇ˦ੴ੮/ˑʮɘͅ੮ɘ˦ʁ੮r;ʁʮɘੴ੮͸ʩʮˑʇ੮ U੮͸ɘͅ੮͸̼ʮ͐ʮ˦ʡ੮͐ʩʮͅ੮ɺ˺˺ˌੳ੮U੮ɘ˚੮ʡ̼ɘ͐ʇʠ͙ˑ੮͐˺੮˚;੮̹ɘ̼͐˦ʇ̼ੴ੮{ɘ̼ʮʇ੮{˺͙̼ɘʁੴ੮ʠ˺̼੮͐ɘˌʮ˦ʡ੮˺˦੮ ʁ˺͙ɺˑʇચʁ͙͐;੮̹ɘ̼ʇ˦͐ʮ˦ʡ੮ͅ˺੮͐ʩɘ͐੮U੮ɻ˺͙ˑʁ੮ɻ˺˦ʁ͙ɻ͐੮ϲʮʇˑʁ੮̼ʇͅʇɘ̼ɻʩ੮ɘ͸ɘ;੮ʠ̼˺˚੮ʩ˺˚ʇੳ੮੮ U੮ʩ˺̹ʇ੮͐ʩɘ͐੮U੮͸ʮˑˑ੮ɘˑ͸ɘ;ͅ੮ˑ˺ͷʇ੮/ˑʮɘͅ੮ɘ˦ʁ੮r;ʁʮɘ੮͸ʮ͐ʩ੮͐ʩʇ੮ͅɘ˚ʇ੮͙˦ή͙ʇ͐ͅʮ˺˦ʮ˦ʡ੮ʁʇͷ˺ચ ͐ʮ˺˦੮˺ʠ੮˚ɘ˦;੮˺ʠ੮͐ʩʇ੮̹ɘ̼ʇ˦͐ͅ੮U੮ʮ˦͐ʇ̼ͷʮʇ͸ʇʁ੮ʠ˺̼੮͐ʩʮͅ੮ɺ˺˺ˌੴ੮ɘ˦ʁ੮͐ʩɘ͐੮͐ʩʇ;੮͸ʮˑˑ੮ʩɘͷʇ੮ ͐ʩʇ੮̼͐ͅʇ˦ʡ͐ʩ੮ʮ˦੮͐ʩʇ੮ʠɘɻʇ੮˺ʠ੮ɘʁͷʇ̼ͅʮ͐;੮U੮ͅɘ͸੮ʠ̼˺˚੮˚ɘ˦;੮˺ʠ੮͐ʩʇʮ̼੮ɻʩʮˑʁ̼ʇ˦ੳ U੮ʁʇʁʮɻɘ͐ʇ੮͐ʩʮͅ੮ɺ˺˺ˌ੮͐˺੮͐ʩʇ੮˚ɘ˦;੮˚˺˚ͅ੮U੮ʩɘͷʇ੮˚ʇ͐੮͸ʩ˺੮˦ʇͷʇ̼੮ʡɘͷʇ੮͙̹ੴ੮ɘɺ˺ͷʇ੮ ɘˑˑ੮˚;੮˺͸˦ੳ

NOTES

PREFACE 1.

Denis Robilard, “Sur la proposition de loi relative aux soins sans consentement en psychiatrie,” Rapport d’Information (Paris: Assemblée Nationale, July 17, 2013); Marion Leboyer and Pierre-Michel Llorca, Ø͇̎Ʉɲɷȡ̙̅ɷɐ‫ףת‬r‫إ‬3͗ȡ̙‫ף‬Ɋ‫إ‬õ̅ɪɐʯɄɐ (Paris: Fayard, 2018). 2. Tami L. Mark et al., “Insurance Financing Increased for Mental Health Conditions but Not for Substance Use Disorders, 1986–2014,” Pɐȡʚ̙ɲ‫ף‬ɩ͖ȡɷ̅̎ 35, no. 6 (2016): 958–65. 3. Substance Abuse and Mental Health Services Administration, “National Mental Health äʇ̼ͷʮɻʇͅ੮ä͙̼ͷʇ;੮ફ‡ણ{Pääબ੮৲ৰ৲ৰੵ੮)ɘ͐ɘ੮˺˦੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮î̼ʇɘ͐˚ʇ˦͐੮Hɘɻʮˑʮ͐ʮʇͅૂ੮ફĔɘͅʩington, DC: Department of Health and Human Services, December 2021), 49, https:// ͅɘ˚ʩͅɘੳʡ˺ͷઃʁɘ͐ɘઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃ৲ৰৱ৶ઢ‡ɘ͐ʮ˺˦ɘˑઢ{ʇ˦͐ɘˑઢPʇɘˑ͐ʩઢäʇ̼ͷʮɻʇͅઢä͙̼ͷʇ;ੳ̹ʁʠੳ ੮ ৴ੳ੮ {ʇʡɘ˦੮#˺˚ʠ˺̼͐੮ʇ͐੮ɘˑੳੴ੮ુP˺͸੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮)ʇ̹̼ʮͷʇੵ੮/͐ʩ˦˺ʡ̼ɘ̹ʩ;ੴ੮ä˺ɻʮɘˑ੮Ĕ˺̼ˌੴ੮ɘ˦ʁ੮U˦͐ʇ̼ventionist Ethics Among the Hypermarginalized,” ÛäH‫ףת‬îɲɐ‫ף‬Û̢̎̎ɐʚʚ‫ף‬äȡɪɐ‫ף‬H˃̢ʯɊȡ̙ɷ˃ʯ‫ף‬k˃̢̅ʯȡʚ‫ף‬ of the Social Sciences 1, no. 1 (2015): 100–119. 5. D. J. Jaffe, Uʯ̎ȡʯɐ‫ ף‬#˃ʯ̎ɐ̢̄ɐʯɄɐ̎‫ ףת‬P˃́‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬UʯɊ̢̙͇̎̅‫ ף‬Hȡɷʚ̎‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚʚ͇‫ ף‬Uʚʚ (Amherst, NY: Prometheus, 2017), 140. 6. S. P. Sashidharan, Roberto Mezzina, and Dainius Puras, “Reducing Coercion in Mental Healthcare,” /̂ɷɊɐʣɷ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬äɄɷɐʯɄɐ̎ 28, no. 6 (2019): 606. Another review concurs that expanding coercive care “does not follow the evidence.” Andrew Molodynski, Yasser Khazaal, and Felicity Callard, “Coercion in Mental Healthcare: Time for a Change in Direction,” "kØ͇̎Ʉɲ‫ף‬Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ 13, no. 1 (2016): 1. Others highlight the lack of clear evidence either way. Nathaniel P. Morris and Robert A. Kleinman, “Taking an Evidence-Based Approach to Involuntary Psychiatric Hospitalization,” Psychiatric Services 74, no. 4 (2023): 431–433. 7. E. Bainbridge et al., “A Three-Month Follow-Up Study Evaluating Changes in Clinical Ø̼˺ϲʮˑʇ੮ɘ˦ʁ੮͐͐ʮ͙͐ʁʇͅ੮î˺͸ɘ̼ʁͅ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮ʁ˚ʮͅͅʮ˺˦ੴૂ੮ European Psychiatry 33, no. S1 ફ৲ৰৱ৶બੵ੮ä৴৷৷જ৷৸੶੮îʩ˺˚ɘͅ੮Ĕੳ੮nɘˑˑʇ̼͐੮ʇ͐੮ɘˑੳੴ੮ુ#˺ʇ̼ɻʇʁ੮P˺̹ͅʮ͐ɘˑ੮ʁ˚ʮͅͅʮ˺˦੮ɘ˦ʁ੮ä;˚̹͐˺˚੮ Change—a Prospective Observational Multi-Centre Study,” PLOS ONE 6, no. 11 (November 30, 2011): e28191; C. Katsakou and S. Priebe, “Outcomes of Involuntary Hospital Admission—a Review,” Ʉ͗ȡ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄȡ‫ף‬äɄȡʯɊɷʯȡ̀ɷɄȡ 114, no. 4 (2006): 232–41.

318

P R E FAC E

੮ ৸ੳ੮ {͙ˑ͐ʮ̹ˑʇ੮͙͐ͅʁʮʇͅ੮ϲʮ˦ʁ੮͐ʩɘ͐੮৴ৰ੮̹ʇ̼ɻʇ˦͐੮˺̼੮˚˺̼ʇ੮˺ʠ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̹ɘ͐ʮʇ˦͐ͅ੮͙ˑ͐ʮ˚ɘ͐ʇˑ;੮ͅʇʇ੮͐ʩʇʮ̼੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ɘͅ੮ˈ͙͐ͅʮϲʮʇʁ੮˺̼੮ɺʇ˦ʇϲʮɻʮɘˑੳ੮Hˑ˺̼ʮɘ˦੮P˺͐Έ;੮ɘ˦ʁ੮{ɘ͐͐ʩʮɘͅ੮kɘʇʡʇ̼ੴ੮ુ#ˑʮ˦ʮɻɘˑ੮ Relevance of Informal Coercion in Psychiatric Treatment—a Systematic Review,” Frontiers in Psychiatry 7 (2016): 197; Gareth S. Owen et al., “Retrospective Views of Psychiatric In-Patients Regaining Mental Capacity,” "̅ɷ̙ɷ̎ɲ‫ ף‬k˃̢̅ʯȡʚ‫˃ ף‬ɩ‫ ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 195, no. 5 (2009): 403–7; Stefan Priebe et al., “Patients’ Views and Readmissions One Year After Involuntary Hospitalisation,” "̅ɷ̙ɷ̎ɲ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 194, no. 1 (2009): 49–54. 9. Diana Paksarian et al., “Perceived Trauma During Hospitalization and Treatment Participation Among Individuals with Psychotic Disorders,” Psychiatric Services 65, no. 2 (2014): 266–69; cf. Harriet Meyer et al., “Posttraumatic Stress Disorder Symptoms Related to Psychosis and Acute Involuntary Hospitalization in Schizophrenic and Delusional Patients,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫‡ף‬ɐ̅̀˃̢̎‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫)ף‬ɷ̎ɐȡ̎ɐ 187, no. 6 (1999): 343–52. 10. Joshua T. Jordan and Dale E. McNiel, “Perceived Coercion During Admission Into Psychiatric Hospitalization Increases Risk of Suicide Attempts After Discharge,” Suicide ȡʯɊ‫ף‬rɷɩɐ؅îɲ̅ɐȡ̙ɐʯɷʯɪ‫"ף‬ɐɲȡ̀ɷ˃̅ 50, no. 1 (2020): 180–88; M. Large et al., “Systematic Review and Meta-Analysis of the Clinical Factors Associated with the Suicide of Psychiatric In-Patients,” Ʉ͗ȡ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄȡ‫ף‬äɄȡʯɊɷʯȡ̀ɷɄȡ 124, no. 1 (2011): 18–19,; Anders Ledberg and Therese Reitana, “Increased Risk of Death Immediately After Discharge from Compulsory Care for Substance Abuse,” )̢̅ɪ‫ף‬ȡʯɊ‫ף‬ʚɄ˃ɲ˃ʚ‫)ף‬ɐ̂ɐʯɊɐʯɄɐ 236 (2022): 109492; Erin F. Ĕɘ̼ʁચ#ʮʇͅʮʇˑͅˌʮ੮ɘ˦ʁ੮äʩʮ̼ʇʇ˦੮rੳ੮ÛʮΈͷʮੴ੮ુîʩʇ੮Ø˺͐ʇ˦͐ʮɘˑ੮Uɘ̼͐˺ʡʇ˦ʮɻ੮/ʠʠʇɻ͐ͅ੮˺ʠ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮ Hospitalization for Suicidal Behavior: A Critical Review and Recommendations for Research,” #ʚɷʯɷɄȡʚ‫ף‬Ø͇̎Ʉɲ˃ʚ˃ɪ͇‫ףת‬äɄɷɐʯɄɐ‫ף‬ȡʯɊ‫ף‬Ø̅ȡɄ̙ɷɄɐ 28, no. 1 (2021): 60–71. 11. Some studies report that involuntary treatment dissuades people from seeking treat˚ʇ˦͐੮͙ͅɺͅʇή͙ʇ˦͐ˑ;ੳ੮‡ʇͷ੮k˺˦ʇͅ੮ʇ͐੮ɘˑੳੴ੮ુU˦ͷʇ͐ͅʮʡɘ͐ʮ˦ʡ੮͐ʩʇ੮U˚̹ɘɻ͐੮˺ʠ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮Øͅ;ɻʩʮɘ͐ric Hospitalization on Youth and Young Adult Trust and Help-Seeking in Pathways to Care,” ä˃Ʉɷȡʚ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬/̂ɷɊɐʣɷ˃ʚ˃ɪ͇ 56 (2021): 2017–27; Marvin S. Swartz, kʇʠʠ̼ʇ;੮Ĕੳ੮ä͸ɘ˦ͅ˺˦ੴ੮ɘ˦ʁ੮{ʮɻʩɘʇˑ੮kੳ੮Pɘ˦˦˺˦ੴ੮ુ)˺ʇͅ੮Hʇɘ̼੮˺ʠ੮#˺ʇ̼ɻʮ˺˦੮nʇʇ̹੮Øʇ˺̹ˑʇ੮͸ɘ;੮ from Mental Health Treatment? Evidence from a Survey of Persons with Schizophrenia and Mental Health Professionals,” Behavioral Sciences & the Law 21, no. 4 (2003): 459–72. Others have found no impact of perceptions of coercion or an involuntary legal status ˺˦੮͙ͅɺͅʇή͙ʇ˦͐੮ɘʁʩʇ̼ʇ˦ɻʇੳ੮k˺˦ɘ͐ʩɘ˦੮"ʮ˦ʁ˚ɘ˦੮ʇ͐੮ɘˑੳੴ੮ુØʇ̼ɻʇʮͷʇʁ੮#˺ʇ̼ɻʮ˺˦੮ɘ͐੮ʁ˚ʮͅͅʮ˺˦੮͐˺੮ Psychiatric Hospital and Engagement with Follow-Up,” Social Psychiatry and Psychiatric /̂ɷɊɐʣɷ˃ʚ˃ɪ͇ 40, no. 2 (2005): 160–66; Susanne Jaeger et al., “Long-Term Effects of Involuntary Hospitalization on Medication Adherence, Treatment Engagement and Perception of Coercion,” ä˃Ʉɷȡʚ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬/̂ɷɊɐʣɷ˃ʚ˃ɪ͇ 48, no. 11 (2013): 1787–96; B. O’Donoghue et al., “Physical Coercion, Perceived Pressures and Procedural Justice in the Involuntary Admission and Future Engagement with Mental Health Services,” European Psychiatry 26, no. 4 (2011): 208–14; S. Opjordsmoen et al., “A Two-Year Follow-up ˺ʠ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮ʁ˚ʮͅͅʮ˺˦ૄͅ੮U˦ϲˑ͙ʇ˦ɻʇ੮õ̹˺˦੮ʁʩʇ̼ʇ˦ɻʇ੮ɘ˦ʁ੮š͙͐ɻ˺˚ʇ੮ʮ˦੮Hʮ̼͐ͅચ/̹ʮͅ˺ʁʇ੮ Psychosis,” Ʉ͗ȡ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄȡ‫ף‬äɄȡʯɊɷʯȡ̀ɷɄȡ 121, no. 5 (2010): 371–76; Sarah D. Rain et al., “Perceived Coercion at Hospital Admission and Adherence to Mental Health Treatment After Discharge,” Psychiatric Services 54, no. 1 (2003): 103–5; Tilman Steinert and Peter äɻʩ˚ʮʁੴ੮ુ/ʠʠʇɻ͐੮˺ϲ੮ē˺ˑ͙˦͐ɘ̼ʮ˦ʇͅͅ੮˺ʠ੮Øɘ̼͐ʮɻʮ̹ɘ͐ʮ˺˦੮ʮ˦੮î̼ʇɘ͐˚ʇ˦͐੮˺˦੮äʩ˺̼͐ચîʇ̼˚੮š͙͐ɻ˺˚ʇ੮ of Inpatients with Schizophrenia,” Psychiatric Services 55, no. 7 (2004): 786–91.

P R E FAC E

319

੮ ৱ৲ੳ੮ kʇ˦˦ʮʠʇ̼੮ rੳ੮ Ĕ̼ʮʡʩ͐ੴ੮ ુI͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ ʠ˺̼੮ Ě˺͙̼੮ š͸˦੮ I˺˺ʁੵ੮ U˚̹̼˺ͷʮ˦ʡ੮ ͐ʩʇ੮ Ĕʇˑˑચ"ʇʮ˦ʡ੮ ˺ʠ੮ Ûʇ̹ͅ˺˦ʁʇ˦͐ͅ੮ɘ˦ʁ੮Ĕɘ̼ʁͅ੮ʮ˦੮͐ʩʇ੮õäੴૂ੮Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 33, no. 5 (2010): 350–68. 13. Arnold Barnes, “Race and Hospital Diagnoses of Schizophrenia and Mood Disorders,” Social Work 53, no. 1 (2008): 77–83; Frederic C. Blow et al., “Ethnicity and Diagnostic Patterns in Veterans with Psychoses,” ä˃Ʉɷȡʚ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬/̂ɷɊɐʣɷ˃ʚ˃ɪ͇ 39, no. 10 (2004): 841–51; Jonathan Metzl, The Protest Psychosis: How Schizophrenia Became a Black )ɷ̎ɐȡ̎ɐ (Boston: Beacon, 2009). 14. Kimberlyn Gray Houston, Marco Mariotto, and J. Ray Hays, “Outcomes for Psychiatric Patients Following First Admission: Relationships with Voluntary and Involuntary Treatment and Ethnicity,” Ø͇̎Ʉɲ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̂˃̙̅̎ 88 (2001): 1012–14; Sommer Knight et al., “Ethnoracial Differences in Coercive Referral and Intervention Among Patients with First-Episode Psychosis,” Psychiatric Services 73, no. 1 (2022): 2–8; Timothy Shea et al., ુÛɘɻʮɘˑ੮ɘ˦ʁ੮/͐ʩ˦ʮɻ੮U˦ʇή͙ʮ͐ʮʇͅ੮ʮ˦੮U˦̹ɘ͐ʮʇ˦͐੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮#ʮͷʮˑ੮#˺˚˚ʮ͐˚ʇ˦͐ੴૂ੮Psychiatric Services 73, no. 12 (2022): 1322–29. 15. Morgan C. Shields, “Patient Characteristics Associated with Admission to Low-Safety U˦̹ɘ͐ʮʇ˦͐੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ Hɘɻʮˑʮ͐ʮʇͅੵ੮ /ͷʮʁʇ˦ɻʇ੮ ʠ˺̼੮ Ûɘɻʮɘˑ੮ U˦ʇή͙ʮ͐ʮʇͅੴૂ੮ Psychiatric Services 72, no. 10 (2021): 1151–59. 16. Colin M. Smith et al., “Association of Black Race with Physical and Chemical Restraint Use Among Patients Undergoing Emergency Psychiatric Evaluation,” Psychiatric Services 73, no. 7 (2022): 730–36; Tina E. Thomas et al., “Race, History of Abuse, and Homelessness Are Associated with Forced Medication Administration During Psychiatric Inpatient Care,” k˃̢̅ʯȡʚ‫˃ ף‬ɩ‫ ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ ף‬Ø̅ȡɄ̙ɷɄɐ 26, no. 4 (2020): 294–304. 17. Paige L. Sweet, îɲɐ‫ ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ ף‬ɩ‫ ף‬ä̢̅̀ɷ̀ɷʯɪ‫ ףת‬P˃́‫ ף‬Ĕ˃ʣɐʯ‫‡ ף‬ȡ̀ɷɪȡ̙ɐ‫˃) ף‬ʣɐ̙̎ɷɄ‫ ף‬ēɷ˃ʚɐʯɄɐ‫ ף‬ȡʯɊ‫ ף‬U̙̎‫ף‬ Aftermath (Berkeley: University of California Press, 2021). 18. Thomas R. Insel, “Rethinking Schizophrenia,” Nature 468, no. 7321 (2010): 187–93; Gavin Newsom, “Getting Serious About Mental Health,” Medium, January 20, 2018, https:// medium.com/@GavinNewsom/getting-serious-about-mental-health-8c09ad95a5ae. ੮ ৱ৹ੳ੮ {ɘ͐͐ʩʇ͸੮ äੳ੮ rʇɺ˺͸ʮ͐Έ੮ ɘ˦ʁ੮ Ĕ˺˺ચˌ;˺͙˦ʡ੮ ʩ˦ੴ੮ ુ/ʠʠʇɻ͐ͅ੮ ˺ʠ੮ "ʮ˺ˑ˺ʡʮɻɘˑ੮ /ͽ̹ˑɘ˦ɘ͐ʮ˺˦ͅ੮ ʠ˺̼੮ Mental Disorders on Clinicians’ Empathy,” Ø̅˃ɄɐɐɊɷʯɪ̎‫˃ ף‬ɩ‫̙ ף‬ɲɐ‫‡ ף‬ȡ̙ɷ˃ʯȡʚ‫ ף‬ɄȡɊɐʣ͇‫˃ ף‬ɩ‫ ף‬äɄɷences 111, no. 50 (2014): 17786–90; B. A. Pescosolido et al., “‘A Disease Like Any Other’? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence,” ʣɐ̅ɷɄȡʯ‫ ף‬k˃̢̅ʯȡʚ‫˃ ף‬ɩ‫ ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 167, no. 11 (2010): 1321–30; G. Schomerus et al., “Evolution of Public Attitudes About Mental Illness: A Systematic Review and Meta-Analysis,” Ʉ͗ȡ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄȡ‫ף‬äɄȡʯɊɷʯȡ̀ɷɄȡ 125, no. 6 (2012): 440–52. 20. Athena McLean, “Empowerment and the Psychiatric Consumer/Ex-Patient Movement in the United States: Contradictions, Crisis and Change,” Social Science & Medicine 40, no. 8 (1995): 1053–71. 21. The debate about “mental” versus “behavioral” health is a little less lively but also merits discussion. I appreciate that “behavioral health” attempts to link together the treatment of substance use and more classic mental illnesses under one roof. In practice, this book ͅʩ˺͸ͅ੮͐ʩɘ͐੮͐ʩʇͅʇ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮ɘ̼ʇ੮ɻˑɘͅͅʮϲʮʇʁੴ੮ʮ˦͐ʇ̼̹̼ʇ͐ʇʁੴ੮ɘ˦ʁ੮̼͐ʇɘ͐ʇʁ੮ή͙ʮ͐ʇ੮ʁʮʠʠʇ̼ʇ˦͐ˑ;ੳ੮͐੮ɘ੮ philosophical level, I believe that people with mental illness have thoughts and emotions

320

22.

23.

24. 25. 26.

P R E FAC E that should be considered in treatment; a focus purely on behaviors seems to treat this inner life as irrelevant. Hence, I mostly speak of mental health. Darcy Haag Granello and Sean R. Gorby, “It’s Time for Counselors to Modify Our Lanʡ͙ɘʡʇੵ੮U͐੮{ɘ͐͐ʇ̼ͅ੮Ĕʩʇ˦੮Ĕʇ੮#ɘˑˑ੮š͙̼੮#ˑʮʇ˦͐ͅ੮äɻʩʮΈ˺̹ʩ̼ʇ˦ʮɻͅ੮ēʇ̼͙ͅͅ੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮äɻʩʮΈ˺phrenia,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬#˃̢ʯ̎ɐʚɷʯɪ‫)ףغף‬ɐ̀ɐʚ˃̂ʣɐʯ̙ 99, no. 4 (2021): 452–61. Substance Abuse and Mental Health Services Administration, “Behavioral Health Barometer United States, Volume 5” (Rockville, MD: U.S. Department of Health and Human Services, 2019), 58. Sukanta Saha et al., “A Systematic Review of the Prevalence of Schizophrenia,” PLoS Med 2, no. 5 (May 31, 2005): e141. Andrew Scull, Madness in Civilization (London: Thames & Hudson, 2015), 11. For an elaboration, see T. M. Luhrmann, šɩ‫ף‬î́˃‫{ף‬ɷʯɊ̎‫ףת‬îɲɐ‫ף‬I̅˃́ɷʯɪ‫)ף‬ɷ̎˃̅Ɋɐ̅‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬ Psychiatry (New York: Knopf, 2000).

INTRODUCTION: THE OTHER MAGNA CARTA 1.

Gwynedd Stuart, “The Renegade Doctor of Skid Row Is Caring for Homeless Addicts in Rev˺ˑ͙͐ʮ˺˦ɘ̼;੮Ĕɘ;ͅੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫{ף‬ȡɪȡ͑ɷʯɐ, March 28, 2019, https://www.lamag.com/citythink blog/the-renegade-doctor-of-skid-row-is-caring-for-homeless-addicts-in-revolutionary -ways/. ੮ ৲ੳ੮ H˺ˑˑ˺͸ʮ˦ʡ੮ɻ˺˦ͷʇ˦͐ʮ˺˦੮ʮ˦੮ͅ˺ɻʮ˺ˑ˺ʡʮɻɘˑ੮͸˺̼ˌੴ੮ͅʮ˦ʡˑʇ੮ή͙˺͐ɘ͐ʮ˺˦੮˚ɘ̼ˌͅ੮ʮ˦ʁʮɻɘ͐ʇ੮ʁʮɘˑ˺ʡ੮͐ʩɘ͐੮ ʩɘͅ੮ ɺʇʇ˦੮ ̼ʇɻ˺˦̼͙͐ͅɻ͐ʇʁ੮ ʠ̼˺˚੮ ˦˺͐ʇͅ੮ ͸ʩʮˑʇ੮ ʁ˺͙ɺˑʇ੮ ή͙˺͐ɘ͐ʮ˺˦ͅ੮ ˚ɘ̼ˌͅ੮ ̼ʇϲˑʇɻ͐੮ ʁʮ̼ʇɻ͐੮ ̼͐ɘ˦ͅɻ̼ʮ̹͐ʮ˺˦ͅ੮ʠ̼˺˚੮̼ʇɻ˺̼ʁʮ˦ʡͅੳ੮îʩʇ੮ˑɘ͐͐ʇ̼੮ɘ̼ʇ੮̹̼ʇ͙ͅ˚ɘɺˑ;੮˚˺̼ʇ੮̹̼ʇɻʮͅʇੴ੮ɺ͙͐੮U੮˺˦ˑ;੮ή͙˺͐ʇ੮͙˦̼ʇɻ˺̼ʁʇʁ੮ɻ˺˦ͷʇ̼ͅɘ͐ʮ˺˦ͅ੮͸ʩʇ˦੮U੮ɘ˚੮ɻ˺˦ϲʮʁʇ˦͐੮͐ʩɘ͐੮͐ʩʇ;੮ɻɘ̹͙̼͐ʇ੮̹ͅʇɘˌʇ̼ͅૄ੮ʮ˦͐ʇ˦ʁʇʁ੮˚ʇɘ˦ʮ˦ʡੳ ੮ ৳ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮Ĕʇˑʠɘ̼ʇ੮ɘ˦ʁ੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮#˺ʁʇੴ੮äʇɻ͐ʮ˺˦੮৵ৰৰ৸ੴ੮ˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅ ઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵ৰৰ৸ੳ 4. Los Angeles Homeless Services Authority, “2022 Greater Los Angeles Homeless Count Ûʇ͙ͅˑ͐ͅੴૂ੮ äʇ̹͐ʇ˚ɺʇ̼੮ ৱ৲ੴ੮ ৲ৰ৲৲ੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳˑɘʩͅɘੳ˺̼ʡઃ˦ʇ͸ͅ੺ɘ̼͐ʮɻˑʇଵ৷৲৶ચ৲ৰ৲ৰચʡ̼ʇɘ͐ʇ̼ચˑ˺ͅ -angeles-homeless-count-results; Department of Mental Health, “Homeless Outreach and Mobile Engagement Program,” accessed October 10, 2022, https://dmh.lacounty.gov /our-services/countywide-services/home/. ੮ ৵ੳ੮ îʩʮͅ੮ ͐ͅɘ͐ʇ˚ʇ˦͐੮ ͸ɘͅ੮ ˚ɘʁʇ੮ ͸ʩʇ˦੮ ‡ʇ͸ͅ˺˚੮ ͸ɘͅ੮ ˚ɘ;˺̼੮ ˺ʠ੮ äɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ੳ੮ #ੳ੮ Ĕੳ੮ ‡ʇͷʮ͙ͅੴ੮ ુHʮ˦ʁʮ˦ʡ੮ Pʇˑ̹੮ ʠ˺̼੮ P˺˚ʇˑʇͅͅ੮ Ĕʩ˺੮ Ĕ˺˦ૄ͐੮ Pʇˑ̹੮ îʩʇ˚ͅʇˑͷʇͅੴૂ੮ San Francisco Chronicle, March 11, 2008. 6. I heard this characterization at a forum on conservatorship in San Francisco on November 28, 2018. A similar claim was made by Representative Claude Pepper in 1978, who stated, “The typical [person subject to conservatorship] has fewer rights than the typʮɻɘˑ੮ɻ˺˦ͷʮɻ͐ʇʁ੮ʠʇˑ˺˦ੳ੯ੳ੯ੳ੯ੳ੮U͐੮ʮͅ੮͐ʩʇ੮˚˺͐ͅ੮̹͙˦ʮ͐ʮͷʇ੮ɻʮͷʮˑ੮̹ʇ˦ɘˑ͐;੮͐ʩɘ͐੮ɻɘ˦੮ɺʇ੮ˑʇͷʮʇʁ੮ɘʡɘʮ˦͐ͅ੮ ɘ˦੮ ˚ʇ̼ʮɻɘ˦੮ ɻʮ͐ʮΈʇ˦ੴ੮ ͸ʮ͐ʩ੮ ͐ʩʇ੮ ʇͽɻʇ̹͐ʮ˺˦ੴ੮ ˺ʠ੮ ɻ˺͙̼ͅʇੴ੮ ˺ʠ੮ ͐ʩʇ੮ ʁʇɘ͐ʩ੮ ̹ʇ˦ɘˑ͐;ੳૂ੮ ĺ͙˺͐ʇʁ੮ ʮ˦੮ National Council on Disability, “Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination,” March 22, 2018, 26, https://ncd.gov/publications/2018 /beyond-guardianship-toward-alternatives. 7. Michael Lipsky, ä̙̅ɐɐ̙؅rɐ̀ɐʚ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡɄ͇‫)ףת‬ɷʚɐʣʣȡ̎‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬UʯɊɷ̀ɷɊ̢ȡʚ‫ף‬ɷʯ‫ף‬Ø̢ɃʚɷɄ‫ף‬äɐ̅̀ɷɄɐ, thirtieth anniversary ed. (New York: Russell Sage Foundation, 2010).

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

321

੮ ৸ੳ੮ U੮ɘ˚੮ʡ̼ɘ͐ʇʠ͙ˑ੮͐˺੮îʇ̼ʇͅɘ੮Øɘͅή͙ʮ˦ʮ੮ʠ˺̼੮͐ʩʮͅ੮̹ʩ̼ɘͅʮ˦ʡੳ 9. The head of the professional association of California’s Public Guardians estimates there are 120,000 conservatees in the state. It is unknown how many are conserved for mental illness versus other conditions or how many are in the public system. Scarlet Hughes, ુš̹ʮ˦ʮ˺˦ੵ੮ "̼ʮ͐˦ʇ;੮ ä̹ʇɘ̼ͅૄ੮ #˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ Ĕɘͅ੮ ͐;̹ʮɻɘˑੳ੮ {˺͐ͅ੮ rɘɻˌ੮ H͙˦ʁͅੴૂ੮ Mercury News, January 18, 2022, https://www.mercurynews.com/2022/01/18/opinion-britney-spears -conservatorship-was-atypical-most-lack-funds/. ੮ ৱৰੳ੮ äʇʇੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮#ɘ̼˺ˑ;˦੮˦̹ͅɘɻʩʇ̼ੴ੮ુĔʩɘ͐ૄͅ੮"ʇ͐ͅ੮ʠ˺̼੮{ʇ˦͐ɘˑ੮Øɘ͐ʮʇ˦͐ͅ੺ੴૂ੮San Francisco Chronicle, September 10, 1975; Patt Morrison, “Opinion: Skid Row’s PR Problem,” Los ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, October 13, 2006; “Senate Passes Mental Health ‘Bill of Rights,’” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬ õʯɷ˃ʯ, August 2, 1967. 11. Eugene Bardach, îɲɐ‫ף‬äʕɷʚʚ‫ף‬HȡɄ̙˃̅‫ף‬ɷʯ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףת‬Ûɐ̂ɐȡʚɷʯɪ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙‫ף‬rȡ́̎‫ף‬ɷʯ‫ף‬#ȡʚɷfornia (Berkeley: University of California Press, 1972). 12. ENKI Research Institute, “A Study of California’s New Mental Health Law” (Chatsworth, CA, 1972), 10. ੮ ৱ৳ੳ੮ )˺˦੮‡ʇʠʠੴ੮ુHɘʮ̼ͷʮʇ͸੮ēʮͅʮ͐੮î̼ʮʡʡʇ̼ͅ੮Ø̼˺ɺʇੵ੮{ɘͅͅʮͷʇ੮U˦ή͙ʮ̼;੮ɘ͐੮ä˺͙͐ʩˑɘ˦ʁ੮{ʇ˦͐ɘˑ੮Hɘɻʮˑʮ͐;੮ Follows Tour,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, April 7, 1963. 14. Nicolas Petris, State Government Oral History Program, December 20, 1988, California State Archives, https://archives.cdn.sos.ca.gov/oral-history/pdf/oh-petris-nicholas.pdf. 15. Constance M. McGovern, {ȡ̙̎ɐ̅̎‫˃ ף‬ɩ‫{ ף‬ȡɊʯɐ̎̎‫ ףת‬ä˃Ʉɷȡʚ‫̅š ף‬ɷɪɷʯ̎‫˃ ף‬ɩ‫̙ ף‬ɲɐ‫ ף‬ʣɐ̅ɷɄȡʯ‫ ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬ Profession੮ફPɘ˦˺ͷʇ̼ੴ੮‡Pੵ੮ēʇ̼˚˺˦͐ੴ੮ৱ৹৸৵બ੶੮š͸ʇ˦੮Ĕʩ˺˺ˑʇ;ੴ੮šʯ‫̙ף‬ɲɐ‫ף‬Pɐɐʚ̎‫˃ף‬ɩ‫ף‬Uɪʯ˃̅ȡʯɄɐ‫ףת‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ף‬ɩ‫ף̙˃‡ף‬nʯ˃́ɷʯɪ (Chicago: University of Chicago Press, 2019). 16. Subcommittee on Mental Health, “The Dilemma of Mental Commitments in California” (Sacramento: California State Legislature, 1966), 12. 17. Subcommittee on Mental Health, “The Dilemma,” 19. ੮ ৱ৸ੳ੮ ̼͐੮"˺ˑ͐˺˦ੴ੮͐ʩʇ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ɘʮʁʇ੮͸ʩ˺੮̹̼ʇ̹ɘ̼ʇʁ੮͐ʩʇ੮̼ʇ̹˺̼͐ੴ੮ɺʇˑʮʇͷʇʁ੮͐ʩɘ͐੮ϲʮ˦ʁʮ˦ʡͅ੮ɘɺ˺͙͐੮ commitment courts were the “most disturbing” part of the investigation. Phyllis Vine, Hɷɪɲ̙ɷʯɪ‫ ף‬ɩ˃̅‫ ף‬ÛɐɄ˃̀ɐ͇̅‫ ףת‬ʯ‫ ף‬Ʉ̙ɷ̀ɷ̙̎̎‫ ףإ‬Pɷ̙̎˃͇̅‫˃ ף‬ɩ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬Ûɐɩ˃̅ʣ (Boston, Beacon, 2022), 23. 19. Bill Boyarsky, “Changing Policies Affect Care of Sick,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 8, 1982. 20. Erving Goffman, ͇̎ʚ̢ʣ̎‫ףת‬/̎̎ȡ͇̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬äɷ̢̙ȡ̙ɷ˃ʯ‫˃ף‬ɩ‫{ף‬ɐʯ͗ȡʚ‫ף‬Øȡ̙ɷɐʯ̙̎‫ף‬ȡʯɊ‫̙šף‬ɲɐ̅‫ף‬Uʯʣȡ̙ɐ̎ (New York: Anchor, 1961), 135. 21. Subcommittee on Mental Health, “The Dilemma,” 46. 22. Harry Nelson, “‘Civil Rights’ Bill on Mental Health Sets High Goals,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, June 11, 1967. This statement has also been attributed to Maurice Rodgers of the Cal State Psychological Association. Bardach, The Skill Factor, 126. 23. Bardach, The Skill Factor, 103. 24. Many contemporary portrayals falsely depict LPS as only a civil rights bill. Susannah Cahalan, îɲɐ‫ף‬I̅ɐȡ̙‫ף‬Ø̅ɐ̙ɐʯɊɐ̅‫ףת‬îɲɐ‫ף‬õʯɊɐ̅Ʉ˃̀ɐ̅‫{ף‬ɷ̎̎ɷ˃ʯ‫ף‬îɲȡ̙‫ף‬#ɲȡʯɪɐɊ‫ף̢̅šף‬õʯɊɐ̅̎͗ȡʯɊɷʯɪ‫˃ף‬ɩ‫ף‬ Madness (New York: Grand Central, 2019); Michael Shellenberger, San Fransicko: Why Ø̅˃ɪ̅ɐ̎̎ɷ̀ɐ̎‫ ף‬Û̢ɷʯ‫ ף‬#ɷ̙ɷɐ̎ (New York: Harper, 2021), 85. Early media coverage of the bill actually paid more attention to its proposals to expand local treatment programs. Alex V. Barnard, “From the ‘Magna Carta’ to ‘Dying in the Streets’: Media Framings of Mental Health Law in California,” ä˃Ʉɷɐ̙͇‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 12, no. 2 (2022): 155–73.

322 25. 26.

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

“Mental Health Parley to Discuss Home Centers,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, June 11, 1968. Jerry Gillam, “Assembly Group OKs Mental Hospital Bill,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, June 15, 1967. 27. Eugene Bardach, îɲɐ‫ף‬Uʣ̂ʚɐʣɐʯ͗ȡ̙ɷ˃ʯ‫ף‬Iȡʣɐ‫ףת‬Ĕɲȡ̙‫ף‬Pȡ̂̂ɐʯ̎‫ף‬ɩ̙ɐ̅‫ף‬ȡ‫"ף‬ɷʚʚ‫"ף‬ɐɄ˃ʣɐ̎‫ף‬ȡ‫ף‬rȡ́ (Cambridge, MA: MIT Press, 1977), 34. 28. Ernesto Flores, “State Mental Health Gains Cited Here,” äȡʯ‫) ף‬ɷɐɪ˃‫ ף‬õʯɷ˃ʯ, August 13, 1970. ੮ ৲৹ੳ੮ Øɘ͙ˑ੮äੳ੮̹̹ʇˑɺɘ͙˚ੴ੮ુ˚ɺʮͷɘˑʇ˦ɻʇ੮#˺ʁʮϲʮʇʁੵ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮‡ʇ͸੮š͙̹͐ɘ͐ʮʇ˦͐੮#˺˚˚ʮ͐˚ʇ˦͐੮ Statute,” Psychiatric Services 54, no. 1 (2003): 26. 30. Uri Aviram, “Care or Convenience? On the Medical-Bureaucratic Model of Commitment of the Mentally Ill,” Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 13, no. 3 (1990): 164. 31. Anna Saya et al., “Criteria, Procedures, and Future Prospects of Involuntary Treatment ʮ˦੮Øͅ;ɻʩʮɘ̼͐;੮̼˺͙˦ʁ੮͐ʩʇ੮Ĕ˺̼ˑʁੵ੮੮‡ɘ̼̼ɘ͐ʮͷʇ੮Ûʇͷʮʇ͸ੴૂ੮Frontiers in Psychiatry 10 (2019): 2. 32. Heather Knight, “SF Looks to Change Law That Lets Mentally Ill Choose to Stay on Streets,” San Francisco Chronicle, December 12, 2017, https://www.sfchronicle.com/news /article/SF-looks-to-change-law-that-lets-mentally-ill-12422969.php. 33. David Garrick, “Gloria Focuses on Infrastructure, Homelessness in Second ‘State of City’ Speech,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ؅î̅ɷɃ̢ʯɐ, January 12, 2022, https://www.sandiegouniontribune.com /news/politics/story/2022-01-12/gloria-focuses-on-infrastructure-homelessness-in-second -state-of-city-speech; Alyssa Jeong Perry, “LA County Gets More Power to Force Severely Mentally Ill Homeless Into Treatment,” LAist, October 2, 2018, https://laist .com/news/la-county-gets-more-power-to-force-severely-mentally-ill-homeless-into ચ̼͐ʇɘ͐˚ʇ˦͐੶੮k˺˦ɘ͐ʩɘ˦੮äʩʇ̼ʮ˦੮ɘ˦ʁ੮)ɘ̼̼ʇˑˑ੮ä͐ʇʮ˦ɺʇ̼ʡੴ੮ુUʠ੮Øʇ˺̹ˑʇ੮Ûʇˈʇɻ͐੮#ɘ̼ʇੴ੮îʩʇ˦੮Ĕʩɘ͐੺ੴૂ੮ r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 20, 2020, https://www.latimes.com/opinion/story/2020-08-20 ઃ˺̹ચʇʁચ˚ʇ˦͐ɘˑˑ;ચʮˑˑચ̹ʇ˺̹ˑʇચ˺ʠ͐ʇ˦ચʁ˺˦͐ચʡʇ͐ચ̼͐ʇɘ͐˚ʇ˦͐ચɺʇɻɘ͙ͅʇચ˺ʠચɘ˦͐ʮή͙ɘ͐ʇʁચˑɘ͸ੳ 34. This statement was reported in a letter to the editor from his longtime administrative assistant. Ellen Dewees, “Letter: Legislation for the Mentally Ill,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, December 5, 1987. 35. Gavin Newsom, “State of the State—Annotated,” CalMatters, February 19, 2020, https:// calmatters.org/projects/newsoms-state-of-the-state-2020-annotated/. 36. See Treatment Advocacy Center, “Active Legislation,” accessed October 22, 2022, https:// ͸͸͸ੳ̼͐ʇɘ͐˚ʇ˦͐ɘʁͷ˺ɻɘɻ;ɻʇ˦͐ʇ̼ੳ˺̼ʡઃϲʮͽʮ˦ʡચ͐ʩʇચͅ;͐ͅʇ˚ઃɘɻ͐ʮͷʇચˑʇʡʮͅˑɘ͐ʮ˺˦ੳ 37. Dominic A. Sisti, Andrea G. Segal, and Ezekiel J. Emanuel, “Improving Long-Term Psychiatric Care: Bring Back the Asylum,” k{ 313, no. 3 (2015): 243–44. 38. In 1969, Judge David Bazelon of the D.C. Circulate of Appeals lauded that LPS “promises virtually to eliminate involuntary hospitalization except for short term crisis situations.” David L. Bazelon, “Implementing the Right to Treatment,” õʯɷ̀ɐ̅̎ɷ̙͇‫˃ף‬ɩ‫ף‬#ɲɷɄȡɪ˃‫ף‬ Law Review 36, no. 4 (1969): 753. 39. For example: “Current law makes it nearly impossible for doctors or judges to compel ̼͐ʇɘ͐˚ʇ˦͐ੳૂ੮/ʁʮ͐˺̼ʮɘˑ੮"˺ɘ̼ʁੴ੮ુPʇˑ̹੮ʠ̼˺˚੮Ĕʮ͐ʩ˺͙͐ੴૂ੮äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ؅î̅ɷɃ̢ʯɐ, June 6, 2001. “California’s 40-year-old mental-health law makes it all but impossible for authorities ͐˺੮ɻ˺˦ϲʮ˦ʇ੮ɘ˦ʁ੮̼͐ʇɘ͐੮ɘ˦੮͙˦͐ͅɘɺˑʇ੮̹ʇ̼ͅ˺˦ੳૂ੮/ʁʮ͐˺̼ʮɘˑ੮"˺ɘ̼ʁੴ੮ુõͅʇ੮#˺˦ϲʮ˦ʇ˚ʇ˦͐ੴૂ੮Riverside Press-Enterpriseੴ੮̹̼ʮˑ੮৲৹ੴ੮৲ৰৰ৷ੳ੮Ĕʮ͐ʩ੮rØäੴ੮ુʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅ੮͸ʇ̼ʇ੮ʇ˦ʁʇʁੳૂ੮Iɘ̼rick, “Gloria Focuses on Infrastructure.”

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA 40. 41.

42. ੮ ৴৳ੳ੮

44.

੮ ৴৵ੳ੮

੮ ৴৶ੳ੮

੮ ৴৷ੳ੮

੮ ৴৸ੳ੮

੮ ৴৹ੳ੮

੮ ৵ৰੳ੮

323

For an excellent exception, see Dinah Miller and Annette Hanson, Committed: The Battle š̀ɐ̅‫ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬#ȡ̅ɐ (Baltimore: Johns Hopkins University Press, 2016). See, for example, Paul Brodwin, /̀ɐ͇̅Ɋȡ͇‫ף‬/̙ɲɷɄ̎ (Berkeley: University of California Press, 2012); Kerry Michael Dobransky, {ȡʯȡɪɷʯɪ‫{ ף‬ȡɊʯɐ̎̎‫ ף‬ɷʯ‫̙ ף‬ɲɐ‫ ף‬#˃ʣʣ̢ʯɷ̙͇‫ ףת‬îɲɐ‫ ף‬#ɲȡʚʚɐʯɪɐ‫˃ ף‬ɩ‫ף‬ #˃ʯ̙ɐʣ̂˃̅ȡ͇̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬#ȡ̅ɐ੮ફ‡ʇ͸੮"̼͙˦ͅ͸ʮɻˌੴ੮‡ĩੵ੮Û͙͐ʡʇ̼ͅ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰৱ৴બ੶੮ Jerry Floersch, {ɐɊ̎‫˃{ ףש‬ʯɐ͇‫ ףש‬ȡʯɊ‫{ ף‬ȡʯʯɐ̅̎‫ ףת‬îɲɐ‫ ף‬#ȡ̎ɐ‫{ ף‬ȡʯȡɪɐʣɐʯ̙‫˃ ף‬ɩ‫ ף‬äɐ̀ɐ̅ɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Uʚʚʯɐ̎̎ ફ‡ʇ͸੮Ě˺̼ˌੵ੮#˺ˑ͙˚ɺʮɘ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰৰ৲બ੶੮‡ʇʮˑ੮I˺˦ʡੴ੮ુ"ʇ͐͸ʇʇ˦੮î˺ˑʇ̼ɘ˦͐੮#˺˦͐ɘʮ˦˚ʇ˦͐੮ ɘ˦ʁ੮ #˺˦ɻʇ̼͐ʇʁ੮ #˺˦̼͐ͅɘʮ˦͐ੵ੮ {ɘ˦ɘʡʮ˦ʡ੮ {ɘʁ˦ʇͅͅ੮ ʠ˺̼੮ ͐ʩʇ੮ #ʮ͐;੮ ɘ˦ʁ੮ ͐ʩʇ੮ Ø̼ʮͷʮˑʇʡʇʁ੮ Family,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 4 (2019): 664–89. Carol Warren, îɲɐ‫ף‬#˃̢̙̅‫˃ף‬ɩ‫ף‬rȡ̙̎‫ף‬Ûɐ̎˃̙̅੮ફ#ʩʮɻɘʡ˺ੵ੮õ˦ʮͷʇ̼ͅʮ͐;੮˺ʠ੮#ʩʮɻɘʡ˺੮Ø̼ʇͅͅੴ੮ৱ৹৸৲બੴ੮৲৳જ৲৴ੳ îʩʇͅʇ੮ɻ̼ʮ͐ʇ̼ʮɘ੮͸ʇ̼ʇ੮ˑɘ͐ʇ̼੮ʮ˚̹˺ͅʇʁ੮ɘɻ̼˺ͅͅ੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅ੮ɺ;੮͐ʩʇ੮ä͙̹̼ʇ˚ʇ੮#˺͙̼͐ੴ੮͸ʩʮɻʩ੮ ʮ˦੮ৱ৹৷৵੮̼͙ˑʇʁ੮͐ʩɘ͐੮͐ʩʇ੮͐ͅɘ͐ʇ੮ɻɘ˦˦˺͐੮ʁʇ͐ɘʮ˦੮ɘ੮ુ˦˺˦ચʁɘ˦ʡʇ̼˺͙ͅૂ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮̹ʇ̼ͅ˺˦੮͸ʩ˺੮ુʮͅ੮ ɻɘ̹ɘɺˑʇ੮˺ʠ੮͙̼ͅͷʮͷʮ˦ʡ੮ͅɘʠʇˑ;੮ʮ˦੮ʠ̼ʇʇʁ˺˚ੳૂ੮š‫إ‬#˃ʯʯ˃̅‫˃)ףר̀ף‬ʯȡʚɊ̎˃ʯੴ੮৴৲৲੮õੳäੳ੮৵৶৳੮ફৱ৹৷৵બੳ Paul S. Appelbaum, ʚʣ˃̙̎‫ף‬ȡ‫ף‬Ûɐ̀˃ʚ̢̙ɷ˃ʯ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬rȡ́‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬rɷʣɷ̙̎‫˃ף‬ɩ‫ף‬#ɲȡʯɪɐ (Oxford: šͽʠ˺̼ʁ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮ৱ৹৹৴બੴ੮৳৷੶੮ͅʇʇ੮ɘˑͅ˺੮äɘ̼ɘʩ੮#ˑʇͷʇˑɘ˦ʁ੮ʇ͐੮ɘˑੳੴ੮ુ)˺੮)ɘ˦ʡʇ̼˺͙ͅ˦ʇͅͅચ š̼ʮʇ˦͐ʇʁ੮#˺˚˚ʮ͐˚ʇ˦͐੮rɘ͸ͅ੮Ûʇ̼͐ͅʮɻ͐੮P˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮˺ʠ੮Øɘ͐ʮʇ˦͐ͅ੮Ĕʩ˺੮‡ʇʇʁ੮î̼ʇɘ͐˚ʇ˦͐੺੮ ੮ îʇ͐ͅੴૂ੮ Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ ף‬äɐ̅̀ɷɄɐ̎੮ ৴ৰੴ੮ ˦˺ੳ੮ ৳੮ ફৱ৹৸৹બੵ੮ ৲৶৶જ৷ৱ੶੮ {ɘ̼;੮ rੳ੮ )͙̼ʩɘ˚ੴ੮ ુU˚̹ˑʮɻɘ͐ʮ˺˦ͅ੮ ˺ʠ੮ ‡ʇʇʁચʠ˺̼ચî̼ʇɘ͐˚ʇ˦͐੮rɘ͸ͅੵ੮੮ä͙͐ʁ;੮˺ϲ੮Ĕɘͅʩʮ˦ʡ͐˺˦੮ä͐ɘ͐ʇૄͅ੮U˦ͷ˺ˑ͙˦͐ɘ̼;੮î̼ʇɘ͐˚ʇ˦͐੮ɻ͐ੴૂ੮ Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬äɐ̅̀ɷɄɐ̎੮৳৶ੴ੮˦˺ੳ੮৹੮ફৱ৹৸৵બੵ੮৹৷৷੶੮k˺ʩ˦੮{˺˦ɘʩɘ˦ੴ੮ુ/˚̹ʮ̼ʮɻɘˑ੮˦ɘˑ;ͅʇͅ੮˺ʠ੮#ʮͷʮˑ੮#˺˚˚ʮ͐˚ʇ˦͐ੵ੮#̼ʮ͐ʮή͙ʇ੮ɘ˦ʁ੮#˺˦͐ʇͽ͐ੴૂ੮rȡ́‫ףغף‬ä˃Ʉɷɐ̙͇‫ף‬Ûɐ̀ɷɐ́ 11, no. 4 (1977): 619–28. ä˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅ੮ʁʇʇ˚ʇʁ੮ɘ੮ʁɘ˦ʡʇ̼੮͐˺੮ͅʇˑʠ੮˺̼੮˺͐ʩʇ̼ͅ੮ɻɘ˦੮ɺʇ੮̹ˑɘɻʇʁ੮˺˦੮ɘ੮͐ʩ̼ʇʇચʁɘ;੮ʩ˺ˑʁ੮ ફɻɘˑˑʇʁ੮ɘ੮৵ৱ৵ৰબ੮ɘ˦ʁ੮ʠ˺͙̼͐ʇʇ˦ચʁɘ;੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ફ৵৲৵ৰબੳ੮ä˺˚ʇ˺˦ʇ੮͸ʩ˺੮ʮͅ੮͙ͅʮɻʮʁɘˑ੮ɻɘ˦੮ɺʇ੮ ʩʇˑʁ੮ʠ˺̼੮ɘ˦˺͐ʩʇ̼੮ʠ˺͙̼͐ʇʇ˦੮ʁɘ;ͅ੮ફ৵৲৶৴બੴ੮ɘ˦ʁ੮ɘ੮̹ʇ̼ͅ˺˦੮ʁʇʇ˚ʇʁ੮ુʮ˚˚ʮ˦ʇ˦͐ˑ;੮ʁɘ˦ʡʇ̼˺͙ͅૂ੮ɻɘ˦੮ be held for additional periods of 180 days. Some counties allow a supplemental thirtyʁɘ;੮ ʩ˺ˑʁ੮ ʠ˺̼੮ ʡ̼ɘͷʇ੮ ʁʮͅɘɺʮˑʮ͐;੮ ફ৵৲৷ৰબੳ੮ îʩʇ੮ ̹̼˺ͷʮͅʮ˺˦ͅ੮ ʠ˺̼੮ ʁɘ˦ʡʇ̼੮ ͐˺੮ ͅʇˑʠ੮ ɘ˦ʁ੮ ˺͐ʩʇ̼ͅ੮ ɘ̼ʇ੮ ̼ɘ̼ʇˑ;੮͙ͅʇʁੳ੮õˑ͐ʮ˚ɘ͐ʇˑ;ੴ੮˚˺͐ͅ੮̹ʇ˺̹ˑʇ੮˚͙͐ͅ੮ʇʮ͐ʩʇ̼੮ɺʇ੮ɻ˺˦ͅʇ̼ͷʇʁ੮˺˦੮͐ʩʇ੮ɺɘͅʮͅ੮˺ʠ੮ʡ̼ɘͷʇ੮ʁʮͅability or be released. #˺˚˚ʇ˦͐ɘ͐˺̼ͅ੮ʠɘͷ˺̼ɘɺˑʇ੮͐˺੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐੮ʁʇͅɻ̼ʮɺʇʁ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ɘͅ੮͐ʩʇ੮ુ̹̼˺ͷʮͅʮ˺˦੮ય˺ʠ੮rØäર੮͐ʩɘ͐੮ɺʇɻɘ˚ʇ੮͐ʩʇ੮ˌʇ;੮͐˺੮ˌʇʇ̹ʮ˦ʡ੮͐ʩʇ੮ͅ;͐ͅʇ˚੮ʠ͙˦ɻ͐ʮ˺˦ɘˑੳૂ੮Ûɘʇˑ੮kʇɘ˦੮Uͅɘɘɻ੮ɘ˦ʁ੮ ēʮ̼ʡʮ˦ʮɘ੮̼˚ɘ͐ੴ੮{ȡɊʯɐ̎̎‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬ä̙̅ɐɐ̙̎‫ףת‬P˃́‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬rȡ́‫ף‬ɃȡʯɊ˃ʯɐɊ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚʚ͇ ફ‡ʇ͸੮Ě˺̼ˌੵ੮H̼ʇʇ੮Ø̼ʇͅͅੴ੮ৱ৹৹ৰબੴ੮ৱ৲৳ੳ k˺ʩ˦੮ੳ੮îɘˑɺ˺͐͐ੴ੮ુ)ʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦ੵ੮ͷ˺ʮʁʮ˦ʡ੮͐ʩʇ੮)ʮͅɘ͐ͅʇ̼ͅ੮˺ʠ੮͐ʩʇ੮Øɘ͐ͅੴૂ੮Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬ äɐ̅̀ɷɄɐ̎੮৳ৰੴ੮˦˺ੳ੮৹੮ફৱ৹৷৹બੵ੮৶৲ৱજ৲৴੶੮k͙ˑʮɘ੮äɻʩ˺˦ੴ੮ુĔʩ;੮̼ʇ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮Ø̼ʮͅ˺˦ͅ੮ɘ˦ʁ੮ä̼͐ʇʇ͐ͅ੮ Hʮˑˑʇʁ੮ ͸ʮ͐ʩ੮ {˺̼ʇ੮ {ʇ˦͐ɘˑˑ;੮ Uˑˑ੮ îʩɘ˦੮ U͐ͅ੮ P˺̹ͅʮ͐ɘˑͅੵ੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ )ʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ Movement,” äȡʯ͗ȡ‫ף‬#ʚȡ̅ȡ‫ף‬rȡ́‫ף‬Ûɐ̀ɷɐ́ 59 (2019): 269. îʩʮͅ੮ɻɘˑˑ੮͐˺੮̹ɘ;੮ɘ͐͐ʇ˦͐ʮ˺˦੮͐˺੮͐ʩ˺ͅʇ੮ˑʇʠ͐੮ɺʇʩʮ˦ʁ੮ʠ̼˺˚੮ʁʇʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑʮΈɘ͐ʮ˺˦੮ʇɻʩ˺ʇͅ੮͐ʩɘ͐੮ ˚ɘʁʇ੮ɺ;੮k˺˦ɘ͐ʩɘ˦੮{ʇ͐Έˑੴ੮îɲɐ‫ף‬Ø̅˃̙ɐ̙̎‫ף‬Ø͇̎Ʉɲ˃̎ɷ̎‫ףת‬P˃́‫ף‬äɄɲɷ͑˃̂ɲ̅ɐʯɷȡ‫"ף‬ɐɄȡʣɐ‫ף‬ȡ‫"ף‬ʚȡɄʕ‫)ף‬ɷ̎ɐȡ̎ɐ (Boston: Beacon, 2009). Û˺˦ɘ˦੮ Hɘ̼̼˺͸੮ ɘ˦ʁ੮ kʮɘ੮ î˺ˑʇ˦͐ʮ˦˺ੴ੮ ુ"̼ʮ͐˦ʇ;੮ ä̹ʇɘ̼ͅૄ੮ #˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ‡ʮʡʩ͐˚ɘ̼ʇੴૂ੮ ‡ɐ́‫ף‬ Ě˃̅ʕɐ̅ੴ੮k͙ˑ;੮৳ੴ੮৲ৰ৲ৱੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳ˦ʇ͸;˺̼ˌʇ̼ੳɻ˺˚ઃ˦ʇ͸ͅઃɘ˚ʇ̼ʮɻɘ˦ચɻʩ̼˺˦ʮɻˑʇͅઃɺ̼ʮ͐˦ʇ;ચ̹ͅʇɘ̼ͅ ચɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ચ˦ʮʡʩ͐˚ɘ̼ʇੳ ˚ʇ̼ʮɻɘ˦੮#ʮͷʮˑ੮rʮɺʇ̼͐ʮʇͅ੮õ˦ʮ˺˦ੴ੮ુĔʩ;੮"̼ʮ͐˦ʇ;੮#ɘ˦ૄ͐੮Iʇ͐੮š͙͐੮˺ʠ੮Pʇ̼੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮ ̙‫ף‬rɷɃɐ̙͇̅੮ફØ˺ʁɻɘ͐ͅબੴ੮ɘɻɻʇͅͅʇʁ੮͙ʡ͙͐ͅ੮৲৷ੴ੮৲ৰ৲ৱੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳɘɻˑ͙ੳ˺̼ʡઃ̹˺ʁɻɘ͐ͅઃ͸ʩ;ચɺ̼ʮ͐˦ʇ; ચɻɘ˦͐ચʡʇ͐ચ˺͙͐ચʩʇ̼ચɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ચʇ̹ચৱ৶৴ੳ

324 51.

