It made sense to me.

Maybe I’m the one who’s being super-annoyingly nitpicky, because it still doesn’t seem like we’re talking about quite the same thing.

Namely: it’s one thing to observe someone behaving erratically and probably in ways that are dangerous to themselves and others and say, “This person probably needs mental healthcare,” even if the person disagrees with you. It’s another to observe someone who outwardly appears healthy, happy, and well-adjusted and say, “This person just doesn’t realize they’re sick. They need mental healthcare.”

The former is what happens anytime a concerned friend or family member tells someone that they probably need to see a professional. I want that to continue happening, even though the concerned friends and family members are probably sometimes wrong, because that’s how many people end up getting the treatment they need. But the latter is what happens when nonpathological differences or lifestyle choices get medicalized, which is what happened with homosexuality, transsexuality, and other forms of “deviance,” and what atheists who consider religion a mental illness are trying to promote.

In the former case, you’re not actually making any claims about what’s going on in that person’s mind. You can see for yourself that they’re unable to cope with life or even in danger. You don’t need to speculate about the mental processes involved to tell someone who’s threatening suicide that they need to go to the hospital.

Likewise with the smoking example, the reasons a person has for smoking, which can indeed be complex, have no bearing on the fact that smoking is physically dangerous, leads to health problems, and costs insurance companies lots of money. While a libertarian could argue that anti-smoking initiatives are paternalistic, it’s also the case that smoking is a massive public health problem that is in the government’s best interest to try to solve. The thought processes of individual smokers, while important in that they can help us understand how to reduce smoking, are not germane to the larger question of “Should we try to reduce smoking?” Because our reason for reducing smoking isn’t because we think people have crappy reasons for smoking, but because we know smoking does a lot of harm both to individuals and to society in general (whether through secondhand smoke, money spent on lung cancer treatment, or whatever).

I am also open to the possibility that nothing I’ve just said makes any sense, in which case I’ll consume more caffeine and try to explain it better. 🙂