What Price is Personal Autonomy?
In July 2008 San Francisco’s Tenderloin received designation as an historic district on the National Register of Historic Places. Once it had a famous jazz club, the Black Hawk, at which Dave Brubeck, Miles Davis, Thelonious Monk, and other famous musicians recorded live albums. In 2017 part of the Tenderloin officially became a Transgender Cultural District.
By 2020 so many immigrant and poor residents were so afraid to leave their homes because of open drug use and crime that they filed a federal lawsuit accusing City Hall of treating poorer zip codes as “containment zones” for San Francisco’s illegal practices. City officials settled the suit by claiming law enforcement would improve and tents would have to be moved to “safe sleeping sites.” Little seems to have happened.
The Tenderloin’s name came from its similarity to a New York City entertainment district on the west side of midtown Manhattan in the last nineteenth century. That name may have originated with a wry remark by Alexander Williams, a New York police captain who said he once could afford only chuck steak on his salary, but in midtown he made enough from bribes that he could now afford tenderloin (‘filet mignon‘) instead.
From what I’ve heard, San Francisco police don’t take bribes to overlook criminal activity: They do so because that’s what San Francisco judges and voters have told them to have “respect for personal autonomy.” But for how long? If we define sanity as “the ability to think and behave in a rational manner,” fentanyl users are insane. They don’t want to die but don’t care if they do, since any hit could be their last.
The Orange County Rescue Mission respects personal autonomy in that anyone in its program can leave the mission at any time — but those who stay have decided to relinquish that autonomy, for their own good. They have to turn over all their medications and receive them only at designated times — and take all the medications prescribed to deal with their mental health issues.
They have to turn over all their cellphones and other electronic devices, and all their credit cards: OCRM locks up those belongings and returns them to students when they make it to the fourth stage of what is typically an 18-month program, or when they drop out. Students aren’t allowed anything containing alcohol, including mouthwash and perfume, They aren’t allowed to have any weapons or consume any pornography.
They can receive only one package per month, with exceptions for medical/health needs or for birthday and Christmas presents. Anyone is free to leave at any time—but cannot return for at least thirty days. “Freshmen,” those in their initial months at OCRM, cannot leave campus. Those who have become “sophomores” or above can receive four-hour passes, and one overnight pass every ninety days. Students must remove all piercings other than earrings. They cannot wear sexually-suggestive clothing and they cannot have romantic relationships with other students.
OCRM has “low severity” penalties for actions such as failure to adhere to the dress code: students have to apologize and commit to change. “Medium severity“ penalties, including having a visitor without permission, bring loss of privileges. “High severity” penalties — possession of any drugs, refusal to take part in drug testing (which occurs at least once a month and can be at random), and so on — can lead to expulsion.
So, OCRM residents give up some personal autonomy. Some decide not to make that sacrifice: In June, 52 people went through OCRM’s pre-screening. Several days later, after passing background checks, 25 had intake interviews. Seventeen came in. Deal-breakers include violent crime within last four years, a record of arson, or sex crimes of any kind at any time.
OCRM also has 600 cameras recording what happens in every public area and corridor. A staffer by the main entrance oversees three computer monitors with eighteen screens on each. In American culture most people give up personal autonomy part of the day: It’s called work, or parenting, or loving our neighbors. Addicts minimize those relationships in order to maximize drug use, giving up 100 percent of their autonomy in the process. At OCRM, residents temporarily give up freedom so as to free themselves from Tenderloin-type slavery.