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

Madison Hirneisen, “California’s Conservatorship Program Proposes Changes After Spears Saga and New Investigation,” Center Square, August 21, 2022, https://www.the ɻʇ˦͐ʇ̼ͅή͙ɘ̼ʇੳɻ˺˚ઃɻɘˑʮʠ˺̼˦ʮɘઃɻɘˑʮʠ˺̼˦ʮɘͅચɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ચ̹̼˺ʡ̼ɘ˚ચ̹̼˺̹˺ͅʇͅચɻʩɘ˦ʡʇͅ ચɘʠ͐ʇ̼ચ̹ͅʇɘ̼ͅચͅɘʡɘચɘ˦ʁચ˦ʇ͸ચʮ˦ͷʇ͐ͅʮʡɘ͐ʮ˺˦ઃɘ̼͐ʮɻˑʇઢৰ৲ɺɘɘ৷ʠɘચ৲ৰৰɘચৱৱʇʁચ৸৷ʁ৹ચɻ৳৸৳৶ɘ৳৳ʠ৴ʁɻ .html. 52. Dan Thompson, “Spears Case Drives California Bid to Limit Conservatorships,” Associated Press, January 19, 2022, https://apnews.com/article/britney-spears-entertainment -business-health-california-9bbf21583f7e42b59eef32754d79a620. 53. For an early discussion of the limits of civil liberties protections under LPS, see Henry L. Fuller, “Civil Commitment of the Mentally Ill in California: 1969 Style,” äȡʯ͗ȡ‫ף‬#ʚȡ̅ȡ‫ף‬ Lawyer 10, no. 1 (1970 1969): 74–98. 54. Two exceptions are Kristen R. Choi et al., “Mental Health Conservatorship Among Homeless People with Serious Mental Illness,” Psychiatric Services 73, no. 6 (2022): 613–19; ɘ˦ʁ੮ I̼ɘ˦͐੮ Pੳ੮ {˺̼̼ʮͅੴ੮ ુrʇ͐ૄͅ੮ )˺੮ ͐ʩʇ੮ îʮ˚ʇ੮ Ĕɘ̼̹੮ ʡɘʮ˦ੵ੮ ͅͅʇͅͅʮ˦ʡ੮ ͐ʩʇ੮ #˺˚̹ʇ͐ʇ˦ɻʇ੮ ˺ʠ੮ Counsel in Mental Health Conservatorship Proceedings,” äȡʯ‫) ף‬ɷɐɪ˃‫ ף‬rȡ́‫ ף‬Ûɐ̀ɷɐ́ 46 (2009): 283–342. 55. A recent state audit of LPS concluded that professionals were applying the law correctly ʮ˦੮ɻɘͅʇͅ੮͸ʩʇ̼ʇ੮ͅ˺˚ʇ˺˦ʇ੮͸ɘͅ੮ɻ˺˦ͅʇ̼ͷʇʁੳ੮U͐੮ͅˌʮ̼͐ʇʁ੮͐ʩʇ੮ή͙ʇ͐ͅʮ˺˦੮˺ʠ੮͸ʩʇ͐ʩʇ̼੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮ people who were not being conserved who needed to be. It provided few data on who conservatees were or where they went. Based on only three counties and containing ˦˺੮ ɘ˦ɘˑ;ͅʮͅ੮ ˺ʠ੮ ͐ʩʇ੮ ʠ͙˦ɻ͐ʮ˺˦ʮ˦ʡ੮ ˺ʠ੮ ̹͙ɺˑʮɻ੮ ʡ͙ɘ̼ʁʮɘ˦ͅૄ੮ ˺ϲϲʮɻʇͅੴ੮ ʮ͐੮ ʮͅ੮ ʠɘ̼੮ ʠ̼˺˚੮ ɘ੮ ͙ͅϲϲʮɻʮʇ˦͐੮ evaluation. California State Auditor, “Lanterman-Petris-Short Act: California Has Not /˦͙̼ͅʇʁ੮ îʩɘ͐੮ U˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʮ͐ʩ੮ äʇ̼ʮ˺͙ͅ੮ {ʇ˦͐ɘˑ੮ Uˑˑ˦ʇͅͅʇͅ੮ Ûʇɻʇʮͷʇ੮ ʁʇή͙ɘ͐ʇ੮ š˦ʡ˺ʮ˦ʡ੮ Care” (Sacramento, CA, July 2020). ੮ ৵৶ੳ੮ ‡ɘ͐ʩɘ˦ʮʇˑ੮Øੳ੮{˺̼̼ʮͅੴ੮ુ)ʇ͐ʇ˦͐ʮ˺˦੮Ĕʮ͐ʩ˺͙͐੮)ɘ͐ɘੵ੮Ø͙ɺˑʮɻ੮î̼ɘɻˌʮ˦ʡ੮˺ʠ੮#ʮͷʮˑ੮#˺˚˚ʮ͐˚ʇ˦͐ੴૂ੮ Psychiatric Services੮ ৷ৱੴ੮ ˦˺ੳ੮ ৷੮ ફ৲ৰ৲ৰબੵ੮ ৷৴ৱજ৴৴੶੮ /ˑʮΈɘɺʇ͐ʩ੮ Ĕɘ̼̼ʇ˦੮ ɘ˦ʁ੮ "˺ɺ੮ #ɘͅʇ;ੴ੮ ુrʇ͐͐ʇ̼੮ to Secretary Becerra and Attorney General Garland,” July 1, 2021, https://www.warren ੳͅʇ˦ɘ͐ʇੳʡ˺ͷઃʮ˚˺ઃ˚ʇʁʮɘઃʁ˺ɻઃ৲ৰ৲ৱੳৰ৷ੳৰৱେ৲ৰrʇ͐͐ʇ̼େ৲ৰ͐˺େ৲ৰ)šĩେ৲ৰɘ˦ʁେ৲ৰPPäେ৲ৰ̼ʇେ৲ৰ Conservatorship.pdf. 57. Andrew Abbott, îɲɐ‫ף‬ä͇̙̎ɐʣ‫˃ף‬ɩ‫ף‬Ø̅˃ɩɐ̎̎ɷ˃ʯ̎‫ףת‬ʯ‫ף‬/̎̎ȡ͇‫˃ף‬ʯ‫̙ף‬ɲɐ‫)ף‬ɷ̀ɷ̎ɷ˃ʯ‫˃ף‬ɩ‫ף‬/͆̂ɐ̙̅‫ף‬rȡɃ˃̅ (Chicago: University of Chicago Press, 1988); Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (Cambridge: Cambridge University Press, 1987). 58. James A. Holstein, #˃̢̙̅؅š̅Ɋɐ̅ɐɊ‫ ף‬Uʯ̎ȡʯɷ̙͇‫ ףת‬Uʯ̙ɐ̅̂̅ɐ̙ɷ̀ɐ‫ ף‬Ø̅ȡɄ̙ɷɄɐ‫ ף‬ȡʯɊ‫ ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ ף‬#˃ʣʣɷ̙ment੮ફ‡ʇ͸੮Ě˺̼ˌੵ੮î̼ɘ˦ͅɘɻ͐ʮ˺˦ੴ੮ৱ৹৹৳બੴ੮৴ৱ੶੮ͅʇʇ੮ɘˑͅ˺੮Ĕɘ̼̼ʇ˦ੴ੮The Court of Last Resort. ੮ ৵৹ੳ੮ )ʇ˦˦ʮͅ੮rੳ੮Ĕʇ˦ʡʇ̼੮ɘ˦ʁ੮#ੳ੮Ûʮɻʩɘ̼ʁ੮Hˑʇ͐ɻʩʇ̼ੴ੮ુîʩʇ੮/ʠʠʇɻ͐੮˺ʠ੮rʇʡɘˑ੮#˺͙˦ͅʇˑ੮˺˦੮ʁ˚ʮͅͅʮ˺˦ͅ੮ to a State Mental Hospital: A Confrontation of Professions,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Pɐȡʚ̙ɲ‫ף‬ȡʯɊ‫ף‬ä˃Ʉɷȡʚ‫ף‬ Behavior 10, no. 1 (1969): 66. ੮ ৶ৰੳ੮ H˺̼੮ ʇͽɘ˚̹ˑʇͅ੮ ˺ʠ੮ ʇ͐ʩʮɻɘˑ੮ ɘ˦ʁ੮ ̹ʩʮˑ˺ͅ˺̹ʩʮɻɘˑ੮ ϲʮʡʩ͐ͅ੮ ˺ͷʇ̼੮ ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐ੴ੮ ͅʇʇ੮ /ˑʮΈɘɺʇ͐ʩ੮ Bennion, “A Right to Remain Psychotic: A New Standard for Involuntary Treatment in Light of Current Science,” Loyola Law Review੮৴৷੮ફ৲ৰৱ৳બੵ੮৲৵ৱ੶੮#ˑɘ̼ʮͅͅɘ੮nɘ̼ɘͅɻʩੴ੮ુĔʩʇ̼ʇ੮ Involuntary Commitment, Civil Liberties, and the Right to Mental Health Care Collide: An Overview of California’s Mental Illness System,” Pȡ̙̎ɷʯɪ̎‫ף‬rȡ́‫ף‬k˃̢̅ʯȡʚ 54 (2003): 493–523; Stephen J. Morse, “A Preference for Liberty: The Case Against Involuntary

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

325

Commitment of the Mentally Disordered,” California Law Review 70, no. 1 (1982): 54–106; Johnathan Simon and Stephen A. Rosenbaum, “Defying Madness: Rethinking Commitment Law in an Age of Mass Incarceration,” õʯɷ̀ɐ̅̎ɷ̙͇‫˃ף‬ɩ‫{ף‬ɷȡʣɷ‫ף‬rȡ́‫ף‬Ûɐ̀ɷɐ́ 70 (2015): 1–52. 61. Brodwin, Everyday Ethics; Dobransky, {ȡʯȡɪɷʯɪ‫{ף‬ȡɊʯɐ̎̎; Gong, “Tolerant Containment.” 62. D. J. Jaffe, Uʯ̎ȡʯɐ‫ ף‬#˃ʯ̎ɐ̢̄ɐʯɄɐ̎‫ ףת‬P˃́‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬UʯɊ̢̙͇̎̅‫ ף‬Hȡɷʚ̎‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚʚ͇‫ ף‬Uʚʚ (Amherst, NY: Prometheus, 2017), 117. Other books make this same argument: LPS set a “gold standard for clueless, destructive government interference” in the treatment of people with mental illness. Ron Powers, ‡˃‫šף‬ʯɐ‫ף‬#ȡ̅ɐ̎‫ף‬Ƀ˃̢̙‫ף‬#̅ȡ͇͑‫ף‬Øɐ˃̂ʚɐ‫ףת‬îɲɐ‫ף‬#ɲȡ˃̎‫ף‬ȡʯɊ‫ף‬ Pɐȡ̙̅Ƀ̅ɐȡʕ‫˃ף‬ɩ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡ੮ફ‡ʇ͸੮Ě˺̼ˌੵ੮Pɘɻʩʇ͐͐ʇੴ੮৲ৰৱ৷બੳ੮rØä੮ુʇͽ̹ɘ˦ʁʇʁ੯ੳ੯ੳ੯ੳ੮ ͐ʩʇ੮̹ʇ̼ͅ˺˦ɘˑ੮ʠ̼ʇʇʁ˺˚੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੯ੳ੯ੳ੯ੳ੮ɘ͐੮͐ʩʇ੮ʇͽ̹ʇ˦ͅʇ੮˺ʠ੮ʡ˺ͷʇ̼˦˚ʇ˦͐ૄͅ੮ɘɺʮˑʮ͐;੮͐˺੯ੳ੯ੳ੯ੳ੮ provide treatment.” Stephen Eide, P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡ‫ףת‬îɲɐ‫ף‬Pɷ̙̎˃͇̅‫ף‬ȡʯɊ‫ף‬î̅ȡɪɐɊ͇‫˃ף‬ɩ‫ף‬ȡʯ‫ף‬ Uʯ̙̅ȡɄ͗ȡɃʚɐ‫ ף‬ä˃Ʉɷȡʚ‫ ף‬Ø̅˃Ƀʚɐʣ੮ ફrɘ˦ʩɘ˚ੴ੮ {)ੵ੮ Û˺͸˚ɘ˦੮ ૟੮ rʮ͐͐ˑʇϲʮʇˑʁੴ੮ ৲ৰ৲৲બੴ੮ ৲৹ੳ੮ rØä੮ ુ˚ɘʁʇ੮ ̼ɘ͐ʮ˺˦ɘˑ੮̼͐ʇɘ͐˚ʇ˦͐੮˺ʠ੮͐ʩʇ੮˚ʇ˦͐ɘˑˑ;੮ʮˑˑ੮ʮ˦ɻ̼ʇɘͅʮ˦ʡˑ;੮ʁʮϲϲʮɻ͙ˑ͐ੳૂ੮/ੳ੮H͙ˑˑʇ̼੮î˺̼̼ʇ;ੴ੮Out of the äɲȡɊ˃́̎‫ףת‬#˃ʯɩ̅˃ʯ̙ɷʯɪ‫ף‬ʣɐ̅ɷɄȡ‫{ף̎إ‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬#̅ɷ̎ɷ̎੮ફ‡ʇ͸੮Ě˺̼ˌੵ੮Ĕʮˑʇ;ੴ੮ৱ৹৹৷બੴ੮ৱ৴৳ੳ੮ુØɘͅͅɘʡʇ੮ of the LPS Act created a national disgrace, the homeless mentally ill.” Stephen Seager, ä̙̅ɐɐ̙‫ף‬#̅ȡ͇͑‫ףת‬ʣɐ̅ɷɄȡ‫{ף̎إ‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬î̅ȡɪɐɊ͇੮ફÛʇʁ˺˦ʁ˺੮"ʇɘɻʩੴ੮#ੵ੮Ĕʇ͐ͅɻ˺˚ੴ੮৲ৰৰৰબੴ੮৲৷ੳ 63. LPS Reform Task Force II, “The Case for Updating California’s Mental Health Treatment Law” (Tustin, CA, March 2012), 11. ੮ ৶৴ੳ੮ H˺̼੮ɘ੮̹ʇ̼̹ͅʇɻ͐ʮͷʇ੮ɻ̼ʮ͐ʮή͙ʮ˦ʡ੮ʩ˺͸੮˚ʇʁʮɻʮ˦ʇ੮ɻ˺˦͐ʮ˦͙ʇͅ੮͐˺੮̼͐ɘ˚̹ˑʇ੮ˑɘ͸ੴ੮˚ɘˌʮ˦ʡ੮ʮ͐੮ͅ˺੮ુ͐ʩʇ੮ very last human right[s] to be recognized” are those of the “mentally disabled,” see Geoffrey Robertson, foreword to {ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ȡʯɊ‫ף‬P̢ʣȡʯ‫ף‬Ûɷɪɲ̙̎‫ףת‬ēɷ̎ɷ˃ʯ‫ףש‬Ø̅ȡ͆ɷ̎‫ףש‬ȡʯɊ‫ף‬#˃̢̅ȡɪɐ, ed. Michael Dudley, Derrick Silove, and Fran Gale (Oxford: Oxford University Press, 2012), vii. 65. Michel Foucault, Ƀʯ˃̅ʣȡʚ‫ףת‬rɐɄ̢̙̅ɐ̎‫ף‬ȡ̙‫̙ף‬ɲɐ‫ף‬#˃ʚʚɡɪɐ‫ף‬Ɋɐ‫ף‬H̅ȡʯɄɐ‫ףש‬ըհծի؇ըհծլ (New York: Palgrave Macmillan, 2007), 32. 66. Miller and Hanson give a more precise rendering of this point: “In other areas of medicine, patients can be treated against their will only when they have been deemed incompetent to make decisions for themselves because they cannot understand the treatment options. Øͅ;ɻʩʮɘ̼͐;੮ʮͅ੮͐ʩʇ੮˺˦ˑ;੮ϲʮʇˑʁ੮͸ʩʇ̼ʇ੮ͅ˺˚ʇ˺˦ʇ੮˚ɘ;੮͙˦ʁʇ̼͐ͅɘ˦ʁ੮͸ʩɘ͐੮ʮͅ੮ɺʇʮ˦ʡ੮˺ʠʠʇ̼ʇʁ੮ɘ˦ʁ੮͐ͅʮˑˑ੮ be denied the right to refuse treatment.” Committed, xxii. 67. Michel Foucault, {ȡɊʯɐ̎̎‫ף‬ȡʯɊ‫ף‬#ɷ̀ɷʚɷ͑ȡ̙ɷ˃ʯ‫ףףת‬Pɷ̙̎˃͇̅‫˃ף‬ɩ‫ף‬Uʯ̎ȡʯɷ̙͇‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬ɪɐ‫˃ף‬ɩ‫ף‬Ûɐȡ̎˃ʯ, trans. Richard Howard (London: Routledge, 1964). 68. Chris Chapman, “Five Centuries’ Material Reforms and Ethical Reformulations of Social Elimination,” in )ɷ̎ȡɃɷʚɷ̙͇‫ף‬UʯɄȡ̅Ʉɐ̅ȡ̙ɐɊ, ed. Liat Ben-Moshe, Chris Chapman, and Allison C. Carey (New York: Palgrave Macmillan, 2014), 39. 69. Castel et al. argue that deinstitutionalization was a “myth.” Françoise Castel, Robert Castel, and Anne Lovell, The Psychiatric Society, trans. Arthur Goldhammer (New York: Columbia University Press, 1982), 298. Scull similarly claims that California “shut down ૃ͙̹ͅʇ̼ϲˑ͙˺͙ͅૄ੮ʮ˦͐ͅʮ͙͐͐ʮ˺˦ͅૂ੮ɘ˦ʁ੮ͅʩʮʠ͐ʇʁ੮͐˺੮ુ˦˺˦ચʮ˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮ɻ˺˦̼͐˺ˑͅੳૂ੮˦ʁ̼ʇ͸੮îੳ੮äɻ͙ˑˑੴ੮ )ɐɄȡ̅Ʉɐ̅ȡ̙ɷ˃ʯ‫ףת‬#˃ʣʣ̢ʯɷ̙͇‫ף‬î̅ɐȡ̙ʣɐʯ̙‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫)ף‬ɐ̀ɷȡʯ̙ੴ੮৲˦ʁ੮ʇʁੳ੮ફ/˦ʡˑʇ͸˺˺ʁ੮#ˑʮʠʠͅੴ੮‡ĩੵ੮Ø˺ˑʮ͐;ੴ੮ 1984), 73. 70. Forrest Stuart, )˃́ʯ‫ףש̢͗šףש‬ȡʯɊ‫ף‬õʯɊɐ̅‫̅̅ף‬ɐ̙̎‫ףת‬Ø˃ʚɷɄɷʯɪ‫ף‬ȡʯɊ‫ף‬/̀ɐ͇̅Ɋȡ͇‫ף‬rɷɩɐ‫ף‬ɷʯ‫ף‬äʕɷɊ‫ף‬Û˃́ (Chicago: University of Chicago Press, 2016).

326 71.

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

Josh Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ‫ףת‬ʣɃ̢ʚȡʯɄɐ‫ף‬#̅ɐ́̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫ף‬H̅˃ʯ̙ʚɷʯɐ̎‫˃ף‬ɩ‫ף‬õ̅Ƀȡʯ‫ף‬ä̢ɩɩɐ̅ɷʯɪ (Berkeley: University of California Press, 2019). 72. Armando Lara-Millán, ÛɐɊɷ̙̎̅ɷɃ̢̙ɷʯɪ‫̙ף‬ɲɐ‫ף‬Ø˃˃̅‫ףת‬kȡɷʚ̎‫ףש‬P˃̎̂ɷ͗ȡʚ̎‫ףש‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬#̅ɷ̎ɷ̎‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Hɷ̎cal Austerity (Oxford: Oxford University Press, 2021); Ji Seon Song, “Policing the Emergency Room,” Harvard Law Review 134, no. 8 (2021): 2646–2720. 73. Kerwin Kaye, “Rehabilitating the ‘Drugs Lifestyle’: Criminal Justice, Social Control, and the Cultivation of Agency,” /̙ɲʯ˃ɪ̅ȡ̂ɲ͇ 14, no. 2 (2013): 207–32; Chad Michael McPherson and Michael Sauder, “Logics in Action: Managing Institutional Complexity in a Drug Court,” Ɋʣɷʯɷ̙̎̅ȡ̙ɷ̀ɐ‫ ף‬äɄɷɐʯɄɐ‫ ף‬Ĺ̢ȡ̙̅ɐ̅ʚ͇ 58, no. 2 (2013): 165–96; Rebecca Tiger, “Drug Courts and the Logic of Coerced Treatment,” ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬H˃̢̅ʣ 26, no. 1 (2011): 169–82. 74. Nikolas Rose, “Governing Risky Individuals: The Role of Psychiatry in New Regimes of Control,” Ø͇̎Ʉɲɷȡ̙͇̅‫ףש‬Ø͇̎Ʉɲ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫ף‬rȡ́ 5, no. 2 (1998): 179. ੮ ৷৵ੳ੮ nɘ͐ʩʇ̼ʮ˦ʇ੮Ĕɘ̼ɺ͙̼͐˺˦੮ɘ˦ʁ੮ä͐ʇ̹ʩʇ˦੮{ੳ੮ä͐ɘʩˑੴ੮ુ"ɘˑɘ˦ɻʮ˦ʡ੮͐ʩʇ੮Øʇ˦ʁ͙ˑ͙˚ੵ੮Ûʇ͐ʩʮ˦ˌʮ˦ʡ੮͐ʩʇ੮ Role of Institutionalization in the Treatment of Serious Mental Illness,” CNS Spectrums 25, no. 2 (2020): 115–18. 76. Disability Rights California, “Voluntary Services as Alternative to Involuntary Detention Under LPS Act,” March 2010, http://www.disabilityrightsca.org/pubs/548701.pdf. 77. Mental Health and Substance Use Disorder Services Division, “California Involuntary Detention Reports (FY 2017–2018)” (Sacramento, CA: Department of Health Care Services, ৲ৰৱ৸બੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁʩɻͅੳɻɘੳʡ˺ͷઃ)˺ɻ͙˚ʇ˦͐ͅઃ#ä)ઢĚēઃ{PäઃU)ÛઃHĚৱ৷ચৱ৸ચU)ÛણÛʇ̹˺̼͐ .pdf; Gi Lee and David Cohen, “Incidences of Involuntary Psychiatric Detentions in 25 U.S. States,” Psychiatric Services੮৷ৱੴ੮˦˺ੳ੮ৱ੮ફ৲ৰ৲ৱબੵ੮৶ৱજ৶৸ੳ੮îʩʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮ϲʮʡ͙̼ʇ੮ʮͅ੮ɘˑ˚˺͐ͅ੮ɻʇ̼͐ɘʮ˦ˑ;੮ɘ˦੮ ͙˦ʁʇ̼ɻ˺͙˦͐ੳ੮îʩʮ̼͐;ચ͐͸˺੮˺ʠ੮ϲʮʠ͐;ચʇʮʡʩ͐੮ɻ˺͙˦͐ʮʇͅ੮ʁʮʁ੮˦˺͐੮̼ʇ̹˺̼͐੮ʁɘ͐ɘ੮͐˺੮͐ʩʇ੮͐ͅɘ͐ʇ੮ʮ˦੮৲ৰৱ৵જ৲ৰৱ৶ੳ੮ A representative of the hospital industry suggested that the real rate of 5150 holds may be more than twice as high. 78. Luke Sheridan Rains et al., “Variations in Patterns of Involuntary Hospitalisation and in Legal Frameworks: An International Comparative Study,” Lancet Psychiatry 6, no. 5 (2019): 403–17. 79. Michel Foucault, îɲɐ‫ף‬Pɷ̙̎˃͇̅‫˃ף‬ɩ‫ף‬äɐ̢͆ȡʚɷ̙͇, vol. 1: An Introduction, trans. Robert Hurley, reissue ed. (New York: Vintage, 1990), 135. 80. Orlando Patterson, äʚȡ̀ɐ͇̅‫ף‬ȡʯɊ‫ף‬ä˃Ʉɷȡʚ‫)ף‬ɐȡ̙ɲ‫ףףת‬#˃ʣ̂ȡ̅ȡ̙ɷ̀ɐ‫ף‬ä̢̙Ɋ͇ (Cambridge, MA: Harvard University Press, 1982), 41. ੮ ৸ৱੳ੮ Û˺ɺʇ̼͐੮/˚ɺ̼;ੴ੮ુîʩʇ੮š̼ʁʇɘˑ੮˺ϲ੮î˺͐ɘˑ੮Ø˺͸ʇ̼ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, September 3, 1972. 82. Heidi Blake and Katie Baker, “Beyond Britney: Abuse, Exploitation, and Death Inside America’s Guardianship Industry,” BuzzFeed News, September 17, 2021, https://www .buzzfeednews.com/article/heidiblake/conservatorship-investigation-free-britney-spears. ੮ ৸৳ੳ੮ {ɘͽ੮Ĕʇɺʇ̼ੴ੮Economy and Societyੴ੮ʇʁੳ੮I͙ʇ˦͐ʩʇ̼੮Û˺͐ʩ੮ɘ˦ʁ੮#ˑɘ͙ͅ੮Ĕʮ͐͐ʮɻʩ੮ફ"ʇ̼ˌʇˑʇ;ੵ੮õ˦ʮͷʇ̼ͅʮ͐;੮ ˺ʠ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ Ø̼ʇͅͅੴ੮ ৱ৹৷৸બੴ੮ ৲ੵ৹৴৳ੳ੮ H˺̼੮ ɘ੮ ͅʩɘ̼̹੮ ʇˑɘɺ˺̼ɘ͐ʮ˺˦੮ ˺ϲ੮ Ĕʇɺʇ̼ૄͅ੮ ͐ʩʇ˺̼;੮ ˺ʠ੮ authority, see Jeffrey Guhin, ɪɐʯ̙̎‫˃ף‬ɩ‫ף‬I˃Ɋ‫̢˃"ףת‬ʯɊȡ̅ɷɐ̎‫ף‬ȡʯɊ‫̢̙ף‬ɲ˃̅ɷ̙͇‫ף‬ɷʯ‫̢̎{ף‬ʚɷʣ‫ף‬ȡʯɊ‫ף‬#ɲ̅ɷ̎tian Schools (New York: Oxford University Press, 2021), 12. 84. Hannah Arendt, Between Past and Future, ed. Jerome Kohn (New York: Penguin, 2006), 93. 85. Daniel A. Menchik, {ȡʯȡɪɷʯɪ‫{ ף‬ɐɊɷɄȡʚ‫̢̙ ף‬ɲ˃̅ɷ̙͇੮ ફØ̼ʮ˦ɻʇ͐˺˦ੴ੮ ‡ĩੵ੮ Ø̼ʮ˦ɻʇ͐˺˦੮ õ˦ʮͷʇ̼ͅʮ͐;੮ Press, 2021); Paul Starr, îɲɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬î̅ȡʯ̎ɩ˃̅ʣȡ̙ɷ˃ʯ‫˃ף‬ɩ‫ף‬ʣɐ̅ɷɄȡʯ‫{ף‬ɐɊɷɄɷʯɐ‫ףת‬îɲɐ‫ף‬Ûɷ̎ɐ‫˃ף‬ɩ‫ף‬ȡ‫ף‬ä˃̀ɐ̅ɐɷɪʯ‫ף‬

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

86.

87. ੮ ৸৸ੳ੮

89.

੮ ৹ৰੳ੮

੮ ৹ৱੳ੮ ੮ ৹৲ੳ੮

93.

94. 95.

96.

327

Ø̅˃ɩɐ̎̎ɷ˃ʯ‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫{ף‬ȡʕɷʯɪ‫˃ף‬ɩ‫ף‬ȡ‫ף‬ēȡ̙̎‫ף‬UʯɊ̢̙͇̎̅ (New York: Basic Books, 1982); Stefan Timmermans, “Suicide Determination and the Professional Authority of Medical Examiners,” American ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 70, no. 2 (2005): 311–33. In an ethnography of an emergency psychiatric unit, Rhodes also emphasizes that patients and staff are subjects of power. But while she presents both as tangled up in the same Foucaultian disciplinary power, I differentiate the types of power to which patients and professionals are exposed. Lorna A. Rhodes, /ʣ̙͇̂ɷʯɪ‫"ף‬ɐɊ̎‫ףת‬îɲɐ‫ף‬Ĕ˃̅ʕ‫˃ף‬ɩ‫ף‬ȡʯ‫ף‬/ʣɐ̅ɪɐʯɄ͇‫ף‬ Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬õʯɷ̙ (Berkeley: University of California Press, 1991). Joseph Raz, The Authority of Law: Essays on Law and Morality (Oxford: Oxford University Press, 1979). Ûʮɻʩɘ̼ʁ੮H̼ʮʇʁ˚ɘ˦ੴ੮ή͙˺͐ʇʁ੮ʮ˦੮ä͐ʇͷʇ˦੮r͙ˌʇͅੴ੮ુØʇ̼̹ͅʇɻ͐ʮͷʇͅ੮˺˦੮͙͐ʩ˺̼ʮ͐;੮Øɘ̼͐੮Uੵ੮#˺˦ɻʇ̹͐ͅੴ੮ Øʇ̼̹ͅʇɻ͐ʮͷʇͅੴ੮ ɘ˦ʁ੮ k͙͐ͅʮϲʮɻɘ͐ʮ˺˦ͅੵ੮ äʇɻ͐ʮ˺˦੮ ৴ੴૂ੮ NOMOS: American Society for Political and rɐɪȡʚ‫ף‬Øɲɷʚ˃̎˃̂ɲ͇ 29 (1987): 65. “Forced treatment by psychiatric and other health and medical professionals is a viola͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮̼ʮʡʩ͐੮͐˺੮ʇή͙ɘˑ੮̼ʇɻ˺ʡ˦ʮ͐ʮ˺˦੮ɺʇʠ˺̼ʇ੮͐ʩʇ੮ˑɘ͸੮ɘ˦ʁ੮ɘ˦੮ʮ˦ʠ̼ʮ˦ʡʇ˚ʇ˦͐੮˺ʠ੮͐ʩʇ੮̼ʮʡʩ͐ͅ੮ to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16).” Committee on the Rights of Persons with Disabilities, “General Comment No. 1” (United Nations, April 11, 2014), 11. îʩʮͅ੮ ʮʁʇɘ੮ ͐ʩɘ͐੮ ɘ੮ ɻ˺̼ʇ੮ ̹˺͸ʇ̼੮ ˺ʠ੮ ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ʮͅ੮ ͐˺੮ ʁʇϲʮ˦ʇ੮ ˌʇ;੮ ɻɘ͐ʇʡ˺̼ʮʇͅઝˑʮˌʇ੮ ુʡ̼ɘͷʇ੮ disability”—and coordinate a range of social actors is developed in Pierre Bourdieu, On ̙ɲɐ‫ף‬ä͗ȡ̙ɐ੮ફ#ɘ˚ɺ̼ʮʁʡʇੵ੮Ø˺ˑʮ͐;ੴ੮৲ৰৱ৵બ੶੮{ɘ͐͐ʩʇ͸੮‡˺̼͐˺˦ੴ੮ુ#ˑɘͅͅʮϲʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮#˺ʇ̼ɻʮ˺˦ੵ੮îʩʇ੮ Destruction of Piracy in the English Maritime System,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬ä˃Ʉɷ˃ʚ˃ɪ͇ 119, no. 6 (2014): 1537–75. /˚ɺ̼;ੴ੮ુîʩʇ੮š̼ʁʇɘˑ੮˺ϲ੮î˺͐ɘˑ੮Ø˺͸ʇ̼ੳૂ ͅ੮͐͸˺੮ʁ˺ɻ͐˺̼ͅ੮̹͙͐੮ʮ͐ੴ੮ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ુʩɘͅ੮ɺʇʇ˦੮ʇ̼˺ʁʇʁ੮ɘͅ੮ɘ੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ʮ˦̹ɘ͐ʮʇ˦͐੮ care.” Joel T. Braslow and Luke Messac, “Medicalization and Demedicalization: A Gravely Disabled Homeless Man with Psychiatric Illness,” ‡ɐ́‫ף‬/ʯɪʚȡʯɊ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫{ף‬ɐɊɷɄɷʯɐ 379, no. 20 (2018): 1886. Little Hoover Commission, “Being There: Making a Commitment to Mental Health” (Sacramento, CA, November 2000); California Mental Health Planning Council, “California Mental Health Master Plan: A Vision for California” (Sacramento, CA, March 2003). Behavioral Health Action, “Answering the Call to Action: A Vision for All Californians’ Behavioral Health,” 2021, 31, https://www.behavioralhealthaction.org/. Kimberly J. Morgan and Andrea Louise Campbell, îɲɐ‫)ף‬ɐʚɐɪȡ̙ɐɊ‫ף‬Ĕɐʚ͖ȡ̅ɐ‫ף‬ä͗ȡ̙ɐ‫{ףת‬ɐɊɷɄȡ̅ɐ‫ףש‬ Markets, and the Governance of Social Policy (New York: Oxford University Press, 2011); Joe Soss, Richard C. Fording, and Sanford F. Schram, )ɷ̎Ʉɷ̂ʚɷʯɷʯɪ‫̙ף‬ɲɐ‫ף‬Ø˃˃̅‫‡ףת‬ɐ˃ʚɷɃɐ̅ȡʚ‫ף‬Øȡ̙ɐ̅nalism and the Persistent Power of Race (Champagne, IL: University of Chicago Press, 2011); Paige L. Sweet, îɲɐ‫ ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ ף‬ɩ‫ ף‬ä̢̅̀ɷ̀ɷʯɪ‫ ףת‬P˃́‫ ף‬Ĕ˃ʣɐʯ‫‡ ף‬ȡ̀ɷɪȡ̙ɐ‫˃) ף‬ʣɐ̙̎ɷɄ‫ ף‬ēɷ˃ʚɐʯɄɐ‫ ף‬ȡʯɊ‫ ף‬U̙̎‫ף‬ Aftermath (Berkeley: University of California Press, 2021). Gerald N. Grob, H̅˃ʣ‫͇̎ ף‬ʚ̢ʣ‫ ף˃̙ ף‬#˃ʣʣ̢ʯɷ̙͇‫{ ףת‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬Ø˃ʚɷɄ͇‫ ף‬ɷʯ‫˃{ ף‬Ɋɐ̅ʯ‫ ף‬ʣɐ̅ɷɄȡ ફØ̼ʮ˦ɻʇ͐˺˦ੴ੮ ‡ĩੵ੮ Ø̼ʮ˦ɻʇ͐˺˦੮ õ˦ʮͷʇ̼ͅʮ͐;੮ Ø̼ʇͅͅੴ੮ ৱ৹৹ৱબੴ੮ ৳੶੮ Iʇ̼ɘˑʁ੮ ‡ੳ੮ I̼˺ɺ੮ ɘ˦ʁ੮ P˺͸ɘ̼ʁ੮ Pੳ੮ Goldman, îɲɐ‫) ף‬ɷʚɐʣʣȡ‫˃ ף‬ɩ‫ ף‬HɐɊɐ̅ȡʚ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬Ø˃ʚɷɄ͇‫ ףת‬ÛȡɊɷɄȡʚ‫ ף‬Ûɐɩ˃̅ʣ‫ ף̅˃ ף‬UʯɄ̅ɐʣɐʯ͗ȡʚ‫ף‬ #ɲȡʯɪɐ‫ׯ‬੮ફ‡ʇ͸੮"̼͙˦ͅ͸ʮɻˌੴ੮‡ĩੵ੮Û͙͐ʡʇ̼ͅ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰৰ৶બੴ੮ৱ৴ੳ

328

I N T R O D U C T I O N : T H E OT H E R M AG N A C A RTA

੮ ৹৷ੳ੮ )˺̼ʮͅ੮ੳ੮H͙ˑˑʇ̼੮ʇ͐੮ɘˑੳੴ੮ુI˺ʮ˦ʡੴ੮I˺ʮ˦ʡੴ੮I˺˦ʇੵ੮î̼ʇ˦ʁͅ੮ɘ˦ʁ੮#˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮/ˑʮ˚ʮ˦ɘ͐ʮ˦ʡ੮ State Psychiatric Beds, 2016” (Treatment Advocacy Center, June 2016). 98. Richard G. Frank and Sherry A. Glied, "ɐ̙̙ɐ̅‫ף‬Ƀ̢̙‫ף̙˃‡ף‬Ĕɐʚʚ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬Ø˃ʚɷɄ͇‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬ õʯɷ̙ɐɊ‫ף‬ä͗ȡ̙ɐ̎‫ף‬äɷʯɄɐ‫ף‬ըհլէ (Baltimore: Johns Hopkins University Press, 2006), 48. 99. Yeheskel Hasenfeld, “Community Mental Health Centers as Human Service Organizations,” American Behavioral Scientist 28, no. 5 (1985): 655–68; H. Brinton Milward and Keith G. Provan, “Governing the Hollow State,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø̢ɃʚɷɄ‫ף‬Ɋʣɷʯɷ̙̎̅ȡ̙ɷ˃ʯ‫ף‬Ûɐ̎ɐȡ̅Ʉɲ‫ף‬ and Theory 10, no. 2 (2000): 359–80. 100. Robert M. Emerson, E. Burke Rochford, and Linda L. Shaw, “Economics and Enterprise in Board and Care Homes for the Mentally Ill,” American Behavioral Scientist 24, no. 6 ફৱ৹৸ৱબੵ੮৷৷ৱજ৸৵੶੮˦ʁ̼ʇ͸੮äɻ͙ˑˑੴ੮ુ੮‡ʇ͸੮î̼ɘʁʇ੮ʮ˦੮r͙˦ɘɻ;ੵ੮îʩʇ੮Ûʇɻ˺˚˚˺ʁʮϲʮɻɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮ Mental Patient,” American Behavioral Scientist 24, no. 6 (1981): 741–54. 101. The way deinstitutionalization has shifted responsibility to families is documented ɘɻ̼˺ͅͅ੮ ͐ʩʇ੮ Ĕʇ͐ͅʇ̼˦੮ ͸˺̼ˑʁ੮ ɺ;੮ äʮ˚˺˦੮ I˺˺ʁ͸ʮ˦ੴ੮ #˃ʣ̂ȡ̅ȡ̙ɷ̀ɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬Ø˃ʚɷɄ͇‫ ףת‬H̅˃ʣ‫ף‬ Institutional to Community Care (London: Sage, 1997). 102. Morgan and Campbell, îɲɐ‫)ף‬ɐʚɐɪȡ̙ɐɊ‫ף‬Ĕɐʚ͖ȡ̅ɐ‫ף‬ä͗ȡ̙ɐ, 4. 103. Lipsky, Street-Level Bureaucracy, 3. 104. Lipsky, Street-Level Bureaucracy, 3. 105. Ellen M. Immergut, Health Politics: Interests and Institutions in Western Europe (New York: Columbia University Press, 1992). 106. Lara-Millán, ÛɐɊɷ̙̎̅ɷɃ̢̙ɷʯɪ‫̙ף‬ɲɐ‫ף‬Ø˃˃̅; Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ੶੮#ʇˑʇ͐ͅʇ੮Ĕɘ͐ˌʮ˦ͅચPɘ;ʇͅੴ੮ îɲɐ‫‡ף‬ɐ́‫ף‬Ĕɐʚ͖ȡ̅ɐ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡ̙̎‫ףת‬/ʯ͗ȡʯɪʚɐʣɐʯ̙̎‫˃ף‬ɩ‫ף‬ÛȡɄɐ‫ףש‬#ʚȡ̎̎‫ףש‬ȡʯɊ‫ף‬Ø˃ʚɷɄ͇‫ף‬Ûɐɩ˃̅ʣ (Chicago: University of Chicago Press, 2009). ੮ৱৰ৷ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ĔU#ੴ੮ äʇɻ͐ʮ˺˦੮ ৵৴ৰৰફɘબੴ੮ ˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৴ৰৰੳ 108. This depiction comes from both right-leaning commentators portraying an ineffectual ˦˺˦̹̼˺ϲʮ͐੮ʮ˦ʁ͙̼͐ͅ;੮ʠʇʇʁʮ˦ʡ੮ɘ͐੮͐ʩʇ੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮̼͐˺͙ʡʩ੮ફ/ʮʁʇੴ੮äʩʇˑˑʇ˦ɺʇ̼ʡʇ̼બ੮ɘ˦ʁ੮ˑʇʠ͐ચˑʇɘ˦ʮ˦ʡ੮ ones assailing potentially well-meaning charities that nonetheless normalize and depoˑʮ͐ʮɻʮΈʇ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ફI˺͸ɘ˦ੴ੮Ĕʮˑˑͅʇબੳ੮/ʮʁʇੴ੮Homelessness in America; Shellenberger, San Fransicko; Teresa Gowan, P˃Ƀ˃̎‫ףש‬P̢̙̎ʚɐ̅̎‫ףש‬ȡʯɊ‫"ף‬ȡɄʕ̎ʚɷɊɐ̅̎‫ףת‬P˃ʣɐʚɐ̎̎‫ף‬ɷʯ‫ף‬äȡʯ‫ף‬H̅ȡʯɄɷ̎Ʉ˃ (Min˦ʇɘ̹˺ˑʮͅੵ੮õ˦ʮͷʇ̼ͅʮ͐;੮˺ʠ੮{ʮ˦˦ʇͅ˺͐ɘ੮Ø̼ʇͅͅੴ੮৲ৰৱৰબ੶੮#̼ɘʮʡ੮Ĕʮˑˑͅʇੴ੮îɲɐ‫ף‬ēȡʚ̢ɐ‫˃ף‬ɩ‫ף‬P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ףת‬ {ȡʯȡɪɷʯɪ‫ף‬ä̢̅̂ʚ̢̎‫ף‬rɷɩɐ‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬õʯɷ̙ɐɊ‫ף‬ä͗ȡ̙ɐ̎ (Minneapolis: University of Minnesota Press, 2015). 109. Starr, The Social Transformation of American Medicine, 10. 110. Kimberly J. Morgan and Ann Shola Orloff, eds., “Introduction,” in The Many Hands of the ä͗ȡ̙ɐ‫ףת‬îɲɐ˃̅ɷ͑ɷʯɪ‫ף‬Ø˃ʚɷ̙ɷɄȡʚ‫̢̙ף‬ɲ˃̅ɷ̙͇‫ף‬ȡʯɊ‫ף‬ä˃Ʉɷȡʚ‫ף‬#˃ʯ̙̅˃ʚ (Cambridge: Cambridge University Press, 2017), 1–32. 111. Milward and Provan, “Governing the Hollow State.”

1. OUTPATIENT 1.

See also, Timothy Tyler Brown et al., “The Impact of California’s Full-Service Partnership Program on Mental Health-Related Emergency Department Visits,” Psychiatric Services 63, no. 8 (2012): 802–7; Timothy Tyler Brown, Juliette S. Hong, and Richard M.

1. O U T PAT I E N T

2. 3. 4.

੮ ৵ੳ੮

੮ ৶ੳ੮

7.

੮ ৸ੳ੮

੮ ৹ੳ੮

੮ ৱৰੳ੮

11.

12.

329

äɻʩʇϲϲˑʇ̼ੴ੮ુ/ͷɘˑ͙ɘ͐ʮ˦ʡ੮͐ʩʇ੮U˚̹ɘɻ͐੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮H͙ˑˑ੮äʇ̼ͷʮɻʇ੮Øɘ̼͐˦ʇ̼ͅʩʮ̹੮Ø̼˺ʡ̼ɘ˚੮õͅʮ˦ʡ੮ a Multidimensional Measure of Outcomes,” Ɋʣɷʯɷ̙̎̅ȡ̙ɷ˃ʯ‫ ף‬ȡʯɊ‫ ף‬Ø˃ʚɷɄ͇‫ ף‬ɷʯ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ף‬ ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬äɐ̅̀ɷɄɐ̎‫ף‬Ûɐ̎ɐȡ̅Ʉɲ 41, no. 3 (2014): 390; Sarah L. Starks et al., “System Transformation Under the California Mental Health Services Act: Implementation of Full-Service Partnerships in L.A. County,” Psychiatric Services 68, no. 6 (2017): 587–95. California Health Care Foundation, “California Health Care Almanac,” June 2022, 3, https://www.chcf.org/wp-content/uploads/2022/06/HealthInsurersAlmanac2022.pdf. Tara F. Bishop et al., “Acceptance of Insurance by Psychiatrists and the Implications for Access to Mental Health Care,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 71, no. 2 (2014): 176–81. As Lewis et al. put it, in the community treatment system that replaced asylums, “care is a matter of personal choice for the patient and the provider.” Dan A. Lewis et al., Worlds ˃ɩ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚʚ͇‫ף‬Uʚʚ‫ףת‬P˃́‫)ף‬ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ͑ȡ̙ɷ˃ʯ‫ף‬Ĕ˃̅ʕ̎‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬#ɷ̙͇ (Carbondale: Southern Illinois University Press, 1991), 93. kɘ˦ʇ͐੮ #˺ʠʠ˚ɘ˦੮ ʇ͐੮ ɘˑੳੴ੮ ુ#ɘˑʮʠ˺̼˦ʮɘૄͅ੮ #͙̼̼ʇ˦͐੮ ɘ˦ʁ੮ H͙͙̼͐ʇ੮ "ʇʩɘͷʮ˺̼ɘˑ੮ Pʇɘˑ͐ʩ੮ Ĕ˺̼ˌʠ˺̼ɻʇૂ੮ (San Francisco: Healthforce Center at UCSF, February 12, 2018), 22, https://healthforce .ucsf.edu/. #ɘˑʮʠ˺̼˦ʮɘ੮̼ʇή͙ʮ̼ʇͅ੮͐ʩɘ͐੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮͐ʩʇ̼ɘ̹ʇ͙͐ʮɻ੮̹̼˺ʡ̼ɘ˚ͅ੮ʠ˺̼੮ɻʩʮˑʁ̼ʇ˦੮ɺʇ੮ુ˺̼ʡɘ˦ʮΈʇʁ੮ɘ˦ʁ੮ ˺̹ʇ̼ɘ͐ʇʁ੮˺˦੮ɘ੮˦˺˦̹̼˺ϲʮ͐੮ɺɘͅʮͅੴૂ੮ͅ˺੮˚ɘ˦;੮ɘʁ˺ˑʇͅɻʇ˦͐ͅ੮ɘ̼ʇ੮ͅʇ˦͐੮˺͙͐੮˺ʠ੮͐ͅɘ͐ʇ੮͸ʩʇ̼ʇ੮ɘ੮ʠ˺̼ચ ̹̼˺ϲʮ͐੮ʮ˦ʁ͙̼͐ͅ;੮ʮͅ੮ϲˑ˺͙̼ʮͅʩʮ˦ʡੳ੮Ø̼˺̹˺ͅɘˑͅ੮͐˺੮̼ʇʡ͙ˑɘ͐ʇ੮͐ʩʇ੮ʮ˦ʁ͙̼͐ͅ;੮ɘ͐੮͐ʩʇ੮ʠʇʁʇ̼ɘˑ੮ˑʇͷʇˑ੮ʩɘͷʇ੮ repeatedly failed. Cameron Evans, “State Laws Aim to Regulate ‘Troubled Teen Industry,’ but Loopholes Remain,” Kaiser Health News, January 22, 2022, https://khn.org/news /article/state-laws-aim-to-regulate-troubled-teen-industry-but-loopholes-remain/. Chad Terhune, “Report: Kaiser Tops State Health Insurance Market with 40 Percent Share,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, January 29, 2013, https://www.latimes.com/business/la-xpm-2013 ચˈɘ˦ચ৲৹ચˑɘચϲʮચ˚˺ચʩʇɘˑ͐ʩચʮ˦͙̼ͅʇચ˚ɘ̼ˌʇ͐ચ৲ৰৱ৳ৰৱ৲৹ચ͐ͅ˺̼;ੳʩ͐˚ˑੳ k˺ɻʇˑ;˦੮ Ĕʮʇ˦ʇ̼ੴ੮ ુH˺̼੮ Hɘ˚ʮˑʮʇͅ੮ ɻ̼˺ͅͅ੮ #ɘˑʮʠ˺̼˦ʮɘੴ੮ ɘ੮ )ʇ̹ͅʇ̼ɘ͐ʇ੮ ä̼͙͐ʡʡˑʇ੮ ͐˺੮ Iʇ͐੮ {ʇ˦͐ɘˑ੮ Health Care,” CALmatters, March 10, 2019, https://calmatters.org/articles/californians ચ̼͙͐ͅʡʡˑʇચ͐˺ચʡʇ͐ચ˚ʇ˦͐ɘˑચʩʇɘˑ͐ʩચɻɘ̼ʇઃ੶੮k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુ{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮š͙͐ɻ̼;੮îɘ̼gets Kaiser—and State Regulators,” CalMatters, December 18, 2019, https://calmatters .org/projects/mental-health-care-outcry-targets-kaiser-california-parity-regulators/. {ɘ̼͐ʮ˦੮/̹ͅʮ˦˺Έɘੴ੮ુ{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Ĕ˺̼ˌʇ̼ͅૄ੮õ˦ʮ˺˦੮#ˑɘʮ˚ͅ੮nɘʮͅʇ̼੮Øʇ̼˚ɘ˦ʇ˦͐ʇ੮‡˺͐੮Ø̼˺ͷʮʁing Psychiatric Crisis Care in Emergency Room,” äȡʯ͗ȡ‫ף‬Û˃̎ȡ‫ף‬Ø̅ɐ̎̎‫)ף‬ɐʣ˃Ʉ̅ȡ̙, September 27, 2022, https://www.pressdemocrat.com/article/news/mental-health-workers-union-claims -kaiser-permanente-not-providing-psychia/. ‡ɘ˦ʇ͐͐ʇ੮ ͅʮ˚˺ͷੴ੮ ુnɘʮͅʇ̼੮ {ɘʁʇ੮ ଏ৸੮ "ʮˑˑʮ˺˦੮ ʮ˦੮ Ø̼˺ϲʮ͐ͅ੮ rɘ͐ͅ੮ Ěʇɘ̼ੳ੮ ä˺੮ Ĕʩ;੮ ̼ʇ੮ Øɘ͐ʮʇ˦͐ͅ੮ Struggling to Get Mental Health Care?” San Francisco Chronicle, September 28, 2022, ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅʠɻʩ̼˺˦ʮɻˑʇੳɻ˺˚ઃɺɘ;ɘ̼ʇɘઃɘ̼͐ʮɻˑʇઃĔʩ˺ચʮͅચʡ˺ʮ˦ʡચ͐˺ચʩ˺ˑʁચnɘʮͅʇ̼ચɘɻɻ˺͙˦͐ɘɺˑʇ -17474027.php. Michael McGough, “Kaiser Settled 2014 Patient-Dumping Class-Action,” Sacramento Bee, December 20, 2018, https://www.sacbee.com/news/local/health-and-medicine/article223368950 .html. Note that the study does not compare these elevated death rates among young people with psychosis on private insurance to young people on public insurance. Michael Schoenbaum et al., “Twelve-Month Health Care Use and Mortality in Commercially

330

1. O U T PAT I E N T

Insured Young People with Incident Psychosis in the United States,” Schizophrenia Bulletin 43, no. 6 (2017): 1262–72. ੮ ৱ৳ੳ੮ k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુૃI˺੮˺˦੮{ʇʁʮચ#ɘˑ੮͐˺੮Iʇ͐੮îʩɘ͐ૄੵ੮Ĕʩ;੮#ɘˑʮʠ˺̼˦ʮɘ˦ͅ੮͸ʮ͐ʩ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅ੮̼ʇ੮ Dropping Private Insurance to Get Taxpayer-Funded Treatment,” CalMatters, July 30, 2020, https://calmatters.org/projects/california-mental-health-private-insurance-medi-cal/. 14. See also Howard Padwa et al., “A Mental Health System in Recovery: The Era of Deinstitutionalisation in California,” in )ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ̎ȡ̙ɷ˃ʯ‫ף‬ȡʯɊ‫ף‬ɩ̙ɐ̅‫ףת‬Ø˃̙̎؅Ĕȡ̅‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ɷʯ‫ף‬ the Western World, ed. Despo Kritsotaki, Vicky Long, and Matthew Smith (Cham, Switzerland: Palgrave Macmillan, 2016), 241–65. 15. One review found that police were involved in accessing care for 29 percent for people ͸ʮ͐ʩ੮ͅʇ̼ʮ˺͙ͅ੮˚ʇ˦͐ɘˑ੮ʮˑˑ˦ʇͅͅ੮ʮ˦੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅੳ੮îʩʇ੮ɘͷʇ̼ɘʡʇ੮ʮ˦੮˺͐ʩʇ̼੮Ĕʇ͐ͅʇ̼˦੮ɻ˺͙˦̼͐ʮʇͅ੮ was 11 percent. James D. Livingston, “Contact Between Police and People with Mental Disorders: A Review of Rates,” Psychiatric Services 67, no. 8 (2016): 850–57. 16. Southern Poverty Law Center, “Costly and Cruel: How Misuse of the Baker Act Harms ৳৷ੴৰৰৰ੮ Hˑ˺̼ʮʁɘ੮ #ʩʮˑʁ̼ʇ˦੮ /ɘɻʩ੮ Ěʇɘ̼ੴૂ੮ ৲ৰ৲ৱੴ੮ ʩ̹͐͐ͅੵઃઃ̹ͅˑɻʇ˦͐ʇ̼ੳ˺̼ʡઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃɻ˺˚ ઢ̹ͅʇɻʮɘˑઢ̼ʇ̹˺̼͐ઢɺɘˌʇ̼ઢɘɻ͐ઢɻ˺͐ͅˑ;ઢɘ˦ʁઢɻ̼͙ʇˑੳ̹ʁʠੳ 17. This practice of only paying for cheaper medications, even if a patient had previous success on a more expensive second-generation antipsychotic, also took place in Florida’s jails. Pete Earley, #̅ȡ͇͑‫ףףת‬Hȡ̙ɲɐ̅‫ף̎إ‬äɐȡ̅Ʉɲ‫ף‬îɲ̅˃̢ɪɲ‫ף‬ʣɐ̅ɷɄȡ‫{ף̎إ‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫{ף‬ȡɊʯɐ̎̎ (New York: Putnam, 2006), 163. 18. Marcia L. Meldrum et al., “Implementation Status of Assisted Outpatient Treatment Programs: A National Survey,” Psychiatric Services 67, no. 6 (2016): 630–35. 19. Substance Abuse and Mental Health Services Administration, “Funding and Characteristics of Single State Agencies for Substance Abuse Services and State Mental Health Agencies, 2015” (Rockville, MD: U.S. Department of Health and Human Services, 2017), ৱ৳৲ੴ੮ʩ̹͐͐ͅੵઃઃ͐ͅ˺̼ʇੳͅɘ˚ʩͅɘੳʡ˺ͷઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃʁ৷ઃ̹̼ʮͷઃͅ˚ɘৱ৷ચ৵ৰ৲৹ੳ̹ʁʠੳ 20. Teknekron Inc., “Improving California’s Mental Health System: Policymaking and Management in the Invisible System” (Berkeley: California Assembly Permanent Subcommittee on Mental Health and Developmental Disabilities, December 1978), 9. Subͅʇή͙ʇ˦͐੮ˑʇʡʮͅˑɘ͐ʮ˺˦ੴ੮ɘ͙͐ʩ˺̼ʇʁ੮ɺ;੮H̼ɘ˦ˌ੮rɘ˦͐ʇ̼˚ɘ˦ੴ੮̼ʇή͙ʮ̼ʇʁ੮͐ʩɘ͐੮ɻ˺͙˦͐ʮʇͅ੮ɻ˺˦̼͐ɘɻ͐੮ʠ˺̼੮ some services rather than run them themselves. Eugene Bardach, îɲɐ‫ ף‬Uʣ̂ʚɐʣɐʯ͗ȡ̙ɷ˃ʯ‫ף‬ Game: What Happens After a Bill Becomes a Law (Cambridge, MA: MIT Press, 1977), 11. ੮ ৲ৱੳ੮ ĺ͙˺͐ʇʁ੮ʮ˦੮/͙ʡʇ˦ʇ੮"ɘ̼ʁɘɻʩੴ੮îɲɐ‫ף‬äʕɷʚʚ‫ף‬HȡɄ̙˃̅‫ף‬ɷʯ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףת‬Ûɐ̂ɐȡʚɷʯɪ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙‫ף‬ Laws in California (Berkeley: University of California Press, 1972), 83. The programs LPS ʠ͙˦ʁʇʁ੮͸ʇ̼ʇ੮ુɻ˺˦͐ɘɻ͐ʮ˦ʡ੮ɘ੮̹˺̹͙ˑɘ͐ʮ˺˦੮ʡ̼˺͙̹੮͐ʩɘ͐੮͸ɘͅ੮˦˺͐੮̼ʇɘɻʩʇʁ੮̹̼ʇચrØä੯ੳ੯ੳ੯ੳ੮͸ʩ˺੮͸ʇ̼ʇ੮ ય˦˺͐ર੮ˑʮˌʇˑ;੮͐˺੮̼ʇή͙ʮ̼ʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ͅʇ̼ͷʮɻʇͅੳૂ੮/‡nU੮Ûʇͅʇɘ̼ɻʩ੮U˦͐ͅʮ͙͐͐ʇੴ੮A Study of California’s ‡ɐ́‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬rȡ́‫ؒף‬ըհխհ؇ըհծըؓ (Chatsworth, CA: Author, 1972), 196. 22. Nicolas Petris, “State Government Oral History Program,” December 20, 1988, California State Archives, https://archives.cdn.sos.ca.gov/oral-history/pdf/oh-petris-nicholas.pdf. 23. John R. Elpers, “Public Mental Health Funding in California, 1959 to 1989,” Psychiatric Services 40, no. 8 (1989): 799–804. 24. Bill Boyarsky, “Changing Policies Affect Care of Sick,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 8, 1982. 25. Deborah Vrana, “California Shifts $2.2 Billion of New Responsibility Onto Its Counties’ Shoulders,” Bond Buyer, July 15, 1991.

1. O U T PAT I E N T 26. ੮ ৲৷ੳ੮ ੮ ৲৸ੳ੮

29.

੮ ৳ৰੳ੮ 31. 32.

33.

34. 35.

36.

37.

੮ ৳৸ੳ੮

39.

40.

331

Linda Roach Monroe, “County Faces Tough Choices on Mental Health,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Times, August 4, 1988. #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৶ৰৰફɘબੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;îʇͽ͐ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ʁʮͷʮͅʮ˺˦ଵ৵ੳ૟͐ʮ͐ˑʇଵ૟̹ɘ̼͐ଵ৲ੳ૟ɻʩɘ̹͐ʇ̼ଵৱੳ r˺˦˦ʮʇ੮ä˦˺͸ʁʇ˦ੴ੮Ûʮɻʩɘ̼ʁ੮äɻʩʇϲϲˑʇ̼ੴ੮ɘ˦ʁ੮˚;੮Ĥʩɘ˦ʡੴ੮ુîʩʇ੮U˚̹ɘɻ͐੮˺ʠ੮Ûʇɘˑʮʡ˦˚ʇ˦͐੮˺˦੮ the Client Population in California’s Public Mental Health System,” Administration and Ø˃ʚɷɄ͇‫ף‬ɷʯ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 29, no. 3 (2002): 229–41. Ben Kane et al., “California County Spending on 24-Hour Behavioral Care” (Berkeley, CA: Goldman School of Public Policy, April 2018); Mac Taylor, “Rethinking the 1991 Ûʇɘˑʮʡ˦˚ʇ˦͐ૂ੮ફäɘɻ̼ɘ˚ʇ˦͐˺ੴ੮#ੵ੮rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅૄͅ੮šϲϲʮɻʇੴ੮šɻ͐˺ɺʇ̼੮ৱ৵ੴ੮৲ৰৱ৸બੳ rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅૄͅ੮šϲϲʮɻʇੴ੮ુÛʇɘˑʮʡ˦˚ʇ˦͐੮Ûʇͷʮͅʮ͐ʇʁੵ੮˦੮/ͷɘˑ͙ɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮ৱ৹৹ৱ੮/ͽ̹ʇ̼ʮment in State-County Relations” (Sacramento, CA, February 6, 2001). Little Hoover Commission, “Promises Still to Keep: A Decade of the Mental Health Services Act” (Sacramento, CA, January 2015), 10. Mental Health Services Oversight and Accountability Commission, “Transparency Suite: Full-Service Partnerships,” accessed January 12, 2022, https://mhsoac.ca.gov/transparency -suite/full-service-partnership/. An investigation by the Sacramento Bee found that only one in ten people with an urgent ̼ʇή͙ʇ͐ͅ੮ ʠ˺̼੮ ͅʇ̼ͷʮɻʇͅ੮ ̼ʇɻʇʮͷʇʁ੮ ɘ˦੮ ɘ̹̹˺ʮ˦͐˚ʇ˦͐੮ ͸ʮ͐ʩʮ˦੮ ˺˦ʇ੮ ͸ʇʇˌੳ੮ {ʮɻʩɘʇˑ੮ Hʮ˦ɻʩੴ੮ ુr˺˦ʡ੮ Ĕɘʮ͐ͅ੮ɘ˦ʁ੮î̼ʇɘ͐˚ʇ˦͐੮äʩ˺̼͐ɘʡʇͅ੮Øˑɘʡ͙ʇ੮äɘɻ̼ɘ˚ʇ˦͐˺੮#˺͙˦͐;ૄͅ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅੴૂ੮ Sacramento Bee, May 27, 2021, https://www.sacbee.com/news/investigations/the-public -eye/article251683983.html. Karen de Sá, “Mental Health Spending Creating Haves and Have-Nots in California,” #˃ʯ̙̅ȡ‫ף‬#˃̎͗ȡ‫ף‬îɷʣɐ̎, June 26, 2011. This is most visible in the state’s mental health workforce crisis: many counties report ͐ʩɘ͐੮৳ৰ੮͐˺੮৴ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɻˑʮ˦ʮɻɘˑ੮̹˺ͅʮ͐ʮ˺˦ͅ੮ɘ̼ʇ੮͙˦ϲʮˑˑʇʁੳ੮k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુõ˦ɘ˦ͅ͸ʇ̼ʇʁ੮#̼ʮʇͅੵ੮ Ĕʩ;੮#ɘˑʮʠ˺̼˦ʮɘ੮Hɘɻʇͅ੮ɘ੮äʩ˺̼͐ɘʡʇ੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Ĕ˺̼ˌʇ̼ͅੴૂ੮CalMatters, September 8, 2022, https://calmatters.org/health/2022/09/california-shortage-mental-health-workers/. Thanks to the ACA and MHSA, the number of people receiving county mental health services was back over 627,000 in 2019. Behavioral Health Concepts, Inc., “Medi-Cal ä̹ʇɻʮɘˑ͐;੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮/ͽ͐ʇ̼˦ɘˑ੮ĺ͙ɘˑʮ͐;੮Ûʇͷʮʇ͸ੴ੮HĚ੮৲ৰ৲ৰચ৲ৱૂ੮ફ)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮ #ɘ̼ʇ੮äʇ̼ͷʮɻʇͅੴ੮kɘ˦͙ɘ̼;੮৲৵ੴ੮৲ৰ৲৲બੴ੮৲৴ੴ੮ʩ̹͐͐ͅੵઃઃɻɘˑʇή̼˺ੳɻ˺˚ઃ˚ʩચʇή̼˺ੳ Department of Health Care Services, “MediCal Managed Care Plan Responsibilities for Outpatient Mental Health Services” (Sacramento, CA, October 27, 2017), https://www .dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2017 /APL17-018.pdf. "ʇ˦ˈɘ˚ʮ˦੮"̼˺͸˦ੴ੮/ˑ˺ʮͅʇ੮šૄ)˺˦˦ʇˑˑੴ੮ɘ˦ʁ੮rɘ͸̼ʇ˦ɻʇ੮Øੳ੮#ɘͅɘˑʮ˦˺ੴ੮ુØ̼ʮͷɘ͐ʇ੮/ή͙ʮ͐;੮U˦ͷʇ͐ͅment in Behavioral Health Treatment Centers,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 77, no. 3 (2020): 229–30, https://doi.org/10.1001/jamapsychiatry.2019.3880. Kim Lewis and Abbi Coursolle, “Mental Health Services in Medi-Cal” (Los Angeles, CA: National Health Law Program, January 12, 2017), 1, https://healthlaw.org/resource /issue-brief-mental-health-services-in-medi-cal/. Xavier Amador, U‫ף‬ʣ‫ף̙˃‡ף‬äɷɄʕ‫ףש‬U‫˃)ף‬ʯ‫‡ף̙إ‬ɐɐɊ‫ף‬Pɐʚ̂‫ף׭‬P˃́‫ף˃̙ף‬Pɐʚ̂‫ף‬ä˃ʣɐ˃ʯɐ‫́ף‬ɷ̙ɲ‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬ Accept Treatment (New York: Vida, 2006).

