California Is Tired of Letting People Die

https://www.theatlantic.com/ideas/2025/11/worst-job-san-francisco/685029/
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California Is Tired of Letting People Die

California is attempting to address its severe homelessness crisis by implementing S.B. 43, a law designed to expand involuntary treatment for individuals suffering from severe mental illness and addiction. The article highlights the ethical dilemmas and practical challenges faced by outreach workers, paramedics, and mental health professionals in San Francisco, one of the first counties to adopt the law. It explores the tension between upholding individual autonomy and providing life-saving care to those gravely disabled on the streets, detailing the difficulties in securing long-term institutionalization despite the new legislation.

Note

what a bold (and possibly believable) claim that the captain of the SF paramedic unit has one of the worst jobs in SF.

the dichotomy of the civil workers on the ground versus institutions, politicians and care takers is the most striking disconnect to recognize.

this isn't an easy problem to resolve. more beds in a hospital will not be enough (and even that is difficult enough to stop most cities from making progress).

compassion is a fun word to throw around until you recognize how much it will cost.

how can we build happy and safe cities, but still acknowledge that people will get sick, will lose hope or not be able to participate in the pathways that have built-in support (economic, social etc etc)?

conservatorship is certainly one answer (that might raise more problems than it solves). i would hope there are others.

Published

2025

Summary

California is attempting to address its severe homelessness crisis by implementing S.B. 43, a law designed to expand involuntary treatment for individuals suffering from severe mental illness and addiction. The article highlights the ethical dilemmas and practical challenges faced by outreach workers, paramedics, and mental health professionals in San Francisco, one of the first counties to adopt the law. It explores the tension between upholding individual autonomy and providing life-saving care to those gravely disabled on the streets, detailing the difficulties in securing long-term institutionalization despite the new legislation.

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