> Yes, either these folks are competent to make decisions, or they are not. A significantly binary decision.
Except it is not binary. "Competence" is an arbitrary threshold we place upon a spectrum and where people fall on that spectrum can vary significantly over time.
> not to face consequences for their behavior has been an absolute disaster.
They face lots of consequences, life in poverty on the street is extremely harsh and it punishes bad choices severely.
Deeming them competent to make treatment decisions but not to face consequences for their behavior has been an absolute disaster.
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