332 41.

1. O U T PAT I E N T

D. J. Jaffe, Uʯ̎ȡʯɐ‫ ף‬#˃ʯ̎ɐ̢̄ɐʯɄɐ̎‫ ףת‬P˃́‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬UʯɊ̢̙͇̎̅‫ ף‬Hȡɷʚ̎‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚʚ͇‫ ף‬Uʚʚ (Amherst, NY: Prometheus, 2017), 72. 42. A 2012 report on reforming LPS, for example, called it the “Magna Carta” for “those ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʩ˺੮ɘ̼ʇ੮͸ʇˑˑ੮ʇ˦˺͙ʡʩ੮͐˺੮̼ʇ̹ͅ˺˦ʁ੮͐˺੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮ɘ੮ͷ˺ˑ͙˦͐ɘ̼;੯ੳ੯ੳ੯ੳ੮ͅ;͐ͅʇ˚ੳૂ੮rØä੮ Reform Task Force II, “The Case for Updating California’s Mental Health Treatment Law” (Tustin, CA, March 2012), 4. 43. Tara A. Niendam et al., “The Rise of Early Psychosis Care in California: An Overview of Community and University-Based Services,” Psychiatric Services 70, no. 6 (2019): 480–87. 44. Iruma Bello et al., “OnTrackNY: The Development of a Coordinated Specialty Care Program for Individuals Experiencing Early Psychosis,” Psychiatric Services 68, no. 4 (2016): 318–20. 45. Henry A. Nasrallah, “For First-Episode Psychosis, Psychiatrists Should Behave Like Cardiologists,” Current Psychiatry 16, no. 8 (2017): 4–7. 46. Elaine Stasiulis et al., “The Disjuncture Between Medication Adherence and RecoveryCentered Principles in Early Psychosis Intervention: An Institutional Ethnography,” ä˃Ʉɷɐ̙͇‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 12, no. 1 (2022): 32–48. 47. Franco Mascayano et al., “Disengagement from Early Intervention Services for Psychosis: A Systematic Review,” Psychiatric Services 72, no. 1 (2021): 49–60. 48. As one psychiatrist put it in 1972, when “the entry of persons exhibiting mentally disorʁʇ̼ʇʁ੮ɺʇʩɘͷʮ˺̼੮ʮ˦͐˺੮͐ʩʇ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮˺ʠ੮ͅ˺ɻʮɘˑ੮ɻ˺˦̼͐˺ˑ੮ʮͅ੮ʮ˚̹ʇʁʇʁ੯ੳ੯ੳ੯ੳ੮ય͐ʩʇ;੮͸ʮˑˑ੮ be] force[d] into the criminal justice system of social control.” Marc F. Abramson, “The Criminalization of Mentally Disordered Behavior,” Psychiatric Services 23, no. 4 (1972): 15. 49. E. Fuller Torrey, the psychiatrist at the helm of the Treatment Advocacy Center (which ˚ʮˑʮ͐ɘ͐ʇͅ੮ʠ˺̼੮˚˺̼ʇ੮ʠ˺̼ɻʇʁ੮̼͐ʇɘ͐˚ʇ˦͐બੴ੮ʮ˦ͅʮ͐ͅͅ੮͐ʩɘ͐੮ુ˦˺ͅ˺ʡ˦˺ͅʮɘ੯ੳ੯ੳ੯ੳ੮ͅʇ̹ɘ̼ɘ͐ʇͅ੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ ̼͐ʇɘ͐˚ʇ˦͐੮ʠ̼˺˚੮ɺʇʮ˦ʡ੮ɘ੮ɻʮͷʮˑ੮̼ʮʡʩ͐ͅ੮ʮ͙ͅͅʇ੮ɘ˦ʁ੮˚ɘˌʇͅ੮ʮ͐੮ɘ੮ɺʮ˺ˑ˺ʡʮɻɘˑ੮˺˦ʇੳૂ੮ĺ͙˺͐ʇʁ੮ʮ˦੮)ʮ˦ɘʩ੮ Miller and Annette Hanson, #˃ʣʣɷ̙̙ɐɊ‫ףת‬îɲɐ‫"ף‬ȡ̙̙ʚɐ‫̀šף‬ɐ̅‫ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬#ȡ̅ɐ (Baltimore: Johns Hopkins University Press, 2016), 21. 50. Neil Gong, “‘That Proves You Mad, Because You Know It Not’: Impaired Insight and the Dilemma of Governing Psychiatric Patients as Legal Subjects,” Theory and Society 46, no. 3 (2017): 220. 51. California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured îʩɘ͐੮U˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘmento, CA, July 2020), 90. 52. A survey found that three hundred was the average caseload of public outpatient clients ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੳ੮P͙˦͐ʇ̼੮rੳ੮{ɻĺ͙ʮ͐ͅʮ˺˦੮ɘ˦ʁ੮Ûɘɻʩʇˑ੮Ĥʮ˦˦ͅੴ੮ુĔ˺̼ˌˑ˺ɘʁͅ੮ʮ˦੮#ˑʮ˦ʮɻɘˑ੮Øͅ;ɻʩʮɘ̼͐;ੵ੮˦˺͐ʩʇ̼੮Ĕɘ;ੴૂ੮Psychiatric Services 70, no. 10 (2019): 963–66. ੮ ৵৳ੳ੮ îʩʮͅ੮ɻ̼ʮ͐ʮή͙ʇ੮˺ʠ੮ɘ੮˚ʇ˦͐ɘˑ੮ʩʇɘˑ͐ʩ੮ͅ;͐ͅʇ˚੮͐ʩɘ͐੮ુɘˑˑ੮͐˺˺੮˺ʠ͐ʇ˦੮˺̹͐ͅ੮ʠ˺̼੮̹ʩɘ̼˚ɘɻʇ͙͐ʮɻɘˑ੮˺ͷʇ̼੮ therapeutic interventions” also emerged in a study of homeless women in Los Angeles. Rose Ricciardelli and Laura Huey, ɊɊɷʯɪ‫ף‬Uʯ̢̎ʚ̙‫ף˃̙ף‬Uʯʑ̢͇̅‫{ؒףת‬ɷ̎ؓî̅ɐȡ̙ɷʯɪ‫ף‬P˃ʣɐʚɐ̎̎‫ף‬Ĕ˃ʣɐʯ‫ף‬ɷʯ‫ף‬ š̢̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ä͇̙̎ɐʣ (Boulder, CO: Lynne Rienner, 2016), 3. 54. Behavioral Health Action, “Answering the Call to Action: A Vision for All Californians’ Behavioral Health,” 2021, https://www.behavioralhealthaction.org/. ੮ ৵৵ੳ੮ #˺ʠʠ˚ɘ˦੮ʇ͐੮ɘˑੳੴ੮ુ#ɘˑʮʠ˺̼˦ʮɘૄͅ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮Ĕ˺̼ˌʠ˺̼ɻʇੴૂ੮৲৷ੳ 56. I am grateful to Jenny Leigh for making this point.

2. CRISIS 57.

58. 59. 60.

333

One review concluded, “Mental health services that integrate elements addressing an individual’s immediate needs may enhance engagement.” Lisa B. Dixon, Yael Holoshitz, and Ilana Nossel, “Treatment Engagement of Individuals Experiencing Mental Illness: Review and Update,” World Psychiatry 15, no. 1 (2016): 14. Thomas E. Smith et al., “Disengagement from Care: Perspectives of Individuals with Serious Mental Illness and of Service Providers,” Psychiatric Services 64, no. 8 (2013): 772. This statement was made at a December 15, 2021 hearing in the state legislature. Isabel M. Perera and Alex V. Barnard, “Myths of Mental Health: Revelations from the French System for the United States,” Øɐ̅̎̂ɐɄ̙ɷ̀ɐ̎‫ף‬ɷʯ‫"ף‬ɷ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫{ף‬ɐɊɷɄɷʯɐ 64, no. 1 (2021): 103–18.

2. CRISIS 1.

2.

3.

4.

5.

6.

A recent investigation in San Francisco found that nearly 20 percent of permanent supported housing residents received eviction notices in a given year; although only a small number were ultimately evicted by the courts, many left to avoid legal proceedings. Joaή͙ʮ˦੮Øɘˑ˺˚ʮ˦˺੮ɘ˦ʁ੮î̼ʮͅʩɘ੮îʩɘʁɘ˦ʮੴ੮ુîʩʇ੮"̼ʇʇʁ੮ʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦੮šʠʠʇ̼ʇʁ੮îʩʇ˚੮P˺˚ʇͅੳ੮ Then It Spent Millions to Kick Them Out,” San Francisco Chronicle, August 22, 2022, https://www.sfchronicle.com/projects/2022/sf-sro-evictions/. In a survey by the Coalition on Homelessness, 18 percent of individuals currently experiencing homelessness in San Francisco had previously been in supported housing. Coalition on Homelessness, “Stop the Revolving Door: A Street-Level Framework for a New System,” September 2020, 19, https://www.cohsf.org/wp-content/uploads/2020/11/Stop-the-Revolving-1.pdf. These statistics do not identify eviction rates for people with serious mental illness ̹ͅʇɻʮϲʮɻɘˑˑ;ੳ Mental Health and Substance Use Disorder Services Division, “California Involuntary Detention Reports (FY 2017–2018)” (Sacramento, CA: Department of Health Care Serͷʮɻʇͅੴ੮৲ৰৱ৸બੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁʩɻͅੳɻɘੳʡ˺ͷઃ)˺ɻ͙˚ʇ˦͐ͅઃ#ä)ઢĚēઃ{PäઃU)ÛઃHĚৱ৷ચৱ৸ચU)Û -Report.pdf. In San Francisco, from 2013 to 2017, the number of 911 calls about homelessness nearly doubled, while “homeless concerns” reported to the city’s 311 number grew almost tenfold. Chris Herring, “Complaint-Oriented Policing: Regulating Homelessness in Public Space,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 5 (2019): 769–800. A review of records in San Francisco found that half of police 5150s were initiated by strangers with no relationship to the person being held; 34 percent were from friends or ɘɻή͙ɘʮ˦͐ɘ˦ɻʇͅੴ੮ৱৰ੮̹ʇ̼ɻʇ˦͐੮ɻˑʮ˦ʮɻʮɘ˦ͅ੮˺̼੮ɻɘͅʇ੮͸˺̼ˌʇ̼ͅੴ੮ɘ˦ʁ੮˺˦ˑ;੮৵੮̹ʇ̼ɻʇ˦͐੮ʁʮ̼ʇɻ͐ˑ;੮ʠ̼˺˚੮ˑɘ͸੮ ʇ˦ʠ˺̼ɻʇ˚ʇ˦͐ੳ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮P˺͙ͅʮ˦ʡ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮Ĕ˺̼ˌʮ˦ʡ੮I̼˺͙̹ੴ੮ુäHØ)੮U˦ɻʮʁʇ˦͐੮ Ûʇ̹˺̼͐੮)ɘ͐ɘੴૂ੮‡˺ͷʇ˚ɺʇ̼੮ৱ৶ੴ੮৲ৰ৲ৰੴ੮ʩ̹͐͐ͅੵઃઃͅʠʁ̹ʩੳ˺̼ʡઃʁ̹ʩઃϲʮˑʇͅઃʩ˺͙ͅʮ˦ʡɻ˺˦ͅʇ̼ͷઃP˺͙ͅʮ˦ʡ ઢ#˺˦ͅʇ̼ͷɘ͐˺̼ʩʮ̹ઢ{ʇʇ͐ʮ˦ʡઢৱৱੳৱ৶ઢ#˺˚ɺʮ˦ʇʁઢ͙̹ʁɘ͐ʇʁੳ̹ʁʠੳ Department of Housing and Urban Development, “2020 AHAR: PIT Estimates of Homelessness in the U.S.,” March 2021, https://www.hudexchange.info/resource/6291 /2020-ahar-part-1-pit-estimates-of-homelessness-in-the-us/. Everyone Home, “Point-in-Time Count” (Alameda County, 2022), https://everyonehome .org/main/continuum-of-care/everyone-counts/.

334 7.

2. CRISIS

From 2009 to 2014, mental health–related calls to Oakland police went up 50 percent, while Berkeley’s police department reported a 43 percent increase in calls leading to an involuntary hold. Holly McDede, “Mental Health 911,” /ȡ̙̎‫"ף‬ȡ͇‫ף‬/͆̂̅ɐ̎̎, April 6, 2016, https://eastbayexpress.com/mental-health-911-2-1/. 8. A 2019 r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎ analysis claimed 67 percent of unsheltered homeless had a mental illness or substance use disorder, which tracks with a survey in San Francisco that ʮʁʇ˦͐ʮϲʮʇʁ੮৵ৰ੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮͐ʩʇ੮ɻʮ͐;ૄͅ੮ʩ˺˚ʇˑʇͅͅ੮ɘͅ੮ʩɘͷʮ˦ʡ੮ɺ˺͐ʩ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅੳ੮)˺͙ʡ੮ä˚ʮ͐ʩ੮ɘ˦ʁ੮ Benjamin Oreskes, “Are Many Homeless People in L.A. Mentally Ill? New Findings Back the Public’s Perception,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, October 7, 2019, https://www.latimes.com /california/story/2019-10-07/homeless-population-mental-illness-disability; Dominic Fracassa and Trisha Thadani, “SF Counts 4,000 Homeless, Addicted and Mentally Ill, but Timeline for Help Still Unclear,” San Francisco Chronicle, December 31, 2019, https://www .sfchronicle.com/bayarea/article/SF-counts-4-000-homeless-addicted-and-mentally -14412061.php. The federal government, however, estimates that only 20.8 percent of homeless people had severe mental illness and 17.0 percent chronic substance use in 2020, although the proportion among unsheltered homeless is higher. U.S. Department of Housing and Urban Development, “Continuum of Care Homeless Assistance Proʡ̼ɘ˚ͅ੮ P˺˚ʇˑʇͅͅ੮ Ø˺̹͙ˑɘ͐ʮ˺˦ͅ੮ ɘ˦ʁ੮ ä͙ɺ̹˺̹͙ˑɘ͐ʮ˺˦ͅੴૂ੮ )ʇɻʇ˚ɺʇ̼੮ ৱ৵ੴ੮ ৲ৰ৲ৰੴ੮ ʩ̹͐͐ͅੵઃઃϲʮˑʇͅ ੳʩ͙ʁʇͽɻʩɘ˦ʡʇੳʮ˦ʠ˺ઃ̼ʇ̹˺̼͐ͅઃ̹͙ɺˑʮͅʩʇʁઃ#˺#ઢØ˺̹ä͙ɺઢ‡ɘ͐ˑîʇ̼̼)#ઢ৲ৰ৲ৰੳ̹ʁʠੳ੮ ä˺ɻʮɘˑ੮ ͅɻʮentists have long argued that claims of a very high prevalence of mental illness among ʩ˺˚ʇˑʇͅͅ੮̹ʇ˺̹ˑʇ੮ɻ˺˦ϲˑɘ͐ʇ੮ͅʇͷʇ̼ʇ੮̹ɘ͐ʩ˺ˑ˺ʡʮʇͅ੮͐ʩɘ͐੮ɻ˺˦̼͐ʮɺ͙͐ʇʁ੮͐˺੮ɻɘ͙ͅʮ˦ʡ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ ͸ʮ͐ʩ੮ˑʇͅͅ੮ͅʇͷʇ̼ʇ੮ɻ˺˦ʁʮ͐ʮ˺˦ͅ੮͐ʩɘ͐੮ɘ̼ʇ੮ɘ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇ੮˺ʠ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅੳ੮I̼ʇʡʡ੮#˺ˑɺ͙̼˦੮ɘ˦ʁ੮ Clayton Page Aldern, P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ף‬U̎‫ף‬ȡ‫ף‬P˃̢̎ɷʯɪ‫ף‬Ø̅˃Ƀʚɐʣ‫ףת‬P˃́‫ף‬ä̢̙̅Ʉ̢̙̅ȡʚ‫ף‬HȡɄ̙˃̅̎‫ף‬/͆̂ʚȡɷʯ‫ף‬õ‫ר‬ä‫ףר‬ Patterns (Berkeley: University of California Press, 2022); David Snow et al., “The Myth of Pervasive Mental Illness Among the Homeless,” ä˃Ʉɷȡʚ‫ף‬Ø̅˃Ƀʚɐʣ̎ 33, no. 5 (1986): 407–23. 9. Elizabeth Sinclair Hancq, Kelli South, and Molly Vencel, “Dual Diagnosis: Serious Mental Illness and Co-Occurring Substance Use Disorders” (Arlington, VA: Treatment Advocacy Center, March 2021), 12. 10. Beth Han et al., “Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among U.S. Adults,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 78, no. 12 (2021): 1329–42. 11. April Dembosky, “Meth Vs. Opioids: America Has Two Drug Epidemics, but Focuses on One,” California Healthline, May 8, 2019, https://californiahealthline.org/news/meth-vs -opioids-america-has-two-drug-epidemics-but-focuses-on-one/. ੮ ৱ৲ੳ੮ Ĕʩʮˑʇ੮˚ɘ˦;੮˺ϲϲʮɻʇ̼ͅ੮͸ʇ̼ʇ੮ɻ̼ʮ͐ʮɻɘˑ੮˺ʠ੮Ø̼˺̹੮৴৷ੴ੮̼ʇͅʇɘ̼ɻʩ੮ͅ˺੮ʠɘ̼੮͙ͅʡʡʇ͐ͅͅ੮ʮ͐੮ʩɘͅ੮˦˺͐੮ˑʇʁ੮͐˺੮ɘ˦੮ increase in violent crimes, although larceny and vehicle theft rose after its passage. Bradˑʇ;੮kੳ੮"ɘ̼͐˺ͅ੮ɘ˦ʁ੮#ʩɘ̼ʮͅ੮/ੳ੮n͙ɺ̼ʮ˦ੴ੮ુ#ɘ˦੮Ĕʇ੮)˺͸˦ͅʮΈʇ੮š͙̼੮Ø̼ʮͅ˺˦ͅ੮ɘ˦ʁ੮kɘʮˑͅ੮Ĕʮ͐ʩ˺͙͐੮ Compromising Public Safety?,” #̅ɷʣɷʯ˃ʚ˃ɪ͇‫ףغף‬Ø̢ɃʚɷɄ‫ף‬Ø˃ʚɷɄ͇ 17, no. 3 (2018): 693–715. ੮ ৱ৳ੳ੮ ä͙ͅɘ˦੮˦͐ʩ˺˦;ੴ੮Ûʇɺʇɻɻɘ੮#ɘ͐͐ʇ̼ͅ˺˦ੴ੮ɘ˦ʁ੮ä͙Έɘ˦˦ʇ੮#ɘ˚̹ɘ˦ʇˑˑɘੴ੮ુU˦੮îʩʇʮ̼੮š͸˦੮Ĕ˺̼ʁͅੵ੮ How Fragmented Care Harms People with Both Mental Illness and Substance Use Disorder” (California Health Care Foundation, August 2021). 14. A recent grand jury report in Alameda observed that, since the county ACCESS line closes at 5 p.m., “There is no place for law enforcement or others to call for mental health referral support during evening hours, so psychiatric emergency services or jail become the only option for law enforcement by default.” Alameda County Grand Jury, “Final

2. CRISIS

15.

16. 17.

18.

19. 20.

21.

22.

23.

24. 25.

335

Report,” 2021–2022, 18, https://grandjury.acgov.org/grandjury-assets/docs/2021-2022 ઃI̼ɘ˦ʁੳk͙̼;ੳÛʇ̹˺̼͐ੳ৲ৰ৲৲ੳʠ˺̼ੳUî)ੳĔʇɺੳ̹ʁʠੳ Department of Health Care Services, ̎̎ɐ̎̎ɷʯɪ‫̙ף‬ɲɐ‫ף‬#˃ʯ̙ɷʯ̢̢ʣ‫˃ף‬ɩ‫ף‬#ȡ̅ɐ‫ף‬ɩ˃̅‫"ף‬ɐɲȡ̀ɷ˃̅ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ äɐ̅̀ɷɄɐ̎‫ף‬ɷʯ‫ף‬#ȡʚɷɩ˃̅ʯɷȡ‫)ף‬ȡ͗ȡ‫ףש‬ä͗ȡʕɐɲ˃ʚɊɐ̅‫ף‬Øɐ̅̎̂ɐɄ̙ɷ̀ɐ̎‫ףש‬ȡʯɊ‫ף‬Uʣ̂ʚɷɄȡ̙ɷ˃ʯ̎ (Sacramento, January 10, 2022), 154. Ed Connolly, “Emergency Call,” /ȡ̙̎‫"ף‬ȡ͇‫ף‬/͆̂̅ɐ̎̎, February 29, 2012, https://m.eastbayexpress .com/oakland/emergency-call/. Tarak K. Trivedi et al., “Emergency Medical Services Use Among Patients Receiving Involuntary Psychiatric Holds and the Safety of an Out-of-Hospital Screening Protocol to ‘Medically Clear’ Psychiatric Emergencies in the Field, 2011 to 2016,” Annals of EmerɪɐʯɄ͇‫{ף‬ɐɊɷɄɷʯɐ 73, no. 1 (2019): 42–51. Los Angeles County made this same point: multiple 5150s do “not necessarily correlate to the need for specialty mental health services or services designed for higher acuity clients [like FSPs or AOT]” because “individuals are at times placed on numerous 5150 holds for reasons other than a primary mental health disorder.” California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured That Individuals with Seri˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘ˚ʇ˦͐˺ੴ੮#ੴ੮k͙ˑ;੮৲ৰ৲ৰબੴ੮৸৷ੳ California State Auditor, “Lanterman-Petris-Short Act,” 40. In Alameda County, 55 percent of people with ten or more holds at John George Hospital in 2018–2020 were Black. The county is 11 percent Black. Disability Rights California, ુ#˺˚̹ˑɘʮ˦͐੮ ʠ˺̼੮ )ʇɻˑɘ̼ɘ͐˺̼;੮ ɘ˦ʁ੮ U˦ˈ͙˦ɻ͐ʮͷʇ੮ Ûʇˑʮʇϲૂ੮ ફõ˦ʮ͐ʇʁ੮ ä͐ɘ͐ʇͅ੮ )ʮ̼͐ͅʮɻ͐੮ #˺͙̼͐ઝ Northern District of California, July 30, 2020), 20, https://www.disabilityrightsca.org ઃͅ;͐ͅʇ˚ઃϲʮˑʇͅઃϲʮˑʇચɘ͐͐ɘɻʩ˚ʇ˦͐ͅઃ/#Hચৱચ#˺˚̹ˑɘʮ˦͐ੳ̹ʁʠੳ According to data from the National Suicide Prevention Lifeline, around 2 percent ˺ʠ੮͙ͅɻʩ੮ʩ˺͐ˑʮ˦ʇ੮ɻɘˑˑͅ੮ˑʇɘʁ੮͐˺੮ɘ੮̹˺ˑʮɻʇ੮͸ʇˑʠɘ̼ʇ੮ɻʩʇɻˌੳ੮Û˺˦੮Ĕʮ̹˺˦ʁੴ੮Your Consent Is Not Ûɐ̢̄ɷ̅ɐɊ‫ףת‬îɲɐ‫ף‬Ûɷ̎ɐ‫ף‬ɷʯ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫)ף‬ɐ̙ɐʯ̙ɷ˃ʯ̎‫ףש‬H˃̅ɄɐɊ‫ף‬î̅ɐȡ̙ʣɐʯ͗‫ףש‬ȡʯɊ‫ף‬Ƀ̢̎ɷ̀ɐ‫ף‬I̢ȡ̅Ɋɷȡʯ̎ɲɷ̂̎ (Dallas, TX: BenBella, 2023), 110. People subjected to involuntary holds feel “trapped,” “ambushed,” or “surrounded,” especially when police are involved. Rebecca Murphy et al., “Service Users’ Experiences of Involuntary Hospital Admission Under the Mental Health Act 2001 in the Republic of Ireland,” Psychiatric Services 68, no. 11 (2017): 1127–35. Scholars have characterized this as “epistemic injustice”: by merit of their disabilities, people with mental illness are blocked from “contesting distorted understandings of their social experiences.” Karen Newbigging and Julie Ridley, “Epistemic Struggles: The Role of Advocacy in Promoting Epistemic Justice and Rights in Mental Health,” Social Science & Medicine 219 (2018): 37. Giorgio Agamben, P˃ʣ˃‫ף‬äȡɄɐ̅‫ףת‬ä˃̀ɐ̅ɐɷɪʯ‫ף‬Ø˃́ɐ̅‫ף‬ȡʯɊ‫"ף‬ȡ̅ɐ‫ף‬rɷɩɐ, trans. Daniel Heller-Roazen (Stanford, CA: Stanford University Press, 1998). One way the authors of LPS gained support for the reform among clinicians was by abolishing the “commitment courts” that had to authorize all hospitalizations, making legal ̼ʇͷʮʇ͸੮ʮ˦͐˺੮ͅ˺˚ʇ͐ʩʮ˦ʡ੮͐ʩɘ͐੮̹ɘ͐ʮʇ˦͐ͅ੮ʩɘʁ੮͐˺੮ɘɻ͐ʮͷʇˑ;੮̼ʇή͙ʇ͐ͅ੮ͷʮɘ੮ɘ੮͸̼ʮ͐ੳ੮/͙ʡʇ˦ʇ੮"ɘ̼ʁɘɻʩੴ੮ îɲɐ‫ף‬äʕɷʚʚ‫ף‬HȡɄ̙˃̅‫ף‬ɷʯ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףת‬Ûɐ̂ɐȡʚɷʯɪ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙‫ף‬rȡ́̎‫ף‬ɷʯ‫ף‬#ȡʚɷɩ˃̅ʯɷȡ (Berkeley: University of California Press, 1972), 185. This changed in )˃ɐ‫ףר̀ף‬Iȡʚʚɷʯ˃̙, discussed in chapter 4.

336

2. CRISIS

੮ ৲৶ੳ੮ /ͅ˚ʋ੮Ĕʇʮˈ͙˦੮Ĕɘ˦ʡੴ੮The Collected Schizophrenias (Minneapolis, MN: Graywolf, 2019), 109. 27. Erving Goffman, “The Moral Career of the Mental Patient,” Psychiatry 22 (1959): 127. ੮ ৲৸ੳ੮ ä͙ɻʩ੮ϲʮˑʮ˦ʡͅ੮ʁ̼˺̹̹ʇʁ੮৹৹੮̹ʇ̼ɻʇ˦͐੮ʮ˦੮͐ʩʇ੮;ʇɘ̼ͅ੮ɘʠ͐ʇ̼੮rØä੮͸ʇ˦͐੮ʮ˦͐˺੮ʇʠʠʇɻ͐ੳ੮ˑɺʇ̼͐੮Pੳ੮õ̼˚ʇ̼ੴ੮ “Implications of California’s New Mental Health Law,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 132, no. 3 (1975): 251. ੮ ৲৹ੳ੮ Ĕʩʇ˦੮{˺ɺʮˑʇ੮#̼ʮͅʮͅ੮ɻɘ˚ʇ੮͐˺੮ä˺˦˺˚ɘ੮#˺͙˦͐;ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮͐ʩʇ੮͐ʇɘ˚੮˺˦ˑ;੮˺̹ʇ̼ɘ͐ʇʁ੮ʮ˦੮ ɘ੮˦ɘ̼̼˺͸੮ɻ˺̼̼ʮʁ˺̼੮ɘ̼˺͙˦ʁ੮Pʮʡʩ͸ɘ;੮ৱৰৱੳ੮kɘͅ˺˦੮Ĕɘˑͅʩੴ੮ુäʩ˺ɻˌ੮#˺̼̼ʮʁ˺̼ੴૂ੮ä˃ʯ˃ʣȡ‫ף‬UʯɊɐ͆؅ î̅ɷɃ̢ʯɐ, May 29, 2018. 30. Molly Hennessy-Fiske, “Mental Health Staff Relying on Police,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, November 21, 2008. 31. Rod Shaner, the former medical director for LA County’s Department of Mental Health, explained this to me: “In the hands of law enforcement, [a 5150] is a passport to scarce ̼ʇͅ˺͙̼ɻʇͅੳ੯ੳ੯ੳ੯ੳ੮îʩ˺ͅʇ੮͸ʩ˺੮ɺʇˑʮʇͷʇ੮͐ʩɘ͐੮ɘˑ͐ʇ̼˦ɘ͐ʮͷʇ੮ɻ̼ʮͅʮͅ੮̼ʇ̹ͅ˺˦ͅʇ੮͐ʇɘ˚ͅ੮͸˺͙ˑʁ੮ɺʇ੮˚˺̼ʇ੮ useful often appear to misunderstand the reason for police presence. It isn’t to control dangerous situations, it’s to assure access into evaluation and treatment.” ੮ ৳৲ੳ੮ îʩʇ੮˺̼ʮʡʮ˦ɘˑ੮rØä੮ɻ͐੮̼ʇή͙ʮ̼ʇʁ੮͐ʩɘ͐੮͐ʩʇ੮ʁʇ͐ʇ̼˚ʮ˦ɘ͐ʮ˺˦੮˺ʠ੮ʁɘ˦ʡʇ̼˺͙ͅ˦ʇͅͅ੮˺̼੮ʁʮͅɘɺʮˑʮ͐;੮ʠ˺̼੮ ɘ੮৵ৱ৵ৰ੮ʩ˺ˑʁ੮ɺʇ੮ɺɘͅʇʁ੮˺˦੮ɘ˦੮ʇͷɘˑ͙ɘ͐˺̼ૄͅ੮ુ̹ʇ̼ͅ˺˦ɘˑ੮˺ɺͅʇ̼ͷɘ͐ʮ˺˦ͅੳૂ੮îʩʮͅ੮ʮ˚̹˺ͅʇʁ੮ુ͙˦ʮή͙ʇ੮ ˑʮ˚ʮ͐ɘ͐ʮ˺˦ͅ੮˺˦੮͐ʩʇ੮ɘ̹̹ˑʮɻɘ͐ʮ˺˦੮˺ʠ੮ɻˑʮ˦ʮɻɘˑ੮ˈ͙ʁʡ˚ʇ˦͐੮ɘͅ੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮ʠ˺̼੮ɻ˺˚˚ʮ͐˚ʇ˦͐ͅૂ੮ as compared to other states. Urmer, “Implications of California’s New Mental Health Law,” 251. Later amendments allowed police or clinicians to consider “information ɘɺ˺͙͐੮͐ʩʇ੮ʩʮ͐ͅ˺̼ʮɻɘˑ੮ɻ˺͙̼ͅʇ੮˺ʠ੮͐ʩʇ੮̹ʇ̼ͅ˺˦ૄͅ੮˚ʇ˦͐ɘˑ੮ʁʮͅ˺̼ʁʇ̼ૂ੮ʠ̼˺˚੮͐ʩʮ̼ʁ੮̹ɘ̼͐ʮʇͅ੮ફĔU#੮ ৵ৱ৵ৰੳৰ৵બ੮ɘ˦ʁ੮ɻˑɘ̼ʮϲʮʇʁ੮͐ʩɘ͐੮ુʁɘ˦ʡʇ̼ૂ੮ʮͅ੮˦˺͐੮ˑʮ˚ʮ͐ʇʁ੮͐˺੮ુʮ˚˚ʮ˦ʇ˦͐੮ʩɘ̼˚ૂ੮ફĔU#੮৵ৱ৵ৰફɺબબੳ੮ The extent to which these amendments are taken into account by the police seems variable. 33. Nationwide, the use of “tactical disengagement” from suicidal individuals is expanding in response to concerns about law enforcement killing people with mental illness. Caren Chesˑʇ̼ੴ੮ુš˦੮#ɘˑˑͅ੮Ĕʩʇ˦੮ɘ੮Øʇ̼ͅ˺˦੮Uͅ੮ä͙ʮɻʮʁɘˑੴ੮ä˺˚ʇ੮Ø˺ˑʮɻʇ੮î̼;੮ɘ੮‡ʇ͸੮̹̹̼˺ɘɻʩੴૂ੮Ĕȡ̎ɲɷʯɪ̙˃ʯ‫ף‬ Post, September 23, 2022, https://www.washingtonpost.com/national-security/2022/09/23 /calls-when-person-is-suicidal-some-police-try-new-approach/. ੮ ৳৴ੳ੮ ˚ɘ˚੮Ĥੳ੮äɘˑʇʩ੮ʇ͐੮ɘˑੳੴ੮ુ)ʇɘ͐ʩͅ੮˺ʠ੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅ੮)͙̼ʮ˦ʡ੮U˦͐ʇ̼ɘɻ͐ʮ˺˦ͅ੮͸ʮ͐ʩ੮ Law Enforcement,” Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 58 (2018): 114. 35. Los Angeles Police Department, “LAPD’s Mental Evaluation Unit Is Selected as a National Law Enforcement/Mental Health Learning Site,” November 9, 2010, https:// ͸͸͸ੳˑɘ̹ʁ˺˦ˑʮ˦ʇੳ˺̼ʡઃ˦ʇ͸̼ͅ˺˺˚ઃ˦ʇ͸ͅઢͷʮʇ͸ઃ৴৶৴৸ৱੳ 36. Malcolm Gladwell, “Million-Dollar Murray,” New Yorker, February 13, 2006. 37. Paul S. Appelbaum and Thomas G. Gutheil, “‘Rotting with Their Rights On’: Constitutional Theory and Clinical Reality in Drug Refusal by Psychiatric Patients,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬ American Academy of Psychiatry and the Law 7, no. 3 (1979): 306–15. 38. Egon Bittner, “Police Discretion in Emergency Apprehension of Mentally Ill Persons,” ä˃Ʉɷȡʚ‫ף‬Ø̅˃Ƀʚɐʣ̎ 14, no. 3 (1967): 287. 39. I’m grateful to Nick Rekenthaler for this turn of phrase. 40. This observation is backed up by other sources. The review of 5150 records in San Francisco cited above (note 4) found that 61 percent of police 5150s were for “danger to self,” 38 percent “danger to others,” and 12 percent “grave disability.” The state auditor found

3. EMERGENCY ROOM

337

that in only nine of sixty 5150s they reviewed were based solely on grave disability. California State Auditor, “Lanterman-Petris-Short Act,” 20.

3. EMERGENCY ROOM 1.

According to many interviewees, California’s public mental health system used to conduct relatively little outreach to homeless individuals. Today, someone in his situation ˚ʮʡʩ͐੮ʩɘͷʇ੮˚˺̼ʇ੮ʠ̼ʇή͙ʇ˦͐੮ɻ˺˦͐ɘɻ͐ͅੳ 2. David Garland, The Culture of Control (Chicago: University of Chicago Press, 2001), 170; Chris Herring, “Complaint-Oriented Policing: Regulating Homelessness in Public Space,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 5 (2019): 780; Forrest Stuart, )˃́ʯ‫ףש̢͗šףש‬ȡʯɊ‫ף‬ õʯɊɐ̅‫̅̅ף‬ɐ̙̎‫ףת‬Ø˃ʚɷɄɷʯɪ‫ף‬ȡʯɊ‫ף‬/̀ɐ͇̅Ɋȡ͇‫ף‬rɷɩɐ‫ף‬ɷʯ‫ף‬äʕɷɊ‫ף‬Û˃́ (Chicago: University of Chicago Press, 2016), 166. 3. Centers for Medicare and Medicaid Services, “Emergency Medical Treatment and Labor Act,” August 25, 2022, https://www.cms.gov/Regulations-and-Guidance/Legislation /EMTALA. ੮ ৴ੳ੮ Û͙͐ʩ੮/ੳ੮{ɘˑ˺˦ʇੴ੮ુĔʩʮ͐ʩʇ̼੮͐ʩʇ੮ˑ˚ͅʩ˺͙ͅʇ੺੮šͷʇ̼͙͐ʮˑʮΈɘ͐ʮ˺˦੮ɘ˦ʁ੮͐ʩʇ੮Û˺ˑʇ੮˺ʠ੮͐ʩʇ੮/˚ʇ̼gency Department,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Pɐȡʚ̙ɲ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףש‬Ø˃ʚɷɄ͇‫ף‬ȡʯɊ‫ף‬rȡ́ 23, no. 5 (1998): 795–832. 5. Janet R. Cummings et al., “The Changing Landscape of Community Mental Health #ɘ̼ʇੵ੮ͷɘʮˑɘɺʮˑʮ͐;੮˺ϲ੮î̼ʇɘ͐˚ʇ˦͐੮äʇ̼ͷʮɻʇͅ੮ʮ˦੮‡ɘ͐ʮ˺˦ɘˑ੮)ɘ͐ɘੴ੮৲ৰৱৰજ৲ৰৱ৷ੴૂ੮Psychiatric Services 72, no. 2 (2021): 204–8; Luther G. Kalb et al., “Trends and Geographic Availability ˺ʠ੮/˚ʇ̼ʡʇ˦ɻ;੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮ĔɘˑˌચU˦੮ɘ˦ʁ੮#̼ʮͅʮͅ੮äʇ̼ͷʮɻʇͅ੮ʮ˦੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅੴૂ੮Psychiatric Services 73, no. 1 (2022): 26–31. 6. California Hospital Association, “California Overview: Behavioral Health Emergency )ʇ̹ɘ̼͐˚ʇ˦͐੮ I̼˺͸͐ʩੴૂ੮ ˦ੳʁੳੴ੮ ʩ̹͐͐ͅੵઃઃɻɘˑʩʇɘˑ͐ʩੳ˺̼ʡઃͅʮ͐ʇͅઃ˚ɘʮ˦ઃϲʮˑʇͅઃϲʮˑʇચɘ͐͐ɘɻʩ˚ʇ˦͐ͅઃৱৱ ઢચઢ̼͐ͅɘ͐ɘͅɘ˦ઢʇʁઢʁɘ͐ɘੳ̹ʁʠੳ 7. See Josh Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ‫ףת‬ʣɃ̢ʚȡʯɄɐ‫ף‬#̅ɐ́̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫ף‬H̅˃ʯ̙ʚɷʯɐ̎‫˃ף‬ɩ‫ף‬õ̅Ƀȡʯ‫ף‬ä̢ɩɩɐ̅ɷʯɪ (Berkeley: University of California Press, 2019). 8. Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ, 124. 9. Clinicians assess as much of one-third of psychiatric ER patients as malingering. These suspicions are strongly predictive of discharge. Sean M. Rumschik and Jacob M. Appel, “Malingering in the Psychiatric Emergency Department: Prevalence, Predictors, and Outcomes,” Psychiatric Services 70, no. 2 (2018): 115–22. 10. U.S. Department of Justice, “Investigation of Alameda County, John George Psychiatric P˺̹ͅʮ͐ɘˑੴ੮ɘ˦ʁ੮äɘ˦͐ɘ੮Ûʮ͐ɘ੮kɘʮˑૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੵ੮#ʮͷʮˑ੮Ûʮʡʩ͐ͅ੮)ʮͷʮͅʮ˺˦ੴ੮̹̼ʮˑ੮৲৲ੴ੮৲ৰ৲ৱબੴ੮৲੶੮ Aaron J. Fischer, Rebecca Cervenak, and Kim Swain, “Suicides in San Diego County Jail: A System Failing People with Mental Illness” (Disability Rights California, April 2018), ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁʮͅɘɺʮˑʮ͐;̼ʮʡʩ͐ͅɻɘੳ˺̼ʡઃͅ;͐ͅʇ˚ઃϲʮˑʇͅઃϲʮˑʇચɘ͐͐ɘɻʩ˚ʇ˦͐ͅઃä)͙ͅʮɻʮʁʇÛʇ̹˺̼͐ੳ̹ʁʠੳ 11. One study, which found that 50 percent of people seen in an ER for a psychiatric issue did not make it to their follow-up appointment, concluded that “transportation and ϲʮ˦ɘ˦ɻʮɘˑ੮ʁʮϲϲʮɻ͙ˑ͐ʮʇͅ੮͸ʇ̼ʇ੮͐ʩʇ੮˚ɘʮ˦੮ɺɘ̼̼ʮʇ̼ͅ੮͐˺੮̼͐ɘ˦ͅʮ͐ʮ˺˦ͅ੮ɘ˦ʁ੮ʇ˦ʡɘʡʇ˚ʇ˦͐ੳૂ੮/ˑʮΈɘɺʇ͐ʩ੮ Ûʇʮͅʮ˦ʡʇ̼੮Ĕɘˑˌʇ̼੮ʇ͐੮ɘˑੳੴ੮ુ੮ĺ͙ɘˑʮ͐ɘ͐ʮͷʇ੮ä͙͐ʁ;੮˺ʠ੮"ɘ̼̼ʮʇ̼ͅ੮ɘ˦ʁ੮Hɘɻʮˑʮ͐ɘ͐˺̼ͅ੮͐˺੮î̼ɘ˦ͅʮ͐ʮ˺˦ͅ੮ from the Emergency Department to Outpatient Mental Health Care,” Psychiatric Services 72, no. 11 (2021): 1316.

338 12.

3. EMERGENCY ROOM

Yeheskel Hasenfeld, “People Processing Organizations: An Exchange Approach,” AmeriɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 37, no. 3 (1972): 256–63; Jeffrey Prottas, Øɐ˃̂ʚɐ‫ף‬Ø̅˃Ʉɐ̎̎ɷʯɪ‫ףת‬îɲɐ‫ף‬ä̙̅ɐɐ̙؅ rɐ̀ɐʚ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡ̙‫ף‬ɷʯ‫ף‬Ø̢ɃʚɷɄ؅äɐ̅̀ɷɄɐ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡɄɷɐ̎ (Lexington, MA: Lexington, 1979). 13. One 2012 survey of 123 emergency department directors in California reported that many psychiatric evaluation teams would not even come to general hospital emergency rooms to evaluate patients if there were no inpatient beds available. Ashley Stone et al., “Impact of the Mental Healthcare Delivery System on California Emergency Departments,” Ĕɐ̙̎ɐ̅ʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬/ʣɐ̅ɪɐʯɄ͇‫{ף‬ɐɊɷɄɷʯɐ 13, no. 1 (2012): 54. 14. Bret Nicks and David Manthey, “The Impact of Psychiatric Patient Boarding in Emergency Departments,” /ʣɐ̅ɪɐʯɄ͇‫{ף‬ɐɊɷɄɷʯɐ‫ף‬Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ 2012 (2012): 360308. 15. This statement was made by Alex Hawthorne at a December 15, 2021 hearing before the ˑʇʡʮͅˑɘ͙̼͐ʇੳ੮îʩʮͅ੮ɻ˺̼̼ʇ̹ͅ˺˦ʁͅ੮͸ʮ͐ʩ੮̼ʇ̹˺̼͐ʇʁ੮ϲʮʡ͙̼ʇͅ੮ʠ̼˺˚੮ˑɘ˚ʇʁɘ੮ɘ˦ʁ੮äʩɘ͐ͅɘ੮ɻ˺͙˦͐ʮʇͅ੮ ɘͅ੮͸ʇˑˑ੮ɘͅ੮˚˺͐ͅ੮˺ʠ੮˚;੮ʮ˦͐ʇ̼ͷʮʇ͸ͅ੮͸ʮ͐ʩ੮/Û੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅͅੳ੮äɻ˺͐͐੮Ĥʇˑˑʇ̼ੴ੮‡ʮɻ˺ˑʇ੮#ɘˑ˚ɘੴ੮ɘ˦ʁ੮ Ashley Stone, “Effects of a Dedicated Regional Psychiatric Emergency Service on Boarding of Psychiatric Patients in Area Emergency Departments,” Ĕɐ̙̎k/{ 15, no. 1 (2014): 1–6; Alayna Shulman, “Untreated, Severe Mental Illness at Root of Other Problems,” ÛɐɊɊɷʯɪ‫ף‬ÛɐɄ˃̅Ɋ, November 7, 2015. ੮ ৱ৶ੳ੮ Pʇ˚ɘˑ੮nੳ੮nɘ˦Έɘ̼ʮɘ੮ʇ͐੮ɘˑੳੴ੮ુH̼ʇή͙ʇ˦͐੮/˚ʇ̼ʡʇ˦ɻ;੮)ʇ̹ɘ̼͐˚ʇ˦͐੮õͅʇ̼ͅੵ੮H˺ɻ͙ͅʮ˦ʡ੮ä˺ˑʇˑ;੮˺˦੮ {ʇʁʮɻɘˑ੮õ͐ʮˑʮΈɘ͐ʮ˺˦੮{ʮͅͅʇͅ੮͐ʩʇ੮Ĕʩ˺ˑʇ੮Øʇ̼ͅ˺˦ੴૂ੮Pɐȡʚ̙ɲ‫ף‬ɩ͖ȡɷ̅̎ 38, no. 11 (2019): 1866–75. 17. Heather Knight, “Mentally Ill People in S.F. Are Cycling in and out of Emergency Rooms,” San Francisco Chronicle, March 9, 2022, https://www.sfchronicle.com/sf/bayarea ઃʩʇɘ͐ʩʇ̼ˌ˦ʮʡʩ͐ઃɘ̼͐ʮɻˑʇઃ{ʇ˦͐ɘˑˑ;ચʮˑˑચ̹ʇ˺̹ˑʇચʮ˦ચäણHચɘ̼ʇચɻ;ɻˑʮ˦ʡચʮ˦ચɘ˦ʁચৱ৶৹৸৷৶৹৴ੳ̹ʩ̹ੳ 18. For many such examples—and an explanation of why psychiatrists choose to discharge them—see Paul Linde, )ȡʯɪɐ̅‫ף˃̙ף‬äɐʚɩ‫šףת‬ʯ‫̙ף‬ɲɐ‫ף‬H̅˃ʯ̙‫ף‬rɷʯɐ‫́ף‬ɷ̙ɲ‫ף‬ȡʯ‫ף‬/Û‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷ̙̎ (Berkeley: University of California Press, 2012). 19. Trisha Thadani and Dominic Fracassa, “SF General Relaxes Policy That Tries to Keep Psychiatric ER Patients Awake to Shorten Visits,” San Francisco Chronicle, August 28, ৲ৰৱ৹ੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅʠɻʩ̼˺˦ʮɻˑʇੳɻ˺˚ઃɺɘ;ɘ̼ʇɘઃɘ̼͐ʮɻˑʇઃäHણIʇ˦ʇ̼ɘˑચ̼ʇˑɘͽʇͅચ̹˺ˑʮɻ;ચ͐ʩɘ͐ચ̼͐ʮʇͅ -to-keep-14383111.php. 20. “Sleep, Its Importance in Preventing Insanity,” ʣɐ̅ɷɄȡʯ‫ ף‬k˃̢̅ʯȡʚ‫˃ ף‬ɩ‫ ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 1, no. 4 (1845): 319–23. 21. One older study estimated that hospital emergency departments lose $2,200 per psychiatric patient as a result of their extended length of stay and low reimbursement rates. Nicks and Manthey, “Psychiatric Patient Boarding.” 22. Ish P. Bhalla et al., “Involuntary Psychiatric Hospitalization: How Patient Characteristics Affect Decision-Making,” Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬Ĺ̢ȡ̙̅ɐ̅ʚ͇ 93, no. 1 (2021): 297–310; George J. Unick et al., “Factors Affecting Psychiatric Inpatient Hospitalization from a Psychiatric Emergency Service,” Iɐʯɐ̅ȡʚ‫ף‬P˃̎̂ɷ͗ȡʚ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 33, no. 6 (2011): 618–25. 23. Christopher G. Hudson, “Behavioral Mental Health: An Emerging Field of Service or an Oxymoron?” Social Work 63, no. 1 (2018): 27–36. California’s 2021 proposal for reforming Medi-Cal, CalAIM, plans to integrate substance and mental health services into a single system. Department of Health Care Services, “California Advancing and Innovating Medi-Cal (CalAIM) Proposal” (Sacramento, CA, January 2021).

3. EMERGENCY ROOM 24.

339

San Francisco Budget and Legislative Analyst, “Performance Audit of the Department of Public Health Behavioral Health Services” (San Francisco, CA, April 19, 2018), v. 25. A 2019 survey by the Department of Public Health claimed that 95 percent of dualdiagnosis homeless individuals in San Francisco had chronic alcoholism. Dominic Fracassa and Trisha Thadani, “SF Counts 4,000 Homeless, Addicted and Mentally Ill, but Timeline for Help Still Unclear,” San Francisco Chronicle, December 31, 2019, https://www .sfchronicle.com/bayarea/article/SF-counts-4-000-homeless-addicted-and-mentally -14412061.php. 26. Mallory Moench, “Five Patients Cost $4 Million in Ambulance Rides,” San Francisco Chronicleੴ੮ k͙ˑ;੮ ৲৸ੴ੮ ৲ৰ৲৲ੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅʠɻʩ̼˺˦ʮɻˑʇੳɻ˺˚ઃͅʠઃɘ̼͐ʮɻˑʇઃ৵ચ̹ɘ͐ʮʇ˦͐ͅચɻ˺͐ͅચäણHચ৴ -million-in-ambulance-17336870.php. ੮ ৲৷ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ĔU#ੴ੮ äʇɻ͐ʮ˺˦ͅ੮ ৵ৱ৷ৰ੮ ɘ˦ʁ੮ ৵৳৴৳ੴ੮ ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅ ઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵ৱ৷ৰੳ 28. A 2020 report from Los Angeles said that commitments for substance users under 5343 ͸ʇ̼ʇ੮ુ˦˺͐੯ੳ੯ੳ੯ੳ੮͙͐ʮˑʮΈʇʁੳૂ੮k˺˦੮äʩʇ̼ʮ˦ੴ੮ુ)ʮ̼͙̹͐ͅʮ˦ʡ੮͐ʩʇ੮#;ɻˑʇ੮˺ʠ੮#ʩ̼˺˦ʮɻ੮P˺˚ʇˑʇͅͅ˦ʇͅͅ੮ʮ˦੮ Los Angeles County” (Los Angeles: Department of Mental Health, January 22, 2020), 2, ʩ̹͐͐ੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱ৴ৰ৳৹ৰੳ̹ʁʠੳ੮Ĕʩʮˑʇ੮͐ʩʮ̼͐;ચ˺˦ʇ੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮ statutes for commitment for substance use, they are invoked very rarely. Paul P. Christopher et al., “Nature and Utilization of Civil Commitment for Substance Abuse in the United States,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬ɄȡɊɐʣ͇‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬rȡ́‫šף‬ʯʚɷʯɐ 43, no. 3 (2015): 313–20. 29. Moench, “Five Patients Cost.” 30. The failure to provide true dual-diagnosis treatment is systemic: nationwide in 2019, only 12.7 percent of people with a serious mental illness and substance use disorder received treatment for both; 52 percent received only mental health services and 1.9 percent only substance use services. Elizabeth Sinclair Hancq, Kelli South, and Molly Vencel, “Dual Diagnosis: Serious Mental Illness and Co-Occurring Substance Use Disorders” (Arlington, VA: Treatment Advocacy Center, March 2021), 25. 31. In one case study, the fact that a chronically psychotic person came to the ER asking for shelter showed that he was “capable of making plans” to meet his basic needs, and he was therefore released. Joel T. Braslow and Luke Messac, “Medicalization and Demedicalization: A Gravely Disabled Homeless Man with Psychiatric Illness,” ‡ɐ́‫ף‬/ʯɪʚȡʯɊ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬ Medicine 379, no. 20 (2018): 1885. ੮ ৳৲ੳ੮ /ʁ͸ɘ̼ʁ੮ Ĕੳ੮ rʇ˚̹ʮ˦ʇ˦ੴ੮ ુ)ʇɺɘ͐ʇ੮ Ûɘʡʇͅ੮ šͷʇ̼੮ r˺ɻˌʮ˦ʡ੮ õ̹੮ ͐ʩʇ੮ {ʇ˦͐ɘˑˑ;੮ î̼˺͙ɺˑʇʁੴૂ੮ San Francisco Chronicle, June 3, 1987. ੮ ৳৳ੳ੮ Ûʇͅʇɘ̼ɻʩ੮ɻ˺˦ͅʮ͐ͅʇ˦͐ˑ;੮ϲʮ˦ʁͅ੮͐ʩɘ͐੮ʁɘ˦ʡʇ̼˺͙ͅ˦ʇͅͅઝ̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮͙ͅʮɻʮʁʇ੮̼ʮͅˌઝʮͅ੮ɘ੮̼͐ͅ˺˦ʡʇ̼੮ prediction of involuntary admission than grave disability. Alisa Lincoln, “Psychiatric Emergency Room Decision-Making, Social Control and the ‘Undeserving Sick,’” Sociol˃ɪ͇‫˃ ף‬ɩ‫ ף‬Pɐȡʚ̙ɲ‫ ףغ ף‬Uʚʚʯɐ̎̎ 28, no. 1 (2006): 54–75; Steven P. Segal, Theresa A. Laurie, and Matthew J. Segal, “Factors in the Use of Coercive Retention in Civil Commitment Evaluations in Psychiatric Emergency Services,” Psychiatric Services 52, no. 4 (2001): 514–20; B. "ੳ੮Ĕɘ;੮ɘ˦ʁ੮äੳ੮"ɘ˦ˌͅੴ੮ુ#ˑʮ˦ʮɻɘˑ੮Hɘɻ͐˺̼ͅ੮Ûʇˑɘ͐ʇʁ੮͐˺੮ʁ˚ʮͅͅʮ˺˦੮ɘ˦ʁ੮Ûʇˑʇɘͅʇ੮)ʇɻʮͅʮ˺˦ͅ੮ʮ˦੮ Psychiatric Emergency Services,” Psychiatric Services 52, no. 2 (2011): 214–18.

340 34.

35.

36. 37.

3. EMERGENCY ROOM For fragmented but consistent data on the overrepresentation of men on conservatorship, see Kristen R. Choi et al., “Mental Health Conservatorship Among Homeless People with Serious Mental Illness,” Psychiatric Services 73, no. 6 (2022): 613–19; Richard H. Lamb ɘ˦ʁ੮ rʮ˦ʁɘ੮ /ੳ੮ Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ ુ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʠ˺̼੮ I̼ɘͷʇˑ;੮ )ʮͅɘɺˑʇʁ੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ Øɘ͐ʮʇ˦͐ͅੵ੮ A Four-Year Follow-Up Study,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅, no. 149 (1992): 909–13; M. Susan Ridgely, Randy Borum, and John Petrila, “The Effectiveness of Involuntary Outpatient Treatment: Empirical Evidence and the Experience of Eight States” (Santa Monica, CA: Rand Corporation, 2001), 90. On differences in how men and women express mental illnesses, see Terrence D. Hill and Belinda L. Needham, “Rethinking Gender and Mental Pʇɘˑ͐ʩੵ੮੮#̼ʮ͐ʮɻɘˑ੮˦ɘˑ;ͅʮͅ੮˺ϲ੮îʩ̼ʇʇ੮Ø̼˺̹˺ͅʮ͐ʮ˺˦ͅੴૂ੮Social Science & Medicine 92 (2013): 83–91. Two iterations of this claim can be found in Dinah Miller and Annette Hanson, Comʣɷ̙̙ɐɊ‫ףת‬îɲɐ‫"ף‬ȡ̙̙ʚɐ‫̀šף‬ɐ̅‫ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬#ȡ̅ɐ (Baltimore: Johns Hopkins University Press, 2016), 64; and D. J. Jaffe, Uʯ̎ȡʯɐ‫ף‬#˃ʯ̎ɐ̢̄ɐʯɄɐ̎‫ףת‬P˃́‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬UʯɊ̢̙͇̎̅‫ף‬Hȡɷʚ̎‫ף‬ ̙ɲɐ‫{ף‬ɐʯ͗ȡʚʚ͇‫ף‬Uʚʚ (Amherst, NY: Prometheus, 2017), 22. Julie Holland, ĔɐɐʕɐʯɊ̎‫ף‬ȡ̙‫"ף‬ɐʚʚɐ̢̀ɐ‫‡ףת‬ɷʯɐ‫ף‬Ěɐȡ̅̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫‡ף‬ɷɪɲ̙‫ף‬äɲɷɩ̙‫ף‬ȡ̙‫̙ף‬ɲɐ‫ף‬Ø͇̎Ʉɲ‫ף‬/Û (New York: Bantam, 2009), 10. Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ, 53.

4. INPATIENT 1.

I would like to acknowledge the assistance of Jenny Leigh, who conducted this thorough and thoughtful interview (as well as interviews with Lola, Florence, Lorraine, and Thatcher). 2. Olufemi Babalola et al., “Length of Hospitalisation for People with Severe Mental Illness,” #˃Ʉɲ̅ȡʯɐ‫)ף‬ȡ͗ȡɃȡ̎ɐ‫˃ף‬ɩ‫ף‬ä͇̙̎ɐʣȡ̙ɷɄ‫ף‬Ûɐ̀ɷɐ́̎, no. 1 (2014). 3. Someone who is involuntarily hospitalized can still be forced to pay whatever costs insurance companies pass on to them. Nathaniel P. Morris and Robert A. Kleinman, “Involuntary Commitments: Billing Patients for Forced Psychiatric Care,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅nal of Psychiatry 177, no. 12 (2020): 1115–16. ੮ ৴ੳ੮ "ɘͅʇʁ੮˺˦੮͐ʩʇ੮͐ͅɘ͐ʇૄͅ੮ફ̹ͅ˺͐͐;બ੮ʁɘ͐ɘੴ੮ʮ˦੮ϲʮͅɻɘˑ੮;ʇɘ̼੮৲ৰৱ৷જ৲ৰৱ৸੮͐ʩʇ̼ʇ੮͸ʇ̼ʇ੮৵৲ੴৰ৶৹੮৵৲৵ৰͅੳ੮š˦ˑ;੮ ৵ੴ৶৴৵੮̹ɘ͐ʮʇ˦͐ͅ੮ફ˺̼੮ৱৰੳ৸੮̹ʇ̼ɻʇ˦͐બ੮͐ͅɘ;ʇʁ੮ʠ˺̼੮ɘ੮͙ͅɺͅʇή͙ʇ˦͐੮ʩ˺ˑʁ੮ફ͸ʩʮɻʩ੮ʮ˦ɻˑ͙ʁʇͅ੮͐ʇ˚̹˺̼ɘ̼;੮ conservatorships). Mental Health and Substance Use Disorder Services Division, “California Involuntary Detention Reports (FY 2017–2018)” (Sacramento, CA: Department ˺ʠ੮ Pʇɘˑ͐ʩ੮ #ɘ̼ʇ੮ äʇ̼ͷʮɻʇͅੴ੮ ৲ৰৱ৸બੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁʩɻͅੳɻɘੳʡ˺ͷઃ)˺ɻ͙˚ʇ˦͐ͅઃ#ä)ઢĚēઃ{Pä ઃU)ÛઃHĚৱ৷ચৱ৸ચU)ÛણÛʇ̹˺̼͐ੳ̹ʁʠੳ 5. Harry Nelson, “Mental Patient Pile Up Blamed on Bureaucracy,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, August 13, 1967. 6. Sarah Linsley Starks and Joel T. Braslow, “The Making of Contemporary American Psychiatry, Part 1: Patients, Treatments, and Therapeutic Rationales Before and After Ĕ˺̼ˑʁ੮Ĕɘ̼੮UUੴૂ੮Pɷ̙̎˃͇̅‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲ˃ʚ˃ɪ͇ 8, no. 2 (2005): 176. 7. Albert H. Urmer, “Implications of California’s New Mental Health Law,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅nal of Psychiatry 132, no. 3 (1975): 252. 8. Phil Brown and Elizabeth Cooksey, “Mental Health Monopoly: Corporate Trends in Mental Health Services,” Social Science & Medicine 28, no. 11 (1989): 1129–38.

4 . I N PAT I E N T 9.

