FOR THE PAST year, a homeless District woman named Mary Bailey has been suffering from a rare disease that wiped out her ability to take care of herself and may have impaired her thinking. She is now receiving treatment at St. Elizabeths Hospital and is said to be in good spirits after workers at a shelter for the homeless had her taken to D.C. General Hospital against her will. This relief might have occurred 12 months ago, when shelter volunteers saw that she was falling down frequently and losing her ability to walk and control her arms and legs. But she refused to go to a hospital for tests at that time.
There is a painful conflict between an individual's right to make his or her own decisions in such circumstances and the humanitarian belief that disabled people in need should be helped even if they refse assistance. Present law allows involuntary commitments only when a person presents an immediate danger to himself or to others. But what about situations such as that of Mary Bailey, or of the mentally ill woman found on the floor of her roach-ridden Dupont Circle apartment not long ago -- she refused to talk or eat, and rejected help that was offered her. Is it sensible in circumstances such as these to expect a deeply troubled individual to make a decision on commitment alone?
Mayors Edward Koch of New York City and W. Wilson Goode of Philadelphia have ordered police to take homeless people off the streets and put them in shelters on bitterly cold days, whether they want to go or not. D.C. Council member John Wilson has urged Mayor Barry to issue similar orders here when the temperature falls below 25. The intent is compassionate and laudable in each case. The alternative is to allow some people to freeze to death when warm places to stay are readily availible.
In the same spirit, the president of the American Psychiatric Association, James Talbott, testifying at a Senate hearing last week, said that "grave disability" should be added as a standard for involuntary commitment. This seems to us a responsible approach. When a law that was intended to help the most disadvantaged men and women in our society becomes a standard that allows some to suffer horribly and die, changes must be made.