341

Howard Seelye, “Owner Claims Hospital Boycotted by Doctors,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, December 12, 1969. Private hospitals “warmly endorsed” LPS because they “perceiv[ed] an opening for private hospitals to gain access to more paying patients.” Eugene Bardach, îɲɐ‫ף‬äʕɷʚʚ‫ף‬HȡɄ̙˃̅‫ף‬ɷʯ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףת‬Ûɐ̂ɐȡʚɷʯɪ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙‫ף‬rȡ́̎‫ף‬ɷʯ‫ף‬#ȡʚɷɩ˃̅ʯɷȡ (Berkeley: University of California Press, 1972), 133. 10. See LPS Reform Task Force, “A New Vision for Mental Health Treatment Laws” (Long "ʇɘɻʩੴ੮ #ੴ੮ Hʇɺ̼͙ɘ̼;੮ ৱ৹৹৹બ੶੮ ä͙ͅɘ˦੮ {˺ʠʠɘ͐ੴ੮ ુPʇɘˑʮ˦ʡ੮ Øɘ͐ʮʇ˦͐ͅੴ੮ ˺̼੮ Ø̼˺ϲʮ͐ͅ੺ૂ੮ r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Times, February 2, 1992. These practices of leveraging involuntary holds to maximize insurance reimbursements have not disappeared. A 2019 Seattle Times investigation found that a private hospital owned by Universal Health Services, which manages 188 ʠɘɻʮˑʮ͐ʮʇͅ੮˦ɘ͐ʮ˺˦͸ʮʁʇੴ੮ʠ̼ʇή͙ʇ˦͐ˑ;੮̹ˑɘɻʇʁ੮ͷ˺ˑ͙˦͐ɘ̼;੮̹ɘ͐ʮʇ˦͐ͅ੮˺˦੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ʩ˺ˑʁͅ੮ʮʠ੮͐ʩʇ;੮ asked to be released, especially if their insurance company had authorized additional days of treatment. County evaluators ultimately found two-thirds of these holds to be ͙˦ˈ͙͐ͅʮϲʮʇʁੳ੮)ɘ˦ʮʇˑ੮Iʮˑɺʇ̼͐ੴ੮ુH̼ʇʇ੮͐˺੮#ʩʇɻˌ੮U˦ੴ੮ɺ͙͐੮‡˺͐੮͐˺੮rʇɘͷʇੴૂ੮Seattle Times, October 6, 2019, https://www.seattletimes.com/seattle-news/times-watchdog/public-crisis -private-toll-free-to-check-in-but-not-to-leave-washington-mental-health-care/. 11. T. M. Luhrmann, šɩ‫ף‬î́˃‫{ף‬ɷʯɊ̎‫ףת‬îɲɐ‫ף‬I̅˃́ɷʯɪ‫)ף‬ɷ̎˃̅Ɋɐ̅‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ (New York: Knopf, 2000), 243. 12. California Hospital Association, “California’s Acute Psychiatric Bed Loss” (Sacramento, #ੴ੮ Hʇɺ̼͙ɘ̼;੮ ৲ৰৱ৹બੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳɻɘˑʩ˺̹ͅʮ͐ɘˑੳ˺̼ʡઃͅʮ͐ʇͅઃ˚ɘʮ˦ઃϲʮˑʇͅઃϲʮˑʇચɘ͐͐ɘɻʩ˚ʇ˦͐ͅઃ৶ ઢચઢ̹ͅ;ɻʩɺʇʁʁɘ͐ɘੳ̹ʁʠੳ ੮ ৱ৳ੳ੮ H˺̼੮ ˚˺̼ʇ੮ ˺˦੮ ͐ʩʇ੮ ͐ʇɻʩ˦ʮή͙ʇͅ੮ ˺ʠ੮ ˚ɘ˦ɘʡʇʁ੮ ɻɘ̼ʇ੮ ʮ˦੮ ˚ʇ˦͐ɘˑ੮ ʩʇɘˑ͐ʩ੮ ͅ;͐ͅʇ˚ͅੴ੮ ͅʇʇ੮ îʇ̼ʇͅɘ੮ rੳ੮ Scheid, îɷɐ‫ף‬ȡ‫ף‬nʯ˃̙‫ף‬ȡʯɊ‫ף‬Pȡʯɪ‫šף‬ʯ‫ףת‬Ø̅˃̀ɷɊɷʯɪ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬#ȡ̅ɐ‫ף‬ɷʯ‫ף‬ȡ‫ף‬î̢̅Ƀ̢ʚɐʯ̙‫ף‬/ʯ̀ɷ̅˃ʯʣɐʯ̙ (Hawthorne, NY: Transaction, 2004). 14. The average stay in a California psychiatric hospital was 8.3 days in 2018, but this is ʮ˦ϲˑɘ͐ʇʁ੮ ɺ;੮ ɘ੮ ͅ˚ɘˑˑ੮ ˦͙˚ɺʇ̼੮ ˺ʠ੮ ̹ʇ˺̹ˑʇ੮ ̼ʇ˚ɘʮ˦ʮ˦ʡ੮ ʠ˺̼੮ ˑ˺˦ʡ੮ ̹ʇ̼ʮ˺ʁͅ੮ ˺ʠ੮ ͐ʮ˚ʇੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮H˺͙˦ʁɘ͐ʮ˺˦ੴ੮ુ{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ʮ˦੮#ɘˑʮʠ˺̼˦ʮɘੵ੮Ĕɘʮ͐ʮ˦ʡ੮ʠ˺̼੮#ɘ̼ʇੴૂ੮k͙ˑ;੮৲ৰ৲৲ੴ੮৴৴ੴ੮ https://www.chcf.org/wp-content/uploads/2022/07/MentalHealthAlmanac2022.pdf. 15. Other scholars have documented a more wholesale embrace of a single-minded focus on shortening length of stay. One psychiatrist told an anthropologist, “Here everyone is an inappropriate admission. I don’t admit patients. I discharge them.” Lorna A. Rhodes, /ʣ̙͇̂ɷʯɪ‫"ף‬ɐɊ̎‫ףת‬îɲɐ‫ף‬Ĕ˃̅ʕ‫˃ף‬ɩ‫ף‬ȡʯ‫ף‬/ʣɐ̅ɪɐʯɄ͇‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬õʯɷ̙ (Berkeley: University of California Press, 1991), 41. 16. In 2020, 89 percent of people in public psychiatric hospitals were involuntary. Substance Abuse and Mental Health Services Administration, “National Mental Health Services ä͙̼ͷʇ;੮ફ‡ણ{Pääબ੮৲ৰ৲ৰੵ੮)ɘ͐ɘ੮˺˦੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮î̼ʇɘ͐˚ʇ˦͐੮Hɘɻʮˑʮ͐ʮʇͅૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੵ੮ Department of Health and Human Services, December 2021), 254, https://samhsa.gov ઃʁɘ͐ɘઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃ৲ৰৱ৶ઢ‡ɘ͐ʮ˺˦ɘˑઢ{ʇ˦͐ɘˑઢPʇɘˑ͐ʩઢäʇ̼ͷʮɻʇͅઢä͙̼ͷʇ;ੳ̹ʁʠੳ 17. One study from a county hospital in Southern California found that patients were “almost exclusively” involuntary. Ish P. Bhalla et al., “Involuntary Psychiatric Hospitalization: How Patient Characteristics Affect Decision-Making,” Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬Ĺ̢ȡ̙̅ɐ̅ʚ͇ 93, no. 1 (2021): 299. ੮ ৱ৸ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৲৵ৰੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৲৵ৰੳ

342 19.

4 . I N PAT I E N T

San Francisco Department of Public Health, “Behavioral Health Bed Optimization Project: Analysis and Recommendations for Improving Patient Flow” (San Francisco, June 2020). ੮ ৲ৰੳ੮ š͸ʇ˦੮Ĕʩ˺˺ˑʇ;ੴ੮šʯ‫̙ף‬ɲɐ‫ף‬Pɐɐʚ̎‫˃ף‬ɩ‫ף‬Uɪʯ˃̅ȡʯɄɐ‫ףת‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ף‬ɩ‫ף̙˃‡ף‬nʯ˃́ɷʯɪ (Chicago: University of Chicago Press, 2019), 50. 21. During the Great Recession, for example, San Francisco cut the number of acute psychiɘ̼͐ʮɻ੮ɺʇʁͅ੮ʮ˦੮äH੮Iʇ˦ʇ̼ɘˑ੮ʠ̼˺˚੮ʇʮʡʩ͐;ચͅʇͷʇ˦੮͐˺੮͐͸ʇ˦͐;ચ˺˦ʇੳ੮#ੳ੮Ĕੳ੮‡ʇͷʮ͙ͅੴ੮ુäH੮P˺̹ͅʮ͐ɘˑ੮ Services for Mentally Ill Suffer Drastic Cuts,” San Francisco Chronicle, March 3, 2016, https://www.sfchronicle.com/bayarea/nevius/article/SF-hospital-services-for-mentally -ill-suffer-6866700.php. ੮ ৲৲ੳ੮ U˦੮ ৲ৰ৲ৱ੮ ͐ʩʇ੮ äɘ˦੮ )ʮʇʡ˺੮ ɻʮ͐;੮ ɘ͐͐˺̼˦ʇ;੮ ϲʮˑʇʁ੮ ͙ͅʮ͐੮ ɘʡɘʮ˦͐ͅ੮ äɻ̼ʮ̹̹ͅ੮ Pʇɘˑ͐ʩ੮ ʠ˺̼੮ ʁʮͅɻʩɘ̼ʡing a sixty-eight-year-old man back to an independent living facility where he was ʠ˺͙˦ʁ੮ ુʁʮͅʩʇͷʇˑʇʁ੮ ɘ˦ʁ੮ ˑʮͷʮ˦ʡ੮ ʮ˦੮ ϲʮˑ͐ʩ;੮ ɻ˺˦ʁʮ͐ʮ˺˦ͅ੯ ੳ੯ ੳ੯ ੳ੮ ˦ɘˌʇʁ੮ ɘ˦ʁ੮ ʁʇˑ͙ͅʮ˺˦ɘˑੴ੮ ͐ʩʮ˦ˌʮ˦ʡ੮ ͐ʩʇ੮ ;ʇɘ̼੮ ͸ɘͅ੮ ৱ৹৹৲ੳૂ੮ ુäɻ̼ʮ̹̹ͅ੮ Pʇɘˑ͐ʩ੮ )ʇ˦ʮʇͅ੮ #ʮ͐;੮ ͐͐˺̼˦ʇ;੮ šϲϲʮɻʇૄͅ੮ ɻɻ͙ͅɘ͐ʮ˺˦੮ ˺ʠ੮ Patient Dumping,” ‡"#‫ ף‬ծ, August 30, 2021, https://www.nbcsandiego.com/news/local ઃͅɻ̼ʮ̹̹ͅચʩʇɘˑ͐ʩચʁʇ˦ʮʇͅચɻʮ͐;ચɘ͐͐˺̼˦ʇ;ચ˺ϲϲʮɻʇͅચɘɻɻ͙ͅɘ͐ʮ˺˦ચ˺ʠચ̹ɘ͐ʮʇ˦͐ચʁ͙˚̹ʮ˦ʡઃ৲৷ৰ৶ৱৰ৴ઃੳ 23. California Health and Safety Code, Section 1262.5(n)(3) and 1262.5(n)(4)(a), https:// ˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;îʇͽ͐ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵPä#૟ʁʮͷʮͅʮ˺˦ ଵ৲ੳ૟͐ʮ͐ˑʇଵ૟̹ɘ̼͐ଵ૟ɻʩɘ̹͐ʇ̼ଵ৲ੳ૟ɘ̼͐ʮɻˑʇଵৱੳ੮îʩʇ੮ˑɘ͸੮ɻ˺˦͐ɘʮ˦ͅ੮ɘ˦੮ɘ͐ͅ˺˦ʮͅʩʮ˦ʡ੮ˑ˺˺̹ʩ˺ˑʇੴ੮ʩ˺͸ever: Psychiatric Health Facilities, which are specialized hospital-like facilities (which also take LPS patients and can apply for conservatorship) are not bound by these disɻʩɘ̼ʡʇચ̹ˑɘ˦˦ʮ˦ʡ੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅੳ੮äʇʇ੮äɘ̼ɘ੮nɘͅͅɘɺʮɘ˦ੴ੮ુૃĔʩɘ͐੮Ĕɘͅ੮Pʇ੮I˺ʮ˦ʡ੮͐˺੮)˺੮͸ʮ͐ʩ੮ {;੮nʮʁ੺ૄੵ੮Ĕ˺˚ɘ˦੮ʠ̼˺˚੮Øɘͅ˺੮Û˺ɺˑʇͅ੮Ĕɘͅ੮Ûʇˑʇɘͅʇʁ੮/ɘ̼ˑ;੮ʠ̼˺˚੮ɘ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮Hɘɻʮˑʮ͐;ੴૂ੮San r̢ɷ̎‫šף‬Ƀɷ̎̂˃‫ף‬î̅ɷɃ̢ʯɐ, October 2, 2022. 24. Kristen R. Choi et al., “Mental Health Conservatorship Among Homeless People with Serious Mental Illness,” Psychiatric Services 73, no. 6 (2022): 615. 25. )˃ɐ‫ףר̀ף‬Iȡʚʚɷʯ˃̙੮ફ#ੳ)ੳ#ɘˑੳ੮ৱ৹৷৹બ੮৴৸৶੮Hੳä͙̹̹ੳ੮৹৸৳ੴ੮৹৹ৱજ৹৹৲ੴ੮ɘϲϲૄʁੴ੮ફ৹͐ʩ੮#ʮ̼ੳ੮ৱ৹৸ৱબ੮৶৵৷੮H৲ੳʁ੮ 1017. 26. Mike Phillips, who oversees Patients’ Rights Advocates in San Diego, told me in 2022 ͐ʩɘ͐੮ ʩʇɘ̼ʮ˦ʡ੮ ˺ϲϲʮɻʇ̼ͅ੮ ̼͙ˑʇʁ੮ ʮ˦੮ ʠɘͷ˺̼੮ ˺ʠ੮ ˌʇʇ̹ʮ˦ʡ੮ ̹ɘ͐ʮʇ˦͐ͅ੮ ʮ˦੮ ͐ʩʇ੮ ʩ˺̹ͅʮ͐ɘˑ੮ ɘ̼˺͙˦ʁ੮ ৸৵੮ ˺̼੮ 90 percent of the time. 27. Previous research also found that psychiatrists in LPS hearings (in this case, when a ̹ɘ͐ʮʇ˦͐੮ϲʮˑʇʁ੮ɘ੮͸̼ʮ͐બ੮ͅ˺˚ʇ͐ʮ˚ʇͅ੮ʁʇˑʮͷʇ̼ʇʁ੮͐ʇ͐ͅʮ˚˺˦;੮ʮ˦੮ʠɘͷ˺̼੮˺ʠ੮͐ʩʇʮ̼੮̼ʇˑʇɘͅʇੳ੮îʩʮͅ੮͸ɘͅ੮ ̹ɘ̼͐ʮɻ͙ˑɘ̼ˑ;੮ɻ˺˚˚˺˦੮ʠ˺̼੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੳ੮#ɘ̼˺ˑ੮Ĕɘ̼̼ʇ˦ੴ੮The Court of Last Resort (Chicago: University of Chicago Press, 1982), 14. 28. As evidence of the backlog, the number of days adults in San Diego on Medi-Cal spent waiting in hospitals for step-down beds increased 48 percent from 2020 to 2021. Lisa Halverstadt, “New Mandate Could Further Stress San Diego’s Clogged Behavioral Health System,” ē˃ɷɄɐ‫˃ף‬ɩ‫ף‬äȡʯ‫)ף‬ɷɐɪ˃, September 21, 2022, https://voiceofsandiego.org/2022/09/21/new -mandate-could-further-stress-san-diegos-clogged-behavioral-health-system/. 29. Department of Health Care Services, “California Code of Regulations: 1820.205. Medical Necessity Criteria for Reimbursement of Psychiatric Inpatient Hospital Services,” accessed November 8, 2022, https://www.dhcs.ca.gov/formsandpubs/MHArchives/InfoNotice01 -attachment.pdf.

4 . I N PAT I E N T 30.

31. 32. 33.

34.

35.

36.

37.

38.

39.

343

The average statewide rate for acute psychiatric hospitalization for Medi-Cal patients is $888 a day, going up to $1575 in the Bay Area. Department of Health Care Services, “MediCal Psychiatric Inpatient Hospital Services Non-Negotiated Rates,” July 1, 2021, https:// www.dhcs.ca.gov/formsandpubs/Documents/BHIN-21-064-Regional-Rates-Enclosure ੳ̹ʁʠੳ੮îʩʇ੮ɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮͷʇ੮̼ɘ͐ʇੴ੮ʮ˦ɻ̼ʇɘͅʇʁ੮ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;੮ʮ˦੮͐ʩʇ੮̹ɘ˦ʁʇ˚ʮɻੴ੮ʮͅ੮ଏ৶৹৳ੳ੮)ʇ̹ɘ̼͐ment of Health Care Services, “Administrative Day Rate Level 1,” accessed November 8, 2022, https://www.dhcs.ca.gov/services/medi-cal/Pages/Administrative-Day-Rate-Level -1.aspx. Department of Health Care Services, “California Designated LPS Facilities,” May 2020, https://www.dhcs.ca.gov/Documents/LPS-24hr.pdf. Los Angeles County Department of Mental Health, “Annual Report to the Board for Expanding LPS Conservatorship,” January 26, 2021. For example, nearly 40 percent of adults discharged from private hospitals in Los Angeles returned to the hospital within thirty days, versus 20 percent in county hospitals. {ʇ̼ɻʇ̼੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮"ʇ˦ʇϲʮ͐ͅ੮rr#ੴ੮ુ#˺͙˦͐;͸ʮʁʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮ä͙ɺ͐ͅɘ˦ɻʇ੮õͅʇ੮)ʮͅorder Needs Assessment” (Los Angeles: Los Angeles County Health Agency, August 15, ৲ৰৱ৹બੴ੮৶ੴ੮ʩ̹͐͐ͅੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱ৴৲৲৶৴ੳ̹ʁʠੳ San Francisco Budget and Legislative Analyst, “Review of Lanterman-Petris-Short (LPS) #˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʮ˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ૂ੮ફäɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮k͙ˑ;੮৳ৰੴ੮৲ৰৱ৹બੴ੮ચৱ৵ੳ੮îʩʇ੮ϲʮʡ͙̼ʇͅ੮ʠ̼˺˚੮ Los Angeles are similar: 75 percent of bed-days in county hospitals were not being paid the full acute rate. LA DMH, “Report Response to Addressing the Shortage of Mental Health Hospital Beds” (Los Angeles, October 29, 2019), 17–18. This is evident in the greater length of stay at county hospitals, which in Los Angeles was twenty-two days versus seven for private fee-for-service hospitals. Mercer, “Countywide Needs Assessment,” 61. Private doctors who bill for each patient they see might also be less willing to spend a half-day in court waiting to testify, vis-à-vis salaried county physicians who testify ʠ͙ˑˑચ͐ʮ˚ʇੳ੮k͙ˑʮʇ੮{ɘ̼ή͙ʮͅ੮ɘ˦ʁ੮)ɘ˦੮{˺̼ɘʮ˦ੴ੮ુîʩʇ੮"̼˺ˌʇ˦੮#˺˦̼͐ɘɻ͐ੵ੮Ûʮʡʩ͐ͅ੮˺ʠ੮{ʇ˦͐ɘˑˑ;੮Uˑˑ੮ Pitted Against Public, Patient Safety,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, November 23, 1999. Research shows that having more private psychiatric hospitals is associated with homelessness and incarceration in the areas they serve, unlike public hospitals. Jangho Yoon, “Effect of Increased Private Share of Inpatient Psychiatric Resources on Jail Population Growth: Evidence from the United States,” Social Science & Medicine 72, no. 4 (2011): 448; Fred E. Markowitz, “Psychiatric Hospital Capacity, Homelessness, and Crime and Arrest Rates,” #̅ɷʣɷʯ˃ʚ˃ɪ͇ 44, no. 1 (2006): 45–72. Over time, counties have threatened to remove LPS designation for other reasons. Los Angeles went after one hospital that discharged people to unlicensed board and care ʠɘɻʮˑʮ͐ʮʇͅ੮͸ʩʇ̼ʇ੮ϲʮͷʇ੮̹ʇ˺̹ˑʇ੮ʁʮʇʁੴ੮͸ʩʮˑʇ੮äɘ˦੮)ʮʇʡ˺੮͐ʩ̼ʇɘ͐ʇ˦ʇʁ੮ɘ੮ʩ˺̹ͅʮ͐ɘˑ੮͐ʩɘ͐੮ˑʇʠ͐੮̹ʇ˺̹ˑʇ੮ in physical restraints for days at a time. Rex Dalton, “Tri-City Hospital Cited for Psychiatric Violations,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ؅î̅ɷɃ̢ʯɐ, August 29, 1993; Charles Ornstein, “Five Residents Die at Unlicensed Care Home That County Tried to Close,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 29, 2002. Inland Valley Daily Bulletin, “Psychiatric Center Stops Adolescent Program,” April 6, 2004; Cindy Carcamo, “Fewer Beds for Mentally Ill,” š̅ȡʯɪɐ‫ף‬#˃̢ʯ̙͇‫ף‬Ûɐɪɷ̙̎ɐ̅, August 12, 2008.

344 40. 41. 42. 43. 44. 45. 46.

4 . I N PAT I E N T Jeffrey Guhin, ɪɐʯ̙̎‫˃ ף‬ɩ‫ ף‬I˃Ɋ‫̢˃" ףת‬ʯɊȡ̅ɷɐ̎‫ ף‬ȡʯɊ‫̢̙ ף‬ɲ˃̅ɷ̙͇‫ ף‬ɷʯ‫̢̎{ ף‬ʚɷʣ‫ ף‬ȡʯɊ‫ ף‬#ɲ̅ɷ̙̎ɷȡʯ‫ ף‬äɄɲ˃˃ʚ̎ (New York: Oxford University Press, 2021). Gail Evanguelidi, a family member and advocate in Los Angeles, told me in 2020 that Los ˦ʡʇˑʇͅ੮͙ͅʇʁ੮͐˺੮̼ʇή͙ʮ̼ʇ੮͐ʩɘ͐੮ɘ੮̹ʇ̼ͅ˺˦੮ʩɘͷʇ੮ɘ͐੮ˑʇɘ͐ͅ੮͐ʩ̼ʇʇ੮ʮ˦̹ɘ͐ʮʇ˦͐੮ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦ͅੳ Michael Oliver, îɲɐ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ף‬ɩ‫)ף‬ɷ̎ȡɃʚɐʣɐʯ̙‫ףףת‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫˃̅̂̂ף‬ȡɄɲ (London: Palgrave Macmillan, 1990). LA DMH, “Report Response,” 12. LA DMH, “Report Response,” 22. LA DMH, “Report Response,” 14. LA DMH, “Report Response,” 10. A recent report out of San Diego similarly concluded that 40 percent of inpatient admissions could be avoided with an appropriate array of alternative crisis responses. Behavioral Health Services, “Optimal Care Pathways Model” (San Diego County, CA: Board of Supervisors, September 27, 2022), https://bosagenda ੳͅɘ˦ʁʮʇʡ˺ɻ˺͙˦͐;ੳʡ˺ͷઃɻ˺ɺઃɻ˺ͅʁઃɻ˺ɺઃʁ˺ɻ੺ʮʁଵৰ৹ৰৱৱ৲৷ʇ৸ৰʠৱ৳ɺ৶ɘੳ

5. PUBLIC GUARDIAN 1.

California Hospital Association, “California’s Acute Psychiatric Bed Loss” (Sacramento, #ੴ੮ Hʇɺ̼͙ɘ̼;੮ ৲ৰৱ৹બੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳɻɘˑʩ˺̹ͅʮ͐ɘˑੳ˺̼ʡઃͅʮ͐ʇͅઃ˚ɘʮ˦ઃϲʮˑʇͅઃϲʮˑʇચɘ͐͐ɘɻʩ˚ʇ˦͐ͅઃ৶ ઢચઢ̹ͅ;ɻʩɺʇʁʁɘ͐ɘੳ̹ʁʠੴ੮৶ੳ 2. Robert Castel, rȡ‫ ף‬ɪɐ̙̎ɷ˃ʯ‫ ף‬Ɋɐ̎‫̅ ף‬ɷ̢̎̄ɐ̎‫ ףת‬Ɋɐ‫ ף‬ʚ‫إ‬ȡʯ̙ɷ؅͇̂̎Ʉɲɷȡ̙̅ɷɐ‫ ף‬ȶ‫ ף‬ʚ‫إ‬ȡ̂̅ɡ̎؅͇̂̎Ʉɲȡʯȡʚ͇̎ɐ (Paris: Minuit, 1981); Michel Foucault, “L’évolution de la notion d’‘individu dangereux’ dans la psychiatrie légale,” )ɔ̀ɷȡʯɄɐ‫ף‬ɐ̙‫˃̎ף‬Ʉɷɔ̙ɔ 5, no. 4 (1981): 403–22; Nikolas Rose, “Governing Risky Individuals: The Role of Psychiatry in New Regimes of Control,” Psychiatry, PsyɄɲ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫ף‬rȡ́ 5, no. 2 (1998): 177–95. 3. Subcommittee on Mental Health, “The Dilemma of Mental Commitments in California” (Sacramento: California State Legislature, 1966), 20. 4. Subcommittee on Mental Health, “The Dilemma of Mental Commitments,” 138. 5. ENKI Research Institute, ‫ף‬ä̢̙Ɋ͇‫˃ף‬ɩ‫ף‬#ȡʚɷɩ˃̅ʯɷȡ‫‡ף̎إ‬ɐ́‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬rȡ́‫ؒף‬ըհխհ؇ըհծըؓ (Chatsworth, CA: Author, 1972), 166. 6. Grant H. Morris, “Conservatorship for the ‘Gravely Disabled’: California’s Nondeclaration of Nonindependence,” Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ ף‬k˃̢̅ʯȡʚ‫˃ ף‬ɩ‫ ף‬rȡ́‫ ף‬ȡʯɊ‫ ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 1 (1978): 405; Mental Health and Substance Use Disorder Services Division, “California Involuntary Detention Report Summary (FY 1990–2000)” (Sacramento, CA: Department of Health Care Services, 2001). ੮ ৷ੳ੮ Ûʮɻʩɘ̼ʁ੮ Pੳ੮ rɘ˚ɺ੮ ɘ˦ʁ੮ rʮ˦ʁɘ੮ /ੳ੮ Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ ુ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ ʠ˺̼੮ I̼ɘͷʇˑ;੮ )ʮͅɘɺˑʇʁ੮ Psychiatric Patients: A Four-Year Follow-Up Study,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅, no. ৱ৴৹੮ ફৱ৹৹৲બੵ੮ ৹ৰ৹જৱ৳੶੮ äੳ੮ rੳ੮ Ûʇ;˦˺ˑʁͅ੮ ɘ˦ʁ੮ nੳ੮ Pੳ੮ Ĕʮˑɺʇ̼ੴ੮ ુØ̼˺͐ʇɻ͐ʮ˦ʡ੮ Øʇ̼ͅ˺˦ͅ੮ ͸ʮ͐ʩ੮ äʇͷʇ̼ʇ੮ Cognitive and Mental Disorders: An Analysis of Public Conservatorship in Los Angeles County, California,” ɪɷʯɪ‫{ףغף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 1, no. 1 (1997): 87–98; John L. Young, Mark kੳ੮ {ʮˑˑͅੴ੮ ɘ˦ʁ੮ Û˺ɺʇ̼͐੮ rੳ੮ äɘɻˌੴ੮ ુ#ʮͷʮˑ੮ #˺˚˚ʮ͐˚ʇ˦͐੮ ɺ;੮ #˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੵ੮ îʩʇ੮ Ĕ˺̼ˌʮ˦ʡͅ੮ of California’s Law,” Bulletin of the American Academy of Psychiatry and the Law 15, no. 2 (1987): 127–39. ੮ ৸ੳ੮ rɘ˚ɺ੮ɘ˦ʁ੮Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ુ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮৹ৰ৹ੳ

5 . P U B L I C G UA R D I A N

345

9. Morris, “Conservatorship for the ‘Gravely Disabled,’” 406. ੮ ৱৰੳ੮ Û˺ɺʇ̼͐੮/˚ɺ̼;ੴ੮ુîʩʇ੮š̼ʁʇɘˑ੮˺ϲ੮î˺͐ɘˑ੮Ø˺͸ʇ̼ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, September 3, 1972. ੮ ৱৱੳ੮ rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅૄͅ੮šϲϲʮɻʇੴ੮ુšͷʇ̼ͷʮʇ͸੮˺ʠ੮H͙˦ʁʮ˦ʡ੮ʠ˺̼੮͐ʩʇ੮rɘ˦͐ʇ̼˚ɘ˦ચØʇ̼͐ʮͅચäʩ˺̼͐੮ɻ͐ૂ੮ (Sacramento, CA, December 15, 2021), 5. The state does provide one million dollars per year for the CAPAPGPC to train and certify guardians. 12. This characterization was made to me by Kim Lewis of the National Health Law Project. A ৲ৰৰ৸੮ɘ͙ʁʮ͐ੴ੮ʠ˺̼੮ʇͽɘ˚̹ˑʇੴ੮ʁʇͅɻ̼ʮɺʇʁ੮){Pૄͅ੮̼ʇͷʮʇ͸੮˺ʠ੮ɻ˺͙˦͐;੮̹ˑɘ˦ͅ੮͙˦ʁʇ̼੮{Pä੮ɘͅ੮ુʮ˦ʇϲϲʮɻʮʇ˦͐ૂ੮ɘ˦ʁ੮ુʮ˦ʇʠʠʇɻ͐ʮͷʇੳૂ੮U͐੮ʩɘʁ੮ુ˦˺͐੮̹̼˺ͷʮʁʇʁ੮ɘʁʇή͙ɘ͐ʇ੮˺̼੮ɻ˺˦ͅʮ͐ͅʇ˦͐੮ʡ͙ʮʁɘ˦ɻʇ੮͐˺੮ɻ˺͙˦͐ʮʇͅੴ੮ ͸ʩʮɻʩ੮̼ʇϲˑʇɻ͐ͅ੮̹˺˺̼ˑ;੮˺˦੮͐ʩʇ੮ɻ˺˚̹ʇ͐ʇ˦ɻ;੮˺ʠ੮){P੮͐ͅɘʠʠੳૂ੮šϲϲʮɻʇ੮˺ʠ੮ä͐ɘ͐ʇ੮͙ʁʮ͐ͅ੮ɘ˦ʁ੮/ͷɘˑuations, “Final Report: California Department of Mental Health, Mental Health Services Act Performance Audit” (Sacramento, CA: Department of Finance, June 2008), 10. 13. It is also frustrating for providers, who face different rules around the release of information, consent to medical procedures, or contact with families based on the county from which a conservatee comes. See Psynergy, “LPS Hearing Comments,” December 14, 2021, ʩ̹͐͐ͅੵઃઃɘˈ͙ʁੳɘͅͅʇ˚ɺˑ;ੳɻɘੳʡ˺ͷઃͅʮ͐ʇͅઃɘˈ͙ʁੳɘͅͅʇ˚ɺˑ;ੳɻɘੳʡ˺ͷઃϲʮˑʇͅઃØͅ;˦ʇ̼ʡ;େ৲ৰØ̼˺ʡ̼ɘ˚ͅੳ̹ʁʠੳ 14. This point has been made in myriad grand jury reports on the functioning of guardians’ ˺ϲϲʮɻʇͅ੮͐ͅɘ͐ʇ͸ʮʁʇੳ੮ˑɘ˚ʇʁɘ੮#˺͙˦͐;੮I̼ɘ˦ʁ੮k͙̼;ੴ੮ુHʮ˦ɘˑ੮Ûʇ̹˺̼͐ੴૂ੮৲ৰ৲ৱજ৲ৰ৲৲ੴ੮ৱ৸ੴ੮ʩ̹͐͐ͅੵઃઃ grandjury.acgov.org/grandjury-assets/docs/2021-2022/Grand.Jury.Report.2022.for.ITD ੳĔʇɺੳ̹ʁʠ੶੮ #˺˦̼͐ɘ੮ #˺͐ͅɘ੮ #˺͙˦͐;੮ I̼ɘ˦ʁ੮ k͙̼;ੴ੮ ુ#ɘ̼ʮ˦ʡ੮ ʠ˺̼੮ îʩ˺ͅʇ੮ Ĕʩ˺੮ #ɘ˦੮ ‡˺੮ r˺˦ʡʇ̼੮ Care for Themselves” (Martinez, CA, May 26, 2015); Humboldt County Grand Jury, “BeHOLD: The Department of Mental Health’s Management of the Public Guardian šϲϲʮɻʇ੮ɘ˦ʁ੮Øɘ͐ʮʇ˦͐ͅૄ੮Ûʮʡʩ͐ͅ੮ʁͷ˺ɻɘ͐ʇૂ੮ફP͙˚ɺ˺ˑʁ͐ੴ੮#ੴ੮৲ৰ৲ৰબੴ੮ʩ̹͐͐ͅੵઃઃʩ͙˚ɺ˺ˑʁ͐ʡ˺ͷੳ˺̼ʡ /DocumentCenter/View/87426/BeHOLD---The-Dept-of-Mental-Healths-Mgmt-of ચ͐ʩʇચØ͙ɺˑʮɻચI͙ɘ̼ʁʮɘ˦ચšϲϲʮɻʇચɘ˦ʁચØɘ͐ʮʇ˦͐ͅચÛʮʡʩ͐ͅચʁͷ˺ɻɘ͐ʇ੶੮ š̼ɘ˦ʡʇ੮ #˺͙˦͐;੮ I̼ɘ˦ʁ੮ k͙̼;ੴ੮ુ#ʩɘ˦ʡʮ˦ʡ੮˺ʠ੮͐ʩʇ੮I͙ɘ̼ʁʮɘ˦ੵ੮rʮʠʇ੮ʠ͐ʇ̼੮͐ʩʇ੮Ûʇ˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮Ø੮ɘ˦ʁ੮ØI੮šϲϲʮɻʇͅૂ੮ ફš̼ɘ˦ʡʇ੮#˺͙˦͐;ੴ੮#ੴ੮৲ৰৱ৶બੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳ˺ɻʡ̼ɘ˦ʁˈ͙̼;ੳ˺̼ʡઃ̹ʁʠͅઃ৲ৰৱ৵ઢ৲ৰৱ৶ઢIĩ̼ʇ̹˺̼͐ઃ৲ৰৱ৶ ચৰ৵ચ৲৳ઢĔʇɺͅʮ͐ʇઢÛʇ̹˺̼͐ੳ̹ʁʠੳ ੮ ৱ৵ੳ੮ {ʮˌʇ੮ૄ)ɘʮ̼ੴ੮ુ{˺̼ʇ੮#˺͙˦͐;੮äʇ̼ͷʮɻʇ੮#͙͐ͅ੮˺˦੮͐ʩʇ੮Ĕɘ;ੴૂ੮Willits News, March 17, 2004. 16. This tenfold variation is only between larger counties. San Francisco Budget and Legislative Analyst, “Review of Lanterman-Petris-Short (LPS) Conservatorship in San Franɻʮͅɻ˺ૂ੮ ફäɘ˦੮ H̼ɘ˦ɻʮͅɻ˺ੴ੮ #ੴ੮ kɘ˦͙ɘ̼;੮ ৱৰੴ੮ ৲ৰ৲৲બੴ੮ ৳ৱੴ੮ ʩ̹͐͐ੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅ /supdocs/116143.pdf. An analysis from Humboldt County of small-to-medium counties found eightfold differences. Humboldt County Grand Jury, “BeHOLD.” 17. In Santa Clara County (which contains San Jose), the average stay in LPS conservatorship is eight to ten years. Public Administrator-Guardian-Conservator, “Annual Report” (Santa Clara County, CA: Department of Aging and Adult Services, 2021), 11, https:// ͅ˺ɻʮɘˑͅʇ̼ͷʮɻʇͅੳͅɻɻʡ˺ͷੳ˺̼ʡઃͅʮ͐ʇͅઃʡઃϲʮˑʇͅઃʇͽˈɻ̹ɺ৷ৰৱઃϲʮˑʇͅઃʁ˺ɻ͙˚ʇ˦͐ͅઃØI#ણ˦˦͙ɘˑચÛʇ̹˺̼͐ -2021.pdf. 18. Some counties have implemented a thirty-day 5270 hold after a 5250; in those counties, a temporary conservatorship would start after forty-seven days of hospitalization. ੮ ৱ৹ੳ੮ ä˺˚ʇ੮ɻ˺͙˦͐ʮʇͅ੮ɻɘˑˑ੮͐ʩʇ੮ɘʡʇ˦ɻ;੮˺ͷʇ̼ͅʇʇʮ˦ʡ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮͐ʩʇ੮šϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮ #˺˦ͅʇ̼ͷɘ͐˺̼ੴ੮͐˺੮ʁʮʠʠʇ̼ʇ˦͐ʮɘ͐ʇ੮͐ʩʇ˚੮ʠ̼˺˚੮͐ʩʇ੮šϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੮ફ˺ͷʇ̼ͅʇʇʮ˦ʡ੮ ̹̼˺ɺɘ͐ʇ੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅબੳ੮H˺̼੮ͅʮ˚̹ˑʮɻʮ͐;ੴ੮U੮͐;̹ʮɻɘˑˑ;੮͙ͅʇ੮šϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੮ for both.

346 20.

21.

੮ ৲৲ੳ੮

੮ ৲৳ੳ੮

24.

25. ੮ ৲৶ੳ੮ 27. ੮ ৲৸ੳ੮ 29. 30.

5 . P U B L I C G UA R D I A N Although I did not ask for Rippee’s consent, his case has been so extensively reported that protecting his anonymity is not possible. As for Mark’s own perspective, he told ̼ʇ̹˺̼͐ʇ̼੮ k˺ɻʇˑ;˦੮ Ĕʮʇ˦ʇ̼ੴ੮ ુU੮ ʁ˺˦ૄ͐੮ ˦ʇʇʁ੮ ͐˺੮ ɺʇ੮ ʮ˦੮ ɘ੮ ˑ˺ɻˌʇʁચ͙̹੮ ʠɘɻʮˑʮ͐;ੳ੮ U͐੮ ͸ɘͅ੮ ˑʮˌʇ੮ U੮ ͸ɘͅ੮ ɘ੮ʩ˺͐ͅɘʡʇੳૂ੮k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુૃĔʇૄͷʇ੮r˺͐ͅ੮š͙̼੮ #˺˚̹ɘͅͅੳૄ੮H˺̼੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮{˺͐ͅ੮ēʮͅʮɺˑʇ੮ Mentally Ill, Is a Return to Forced Treatment a Solution—or a False Promise?,” CalMatters, December 30, 2019, https://calmatters.org/projects/mentally-ill-forced-treatment -conservatorship-california-debate/. There are other technicalities that can justify a denial of conservatorship for people with ɘ੮{ɘ̼ˌ੮Ûʮ̹̹ʇʇજˑʇͷʇˑ੮˺ʠ੮ͷ͙ˑ˦ʇ̼ɘɺʮˑʮ͐;ੳ੮ͅʩˑ;˦˦੮{ʮˑʇͅ੮ʩɘʁ੮ɺʇʇ˦੮ʩ˺̹ͅʮ͐ɘˑʮΈʇʁ੮ϲʮʠ͐;੮͐ʮ˚ʇͅੴ੮ been raped twelve times, attempted suicide eight times, and been stabbed and beaten over the course of four years before being admitted to a psychiatric health facility in San Luis Obispo. The hospital applied for a conservatorship, but the public guardian denied the application claiming they lacked records from a hospitalization in Nevada, where Ashlynn had attempted to kidnap a child thinking it was her own. She was discharged to a homeless shelter, despite having been previously banned by shelters for violence. Ĕʮ͐ʩʮ˦੮ͅʇͷʇ˦͐;ચ͐͸˺੮ʩ˺͙̼ͅੴ੮ͅʩʇ੮͸ɘͅ੮ʠ˺͙˦ʁ੮ʮ˦੮͐ʩʇ੮ɺɘɻˌ੮˺ʠ੮ɘ੮̼͙͐ɻˌ੮ʁ̼ʮͷʇ˦੮ɺ;੮ɘ੮̼ʇʡʮ͐ͅʇ̼ʇʁ੮ͅʇͽ੮ offender in Arizona. The hospital in California would not accept a transfer, so she would ɺʇ੮̼ʇˑʇɘͅʇʁ੮͐˺੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ੮äɘ̼ɘ੮nɘͅͅɘɺʮɘ˦ੴ੮ુØɘͅ˺੮Ĕ˺˚ɘ˦੮Øʮɻˌʇʁ੮õ̹੮ɺ;੮äʇͽ੮šʠʠʇ˦ʁʇ̼੮Pɘͅ੮ Been Hospitalized More than 50 Times in 4 Years,” äȡʯ‫ף‬r̢ɷ̎‫šף‬Ƀɷ̎̂˃‫ף‬î̅ɷɃ̢ʯɐ, September 30, 2022, https://www.sanluisobispo.com/news/local/article265797411.html. H˺̼੮ɘ੮ʁʮͅɻ͙ͅͅʮ˺˦੮˺ʠ੮͐ʩʇ੮ʁʇɺɘ͐ʇͅ੮˺ͷʇ̼੮͸ʩʇ˦੮ʁʇ˚ʇ˦͐ʮɘ੮ή͙ɘˑʮϲʮʇͅ੮ʠ˺̼੮rØäੴ੮ͅʇʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮ ͙ʁʮ͐˺̼ચ#˺˦̼͐˺ˑˑʇ̼ੴ੮ુ{ɘ˦ɘʡʇ˚ʇ˦͐੮͙ʁʮ͐੮˺ʠ੮͐ʩʇ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩઝšϲϲʮɻʇ੮ of the Public Guardian” (Los Angeles: County of Los Angeles, May 11, 2005), 44. U˦੮ɘ˦˺͐ʩʇ̼੮ʩʮʡʩચ̹̼˺ϲʮˑʇ੮ɻɘͅʇੴ੮ɺ̼ɘʩɘ˚੮äʮˑʮʇΈɘ̼੮͸ɘͅ੮ʠ˺͙˦ʁ੮ʁʇɘʁ੮ʮ˦੮ɘ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮̹ɘ̼ˌ੮ after his family spent years trying to get him conserved for a combination of PTSD, ɘˑɻ˺ʩ˺ˑʮͅ˚ੴ੮ɘ˦ʁ੮ɘ੮̼͐ɘ͙˚ɘ͐ʮɻ੮ɺ̼ɘʮ˦੮ʮ˦ˈ͙̼;ੳ੮{ɘˑˑ˺̼;੮{˺ʇ˦ɻʩੴ੮ુ੮ä̼͙͐ʡʡˑʮ˦ʡ੮ēʇ͐ʇ̼ɘ˦੮Ĕɘͅ੮ Found Dead in an S.F. Park Ravine. Could Conservatorship Have Helped Prevent His Death?,” San Francisco Chronicle, October 21, 2021, https://www.sfchronicle.com/bayarea /article/A-struggling-veteran-was-found-in-a-Lands-End-16546952.php. A RAND study also found that facilities reported a consistent inability to place individuals with dementia or traumatic brain injuries. Ryan McBain et al., “Adult Psychiatric Bed Capacity, Need, and Shortage Estimates in California—2021” (Santa Monica, CA: Rand #˺̼̹˺̼ɘ͐ʮ˺˦ੴ੮৲ৰ৲৲બੴ੮৴ੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳ̼ɘ˦ʁੳ˺̼ʡઃ̹͙ɺͅઃ̼ʇͅʇɘ̼ɻʩઢ̼ʇ̹˺̼͐ͅઃĻÛৱ৸৲৴ચৱચͷ৲ੳʩ͐˚ˑੳ Solano’s head of Social Services gave precisely this explanation when asked about Mark’s ɻɘͅʇੳ੮Ĕʮʇ˦ʇ̼ੴ੮ુૃĔʇૄͷʇ੮r˺͐ͅ੮š͙̼੮#˺˚̹ɘͅͅੳૄૂ #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৳৵ৰફʇબફৱબੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ; äʇɻ͐ʮ˺˦ੳͽʩ͐˚ˑ੺ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৳৵ৰੳ Deborah A. Stone, îɲɐ‫)ף‬ɷ̎ȡɃʚɐɊ‫ף‬ä͗ȡ̙ɐ (Philadelphia: Temple University Press, 1984), 4. #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৳৵৲ੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৳৵৲ੳ See, also, Nathaniel P. Morris and Renée L. Binder, “Grave Disability in U.S. Jails and Prisons,” Psychiatric Services 73, no. 5 (2022): 577–79. David Sjostedt, “In SF and Across California, People with Severe Mental Illness Languish Untreated in Jails, Hospitals,” äH‫ ף‬ä͗ȡʯɊȡ̅Ɋ, October 4, 2022, https://sfstandard

6 . C O U RT

3 47

.com/public-health/under-conservatorships-sf-mental-health-patients-languish-in-jails -hospitals-awaiting-care/. 31. California Assembly Bill 1810, Chapter 2.8A: Diversion of Individuals with Mental Disorders, ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑîʇͽ͐#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৷৲ৰৱ৸ৰ"ৱ৸ৱৰੳ੮ Such individuals can also be offered voluntary diversion programs or assisted outpatient treatment. ੮ ৳৲ੳ੮ äʇʇ੮ ɘˑͅ˺੮ nɘ͐ʩʇ̼ʮ˦ʇ੮ Ĕɘ̼ɺ͙̼͐˺˦੮ ʇ͐੮ ɘˑੳੴ੮ ુ੮ ä͙̼ͷʇ;੮ ˺ʠ੮ ‡ɘ͐ʮ˺˦ɘˑ੮ î̼ʇ˦ʁͅ੮ ʮ˦੮ Øͅ;ɻʩʮɘ̼͐ʮɻ੮ Patients Found Incompetent to Stand Trial: Reasons for the Reinstitutionalization of People with Serious Mental Illness in the United States,” CNS Spectrums 25, no. 2 (2020): 245–51. 33. Another pathway, called a Murphy conservatorship, applies to people who are not gravely disabled but are charged with violent felonies for which they cannot stand trial. k˺ͅʇ̹ʩ੮ Ûੳ੮ äʮ˚̹ͅ˺˦ੴ੮ ુĔʩʇ˦੮ Ûʇ͐ͅ˺̼ɘ͐ʮ˺˦੮ Hɘʮˑͅੵ੮ š˦ʇ੮ ä͐ɘ͐ʇૄͅ੮ ˦ͅ͸ʇ̼੮ ͐˺੮ ͐ʩʇ੮ )ʮˑʇ˚˚ɘ੮ ˺ʠ੮ Permanent Incompetence,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬ɄȡɊɐʣ͇‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬rȡ́ 44, no. 2 (2016): 171–79. 34. California Senate Bill 317, Competence to Stand Trial, https://leginfo.legislature.ca.gov ઃʠɘɻʇͅઃɺʮˑˑ‡ɘͷ#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰ৲ৱ৲ৰ৲৲ৰä"৳ৱ৷ੳ 35. Armando Lara-Millán, “States as a Series of People Exchanges,” in The Many Hands of the ä͗ȡ̙ɐ‫ףת‬îɲɐ˃̅ɷ͑ɷʯɪ‫ף‬Ø˃ʚɷ̙ɷɄȡʚ‫̢̙ף‬ɲ˃̅ɷ̙͇‫ף‬ȡʯɊ‫ף‬ä˃Ʉɷȡʚ‫ף‬#˃ʯ̙̅˃ʚ, ed. Kimberly J. Morgan and Ann Shola Orloff (New York: Cambridge University Press, 2017), 82. ੮ ৳৶ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮৵৳৵৸ફɘબફৱબફબੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৳৵৸ੳ 37. Gøsta Esping-Andersen, îɲɐ‫ף‬îɲ̅ɐɐ‫ף‬Ĕ˃̅ʚɊ̎‫˃ף‬ɩ‫ף‬Ĕɐʚ͖ȡ̅ɐ‫ף‬#ȡ̂ɷ͗ȡʚɷ̎ʣ੮ફØ̼ʮ˦ɻʇ͐˺˦ੴ੮‡ĩੵ੮Ø̼ʮ˦ɻʇ͐˺˦੮ University Press, 1990), 61. 38. SF BLA, “Review of LPS Conservatorship,” July 30, 2019; Abby Sewell, “The Ordeal of His Illness,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, April 13, 2015; Los Angeles County Department of Mental Health, “Annual Report to the Board for Expanding Lanterman-Petris-Short and Probate Conservatorship Capacity” (Los Angeles, January 26, 2021). San Diego appears ͐˺੮ɺʇ੮ɘ੮ˑɘ̼ʡʇચɻ˺͙˦͐;੮ʇͽɻʇ̹͐ʮ˺˦ੴ੮ϲʮˑʮ˦ʡ੮˺˦੮৵৳੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̼ʇʠʇ̼̼ɘˑͅ੮ʮ˦੮ϲʮͅɻɘˑ੮;ʇɘ̼੮৲ৰ৲ৰજ৲ৰ৲ৱੳ੮ Jennifer Bowman, “More San Diegans Could Enter Mental Health Conservatorships. But the System Is Already Struggling,” INewSource, September 19, 2022, https://inewsource .org/2022/09/19/california-lps-conservatorships-mental-illness-homeless-crisis/.

6. COURT 1. 2. 3.

4.

Paul Starr, îɲɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬î̅ȡʯ̎ɩ˃̅ʣȡ̙ɷ˃ʯ‫˃ף‬ɩ‫ף‬ʣɐ̅ɷɄȡʯ‫{ף‬ɐɊɷɄɷʯɐ‫ףת‬îɲɐ‫ף‬Ûɷ̎ɐ‫˃ף‬ɩ‫ף‬ȡ‫ף‬ä˃̀ɐ̅ɐɷɪʯ‫ף‬Ø̅˃ɩɐ̎̎ɷ˃ʯ‫ף‬ ȡʯɊ‫̙ף‬ɲɐ‫{ף‬ȡʕɷʯɪ‫˃ף‬ɩ‫ף‬ȡ‫ף‬ēȡ̙̎‫ף‬UʯɊ̢̙͇̎̅ (New York: Basic Books, 1982), 13. People v. Sanchez (2016), 63 Cal. 4th 665. Prior to LPS, California’s commitment standard was that a person be “of such mental condition that they are in need of supervision, treatment, care or restraint.” Subcommittee on Mental Health, “The Dilemma of Mental Commitments in California” (Sacramento: California State Legislature, 1966), 6. Robert A. Kagan, Ɋ̀ɐ̅̎ȡ̅ɷȡʚ‫ף‬rɐɪȡʚɷ̎ʣ‫ףת‬îɲɐ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬Ĕȡ͇‫˃ף‬ɩ‫ף‬rȡ́ (Cambridge, MA: Harvard University Press, 2003).

348 5. ੮ ৶ੳ੮

7. 8.

9. 10. ੮ ৱৱੳ੮

12.

13.

14.

੮ ৱ৵ੳ੮ ੮ ৱ৶ੳ੮ 17. 18. ੮ ৱ৹ੳ੮

6 . C O U RT Meta S. David, “Legal Guardianship of Individuals Incapacitated by Mental Illness: Ĕʩʇ̼ʇ੮)˺੮Ĕʇ੮)̼ɘ͸੮͐ʩʇ੮rʮ˦ʇ੺ੴૂ੮ä̢ɩɩ˃ʚʕ‫ף‬õʯɷ̀ɐ̅̎ɷ̙͇‫ף‬rȡ́‫ף‬Ûɐ̀ɷɐ́ 45, no. 2 (2012): 482. {;੮ ͙˦ʁʇ̼͐ͅɘ˦ʁʮ˦ʡ੮ ˺ʠ੮ rØä੮ ʩʇɘ̼ʮ˦ʡͅ੮ ʩɘͅ੮ ɺʇ˦ʇϲʮ͐ʇʁ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;੮ ʠ̼˺˚੮ ͐ʩʇ੮ ɘͅͅʮ͐ͅɘ˦ɻʇ੮ ˺ʠ੮ Morgan Smythe, whose website is a wealth of information on case law and legal procedures. See https://www.lpsconservatorship.com/. “Hearing: Dilemma of Mental Commitments in California” (Sacramento, CA, January 18, 1966), 14–15. Disability theorists, for their part, have argued that different forms of incarceration are all common “manifestations of a centuries’ old process of segregating and isolating those individuals deemed unworthy and incapable of full participation in society.” Michael Rembis, “The New Asylums: Madness and Mass Incarceration in the Neoliberal Era,” in )ɷ̎ȡɃɷʚɷ̙͇‫ף‬UʯɄȡ̅Ʉɐ̅ȡ̙ɐɊ, ed. Liat Ben-Moshe, Chris Chapman, and Allison C. Carey (New York: Palgrave Macmillan, 2014), 144. )˃ɐ‫ףר̀ף‬Iȡʚʚɷʯ˃̙੮ફ#ੳ)ੳ#ɘˑੳ੮ৱ৹৷৹બ੮৴৸৶੮Hੳä͙̹̹ੳ੮৹৸৳ੴ੮৹৹ৱજ৹৹৲ੴ੮ɘϲϲૄʁ੮ફ৹͐ʩ੮#ʮ̼ੳ੮ৱ৹৸ৱબ੮৶৵৷੮H৲ੳʁ੮ৱৰৱ৷ੳ Hannah Arendt, îɲɐ‫̅šף‬ɷɪɷʯ̎‫˃ף‬ɩ‫ף‬î˃͗ȡʚɷ͗ȡ̅ɷȡʯɷ̎ʣ (San Diego, CA: Harcourt, Brace, Jovanovich, 1973), 296. îʩʮͅ੮̹˺ʮ˦͐੮ʩɘͅ੮ɺʇʇ˦੮˚ɘʁʇ੮̹ͅʇɻʮϲʮɻɘˑˑ;੮ʮ˦੮͐ʩʇ੮ɻɘͅʇ੮˺ʠ੮̹ʇ˺̹ˑʇ੮͸ʮ͐ʩ੮ʁʮͅɘɺʮˑʮ͐ʮʇͅ੮ɺ;੮ˑˑʮͅ˺˦੮ C. Carey, šʯ‫̙ף‬ɲɐ‫{ף‬ȡ̅ɪɷʯ̎‫˃ף‬ɩ‫ף‬#ɷ̙ɷ͑ɐʯ̎ɲɷ̂‫ףת‬Uʯ̙ɐʚʚɐɄ̢̙ȡʚ‫)ף‬ɷ̎ȡɃɷʚɷ̙͇‫ף‬ȡʯɊ‫ף‬#ɷ̀ɷʚ‫ף‬Ûɷɪɲ̙̎‫ף‬ɷʯ‫ף‬î́ɐʯ̙ɷɐ̙ɲ؅ Century America (Philadelphia: Temple University Press, 2009); David M. Engel and H̼ɘ˦ˌ੮Ĕੳ੮{͙˦ʡʇ̼ੴ੮Ûɷɪɲ̙̎‫˃ף‬ɩ‫ף‬UʯɄʚ̢̎ɷ˃ʯ‫ףת‬rȡ́‫ף‬ȡʯɊ‫ף‬UɊɐʯ̙ɷ̙͇‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬rɷɩɐ‫ף‬ä̙˃̅ɷɐ̎‫˃ף‬ɩ‫ף‬ʣɐ̅ɷɄȡʯ̎‫́ף‬ɷ̙ɲ‫ף‬ )ɷ̎ȡɃɷʚɷ̙ɷɐ̎ (Chicago: University of Chicago Press, 2003). Sheila Shea, “The Mental Hygiene Legal Service at 50: A Retrospective and Prospective Examination of Advocacy for People with Mental Disabilities,” I˃̀ɐ̅ʯʣɐʯ͗‫ ףש‬rȡ́‫ ףש‬ȡʯɊ‫ף‬ Ø˃ʚɷɄ͇‫ף‬k˃̢̅ʯȡʚ 14, no. 2 (2012): 35–41. The Treatment Advocacy Center, which advocates for expanding involuntary treatment, gives New York’s laws a grade of “C” while California gets a “D-,” suggesting that patients have more protections from forced treatment in the latter. Treatment Advocacy Center, “Grading the States: An Analysis of Involuntary Psychiatric Treatment Laws” (Arlington, VA, September 2020), 5, https://www.treatmentadvocacycenter.org/storage/documents /grading-the-states.pdf. A review of the available literature concluded, “Empirical surveys are consistent. The ή͙ɘˑʮ͐;੮˺ʠ੮ɻ˺͙˦ͅʇˑ੮̼ʇ˚ɘʮ˦ͅ੮͐ʩʇ੮ͅʮ˦ʡˑʇ੮˚˺͐ͅ੮ʮ˚̹˺̼͐ɘ˦͐੮ʠɘɻ͐˺̼੮ʮ˦੮͐ʩʇ੮ʁʮ̹ͅ˺ͅʮ͐ʮ˺˦੮˺ʠ੮ɻɘͅʇͅ੮ʮ˦੮ involuntary civil commitment.” Michael L. Perlin, “Fatal Assumption: A Critical Evaluation of the Role of Counsel in Mental Disability Cases,” Law and Human Behavior 16, no. 1 (1992): 49. äʩʇ̼;ˑ੮ä͐˺ˑɺʇ̼ʡੴ੮ુĔʩʇ̼ʇ੮Øɘ͐ʮʇ˦͐ͅ੮Hʮʡʩ͐੮ʠ˺̼੮)ʮʡ˦ʮ͐;ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 24, 1992. ‡ɘ͐ɘˑʮʇ੮Ĕ˺ˑʠੴ੮ુîʩʇ੮/͐ʩʮɻɘˑ੮)ʮˑʇ˚˚ɘͅ੮Hɘɻʇʁ੮ɺ;੮͐͐˺̼˦ʇ;ͅ੮Ûʇ̹̼ʇͅʇ˦͐ʮ˦ʡ੮͐ʩʇ੮{ʇ˦͐ɘˑˑ;੮Uˑˑ੮ in Civil Commitment Proceedings,” Iɐ˃̅ɪɐ̙˃́ʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rɐɪȡʚ‫ף‬/̙ɲɷɄ̎ 6 (1992): 175. James A. Holstein, #˃̢̙̅؅š̅Ɋɐ̅ɐɊ‫ ף‬Uʯ̎ȡʯɷ̙͇‫ ףת‬Uʯ̙ɐ̅̂̅ɐ̙ɷ̀ɐ‫ ף‬Ø̅ȡɄ̙ɷɄɐ‫ ף‬ȡʯɊ‫ ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ ף‬#˃ʣʣɷ̙ment (New York: Transaction, 1993), 48. Morgan Smythe, an expert in LPS law, said that these “submittals” affect a patient’s right to have rights because they may lose their opportunity to later appeal the case. I̼ɘ˦͐੮Pੳ੮{˺̼̼ʮͅੴ੮ુrʇ͐ૄͅ੮)˺੮͐ʩʇ੮îʮ˚ʇ੮Ĕɘ̼̹੮ʡɘʮ˦ੵ੮ͅͅʇͅͅʮ˦ʡ੮͐ʩʇ੮#˺˚̹ʇ͐ʇ˦ɻʇ੮˺ʠ੮#˺͙˦ͅʇˑ੮ in Mental Health Conservatorship Proceedings,” äȡʯ‫) ף‬ɷɐɪ˃‫ ף‬rȡ́‫ ף‬Ûɐ̀ɷɐ́ 46 (2009): 317.

7. LO C K E D I N

349

Statistics from other states also show that between 10 and 20 percent of involuntary ̹ɘ͐ʮʇ˦͐ͅ੮ɘϲϲʮ̼˚ɘ͐ʮͷʇˑ;੮ϲʮˑʇ੮ʠ˺̼੮͐ʩʇʮ̼੮̼ʇˑʇɘͅʇੳ੮)ʮ˦ɘʩ੮{ʮˑˑʇ̼੮ɘ˦ʁ੮˦˦ʇ͐͐ʇ੮Pɘ˦ͅ˺˦ੴ੮Commit̙ɐɊ‫ ףת‬îɲɐ‫" ף‬ȡ̙̙ʚɐ‫̀š ף‬ɐ̅‫ ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ ף‬#ȡ̅ɐ (Baltimore: Johns Hopkins University Press, 2016), 64; Shea, “MHLS at 50,” 38. ੮ ৲ৰੳ੮ îʩʇ੮͐ʇɻʩ˦ʮή͙ʇͅ੮ˑɘ͸;ʇ̼ͅ੮͙ͅʇ੮͐˺੮̹̼ʇ͙̼ͅͅʇ੮ɻˑʮʇ˦͐ͅ੮͐˺੮ɘʡ̼ʇʇ੮͐˺੮ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮̼͐ʇɘ͐˚ʇ˦͐੮ʮͅ੮͸ʇˑˑ੮ documented in Dan A. Lewis et al., “The Negotiation of Involuntary Civil Commitment,” Law & Society Review 18, no. 4 (1984): 629–49. 21. Conservatorship of Benevuto (1986) 180 Cal.App.3d 1030. 22. #˃ʯ̎ɐ̅̀ȡ̙˃̅̎ɲɷ̂‫˃ף‬ɩ‫ף‬#ɲȡʣɃɐ̅̎ (1977) 71 Cal.App.3d 277, 284 [139 Cal.Rptr. 357]. 23. Data from San Diego show that 85 percent of petitions are granted by the court. Jennifer Bowman, “More San Diegans Could Enter Mental Health Conservatorships. But the System Is Already Struggling,” INewSource, September 19, 2022, https://inewsource .org/2022/09/19/california-lps-conservatorships-mental-illness-homeless-crisis/. ੮ ৲৴ੳ੮ Pɘ̼˺ˑʁ੮Iɘ̼ϲʮ˦ˌʇˑੴ੮ુ#˺˦ʁʮ͐ʮ˺˦ͅ੮˺ʠ੮ä͙ɻɻʇͅͅʠ͙ˑ੮)ʇʡ̼ɘʁɘ͐ʮ˺˦੮#ʇ̼ʇ˚˺˦ʮʇͅੴૂ੮ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫ף‬ ˃ɩ‫ף‬ä˃Ʉɷ˃ʚ˃ɪ͇ 61, no. 5 (1956): 421. 25. In Los Angeles, 20 percent of conservatorships were dropped because of doctor no-shows at hearings. California State Auditor, “Lanterman-Petris-Short Act: California Has Not /˦͙̼ͅʇʁ੮ îʩɘ͐੮ U˦ʁʮͷʮʁ͙ɘˑͅ੮ ͸ʮ͐ʩ੮ äʇ̼ʮ˺͙ͅ੮ {ʇ˦͐ɘˑ੮ Uˑˑ˦ʇͅͅʇͅ੮ Ûʇɻʇʮͷʇ੮ ʁʇή͙ɘ͐ʇ੮ š˦ʡ˺ʮ˦ʡ੮ Care” (Sacramento, CA, July 2020), 31.

7. LOCKED IN 1.

In one MHRC in Los Angeles, 86 percent of residents had “past serious violence against ̹ʇ̼ͅ˺˦ͅੳૂ੮Ûʮɻʩɘ̼ʁ੮Pੳ੮rɘ˚ɺ੮ɘ˦ʁ੮rʮ˦ʁɘ੮/ੳ੮Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ુš˦ʇચĚʇɘ̼੮H˺ˑˑ˺͸ચõ̹੮˺ʠ੮Øʇ̼ͅ˺˦ͅ੮ Discharged from a Locked Intermediate Care Facility,” Psychiatric Services 56, no. 2 (2005): 198–201. 2. Kristen R. Choi et al., “Mental Health Conservatorship Among Homeless People with Serious Mental Illness,” Psychiatric Services 73, no. 6 (2022): 613–19. 3. Conservatorship of Roulet (1979) 23 Cal.3d 219, 223. 4. Department of State Hospitals, “2021–22 May Revision Budget Estimate” (Sacramento, CA, {ɘ;੮ ৱ৴ੴ੮ ৲ৰ৲ৱબੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁͅʩੳɻɘੳʡ˺ͷઃɺ˺͙͐ઢõͅઃʁ˺ɻͅઃHĚઢ৲ৰ৲ৰચ৲ৱઢ)äPઢ{ɘ;ઢÛʇͷʮͅʮ˺˦ ઢ/͐ͅʮ˚ɘ͐ʇੳ̹ʁʠੳ 5. Internal data provided to the author by the Department of State Hospitals. ੮ ৶ੳ੮ )˺̼ʮͅ੮ੳ੮H͙ˑˑʇ̼੮ʇ͐੮ɘˑੳੴ੮ુI˺ʮ˦ʡੴ੮I˺ʮ˦ʡੴ੮I˺˦ʇੵ੮î̼ʇ˦ʁͅ੮ɘ˦ʁ੮#˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮/ˑʮ˚ʮ˦ɘ͐ʮ˦ʡ੮ State Psychiatric Beds, 2016” (Treatment Advocacy Center, June 2016), 14. Although Fuller puts California as having the fourteenth-most beds per capita in 2016, the state’s ̼ʇ̹˺̼͐ʇʁ੮˦͙˚ɺʇ̼੮˺ʠ੮̹ɘ͐ʮʇ˦͐ͅ੮ʮ˦੮৲ৰ৲৲੮ʮͅ੮ͅʮʡ˦ʮϲʮɻɘ˦͐ˑ;੮ˑɘ̼ʡʇ̼੮ɘ˦ʁ੮͸˺͙ˑʁ੮̹͙͐੮ʮ͐੮ʮ˦੮ʠ˺͙̼͐ʩ੮ place, assuming the number of patients in other states has not increased. 7. Fuller et al., “Going, Going, Gone,” 19. 8. Some large counties, such as San Diego, now have no LPS patients in state hospitals (although as of 2022 they had thirty-six clients awaiting a bed). Behavioral Health Services, “Optimal Care Pathways Model” (San Diego County, CA: Board of Supervisors, September 27, 2022), 13, https://bosagenda.sandiegocounty.gov/cob/cosd/cob/doc?id ଵৰ৹ৰৱৱ৲৷ʇ৸ৰʠৱ৳ɺ৶ɘੳ

350 9.

੮ ৱৰੳ੮

੮ ৱৱੳ੮

12.

13. 14.

੮ ৱ৵ੳ੮

੮ ৱ৶ੳ੮ 17.

18.

19. 20.

੮ ৲ৱੳ੮ 22. 23.

7. LO C K E D I N Until recently, state hospitals were the only place where “restoration” treatment was possible. Local jails can now provide this treatment, while misdemeanor IST cases are now being referred to diversion programs, AOT, or conservatorship (see chapter 5). U˦ɻ˺˚̹ʇ͐ʇ˦͐੮͐˺੮ä͐ɘ˦ʁ੮î̼ʮɘˑ੮Ĕ˺̼ˌʡ̼˺͙̹ੴ੮ુÛʇ̹˺̼͐੮˺ʠ੮Ûʇɻ˺˚˚ʇ˦ʁʇʁ੮ä˺ˑ͙͐ʮ˺˦ͅૂ੮ફ)ʇ̹ɘ̼͐ment of Health and Human Services, November 2021), 9, https://www.chhs.ca.gov/wp ચɻ˺˦͐ʇ˦͐ઃ͙̹ˑ˺ɘʁͅઃ৲ৰ৲ৱઃৱ৲ઃUäîઢä˺ˑ͙͐ʮ˺˦ͅઢÛʇ̹˺̼͐ઢHʮ˦ɘˑઢͷ৲ੳ̹ʁʠੳ nɘ͐ʩʇ̼ʮ˦ʇ੮Ĕɘ̼ɺ͙̼͐˺˦੮ʇ͐੮ɘˑੳੴ੮ુ੮ä͙̼ͷʇ;੮˺ʠ੮‡ɘ͐ʮ˺˦ɘˑ੮î̼ʇ˦ʁͅ੮ʮ˦੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮Øɘ͐ʮʇ˦͐ͅ੮H˺͙˦ʁ੮ Incompetent to Stand Trial: Reasons for the Reinstitutionalization of People with Serious Mental Illness in the United States,” CNS Spectrums 25, no. 2 (2020): 248. County Behavioral Health Directors’ Association, “RE: May Revision Proposal to Discontinue Lanterman-Petris-Short Department of State Hospital Contracts with Counties—OPPOSE,” May 25, 2021, http://64.166.146.245/docs/2021/MXCAB/20210714 ઢৱ৸৵৳ઃ৴৶৳৲৹ઢrØäେ৲ৰä͐ɘ͐ʇେ৲ৰP˺̹ͅʮ͐ɘˑେ৲ৰ#˺˦̼͐ɘɻ͐େ৲ৰ)ʮͅɻ˺˦͐ʮ˦͙ɘ͐ʮ˺˦ઢେ৲ৰ š̹̹˺ͅʇઢେ৲ৰ৵ੳ৲৵ੳ৲ৱઢHʮ˦ɘˑେ৲ৰେ৲৸ৱେ৲৹ੳ̹ʁʠੳ Stiavetti v. Clendenin (June 15, 2021, A157553). Cal.App.5th. California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured îʩɘ͐੮U˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘmento, CA, July 2020), 22. îʩʮͅ੮ͷʮͅʮ˺˦੮͸ɘͅ੮˚˺͐ͅ੮͐ʩ˺̼˺͙ʡʩˑ;੮ϲˑʇͅʩʇʁ੮˺͙͐੮ʮ˦੮ɘ੮ુ˚ɘ͐ͅʇ̼੮̹ˑɘ˦ૂ੮ʁʇͷʮͅʇʁ੮ɺ;੮͐ͅɘˌʇʩ˺ˑʁʇ̼ͅ੮ in the mental health system in the late 1970s. Areta Crowell, “A Model for California: Community Mental Health Programs” (Sacramento, CA: Mental Health Association of California, 1981). õੳäੳ੮#˺ʁʇੴ੮৴৲੮õੳäੳ#ੳ੮ૡৱ৳৹৶ʁੴ੮͙ͅɻ˺ʁʇੳʩ˺͙ͅʇੳʡ˺ͷઃͷʮʇ͸ੳͽʩ͐˚ˑ੺̼ʇ̻ଵફ͐ʮ͐ˑʇੵ৴৲େ৲ৰͅʇɻ͐ʮ˺˦ੵৱ৳৹৶ʁେ 20edition:prelim. Stephen Eide and Carolyn D. Gorman, “Medicaid’s IMD Exclusion: The Case for Repeal” (Manhattan Institute, February 2021), https://www.manhattan-institute.org /medicaids-imd-exclusion-case-repeal. Isabel M Perera, “States of Mind: A Comparative and Historical Study on the Political Economy of Mental Health” (Philadelphia: University of Pennsylvania, 2018), https:// repository.upenn.edu/dissertations/AAI10978250. I am grateful to Steve Fields from the Progress Foundation and Lucille Lyon from the LA šϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੮ʠ˺̼੮̼ʇɻ˺͙˦͐ʮ˦ʡ੮͐ʩʮͅ੮ફͅʇʇ˚ʮ˦ʡˑ;੮͙˦͸̼ʮ͐͐ʇ˦બ੮ʩʮ͐ͅ˺̼;੮͐˺੮˚ʇੳ As a 1980 federal report observed, the IMD exclusion “has led to younger persons being misdiagnosed in order to be admitted to traditional nursing homes, where there are little or no mental health services.” Steering Committee on the Chronically Mentally Ill, “Toward a National Plan for the Chronically Mentally Ill” (Rockville, MD: U.S. Department of Health and Human Services, December 1980), 1–5. rʇʡʮͅˑɘ͐ʮͷʇ੮ ˦ɘˑ;͐ͅૄͅ੮ šϲϲʮɻʇੴ੮ ુÛʇʠ˺̼˚ʮ˦ʡ੮ #ɘˑʮʠ˺̼˦ʮɘૄͅ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ ä;͐ͅʇ˚ૂ੮ ફäɘɻ̼ɘmento, CA, March 26, 1991), 5. Dan Morain, “Leaving State Hospitals Sent Many Into Psychotic Abyss,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Times, November 22, 1999. Ben Kane et al., “California County Spending on 24-Hour Behavioral Care” (Berkeley, CA: Goldman School of Public Policy, April 2018).

7. LO C K E D I N

351

੮ ৲৴ੳ੮ )ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ͷʮɻʇͅੳ੮ુHɘɻʮˑʮ͐ʮʇͅ੮ɘ˦ʁ੮Ø̼˺ʡ̼ɘ˚ͅ੮)ʇϲʮ˦ʇʁ੮ɘͅ੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮ for Mental Disease—2022 Q4.” https://www.dhcs.ca.gov/services/MH/Documents/Qtr -4-2022-IMD.pdf; CHHS Open Data, data.chhs.ca.gov/dataset/licensed-mental-health -rehabilitation-centers-mhrc-and-psychiatric-health-facilities-phf. 25. In 1996, San Francisco opened an MHRC but wouldn’t staff it because unionized public employees would cost two million dollars a year more than private ones. Clarence Johnson, “S.F. Supervisor Unhappy with Empty Hospital,” San Francisco Chronicle, February 2, 1996. In 2001, an MHRC in Fresno that had been successful in returning patients to the community closed because its operating costs were “two to three times more than similar private programs.” Jim Davis, “Rehab Center’s Future Unsure,” Fresno Bee, September 9, 2001. 26. “Mental Health Misers,” Mercury News, July 3, 1985. 27. Internal data provided to the author in January 2021. ੮ ৲৸ੳ੮ {ʇ̼ɻʇ̼੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮"ʇ˦ʇϲʮ͐ͅ੮rr#ੴ੮ુ#˺͙˦͐;͸ʮʁʇ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮ä͙ɺ͐ͅɘ˦ɻʇ੮õͅʇ੮)ʮͅorder Needs Assessment” (Los Angeles: Los Angeles County Health Agency, August 15, ৲ৰৱ৹બੴ੮ৱ৶ੴ੮ʩ̹͐͐ͅੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱ৴৲৲৶৴ੳ̹ʁʠੳ 29. San Francisco Board of Supervisors Budget and Legislative Analyst (SF BLA), “Review of LPS Conservatorship,” January 10, 2022, iv; Los Angeles County Department of Mental Health, “Annual Report to the Board for Expanding Lanterman-Petris-Short and Probate Conservatorship Capacity” (Los Angeles, February 14, 2022), 4. 30. San Francisco Department of Public Health, “Behavioral Health Bed Optimization Project: Analysis and Recommendations for Improving Patient Flow” (San Francisco, June 2020), 6; see also Mercer, “Countywide Needs Assessment,” 109. ੮ ৳ৱੳ੮ îʩʮͅ੮ ͐ʇ̼˚੮ ʮͅ੮ ʠ̼˺˚੮ îʇ̼ʇͅɘ੮ Øɘͅή͙ʮ˦ʮ੮ ɘ˦ʁ੮ rɘ͙̼ʇ˦੮ Ûʇ͐͐ɘʡˑʮɘ͐ɘੴ੮ ુP˺͙ͅʮ˦ʡ੮ îʩɘ͐੮ Pʇɘˑͅੵ੮ ੮ Search for a Place Like Home for Families Like Ours,” May 2020, https://hth.ttinet.com ઃP˺͙ͅʮ˦ʡઢîʩɘ͐ઢPʇɘˑͅઢ৲ৰ৲ৰੳ̹ʁʠੳ 32. For example, in 2021 one-third of California’s patients at the subacute level met criteria for discharge but were waiting for step-down to a lower level of care. Ryan McBain et al., “Adult Psychiatric Bed Capacity, Need, and Shortage Estimates in California—2021” (Santa Monica, CA: Rand Corporation, 2022), 17, https://www.rand.org/pubs/research ઢ̼ʇ̹˺̼͐ͅઃĻÛৱ৸৲৴ચৱચͷ৲ੳʩ͐˚ˑੳ 33. There are at least some cases on which this legal advocacy seems to have had an impact. U˦੮äʇ̹͐ʇ˚ɺʇ̼੮৲ৰৱ৹ੴ੮ɘ੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮̹͙ɺˑʮɻ੮ʁʇʠʇ˦ʁʇ̼੮ή͙ʮΈΈʇʁ੮͐ʩʇ੮̹ˑɘɻʇ˚ʇ˦͐੮ɻ˺˺̼ʁʮ˦ɘ͐˺̼੮ from the Department of Public Health as to why his client had skipped ten places on the waitlist to get from jail into an IMD. “To get him out before this hearing, so we wouldn’t have to appear,” the coordinator replied. Joe Eskenazi, “Breaking: SF Health )ʇ̹͐ੳ੮ˑˑ˺͸ʇʁ੮{ʇ˦͐ɘˑ੮Øɘ͐ʮʇ˦͐੮͐˺੮äˌʮ̹੮Ĕɘʮ͐ˑʮ͐ͅ੮ʠ˺̼੮Øͅ;ɻʩ੮Hɘɻʮˑʮ͐;ઝä˺ˑʇˑ;੮͐˺੮ͷ˺ʮʁ੮rʇʡɘˑ੮ Scrutiny,” Mission Local, September 25, 2019, https://missionlocal.org/2019/09/breaking -sf-health-dept-allowed-mental-patient-to-skip-waitlist-for-psych-facility-solely-to -avoid-legal-scrutiny/. 34. SF BLA, “Review of LPS Conservatorship,” July 30, 2019, 7. 35. Los Angeles County Department of Mental Health, “Report Response to Addressing the Shortage of Mental Health Hospital Beds” (Los Angeles, October 29, 2019), 19–20.

352

7. LO C K E D I N

੮ ৳৶ੳ੮ îʩʇ੮˺˦ˑ;੮ʇͷɘˑ͙ɘ͐ʮ˺˦੮͙͐ͅʁ;੮U੮ɻ˺͙ˑʁ੮ϲʮ˦ʁ੮̼ʇ̹˺̼͐ʇʁ੮͐ʩɘ͐ੴ੮ʮ˦੮͐ʩʇ੮;ʇɘ̼੮ɘʠ͐ʇ̼੮ʁʮͅɻʩɘ̼ʡʇ੮ʠ̼˺˚੮ an IMD, more than half of individuals spent at least ninety days in a hospital, jail, or another IMD, suggesting that the stabilizing effects of an IMD stay were not enduring. rɘ˚ɺ੮ɘ˦ʁ੮Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ુš˦ʇચĚʇɘ̼੮H˺ˑˑ˺͸ચõ̹ੳૂ

8. STEPPED DOWN ੮ ৱੳ੮ /ʮʁʇ੮ɘ̼ʡ͙ʇͅ੮͐ʩɘ͐੮͐ʩʇ੮ʁʇɻˑʮ˦ʮ˦ʡ੮ɘͷɘʮˑɘɺʮˑʮ͐;੮˺ʠ੮ુˑ˺͸ચή͙ɘˑʮ͐;ૂ੮ʩ˺͙ͅʮ˦ʡ੮ˑʮˌʇ੮äۚͅ੮˺̼੮ɺ˺ɘ̼ʁ੮ and cares is a key driver of the contemporary crisis of chronic homelessness. Stephen Eide, P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡ‫ףת‬îɲɐ‫ף‬Pɷ̙̎˃͇̅‫ף‬ȡʯɊ‫ף‬î̅ȡɪɐɊ͇‫˃ף‬ɩ‫ף‬ȡʯ‫ף‬Uʯ̙̅ȡɄ͗ȡɃʚɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬Ø̅˃Ƀʚɐʣ (Lanʩɘ˚ੴ੮{)ੵ੮Û˺͸˚ɘ˦੮૟੮rʮ͐͐ˑʇϲʮʇˑʁੴ੮৲ৰ৲৲બੴ੮৲৵ੳ 2. A journalist recently uncovered one revealing example of how some operators view ͐ʩʇʮ̼੮ ɻˑʮʇ˦͐ͅੵ੮ ϲʮͷʇ੮ ̼ʇͅʮʁʇ˦͐ʮɘˑ੮ ʠɘɻʮˑʮ͐ʮʇͅ੮ ʮ˦੮ ä˺͙͐ʩʇ̼˦੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ɘ̼ʇ੮ ˺͸˦ʇʁ੮ ɺ;੮ {ʇͅʩ͙ʡɘ੮ Operations Holdings LLC. “Meshuga” is the Yiddish word for “crazy.” Thomas Curwen, ુ੮Ĕ˺̼ˑʁ੮I˺˦ʇ੮{ɘʁੵ੮äɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ɘ˦ʁ੮ɘ੮k˺͙̼˦ʇ;੮͐ʩ̼˺͙ʡʩ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮Hɘʮˑʇʁ੮{ʇ˦͐ɘˑ੮ Health System,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, December 8, 2022, https://www.latimes.com/california /story/2022-12-08/young-mans-life-with-schizophrenia. ੮ ৳ੳ੮ Ûʮɻʩɘ̼ʁ੮Pੳ੮rɘ˚ɺ੮ɘ˦ʁ੮rʮ˦ʁɘ੮/ੳ੮Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ુ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʠ˺̼੮I̼ɘͷʇˑ;੮)ʮͅɘɺˑʇʁ੮Øͅ;chiatric Patients: A Four-Year Follow-Up Study,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅, no. 149 (1992): 909. 4. After LPS, “tens of thousands of patients from the big asylums streamed out across the ͐ͅɘ͐ʇੴ੮˺ͷʇ̼͸ʩʇˑ˚ʮ˦ʡ੮͐ʩʇ੮͙˦̹̼ʇ̹ɘ̼ʇʁ੮ɻ˺͙˦͐;੮ɘ˦ʁ੮̹̼ʮͷɘ͐ʇ੮̼͐ʇɘ͐˚ʇ˦͐੮ɘʡʇ˦ɻʮʇͅ੮ɘ˦ʁ੮ϲˑ˺˺ʁʮ˦ʡ੮ the streets and the criminal justice system.” Ron Powers, ‡˃‫šף‬ʯɐ‫ף‬#ȡ̅ɐ̎‫ף‬Ƀ˃̢̙‫ף‬#̅ȡ͇͑‫ף‬Øɐ˃̂ʚɐ‫ףת‬ îɲɐ‫ף‬#ɲȡ˃̎‫ף‬ȡʯɊ‫ף‬Pɐȡ̙̅Ƀ̅ɐȡʕ‫˃ף‬ɩ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡ (New York: Hachette, 2017), 194. Deinstitutionalization was an “unplanned social disaster.” Pete Earley, Crazy: A Father’s äɐȡ̅Ʉɲ‫ף‬îɲ̅˃̢ɪɲ‫ף‬ʣɐ̅ɷɄȡ‫{ף̎إ‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫{ף‬ȡɊʯɐ̎̎ (New York: Putnam, 2006), 71. The “most massive movement of medical care in twentieth-century America” had “no master plan, no coordination, no corrective mechanism, no authority, no one in charge.” E. Fuller Torrey, ʣɐ̅ɷɄȡʯ‫ף‬Ø͇̎Ʉɲ˃̎ɷ̎‫ףת‬P˃́‫̙ף‬ɲɐ‫ף‬HɐɊɐ̅ȡʚ‫ף‬I˃̀ɐ̅ʯʣɐʯ̙‫)ף‬ɐ̙̎̅˃͇ɐɊ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬î̅ɐȡ̙ʣɐʯ̙‫ף‬ System (Oxford: Oxford University Press, 2013), 94. 5. James T. Barter, “California: Transformation of Mental Health Care: 1957–1982,” New )ɷ̅ɐɄ̙ɷ˃ʯ̎‫ף‬ɩ˃̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬äɐ̅̀ɷɄɐ̎ 1983, no. 18 (1983): 10,. ੮ ৶ੳ੮ ુ)˺Έʇ˦ͅ੮ ˺ʠ੮ #ʩʮˑʁ̼ʇ˦੮ ɘ˦ʁ੮ ʁ͙ˑ͐ͅ੮ r˺˺ˌʮ˦ʡ੮ ʠ˺̼੮ ૃPɘˑʠચĔɘ;ૄ੮ P˺˚ʇͅੴૂ੮ r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, October 20, 1968. 7. Eugene Bardach, îɲɐ‫ף‬Uʣ̂ʚɐʣɐʯ͗ȡ̙ɷ˃ʯ‫ף‬Iȡʣɐ‫ףת‬Ĕɲȡ̙‫ף‬Pȡ̂̂ɐʯ̎‫ף‬ɩ̙ɐ̅‫ף‬ȡ‫"ף‬ɷʚʚ‫"ף‬ɐɄ˃ʣɐ̎‫ף‬ȡ‫ף‬rȡ́ (Cambridge, MA: MIT Press, 1977), 161. ੮ ৸ੳ੮ ˦ʁ̼ʇ͸੮äɻ͙ˑˑੴ੮ુ੮‡ʇ͸੮î̼ɘʁʇ੮ʮ˦੮r͙˦ɘɻ;ੵ੮îʩʇ੮Ûʇɻ˺˚˚˺ʁʮϲʮɻɘ͐ʮ˺˦੮˺ʠ੮͐ʩʇ੮{ʇ˦͐ɘˑ੮Øɘ͐ʮʇ˦͐ੴૂ੮ American Behavioral Scientist 24, no. 6 (1981): 747. ੮ ৹ੳ੮ ä͐ʇͷʇ˦੮Øੳ੮äʇʡɘˑੴ੮kʮ˚੮"ɘ͙˚˺ʩˑੴ੮ɘ˦ʁ੮/ʁ͸ʮ˦੮Ĕੳ੮{˺;ˑʇͅੴ੮ુ‡ʇʮʡʩɺ˺̼ʩ˺˺ʁ੮î;̹ʇͅ੮ɘ˦ʁ੮#˺˚munity Reaction to the Mentally Ill: A Paradox of Intensity,” k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Pɐȡʚ̙ɲ‫ף‬ȡʯɊ‫ף‬ä˃Ʉɷȡʚ‫ף‬ Behavior 21, no. 4 (1980): 345–59. 10. Robert M. Emerson, E. Burke Rochford, and Linda L. Shaw, “Economics and Enterprise in Board and Care Homes for the Mentally Ill,” American Behavioral Scientist 24, no. 6 (1981): 771–85.

8. STEPPED DOWN 11.

353

Doug Shuit, “Board and Care: A New Approach to Mental Illness,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, May 13, 1972. 12. Andrew Scull, The Insanity of Place / The Place of Insanity: Essays on the History of Psychiatry (London: Routledge, 2006), 93. 13. Legislative Analyst, “Overview of the Public Mental Health System in California” (Sac̼ɘ˚ʇ˦͐˺ੴ੮#ੴ੮ৱ৹৸৴બੳ੮š͐ʩʇ̼੮ϲʮʡ͙̼ʇͅ੮̹͙͐੮ʮ͐੮ɘ͐੮৶৴ੴৰৰৰੳ੮îʇˌ˦ʇˌ̼˺˦੮U˦ɻੳੴ੮ુU˚̹̼˺ͷʮ˦ʡ੮#ɘˑʮfornia’s Mental Health System: Policymaking and Management in the Invisible System” (Berkeley: California Assembly Permanent Subcommittee on Mental Health and Developmental Disabilities, December 1978), 3. The federal government in 1980 estimated that there were at least 300,000 people in such facilities nationally, most of them “substandard, isolating, and a form of ‘trans-institutionalization’ and continued neglect.” Steering Committee on the Chronically Mentally Ill, “Toward a National Plan for the Chronically Mentally Ill” (Rockville, MD: U.S. Department of Health and Human Services, December 1980),” 2–20. 14. Richard H. Lamb and Marjorie B. Edelson, “The Carrott and the Stick: Inducing Local Programs to Serve Long-Term Patients,” #˃ʣʣ̢ʯɷ̙͇‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬k˃̢̅ʯȡʚ 12, no. 2 (1976): 139. 15. Bardach, îɲɐ‫ף‬Uʣ̂ʚɐʣɐʯ͗ȡ̙ɷ˃ʯ‫ף‬Iȡʣɐ, 161. ੮ ৱ৶ੳ੮ Øɘ͙ˑ੮kɘɻ˺ɺͅੴ੮ુ{ʇ˦͐ɘˑˑ;੮Uˑˑੵ੮îʩʇ੮Ĕɘ;੮ä͐ɘ͐ʇ੮Hʮͽʇͅ੮"ʇ˦ʇϲʮ͐ͅੴ੮îʩʇ;ૄ̼ʇ੮r͙ɻˌ;੮Uϲ੮îʩʇ;੮̼ʇ੮ˑͅ˺੮ Retarded,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, May 19, 1985. 17. Lisa O’Neill, “Home for Mentally Ill May Lose Its License,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, February 24, 1995. 18. Jack Leonard, “State to Revoke Board-Care Home’s License,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, January 15, 2005. ੮ ৱ৹ੳ੮ îʩʇ੮ɘɺͅʇ˦ɻʇ੮˺ʠ੮͐ͅɘ͐ʇ੮̹˺ˑʮɻ;੮ʮͅ੮ʁ˺ɻ͙˚ʇ˦͐ʇʁ੮ʮ˦੮k˺˦ɘ͐ʩɘ˦੮Ĕʮͅ˦ʇ̼ੴ੮ુ‡˺੮îʮ˚ʇ੮͐˺੮Ĕɘ͐ͅʇੵ੮˦੮ Imminent Housing Crisis for People with Serious Mental Illness Living in Adult Residential Facilities” (Los Angeles: Heart Forward, October 2021). 20. Caroline Kelly et al., “A Call to Action: The Precarious State of the Board and Care System Serving Residents Living with Mental Illness in Los Angeles County” (Los Angeles: County Mental Health Commission, January 22, 2018), 7; see also California Mental Health Planning Council, “Adult Residential Facilities (ARFs): Highlighting the Critical Need for Adult Residential Facilities for Adults with Serious Mental Illness in California” (October 2017). 21. Los Angeles County Department of Mental Health, “Addressing the Ongoing Board ɘ˦ʁ੮ #ɘ̼ʇ੮ #̼ʮͅʮͅૂ੮ ફr˺ͅ੮ ˦ʡʇˑʇͅੴ੮ {ɘ̼ɻʩ੮ ৴ੴ੮ ৲ৰ৲৲બੴ੮ ৱ৴ੴ੮ ʩ̹͐͐ͅੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ /bos/supdocs/141894.pdf. In San Diego, 146 of 781 licensed ARFs have closed since 2017. Behavioral Health Services, “Optimal Care Pathways Model” (San Diego County, CA: Board of Supervisors, September 27, 2022), 16, https://bosagenda.sandiegocounty.gov ઃɻ˺ɺઃɻ˺ͅʁઃɻ˺ɺઃʁ˺ɻ੺ʮʁଵৰ৹ৰৱৱ৲৷ʇ৸ৰʠৱ৳ɺ৶ɘੳ ੮ ৲৲ੳ੮ k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુšͷʇ̼ˑ˺˺ˌʇʁ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ૃ#ɘ͐ɘ̼͐ͅ˺̹ʩʇૄੵ੮ēɘ˦ʮͅʩʮ˦ʡ੮"˺ɘ̼ʁચɘ˦ʁચ#ɘ̼ʇચ Homes Leave Residents with Few Options,” CalMatters, April 15, 2019, https://calmatters .org/articles/board-and-care-homes-closing-in-california-mental-health-crisis/. 23. This shift was reported to me by two individuals who worked as ombudspeople with the state Department of Aging. For additional documentation, see Kelly et al., “A Call to

354

8. STEPPED DOWN

Action,” 4; Doug Smith, “To Stop Adults with Mental Illness from Losing Their Housing, L.A. County May Intervene,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, November 6, 2019, https://www.latimes.com /california/story/2019-11-06/homeless-housing-board-and-care-homes-mental-illness. 24. Residential homes for people with developmental disabilities typically receive between $85 and $150 a day but face much greater state oversight through the Regional Center system. 25. Hector Tobar and Jeff Brazil, “Boarding Home Abductions on the Rise,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Timesੴ੮ äʇ̹͐ʇ˚ɺʇ̼੮ ৱ৶ੴ੮ ৱ৹৹৶੶੮ kʇʠʠ੮ "̼ɘΈʮˑੴ੮ ુØ̼˺ϲʮ͐ʮ˦ʡ੮ ɺ;੮ Ø̼ʇ;ʮ˦ʡ੮ ˺˦੮ ͐ʩʇ੮ Ø˺˺̼ੴૂ੮ r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Times, December 22, 1996. 26. Kelly et al., “A Call to Action,” 10. 27. Kelly et al., “A Call to Action,” 12. 28. The rate of conservatees is higher—like 90 or 95 percent—for “augmented” board and cares like Psynergy in Morgan Hill, which provides much more intensive services that counties have to pay for directly. ੮ ৲৹ੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৳৵৸ੳ৵ੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ ੳͽʩ͐˚ˑ੺ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৳৵৸ੳ৵ੳ 30. Overall, people with schizophrenia who take antipsychotic medications have lower mortality rates than those who do not. However, prolonged use of higher doses may ultimately increase mortality. J. Vermeulen et al., “Antipsychotic Medication and Long-Term Mortality Risk in Patients with Schizophrenia: A Systematic Review and Meta-Analysis,” Ø͇̎Ʉɲ˃ʚ˃ɪɷɄȡʚ‫{ף‬ɐɊɷɄɷʯɐ 47, no. 13 (2017): 2217–28. ੮ ৳ৱੳ੮ U˦ʠ˺̼˚ɘ˦͐ͅ੮ʁʇͅɻ̼ʮɺʇʁ੮ɘ੮ʡ̼˺͸ʮ˦ʡ੮Ĕʮˑʁ੮Ĕʇ͐ͅ੮˺ʠ੮͙˦ˑʮɻʇ˦ͅʇʁ੮ɺ˺ɘ̼ʁ੮ɘ˦ʁ੮ɻɘ̼ʇ੮ʩ˺˚ʇͅ੮ફͅ˺˚ʇtimes called room and boards) that lure people by promising that, with a lower rent ફɻˑ˺ͅʇ̼੮͐˺੮ϲʮͷʇ੮ʩ͙˦ʁ̼ʇʁ੮ʁ˺ˑˑɘ̼ͅ੮ɘ੮˚˺˦͐ʩબੴ੮̼ʇͅʮʁʇ˦͐ͅ੮ɻɘ˦੮ˌʇʇ̹੮˚˺̼ʇ੮˺ʠ੮͐ʩʇʮ̼੮ääU੮ɻʩʇɻˌੳ ੮ ৳৲ੳ੮ îʩʮͅ੮̹ʩ̼ɘͅʇ੮ʮͅ੮ɺ˺̼̼˺͸ʇʁ੮ʠ̼˺˚੮#ɘ͐ʩ;੮Ĕɘ̼˦ʇ̼ੴ੮͐ʩʇ੮)ʇ̹͙͐;੮)ʮ̼ʇɻ͐˺̼੮˺ʠ੮r˺ͅ੮˦ʡʇˑʇͅ੮){Pੳ੮ äʇʇ੮{ɘ̼ɻʮɘ੮{ʇˑʁ̼͙˚ੴ੮ુU˦͐ʇ̼ͷʮʇ͸੮͸ʮ͐ʩ੮#ɘ͐ʩ;੮Ĕɘ̼˦ʇ̼ੴૂ੮õ#r‫ף‬P˃̂ɐ‫ף‬ä̙˃͇̅‫ף‬Ø̅˃ʑɐɄ̙, accessed October 28l 2022, https://hpmh.semel.ucla.edu/oral-histories/#1614060063588-5e5e4b79 -62de. 33. Sandra R. Levitsky, #ȡ̅ɷʯɪ‫ף‬ɩ˃̅‫́šף̢̅šף‬ʯ‫ףת‬Ĕɲ͇‫ף‬îɲɐ̅ɐ‫ף‬U̎‫ף˃‡ף‬Ø˃ʚɷ̙ɷɄȡʚ‫)ף‬ɐʣȡʯɊ‫ף‬ɩ˃̅‫‡ף‬ɐ́‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷȡʚ‫ף‬Ĕɐʚ͖ȡ̅ɐ‫ף‬Ûɷɪɲ̙̎ (Oxford: Oxford University Press, 2014). 34. Not all the facilities that closed cater to people with mental illness. Yet, given that payments are higher for other populations potentially living in board and cares (people who are elderly, homeless, or living with developmental disabilities), it seems likely that homes serving people with mental illness made up the lion’s share of closures. 35. These reforms are detailed in Los Angeles County Department of Mental Health, “Addressing the Ongoing Board and Care Crisis.”

9. NEGLECT AND ABUSE 1.

Erving Goffman, ä̙ɷɪʣȡ‫̙˃‡ףת‬ɐ̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫{ף‬ȡʯȡɪɐʣɐʯ̙‫˃ף‬ɩ‫ף‬ä̂˃ɷʚɐɊ‫ף‬UɊɐʯ̙ɷ̙͇ (Englewood Cliffs, ‡ĩੵ੮Ø̼ʇ˦͐ʮɻʇ੮Pɘˑˑੴ੮ৱ৹৶৳બੴ੮৳ੳ ੮ ৲ੳ੮ /ͅ˚ʋ੮Ĕʇʮˈ͙˦੮Ĕɘ˦ʡੴ੮The Collected Schizophrenias (Minneapolis, MN: Graywolf, 2019), 104. 3. “Mental Commitment Abuse,” San Francisco Chronicleੴ੮k͙˦ʇ੮৲৷ੴ੮ৱ৹৷৵ੳ੮ͅ੮͐ʩʇ੮ϲʮ̼͐ͅ੮˚ɘˈ˺̼੮ evaluation of LPS concluded, “the ‘gravely disabled’ category may have been used as a

9. N E G L E C T A N D A B U S E

4.

5. 6. ੮ ৷ੳ੮

8. 9.

10.

੮ ৱৱੳ੮ 12.

13.

੮ ৱ৴ੳ੮ 15. ੮ ৱ৶ੳ੮

17.

355

ɻɘ͐ɻʩɘˑˑ੮ʠ˺̼੮̹ɘ͐ʮʇ˦͐ͅ੮͐ʩʇ੮ʩ˺̹ͅʮ͐ɘˑ੮ʠʇˑ͐੮ʮ͐੮ɻ˺͙ˑʁ੮˦˺͐੮ʩ˺ˑʁ੮͙˦ʁʇ̼੮͐ʩʇ੮̼͐ͅʮɻ͐ʇ̼੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ય˺ʠ੮ dangerousness].” ENKI Research Institute, “A Study of California’s New Mental Health Law” (Chatsworth, CA, 1972), 155. Teknekron Inc., “Improving California’s Mental Health System: Policymaking and Management in the Invisible System” (Berkeley: California Assembly Permanent Subcommittee on Mental Health and Developmental Disabilities, December 1978), 167. Erving Goffman, ͇̎ʚ̢ʣ̎‫ףת‬/̎̎ȡ͇̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬äɷ̢̙ȡ̙ɷ˃ʯ‫˃ף‬ɩ‫{ף‬ɐʯ͗ȡʚ‫ף‬Øȡ̙ɷɐʯ̙̎‫ף‬ȡʯɊ‫̙šף‬ɲɐ̅‫ף‬Uʯʣȡ̙ɐ̎ (New York: Anchor, 1961), 135. Leigh Fenly, “Gravely Disabled? Court May Stop Man’s Career,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ, April 28, 1978. ੮ˑɘ͐ʇ̼੮ɘ̼͐ʮɻˑʇ੮͙ͅʡʡʇ͐ͅʇʁ੮͐ʩʇ̼ʇ੮͸ɘͅ੮ή͙ʮ͐ʇ੮ɘ੮ɺʮ͐੮˚˺̼ʇ੮͐˺੮͐ʩʇ੮͐ͅ˺̼;ੳ੮{ʮɻʩɘʇˑ੮Ø੮ʁʇͷʇˑ˺̹ʇʁ੮ psychosis after taking mescaline; he had two passages through the state hospital before the county made a conservatorship application. In any case, at trial, Michael’s psychia̼͐ʮ͐ͅ੮͐ʇ͐ͅʮϲʮʇʁ੮͐ʩɘ͐੮ʩʮͅ੮ͅɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮͸ɘͅ੮ʮ˦੮̼ʇ˚ʮͅͅʮ˺˦੮ɘ˦ʁ੮͐ʩɘ͐੮ʩʇ੮͸ɘͅ੮˦˺੮ˑ˺˦ʡʇ̼੮ʡ̼ɘͷʇˑ;੮ disabled; the judge denied the petition. Leigh Fenly, “Court Gives Michael P. a New Lease on Life,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ, May 24, 1978. Leigh Fenly, “Patients Lose Rights, Freedom,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ, April 9, 1978. Richard Neugebauer, “Diagnosis, Guardianship, and Residential Care of the Mentally Ill in Medieval and Early Modern England,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 146, no. 12 (1989): 1581. By contrast to the treatment of “idiots,” guardians were expected to maintain “lunatics” at their previous standard of living. Gertrude Bonnin, Charles Fabens, and Matthew Sniffen, “Oklahoma’s Poor Rich Indians: An Orgy of Graft and Exploitation of the Five Civilized Tribes—Legalized Robbery” (Philadelphia: Indian Rights Association, 1924), 6. {ɘ̼͐ʩɘ੮Ĕʮˑˑ˚ɘ˦ੴ੮ુ#˺͙˦͐;੮#˺˦ϲʮͅɻɘ͐ʇͅ੮Ø̼˺̹ʇ̼͐;ੵ੮ૃ)ʮ̼͐;੮äɘˑˑ;ૄ੮#ɘ˦ૄ͐੮I˺੮P˺˚ʇੴૂ੮r˃̎‫ף‬ʯɪɐles Times, January 15, 1976. Ronan Farrow and Gia Tolentino, “Britney Spears’ Conservatorship Nightmare,” New Yorker, July 3, 2021, https://www.newyorker.com/news/american-chronicles/britney -spears-conservatorship-nightmare. Heidi Blake and Katie Baker, “Beyond Britney: Abuse, Exploitation, and Death Inside America’s Guardianship Industry,” BuzzFeed News, September 17, 2021, https://www .buzzfeednews.com/article/heidiblake/conservatorship-investigation-free-britney-spears. Û˺ɺʮ˦੮ Hʮʇˑʁͅੴ੮ /ͷʇˑ;˦੮ rɘ̼̼͙ɺʮɘੴ੮ ɘ˦ʁ੮ kɘɻˌ੮ rʇ˺˦ɘ̼ʁੴ੮ ુI͙ɘ̼ʁʮɘ˦ͅ੮ ʠ˺̼੮ Ø̼˺ϲʮ͐ੴૂ੮ r˃̎‫ ף‬ʯɪɐʚɐ̎‫ף‬ Times, November 13, 2005. Rachel Aviv, “How the Elderly Lose Their Rights,” New Yorker, October 2, 2017, https:// www.newyorker.com/magazine/2017/10/09/how-the-elderly-lose-their-rights. îʩʇ̼ʇ੮˚ɘ;੮ɺʇ੮ɘ੮ʁʮʠʠʇ̼ʇ˦͐੮ˌʮ˦ʁ੮˺ʠ੮ϲʮ˦ɘ˦ɻʮɘˑ੮ʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦੮˺ʠ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੴ੮ʩ˺͸ʇͷʇ̼ੳ੮ Several public defenders reported that, in their counties, the public guardian takes a ͅʮʡ˦ʮϲʮɻɘ˦͐੮ɻ͙͐੮˺ʠ੮͐ʩʇʮ̼੮ɻˑʮʇ˦͐ͅૄ੮˚ʇɘʡʇ̼੮ääU੮ɻʩʇɻˌͅ੮͐˺੮ʩʇˑ̹੮ϲʮ˦ɘ˦ɻʇ੮͐ʩʇʮ̼੮˺ϲϲʮɻʇੳ Adrianna Bagnall and Gil Eyal, “Forever Children and Autonomous Citizens: Comparing the Deinstitutionalizations of Psychiatric Patients and Developmentally Disabled Individuals in the United States,” in Hɷɩ̙͇‫ף‬Ěɐȡ̅̎‫ף‬ɩ̙ɐ̅‫)ף‬ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ͑ȡ̙ɷ˃ʯ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬ in Contemporary Communities, ed. Brea L. Perry (Bingley, UK: Emerald, 2016), 27–61; National Council on Disability, “Turning Rights Into Reality: How Guardianship and

356

9. N E G L E C T A N D A B U S E

Alternatives Impact the Autonomy of People with Intellectual and Developmental Disabilities,” June 10, 2019, 29, https://ncd.gov/publications/2019/turning-rights-into-reality. 18. Robert Perske, “The Dignity of Risk and the Mentally Retarded,” {ɐʯ͗ȡʚ‫ף‬Ûɐ͗ȡ̅Ɋȡ̙ɷ˃ʯ 10, no. 1 (1972): 24–27. 19. Neil Gong describes this approach of leaving public mental health clients to deal with ͐ʩʇ੮ɻ˺˦ͅʇή͙ʇ˦ɻʇͅ੮˺ʠ੮͐ʩʇʮ̼੮ɘɻ͐ʮ˺˦ͅ੮ɘͅ੮ુ͐˺ˑʇ̼ɘ˦͐੮ɻ˺˦͐ɘʮ˦˚ʇ˦͐ੳૂ 20. National Council on Disability, “Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination,” March 22, 2018, 98, https://ncd.gov/publications/2018 /beyond-guardianship-toward-alternatives. 21. For more on the public guardians’ “trouble performing basic services for their clients, such ɘͅ੮ͅʩ˺̹̹ʮ˦ʡ੮ʠ˺̼੮ɻˑ˺͐ʩʇͅ੮˺̼੮ɘɻή͙ʮ̼ʮ˦ʡ੮ɘ੮ɻʇˑˑ੮̹ʩ˺˦ʇੴ੮ʮ˦੮ɘ੮͐ʮ˚ʇˑ;੮ʠɘͅʩʮ˺˦ૂ੮ʁ͙ʇ੮͐˺੮ʡ̼˺͸ʮ˦ʡ੮ɻɘͅʇloads, see Humboldt County Grand Jury, “BeHOLD: The Department of Mental Health’s {ɘ˦ɘʡʇ˚ʇ˦͐੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦੮šϲϲʮɻʇ੮ɘ˦ʁ੮Øɘ͐ʮʇ˦͐ͅૄ੮Ûʮʡʩ͐ͅ੮ʁͷ˺ɻɘ͐ʇૂ੮ફP͙˚ɺ˺ˑʁ͐ੴ੮ CA, 2020), 7, https://humboldtgov.org/DocumentCenter/View/87426/BeHOLD---The ચ)ʇ̹͐ચ˺ʠચ{ʇ˦͐ɘˑચPʇɘˑ͐ʩͅચ{ʡ˚͐ચ˺ʠચ͐ʩʇચØ͙ɺˑʮɻચI͙ɘ̼ʁʮɘ˦ચšϲϲʮɻʇચɘ˦ʁચØɘ͐ʮʇ˦͐ͅચÛʮʡʩ͐ͅ -Advocate. 22. João Biehl, ēɷ͗ȡ‫ףת‬rɷɩɐ‫ף‬ɷʯ‫ף‬ȡ‫ף‬Ĥ˃ʯɐ‫˃ף‬ɩ‫ף‬ä˃Ʉɷȡʚ‫ף‬ɃȡʯɊ˃ʯʣɐʯ̙ (Berkeley: University of California Press, 2013), 4. 23. Michael Lipsky, ä̙̅ɐɐ̙؅rɐ̀ɐʚ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡɄ͇‫)ףת‬ɷʚɐʣʣȡ̎‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬UʯɊɷ̀ɷɊ̢ȡʚ‫ף‬ɷʯ‫ף‬Ø̢ɃʚɷɄ‫ף‬äɐ̅̀ɷɄɐ, thirtieth anniversary ed. (New York: Russell Sage Foundation, 2010), 181. 24. Department of Auditor-Controller, “Management Audit of the Department of Mental Pʇɘˑ͐ʩઝšϲϲʮɻʇ੮˺ʠ੮͐ʩʇ੮Ø͙ɺˑʮɻ੮I͙ɘ̼ʁʮɘ˦ૂ੮ફr˺ͅ੮˦ʡʇˑʇͅੵ੮#˺͙˦͐;੮˺ʠ੮r˺ͅ੮˦ʡʇˑʇͅੴ੮{ɘ;੮ৱৱੴ੮ 2005), 67. 25. Blake and Baker, “Beyond Britney.” 26. As usual, this varies among counties: Sacramento reported that one person lost voting rights from 2014 to 2015, whereas 132 did in Los Angeles. These reports do not specify how many of those individuals were on LPS versus probate conservatorships. Dan Morain, “Stepping Toward Full Voting Rights,” East Bay Times, August 15, 2015, https:// www.eastbaytimes.com/2015/08/17/dan-morain-stepping-toward-full-voting-rights/. ੮ ৲৷ੳ੮ îʩʇ੮ ɘɻ͙͐ɘˑ੮ ʇϲϲʮɻɘɻ;੮ ˺ʠ੮ ʮ˦̹ɘ͐ʮʇ˦͐੮ ʩ˺̹ͅʮ͐ɘˑʮΈɘ͐ʮ˺˦੮ ʮ˦੮ ̹̼ʇͷʇ˦͐ʮ˦ʡ੮ ͙ͅʮɻʮʁʇੴ੮ ʡʮͷʇ˦੮ ʇͽ̼͐ɘ˺̼ʁʮ˦ɘ̼;੮̼ɘ͐ʇͅ੮˺ʠ੮͙ͅʮɻʮʁʇ੮̼ʮʡʩ͐੮ɘʠ͐ʇ̼੮ʁʮͅɻʩɘ̼ʡʇੴ੮ʮͅ੮ɻ˺˦͐ʇ͐ͅʇʁੳ੮/̼ʮ˦੮Hੳ੮Ĕɘ̼ʁચ#ʮʇͅʮʇˑͅˌʮ੮ɘ˦ʁ੮ Shireen L. Rizvi, “The Potential Iatrogenic Effects of Psychiatric Hospitalization for Suicidal Behavior: A Critical Review and Recommendations for Research,” Clinical PsyɄɲ˃ʚ˃ɪ͇‫ףת‬äɄɷɐʯɄɐ‫ף‬ȡʯɊ‫ף‬Ø̅ȡɄ̙ɷɄɐ 28, no. 1 (2021): 60–71. ੮ ৲৸ੳ੮ ä˺͙˚;ɘ੮ nɘ̼ˑɘ˚ɘ˦ʡˑɘੴ੮ ુîʩʇʮ̼੮ #ʩʮˑʁ̼ʇ˦੮ )ʮʇʁ੮ ˺˦੮ ɘ੮ Øͅ;ɻʩ੮ Ĕɘ̼ʁੳ੮ Ĕɘͅ੮ U͐੮ Ø̼ʇͷʇ˦͐ɘɺˑʇ੺ૂ੮ r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, December 1, 2019, https://www.latimes.com/california/story/2019-12-01 /psychiatric-hospital-deaths-california. More recently, the characteristics of psychiatric ʠɘɻʮˑʮ͐ʮʇͅઝʠ̼ʇή͙ʇ˦͐੮ɻ˺˚˺̼ɺʮʁ੮˚ʇʁʮɻɘˑ੮ʮ͙ͅͅʇͅ੮ɘ˚˺˦ʡ੮̹ɘ͐ʮʇ˦͐ͅੴ੮ʁʮϲϲʮɻ͙ˑ͐;੮ʇ˦ʠ˺̼ɻʮ˦ʡ੮ͅ˺ɻʮɘˑ੮ʁʮͅtancing, and an unwillingness of facilities to transfer patients to open settings—made them particularly vulnerable to COVID. The Department of State Hospitals resisted calls to draw ʁ˺͸˦੮ʮ͐ͅ੮ɻʇ˦͙ͅͅ੮ફɘͅ੮˚ɘ˦;੮̹̼ʮͅ˺˦ͅ੮ɘ˦ʁ੮ˈɘʮˑͅ੮ʩɘʁ੮ʁ˺˦ʇબੴ੮ʇͷʇ˦੮ɘͅ੮ϲʮʠ͐;ચͅʮͽ੮̹ɘ͐ʮʇ˦͐ͅ੮ʁʮʇʁ੮˺ʠ੮͐ʩʇ੮ʁʮͅease. “California Argues Mentally Ill Patients Must Stay Put at State Hospital Despite COVID Outbreak,” Mercury News, January 11, 2021, https://www.sbsun.com/2021/01/10/state-argues -mentally-ill-patients-must-stay-put-at-patton-state-hospital-despite-covid-outbreak/.

9. N E G L E C T A N D A B U S E

357

੮ ৲৹ੳ੮ Ûʇɺʇɻɻɘ੮nʮ˚ʮ͐ɻʩੴ੮ુäɘʠʇ͐;੮ĺ͙ʇ͐ͅʮ˺˦ʇʁ੮ɘ͐੮r˺˦ʡ੮"ʇɘɻʩ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮Hɘɻʮˑʮ͐;ੴૂ੮UʯʚȡʯɊ‫ף‬ēȡʚʚɐ͇‫) ף‬ȡɷʚ͇‫̢" ף‬ʚʚɐ̙ɷʯ, September 22, 2013, https://www.dailybulletin.com/2013/09/22/safety ચή͙ʇ͐ͅʮ˺˦ʇʁચɘ͐ચˑ˺˦ʡચɺʇɘɻʩચ˚ʇ˦͐ɘˑચʩʇɘˑ͐ʩચʠɘɻʮˑʮ͐;ઃੳ 30. A r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎ database found multiple incidents of sexual assaults between patients at John George. Soumya Karlamangla and Iris Lee, “Database of Deaths and Assaults at California Psychiatric Facilities,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣes, December 1, 2019, https://www .latimes.com/projects/psychiatric-hospital-deaths-incidents-database/. 31. Joshua T. Jordan and Dale E. McNiel, “Perceived Coercion During Admission Into Psychiatric Hospitalization Increases Risk of Suicide Attempts After Discharge,” Suicide ȡʯɊ‫ף‬rɷɩɐ؅îɲ̅ɐȡ̙ɐʯɷʯɪ‫"ף‬ɐɲȡ̀ɷ˃̅ 50, no. 1 (2020): 180–88; Diana Paksarian et al., “Perceived Trauma During Hospitalization and Treatment Participation Among Individuals with Psychotic Disorders,” Psychiatric Services 65, no. 2 (2014): 266–69. 32. Department of State Hospitals, “Violence Report: 2010–2019,” September 2020, 14, ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁͅʩੳɻɘੳʡ˺ͷઃØ͙ɺˑʮɻɘ͐ʮ˺˦ͅઃÛʇ̹˺̼͐ͅઢɘ˦ʁઢ)ɘ͐ɘઃʁ˺ɻͅઃ)äPઢēʮ˺ˑʇ˦ɻʇÛʇ̹˺̼͐ ઢ৲ৰৱৰચ৲ৰৱ৹ੳ̹ʁʠੳ 33. Susan Goldsmith, “The Lunatics Have Taken Over the Asylum,” /ȡ̙̎‫"ף‬ȡ͇‫ף‬/͆̂̅ɐ̎̎, February 18, 2004, https://eastbayexpress.com/the-lunatics-have-taken-over-the-asylum-1/. 34. U.S. Bureau of Labor Statistics, “Psychiatric Technicians and Aides,” Occupational Outlook PȡʯɊɃ˃˃ʕ, October 4, 2022, https://www.bls.gov/ooh/healthcare/psychiatric-technicians -and-aides.htm#tab-3. ੮ ৳৵ੳ੮ äɻ˺͐͐੮Ĥʇˑˑʇ̼ੴ੮‡ʮɻ˺ˑʇ੮#ɘˑ˚ɘੴ੮ɘ˦ʁ੮ͅʩˑʇ;੮ä͐˺˦ʇੴ੮ુ/ʠʠʇɻ͐ͅ੮˺ʠ੮ɘ੮)ʇʁʮɻɘ͐ʇʁ੮Ûʇʡʮ˺˦ɘˑ੮Øͅ;ɻʩʮatric Emergency Service on Boarding of Psychiatric Patients in Area Emergency Departments,” Ĕɐ̙̎k/{ 15, no. 1 (2014): 1–6. 36. U.S. Department of Justice, “Investigation of Alameda County, John George Psychiatric P˺̹ͅʮ͐ɘˑੴ੮ɘ˦ʁ੮äɘ˦͐ɘ੮Ûʮ͐ɘ੮kɘʮˑૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੵ੮#ʮͷʮˑ੮Ûʮʡʩ͐ͅ੮)ʮͷʮͅʮ˺˦ੴ੮̹̼ʮˑ੮৲৲ੴ੮৲ৰ৲ৱબੴ੮৸ੳ ੮ ৳৷ੳ੮ Ĕɘ˦ʡੴ੮The Collected Schizophrenias, 110. ੮ ৳৸ੳ੮ "ੳ੮ #ʩ̼ʮ͐ͅ˺̹ʩʇ̼੮ H̼͙ʇʩ੮ ʇ͐੮ ɘˑੳੴ੮ ુØɘ͐ʮʇ˦͐ͅૄ੮ Ûʇ̹˺̼͐ͅ੮ ˺ϲ੮ î̼ɘ͙˚ɘ͐ʮɻ੮ ˺̼੮ Pɘ̼˚ʠ͙ˑ੮ /ͽ̹ʇ̼ʮʇ˦ɻʇͅ੮ Ĕʮ͐ʩʮ˦੮͐ʩʇ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮äʇ͐͐ʮ˦ʡੴૂ੮Psychiatric Services 56, no. 9 (2005): 1123–33. 39. Vern Pierson, “Hard Truths About Deinstitutionalization, Then and Now,” Press Enterprise, May 13, 2019, http://www.pe.com/hard-truths-about-deinstitutionalization-then-and-now. ੮ ৴ৰੳ੮ Û˺ɺʇ̼͐੮/˚ɺ̼;ੴ੮ુîʩʇ੮š̼ʁʇɘˑ੮˺ϲ੮î˺͐ɘˑ੮Ø˺͸ʇ̼ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, September 3, 1972. 41. Goffman, Asylums, 14, 43. 42. Goffman, Asylums, 305. 43. Goffman, Asylums, 189. 44. Margaret Blenkner et al., “Protective Services for Older People—Findings from the Benˈɘ˚ʮ˦੮Û˺ͅʇ੮U˦͐ͅʮ͙͐͐ʇ੮ä͙͐ʁ;ੴૂ੮ৱ৹৷৴ੴ੮৸ৱજ৸৳ੴ੮ή͙˺͐ʇʁ੮ʮ˦੮kʇ˦˦ʮʠʇ̼੮rੳ੮Ĕ̼ʮʡʩ͐ੴ੮ુI͙ɘ̼ʁʮɘ˦ͅʩʮ̹੮ ʠ˺̼੮Ě˺͙̼੮š͸˦੮I˺˺ʁੵ੮U˚̹̼˺ͷʮ˦ʡ੮͐ʩʇ੮Ĕʇˑˑચ"ʇʮ˦ʡ੮˺ʠ੮Ûʇ̹ͅ˺˦ʁʇ˦͐ͅ੮ɘ˦ʁ੮Ĕɘ̼ʁͅ੮ʮ˦੮͐ʩʇ੮õäੴૂ੮ Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 33, no. 5 (2010): 350–68. 45. Although it’s hard to know if there’s a link, in 1971 Governor Reagan—in one of the many moments when he showed his deep concern for people living with mental illness— appointed a union boss who believed a “huge dose of vitamins is the best cure for schizophrenia” to the state mental health council. Apparently, this partisan for mineral cures was the only one on the council who could get the governor on the phone. Harry Nelson, “Union Chief DeSilva Named by Reagan to Mental Health Board,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, March 26, 1971.

358 46.

47.

48. 49.

9. N E G L E C T A N D A B U S E See Héctor Ramírez, “After Thirty Years the ADA Leaves People with Psychiatric Disabilities Behind,” )ɷ̎ȡɃɷʚɷ̙͇‫ף‬ēɷ̎ɷɃɷʚɷ̙͇‫ף‬Ø̅˃ʑɐɄ̙, July 19, 2020, https://disabilityvisibility project.com/2020/07/19/after-30-years-the-ada-leaves-people-with-psychiatric-disabilities -behind/. Adult residential facilities (i.e., board and cares) are limited to only 25 percent of their residents over sixty and generally cannot accept clients who are nonambulatory or ̼ʇή͙ʮ̼ʇ੮˦͙̼ͅʮ˦ʡ੮ɻɘ̼ʇ੮ફͅʇʇ੮#ɘˑʮʠ˺̼˦ʮɘ੮#˺ʁʇ੮˺ʠ੮Ûʇʡ͙ˑɘ͐ʮ˺˦ͅੴ੮îʮ͐ˑʇ੮৲৲ੴ੮)ʮͷʮͅʮ˺˦੮৶ੴ੮#ʩɘ̹͐ʇ̼੮৶ੴ੮ 85068.4(g)). However, residential care facilities for the elderly, which serve as a board ɘ˦ʁ੮ɻɘ̼ʇ੮ʇή͙ʮͷɘˑʇ˦͐੮ʠ˺̼੮̹ʇ˺̹ˑʇ੮˺ͷʇ̼੮ͅʮͽ͐;ੴ੮ɘ̼ʇ੮ɺɘ̼̼ʇʁ੮ʠ̼˺˚੮ͅʇ̼ͷʮ˦ʡ੮ʮ˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮ુɘ˦੮ ongoing behavior, caused by a mental disorder, that would upset the general resident group” (see California Code of Regulations, Title 22, Division 6, Chapter 8, 87455(3)(A)). People over sixty with comorbid medical and mental health needs, then, must in effect either go to a nursing home or die. Goffman, Asylums, 15. Arboleda-Flórez argues that the primary “challenges currently facing mental patients in many countries are not individual abuses of freedom or autonomy, but structural and systematic neglect that covers all mental patients as an unprotected social underclass.” As I have shown in this chapter, conservatees face both individual abuse and collective abandonment. Julio Arboleda-Flórez, “Mental Illness and Human Rights,” Current Opinion in Psychiatry 21, no. 5 (2008): 481.

10. STABILIZATION AND RECOVERY ੮ ৱੳ੮ Û˺ɺʇ̼͐੮/˚ɺ̼;ੴ੮ુîʩʇ੮š̼ʁʇɘˑ੮˺ϲ੮î˺͐ɘˑ੮Ø˺͸ʇ̼ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, September 3, 1972. ੮ ৲ੳ੮ ĺ͙˺͐ʇʁ੮ ʮ˦੮ kɘ˦ʇ੮ kʇ˦ˌʮ˦ͅੴ੮ /̙͆̅ȡ˃̅Ɋɷʯȡ͇̅‫ ף‬#˃ʯɊɷ̙ɷ˃ʯ̎ (Berkeley: University of California Press, 2015), 23. 3. Neil Gong, “Between Tolerant Containment and Concerted Constraint: Managing Madness for the City and the Privileged Family,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 4 (2019): 664–89. 4. Kristen R. Choi et al., “Mental Health Conservatorship Among Homeless People with Serious Mental Illness,” Psychiatric Services 73, no. 6 (2022): 613–19; Richard H. Lamb ɘ˦ʁ੮rʮ˦ʁɘ੮/ੳ੮Ĕʇʮ˦ɺʇ̼ʡʇ̼ੴ੮ુ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮ʠ˺̼੮I̼ɘͷʇˑ;੮)ʮͅɘɺˑʇʁ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮Øɘ͐ʮʇ˦͐ͅੵ੮੮ Four-Year Follow-Up Study,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅, no. 149 (1992): 909–13; John L. Young, Mark J. Mills, and Robert L. Sack, “Civil Commitment by Conservatorship: îʩʇ੮Ĕ˺̼ˌʮ˦ʡͅ੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮rɘ͸ੴૂ੮Bulletin of the American Academy of Psychiatry and the Law 15, no. 2 (1987): 127–39. ੮ ৵ੳ੮ Û˺˦੮Ĕʮ̹˺˦ʁੴ੮Ě˃̢̅‫ף‬#˃ʯ̎ɐʯ̙‫ף‬U̎‫ף̙˃‡ף‬Ûɐ̢̄ɷ̅ɐɊ‫ףת‬îɲɐ‫ף‬Ûɷ̎ɐ‫ף‬ɷʯ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫)ף‬ɐ̙ɐʯ̙ɷ˃ʯ̎‫ףש‬H˃̅ɄɐɊ‫ף‬î̅ɐȡ̙ʣɐʯ͗‫ףש‬ȡʯɊ‫ף‬Ƀ̢̎ɷ̀ɐ‫ף‬I̢ȡ̅Ɋɷȡʯ̎ɲɷ̂̎ (Dallas, TX: BenBella, 2023), 169. ੮ ৶ੳ੮ /̼ʮɻɘ੮Ĕ˺˺ʁੴ੮Øɘ˚ʇˑɘ੮îʇɘ͐ͅʇ̼ੴ੮ɘ˦ʁ੮kʇ˦ʇˌɘ੮#ɘͅͅʮʁ;ੴ੮ુÛʇ͐ͅ˺̼ɘ͐ʮ˺˦੮˺ʠ੮Ûʮʡʩ͐ͅ੮ʮ˦੮ʁ͙ˑ͐੮I͙ɘ̼ʁianship” (American Bar Association Commission on Law and Aging, 2017), https://www ੳɘ˚ʇ̼ʮɻɘ˦ɺɘ̼ੳ˺̼ʡઃɻ˺˦͐ʇ˦͐ઃʁɘ˚ઃɘɺɘઃɘʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮͷʇઃˑɘ͸ઢɘʡʮ˦ʡઃ̼ʇ͐ͅ˺̼ɘ͐ʮ˺˦େ৲ৰ̼ʇ̹˺̼͐ .authcheckdam.pdf. 7. San Francisco Budget and Legislative Analyst (SF BLA), “Review of LPS Conservatorship,” July 30, 2019, A-10.

1 0 . S TA B I L I Z AT I O N A N D R E C OV E RY 8.

9.

10. ੮ ৱৱੳ੮ 12.

੮ ৱ৳ੳ੮ 14. 15.

16. 17.

18. ੮ ৱ৹ੳ੮

੮ ৲ৰੳ੮ 21.

359

One of the few studies on the impacts of conservatorship suggests it can reduce hospitalization, arrests, and ER visits precisely through improved care coordination. Eliot Levine et al., “Outcomes of a Care Coordination Guardianship Intervention for Adults with Severe Mental Illness: An Interrupted Time Series Analysis,” Administration and Policy in {ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬äɐ̅̀ɷɄɐ̎‫ף‬Ûɐ̎ɐȡ̅Ʉɲ 47 (2019): 1–7. California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured îʩɘ͐੮U˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘmento, CA, July 2020), 41. Giorgia Agamben, P˃ʣ˃‫ף‬äȡɄɐ̅‫ףת‬ä˃̀ɐ̅ɐɷɪʯ‫ף‬Ø˃́ɐ̅‫ף‬ȡʯɊ‫"ף‬ȡ̅ɐ‫ף‬rɷɩɐ, trans. Daniel Heller-Roazen (Stanford, CA: Stanford University Press, 1998). äʇʇ੮ɘˑͅ˺੮/ͷʮ੮ēʇ̼ɺʇˌʇ੮ʇ͐੮ɘˑੳੴ੮ુ#˺ʇ̼ɻʮ˺˦੮ɘ˦ʁ੮Ø˺͸ʇ̼੮ʮ˦੮Øͅ;ɻʩʮɘ̼͐;ੵ੮੮ĺ͙ɘˑʮ͐ɘ͐ʮͷʇ੮ä͙͐ʁ;੮͸ʮ͐ʩ੮ Ex-Patients,” Social Science & Medicine 223 (2019): 89–96. Nev Jones et al., “Investigating the Impact of Involuntary Psychiatric Hospitalization on Youth and Young Adult Trust and Help-Seeking in Pathways to Care,” Social Psychiatry ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬/̂ɷɊɐʣɷ˃ʚ˃ɪ͇ 56 (2021): 2017–27; J. Monahan et al., “Coercion and Commitment: Understanding Involuntary Mental Hospital Admission,” Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫ף‬ of Law and Psychiatry 18, no. 3 (1995): 249–63; Stefan Priebe et al., “Patients’ Views and Readmissions One Year After Involuntary Hospitalisation,” "̅ɷ̙ɷ̎ɲ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 194, no. 1 (2009): 49–54. "̼͙ɻʇ੮kੳ੮Ĕʮ˦ʮɻˌੴ੮ુ੮îʩʇ̼ɘ̹ʇ͙͐ʮɻ੮k͙̼ʮ̹̼͙ͅʁʇ˦ɻʇ੮̹̹̼˺ɘɻʩ੮͐˺੮)ʇɘˑʮ˦ʡ੮͸ʮ͐ʩ੮#˺ʇ̼ɻʮ˺˦੮ʮ˦੮ the Mental Health System,” Ø͇̎Ʉɲɷȡ̙͇̅‫ףש‬Ø͇̎Ʉɲ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫ף‬rȡ́ 15, no. 1 (2008): 25–39. Subcommittee on Mental Health, “The Dilemma of Mental Commitments in California” (Sacramento: California State Legislature, 1966), 135. National Council on Disability, “Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination,” March 22, 2018, 88, https://ncd.gov/publications/2018 /beyond-guardianship-toward-alternatives.” SF BLA, “Review of LPS Conservatorship,” January 10, 2022, 27. Note that this cohort is carefully selected and not representative of the broader popuˑɘ͐ʮ˺˦੮˺ʠ੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐ʇʇͅੳ੮"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇ੮äʇ̼ͷʮɻʇͅੴ੮ુäʇ̼ͷʮ˦ʡ੮U˦ʁʮͷʮʁ͙ɘˑͅ੮Ĕʩ˺੮ Are Conserved Through Lanterman-Petris-Short (LPS) Conservatorships” (Alameda County Board of Supervisors: Joint Social Services and Public Protection Committee {ʇʇ͐ʮ˦ʡੴ੮‡˺ͷʇ˚ɺʇ̼੮৲৹ੴ੮৲ৰ৲ৱબੴ੮ৱ৲ੴ੮ʩ̹͐͐ੵઃઃ͸͸͸ੳɘɻʡ˺ͷੳ˺̼ʡઃɺ˺ɘ̼ʁઃɺ˺ͅઢɻɘˑʇ˦ʁɘ̼ઃʁ˺ɻ͙˚ʇ˦͐ͅ ઃ)˺ɻͅʡʇ˦ʁɘÛʇʡઢääØØઃI/‡/Ûrେ৲ৰ){U‡UäîÛîUš‡ઃÛʇʡ͙ˑɘ̼େ৲ৰ#ɘˑʇ˦ʁɘ̼ ઃU͐ʇ˚ઢ৲ઢrØäઢ#˺˦ͅʇ̼ͷɘ͐˺̼ઢৱৱઢ৲৹ઢ৲ৱੳ̹ʁʠੳ Substance Abuse and Mental Health Services Administration, “Recovery and Recovery ä͙̹̹˺̼͐ੴૂ੮äʇ̹͐ʇ˚ɺʇ̼੮ৱ৳ੴ੮৲ৰ৲৲ੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅɘ˚ʩͅɘੳʡ˺ͷઃϲʮ˦ʁચʩʇˑ̹ઃ̼ʇɻ˺ͷʇ̼;ੳ ੮ ϲʮ˦ʁʮ˦ʡ੮ ˺ʠ੮ ુ̹ʇ̼˚ɘ˦ʇ˦͐ૂ੮ ʁʮͅɘɺʮˑʮ͐;੮ ʮͅ੮ ̼ʇή͙ʮ̼ʇʁ੮ ʠ˺̼੮ ̼ʇɻʇʮ̹͐੮ ˺ʠ੮ ä͙̹̹ˑʇ˚ʇ˦͐ɘˑ੮ äʇɻ͙̼ʮ͐;੮ U˦ɻ˺˚ʇੴ੮ɺ͙͐੮˦˺͐੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੳ੮îʩʮͅ੮ή͙˺͐ʇ੮͐ʩ͙ͅ੮̼ʇϲˑʇɻ͐ͅ੮˺˦ʇ੮ɻ˺͙˦͐;ૄͅ੮ʁʇɻʮͅʮ˺˦੮ about how to use conservatorship, not the law itself. ‡˺̼ɘ੮ kɘɻ˺ɺͅ˺˦੮ ɘ˦ʁ੮ )ʮɘ˦˦ʇ੮ I̼ʇʇ˦ˑʇ;ੴ੮ ુĔʩɘ͐੮ Uͅ੮ Ûʇɻ˺ͷʇ̼;੺੮ ੮ #˺˦ɻʇ̹͙͐ɘˑ੮ {˺ʁʇˑ੮ ɘ˦ʁ੮ Explication,” Psychiatric Services 52, no. 4 (2001): 482–85. Psynergy is technically licensed as a board and care (adult residential facility), but its programs are “augmented” by a county “patch” of around $150 a day (on top of patients’ society security checks).

360 22. 23.

24. 25.

1 0 . S TA B I L I Z AT I O N A N D R E C OV E RY U.S. Department of Justice, “Investigation of Alameda County, John George Psychiatric P˺̹ͅʮ͐ɘˑੴ੮ɘ˦ʁ੮äɘ˦͐ɘ੮Ûʮ͐ɘ੮kɘʮˑૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੵ੮#ʮͷʮˑ੮Ûʮʡʩ͐ͅ੮)ʮͷʮͅʮ˺˦ੴ੮̹̼ʮˑ੮৲৲ੴ੮৲ৰ৲ৱੴ੮ৱ৳ੳ U.S. Department of Justice, “Breaking Down Barriers to Employment of People with Disabilities,” October 14, 2015, https://www.justice.gov/archives/opa/blog/breaking-down -barriers-employment-individuals-disabilities. Neely Laurenzo Myers, “Culture, Stress and Recovery from Schizophrenia: Lessons from the Field for Global Mental Health,” Culture, Medicine, and Psychiatry 34, no. 3 (2010): 515. Jenkins, /̙͆̅ȡ˃̅Ɋɷʯȡ͇̅‫ף‬#˃ʯɊɷ̙ɷ˃ʯ̎, 68; see also Kerry Michael Dobransky, {ȡʯȡɪɷʯɪ‫{ף‬ȡɊʯɐ̎̎‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬#˃ʣʣ̢ʯɷ̙͇‫ףת‬îɲɐ‫ף‬#ɲȡʚʚɐʯɪɐ‫˃ף‬ɩ‫ף‬#˃ʯ̙ɐʣ̂˃̅ȡ͇̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬#ȡ̅ɐ (New Brunswick, ‡ĩੵ੮Û͙͐ʡʇ̼ͅ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰৱ৴બੳ

11. PAVING A NEW PATHWAY 1.

2. 3.

੮ ৴ੳ੮ 5.

੮ ৶ੳ੮ ੮ ৷ੳ੮ ੮ ৸ੳ੮

9. 10. 11.

12.

Harder & Co. Community Research, “San Francisco Housing Conservatorship: Preliminary Evaluation Report” (San Francisco, CA, January 2022), 2, https://www.sfdph.org/dph ઃϲʮˑʇͅઃʩ˺͙ͅʮ˦ʡɻ˺˦ͅʇ̼ͷઃäHઢP˺͙ͅʮ˦ʡઢ#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ઢr˺ɻɘˑઢÛʇ̹˺̼͐ઢõ̹ʁɘ͐ʇʁઢৰৱੳ৲ৰੳ৲৲ੳ̹ʁʠੳ Senate Bill 1045, “Conservatorship: Serious Mental Illness and Substance Use Disorders,” ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑîʇͽ͐#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৷৲ৰৱ৸ৰä"ৱৰ৴৵ੳ In San Francisco, the number of locked skilled nursing and mental health rehabilitation center beds dropped 29 percent from 2010 to 2016; 37 percent of unlocked board and care beds disappeared during this period. San Francisco Budget and Legislative Analyst (SF BLA), “Performance Audit of the Department of Public Health Behavioral Health Services” (San Francisco, CA, April 19, 2018), 84. #ੳ੯Ĕੳ੮‡ʇͷʮ͙ͅੴ੮ુHʮ˦ʁʮ˦ʡ੮Pʇˑ̹੮ʠ˺̼੮P˺˚ʇˑʇͅͅ੮Ĕʩ˺੮Ĕ˺˦ૄ͐੮Pʇˑ̹੮îʩʇ˚ͅʇˑͷʇͅੴૂ੮San Francisco Chronicle, March 11, 2008. Heather Knight, “SF Looks to Change Law That Lets Mentally Ill Choose to Stay on Streets,” San Francisco Chronicle, December 12, 2017, https://www.sfchronicle.com/news /article/SF-looks-to-change-law-that-lets-mentally-ill-12422969.php. Pʇɘ͐ʩʇ̼੮n˦ʮʡʩ͐ੴ੮ુ੮rʮʠʇ੮˺˦੮͐ʩʇ੮äʮʁʇ͸ɘˑˌ੮/˦ʁͅ੮͸ʮ͐ʩ੮ɘ੮)ʮʡ˦ʮϲʮʇʁ੮)ʇɘ͐ʩੴૂ੮San Francisco Chronicle, February 27, 2018. äɻ˺͐͐੮Ĕʮʇ˦ʇ̼ੴ੮ુØ̼ʇͅͅ੮Ûʇˑʇɘͅʇੵ੮äʇ˦ɘ͐˺̼ͅ੮Ĕʮʇ˦ʇ̼੮ɘ˦ʁ੮ä͐ʇ̼˦੮˦˦˺͙˦ɻʇ੮"ʮˑˑ੮͐˺੮/ͽ̹ɘ˦ʁ੮#˺˦servatorships,” February 1, 2018, http://sd11.senate.ca.gov. Ûɘɻʩʇˑ੮ä͸ɘ˦ੴ੮ુäH੮Ĕʮˑˑ੮î̼;੮‡ʇ͸੮̹̹̼˺ɘɻʩ੮ʠ˺̼੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ͅ੮ʠ˺̼੮͐ʩʇ੮{˺͐ͅ੮î̼˺͙ɺˑʇʁੴૂ੮ San Francisco Chronicle, May 2, 2018, https://www.sfchronicle.com/politics/article/SF-will -move-mental-health-conservatorships-from-12879660.php. Editorial Board, “Getting Help to the Homeless,” San Francisco Chronicle, February 14, 2018. Andrea M. López, “Necropolitics in the ‘Compassionate’ City: Care/Brutality in San Francisco,” {ɐɊɷɄȡʚ‫ף‬ʯ̙ɲ̅˃̂˃ʚ˃ɪ͇ 39, no. 8 (2020): 761. Senate Judiciary Committee, “SB 1045: Conservatorship: Chronic Homelessness: Mental Illness and Substance Use Disorders” (Sacramento: California State Legislature, April 9, 2018), 18. Nuala Sawyer, “Mental Health, Homelessness and Civil Rights: S.F.’s Crisis of Conscience,” SF Weekly, March 20, 2019, http://www.sfweekly.com/news/mental-health-homelessness -and-civil-rights-s-f-s-crisis-of-conscience/.

1 1. PAV I N G A N E W PAT H WAY 13.

361

For example, in one 2019 poll, 89 percent of Californians supported “involuntary commitment of homeless individuals who have severe mental/behavioral issues that may be a danger or harm to themselves or others in the community.” California Chamber of Commerce, “The People’s Voice: CalChamber’s Fifth Annual Survey of California Voter Attitudes,” 2019, 26, https://advocacy.calchamber.com/wp-content/uploads/2019/10 /ThePeoplesVoicePoll2019.pdf. ੮ ৱ৴ੳ੮ š˦ʇ੮̼ʇͷʮʇ͸੮ɻ˺˦ɻˑ͙ʁʇʁ੮͐ʩɘ͐੮͐ʩʇ੮˚ɘˈ˺̼ʮ͐;੮˺ʠ੮͙͐ͅʁʮʇͅ੮ુʠɘʮˑʇʁ੮͐˺੮ʁʇ͐ʇɻ͐੮ɘ˦;੮ͅʮʡ˦ʮϲʮɻɘ˦͐੮̹˺ͅʮ͐ʮͷʇ੮ʮ˚̹ɘɻ͐ͅૂ੮ʠ̼˺˚੮ɻ˺˚̹͙ˑͅ˺̼;੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐ੳ੮)ੳ੮Ĕʇ̼ɺ੮ʇ͐੮ɘˑੳੴ੮ુîʩʇ੮/ʠʠʇɻ͐ʮͷʇ˦ʇͅͅ੮˺ʠ੮ Compulsory Drug Treatment: A Systematic Review,” Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ʯ‫̢̅)ף‬ɪ‫ף‬Ø˃ʚɷɄ͇ 28 (2016): 7; see also Abhishek Jain, Paul Christopher, and Paul S. Appelbaum, “Civil #˺˚˚ʮ͐˚ʇ˦͐੮ʠ˺̼੮š̹ʮ˺ʮʁ੮ɘ˦ʁ੮š͐ʩʇ̼੮ä͙ɺ͐ͅɘ˦ɻʇ੮õͅʇ੮)ʮͅ˺̼ʁʇ̼ͅੵ੮)˺ʇͅ੮U͐੮Ĕ˺̼ˌ੺ੴૂ੮Psychiatric Services 69, no. 4 (2018): 374–76. 15. Senate Judiciary Committee, “SB 1045,” 16. 16. Sawyer, “Mental Health, Homelessness and Civil Rights.” 17. Joshua Sabatini, “Impact of Homeless Conservatorship Plan More Limited Than Expected,” äȡʯ‫ף‬H̅ȡʯɄɷ̎Ʉ˃‫ף‬/͆ȡʣɷʯɐ̅, February 11, 2019, https://www.sfexaminer.com/news /impact-of-homeless-conservatorship-plan-more-limited-than-expected/. 18. Senate Bill 40, “Conservatorship: Serious Mental Illness and Substance Use Disorders,” ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑîʇͽ͐#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৹৲ৰ৲ৰৰä"৴ৰੳ 19. Senate Judiciary Committee, “SB 40: Conservatorship: Serious Mental Illness and Substance Use Disorders” (Sacramento: California State Legislature, April 4, 2019). ੮ ৲ৰੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৵৴৵ৰફɺબ৲ੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑîʇͽ͐#ˑʮʇ˦͐ ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৷৲ৰৱ৸ৰä"ৱৰ৴৵ੳ 21. Alyssa Jeong Perry, “LA County Gets More Power to Force Severely Mentally Ill Homeless Into Treatment,” LAist, October 2, 2018, https://laist.com/news/la-county-gets-more ચ̹˺͸ʇ̼ચ͐˺ચʠ˺̼ɻʇચͅʇͷʇ̼ʇˑ;ચ˚ʇ˦͐ɘˑˑ;ચʮˑˑચʩ˺˚ʇˑʇͅͅચʮ˦͐˺ચ̼͐ʇɘ͐˚ʇ˦͐੶੮Iɘ̼;੮Ĕɘ̼͐ʩੴ੮ુP˺˚ʇˑʇͅͅ੮ Conservatorship Tried,” äȡʯ‫)ף‬ɷɐɪ˃‫ף‬õʯɷ˃ʯ؅î̅ɷɃ̢ʯɐ, November 10, 2019. 22. Los Angeles estimated that 150–180 individuals met the eight-5150s criterion but conɻˑ͙ʁʇʁ੮͐ʩɘ͐੮͐ʩʇͅʇ੮ʁ˺ɻ͙˚ʇ˦͐ɘ͐ʮ˺˦੮̼ʇή͙ʮ̼ʇ˚ʇ˦͐ͅ੮͸ʇ̼ʇ੮ુͷʇ̼;੮ɻʩɘˑˑʇ˦ʡʮ˦ʡૂ੮ʠ˺̼੮ɘ੮ɻ˺͙˦͐;੮˺ʠ੮ its size. Los Angeles County Department of Mental Health, “Disrupting the Cycle of Chronic Homelessness in Los Angeles County” (Los Angeles, January 22, 2020), 9, http:// ϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱ৴ৰ৳৹ৰੳ̹ʁʠੳ੮äɘ˦੮)ʮʇʡ˺੮ʁʇɻˑʮ˦ʇʁ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚੮ɺ;੮ citing a “disproportionate administrative burden” relative to “very few individuals” who would be directly affected. Helen Robbins-Meyer, “Report Back on Housing Conservatorship: A New Tool for Addressing Serious Mental Illness and Substance Use Disorder” (County of San Diego, November 17, 2020), 3, https://bosagenda.sandiegocounty.gov/cob ઃɻ˺ͅʁઃɻ˺ɺઃʁ˺ɻ੺ʮʁଵৰ৹ৰৱৱ৲৷ʇ৸ৰɻ৳ɻʇʇʁੳ 23. Chris Herring, “Complaint-Oriented ‘Services’: Shelters as Tools for Criminalizing Homelessness,” Annals of the American Academy of Political and Social Science 693, no. 1 (2021): 264–83. ੮ ৲৴ੳ੮ Pʇɘ͐ʩʇ̼੮n˦ʮʡʩ͐ੴ੮ુ"̼ʇʇʁੴ੮Ĕʮʇ˦ʇ̼੮Ĕ˺̼ˌʮ˦ʡ੮͐˺੮/ɘͅʇ੮)ʇ̼͙͐ͅɻ͐ʮͷʇ੮"ʇʩɘͷʮ˺̼੮˺˦੮ä̼͐ʇʇ͐ੴૂ੮San Francisco Chronicle, February 10, 2018, https://www.sfchronicle.com/news/article/Breed ચĔʮʇ˦ʇ̼ચ͸˺̼ˌʮ˦ʡચ͐˺ચʇɘͅʇચʁʇ̼͙͐ͅɻ͐ʮͷʇચৱ৲৵৹৷৷৵৲ੳ̹ʩ̹ੳ 25. Sabatini, “Impact of Homeless Conservatorship Plan.”

362 26.

1 1. PAV I N G A N E W PAT H WAY

One audit found that 5 percent of users of the city’s urgent care and emergency services accounted for 52 percent of spending; 90 percent of them had a psychiatric diagnosis. SF BLA, “Performance Audit,” vii. ੮ ৲৷ੳ੮ îʇͅͅɘ੮Øɘ˺ˑʮੴ੮ુ#̼ʮ͐ʮɻͅ੮Iɘ͐ʩʇ̼੮ʮ˦੮͐ʩʇ੮{ʮͅͅʮ˺˦੮͐˺੮ĺ͙ʇ͐ͅʮ˺˦੮õ̹ɻ˺˚ʮ˦ʡ੮ē˺͐ʇ੮˺˦੮#˺˦ͅʇ̼ͷɘtorship,” Mission Local, February 25, 2019, https://missionlocal.org/2019/02/critics-gather ચʮ˦ચ͐ʩʇચ˚ʮͅͅʮ˺˦ચ͐˺ચή͙ʇ͐ͅʮ˺˦ચ͙̹ɻ˺˚ʮ˦ʡચͷ˺͐ʇચ˺˦ચɻ˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ઃੳ 28. Coalition on Homelessness, “Stop the Revolving Door: A Street-Level Framework for a New System,” September 2020, 19, https://www.cohsf.org/wp-content/uploads/2020/11/Stop-the -Revolving-1.pdf. ੮ ৲৹ੳ੮ kʇͅͅʮɻɘ੮rʇʩ˚ɘ˦੮ή͙˺͐ʇʁ੮ʮ˦੮k˺ͅʩ͙ɘ੮äɘɺɘ͐ʮ˦ʮੴ੮ુ{ɘ;˺̼੮Ø̼ʇ̹ɘ̼ʇʁ੮͐˺੮#˺˚̹ʇˑ੮î̼ʇɘ͐˚ʇ˦͐੮ʠ˺̼੮ H̼ʇή͙ʇ˦͐ˑ;੮ )ʇ͐ɘʮˑʇʁ੮ P˺˚ʇˑʇͅͅੴૂ੮ äȡʯ‫ ף‬H̅ȡʯɄɷ̎Ʉ˃‫ ף‬/͆ȡʣɷʯɐ̅, September 28, 2018, https:// ͸͸͸ੳͅʠʇͽɘ˚ʮ˦ʇ̼ੳɻ˺˚ઃ˦ʇ͸ͅઃ˚ɘ;˺̼ચ̹̼ʇ̹ɘ̼ʇʁચ͐˺ચɻ˺˚̹ʇˑચ̼͐ʇɘ͐˚ʇ˦͐ચʠ˺̼ચʠ̼ʇή͙ʇ˦͐ˑ; -detained-homeless/. 30. This statement was made in a hearing on SB 40 before the Senate Judiciary Committee on April 18, 2019. 31. Bay City News Service, “City Adds Dozens of Conservatorship Beds to Help Mentally Ill,” SFGate, March 6, 2018, https://www.sfgate.com/news/bayarea/article/City-Adds -Dozens-Of-Conservatorship-Beds-To-Help-12731188.php. 32. Trisha Thadani, “Supes Reach Deal on Care for Mentally Ill,” San Francisco Chronicle, June 4, 2019. 33. “At Issue: Housing Crisis / Homeless ‘Conservatorship,’” KPIX 5, March 10, 2019. 34. Harder & Co., “San Francisco Housing Conservatorship,” 10. 35. Harder & Co., “San Francisco Housing Conservatorship,” 7. ੮ ৳৶ੳ੮ î̼ʮͅʩɘ੮îʩɘʁɘ˦ʮੴ੮ુĔʩ;੮äHૄͅ੮‡ʇ͸੮rɘ͸ͅ੮͐˺੮H˺̼ɻʇ੮{˺̼ʇ੮{ʇ˦͐ɘˑˑ;੮Uˑˑੴ੮ʁʁʮɻ͐ʇʁ੮U˦͐˺੮î̼ʇɘ͐˚ʇ˦͐੮ Haven’t Been Used Yet,” San Francisco Chronicle, June 4, 2020, https://www.sfchronicle ੳɻ˺˚ઃ̹˺ˑʮ͐ʮɻͅઃɘ̼͐ʮɻˑʇઃĔʩ;ચäHચͅચ˦ʇ͸ચˑɘ͸ͅચ͐˺ચʠ˺̼ɻʇચ˚˺̼ʇચ˚ʇ˦͐ɘˑˑ;ચʮˑˑચৱ৵৳ৱ৸৵৷৴ੳ̹ʩ̹ੳ 37. Department of Health Care Services, “California Designated LPS Facilities,” May 2020, https://www.dhcs.ca.gov/Documents/LPS-24hr.pdf. 38. California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured îʩɘ͐੮U˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘ˚ʇ˦͐˺ੴ੮#ੴ੮k͙ˑ;੮৲ৰ৲ৰબੴ੮৳৴੶੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺੮P˺͙ͅʮ˦ʡ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹੮Ĕ˺̼ˌʮ˦ʡ੮I̼˺͙̹ੴ੮ “SFPD Incident Report Data,” October 18, 2021. 39. The bad data informing policy making in San Francisco is appalling. In 2019, a report commissioned by Mandelman declared that San Francisco was “below the statewide average” for conservatorship, basing the conclusion on data from the state. SF BLA, ુÛʇͷʮʇ͸੮˺ʠ੮rØä੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮k͙ˑ;੮৳ৰੴ੮৲ৰৱ৹ੴ੮ચ৹ੳ੮Ĕʩʇ˦੮͐ʩʇ੮ɺ͙ʁʡʇ͐੮ɘ˦ʁ੮ˑʇʡʮͅˑɘ͐ʮͷʇ੮ analyst went back in 2022 and relied on internal data from the public conservator, it turned out that San Francisco had the most permanent conservatorships relative to population of twelve large counties. SF BLA, “Review of LPS Conservatorship,” January 10, 2022, ii. Needless to say, these data paint contrasting portraits as to whether San Francisco suffers from an overly constricted conservatorship system. 40. Presciently, San Diego had cited this as a reason not to implement SB 1045: many facilities “do not share data regarding detainment and 5150 status [with the county] and are not ˑʇʡɘˑˑ;੮̼ʇή͙ʮ̼ʇʁ੮͐˺੮ʁ˺੮ͅ˺ੳૂ੮Û˺ɺɺʮ˦ͅચ{ʇ;ʇ̼ੴ੮ુÛʇ̹˺̼͐੮"ɘɻˌ੮˺˦੮P˺͙ͅʮ˦ʡ੮#˺˦ͅʇ̼ͷɘ͐˺̼ͅʩʮ̹ੴૂ੮৳ੳ

1 2 . A SY LU M F O R T H E DY I N G

363

41.

The Shelter-in-Place program in San Francisco reduced psychiatric emergency services use by 75 percent for previously high-utilizing individuals, relative to people not placed in such hotels. Mark D. Fleming et al., “Association of Shelter-in-Place Hotels with Health Services Use Among People Experiencing Homelessness During the COVID-19 Pandemic,” k{‫‡ף‬ɐ̙́˃̅ʕ‫̂šף‬ɐʯ 5, no. 7 (2022): e2223891. ੮ ৴৲ੳ੮ kੳ੯)ੳ੮{˺̼̼ʮͅੴ੮ુäੳHੳ੮Øˑɘ˦˦ʇʁ੮͐˺੮#˺˚̹ʇˑ੮{˺̼ʇ੮Øʇ˺̹ˑʇ੮U˦͐˺੮)̼͙ʡ੮ɘ˦ʁ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮î̼ʇɘ͐ment. So Far, Only Two Have Been Helped,” San Francisco Chronicle, February 5, 2022, ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅʠɻʩ̼˺˦ʮɻˑʇੳɻ˺˚ઃɺɘ;ɘ̼ʇɘઃɘ̼͐ʮɻˑʇઃäણHચ̹ˑɘ˦˦ʇʁચ͐˺ચɻ˺˚̹ʇˑચ˚˺̼ʇચ̹ʇ˺̹ˑʇ -into-drug-and-16833440.php.

12. ASYLUM FOR THE DYING 1.

2. 3.

4.

5.

6. 7.

8.

County of Los Angeles Public Health, “Mortality Among People Experiencing Homelessness in Los Angeles County: One Year Before and After the Start of the COVID-19 Pandemic” (Los Angeles, April 2022), http://publichealth.lacounty.gov/chie/reports ઃP˺˚ʇˑʇͅͅઢ{˺̼͐ɘˑʮ͐;ઢÛʇ̹˺̼͐ઢ৲ৰ৲৲ੳ̹ʁʠੳ Chris Herring, “Complaint-Oriented Policing: Regulating Homelessness in Public Space,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 5 (2019): 769–800. For a portrait from a journalist who had access to some HOME clients, see Doug Smith, “L.A.’s First Street Psychiatrist Makes His Sidewalk Rounds, Transforming Homeless Lives,” r˃̎‫ ף‬ʯɪɐʚɐ̎‫ ף‬îɷʣɐ̎, September 7, 2022, https://www.latimes.com/california/story ઃ৲ৰ৲৲ચৰ৹ચৰ৷ઃˑચɘચɻ˺͙˦͐;ͅચϲʮ̼͐ͅચ̼͐ͅʇʇ͐ચ̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅચ̼͐ʇɘ͐ͅચ̹ɘ͐ʮʇ˦͐ͅચ͸ʩʇ̼ʇચ͐ʩʇ;ચˑʮͷʇੳ According to state statute, “agencies and departments administering state programs” ɘ̼˺͙˦ʁ੮ʩ˺˚ʇˑʇͅͅ˦ʇͅͅ੮ુͅʩɘˑˑ੯ੳ੯ੳ੯ੳ੮ʮ˦ɻ˺̼̹˺̼ɘ͐ʇ੮͐ʩʇ੮ɻ˺̼ʇ੮ɻ˺˚̹˺˦ʇ˦͐ͅ੮˺ʠ੮P˺͙ͅʮ˦ʡ੮Hʮ̼͐ͅੳૂ੮#ɘˑʮʠ˺̼˦ʮɘ੮ĔU#ੴ੮äʇɻ͐ʮ˺˦੮৸৲৵৶ફɺબੴ੮ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅઢʁʮ̹ͅˑɘ;îʇͽ͐ ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ʁʮͷʮͅʮ˺˦ଵ৸ੳ૟͐ʮ͐ˑʇ૟̹ɘ̼͐૟ɻʩɘ̹͐ʇ̼ଵ৶ੳ৵ੳ Maria C. Raven, Matthew J. Niedzwiecki, and Margot Kushel, “A Randomized Trial of Permanent Supportive Housing for Chronically Homeless Persons with High Use of Publicly Funded Services,” Health Services Research 55, no. S2 (2020): 797–806. San Francisco Budget and Legislative Analyst, “Impact of Supportive Housing on the Costs of Homelessness” (San Francisco, CA, May 31, 2016), 8. One report from Los Angeles found 418 deaths in shelter-in-place hotels during the pandemic. Of these, 60 percent were attributed to drug or alcohol overdoses, a much higher ̹̼˺̹˺̼͐ʮ˺˦੮͐ʩɘ˦੮ʁʇɘ͐ʩͅ੮˺˦੮͐ʩʇ੮̼͐ͅʇʇ͐ͅੳ੮˦ɘ˦;ɘ੮Û˺;੮ɘ˦ʁ੮#ʩˑ˺ʇ੮Û˺ͅʇ˦͐ͅ˺ɻˌੴ੮ુĔʇ੮)˺੮‡˺͐੮ Forget: Stolen Lives of LA’s Unhoused During the COVID-19 Pandemic” (UCLA Luskin U˦͐ͅʮ͙͐͐ʇ੮ ˺˦੮ U˦ʇή͙ɘˑʮ͐;੮ ɘ˦ʁ੮ )ʇ˚˺ɻ̼ɘɻ;ੴ੮ )ʇɻʇ˚ɺʇ̼੮ ৱੴ੮ ৲ৰ৲ৱબੴ੮ ৶ੴ੮ ʩ̹͐͐ͅੵઃઃʇͅɻʩ˺ˑɘ̼ͅʩʮ̹ੳ˺̼ʡ ઃ͙ɻઃʮ͐ʇ˚ઃ৹ৱৰ৴ˈ৹৴৳ੳ੮U˦੮äɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮ৱ৶৶੮̹ʇ˺̹ˑʇ੮˺ͷʇ̼ʁ˺ͅʇʁ੮ʮ˦੮ɻʮ͐;ચϲʮ˦ɘ˦ɻʇʁ੮ʩ˺͐ʇˑͅੴ੮ɻ˺˚̹̼ʮͅʮ˦ʡ੮ৱ৴੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮ɘˑˑ੮˺ͷʇ̼ʁ˺ͅʇ੮ʁʇɘ͐ʩͅ੮ʮ˦੮͐ʩʇ੮ɻʮ͐;੮ʮ˦੮৲ৰ৲ৰ੮ɘ˦ʁ੮৲ৰ৲ৱੳ੮k˺ɘή͙ʮ˦੮Øɘˑ˺˚ʮ˦˺੮ and Trisha Thadani, “Broken Homes,” San Francisco Chronicle, April 26, 2022. Yoohyun Jung, “Drug Overdose Deaths in California Are Skyrocketing, as the Fentanyl Crisis Reaches Beyond San Francisco,” San Francisco Chronicle, October 14, 2022, https:// www.sfchronicle.com/health/article/california-fentanyl-overdose-deaths-17508010.php; Benjamin Schneider, “Fentanyl: The City’s Biggest Public Health Crisis,” SF Weekly, May 6, 2021, https://www.sfweekly.com/news/fentanyl-the-citys-biggest-public-health-crisis/.

364

1 2 . A SY LU M F O R T H E DY I N G

੮ ৹ੳ੮ Ûʇͷʇɘˑʮ˦ʡˑ;ੴ੮ ˺˦ʇ੮ ˺ʠ੮ ͐ʩʇ੮ ˚˺͐ͅ੮ ɻʮ͐ʇʁ੮ ͙͐ͅʁʮʇͅ੮ ͅʩ˺͸ʮ˦ʡ੮ ͐ʩʇ੮ ʇϲϲʮɻɘɻ;੮ ˺ʠ੮ P˺͙ͅʮ˦ʡ੮ Hʮ̼͐ͅ੮ approaches actually logged more deaths among people who were housed through the program than those who were not. Raven, Niedzwiecki, and Kushel, “Randomized Trial of PSH”; see also Jill S. Roncarati et al., “Housing Boston’s Chronically Homeless Unsheltered Population: 14 Years Later,” Medical Care 59 (2021): S170. 10. Eugene Bardach, îɲɐ‫ף‬äʕɷʚʚ‫ף‬HȡɄ̙˃̅‫ף‬ɷʯ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫ףת‬Ûɐ̂ɐȡʚɷʯɪ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬#˃ʣʣɷ̙ʣɐʯ̙‫ף‬rȡ́̎‫ף‬ɷʯ‫ף‬#ȡʚɷfornia (Berkeley: University of California Press, 1972), 126, 130. ੮ ৱৱੳ੮ ä͙ͅɘ˦੮Øɘ̼͐˺ͷʮੴ੮ુPʮʁʮ˦ʡ੮"ʇʩʮ˦ʁ੮ૃH̼ʇʇ੮Ĕʮˑˑੴૄૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, June 10, 2007. 12. Barbara Mauer, “Morbidity and Mortality in People with Serious Mental Illness” (Alexandria, VA: National Association of State Mental Health Program Directors, October 2006), 5, https://www.nasmhpd.org/content/morbidity-and-mortality-people-serious -mental-illness. 13. Emily Alpert Reyes and Thomas Curwen, “Panel Looks at Policing, Mentally Ill,” Los ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, June 14, 2018. 14. Los Angeles County Department of Mental Health, “Assessment of Grave Disability” (Los ˦ʡʇˑʇͅੴ੮kɘ˦͙ɘ̼;੮ৱৰੴ੮৲ৰৱ৸બੴ੮৳ੴ੮ʩ̹͐͐ੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱ৲ৰ৷৹ৰੳ̹ʁʠੳ 15. LA Public Health, “Mortality Among PEH,” 8. 16. Alex V. Barnard, “From the ‘Magna Carta’ to ‘Dying in the Streets’: Media Framings of Mental Health Law in California,” ä˃Ʉɷɐ̙͇‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 12, no. 2 (2022): 155–73. 17. Senate Judiciary Committee, “AB 1971: Mental Health Services: Involuntary Detention: Gravely Disabled” (Sacramento: California State Legislature, April 12, 2018), https:// ˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑ˦ɘˑ;ͅʮͅ#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৷৲ৰৱ৸ৰ"ৱ৹৷ৱੳ 18. Melody Gutierrez, “SF Could Hold More Mentally Ill People for Care,” San Francisco Chronicle, August 31, 2018, https://www.sfchronicle.com/politics/article/SF-could-hold -more-mentally-ill-people-for-care-13195276.php. ੮ ৱ৹ੳ੮ äʇ˦ɘ͐ʇ੮ k͙ʁʮɻʮɘ̼;੮ #˺˚˚ʮ͐͐ʇʇੴ੮ ુä"੮ ৵ৱ৶ੵ੮ #ʇ̼͐ʮϲʮɻɘ͐ʮ˺˦੮ ʠ˺̼੮ U˦͐ʇ˦ͅʮͷʇ੮ î̼ʇɘ͐˚ʇ˦͐ੵ੮ Ûʇͷʮʇ͸੮ Hearing” (Sacramento: California State Legislature, February 17, 2021), 15–16, https:// ˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɺʮˑˑ˦ɘˑ;ͅʮͅ#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰ৲ৱ৲ৰ৲৲ৰä"৵ৱ৶ંੳ ੮ ৲ৰੳ੮ Øɘ͙ˑ੮äੳ੮̹̹ʇˑɺɘ͙˚ੴ੮ુ˚ɺʮͷɘˑʇ˦ɻʇ੮#˺ʁʮϲʮʇʁੵ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮‡ʇ͸੮š͙̹͐ɘ͐ʮʇ˦͐੮#˺˚˚ʮ͐˚ʇ˦͐੮ Statute,” Psychiatric Services 54, no. 1 (2003): 26–28. 21. A narrower attempt to incorporate evidence of “medical conditions” into probable cause hearings (automatically held during a fourteen-day hold) was similarly amended to oblivion in 2020. For an explanation, see Senate Judiciary Committee, “SB 516.” 22. California State Auditor, “Lanterman-Petris-Short Act: California Has Not Ensured îʩɘ͐੮U˦ʁʮͷʮʁ͙ɘˑͅ੮͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅʇͅ੮Ûʇɻʇʮͷʇ੮ʁʇή͙ɘ͐ʇ੮š˦ʡ˺ʮ˦ʡ੮#ɘ̼ʇૂ੮ફäɘɻ̼ɘmento, CA, July 2020), 21. 23. Editorial Board, “Forced Care Is Not the Answer,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, August 7, 2020, https:// www.latimes.com/opinion/story/2020-08-07/improve-mental-health-care-before-forcing -it-on-people. 24. Nicole Nixon, “Pandemic, Climate Change, Homelessness Highlight Newsom’s Initial California Budget Proposal,” CAPRadio, January 10, 2022, https://www.capradio.org/173161. ੮ ৲৵ੳ੮ k˺ɻʇˑ;˦੮ Ĕʮʇ˦ʇ̼ੴ੮ ુĔʩ;੮ Uͅ੮ U͐੮ ä˺੮ Pɘ̼ʁ੮ ͐˺੮ Iʇ͐੮ {ʇ˦͐ɘˑˑ;੮ Uˑˑ੮ #ɘˑʮʠ˺̼˦ʮɘ˦ͅ੮ U˦͐˺੮ î̼ʇɘ͐ment?” CalMatters, August 30, 2018, https://calmatters.org/articles/california-homeless -mental-illness-conservatorship-law/.

1 2 . A SY LU M F O R T H E DY I N G

365

੮ ৲৶ੳ੮ îʩʇ੮ɻ˺͙̼͐ͅ੮ɻ˺˦ϲʮ̼˚ʇʁ੮͐ʩɘ͐੮ɘ੮ʁʇ˚ʇ˦͐ʮɘ੮ʁʮɘʡ˦˺ͅʮͅ੮ɻɘ˦੮ɺʇ੮ɘ੮ɺɘͅʮͅ੮ʠ˺̼੮ɘ˦੮rØä੮ɻ˺˦ͅʇ̼ͷɘ͐˺̼ship in #˃̢ʯ̙͇‫˃ף‬ɩ‫ף‬r˃̎‫ף‬ʯɪɐʚɐ̎‫ףר̀ף‬ä̢̂ɐ̅ɷ˃̅‫ף‬#˃̢̙̅ (2013) 222 Cal.App.4th 434. 27. San Diego Health and Human Services Agency, “Public Guardian,” https://www.sandiego ɻ˺͙˦͐;ੳʡ˺ͷઃɻ˺˦͐ʇ˦͐ઃͅʁɻઃʩʩͅɘઃ̹̼˺ʡ̼ɘ˚ͅઃ̹ɘ̹ʡઃ̹͙ɺˑʮɻઢʡ͙ɘ̼ʁʮɘ˦ੳʩ͐˚ˑੳ 28. California Probate Code, Section 2920(b), https://law.justia.com/codes/california/2005 /prob/2920-2922.html. ੮ ৲৹ੳ੮ ੮ ̼ʇɻʇ˦͐੮ ̼ʇ̹˺̼͐੮ ή͙ɘ˦͐ʮϲʮʇʁ੮ ͐ʩʇ੮ ɻ˺˚ʮ˦ʡ੮ ɘͷɘˑɘ˦ɻʩʇ੮ ˺ʠ੮ ɻɘͅʇͅ੮ ˑʮˌʇ੮ kʇ͙ͅͅૄͅੴ੮ ʁʇ͐ʇ̼˚ʮ˦ʮ˦ʡ੮ that San Diego needed thirteen times as many neuropsych beds. Behavioral Health Services, “Optimal Care Pathways Model” (San Diego County, CA: Board of Supervisors, September 27, 2022), https://bosagenda.sandiegocounty.gov/cob/cosd/cob/doc?id ଵৰ৹ৰৱৱ৲৷ʇ৸ৰʠৱ৳ɺ৶ɘੳ ੮ ৳ৰੳ੮ #ɘˑʮʠ˺̼˦ʮɘ੮ ĔU#ੴ੮ äʇɻ͐ʮ˺˦ͅ੮ ৵৲ৰৰ੮ ɘ˦ʁ੮ ৵৳৵৲ੴ੮ ʩ̹͐͐ͅੵઃઃˑʇʡʮ˦ʠ˺ੳˑʇʡʮͅˑɘ͙̼͐ʇੳɻɘੳʡ˺ͷઃʠɘɻʇͅઃɻ˺ʁʇͅ ઢʁʮ̹ͅˑɘ;äʇɻ͐ʮ˺˦ੳͽʩ͐˚ˑ੺ˑɘ͸#˺ʁʇଵĔU#૟ͅʇɻ͐ʮ˺˦‡͙˚ଵ৵৳৵৲ੳ 31. Elizabeth Bromley, “Clinical Assessment and Management of Grave Disability,” PMHP î̅ȡɷʯɷʯɪ̎ੴ੮ ̼ʮͅʇੳɘ̼͐ʮɻ͙ˑɘ͐ʇੳɻ˺˚ઃͅʩɘ̼ʇઃˑ৲ʠ͐ɺĔ"rͅĚ#͐ʇē৵৶ͅēĤΈɻৱɺˑęʡ;ͷäĚʡંઃˑʇͅͅ˺˦ͅ ઃH৶৵˚U৹Ûʮˈ"îৰ#ɘˈ৸{৳õʇ̼৳৳n৷Έͅઢ‡nnšੳ 32. Elizabeth Bromley et al, “Outpatient Conservatorship: Preliminary Results from a Pilot Program Serving Gravely Disabled Adults Experiencing Homelessness in Los Angeles County,” unpublished manuscript, February 13, 2022. 33. Los Angeles County Department of Mental Health (LA DMH), “Report Response on Expanding Lanterman-Petris-Short and Probate Conservatorship Capacity” (Los Angeˑʇͅੴ੮k͙ˑ;੮ৱৰੴ੮৲ৰৱ৸બੴ੮ৱৰੴ੮ʩ̹͐͐ੵઃઃϲʮˑʇੳˑɘɻ˺͙˦͐;ੳʡ˺ͷઃä)äU˦͐ʇ̼ઃɺ˺ͅઃ͙̹ͅʁ˺ɻͅઃৱৱ৶ৱ৴৳ੳ̹ʁʠੳ 34. Cathie Anderson, “New Psychiatric Hospital Opens in Sacramento with 117 Beds Amid Demand for Mental Health,” Sacramento Bee, January 7, 2022, https://www.sacbee.com /article257098382.html. 35. Trevor Montgomery, “Supervisors Unanimously Vote to Add 20 Mental Health Beds at SRMC,” äɲȡ̎͗ȡ‫ף‬#˃̢ʯ̙͇‫‡ף‬ɐ́̎‫ף‬äɐ̅̀ɷɄɐ, September 14, 2018, https://myrcns.com/2018/09/14 /supervisors-unanimously-vote-to-add-20-mental-health-beds-at-srmc/. 36. Ricardo Lopez, “Indio City Council Unanimously Approves Behavioral Health Center Despite Neighborhood Opposition,” )ɐ̎ɐ̙̅‫ ף‬ä̢ʯ, February 6, 2019, https://www .desertsun.com/story/news/local/indio/2019/02/06/indio-approves-mental-health -facility-despite-resident-objections/2795228002/; Kevin Forestieri, “El Camino Completes New $96M Mental Health Care Facility,” {˃̢ʯ͗ȡɷʯ‫ף‬ēɷɐ́‫ף‬ē˃ɷɄɐ, November 1, 2019, https://mv-voice.com/news/2019/11/01/el-camino-completes-new-96m-mental-health -care-facility; Sam Morgen, “Kern Supervisors Approve Two New Psychiatric Health Facilities,” "ȡʕɐ̅̎ͷɷɐʚɊ‫ר‬#˃ʣੴ੮̹̼ʮˑ੮৲৷ੴ੮৲ৰ৲ৱੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳɺɘˌʇ̼ͅϲʮʇˑʁੳɻ˺˚ઃ˦ʇ͸ͅઃˌʇ̼˦ચ͙̹ͅʇ̼ͷʮͅ˺̼ͅ ચɘ̹̹̼˺ͷʇચ͐͸˺ચ˦ʇ͸ચ̹ͅ;ɻʩʮɘ̼͐ʮɻચʩʇɘˑ͐ʩચʠɘɻʮˑʮ͐ʮʇͅઃɘ̼͐ʮɻˑʇઢ৲৳৹৳৳৹৹ɘચɘ৷৹৵ચৱৱʇɺચɘʁɘৱ -aba5e0219dc9.html; Cara Hallam, “Momentum Builds for Psychiatric Facility Opening,” î̢̅ʚ˃Ʉʕ‫ ף‬k˃̢̅ʯȡʚ, February 14, 2014, https://www.turlockjournal.com/news/government /momentum-builds-for-psychiatric-facility-opening/. 37. This same conclusion was made in reports on the need for beds in San Francisco, Los Angeles, San Diego, and statewide. San Francisco Department of Public Health, “Behavioral Health Bed Optimization Project: Analysis and Recommendations for Improving Patient Flow” (San Francisco, June 2020); LA DMH, “Report Response,” October 29,

366

1 2 . A SY LU M F O R T H E DY I N G

2019; BHS, “Optimal Care Pathways Model”; Ryan McBain et al., “Adult Psychiatric Bed Capacity, Need, and Shortage Estimates in California—2021” (Santa Monica, CA: Rand Corporation, 2022). 38. Morgan C. Shields et al., “Increases in Inpatient Psychiatry Beds Operated by Systems, H˺̼ચØ̼˺ϲʮ͐ͅੴ੮ɘ˦ʁ੮#ʩɘʮ˦ͅੴ੮৲ৰৱৰજ৲ৰৱ৶ੴૂ੮Psychiatric Services 73, no. 5 (2022): 561–64. 39. Newsom, “State of the State—Annotated.” ੮ ৴ৰੳ੮ rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅૄͅ੮šϲϲʮɻʇੴ੮ુ"ʇʩɘͷʮ˺̼ɘˑ੮Pʇɘˑ͐ʩੵ੮#˺˦͐ʮ˦͙͙˚੮U˦ʠ̼ɘ̼͙͐ͅɻ͙̼͐ʇ੮H͙˦ʁʮ˦ʡ੮Ø̼˺posal,” February 2021, https://lao.ca.gov/reports/2021/4379/Behavioral-Health-Continuum -Infrastructure-021721.pdf. 41. McBain et al., “Adult Psychiatric Bed Capacity,” 8. 42. D. J. Jaffe, Uʯ̎ȡʯɐ‫ ף‬#˃ʯ̎ɐ̢̄ɐʯɄɐ̎‫ ףת‬P˃́‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬UʯɊ̢̙͇̎̅‫ ף‬Hȡɷʚ̎‫̙ ף‬ɲɐ‫{ ף‬ɐʯ͗ȡʚʚ͇‫ ף‬Uʚʚ (Amherst, NY: Prometheus, 2017), 82. The evidence so far does not support Jaffe’s claim. A federal pilot project found that allowing IMDs to receive Medicaid funds had little impact on patient outcomes beyond shifting costs from states to the federal government. Mathematica Policy Research, “Medicaid Emergency Psychiatric Services Demonstra͐ʮ˺˦੮ /ͷɘˑ͙ɘ͐ʮ˺˦ੵ੮ Hʮ˦ɘˑ੮ Ûʇ̹˺̼͐ૂ੮ ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮ )#ੵ੮ )ʇ̹ɘ̼͐˚ʇ˦͐੮ ˺ʠ੮ Pʇɘˑ͐ʩ੮ ɘ˦ʁ੮ P͙˚ɘ˦੮ Services, August 18, 2016). 43. As of August 2022, ten states had an IMD waiver for mental health while thirty-four (including California) had one for substance use facilities. Kaiser Family Foundation, ુ{ʇʁʮɻɘʮʁ੮Ĕɘʮͷʇ̼੮î̼ɘɻˌʇ̼ੵ੮̹̹̼˺ͷʇʁ੮ɘ˦ʁ੮Øʇ˦ʁʮ˦ʡ੮ৱৱৱ৵੮Ĕɘʮͷʇ̼ͅ੮ɺ;੮ä͐ɘ͐ʇੴૂ੮Hʇɺ̼͙ɘ̼;੮ৱੴ੮ 2022, https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and -pending-section-1115-waivers-by-state/. 44. Actually implementing an IMD waiver is tricky. One condition imposed by the federal government is that the average statewide length of stay be under thirty days; no stay above sixty days will be reimbursed. The state’s plan for the waiver, released in 2022, delegated ʮ˚̹ˑʇ˚ʇ˦͐ɘ͐ʮ˺˦੮ɺɘɻˌ੮͐˺੮ɻ˺͙˦͐ʮʇͅੴ੮͸ʩ˺੮͸˺͙ˑʁ੮ʩɘͷʇ੮͐˺੮˺̹͐੮ʮ˦ੳ੮Ĕʩʇ͐ʩʇ̼੮͐ʩʇ;੮ʁ˺੮ͅ˺੮͸ʮˑˑੴ੮ʮ˦੮ ͙̼͐˦ੴ੮ʁʇ̹ʇ˦ʁ੮˺˦੮ɻ˺˚̹ˑʇͽ੮˦ʇʡ˺͐ʮɘ͐ʮ˺˦ͅ੮ɺʇ͐͸ʇʇ˦੮ɻ˺͙˦͐ʮʇͅ੮ɘ˦ʁ੮ʠ˺̼ચ̹̼˺ϲʮ͐੮U{)੮˺̹ʇ̼ɘ͐˺̼ͅ੮ over who foots the bill for patients who stay too long (recall that sojourns in IMDs in California are often many months). Department of Health Care Services, “The California Behavioral Health Community-Based Continuum Demonstration,” November 2022, ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʁʩɻͅੳɻɘੳʡ˺ͷઃ#ɘˑU{ઃ)˺ɻ͙˚ʇ˦͐ͅઃ#ɘˑ"Pણ#"#ણ)ʇ˚˺˦̼͐ͅɘ͐ʮ˺˦ચ/ͽ͐ʇ̼˦ɘˑ -Concept-Paper-11-14-22.pdf. 45. Some academics and psychiatrists have echoed this call. Dominic A. Sisti, Andrea G. Segal, and Ezekiel J. Emanuel, “Improving Long-Term Psychiatric Care: Bring Back the Asylum,” k{ 313, no. 3 (2015): 243–44. 46. Dick Spotswood, “Opinion: Our Society Needs to Care for the Homeless Mentally Ill,” {ȡ̅ɷʯ‫ף‬UʯɊɐ̂ɐʯɊɐʯ̙‫ף‬k˃̢̅ʯȡʚ, August 1, 2018.

13. SHARING AUTHORITY, RESTORING AUTONOMY 1.

California’s program conducted twenty thousand forced sterilizations, one-third of the national total. Alexandra Minna Stern, “Sterilized in the Name of Public Health,” AmerɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø̢ɃʚɷɄ‫ף‬Pɐȡʚ̙ɲ 95, no. 7 (2005): 1128–38.

1 3 . S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y 2.

367

The most famous statement of this perspective is Thomas S. Szasz, “The Myth of Mental Illness,” ʣɐ̅ɷɄȡʯ‫ף‬Ø͇̎Ʉɲ˃ʚ˃ɪɷ̙̎ 15, no. 2 (1960): 113–18. 3. Karen L. Fortuna, Phyllis Solomon, and Jennifer Rivera, “An Update of Peer Support/ Øʇʇ̼੮Ø̼˺ͷʮʁʇʁ੮äʇ̼ͷʮɻʇͅ੮õ˦ʁʇ̼ˑ;ʮ˦ʡ੮Ø̼˺ɻʇͅͅʇͅੴ੮"ʇ˦ʇϲʮ͐ͅੴ੮ɘ˦ʁ੮#̼ʮ͐ʮɻɘˑ੮U˦ʡ̼ʇʁʮʇ˦͐ͅੴૂ੮Psychiȡ̙̅ɷɄ‫ף‬Ĺ̢ȡ̙̅ɐ̅ʚ͇ 93 (2022): 575. ੮ ৴ੳ੮ Pʇ˦̼ʮή͙ʇͅ੮ɘͅˌʇʁ੮˚ʇ੮͐˺੮̹ͅʇɻʮʠ;੮͐ʩɘ͐੮ʩʮͅ੮ͷʮʇ͸ͅ੮ɘ̼ʇ੮ʩʮͅ੮˺͸˦ੴ੮˦˺͐੮˦ʇɻʇͅͅɘ̼ʮˑ;੮͐ʩ˺ͅʇ੮˺ʠ੮{Pੳ ੮ ৵ੳ੮ nʇͷʮ˦੮Pʇͅˑʮ˦੮ɘ˦ʁ੮͙ʁ̼ʇ;੮Ĕʇʮͅͅੴ੮ુP˺̹ͅʮ͐ɘˑ੮Ûʇɘʁ˚ʮͅͅʮ˺˦ͅ੮U˦ͷ˺ˑͷʮ˦ʡ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮)ʮͅ˺̼ʁʇ̼ͅੴ੮ ৲ৰৱ৲ૂ੮ ફʡʇ˦ɻ;੮ ʠ˺̼੮ Pʇɘˑ͐ʩɻɘ̼ʇ੮ Ûʇͅʇɘ̼ɻʩ੮ ɘ˦ʁ੮ ĺ͙ɘˑʮ͐;ੴ੮ {ɘ;੮ ৲ৰৱ৵બੴ੮ ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʩɻ͙̹ચ͙ͅ .ahrq.gov/reports/statbriefs/sb189-Hospital-Readmissions-Psychiatric-Disorders -2012.pdf. 6. According to a 2018 report, governments in Canada, Great Britain, Israel, Bulgaria, Israel, U˦ʁʮɘੴ੮͐ʩʇ੮#Έʇɻʩ੮Ûʇ̹͙ɺˑʮɻੴ੮ä͸ʇʁʇ˦ੴ੮‡˺̼͸ɘ;ੴ੮ɘ˦ʁ੮̹ɘ̼͐ͅ੮˺ʠ੮Iʇ̼˚ɘ˦;ੴ੮‡ʇ͸੮Ĥʇɘˑɘ˦ʁੴ੮ɘ˦ʁ੮͙ͅtralia have adopted features of supported decision making. National Council on Disability, “Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination,” March 22, 2018, 61, https://ncd.gov/publications/2018/beyond-guardianship-toward -alternatives. ੮ ৷ੳ੮ šϲϲʮɻʇ੮˺ʠ੮I˺ͷʇ̼˦˺̼੮Iɘͷʮ˦੮‡ʇ͸ͅ˺˚ੴ੮ુI˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮äʮʡ˦ͅ੮rʇʡʮͅˑɘ͐ʮ˺˦੮͐˺੮Ø̼˺͐ʇɻ͐੮#ʮͷʮˑ੮ Rights, Support Community Living for Californians with Disabilities,” September 30, 2022, https://www.gov.ca.gov/2022/09/30/governor-newsom-signs-legislation-to-protect -civil-rights-support-community-living-for-californians-with-disabilities/. 8. National Council on Disability, “Turning Rights Into Reality: How Guardianship and Alternatives Impact the Autonomy of People with Intellectual and Developmental Disabilities,” June 10, 2019, 27, https://ncd.gov/publications/2019/turning-rights-into-reality. 9. Emma Frankham, Christopher Jacobi, and Brandon Vaidyanathan, “Race, Trust in Police, and Mental Health Crisis Support,” #˃ʯ̙ɐ̙͆̎ 20, no. 3 (2021): 60–62. 10. In San Diego, Supervisor Nathan Fletcher stated that it was “the spirit of reform that followed the death of George Floyd” that helped get the city’s nonpolice crisis response “off the ʡ̼˺͙˦ʁੳૂ੮r;˦ʁͅɘ;੮Ĕʮ˦ˌˑʇ;੮ɘ˦ʁ੮îɘ˚˚;੮{͙̼ʡɘੴ੮ુ‡˺੮I͙˦ͅੴ੮‡˺੮"ɘʁʡʇͅੴ੮‡˺੮äʮ̼ʇ˦ͅੳ੮#˺͙˦͐;੮ Reimagines Response to Mental Health Calls,” äȡʯ‫) ף‬ɷɐɪ˃‫ ף‬õʯɷ˃ʯ؅î̅ɷɃ̢ʯɐ, February 27, 2022, https://www.sandiegouniontribune.com/news/health/story/2022-02-27/a-year-in-the -works-san-diegos-mobile-crisis-response-teams-expand-operations-countywide. 11. Harder & Co. Community Research, “Street Crisis Response Team [SCRT] Pilot: Final Ûʇ̹˺̼͐ૂ੮ફäɘ˦੮H̼ɘ˦ɻʮͅɻ˺ੴ੮#ੴ੮{ɘ;੮৲ৰ৲৲બੴ੮ৱੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅʠʁ̹ʩੳ˺̼ʡઃʁ̹ʩઃϲʮˑʇͅઃUĔIઃä#Ûî ઢHʮ˦ɘˑઢÛʇ̹˺̼͐ઢHU‡rચৱઢ;ʇɘ̼ੳ̹ʁʠੳ 12. Harder & Co., “SCRT Pilot,” 7. 13. Although the city’s “coordinated entry” program contacts 63 percent of SCRT cases referred to them, only 9 percent were seen more than once. Harder & Co., “SCRT Pilot,” 16. 14. Harder & Co., “SCRT Pilot,” 13. 15. For a review Margaret E. Balfour et al., “Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies,” Psychiatric Services 73, no. 6 (2022): 658–69. 16. Harder & Co., “SCRT Pilot,” 10.

368 17. ੮ ৱ৸ੳ੮

19.

20. 21. ੮ ৲৲ੳ੮

੮ ৲৳ੳ੮ 24. ੮ ৲৵ੳ੮

26.

27.

28.

1 3 . S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y Sherry Glied and Richard G. Frank, “Mental Illness and Violence: Lessons from the Evidence,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø̢ɃʚɷɄ‫ף‬Pɐȡʚ̙ɲ 104, no. 2 (2014): e5–6. )ɘ˦ʮʇˑ੮Ĕʩʮ͐ʮ˦ʡ੮ʇ͐੮ɘˑੳੴ੮ુͅͅ˺ɻʮɘ͐ʮ˺˦੮˺ʠ੮äɻʩʮΈ˺̹ʩ̼ʇ˦ʮɘ੮ä̹ʇɻ̼͙͐˚੮)ʮͅ˺̼ʁʇ̼ͅ੮ɘ˦ʁ੮ēʮ˺ˑʇ˦ɻʇ੮ Perpetration in Adults and Adolescents from 15 Countries: A Systematic Review and Meta-Analysis,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 79, no. 2 (2022): 120–32. Patrick Sharkey, Gerard Torrats-Espinosa, and Delaram Takyar, “Community and the #̼ʮ˚ʇ੮ )ʇɻˑʮ˦ʇੵ੮ îʩʇ੮ #ɘ͙ͅɘˑ੮ /ʠʠʇɻ͐੮ ˺ʠ੮ r˺ɻɘˑ੮ ‡˺˦̹̼˺ϲʮ͐ͅ੮ ˺˦੮ ēʮ˺ˑʇ˦͐੮ #̼ʮ˚ʇੴૂ੮ American ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 82, no. 6 (2017): 1214–40. Marcia L. Meldrum et al., “Implementation Status of Assisted Outpatient Treatment Programs: A National Survey,” Psychiatric Services 67, no. 6 (2016): 630–35. Jeffrey Geller, “The Evolution of Outpatient Commitment in the USA: From Conunʁ̼͙˚੮͐˺੮ĺ͙ɘʡ˚ʮ̼ʇੴૂ੮Uʯ̙ɐ̅ʯȡ̙ɷ˃ʯȡʚ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬rȡ́‫ף‬ȡʯɊ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 29, no. 3 (2006): 236. îʩʮͅ੮ɻʩɘ˦ʡʇʁ੮ʮ˦੮৲ৰ৲ৰੴ੮͸ʩʇ˦੮"੮ৱ৹৷৶੮̼ʇή͙ʮ̼ʇʁ੮ɻ˺͙˦͐ʮʇͅ੮͐˺੮ʩɘͷʇ੮ɘ˦੮šî੮̹̼˺ʡ̼ɘ˚੮͙˦ˑʇͅͅ੮ their board of supervisors expressly opted out of it. See https://leginfo.legislature.ca.gov ઃʠɘɻʇͅઃɺʮˑˑ‡ɘͷ#ˑʮʇ˦͐ੳͽʩ͐˚ˑ੺ɺʮˑˑઢʮʁଵ৲ৰৱ৹৲ৰ৲ৰৰ"ৱ৹৷৶ੳ Øɘ͙ˑ੮äੳ੮̹̹ʇˑɺɘ͙˚ੴ੮ુ˚ɺʮͷɘˑʇ˦ɻʇ੮#˺ʁʮϲʮʇʁੵ੮#ɘˑʮʠ˺̼˦ʮɘૄͅ੮‡ʇ͸੮š͙̹͐ɘ͐ʮʇ˦͐੮#˺˚˚ʮ͐˚ʇ˦͐੮ Statute,” Psychiatric Services 54, no. 1 (2003): 27. John Coté and Heather Knight, “New Focus on Law to Help Mentally Ill,” San Francisco Chronicle, February 10, 2014. ä͐ɘ͐ʇ͸ʮʁʇੴ੮˺˦ˑ;੮ɘɺ˺͙͐੮৲৵੮̹ʇ̼ɻʇ˦͐੮˺ʠ੮̹ʇ˺̹ˑʇ੮̼ʇʠʇ̼̼ʇʁ੮͐˺੮šî੮ɘ˦ʁ੮ʠ˺͙˦ʁ੮͐˺੮ή͙ɘˑʮʠ;੮ɘ̼ʇ੮ placed on a court order. That totaled 218 individuals in 2018–2019. Department of Health Care Services (DHCS), “Laura’s Law: Assisted Outpatient Treatment Demonstration Project Act of 2002” (Community Services Division, May 2021), 10, https://www.dhcs.ca .gov/formsandpubs/Documents/Legislative%20Reports/Lauras-LawLegRpt-July2018 -June2019.pdf. DHCS, “Laura’s Law,” 4. A meta-review found there is “little evidence for the effectiveness of compulsory community treatment.” Steve R. Kisely and Meredith A. Campbell, “Compulsory Community and Involuntary Outpatient Treatment for People with Severe Mental Disorders,” in #˃Ʉɲ̅ȡʯɐ‫)ף‬ȡ͗ȡɃȡ̎ɐ‫˃ף‬ɩ‫ף‬ä͇̙̎ɐʣȡ̙ɷɄ‫ף‬Ûɐ̀ɷɐ́̎੮ફĔʮˑʇ;ੴ੮৲ৰৱ৴બੴ੮৲৲ੴ੮ http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004408.pub4/abstract. The evidence is particularly lacking for AOT as a form of violence prevention, even though this ʩɘͅ੮˺ʠ͐ʇ˦੮ɺʇʇ˦੮ɺʮˑˑʇʁ੮ɘͅ੮ʮ͐ͅ੮̹̼ʮ˚ɘ̼;੮ˈ͙͐ͅʮϲʮɻɘ͐ʮ˺˦੮ફɘͅ੮ʩʮ˦͐ʇʁ੮ɘ͐੮ɺ;੮͐ʩʇ੮ɻʩ˺ʮɻʇ੮͐˺੮˦ɘ˚ʇ੮ɺʮˑˑͅ੮ after homicide victims). Marvin S. Swartz et al., “Involuntary Outpatient Commitment ɘ˦ʁ੮͐ʩʇ੮/ˑ͙ͅʮͷʇ੮Ø͙̼͙ͅʮ͐੮˺ϲ੮ēʮ˺ˑʇ˦ɻʇ੮Ø̼ʇͷʇ˦͐ʮ˺˦ੵ੮੮ēʮʇ͸੮ʠ̼˺˚੮͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅੴૂ੮CanaɊɷȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 62, no. 2 (2017): 102–8. The statement about San Bernardino’s program was made at a hearing on LPS in the state legislature on December 15, 2021. In Los Angeles, people referred to AOT receive an average of ten contacts with outreach workers. At the end, three times as many people agree to participate in AOT voluntarily as are placed on a court order. Sarah L. Starks et al., “Client Outreach in Los Angeles County’s Assisted Outpatient Treatment Program: Strategies and Barriers to Engagement,” Research on Social Work Practice 32, no. 7 (2022): 839–54. Many ethnographers have documented the skills homeless people develop to survive on the streets. My point here is that at least some individuals, whom we might identify as

1 3 . S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

੮ ৲৹ੳ੮ 30.

31.

32. 33.

34. ੮ ৳৵ੳ੮ 36. ੮ ৳৷ੳ੮ 38.

39.

੮ ৴ৰੳ੮

369

gravely disabled by mental illness, either lack these skills and are dying or have skills that do not translate to life indoors. Mitch Duneier, Sidewalk (New York: Farrar, Straus, and Giroux, 1999); Teresa Gowan, P˃Ƀ˃̎‫ףש‬P̢̙̎ʚɐ̅̎‫ףש‬ȡʯɊ‫"ף‬ȡɄʕ̎ʚɷɊɐ̅̎‫ףת‬P˃ʣɐʚɐ̎̎‫ף‬ɷʯ‫ף‬äȡʯ‫ף‬H̅ȡʯcisco (Minneapolis: University of Minnesota Press, 2010); Tanya Marie Luhrmann, “‘The ä̼͐ʇʇ͐੮Ĕʮˑˑ੮)̼ʮͷʇ੮Ě˺͙੮#̼ɘΈ;ૄੵ੮Ĕʩ;੮P˺˚ʇˑʇͅͅ੮Øͅ;ɻʩ˺͐ʮɻ੮Ĕ˺˚ʇ˦੮ʮ˦੮͐ʩʇ੮U˦͐ͅʮ͙͐͐ʮ˺˦ɘˑ੮#ʮ̼cuit in the United States Often Say No to Offers of Help,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 165, no. 1 (2008): 15–20. k˺ɘή͙ʮ˦੮Øɘˑ˺˚ʮ˦˺੮ɘ˦ʁ੮î̼ʮͅʩɘ੮îʩɘʁɘ˦ʮੴ੮ુ"̼˺ˌʇ˦੮P˺˚ʇͅੴૂ੮San Francisco Chronicle, April 26, 2022. See Stephen Eide, P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ף‬ɷʯ‫ף‬ʣɐ̅ɷɄȡ‫ףת‬îɲɐ‫ף‬Pɷ̙̎˃͇̅‫ף‬ȡʯɊ‫ף‬î̅ȡɪɐɊ͇‫˃ף‬ɩ‫ף‬ȡʯ‫ף‬Uʯ̙̅ȡɄ͗ȡɃʚɐ‫ף‬ä˃Ʉɷȡʚ‫ף‬ Ø̅˃Ƀʚɐʣ੮ફrɘ˦ʩɘ˚ੴ੮{)ੵ੮Û˺͸˚ɘ˦੮૟੮rʮ͐͐ˑʇϲʮʇˑʁੴ੮৲ৰ৲৲બ੶੮{ʮɻʩɘʇˑ੮äʩʇˑˑʇ˦ɺʇ̼ʡʇ̼ੴ੮San Fran̎ɷɄʕ˃‫ףת‬Ĕɲ͇‫ף‬Ø̅˃ɪ̅ɐ̎̎ɷ̀ɐ̎‫ף‬Û̢ɷʯ‫ף‬#ɷ̙ɷɐ̎ (New York: Harper, 2021). The emergence of the fatalistic categorization of board and care residents as “young chronics” is charted by Martin Fleishman, “Board and Care Homes 1984: Return of the House Call,” Psychiatric Annals 15, no. 11 (1985): 654–60. Nineteen percent of clients transported by SCRT are taken to Dore. Harder & Co., “SCRT Pilot,” 13. Research has generally shown that residential crisis services are as effective in improving symptoms and functioning as inpatient stays, with higher user satisfaction and ˑ˺͸ʇ̼੮ɻ˺͐ͅͅੳ੮"ʇͷʮ˦੮#̼˺ʠ͐੮ɘ˦ʁ੮‡ʮˑͣʠʇ̼੮aͅͷɘ˦ੴ੮ુU˚̹ɘɻ͐੮˺ʠ੮͐ʩʇ੮äʇɻ˺˦ʁ੮ä͐˺̼;੮Øʇʇ̼੮Ûʇ̹ͅʮ͐ʇ੮ Program on Use of Inpatient and Emergency Services,” Psychiatric Services 66, no. 6 ફ৲ৰৱ৵બੵ੮৶৳৲જ৳৷੶੮îʩ˺˚ɘͅ੮nੳ੮I̼ʇʇ˦ϲʮʇˑʁ੮ʇ͐੮ɘˑੳੴ੮ુ੮Ûɘ˦ʁ˺˚ʮΈʇʁ੮î̼ʮɘˑ੮˺ʠ੮ɘ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ Consumer-Managed Alternative to Civil Commitment for Acute Psychiatric Crisis,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬#˃ʣʣ̢ʯɷ̙͇‫ף‬Ø͇̎Ʉɲ˃ʚ˃ɪ͇ 42, no. 1 (2008): 135–44; Kerry A. Thomas and Debra Rickwood, “Clinical and Cost-Effectiveness of Acute and Subacute Residential Mental Health Services: A Systematic Review,” Psychiatric Services 64, no. 11 (2013): 1140–49. California State Legislature, “AB 3052: Community Residential Treatment Act,” 1978. ä˺ˑͷʇʮʡ੮ Ûʇʮ˦ʁɘˑੴ੮ ુU˦ʁʇ̹ʇ˦ʁʇ˦ɻʇੴ੮ )ʇ̹ʇ˦ʁʇ˦ɻʇੴ੮ U˦͐ʇ̼ʁʇ̹ʇ˦ʁʇ˦ɻʇੵ੮ ä˺˚ʇ੮ Ûʇϲˑʇɻ͐ʮ˺˦ͅ੮ ˺˦੮ the Subject and Personal Autonomy,” )ɷ̎ȡɃɷʚɷ̙͇‫ףغף‬ä˃Ʉɷɐ̙͇ 14, no. 3 (1999): 364. This comment was made in a hearing before the State Assembly Judiciary Committee on LPS reform on December 15, 2021. Pʇɘ̼͐੮H˺̼͸ɘ̼ʁੴ੮ુĔʩɘ͐੮Uͅ੮Øʇʇ̼੮Ûʇ̹ͅʮ͐ʇ੮ɘ˦ʁ੮Ĕʩ;੮)˺˦ૄ͐੮Ĕʇ੮Pɘͷʇ੮{˺̼ʇ੮#̼ʮͅʮͅ੮"ʇʁͅ੮ͷɘʮˑable?” April 5, 2022, https://www.heartforwardla.org/season-3. Some studies show that respites help reduce the use of hospitals and ERs while othʇ̼ͅ੮ ʮʁʇ˦͐ʮʠ;੮ ͐ʩʇʮ̼੮ ˚ɘʮ˦੮ ʮ˚̹ɘɻ͐੮ ɘͅ੮ ʮ˚̹̼˺ͷʮ˦ʡ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ͅɘ͐ʮͅʠɘɻ͐ʮ˺˦ੳ੮ #̼˺ʠ͐੮ ɘ˦ʁ੮ aͅͷɘ˦ੴ੮ ુU˚̹ɘɻ͐੮ ˺ʠ੮ ͐ʩʇ੮ äʇɻ˺˦ʁ੮ ä͐˺̼;੮ Øʇʇ̼੮ Ûʇ̹ͅʮ͐ʇ੮ Ø̼˺ʡ̼ɘ˚ૂ੶੮ I̼ʇʇ˦ϲʮʇˑʁ੮ ʇ͐੮ ɘˑੳੴ੮ ુÛɘ˦ʁ˺˚ʮΈʇʁ੮ Trial of a Mental Health Consumer-Managed Alternative.” Sarah Kwon, “These Neighborly Havens Help People Facing Mental Health Crises,” Los ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, January 11, 2021, https://www.latimes.com/california/story/2021-01-11/peer -respites-people-facing-mental-health-crises-pandemic. k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ુõ˦ɘ˦ͅ͸ʇ̼ʇʁ੮#̼ʮʇͅੵ੮Ĕʩ;੮#ɘˑʮʠ˺̼˦ʮɘ੮Hɘɻʇͅ੮ɘ੮äʩ˺̼͐ɘʡʇ੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ Ĕ˺̼ˌʇ̼ͅੴૂ੮CalMatters, September 25, 2022, https://www.ijpr.org/health-and-medicine/2022 -09-25/unanswered-cries-why-california-faces-a-shortage-of-mental-health-workers.

370 41.

1 3 . S H A R I N G AU T H O R I T Y, R E S TO R I N G AU TO N O M Y

Liat Ben-Moshe, “Alternatives to (Disability) Incarceration,” in )ɷ̎ȡɃɷʚɷ̙͇‫ ף‬UʯɄȡ̅Ʉɐ̅ȡ̙ɐɊ‫ףת‬ Uʣ̂̅ɷ̎˃ʯʣɐʯ̙‫ ף‬ȡʯɊ‫) ף‬ɷ̎ȡɃɷʚɷ̙͇‫ ף‬ɷʯ‫̙ ף‬ɲɐ‫ ף‬õʯɷ̙ɐɊ‫ ף‬ä͗ȡ̙ɐ̎‫ ף‬ȡʯɊ‫ ף‬#ȡʯȡɊȡ, ed. Liat Ben-Moshe, Chris Chapman, and Allison C. Carey (New York: Palgrave Macmillan, 2014), 262. ੮ ৴৲ੳ੮ Pʇɘ̼͐੮H˺̼͸ɘ̼ʁੴ੮ુĔʩɘ͐੮Uͅ੮Øʇʇ̼੮Ûʇ̹ͅʮ͐ʇ੺ૂ ੮ ৴৳ੳ੮ H˺͙˦͐ɘʮ˦੮ P˺͙ͅʇੴ੮ ુîʩʇ੮ Ĕʇˑˑ̹̼ͅʮ˦ʡ੮ ˺ʠ੮ ͐ʩʇ੮ #ˑ͙ɺʩ˺͙ͅʇ੮ {˺ʁʇˑ੮ ʠ˺̼੮ ä˺ɻʮɘˑ੮ ɘ˦ʁ੮ ē˺ɻɘ͐ʮ˺˦ɘˑ੮ Adjustment of Persons with Serious Mental Illness,” Psychiatric Services 50 (1999): 1473–76. 44. Clubhouse International, “Clubhouse Directory,” accessed October 18, 2022, https:// clubhouse-intl.org/what-we-do/international-directory/. 45. John H. Beard, Rudyard N. Propst, and Thomas J. Malamud, “The Fountain House Model of Psychiatric Rehabilitation,” Ø͇̎Ʉɲ˃̎˃Ʉɷȡʚ‫ף‬ÛɐɲȡɃɷʚɷ͗ȡ̙ɷ˃ʯ‫ף‬k˃̢̅ʯȡʚ 5 (1982): 47. 46. Sue E. Estroff, {ȡʕɷʯɪ‫ף‬U̙‫ף‬#̅ȡ͇͑‫ףת‬ʯ‫ף‬/̙ɲʯ˃ɪ̅ȡ̂ɲ͇‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬#ʚɷɐʯ̙̎‫ף‬ɷʯ‫ף‬ȡʯ‫ף‬ʣɐ̅ɷɄȡʯ‫ף‬#˃ʣmunity (Berkeley: University of California Press, 1981), 119; see also Helena Hansen, Philippe Bourgois, and Ernest Drucker, “Pathologizing Poverty: New Forms of Diagnosis, )ʮͅɘɺʮˑʮ͐;ੴ੮ɘ˦ʁ੮ä̼͙͐ɻ͙̼͐ɘˑ੮ä͐ʮʡ˚ɘ੮õ˦ʁʇ̼੮Ĕʇˑʠɘ̼ʇ੮Ûʇʠ˺̼˚ੴૂ੮Social Science & Medicine 103 (2014): 76–83. 47. Fortuna, Solomon, and Rivera, “An Update of Peer Support”; Steve Gillard et al., “Peer Support for Discharge from Inpatient Mental Health Care Versus Care as Usual in England (ENRICH): A Parallel, Two-Group, Individually Randomised Controlled Trial,” Lancet Psychiatry੮৹ੴ੮˦˺ੳ੮৲੮ફ৲ৰ৲৲બੵ੮ৱ৲৵જ৳৶੶੮äɘ̼ɘʩ੮Ĕʩʮ͐ʇ੮ʇ͐੮ɘˑੳੴ੮ુîʩʇ੮/ʠʠʇɻ͐ʮͷʇ˦ʇͅͅ੮˺ʠ੮š˦ʇચ͐˺ચ One Peer Support in Mental Health Services: A Systematic Review and Meta-Analysis,” BMC Psychiatry 20, no. 1 (2020): 534; Cecilie Høgh Egmose, Chalotte Heinsvig Poulsen, Carsten Hjorthøj, Sara Skriver Mundy, Lone Hellström, Mette Nørgaard Nielsen, Lisa Korsbek, Klavs Serup Rasmussen, and Lene Falgaard Eplov, “The Effectiveness of Peer Support in Personal and Clinical Recovery—Systematic Review and Meta-Analysis.” Psychiatric Services appi.ps.202100138. doi: 10.1176/appi.ps.202100138 (2023). 48. Anne-Sophie Gaillard et al., “The Content of Psychiatric Advance Directives: A Systematic Review,” Psychiatric Services, August 30, 2022. 49. Mark H. de Jong et al., “Interventions to Reduce Compulsory Psychiatric Admissions: A Systematic Review and Meta-Analysis,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 73, no. 7 (2016): 657–64; Emma Molyneaux et al., “Crisis-Planning Interventions for People with Psychotic Illness or Bipolar Disorder: Systematic Review and Meta-Analyses,” "kØ͇̎Ʉɲ‫̂šף‬ɐʯ 5, no. 4 (2019). 50. Christopher Schneiders et al., “Psychiatric Advance Directives and Supported Decision-Making: Preliminary Developments and Pilot Studies in California,” in {ɐʯ͗ȡʚ‫ף‬ Pɐȡʚ̙ɲ‫ףש‬rɐɪȡʚ‫ף‬#ȡ̂ȡɄɷ̙͇‫ףש‬ȡʯɊ‫ף‬P̢ʣȡʯ‫ף‬Ûɷɪɲ̙̎, ed. Charlene Sunkel et al. (Cambridge: Cambridge University Press, 2021), 300. 51. Concepts Forward, Inc, “Psychiatric Advance Directives Multi-County Collaborative” (Mental Health Services Oversight and Accountability Commission, May 2021), http:// ͸͸͸ੳ˚ʩͅ˺ɘɻੳɻɘੳʡ˺ͷઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃ{͙ˑ͐ʮେ৲ৰ#˺͙˦͐;ઢU‡‡ઢØ)ͅઢৰੳ̹ʁʠੳ 52. Emile Durkheim, Suicide (New York: Free Press, 1997 [1897]), 276. 53. As one review concluded, “the clinical reality suggests that residual autonomy and decisional freedom exist, even for involuntarily hospitalized patients.” Anna Saya et al., “Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around ͐ʩʇ੮Ĕ˺̼ˑʁੵ੮੮‡ɘ̼̼ɘ͐ʮͷʇ੮Ûʇͷʮʇ͸ੴૂ੮Frontiers in Psychiatry 10 (2019): 2.

C O N C LU S I O N 54.

55. 56.

57.

371

Aurélie Tinland et al., “Effect of Psychiatric Advance Directives Facilitated by Peer Ĕ˺̼ˌʇ̼ͅ੮˺˦੮#˺˚̹͙ˑͅ˺̼;੮ʁ˚ʮͅͅʮ˺˦੮˚˺˦ʡ੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅੵ੮੮Ûɘ˦ʁ˺˚ʮΈʇʁ੮ Clinical Trial,” k{‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 79, no. 8 (2022): 752–59. Jeffrey Guhin, ɪɐʯ̙̎‫˃ ף‬ɩ‫ ף‬I˃Ɋ‫̢˃" ףת‬ʯɊȡ̅ɷɐ̎‫ ף‬ȡʯɊ‫̢̙ ף‬ɲ˃̅ɷ̙͇‫ ף‬ɷʯ‫̢̎{ ף‬ʚɷʣ‫ ף‬ȡʯɊ‫ ף‬#ɲ̅ɷ̙̎ɷȡʯ‫ ף‬äɄɲ˃˃ʚ̎ (New York: Oxford University Press, 2021). Adrianna Bagnall and Gil Eyal, “Forever Children and Autonomous Citizens: Comparing the Deinstitutionalizations of Psychiatric Patients and Developmentally Disabled Individuals in the United States,” in Hɷɩ̙͇‫ף‬Ěɐȡ̅̎‫ף‬ɩ̙ɐ̅‫)ף‬ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ͑ȡ̙ɷ˃ʯ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬ in Contemporary Communities, ed. Brea L. Perry (Bingley, UK: Emerald, 2016), 42. Hannah Arendt, Between Past and Future, ed. Jerome Kohn (New York: Penguin, 2006), 92.

CONCLUSION: BEYOND MIRACLES ੮ ৱੳ੮ H˺̼੮ʇͽɘ˚̹ˑʇੴ੮͐͸ʇ˦͐;ચϲʮͷʇ੮͐ͅɘ͐ʇͅ੮ʩɘͷʇ੮̹ɘͅͅʇʁ੮ˑɘ͸ͅ੮ʇͽ̹ɘ˦ʁʮ˦ʡ੮ʠ˺̼ɻʇʁ੮ʁ̼͙ʡ੮̼͐ʇɘ͐˚ʇ˦͐੮ʮ˦੮͐ʩʇ੮ past four years. Health in Justice Lab, “Involuntary Commitment for Substance Use,” accessed October 17, 2022, https://www.healthinjustice.org/involuntary-commitment-for -substanc. 2. Gi Lee and David Cohen, “Incidences of Involuntary Psychiatric Detentions in 25 U.S. States,” Psychiatric Services 71, no. 1 (2021): 61–68; Luke Sheridan Rains et al., “Variations in Patterns of Involuntary Hospitalisation and in Legal Frameworks: An International Comparative Study,” Lancet Psychiatry 6, no. 5 (2019): 403–17. 3. Bernice A. Pescosolido, Bianca Manago, and John Monahan, “Evolving Public Views ˺˦੮͐ʩʇ੮rʮˌʇˑʮʩ˺˺ʁ੮˺ϲ੮ēʮ˺ˑʇ˦ɻʇ੮ʠ̼˺˚੮Øʇ˺̹ˑʇ੮͸ʮ͐ʩ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅੵ੮ä͐ʮʡ˚ɘ੮ɘ˦ʁ੮U͐ͅ੮#˺˦ͅʇή͙ʇ˦ɻʇͅੴૂ੮Pɐȡʚ̙ɲ‫ף‬ɩ͖ȡɷ̅̎ 38, no. 10 (2019): 1735–43. 4. California State Assembly, Committee on Judiciary, https://ajud.assembly.ca.gov/reports. ੮ ৵ੳ੮ äʮʡ̼ʮʁ੮"ɘ͐ʩʇ˦ੴ੮ુ#ɘ̹ʮ͐˺ˑ੮Ĕʇʇˌˑ;੮U˦͐ʇ̼ͷʮʇ͸ੵ੮ä͙ͅɘ˦੮îɘˑɘ˚ɘ˦͐ʇͅ੮/ʡʡ˚ɘ˦ੴૂ੮Capitol Weekly, September 20, 2021; Susan Eggman, “Modernizing Our Behavioral Health Continuum” (Stockton: California State Senate, April 4, 2022), 2, https://sd05.senate.ca.gov/sites/sd05 ੳͅʇ˦ɘ͐ʇੳɻɘੳʡ˺ͷઃϲʮˑʇͅઃ̹ʁʠઃØɘɻˌʇ͐େ৲ৰ{˺ʁʇ̼˦ʮΈʮ˦ʡେ৲ৰš͙̼େ৲ৰ"ʇʩɘͷʮ˺̼ɘˑେ৲ৰPʇɘˑ͐ʩେ৲ৰ Continuum.pdf. 6. This process of serial or stacked 5150s takes place in at least seven counties. In Imperial County, one individual stayed in an ER for forty-four days. Although LPS is unclear about when exactly the seventy-two-hour clock starts—which creates some ambiguity ͐ʩɘ͐੮͐ͅɘ͐ʇ੮̼ʇʡ͙ˑɘ͐˺̼ͅ੮ʩɘʁ੮ʠɘʮˑʇʁ੮͐˺੮ɻˑɘ̼ʮʠ;ઝʮ͐ૄͅ੮ʁʮϲϲʮɻ͙ˑ͐੮͐˺੮ɺʇˑʮʇͷʇ੮͐ʩɘ͐੮ʩ˺̹ͅʮ͐ɘˑͅ੮͐ʩʮ˦ˌ੮ denying someone the hearing they would get if they passed to a 5250 is consistent with the spirit of the law. Jennifer Bowman, “Imperial County’s Use of Psychiatric Holds Appears to Violate State Law,” INewSource, September 22, 2022, https://inewsource.org /2022/09/22/imperial-county-serial-psychiatric-holds/. 7. The laws discussed in this section are, in order, SB 929, Community Mental Health Services: Data Collection; AB 2275, Mental Health: Involuntary Commitment; SB 970, Mental Health Services Act; SB 1154, Facilities for Mental Health or Substance Use Disorder Crisis: Database; SB 965, Conservatorships: Medical Record: Hearsay Rule; SB 1227, Mental Health Services: Gravely Disabled Persons. Information on each bill can be found at leginfo.legislature.ca.gov.

372

C O N C LU S I O N

੮ ৸ੳ੮ äʮʡ̼ʮʁ੮"ɘ͐ʩʇ˦ੴ੮ુ#ɘ̹ʮ͐˺ˑ੮Ĕʇʇˌˑ;੮U˦͐ʇ̼ͷʮʇ͸ੵ੮Ûɘ˦ʁɘˑˑ੮Pɘʡɘ̼੮ɘ˦ʁ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮#ɘ̼ʇੴૂ੮Capitol Weekly, September 12, 2022, https://capitolweekly.net/capitol-weekly-interview-randall -hagar-and-mental-health-care/. ੮ ৹ੳ੮ î͸˺੮ ̹˺͐ʇ˦͐ʮɘˑˑ;੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ʇͽ̹ɘ˦ͅʮ˺˦ͅ੮ ˺ʠ੮ ʠ˺̼ɻʇʁ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ̹̼˺̹˺ͅʇʁ੮ ɺ;੮ /ʡʡ˚ɘ˦੮ ʁʮʁ੮ pass, however. One bill would allow medication to be included in court-ordered AOT plans (SB-1035, Mental Health Services: Assisted Outpatient Treatment). Another would expand the use of 5270s, an alternative to temporary conservatorship that allows hospitals to hold a gravely disabled person for an additional thirty days without going to court. The bill would allow for a second 5270 hold (SB 1227, Involuntary Commitment: Intensive Treatment). 10. Newsom’s senior counselor, Jason Elliot, stated, “One of the important and early stra͐ʇʡʮɻ੮ ̹˺ˑʮɻ;੮ ʁʇɻʮͅʮ˺˦ͅ੮ ͐ʩʇ੮ ʡ˺ͷʇ̼˦˺̼੮ ˚ɘʁʇ੮ ͸ɘͅ੮ ˦˺͐੮ ͐˺੮ ɘ͐͐ʇ˚̹͐੮ ɘ੮ ͅʮʡ˦ʮϲʮɻɘ˦͐੮ ̼ʇʠ˺̼˚੮ ˺ʠ੮ rØäੳ੯ੳ੯ੳ੯ੳ੮ä˺˚ʇ͐ʮ˚ʇͅ੮͐˺੮˚ɘˌʇ੮ɘ੮̼ʇɘˑ੮̹˺ˑʮɻ;੮ɺ̼ʇɘˌ͐ʩ̼˺͙ʡʩੴ੮;˺͙੮˦ʇʇʁ੮͐˺੮ɻ͙͐੮ɘ੮˦ʇ͸੮̹ɘ͐ʩੳૂ੮ Sigrid Bathen, “Helping Mentally Ill People: The Debate Over ‘Involuntary Treatment,’” Capitol Weekly, May 18, 2022, https://capitolweekly.net/helping-mentally-ill-people-the -debate-over-involuntary-treatment/. 11. California Health and Human Services Agency, “CARE Court FAQ” (Sacramento, CA, äʇ̹͐ʇ˚ɺʇ̼੮৲ৰ৲৲બੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳɻʩʩͅੳɻɘੳʡ˺ͷઃ͸̹ચɻ˺˦͐ʇ˦͐ઃ͙̹ˑ˺ɘʁͅઃ৲ৰ৲৲ઃৰ৹ઃ#Û/ઢHÚੳ̹ʁʠੳ 12. Governor Gavin Newsom, “Press Conference: Governor Newsom Unveils Plan for Californians Struggling with Behavioral Health Challenges,” March 3, 2022, https://www ੳ;˺͙͙͐ɺʇੳɻ˺˚ઃ͸ɘ͐ɻʩ੺ͷଵ‡IͷÚઢĚÛ̼Ø/ੳ 13. A member of the governor’s team “disputes widespread criticism that the plan entails ૃʠ˺̼ɻʇʁૄ੮̼͐ʇɘ͐˚ʇ˦͐ੴૂ੮͐ͅɘ͐ʮ˦ʡੴ੮ુîʩʇ̼ʇ੮ʮͅ੮ɘ੮ɻ˺͙̼͐ચ˺̼ʁʇ̼ʇʁ੮ɻɘ̼ʇ੮̹ˑɘ˦੮યɺ͙͐ર੯ੳ੯ੳ੯ੳ੮˦˺͐੮ɘ੮ˑ˺ɻˌʇʁ੮ door.” Bathen, “Helping Mentally Ill People.” 14. Darrell Steinberg, “CARE Court Plan Rightly Targets Government’s Responsibilities on Homelessness,” CalMatters, August 19, 2022, https://calmatters.org/commentary/2022/08 /care-court-plan-rightly-targets-states-responsibilities-on-homelessness/. 15. The 2022 budget allocation for CARE courts was $88 million: $57 million for county ͐ͅɘ̼͐ચ͙̹੮ɻ˺͐ͅͅ੮ɘ˦ʁ੮ଏ৳ৱ੮˚ʮˑˑʮ˺˦੮͐˺੮̼͐ɘʮ˦੮ɻ˺͙̼͐੮͐ͅɘʠʠੳ੮{ɘ˦͙ʇˑɘ੮î˺ɺʮɘͅ੮ɘ˦ʁ੮k˺ɻʇˑ;˦੮Ĕʮʇ˦ʇ̼ੴ੮ ુ#ɘˑʮʠ˺̼˦ʮɘ੮rɘ͸˚ɘˌʇ̼ͅ੮̹̹̼˺ͷʇʁ੮#Û/੮#˺͙̼͐ੳ੮Ĕʩɘ͐੮#˺˚ʇͅ੮‡ʇͽ͐੺ੴૂ੮CalMatters, September 8, 2022, https://calmatters.org/housing/2022/09/california-lawmakers-approved-care -court-what-comes-next/. ੮ ৱ৶ੳ੮ šϲϲʮɻʇ̼੮˺ʠ੮I˺ͷʇ̼˦˺̼੮Iɘͷʮ˦੮‡ʇ͸ͅ˺˚ੴ੮ુI˺ͷʇ̼˦˺̼੮‡ʇ͸ͅ˺˚੮äʮʡ˦ͅ੮#Û/੮#˺͙̼͐੮U˦͐˺੮rɘ͸ੴ੮ Providing a New Path Forward for Californians Struggling with Serious Mental Illness,” September 14, 2022, https://www.gov.ca.gov/2022/09/14/governor-newsom-signs-care -court-into-law-providing-a-new-path-forward-for-californians-struggling-with-serious -mental-illness/. 17. E. Fuller Torrey, ʣɐ̅ɷɄȡʯ‫ף‬Ø͇̎Ʉɲ˃̎ɷ̎‫ףת‬P˃́‫̙ף‬ɲɐ‫ף‬HɐɊɐ̅ȡʚ‫ף‬I˃̀ɐ̅ʯʣɐʯ̙‫)ף‬ɐ̙̎̅˃͇ɐɊ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬ Treatment System (Oxford: Oxford University Press, 2013), 88. “The system has become decentralized, so much so that the term ‘system’ borders on a misnomer.” Richard G. Frank and Sherry A. Glied, "ɐ̙̙ɐ̅‫ף‬Ƀ̢̙‫ף̙˃‡ף‬Ĕɐʚʚ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬Ø˃ʚɷɄ͇‫ף‬ɷʯ‫̙ף‬ɲɐ‫ף‬õʯɷ̙ɐɊ‫ף‬ä͗ȡ̙ɐ̎‫ף‬ äɷʯɄɐ‫ף‬ըհլէ (Baltimore: Johns Hopkins University Press, 2006), 5. 18. Community mental health centers “attracted a new type of patient who was not very ill and not a candidate for hospitalization in a state institution.” Comptroller General of

C O N C LU S I O N

373

͐ʩʇ੮õ˦ʮ͐ʇʁ੮ä͐ɘ͐ʇͅੴ੮ુÛʇ͙̼͐˦ʮ˦ʡ੮͐ʩʇ੮{ʇ˦͐ɘˑˑ;੮)ʮͅɘɺˑʇʁ੮͐˺੮͐ʩʇ੮#˺˚˚͙˦ʮ͐;ૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮ DC, 1977), 73. 19. Comptroller General, “Returning the Mentally Disabled to the Community,” 5; Steering Committee on the Chronically Mentally Ill, “Toward a National Plan for the Chronically Mentally Ill” (Rockville, MD: U.S. Department of Health and Human Services, December 1980), 1–6. 20. Torrey, American Psychosis, 89. 21. Substance Abuse and Mental Health Services Administration, “Projections of National Expenditures for Treatment of Mental and Substance Use Disorders, 2010–2020” (Rockville, MD: U.S. Department of Health and Human Services, 2014). Note that part of Medicaid (which provided 30 percent of the budget for mental health in 2020) is paid for by states. 22. David Mechanic, “More People Than Ever Before Are Receiving Behavioral Health Care in the United States, but Gaps and Challenges Remain,” Pɐȡʚ̙ɲ‫ף‬ɩ͖ȡɷ̅̎ 33, no. 8 (2014): 1416–24. ੮ ৲৳ੳ੮ ‡ɘ͐ʮ˺˦ɘˑ੮ U˦͐ͅʮ͙͐͐ʇ੮ ˺ʠ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩੴ੮ ુ{ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ õ˦ʮ͐ʇʁ੮ ä͐ɘ͐ʇͅੴૂ੮ )PPäણ){ચ 85-1378 (Rockville, MD: U.S. Department of Health and Human Services, 1985). The National Mental Health Services Survey provides a point-in-time percentage of hospital inpatients by legal status, but the survey design does not allow us to estimate the total number of people subject to involuntary care. Substance Abuse and Mental Health Services ʁ˚ʮ˦ʮ̼͐ͅɘ͐ʮ˺˦ੴ੮ુ‡ɘ͐ʮ˺˦ɘˑ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇͅ੮ä͙̼ͷʇ;੮ફ‡ણ{Pääબ੮৲ৰ৲ৰੵ੮)ɘ͐ɘ੮˺˦੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮î̼ʇɘ͐˚ʇ˦͐੮Hɘɻʮˑʮ͐ʮʇͅૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੵ੮)ʇ̹ɘ̼͐˚ʇ˦͐੮˺ʠ੮Pʇɘˑ͐ʩ੮ɘ˦ʁ੮P͙˚ɘ˦੮äʇ̼ͷʮɻʇͅੴ੮ )ʇɻʇ˚ɺʇ̼੮ ৲ৰ৲ৱબੴ੮ ʩ̹͐͐ͅੵઃઃͅɘ˚ʩͅɘੳʡ˺ͷઃʁɘ͐ɘઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃ৲ৰৱ৶ઢ‡ɘ͐ʮ˺˦ɘˑઢ{ʇ˦͐ɘˑ ઢPʇɘˑ͐ʩઢäʇ̼ͷʮɻʇͅઢä͙̼ͷʇ;ੳ̹ʁʠ 24. President’s New Freedom Commission on Mental Health, “Achieving the Promise: Transforming Mental Health Care in America” (Rockville, MD, 2003). A recently published report on civil commitments reviews the history of commitment statutes and lays out ethical principles, but does not provide any new data on how commitments are being used. Substance Abuse and Mental Health Services Administration, “Civil Commitment and the Mental Health Care Continuum: Historical Trends and Principles for Law and Practice” (Rockville, MD: Department of Health and Human Services, 2019), ʩ̹͐͐ͅੵઃઃ͸͸͸ੳͅɘ˚ʩͅɘੳʡ˺ͷઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃɻʮͷʮˑચɻ˺˚˚ʮ͐˚ʇ˦͐ચɻ˺˦͐ʮ˦͙͙˚ચ˺ʠચɻɘ̼ʇੳ̹ʁʠੳ 25. “President Joe Biden: The 2022 60 Minutes Interview,” խէ‫{ף‬ɷʯ̢̙ɐ̎ (CBS, September 18, 2022), https://www.cbsnews.com/news/president-joe-biden-60-minutes-interview-transcript -2022-09-18/. 26. Gregg Gonsalves, “No, Joe Biden, the Pandemic Is Not Over,” Nation, September 30, 2022, https://www.thenation.com/article/society/biden-pandemic-over-deaths/. ੮ ৲৷ੳ੮ rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅ੮šϲϲʮɻʇੴ੮ુîʩʇ੮৲ৰ৲ৱજ৲৲੮"͙ʁʡʇ͐ੵ੮ä͐ɘ͐ʇ੮#˺̼̼ʇɻ͐ʮ˺˦ɘˑ੮Ø˺̹͙ˑɘ͐ʮ˺˦੮š͙͐ˑ˺˺ˌૂ੮ (Sacramento, CA, November 2020), https://lao.ca.gov/reports/2020/4304/correctional -population-outlook-111920.pdf. ੮ ৲৸ੳ੮ {ɘ;ɘ੮rɘ͙ੴ੮ુU˦੮rɘ˦ʁ˚ɘ̼ˌ੮{˺ͷʇੴ੮rੳੳ੮#˺͙˦͐;੮Ĕʮˑˑ੮Ûʇ̹ˑɘɻʇ੮{ʇ˦ૄͅ੮#ʇ˦̼͐ɘˑ੮kɘʮˑ੮͸ʮ͐ʩ੮{ʇ˦͐ɘˑ੮ Health Hospital for Inmates,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, February 13, 2019, https://www.latimes .com/local/lanow/la-me-jail-construction-20190212-story.html. 29. Francisco Aviles Pino, “Los Angeles County Votes to Stop Construction of New Jail-Like Facility, Adding Momentum to National Abolition Movement,” Intercept, August 22,

3 74

C O N C LU S I O N

2019, https://theintercept.com/2019/08/22/los-angeles-county-mental-health-facility -abolition/. 30. James Blanco, “Op-Ed: An L.A. Program Helps People Get Mental Health Care Instead ˺ʠ੮kɘʮˑ੮îʮ˚ʇੳ੮Ĕʩ;੮‡˺͐੮/ͽ̹ɘ˦ʁ੮U͐੺ੴૂ੮r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, July 18, 2022, https://www.latimes .com/opinion/story/2022-07-18/jails-mental-health-los-angeles-county-diversion. 31. See also Armando Lara-Millán, “The Administrative Disappearing of State Crisis: The Resolution of Prison Realignment in Los Angeles County,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬ä˃Ʉɷ˃ʚ˃ɪ͇ 127, no. 5 (2022): 1460–1506. 32. Frances Fox Piven and Richard Cloward, Ûɐɪ̢ʚȡ̙ɷʯɪ‫̙ף‬ɲɐ‫ף‬Ø˃˃̅‫ףת‬îɲɐ‫ף‬H̢ʯɄ̙ɷ˃ʯ̎‫˃ף‬ɩ‫ף‬Ø̢ɃʚɷɄ‫ף‬Ĕɐʚ͖ȡ̅ɐ (New York: Vintage, 2012); Joe Soss, Richard C. Fording, and Sanford F. Schram, )ɷ̎Ʉɷ̂ʚɷʯɷʯɪ‫̙ף‬ɲɐ‫ף‬Ø˃˃̅‫‡ףת‬ɐ˃ʚɷɃɐ̅ȡʚ‫ף‬Øȡ̙ɐ̅ʯȡʚɷ̎ʣ‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬Øɐ̅̎ɷ̙̎ɐʯ̙‫ף‬Ø˃́ɐ̅‫˃ף‬ɩ‫ף‬ÛȡɄɐ (Champagne, IL: University of Chicago Press, 2011); Forrest Stuart, )˃́ʯ‫ףש̢͗šףש‬ȡʯɊ‫ף‬õʯɊɐ̅‫̅̅ף‬ɐ̙̎‫ףת‬Ø˃ʚɷɄɷʯɪ‫ף‬ and Everyday Life in Skid Row (Chicago: University of Chicago Press, 2016). 33. Yeheskel Hasenfeld, “People Processing Organizations: An Exchange Approach,” AmerɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 37, no. 3 (1972): 256–63; Michael Lipsky, Street-Level Bureaucracy: )ɷʚɐʣʣȡ̎‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬UʯɊɷ̀ɷɊ̢ȡʚ‫ף‬ɷʯ‫ף‬Ø̢ɃʚɷɄ‫ף‬äɐ̅̀ɷɄɐ, thirtieth anniversary ed. (New York: Russell Sage Foundation, 2010); Jeffrey Prottas, Øɐ˃̂ʚɐ‫ ף‬Ø̅˃Ʉɐ̎̎ɷʯɪ‫ ףת‬îɲɐ‫ ף‬ä̙̅ɐɐ̙؅rɐ̀ɐʚ‫̢̅" ף‬ɐȡ̢Ʉ̅ȡ̙‫ ף‬ɷʯ‫ף‬ Ø̢ɃʚɷɄ؅äɐ̅̀ɷɄɐ‫̢̅"ף‬ɐȡ̢Ʉ̅ȡɄɷɐ̎ (Lexington, MA: Lexington, 1979). 34. Josh Seim, "ȡʯɊȡɪɐ‫ףש‬ä˃̅͗‫ףש‬ȡʯɊ‫ף‬P̢̙̎ʚɐ‫ףת‬ʣɃ̢ʚȡʯɄɐ‫ף‬#̅ɐ́̎‫˃ף‬ʯ‫̙ף‬ɲɐ‫ף‬H̅˃ʯ̙ʚɷʯɐ̎‫˃ף‬ɩ‫ף‬õ̅Ƀȡʯ‫ף‬ä̢ɩɩɐ̅ɷʯɪ (Berkeley: University of California Press, 2019). 35. Armando Lara-Millán, ÛɐɊɷ̙̎̅ɷɃ̢̙ɷʯɪ‫̙ ף‬ɲɐ‫ ף‬Ø˃˃̅‫ ףת‬kȡɷʚ̎‫ ףש‬P˃̎̂ɷ͗ȡʚ̎‫ ףש‬ȡʯɊ‫̙ ף‬ɲɐ‫ ף‬#̅ɷ̎ɷ̎‫˃ ף‬ɩ‫ ף‬rȡ́‫ ף‬ȡʯɊ‫ף‬ Fiscal Austerity (Oxford: Oxford University Press, 2021). ੮ ৳৶ੳ੮ {ʇʡɘ˦੮#˺˚ʠ˺̼͐੮ʇ͐੮ɘˑੳੴ੮ુP˺͸੮U˦͐ͅʮ͙͐͐ʮ˺˦ͅ੮)ʇ̹̼ʮͷʇੵ੮/͐ʩ˦˺ʡ̼ɘ̹ʩ;ੴ੮ä˺ɻʮɘˑ੮Ĕ˺̼ˌੴ੮ɘ˦ʁ੮U˦͐ʇ̼ventionist Ethics Among the Hypermarginalized,” ÛäH‫ףת‬îɲɐ‫ף‬Û̢̎̎ɐʚʚ‫ף‬äȡɪɐ‫ף‬H˃̢ʯɊȡ̙ɷ˃ʯ‫ף‬k˃̢̅ʯȡʚ‫ף‬ of the Social Sciences 1, no. 1 (2015): 101; see also Patricia Fernández-Kelly, îɲɐ‫ף‬Pɐ̅˃‫ף̎إ‬Hɷɪɲ̙‫ףת‬ ɩ̅ɷɄȡʯ‫ף‬ʣɐ̅ɷɄȡʯ̎‫ף‬ɷʯ‫ף‬Ĕɐ̙̎‫"ף‬ȡʚ̙ɷʣ˃̅ɐ‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬äɲȡɊ˃́‫˃ף‬ɩ‫̙ף‬ɲɐ‫ף‬ä͗ȡ̙ɐ੮ફØ̼ʮ˦ɻʇ͐˺˦ੴ੮‡ĩੵ੮Ø̼ʮ˦ɻʇ͐˺˦੮ University Press, 2015). 37. Carolyn Sufrin, kȡɷʚɄȡ̅ɐ‫ףת‬HɷʯɊɷʯɪ‫̙ף‬ɲɐ‫ף‬äȡɩɐ̙͇‫‡ף‬ɐ̙‫ף‬ɩ˃̅‫ף‬Ĕ˃ʣɐʯ‫"ף‬ɐɲɷʯɊ‫"ף‬ȡ̅̎ (Berkeley: University of California Press, 2017). ੮ ৳৸ੳ੮ ä͐ʇͷʇ˦੮r͙ˌʇͅੴ੮ુØʇ̼̹ͅʇɻ͐ʮͷʇͅ੮˺˦੮͙͐ʩ˺̼ʮ͐;੮Øɘ̼͐੮Uੵ੮#˺˦ɻʇ̹͐ͅੴ੮Øʇ̼̹ͅʇɻ͐ʮͷʇͅੴ੮ɘ˦ʁ੮k͙͐ͅʮϲʮɻɘtions: Section 4,” ‡š{šä‫ףת‬ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷɐ̙͇‫ף‬ɩ˃̅‫ף‬Ø˃ʚɷ̙ɷɄȡʚ‫ף‬ȡʯɊ‫ף‬rɐɪȡʚ‫ף‬Øɲɷʚ˃̎˃̂ɲ͇ 29 (1987): 70. 39. Robert Castel, rȡ‫ ף‬Iɐ̙̎ɷ˃ʯ‫ ף‬Ɋɐ̎‫̅ ף‬ɷ̢̎̄ɐ̎‫ ףת‬Ɋɐ‫ ף‬ʚ‫إ‬ȡʯ̙ɷ؅͇̂̎Ʉɲɷȡ̙̅ɷɐ‫ ף‬ȶ‫ ף‬ʚ‫إ‬ȡ̂̅ɡ̎؅͇̂̎Ʉɲȡʯȡʚ͇̎ɐ (Paris: Minuit, 1981); Michel Foucault, “L’évolution de la notion d’‘individu dangereux’ dans la psychiatrie légale,” )ɔ̀ɷȡʯɄɐ‫ף‬ɐ̙‫˃̎ף‬Ʉɷɔ̙ɔ 5, no. 4 (1981): 403–22; Nikolas Rose, “Governing Risky Individuals: The Role of Psychiatry in New Regimes of Control,” Psychiatry, PsyɄɲ˃ʚ˃ɪ͇‫ף‬ȡʯɊ‫ף‬rȡ́੮৵ੴ੮˦˺ੳ੮৲੮ફৱ৹৹৸બੵ੮ৱ৷৷જ৹৵੶੮rʮͷʮɘ੮ēʇˑ̹̼;੮ɘ˦ʁ੮"ʇ˦˺ʹ͐੮/;̼ɘ͙ʁੴ੮ુ#˺˦ϲʮ˦ʇ˚ʇ˦͐੮ and Psychiatric Care: A Comparison Between High-Security Units for Prisoners and for )ʮϲϲʮɻ͙ˑ͐੮Øɘ͐ʮʇ˦͐ͅ੮ʮ˦੮H̼ɘ˦ɻʇੴૂ੮Culture, Medicine, and Psychiatry 38, no. 4 (2014): 550–77. ੮ ৴ৰੳ੮ "̼ʇɘ੮rੳ੮Øʇ̼̼;ੴ੮/˚˚ɘ੮H̼ʮʇʩੴ੮ɘ˦ʁ੮/̼ʮɻ੮Ûੳ੮Ĕ̼ʮʡʩ͐ੴ੮ુîʩʇ̼ɘ̹ʇ͙͐ʮɻ੮ä˺ɻʮɘˑ੮#˺˦̼͐˺ˑ੮˺ʠ੮Øʇ˺̹ˑʇ੮ ͸ʮ͐ʩ੮äʇ̼ʮ˺͙ͅ੮{ʇ˦͐ɘˑ੮Uˑˑ˦ʇͅͅੵ੮˦੮/˚̹ʮ̼ʮɻɘˑ੮ēʇ̼ʮϲʮɻɘ͐ʮ˺˦੮ɘ˦ʁ੮/ͽ͐ʇ˦ͅʮ˺˦੮˺ϲ੮îʩʇ˺̼;ੴૂ੮Society ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 8, no. 2 (2018): 109. 41. Studies show that, among public outpatient clients, as many as 40 percent experience ુˑʇͷʇ̼ɘʡʇʁૂ੮ ̼͐ʇɘ͐˚ʇ˦͐੮ ͐ʩɘ͐੮ ˑʮ˦ˌͅ੮ ɘʁʩʇ̼ʇ˦ɻʇ੮ ͐˺੮ ɺʇ˦ʇϲʮ͐ͅ੮ ˑʮˌʇ੮ ʩ˺͙ͅʮ˦ʡੳ੮ Øɘ˚ʇˑɘ੮ #ˑɘ̼ˌ੮ Robbins et al., “The Use of Housing as Leverage to Increase Adherence to Psychiatric

C O N C LU S I O N

42.

43.

44.

45.

46.

47. 48.

49. 50.

51.

52.

375

Treatment in the Community,” Ɋʣɷʯɷ̙̎̅ȡ̙ɷ˃ʯ‫ ף‬ȡʯɊ‫ ף‬Ø˃ʚɷɄ͇‫ ף‬ɷʯ‫{ ף‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬ȡʯɊ‫{ ף‬ɐʯ͗ȡʚ‫ף‬ Health Services Research 33, no. 2 (2006): 226–36. Scholars have observed an inverse relationship between declining internment in hospitals and increasing incarceration in jails and prisons in the second half of the twentieth century. Bernard E. Harcourt, “From the Asylum to the Prison: Rethinking the Incarceration Revolution,” îɐ͆ȡ̎‫ף‬rȡ́‫ף‬Ûɐ̀ɷɐ́ 84 (2005): 1751–86. There has been little research on whether, as incarcerated populations decline, forced internment in health care institutions is rising in turn. Forrest Stuart, Amada Armenta, and Melissa Osborne, “Legal Control of Marginal Groups,” Annual Review of Law and Social Science 11 (2015): 246; see also Kerwin Kaye, “Rehabilitating the ‘Drugs Lifestyle’: Criminal Justice, Social Control, and the Cultivation of Agency,” /̙ɲʯ˃ɪ̅ȡ̂ɲ͇ 14, no. 2 (2013): 207–32; Allison McKim, “‘Getting Gut-Level’: Punishment, Gender, and Therapeutic Governance,” Gender & Society 22, no. 3 (2008): 303–23. Neil Gong, “Between Tolerant Containment and Concerted Constraint: Managing Madness for the City and the Privileged Family,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 84, no. 4 (2019): 664–89. See, for example, Peter Conrad, The Medicalization of Society: On the Transformation of P̢ʣȡʯ‫ ף‬#˃ʯɊɷ̙ɷ˃ʯ̎‫ ף‬Uʯ̙˃‫ ף‬î̅ɐȡ͗ȡɃʚɐ‫) ף‬ɷ̎˃̅Ɋɐ̅̎ (Baltimore: Johns Hopkins University Press, 2007); Allan V. Horwitz, #̅ɐȡ̙ɷʯɪ‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎ (Chicago: University of Chicago Press, ৲ৰৰৱબ੶੮š͸ʇ˦੮Ĕʩ˺˺ˑʇ;ੴ੮šʯ‫̙ף‬ɲɐ‫ף‬Pɐɐʚ̎‫˃ף‬ɩ‫ף‬Uɪʯ˃̅ȡʯɄɐ‫ףת‬Ø͇̎Ʉɲɷȡ̙͇̅‫ף‬ȡʯɊ‫̙ף‬ɲɐ‫ף‬Ø˃ʚɷ̙ɷɄ̎‫˃ף‬ɩ‫ף̙˃‡ף‬nʯ˃́ɷʯɪ (Chicago: University of Chicago Press, 2019). This draws inspiration from theories of legal cynicism: the idea that in certain groups, people endorse the aims of controlling deviance through law but doubt that courts or the police can actually do it in ways that are rational, fair, or effective. Robert J. Sampson and Dawn Jeglum Bartusch, “Legal Cynicism and (Subcultural) Tolerance of Deviance: The Neighborhood Context of Racial Difference,” Law & Society Review, no. 4 (1998): 777–804. Anthony DiMario, “To Punish, Parent, or Palliate: Governing Urban Poverty Through Institutional Failure,” ʣɐ̅ɷɄȡʯ‫ף‬ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫ף‬Ûɐ̀ɷɐ́ 87, no. 5 (2022): 860–88. Didier Fassin, “That Obscure Object of Global Health,” in {ɐɊɷɄȡʚ‫ף‬ʯ̙ɲ̅˃̂˃ʚ˃ɪ͇‫ף‬ȡ̙‫̙ף‬ɲɐ‫ף‬ Intersectionsੴ੮ʇʁੳ੮{ɘ̼ɻʮɘ੮#ੳ੮U˦ʩ˺̼˦੮ɘ˦ʁ੮/˚ʮˑ;੮ੳ੮Ĕʇ˦͐Έʇˑˑ੮ફ)͙̼ʩɘ˚ੴ੮‡#ੵ੮)͙ˌʇ੮õ˦ʮͷʇ̼ͅʮ͐;੮ Press, 2012), 95–115. One of the clearest statements of this position is D. J. Jaffe, Insane Consequences: How the {ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬UʯɊ̢̙͇̎̅‫ף‬Hȡɷʚ̎‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚʚ͇‫ף‬Uʚʚ (Amherst, NY: Prometheus, 2017). The extent to which Reagan actually defunded public housing and his contribution to the concomitant rise in homelessness are contested. Stephen Eide, Homelessness in AmerɷɄȡ‫ ףת‬îɲɐ‫ ף‬Pɷ̙̎˃͇̅‫ ף‬ȡʯɊ‫ ף‬î̅ȡɪɐɊ͇‫˃ ף‬ɩ‫ ף‬ȡʯ‫ ף‬Uʯ̙̅ȡɄ͗ȡɃʚɐ‫ ף‬ä˃Ʉɷȡʚ‫ ף‬Ø̅˃Ƀʚɐʣ (Lanham, MD: Rowman & rʮ͐͐ˑʇϲʮʇˑʁੴ੮৲ৰ৲৲બੳ For a recent example, see Editorial Board, “The Solution to America’s Mental Health Crisis Already Exists,” New York Times, October 4, 2022, https://www.nytimes.com/2022 /10/04/opinion/us-mental-health-community-centers.html. A panel of experts recently deemed changing legal criteria one of the least effective strategies for improving the conservatorship system. Amy L. Shearer et al., “Improving

376

C O N C LU S I O N

Mental Health Guardianship: From Prevention to Treatment,” Psychiatric Services 73, no. 6 (2022): 642–49. 53. Paul S. Appelbaum, ʚʣ˃̙̎‫ ף‬ȡ‫ ף‬Ûɐ̀˃ʚ̢̙ɷ˃ʯ‫{ ףת‬ɐʯ͗ȡʚ‫ ף‬Pɐȡʚ̙ɲ‫ ף‬rȡ́‫ ף‬ȡʯɊ‫̙ ף‬ɲɐ‫ ף‬rɷʣɷ̙̎‫˃ ף‬ɩ‫ ף‬#ɲȡʯɪɐ (Oxford: Oxford University Press, 1994); Jonathan I. Marx and Richard M. Levinson, “Statutory Change and ‘Street-Level’ Implementation of Psychiatric Commitment,” Social Science & Medicine 27, no. 11 (1988): 1247–56; Robert D. Miller, “Need-for-Treatment Criteria for Involuntary Civil Commitment: Impact in Practice,” ʣɐ̅ɷɄȡʯ‫ף‬k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎chiatry 149, no. 10 (1992): 1380–84. For a counterexample from North Carolina, see Mary rੳ੮)͙̼ʩɘ˚ੴ੮ુU˚̹ˑʮɻɘ͐ʮ˺˦ͅ੮˺ʠ੮‡ʇʇʁચʠ˺̼ચî̼ʇɘ͐˚ʇ˦͐੮rɘ͸ͅੵ੮੮ä͙͐ʁ;੮˺ϲ੮Ĕɘͅʩʮ˦ʡ͐˺˦੮ä͐ɘ͐ʇૄͅ੮ Involuntary Treatment Act,” Psychiatric Services 36, no. 9 (1985): 975–77. 54. Rains et al., “Variations in Patterns of Involuntary Hospitalisation.” 55. One study found, for example, that whether clinicians perceived beds as available was the primary determinant of involuntary admissions decisions. Nancy B. Engleman, David A. Jobes, Alan L. Berman, and Laura I. Langbein, “Clinicians’ Decision Making About Involuntary Commitment,” Psychiatric Services 49, no.7 (1998): 941–45. 56. Two LPS reform task forces, for example, proposed sensible reforms around combining hearings for detention and involuntary medication, ensuring that family members’ views are considered in hearings, and clarifying hospitals’ responsibilities before discharge. LPS Reform Task Force, “A New Vision for Mental Health Treatment Laws” (Long Beach, CA, February 1999); LPS Reform Task Force II, “The Case for Updating California’s Mental Health Treatment Law” (Tustin, CA, March 2012). 57. Bathen, “Helping Mentally Ill People.” 58. Disability Rights California, “Joint Letter in Opposition to CARE Court,” June 22, 2022, https://www.disabilityrightsca.org/latest-news/disability-rights-california-advocates ચ͙̼ʡʇચɘͅͅʇ˚ɺˑ;ચʩʇɘˑ͐ʩચɻ˺˚˚ʮ͐͐ʇʇચ͐˺ચͷ˺͐ʇચ˦˺ચ˺˦ચͅɺ੶੮P͙˚ɘ˦੮Ûʮʡʩ͐ͅ੮Ĕɘ͐ɻʩੴ੮ુš̹̹˺ͅʮ͐ʮ˺˦੮ to CARE Court (SB 1338) as Amended May 19, 2022,” June 14, 2022, https://www.hrw.org /news/2022/06/14/human-rights-watchs-opposition-care-court-sb-1338. ੮ ৵৹ੳ੮ ĺ͙˺͐ʇʁ੮ʮ˦੮ʮ˦੮äʩɘ̼˺˦੮äʩ͙ʇ˚ɘ˦੮ɘ˦ʁ੮kɘ˦ʇˑ੮k˺ʩ˦ͅ˺˦ੴ੮ુä̼͐ʇ˦ʡ͐ʩʇ˦ʮ˦ʡ੮͐ʩʇ੮#˺˚˚ʮ͐˚ʇ˦͐੯ੳ੯ੳ੯ੳ੮ Reinvesting in the System: A Journey of Community Partnership” (Los Angeles: Frank D. Lanterman Regional Center, 2016), 8. 60. Adrianna Bagnall and Gil Eyal, “Forever Children and Autonomous Citizens: Comparing the Deinstitutionalizations of Psychiatric Patients and Developmentally Disabled Individuals in the United States,” in Hɷɩ̙͇‫ף‬Ěɐȡ̅̎‫ף‬ɩ̙ɐ̅‫)ף‬ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ͑ȡ̙ɷ˃ʯ‫{ףת‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫ף‬ in Contemporary Communities, ed. Brea L. Perry (Bingley, UK: Emerald, 2016). 61. These strict criteria can lead to people with mental illness and developmental disabilities being bounced between the two systems. 62. “Taken by the State,” The Price of Care (ABC 10, August 18, 2022), https://www.abc10 .com/article/news/local/abc10-originals/conservatorships-price-of-care-taken-by-the -state/103-1e797c90-e530-4beb-8923-0c75d49f420b. ੮ ৶৳ੳ੮ îʮ˚˺͐ʩ;੮îੳ੮"̼˺͸˦੮ʇ͐੮ɘˑੳੴ੮ુĔʩɘ͐੮Ø̼ʇʁʮɻ͐ͅ੮Ûʇɻ˺ͷʇ̼;੮š̼ʮʇ˦͐ɘ͐ʮ˺˦੮ʮ˦੮#˺͙˦͐;੮)ʇ̹ɘ̼͐˚ʇ˦͐ͅ੮ of Mental Health? A Pilot Study,” Ɋʣɷʯɷ̙̎̅ȡ̙ɷ˃ʯ‫ף‬ȡʯɊ‫ף‬Ø˃ʚɷɄ͇‫ף‬ɷʯ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬ Health Services Research 37, no. 5 (2010): 388–98; Todd P. Gilmer et al., “Variation in the Implementation of California’s Full Service Partnerships for Persons with Serious Mental Illness,” Health Services Research 48, no. 6pt2 (2013): 2245–67; Tara A. Niendam et

C O N C LU S I O N

377

al., “The Rise of Early Psychosis Care in California: An Overview of Community and University-Based Services,” Psychiatric Services 70, no. 6 (2019): 480–87. 64. Research shows highly involved Departments of Mental Health are crucial for ensuring adherence to best practices. Sushmita Shoma Ghose et al., “State Mental Health Authority Level of Involvement in Coordinated Specialty Care Clinics and Client Outcomes,” Psychiatric Services 74, no.3 (2023): 250–56. ੮ ৶৵ੳ੮ HäØͅ੮͸ʮ͐ʩ੮ુʩʮʡʩ੮ϲʮʁʇˑʮ͐;ૂ੮͐˺੮͐ʩʇ੮#î੮˚˺ʁʇˑ੮ɘ̼ʇ੮˚˺̼ʇ੮ʇʠʠʇɻ͐ʮͷʇ੮ʮ˦੮ʮ˦ɻ̼ʇɘͅʮ˦ʡ੮͐ʩʇ੮͙ͅʇ੮˺ʠ੮ outpatient services. Todd P. Gilmer et al., “Fidelity to the Housing First Model and Variɘ͐ʮ˺˦੮ʮ˦੮Pʇɘˑ͐ʩ੮äʇ̼ͷʮɻʇ੮õͅʇ੮Ĕʮ͐ʩʮ˦੮Øʇ̼˚ɘ˦ʇ˦͐੮ä͙̹̹˺̼͐ʮͷʇ੮P˺͙ͅʮ˦ʡੴૂ੮Psychiatric Services 66, no. 12 (2015): 1283–89. 66. Department of Mental Health, “The TRIESTE Project: True Recovery Innovation Embraces Systems That Empower” (Los Angeles, April 18, 2019), 19. ੮ ৶৷ੳ੮ îʩʮͅ੮͸ɘͅ੮ɘˑͅ˺੮͐ʩʇ੮ɘ̹̹̼˺ɘɻʩ੮˺ϲ੮îʩʇ੮ēʮˑˑɘʡʇ੮ʮ˦੮r˺˦ʡ੮"ʇɘɻʩ੮ʮ˦੮͐ʩʇ੮ৱ৹৸ৰͅੴ੮ɘͅ੮ʁʇͅɻ̼ʮɺʇʁ੮͐˺੮ ˚ʇ੮ɺ;੮{ɘ̼ˌ੮Ûɘʡʮ˦ͅ੮ફɘ੮̹ͅ;ɻʩʮɘ̼͐ʮ͐ͅ੮͸ʩ˺੮ˑʇʁ੮͐ʩʇ੮̹̼˺ʡ̼ɘ˚બੳ੮Pʮͅ੮͐ʇɘ˚੮ʩɘʁ੮ɘ੮ϲʮͽʇʁ੮ɺ͙ʁʡʇ͐੮ per client, which they would also have to tap into if someone needed to be hospitalized. The Village’s clinical approach became the basis for FSPs, but its funding model was discarded in favor of billing Medi-Cal. 68. I am grateful to Chad Costello, from the California Association of Social Rehabilitation Agencies, for this pithy point. 69. Seventy-six percent of registered voters favored CARE court while only 15 percent were ˺̹̹˺ͅʇʁੳ੮ Pɘ˦˦ɘʩ੮ Ĕʮˑʇ;੮ ɘ˦ʁ੮ Øʩʮˑ੮ Ĕʮˑˑ˺˦ੴ੮ ુē˺͐ʇ̼ͅ੮ ä͙̹̹˺̼͐੮ ‡ʇ͸ͅ˺˚ૄͅ੮ {ʇ˦͐ɘˑ੮ Pʇɘˑ͐ʩ੮ Plan and Back Mandatory Kindergarten, Poll Shows,” r˃̎‫ף‬ʯɪɐʚɐ̎‫ף‬îɷʣɐ̎, October 6, 2022, https://www.latimes.com/california/story/2022-10-06/voters-strongly-support-newsoms -mental-health-plan. 70. Stephen Allison, Tarun Bastiampillai, and Doris A. Fuller, “Should the Government Change the Mental Health Act or Fund More Psychiatric Beds?,” Lancet Psychiatry 4, no. 8 (2017): 585–86; Magali Coldefy, Sarah Fernandes, and David Lapalus, “De l’hospitalisation aux soins sans consentement en psychiatrie: premiers résultats de la mise en place de la loi du 5 juillet 2011,” Ĺ̢ɐ̙̎ɷ˃ʯ̎‫ף‬Ɋ‫إ‬ɔɄ˃ʯ˃ʣɷɐ‫ף‬Ɋɐ‫ף‬rȡ‫ף‬äȡʯ̙ɔ (Paris: Institut de recherche et documentation en économie de la santé, February 2017); Patrick Keown et al., “Association Between Provision of Mental Illness Beds and Rate of Involuntary Admissions in the NHS in England 1988–2008: Ecological Study,” "{k 343 (2011): d3736. 71. For competing evidence, see Pauline Vaillancourt Rosenau and Stephen H. Linder, “A #˺˚̹ɘ̼ʮͅ˺˦੮˺ʠ੮͐ʩʇ੮Øʇ̼ʠ˺̼˚ɘ˦ɻʇ੮˺ʠ੮H˺̼ચØ̼˺ϲʮ͐੮ɘ˦ʁ੮‡˺˦̹̼˺ϲʮ͐੮õੳäੳ੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮U˦̹ɘ͐ʮʇ˦͐੮ Care Providers Since 1980,” Psychiatric Services 54, no. 2 (2003): 183–87; Morgan C. Shields ɘ˦ʁ੮{ʇ̼ʇʁʮ͐ʩ੮"ੳ੮Û˺ͅʇ˦͐ʩɘˑੴ੮ુĺ͙ɘˑʮ͐;੮˺ʠ੮U˦̹ɘ͐ʮʇ˦͐੮Øͅ;ɻʩʮɘ̼͐ʮɻ੮#ɘ̼ʇ੮ɘ͐੮ēੴ੮š͐ʩʇ̼੮I˺ͷʇ̼˦˚ʇ˦͐ੴ੮‡˺˦̹̼˺ϲʮ͐ੴ੮ɘ˦ʁ੮H˺̼ચØ̼˺ϲʮ͐੮P˺̹ͅʮ͐ɘˑͅੵ੮੮#˺˚̹ɘ̼ʮͅ˺˦ੴૂ੮Psychiatric Services 68, no. 3 (2016): 225–30. 72. Sheila Shea, “The Mental Hygiene Legal Service at 50: A Retrospective and Prospective Examination of Advocacy for People with Mental Disabilities,” I˃̀ɐ̅ʯʣɐʯ͗‫ ףש‬rȡ́‫ ףש‬ȡʯɊ‫ף‬ Ø˃ʚɷɄ͇‫ף‬k˃̢̅ʯȡʚ 14, no. 2 (2012): 35–41. 73. Previous research has shown how an expansion of community-based services can reduce rates of involuntary treatment, even absent legal reform. Tim A. Bruckner et al., “Involuntary Civil Commitments After the Implementation of California’s Mental Health

378

C O N C LU S I O N

Services Act,” Psychiatric Services 61, no. 10 (2010): 1006–11; Coralie Gandré et al., “Involuntary Psychiatric Admissions and Development of Psychiatric Services as an Alternative to Full-Time Hospitalization in France,” Psychiatric Services 68, no. 9 (2017): 923–30. 74. Liana Fox and Kalee Burns, “The Supplemental Poverty Measure: 2020” (U.S. Census Bureau, September 2021), https://www.census.gov/content/dam/Census/library/publications /2021/demo/p60-275.pdf. ੮ ৷৵ੳ੮ šϲϲʮɻʇ੮˺ʠ੮#˺˚˚͙˦ʮ͐;੮Øˑɘ˦˦ʮ˦ʡ੮ɘ˦ʁ੮)ʇͷʇˑ˺̹˚ʇ˦͐ੴ੮ુîʩʇ੮৲ৰ৲ৰ੮˦˦͙ɘˑ੮P˺˚ʇˑʇͅͅ੮ͅͅʇͅͅment Report (AHAR) to Congress” (U.S. Department of Housing and Urban Devel˺̹˚ʇ˦͐ੴ੮kɘ˦͙ɘ̼;੮৲ৰ৲ৱબੴ੮ৱৰੴ੮ʩ̹͐͐ͅੵઃઃ͸͸͸ੳʩ͙ʁ͙ͅʇ̼ੳʡ˺ͷઃ̹˺̼͐ɘˑઃͅʮ͐ʇͅઃʁʇʠɘ͙ˑ͐ઃϲʮˑʇͅઃ̹ʁʠઃ৲ৰ৲ৰ ચPÛણØɘ̼͐ચৱੳ̹ʁʠੳ 76. For example, in 2010 the Black incarceration rate in California was 3,036 per 100,000; it was 757 for Hispanics. In Cuba, the incarceration rate is 510. 77. Brendan D. Kelly, “Structural Violence and Schizophrenia,” Social Science & Medicine 61, no. 3 (2005): 727. 78. Giorgio Agamben, P˃ʣ˃‫ף‬äȡɄɐ̅‫ףת‬ä˃̀ɐ̅ɐɷɪʯ‫ף‬Ø˃́ɐ̅‫ף‬ȡʯɊ‫"ף‬ȡ̅ɐ‫ף‬rɷɩɐ, trans. Daniel Heller-Roazen (Stanford, CA: Stanford University Press, 1998), 4. 79. American Psychiatric Association, “The Psychiatric Bed Crisis in the US: Understandʮ˦ʡ੮͐ʩʇ੮Ø̼˺ɺˑʇ˚੮ɘ˦ʁ੮{˺ͷʮ˦ʡ੮î˺͸ɘ̼ʁ੮ä˺ˑ͙͐ʮ˺˦ͅૂ੮ફĔɘͅʩʮ˦ʡ͐˺˦ੴ੮)#ੴ੮{ɘ;੮৲ৰ৲৲બੴ੮৳৹ੳ 80. Gregg Colburn and Clayton Page Aldern, P˃ʣɐʚɐ̎̎ʯɐ̎̎‫ף‬U̎‫ף‬ȡ‫ף‬P˃̢̎ɷʯɪ‫ף‬Ø̅˃Ƀʚɐʣ‫ףת‬P˃́‫ף‬ä̢̙̅Ʉ̢̙̅ȡʚ‫ף‬HȡɄ̙˃̅̎‫ף‬/͆̂ʚȡɷʯ‫ף‬õ‫ר‬ä‫ףר‬Øȡ̙̙ɐ̅ʯ̎ (Berkeley: University of California Press, 2022). 81. Thomas R. Insel, Pɐȡʚɷʯɪ‫ף̢̅šףת‬Øȡ̙ɲ‫ף‬ɩ̅˃ʣ‫{ף‬ɐʯ͗ȡʚ‫ף‬Uʚʚʯɐ̎̎‫{ף˃̙ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ (New York: Penguin, 2022), 42.

METHODOLOGICAL APPENDIX 1.

Kathleen Gerson and Sarah Damaske, îɲɐ‫ף‬äɄɷɐʯɄɐ‫ף‬ȡʯɊ‫˃ף̙̅ף‬ɩ‫ף‬Uʯ̙ɐ̅̀ɷɐ́ɷʯɪ (Oxford: Oxford University Press, 2021), 46. ੮ ৲ੳ੮ äʇʇ੮‡ʮɻ˺ˑʇ੮{ੳ੮)ʇ͐ʇ̼ʁʮ˦ʡ੮ɘ˦ʁ੮{ɘ̼;੮#ੳ੮Ĕɘ͐ʇ̼ͅੴ੮ુHˑʇͽʮɺˑʇ੮#˺ʁʮ˦ʡ੮˺ʠ੮U˦ચ)ʇ̹͐ʩ੮U˦͐ʇ̼ͷʮʇ͸ͅੵ੮ A Twenty-First-Century Approach,” ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫{ ף‬ɐ̙ɲ˃Ɋ̎‫ ףغ ף‬Ûɐ̎ɐȡ̅Ʉɲ 50, no. 2 (2021): 708–39. 3. See, for example, Paul Brodwin, Everyday Ethics (Berkeley: University of California Press, 2012); Kerry Michael Dobransky, {ȡʯȡɪɷʯɪ‫{ ף‬ȡɊʯɐ̎̎‫ ף‬ɷʯ‫̙ ף‬ɲɐ‫ ף‬#˃ʣʣ̢ʯɷ̙͇‫ ףת‬îɲɐ‫ ף‬#ɲȡʚʚɐʯɪɐ‫˃ ף‬ɩ‫ף‬ #˃ʯ̙ɐʣ̂˃̅ȡ͇̅‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬#ȡ̅ɐ੮ફ‡ʇ͸੮"̼͙˦ͅ͸ʮɻˌੴ੮‡ĩੵ੮Û͙͐ʡʇ̼ͅ੮õ˦ʮͷʇ̼ͅʮ͐;੮Ø̼ʇͅͅੴ੮৲ৰৱ৴બ੶੮ James A. Holstein, #˃̢̙̅؅š̅Ɋɐ̅ɐɊ‫ ף‬Uʯ̎ȡʯɷ̙͇‫ ףת‬Uʯ̙ɐ̅̂̅ɐ̙ɷ̀ɐ‫ ף‬Ø̅ȡɄ̙ɷɄɐ‫ ף‬ȡʯɊ‫ ף‬Uʯ̀˃ʚ̢ʯ͗ȡ͇̅‫ ף‬#˃ʣʣɷ̙ment (New York: Transaction, 1993); Lorna A. Rhodes, /ʣ̙͇̂ɷʯɪ‫" ף‬ɐɊ̎‫ ףת‬îɲɐ‫ ף‬Ĕ˃̅ʕ‫˃ ף‬ɩ‫ ף‬ȡʯ‫ף‬ /ʣɐ̅ɪɐʯɄ͇‫ף‬Ø͇̎Ʉɲɷȡ̙̅ɷɄ‫ף‬õʯɷ̙੮ફ"ʇ̼ˌʇˑʇ;ੵ੮õ˦ʮͷʇ̼ͅʮ͐;੮˺ʠ੮#ɘˑʮʠ˺̼˦ʮɘ੮Ø̼ʇͅͅੴ੮ৱ৹৹ৱબ੶੮#ɘ̼˺ˑ੮Ĕɘ̼̼ʇ˦ੴ੮ The Court of Last Resort (Chicago: University of Chicago Press, 1982). 4. Colin Jerolmack and Shamus Khan, “Talk Is Cheap: Ethnography and the Attitudinal Fallacy,” ä˃Ʉɷ˃ʚ˃ɪɷɄȡʚ‫{ף‬ɐ̙ɲ˃Ɋ̎‫ףغף‬Ûɐ̎ɐȡ̅Ʉɲ 43, no. 2 (2014): 178–209. ੮ ৵ੳ੮ ēʮɻ͐˺̼ʮɘ੮ Ûʇ;ʇͅੴ੮ ુîʩ̼ʇʇ੮ {˺ʁʇˑͅ੮ ˺ϲ੮ î̼ɘ˦̹ͅɘ̼ʇ˦ɻ;੮ ʮ˦੮ /͐ʩ˦˺ʡ̼ɘ̹ʩʮɻ੮ Ûʇͅʇɘ̼ɻʩੵ੮ ‡ɘ˚ʮ˦ʡ੮ Places, Naming People, and Sharing Data,” /̙ɲʯ˃ɪ̅ȡ̂ɲ͇ 19, no. 2 (2018): 204–26. 6. Alex V. Barnard, “From the ‘Magna Carta’ to ‘Dying in the Streets’: Media Framings of Mental Health Law in California,” ä˃Ʉɷɐ̙͇‫ף‬ȡʯɊ‫{ף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ 12, no. 2 (2022): 155–73.

M E T H O D O LO G I C A L A P P E N D I X 7.

8.

379

See, for example, Dan A. Lewis et al., Ĕ˃̅ʚɊ̎‫˃ף‬ɩ‫̙ף‬ɲɐ‫{ף‬ɐʯ͗ȡʚʚ͇‫ף‬Uʚʚ‫ףת‬P˃́‫)ף‬ɐɷʯ̙̎ɷ̢̙̙ɷ˃ʯȡʚɷ͑ȡ̙ɷ˃ʯ‫ף‬ Works in the City (Carbondale: Southern Illinois University Press, 1991); Tanya Marie r͙ʩ̼˚ɘ˦˦ੴ੮ુૃîʩʇ੮ä̼͐ʇʇ͐੮Ĕʮˑˑ੮)̼ʮͷʇ੮Ě˺͙੮#̼ɘΈ;ૄੵ੮Ĕʩ;੮P˺˚ʇˑʇͅͅ੮Øͅ;ɻʩ˺͐ʮɻ੮Ĕ˺˚ʇ˦੮ʮ˦੮͐ʩʇ੮ Institutional Circuit in the United States Often Say No to Offers of Help,” American k˃̢̅ʯȡʚ‫˃ף‬ɩ‫ף‬Ø͇̎Ʉɲɷȡ̙͇̅ 165, no. 1 (2008): 15–20; Rose Ricciardelli and Laura Huey, ɊɊɷʯɪ‫ף‬ Uʯ̢̎ʚ̙‫ף˃̙ף‬Uʯʑ̢͇̅‫{ؒףת‬ɷ̎ؓî̅ɐȡ̙ɷʯɪ‫ף‬P˃ʣɐʚɐ̎̎‫ף‬Ĕ˃ʣɐʯ‫ף‬ɷʯ‫{ף̢̅šף‬ɐʯ͗ȡʚ‫ף‬Pɐȡʚ̙ɲ‫ף‬ä͇̙̎ɐʣ (Boulder, CO: Lynne Rienner, 2016. See Jennifer A. Reich, “Old Methods and New Technologies: Social Media and Shifts in Ø˺͸ʇ̼੮ʮ˦੮ĺ͙ɘˑʮ͐ɘ͐ʮͷʇ੮Ûʇͅʇɘ̼ɻʩੴૂ੮/̙ɲʯ˃ɪ̅ȡ̂ɲ͇ 16, no. 4 (2015): 394–415.

INDEX

AB 1971, 233, 234, 237 abdication of authority, 17, 72, 275–76; extending, 280–85 Abilify, 2, 45 Access World News, 300 ACLU. See American Civil Liberties Union ACT. See Assertive Community Treatment Acute Diversion Unit (ADU), 98, 258, 259, 261, 262, 309 addiction: ERs and, 79–81; service resistance and, 220 addiction treatment: locked facilities and, 110; SB 1045 and, 221 ADU. See Acute Diversion Unit Adult Protective Services, 66, 231 adult residential facility (ARF), 159, 309, 358n47; closures of, 170 Advancing and Innovating Medi-Cal (CalAIM), 292 Affordable Care Act, 34, 37, 37, 279 aftercare, 173 Agamben, Giorgio, 59 Aid to the Totally Disabled, 161 Alameda County, California, 53–57, 183; ACCESS line, 334n14; jail suicides in, 75 Alameda model, 184 Alcoholics/Narcotics Anonymous, 206 alcoholism, 49, 52, 235–37; emergency services utilization and, 80–81; grave disability and, 238–39 Amador, Xavier, 39

American Civil Liberties Union (ACLU), 4, 215, 246 American Psychiatric Association, 292 Americans with Disabilities Act, 207 anosognosia, 29, 39–42, 130, 185, 199, 332n49; collaborative relationships and, 270; service resistance and, 220 antipoverty programs, 18 antipsychotic medications, 187; mortality and, 354n30 AOT. See Assisted Outpatient Treatment Appelbaum, Paul, 234 Arendt, Hannah, 15, 125, 270 ARF. See adult residential facility Assertive Community Treatment (ACT), 288, 310 Assisted Outpatient Treatment (AOT), 32–34, 254–56, 290, 309, 368n27; courtordered plans, 372n9; New York oversight of, 288; SB 1045 and, 216 authority, 15; abdication of, 17, 72, 275–76, 280–85; cultural, 120, 130, 135, 137; engaged, 285; fragmentation of, 144; LPS and, 16; over conservatorship, 14–17; public, 155–56, 289 Bahrani, Ahmadreza, 267 Baker Act (Florida), 34 Beautiful Mind, A੮ફϲʮˑ˚બੴ੮ৱ৹৹ bed availability, 67 ɺʇʁ੮ϲˑ˺͸ੴ੮৹ৱੴ੮৹৴

382

INDEX

behavioral health, 319n21 Behavioral Health Department, 103, 104, 156, 255, 267, 273, 311 betrayal tunnel, 62 BID. See Business Improvement District Biden, Joe, 280 Biehl, Joao, 181 Bixler, Brian, 57, 66 Black, John, 58–59 blacklisting, 146, 150–53 black robe effect, 202 blinded discretion. See discretion board and care home, 72, 92, 159, 194, 309, 352n1, 358n47; admissions criteria, 164–65; closures of, 163, 168, 170; community resistance to, 161; discharge plans and, 167; evictions from, 168–69; licensing of, 161; limits of care, 169; oversight of, 160–63; referrals to, 164; treatment outcomes and, 166–68 Bolton, Art, 6 Breed, London, 211, 214–16, 221, 250 Bromley, Elizabeth, 239–40 Brown, Jerry, 216 brutal compassion, 214 ɺ͙̼ʁʇ˦੮ͅʩ͙ϲϲˑʮ˦ʡੴ੮৷৴ੴ੮৲৸৲ Bureau of Labor Statistics, 184 Bureau of Social Work, 160–61 Business Improvement District (BID), 71, 180, 193 Cabrera, Michelle, 32, 46 CalAIM. See Advancing and Innovating Medi-Cal California Assembly Judiciary Committee, 211, 215, 278 California Association of Public Administrators, Public Guardians, and Public Conservators (CAPAPGPC), 105, 179, 310 California Association of Social Rehabilitation Agencies, 147, 262 California Behavioral Health Planning Council, 59

California Clubhouse, 263–65, 270 California Hospital Association, 237 California Psychiatric Transitions (CPT), 152, 204, 206 CAMP. See Case Assessment Management Program CAPAPGPC. See California Association of Public Administrators, Public Guardians, and Public Conservators; County Public Guardians’ and Conservators’ Association carceral system, 124, 144; downsizing of, 281 care: collapses of chronic, 170–71; community, 279; control and, 12; costs of full-time, 161, 162; custodial, 6; deinstitutionalizing, 7; follow-up, 43; integrated, 236; legal status and level of, 289; managed, 37, 38, 89–91; rehabilitation, 188. See also inpatient care; ̎̂ɐɄɷͷɷɄ‫̂˃̙ף‬ɷɄ̎ CARE courts, 278, 279, 286, 288 CARES. See Community Assessment, Referral, and Engagement Services Case Assessment Management Program (CAMP), 65–67, 273, 311 Chapman, Chris, 11 charities, 328n108; reliance on, 17 cherry-picking, 146, 150–53, 164 Child, Curtis, 212 children: with developmental disabilities, 178; residential programs and, 329n6 choice: under constraint, 197–200; of patients, by providers, 30–31; private facilities and patient, 67 chronic care, 138; Bureau of Social Work and, 161; collapses of, 170–71 Chu, David, 212 Cindy Lei hearings, 94 civil commitment, 6, 8, 124, 283, 310; IST referrals and, 145 civil liberties, 104, 199; LPS and, 11, 12 civil rights, 4, 7, 10, 15, 214, 216 client disengagement, 45 Clozaril, 38, 187, 192, 193, 204 Clubhouse movement, 263–65, 270

INDEX Coalition for Elder and Dependent Rights, 179 Coalition on Homelessness, 217, 219, 252, 333n1 coercion, 12, 211, 274–75; concerted constraint, 193; consenting to, 127–30; PADs and, 267; reform efforts and, 219–22 cognitive impairment, 235 Colantuono, Guyton, 262, 263 collaboration: constructing, 270–71; of law and medicine, 10–14. See also continuum of collaboration commitment: civil, 6, 8, 124, 283, 310; 5343 commitments, 339n28; initial, rates of, 13; involuntary, 124, 361n13 commitment courts, 6, 335n25 Community Assessment, Referral, and Engagement Services (CARES), 55–56 community-based care and housing, 14 community-based services, 377n73 community-based solutions, 108 community care, 279 Community Care Licensing, 309 community conservatorship, 200–202 Community Mental Health Act, 279 community mental health centers, 372n18 Community Mental Health Services, 124 Community Residential Treatment Act, 260–61 comorbid medical issues, 66, 165, 229, 356n28 complaint-driven reform, 216–19 complex delusional systems, 82 concerted constraint. See constraint ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐ੴ੮ৱৱજৱ৲੶੮ʮ˦ɻɘ̼ɻʇ̼ɘ͐ʮ˺˦੮ͅʮ˚ʮˑɘ̼ʮ͐;੮ to, 124; involuntary, 124, 215; judicial review and, 93; solitary, 34, 41, 276 congregate settings, 259 consent: to coercion, 127–30; involuntary medication and, 201; medical treatment and, 11; medications and, 182–83; services and, 29 consent-by-proxy, 183

383

conservatees, 301; families and, 112–13; power over, 14–17; views on conservatorship of, 199–200 conservators, 191, 192, 310 conservatorship, 3–5, 72, 193; access to services and, 129–30; authority over, 14–17; average times in, 194; bed availability and, 67; as civil penalty, 320n6; community, 200–202; courts as oversight for, 123–24; crisis management through, 195; denial of, 346n21; discretion in, 19; diversion to, 115–18; due process protections in, 125; ERs as veto points in, 73; facility ownership types and applications for, 96ੴ੮৹৶જ৹৷੶੮ϲʮ˦ɘ˦ɻʮɘˑ੮ disincentives and, 94, 95; forcible medication and, 183; grave disability and, 8–10; human logjams in placement, 153–55; least restrictive placements in, 153, 154; Murphy, 347n33; mythos of, 285; outpatient, 238–41; PADs and, 268; probate, 176–78, 237, 248, 311–12; protections from, 290; as punishment, 174; renewal of, 107; as revolving door, 196–97; self-worth and, 204; skills development and, 260; as social death, 14, 268; as state of exception, 197; as substituted decision making, 248; wrongful, 176 conservatorship continuum, 21–23, 47, ৴৸ੴ੯ৱ৹৴੶੮/Û੮̼˺ˑʇ੮ʮ˦ੴ੮৷৵੶੮ʡ˺ͷʇ̼˦˚ʇ˦͐੮ ɘɻ͐˺̼ͅ੯ɘɻ̼˺ͅͅੴ੮ৱৱ৲੶੮ʮ˦͐ʇ̼ͷʮʇ͸ʮ˦ʡ੮ɘɻ̼˺ͅͅੴ੮ 295–97, 297 conservatorship hearings: self-care plans and, 131–32; uncontested, 128 conservatorship investigations, 14, 22, 178–79; discretion in, 107–8; renewals and, 177 Conservatorship of Benevuto, 134 Conservatorship of Chambers, 134 Conservatorship of Early, 134 Conservatorship of Guerrero, 134 constraint: choice and dignity amid, 197–200; concerted, 193

384

INDEX

continuum of collaboration, 249, 249–50; services, 253–57; shared decision making, 265–69; skills, 257–61; stabilization, 250–53; support, 261–65 control: of admissions, 164–65; care and, 12; medicolegal, 11, 12, 14, 284; social, 97, 254, 283 Costello, Chad, 262 County Behavioral Health Directors Association, 32, 145 county jails: mental health treatment in, 115; restoration treatment in, 350n9 court-ordered involuntary medication, 41 courts: judge assignment, 126; as oversight mechanism, 123–24; schedules in, 127 COVID-19 pandemic, 280, 296, 356n28, 363n7; facility operating costs and, 163; ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅ੮ʁ͙̼ʮ˦ʡੴ੮৷৷੶੮ʩ˺˚ʇˑʇͅͅ੮ deaths during, 226, 227; Project Roomkey and, 2; shelter-in-place programs during, 224, 230 CPT. See California Psychiatric Transitions Crestwood Behavioral Health, 147, 148, 149–52, 193–94, 221, 276 criminal-legal system, 144; civil commitment system strictness and, 145; coercive health care and, 283; detention, 124; PAD programs and, 267; referrals, 115, 117 crisis in public, 53–57 crisis resources, 220; cuts in, 73–74 crisis services, 287 cultural authority, 120, 130, 135, 137 culturally competence, 44 Cunningham, Jordan, 212 custodial care, 6 )ɘˑή͙ʮ͐ͅੴ੮"ʇ͐͐;ੴ੮ৱ৴৷ dangerousness, 336n32, 339n33 data sources, 300 decarceration, 281 decision making: conservatorship and, 248; shared, 265–69 decompensating at home, 49, 51, 61–65 Dedoose (software), 301

deinstitutionalization, 7, 18, 147, 160, 352n4 delegation, 17–21; of discretion, 100-101; of IMD care, to contracted providers, 150; public authority and, 155–56 delusions of persecution, 132–33 dementia, 237 Democratic Socialists of America, 219 Department of Health and Human Services, 10 Department of Health Care Services (DHCS), 20, 31, 277, 310; conservatorship system and, 106 Department of Justice, 10, 184, 207 Department of Mental Health (DMH), 19–20, 66–68, 71, 161, 226, 239, 310; county ̹ˑɘ˦੮̼ʇͷʮʇ͸ͅ੮ɺ;ੴ੮৳৴৵˦ৱ৲੶੮rØä੮˺ϲϲʮɻʇ੮ʮ˦ੴ੮ 106; merger with DHCS, 106 Department of Mental Health (Los Angeles County), 96, 128, 170, 192, 230, 232 Department of Mental Hygiene, 5; Bureau of Social Work, 160–61 Department of Public Health (San Francisco), 217, 256 Department of Social Services, 161 Department of Social Welfare, 161 Department of State Hospitals, 144 Depressed While Black, 246 deputy public guardians, 106–7, 112 Deukmejian (Governor), 35 developmental disabilities, 111, 178, 249, 287 DeVico, Joseph, 108, 110, 236 DHCS. See Department of Health Care Services Diagnostic and Statistics Manual (DSM), 79, 125 dignity: under constraint, 197–200; of risk, 178, 179. See also Operation Dignity “Dilemma of Mental Commitments” report, 6, 105, 200 disability: developmental, 178; epistemic injustice and, 335n23; expectations and, 114; models of, 99, 100 disability rights advocates, 187, 248 Disability Rights California, 9, 212, 215

INDEX discharge plans, 88, 92; board and cares and, 167; exemptions from, 342n23 discharges, 91–94; families and, 112–13 discretion, 17–21; in admissions decisions, 164; blinded, 137–38; in conservatorship investigations, 107–8; delegated, 100–101; disorder-driven, 68–69; in IMD admission, 150; negative, 20, 84; residual, 118–19 disorder-driven discretion, 68–69 disorder management, 74 diversion programs, 67, 115–18 DMH. See Department of Mental Health doctor-to-doctor utilization reviews, 90 Doe v. Gallinot, 93–94, 134, 335n25 do-not-resuscitate orders, 15 Dore Crisis Clinic, 258, 261 drug treatment programs, 81 DSM. See Diagnostic and Statistics Manual dual-diagnosis treatment, 339n30; admissions decisions and, 165 due process protections, 125 due process rights, 128; IST and, 146 Durkheim, Emile, 268 dying on the streets, 65–68, 211-212 Early Intervention in Psychosis programs, 40-41, 288 ECT. See electroconvulsive therapy Eggman, Susan, 276 electroconvulsive therapy (ECT), 204, 247, 248 emergency medical condition, 73 Emergency Medical Treatment and Labor Act (EMTALA), 73 emergency rooms (ERs): conservatorship continuum role of, 75; EMTALA impact on, 73; evaluation by, 62, 68; ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅ੮ʮ˦ੴ੮৷৶જ৷৹੶੮ʩɘ˦ʁ˺ʠʠͅ੮͐˺ੴ੮ 65; moral injury from working in, 235; people processing in, 73–76; psychotic patients in, 74; regular visitors to, 66; substance users and, 79–81; as veto points, 73

385

EMTALA. See Emergency Medical Treatment and Labor Act endless institutionalization, 185–89 engaged authority, 285 enhanced residential treatment, 99 epistemic injustice, 335n23 ERs. See emergency rooms Estroff, Sue, 264 evidence-based intervention, 289 Ewing, Toby, 286 expert witnesses, 121 exploitation, 175–79 fact checking, 297–99 Fairview hospital, 5 fentanyl, 230, 257, 261 Fields, Steve, 257, 258, 260, 270 ϲʮ˦ɘ˦ɻʮɘˑ੮ʇͽ̹ˑ˺ʮ͐ɘ͐ʮ˺˦ੴ੮ৱ৷৸ ϲʮ̼͐ͅ੮ɺ̼ʇɘˌ੮ʇ̹ʮͅ˺ʁʇͅੴ੮৳৲੶੮͙̼ʡʇ˦ɻ;੮˺ʠ੮ treating, 40 5150 hold, 21–22, 48–54, 56, 72, 309, 323n45; admissions decisions and, 164; admit rates for, 84; dangerousness and, 336n32; disruptive persons and, 116; ER processing of, 74; grave disability and, 83, 336n40; people with many, 57–58; police applications for, 68; public guardians and, 102–3; relationship of people initiating, 333n4; rights and evaluation for, 60–61; San Francisco facilities for, 223; SCRT and, 252; serial or stacked, 371n6; in song lyrics, 58; stress from, 59; tracking numbers per patient of, 223; voluntary evaluations for, 62, 63; weaponized uses of, 173 5343 commitment, 339n28 5250 hospitalization, 72, 87, 89, 111, 183, 309, 323n45; conservatorship investigations and, 107; patients’ rights advocates and, 113 5264 hold, 323n45 5270 hold, 323n45, 372n9 Florida: involuntary holds in, 34; mental health care spending in, 35

386

INDEX

Floyd, George, 250 forced drug treatment, 110, 371n1 forced sterilizations, 366n1 forced treatment, 327n89, 372n9 forcible medication, 183, 200–202 ʠ˺̼ચ̹̼˺ϲʮ͐੮ʇ˦͐ʮ͐ʮʇͅੵ੮̹̼ʮͅ˺˦ͅੴ੮৲ৰ੶੮̼ʇͅʮʁʇ˦͐ʮɘˑ੮ board and care facilities, 18; veto points in, 20 Foucault, Michel, 11, 14, 104 Fountain House, 263, 264 France, social services in, 73 “Free Britney Spears” movement, 9 ʠ̼ʇή͙ʇ˦͐੮ϲˑ;ʇ̼ͅੴ੮৷৶જ৷৹ੴ੮৲৳৵ Fresno Adult Behavioral Health Services, 267-268 Friedenbach, Jennifer, 252 Full-Service Partnership (FSP), 2, 27–29, ৳৶જ৳৷ੴ੮৸৲ੴ੮ৱৱ৷ੴ੮৲৸৸ੴ੮৳ৱৰ੶੮ɻˑ˺ͅʮ˦ʡ੮ϲʮˑʇͅ੮ʠ˺̼੮ refusal of treatment, 255; COVID-19 and, 77 Gladwell, Malcolm, 66 Goffman, Erving, 62, 173, 186, 188 Gong, Neil, 166, 193, 284 grave disability, 1, 3, 8–10, 16, 98–99, 193, 310; alcoholism and, 238–39; as catchall category, 83; from chronic psychosis, 81–83; cultural authority in identifying, 130; discharges and, 91–94; drug use ɘ˦ʁੴ੯৸ৰ੶੮৵ৱ৵ৰ੮ʩ˺ˑʁͅ੮ɘ˦ʁੴ੮৳৳৶˦৴ৰ੶੮ futility and, 81–84; homelessness and, 113–14; mental illness nexus with, ৱ৲ৱજ৲৲੶੮̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅૄ੮ʮ˦ϲˑ͙ʇ˦ɻʇ੮ on, 20; probable cause hearings and, ৹৴੶੮̼ʇʁʇϲʮ˦ʮ˦ʡੴ੮৲৳ৱજ৳৴ੴ੮৲৷৶੶੮ͅ˺ͷʇ̼ʇʮʡ˦੮ ̹˺͸ʇ̼੯ɘ˦ʁੴ੮৹৴੶੮͙˦˚ʇ͐੮˚ʇʁʮɻɘˑ੮˦ʇʇʁͅ੮ and, 232 I̼ʇɘ͐੮#˺˦ϲʮ˦ʇ˚ʇ˦͐ੴ੮ৱৱજৱ৲ Great Recession, 37, 73, 92, 342n21 Great Resignation, 196 Great Society, 18 group therapy, 151, 174, 205 guaranteed housing, 239 guardianship abuse, 179

guardianships, plenary, 200 Guest Home, 157–60, 163, 166, 168 Hacienda of Hope, 262 Haldol, 34 Hallmark, Laurie, 266 harm reduction drug programs, 284 health insurance: conservatorship and, 88; disenrolling from, 31–32; psychiatrists and, 30; residential programs and, 31 hearings: conservatorship, 128, 131–32; probable cause, 93–94, 113, 311, 364n21; Riese, 183, 301, 312; thrown, 93–94; uncontested, 128 hearsay, 121 ુPʇɘ̼͐੮Øɘ̹ʇ̼ૂ੮ફØɘͅή͙ʮ˦ʮ੮ɘ˦ʁ੮Ûʇ͐͐ɘˑʡʮɘ͐ɘબੴ੮৲৹৶ Pʇ˦̼ʮή͙ʇͅੴ੮/̼ʮɻੴ੮৲৴৶જ৴৸ੴ੮৲৵ৰੴ੮৲৶৲ੴ੮৲৷ৰ heroin, 230 Herring, Chris, 218, 333n3 high-end mental health services, 193 high-utilization persons, 65, 66, 76–80, 273; substance use and, 81–83 HIPAA, 301 Hollywood Top 14, 71, 72 HOME. See Homeless Outreach and Mobile Engagement team Homeless Health Care, 226 homelessness: grave disability and, 113–14; ˑ˺͸ચή͙ɘˑʮ͐;੮ʩ˺͙ͅʮ˦ʡ੮ɘͷɘʮˑɘɺʮˑʮ͐;੮ɘ˦ʁੴ੮ 352n1; managing lifestyle of, 111–14; mental illness and, 334n8; mortality and, 226, 227; 911 and 311 calls about, 333n3; in San Francisco, 54, 213, 216; SCRT and, 251, 252; skills in, 368n28; substance use and, 334n8 Homeless Outreach and Mobile Engagement team (HOME), 3, 227, 228, 229, 239, 293 Homeless Outreach Team (HOT), 132–33 homeless patients, discharges and, 93 Homeless Services Authority, 71 hospitalization: 5250, 72, 87, 89, 107, 111, 113, 183, 309, 323n45; involuntary, 13, 182, 200, 318n8, 341n17; lengths of, 89; suicide prevention and, 356n27

INDEX HOT. See Homeless Outreach Team Housing Conservatorship pilot program, 222 Housing First, 229, 257, 364n9 housing plans, 278 Housing That Heals, 296 Hughes, Scarlet, 105, 115, 179 human rights, 125 hyper-marginalized populations, xiii, 282 I Care a Lot੮ફϲʮˑ˚બੴ੮ৱ৹ৰ ICM. See Intensive Care Management IMD. See Institution for Mental Disease IMD exclusion, 147, 243, 310 IMD waivers, 244, 366n44 I’m Not Sick, I Don’t Need Help (Amador), 39 incarceration, 124 incarceritis, 74 incompetent to stand trial (IST), 310; due process rights and, 146; rise in, 145 independent housing, 187 initial commitments, rates of, 13 inpatient care, 85–86; insurance pressures and, 89–91; outpatient conservatorship and, 238–41; reimbursement criteria ɘ˦ʁੴ੯৹ৱ Insane Consequences (Jaffe), 39 Insel, Thomas, 292 institutionalization, 244–45; endless, 185–89; harms of, 88; long-term, 185 Institution for Mental Disease (IMD), 28, 174, 194, 204–5, 310, 350n20, 351n35, 352n36; admissions criteria, 164; blacklisting and cherry-picking and, 150–53; community placement and, 141; cost of, 147; county contracts with, 142–43, 148–49; deaths ʮ˦ੴ੮ৱ৸৲੶੮ʠ˺̼ʇ˦ͅʮɻ੮ɻɘͅʇͅ੮ʮ˦ੴ੮ৱৱ৷੶੮ʠ˺̼ચ̹̼˺ϲʮ͐ੴ੮ 143; Medicaid funding and, 147, 366n42; revenue of, 143; stabilization in, 196; violence in, 142 insurance companies, 17; discharge pressures form, 89–91; managed care policies and, 89–91; Medicaid money passing through, 37; oversight by, 90

387

insurance reimbursement, involuntary holds and, 341n10 integrated care, 236 Intensive Care Management (ICM), 28 interdependence, 261 interviews, 295–97, 302 involuntary commitment, 124, 192; public support for, 361n13 involuntary holds, 40, 274–75; in Florida, 34; harms in, 182–85; insurance reimbursement and, 341n10; rates of, 13 involuntary hospitalizations, 182, 200, 318n8, 341n17; rates of, 13 involuntary medication, 183, 200–202; court-ordered, 41 involuntary treatment, 198, 283, 325n66, 327n89; seeking treatment after, 318n11 IST. See incompetent to stand trial Jaffe, D. J., 39, 243, 366n42 jail psychiatric units, 41, 115 John George Psychiatric Hospital, 56, ৱ৸৳ੴ੯ৱ৸৴ Johnson, Lyndon, 155 joint police-clinician response teams, 64 judges, case assignment to, 126 judge trials, 129 judicial review, 93 jury trials, 128–29 Kaiser Permanente, 27, 28; mental health services and, 31–32 Kalra, Ash, 212 Kelly, Veronica, 255 Kincaid, Linda, 179 Knight, Heather, 7, 213, 214 La Amistad, 259, 260 La Casa, 182 Lanterman, Frank, 5, 89, 287 Lanterman Mental Retardation Act (1969), 287 Lanterman-Petris-Short Act (LPS), 5–12, 311; audit of usage, 324n55; authority and, 16;

388

INDEX

Lanterman-Petris-Short Act (LPS) (continuedੰબ betrayal tunnel and, 62; chronic inebriates provision in, 81; commitment courts and, 335n25; conservatorship under, 105; criticisms of, 214; dangerousness determination and, 336n32; delegation and, 17–18; DMH ˺ϲϲʮɻʇ੮ʠ˺̼ੴ੮ৱৰ৶੶੮ʠ̼˺˦͐ˑʮ˦ʇ੮͸˺̼ˌʇ̼੮ͷʮʇ͸ͅ੮˺ʠੴ੮ 274; hospital stay length and, 89; judges assigned to cases under, 126; jury trials and, 128–29; key case law, 134; matching funds under, 35; private hospitals dropping designations under, 97; public defenders assigned to cases under, 125–27; reform attempts, 17, 225, 231–34, 276–78, 285, 286, 376n56; rights suspensions and, 61; tri-morbidities and, 237, 238; writs of habeas corpus and, 93. See also 5150 hold “Lanterman-Petris-Short Act, The: How Can It Be Improved” (hearing), 276–77 La Posada, 258, 260, 261 Lara-Millán, Armando, 118, 282, 283 Laura’s Law programs, 254, 255 law: medical system incompatibilities with, ৱ৳ৱ੶੮˚ʇʁʮɻʮ˦ʇ੮ɻ˺˦ϲˑʮɻ͐ͅ੮ɘ˦ʁ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦ͅ੮ with, 10–14 Lee, Ed, 214, 254 Legal Aid, 266 legal cynicism, 375n46 legal status: involuntary hospitalization experience and, 200; level of care and, 289 rʇʡʮͅˑɘ͐ʮͷʇ੮˦ɘˑ;͐ͅ੮šϲϲʮɻʇੴ੮৳৶ level of care: conservatorship orders and, 153; drug treatment and, 81; least restrictive, 75; legal status and, 289 LexisUni, 300 Lipsky, Michael, 19, 181 locked facilities, 22, 103, 147–50, 153; addiction treatment and, 110 long-term care, 143 long-term housing, 133 long-term institutionalization, 185 López, Andrea, 214

Los Angeles, 65-67, 96-97, 99-100, 149, 291; homeless deaths in, 226, 227; county jail, 115, 281. See also Skid Row Los Angeles Times (newspaper), 182, 234, 300; on conservators, 192 loss of self, 186 LPS. See Lanterman-Petris-Short Act LPS conservatorship (versus probate), 176–78, 177 LPS Designation, 53, 97, 311 Mad Mob, 219, 246 Magna Carta, 6, 8, 87 managed care, 37, 38, 89–91 Mandelman, Raphael, 212, 217–18, 221, 222, 224, 225 manic episodes, 42, 182-183 Marin County, California, 191, 192, 247 mass incarceration, 144 MCT. See mobile crisis team Medicaid, 34, 37, 41, 155, 244, 279; community-based solutions and, 108; creation of, 147; IMD exclusion and, 147, 243, 310; IMDs and funds from, 366n42 Medi-Cal, 46, 90, 310, 311; acute psychiatric hospitalization reimbursement rates, ৳৴৳˦৳ৰ੶੮ɺʮˑˑʮ˦ʡ੮ͅ;͐ͅʇ˚ੴ੮৲৸৸੶੮ɻˑ˺ͅʇʁ੮ϲʮˑʇͅ੮ and, 255; expansion of, 38; IST referrals and, 145; medical necessity criteria, 95, 96; private hospital contracting with, 299; reforms in, 99, 292; services on, 37 medical malpractice, 40 medical model of disability, 99 medical necessity criteria, 95, 96 medical paternalism, 7 medical system, law incompatibilities with, 131 Medicare: comorbid conditions and, 165; creation of, 147; nursing homes and, 143 medications: antipsychotic, 187, 354n30; community conservatorship and, 200– 202; consent and, 182–83; court-ordered involuntary, 41; forcible administration

INDEX of, 183, 200–202; nonadherence factors, ৴৳੶੮̼ʇɻ˺ͷʇ̼;੮ɘ˦ʁੴ੮৴৳જ৴৴੶੮̼ʇϲʮˑˑͅ੮ʠ˺̼ੴ੮৴৲જ৴৳ ˚ʇʁʮɻʮ˦ʇੴ੮ˑɘ͸੮ɻ˺˦ϲˑʮɻ͐ͅ੮ɘ˦ʁ੮ɻ˺ˑˑɘɺ˺̼ɘ͐ʮ˺˦ͅ੮ with, 10–14 ˚ʇʁʮɻ˺ˑʇʡɘˑ੮ɻ˺˦ϲˑʮɻ͐ੴ੮ৱৰੴ੮ৱ৲ medicolegal control, 11, 12, 14, 284 Mental Health Advisory Board (San Francisco), 175 Mental Health Association of San Francisco ફ{PણäHબੴ੮৲ৱ৹ੴ੮৲৴৷ੴ੮৲৴৸ੴ੮৲৶৲ mental health providers: Affordable Care Act and, 37; availability of, 31; choices of patients by, 30–31 Mental Health Rehabilitation Center (MHRC), 141, 147–48, 311; costs of, 351n25; owners/operators of, 148, 148 Mental Health Resource Card, 60, 60 mental health services, high-end, 193 Mental Health Services Act (MHSA), 36–37, 37, 148, 262, 310; county plan reviews under, 345n12; PAD programs and, 267; recovery as principle of, 203; shared decision making and, 266 Mental Health Services Oversight and Accountability Commission, 286 Mental Hygiene Legal Services, 125, 290 mental illness, 319n21; epistemic injustice and, 335n23; grave disability nexus with, 121–22; homelessness and, 334n8 meta-rights, 125 methamphetamine, 34, 54–56, 79, 80, 189, 256–57, 273; fentanyl in supplies of, 230 meth-induced psychosis, 54–55 MEU. See Mobile Evaluation Unit Meyer, Aaron, 234, 235, 237, 238, 299 {PણäHੳ੮See Mental Health Association of San Francisco MHRC. See Mental Health Rehabilitation Center MHSA. See Mental Health Services Act Miles, Ashlynn, 346n21 milieu therapy, 6 Million Dollar Murray, 66 mineral cures, 357n45

389

Miranda rights, 60 mobile crisis team (MCT), 28, 56, 62, 63, 252, 311 Mobile Evaluation Unit (MEU), 54, 65, 66, 311 moral injury, 235 Morrison, Kerry, 71–73, 180–81, 193, 232 Moss, Hillary, “Dirty Sally,” 176 {Ø৳੮ϲʮˑʇͅੴ੮৲ৰ৵ੴ੮৲ৰ৷ Murphy conservatorship, 347n33 Myrick, Keris, 276 myths, 285–88 NAMI. See National Alliance for Mental Illness Napa State Hospital, 192, 247, 258 Narcan, 231 National Alliance for Mental Illness (NAMI), 39, 40, 64, 95, 97 National Institute of Mental Health, 292 Navigation Center, 257 negative discretion, 20, 84, 282 ‡ʇ͐ϲˑʮͽੴ੮ৱ৹ৰ neurodiversity, 292 Newsom, Gavin, 213, 287; CARE courts and, 278, 286; conservatorship reforms and, 4, 7, 234, 243; IST waitlist and, 145; supported decision making and, 248 New York, 300; chronic homeless tracking in, 228; commitment statute reforms in, 125; ʮ˦ͷ˺ˑ͙˦͐ɘ̼;੮ɻ˺˚˚ʮ͐˚ʇ˦͐੮ʮ˦ੴ੮ৱ৹৲੶੮šϲϲʮɻʇ੮ of Mental Health, 288, 301 nexus, 121, 133, 135 nonpolice crisis response, 250–53, 367n10 ˦˺˦̹̼˺ϲʮ͐੮˺̼ʡɘ˦ʮΈɘ͐ʮ˺˦ͅੴ੮ͅʇ̼ͷʮɻʇ੮̹̼˺ͷʮͅʮ˺˦੮ contracted out to, 18 nonstate actors, 17–18 nursing homes, 18; Medicare payments for, 143; rehabilitation care in, 188; rehabilitation center conversions of, 148; transition to, 167–68 Obolensky, Serge, 70, 71, 180 šϲϲʮɻʇ੮˺ʠ੮{ʇ˦͐ɘˑ੮Pʇɘˑ͐ʩ੮ફ‡ʇ͸੮Ě˺̼ˌબੴ੮৲৸৸ੴ੮৳ৰৱ Olmstead v. L.C. by Zimring, 118

390

INDEX

Operation Dignity, 234–38, 245, 299 Orange County Register (newspaper), 300 Organization for Economic Cooperation and Development, 300 orthomolecular treatment, 186 outpatient conservatorship, 238–41 overdose deaths, 230, 230–31 PAD. See Psychiatric Advance Directive paid private guardians, 178 pain restraint hold, 183 palliative governance, 284 Pang, Simon, 218, 251–53, 261 parens patriae, 8 Partial Hospitalization Programs, 99 Partovi, Susan, 1–4, 226, 231–33, 240, 291, 293 Øɘͅή͙ʮ˦ʮੴ੮îʇ̼ʇͅɘੴ੮ৱ৵ৱજ৵৲ੴ੮৲৷৶ੴ੮৲৹৶ paternalism, 86, 175–79 patients’ rights advocate, 113, 269, 311 payee, 311 peer respite centers, 99, 262 peer specialists, 263 peer support work, 88 People v. Sanchez, 121, 130, 131, 134, 135 Pepper, Claude, 320n6 permanent supported housing, 170, 217, 311; eviction from, 53, 333n1 PERT. See Psychiatric Emergency Response Team PES. See psychiatric emergency services Petris, Nicholas, 5, 35 PHF. See Psychiatric Health Facility physical complaints, 45 placements, 108–11; continuum of, 138; hearings, 154 plenary guardianship, 200 PMRT. See Psychiatric Mobile Ûʇ̹ͅ˺˦ͅʇ੯îʇɘ˚ power: differentiation of forms of, 14-16, 284; psychiatric, 283 preauthorization, 90 ̹̼ʮͅ˺˦੮ͅ;͐ͅʇ˚ੵ੮ʁ˺͸˦ͅʮΈʮ˦ʡ੮˺ʠੴ੮৲৸ৱ੶੮ʠ˺̼ચ̹̼˺ϲʮ͐ੴ੮ 20; IST referrals and, 145; transfers ʠ̼˺˚ੴ੯ৱ৴৴

private facilities: conservatorship referrals and, 96, 96, 97; counties bidding for beds in, 149; patient choice and, 67; ή͙ɘˑʮ͐;੮˺ʠ੮ɻɘ̼ʇ੮ɘ˦ʁੴ੮৹৶੶੮ɘͅ੮Έ˺˦ʇ੮˺ʠ੮ͅ˺ɻʮɘˑ੮ abandonment, 181 private guardians, 178 ̹̼ʮͷɘ͐ʇ੮ʩ˺̹ͅʮ͐ɘˑͅੵ੮ɻˑ˺ͅʮ˦ʡ੮˺ʠੴ੮৹৲੶੮̹̼˺ϲʮ͐ચʁ̼ʮͷʇ˦੮ preferences of, 20 private therapists, choices of patients by, 30–31 Privatte, Linda, 109 probable cause hearing, 93–94, 311; medical conditions and, 364n21; patients’ rights advocates in, 113 probate conservatorship, 176–78, 177, 237, 248, 311–12 Progress Foundation, 258–62, 270 Project Return Peer Support Network, 262, 263 Project Roomkey, 2 Prop C, 215 Proposition 47, 55, 334n12 Ø̼˺ĺ͙ʇ͐ͅੴ੮৳ৰৰ Protecting Our Kids bill (2022), 287 Prozac, 86 Psychiatric Advance Directive (PAD), 266–69, 290, 312 Psychiatric Emergency Response Team (PERT), 311 psychiatric emergency services (PES), 77, 78, 81, 214, 218, 312 Psychiatric Health Facility (PHF), 312; discharge planning and, 342n23 psychiatric hospital beds, availability of, 75, 76, 242, 242 psychiatric hospitals: average stay in, 341n14; building new, 241–44; deaths in, 182–85; IMD exclusion and investment in, 243; involuntary stays in, 341n17; violence in, 183–84 Psychiatric Mobile Response Team (PMRT), 311 psychiatric power, 283

INDEX psychiatric technicians and aides, injury rates among, 184 psychiatrists: cultural competence and, 44; health insurance and, 30; physical complaints and, 45 psychosis, 54, 70, 273, 293; death rates in, 329n12; ER procedures and, 74; grave disability from chronic, 81–83; private insurance and, 31–32 psychotic breaks, 173, 263 Psynergy, 152, 187, 188, 205, 206 public authority, 155–56; residential care system and, 289 public defenders, 117, 121–23, 130–36, 198; IST referrals and, 145; reasons for taking LPS cases, 125–27; uncontested hearings and, 128 public guardians, 41, 102–3, 135, 191, 193, 312; county government and, 106; diversion programs and, 115–18; funding of, 104; investigations by, 22, 107–8; “least restrictive” obligation for, 118, 154; limited resources for, 179–81; powers of, 182, 189; responsibility passed by, 110–11; sovereign power and, 14–16; stabilization cycles and, 194–97; state government and, 106; systems brokered by, 195; as veto point, 104 public hospitals, conservatorships and, 96, 97 public mental health system, access to, 33–39 Public Nuisance Abatement Unit, 237 public services, 30, 46 RAP. See Resource Action Program Raz, Joseph, 15 Reagan, Ronald, 7, 35, 73, 144, 279, 357n45; myths of, 285–88 realignment, 35–36, 90, 155, 255 recovery, 43–44; reality of, 203–7 Recovery Anonymous, 168 recovery-oriented mental health programs, 207 Recovery with Inspiration, Support, and Empowerment (RISE), 268, 289

391

referrals: to board and cares, 164; cherrypicking and, 151; conservatorship investigations and, 108; IST, 145; outsourcing, 94–98 reform, 22, 211–13; coercion and, 219–22; complaint-driven, 216–19; grave disability ̼ʇʁʇϲʮ˦ʮ͐ʮ˺˦ͅ੮ɘ˦ʁੴ੮৲৳ৱ੶੮˦ʇ͸੮ʠɘɻʮˑʮ͐ʮʇͅ੮ɘ˦ʁੴ੮ 243; outside mental health system, 292 Regional Centers, 287 residential care system: collapse of, 213; public authority and, 289 residential crisis services, 369n33 residential therapeutic programs: children ɘ˦ʁੴ੮৳৲৹˦৶੶੮̹ʇʇ̼੮͐ͅɘϲϲʮ˦ʡ੮ʮ˦ੴ੮৲৶৲ residential treatment facilities, 187, 205, 260 residual discretion, 118–19 Resource Action Program (RAP), 235, 236, 273 Rettagliata, Lauren, 296 Reyes, Eloise, 277 Riese hearing, 183, 301, 312 Ûɷɐ̎ɐ‫ףר̀ף‬ä͗‫{ףר‬ȡ͇̅‫ף̎إ‬P˃̎̂ɷ͗ȡʚ, 134 rights to refuse treatment, 125 right to fail, 187 right to have rights, 124–27 Rigney, Francis, 175 Rippee, Linda, 119 Rippee, Mark, 108–11, 291, 346n20 RISE. See Recovery with Inspiration, Support, and Empowerment risk, dignity of, 178, 179 Roberts, Jim, 259 Rockland State Hospital, 263 Ronen, Hillary, 221 Rose, Nikolas, 12, 104 Sacramento Bee (newspaper), 300 Sacramento Behavioral Health Facility, 241 safe consumption sites, 284 San Bernardino County, 255 Sanchez. See People v. Sanchez San Diego county: budget cut triage planning in, 35; conservatorship bounty system in, 176; jail suicides in, 75

392

INDEX

San Diego Union (newspaper), 7, 176, 300 San Francisco, 22; AOT program in, 224, 254– 56; community conservatorship programs in, 200, 201; conservatee placement in, 149; high-utilization persons in, 76, 80–81; homelessness in, 54, 213, 216; meth-related ER visits in, 54; overdose deaths in, 230, 230–31; reform efforts and, 211, 213–14, 217; SCRT in, 250–53; services access in, 220, 221; thrown hearings in, 94 San Francisco Chronicle (newspaper), 7, 213, 214, 218, 300 San Francisco General Hospital, 42, 78, 218, 256; LPS beds in, 223; psychiatric beds in, 97 Santiago, Miguel, 276 schizoaffective disorder, 46, 59, 61, 94, 108, 120, 246 schizophrenia, 204, 273, 291; delusions of persecution in, 132–33; meth use similarities to, 80; readmissions for, 248; treatment-resistant, 185 school-to-guardianship pipeline, 178 Scripps Health, 342n22 SCRT. See Street Crisis Response Team Scull, Andrew, 161 Seelig, Jerry, 243 Seim, Josh, 84, 282 self, loss of, 186 self-care plans, 93 self-harm, 87, 247 self-worth, conservatorship and, 204 Senate Bill 40, 216 Senate Bill 803, 263 Senate Bill 1045, 211, 213, 218, 224–25, 231, 233–34, 299; adoption of, 222; opposition to, 212, 215–16, 219; passing of, 221; service resistance and, 220 Senior and Disability Action, 220, 246 äʇ̼˺ή͙ʇˑੴ੮৳৴ service resistance, 220 services, 253–57; consent and, 29 Shaner, Rod, 96, 97, 192, 299 shared decision making, 265–69

Shasta County, California, 241 sheltered employment, 207 shelter-in-place hotels, 224, 230, 363n7, 363n41 Sherin, Jon, 149, 170, 239, 241, 243 Short, Alan, 6 Short-Doyle, 35 short-term stabilization, 155 Siliezar, Abraham, 346n23 single-room occupancy (SRO), 92, 99, 224, 256, 352n1 Skid Row, 226, 227, 276, 291; board and care patients from, 164; therapeutic policing in, 12 skilled nursing facility (SNF), 312 skills, 250, 257–61 Slack, 264 Slipknot (band), 205 SMART. See Systemwide Mental Assessment Response Team SNF. See skilled nursing facility social control, 97, 283; AOT as, 254 social death, 14, 181, 268; conservatorship as, 14 social determinants, 292 socialization centers, 112 social model of disability, 99, 100, 155 Social Security, 279 Social Security Act Amendments (1965), 147 Social Security Disability Income (SSDI), 313 social services: in France, 73; public guardians as subdivision of, 106 social workers, 92; PES and, 78 ͅ˺ˑʮ͐ɘ̼;੮ɻ˺˦ϲʮ˦ʇ˚ʇ˦͐ੴ੮৳৴ੴ੮৴ৱੴ੮৲৷৶ sovereign power, 14, 15; 5150 holds and, ৶৸੶੯ʡ̼ɘͷʇ੮ʁʮͅɘɺʮˑʮ͐;੮ɘ˦ʁੴ੮৹৴੶੮ͷʇ͐˺੮̹˺ʮ˦͐ͅ੮ and, 19 Spears, Britney, 9, 10, 175, 177, 179, 194 äή͙ɘ̼ʇੴ੮৲৶৴ SRO. See single-room occupancy SSDI. See Social Security Disability Income SSI. See Supplemental Security Income stabilization, 250–53, 261; cycles of, 194–97 Starbucks, 206 Starr, Paul, 120

INDEX stated interest, 126 state hospitals, 17, 144–46, 152, 312; arrivals units in, 204; deinstitutionalization and closing of, 18, 160; loss of self at, 186 state of exception, 59–61, 183, 197 state-run asylums, 5 status degradation ceremony, 135 Steinberg, Darrell, 278 step-down programs, 88, 91, 103, 168, 187, 207; average wait times for, 342n28 Stern, Henry, 233 St. Francis Hospital, 248 St. Mary’s Medical Center, 221 Stone, Deborah, 114 Street Crisis Response Team (SCRT), 250–53, 258, 261, 270, 273, 312 Substance Abuse and Mental Health Services Agency, 203 substance abuse programs, 49, 110, 236 substance use, 172, 216; behavioral health and, 319n21; 5343 commitments and, 339n28; homelessness and, 334n8 substance users: board and cares and, 164–65; ERs and, 79–81 substituted decision making, 248 suicide, 67, 75, 87, 268; admissions decisions and risk of, 164; dangerousness and, 339n33; hospitalization and prevention of, 356n27 Supplemental Security Income (SSI), 132, 158–59, 206, 312–13; board and cares and, 161, 163, 165, 166 support, 250, 261–65 supported decision making, 248 supported housing, 228, 253, 288 survival plans, 113, 137 Systemwide Mental Assessment Response Team (SMART), 54, 65, 311 tactical disengagement, 63, 336n33 tardive dyskinesia, 167 Taylor, Kimberley, 258, 259 TBI. See traumatic brain injury Telecare, 148, 149, 182

393

temporary conservatorship, 111 Texas RioGrande Legal Aid, 266 theoretical sampling, 296 therapeutic policing, 12 Thirteen੮ફϲʮˑ˚બੴ੮৳ৰ Threat Management, 65 thrown hearings, 93–94 token economy, 157-158, 205 tolerant containment, 284 Torrey, E. Fuller, 279, 332fn49 “toxic conservatorship” forum, 246 traumatic brain injury (TBI), 49, 108, 111 Treatment Advocacy Center, 332n49, 348n13 treatment-resistant schizophrenia, 185 triangulating data, 299–301 tri-morbidities, 234–38 Trump, Donald, 63 Twin Towers jail, 115, 117 Tylenol PM, 58 UC San Diego hospital system, 235, 236, 238 Umberg, Thomas, 279 UMH. See Urban Mental Health uncontested hearings, 128 UN Convention on the Rights of People with Disabilities, 16 Underwood, Carrie, 205 Universal Health Services, 341n10 unmet medical needs, grave disability and, 232 Urban Mental Health (UMH), 27–29, 38, 45, 46, 63, 169, 255, 299 use of force, 57 utilization reviews, 90 Vanbruggen, Stacy, 268 Vargas, Claudia, 269 Venice Family Clinic, 231 vertical therapy, 78 Veterans Affairs health care system, 287 veto points, 19, 20, 104; ERs as, 73 violence interrupters, 253 “Vision for All Californians’ Behavioral Health,” 17

394

INDEX

vocational skills, 264 Voluntary Services Coalition, 219, 221 voting rights, 356n26 Waldie, Jerome, 124 Walton, Shamann, 221 Wang, Esmé Weijun, 61, 174, 185 Warren, Elizabeth, 10 Weber, Max, 15 Weiss, Rick, 115, 117, 153 Welfare and Institutions Code, 98; grade ʁʮͅɘɺʮˑʮ͐;੮ʁʇϲʮ˦ʮ͐ʮ˺˦੮ʮ˦ੴ੮ৱ੶੮äʇɻ͐ʮ˺˦੮৵ৱ৵ৰੴ੮ 309; section 5358.5, 166, 167

welfare checks, 63–65 welfare state, 30, 118, 207 Wellness and Advocacy Center, 88 Western Center on Law and Poverty, 212 Wiener, Scott, 211, 214–16, 220, 222, 224 Wilcox, Laura, 254 Wood, Jim, 277 World Health Organization, 300 writ of habeas corpus, 6, 93, 313 wrongful conservatorship, 176 Zoom era, 296 Zyprexa, 273