Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-24T01:39:30.156Z Has data issue: false hasContentIssue false

The Presumption for Treatment: Has it been Justified?

Published online by Cambridge University Press:  28 April 2021

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Commentary
Copyright
Copyright © American Society of Law, Medicine and Ethics 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

See, e.g., Ramsey, P., The Saikewicz Precedent: What's Good for an Incompetent Patient, Hastings Center Report 8(6): 36, 39 (December 1979).Google Scholar
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Deciding to Forego Life-Sustaining Treatment (U.S. Gov't Printing Ofc., Washington, D.C.) (1982) at 134–35.Google Scholar
Rogers v. Okin, 634 F.2d 650, 653 (1st Cir. 1980), vacated and remanded, sub nom. Mills v. Rogers, 457 U.S. 291 (1982); Rennie v. Klein, 653 F.2d 836 (3d Cir. 1981), vacated and remanded, 458 U.S. 1119 (1982). See Mills, M., Gutheil, T., Legal Approaches to Treating the Treatment-Refusing Patient, in Refusing Treatment in Mental Health Institutions—Values in Conflict (Doudera, A. & Swazey, J., eds.) (AUPHA Press, Ann Arbor, Mich.) (1982) at 103 (treatment refusal should be honored unless there is significant evidence that the patient is not competent).Google Scholar
Carter, Sestak, R.M. Roth, L.H., Informed Consent: A Study of Decision-Making in Psychiatry (Guilford Press, New York, Psychiatry (Guilford Press, New York, N.Y.) (1984) at 35.Google Scholar
See Michels, , Right to Refuse Treatment: Ethical Issues, Hospital and Community Psychiatry 32: 251, 252 (1981) (noting that although logically the same level of competency should be required for consenting as for refusing, in practice competency is much more likely to be questioned when the patient's decision is an unpopular one).Google ScholarPubMed
See generally Roth, L.H., Meisel, A., Lidz, C.W., Tests of Competency to Consent to Treatment, American Journal of Psychiatry 134(3): 134 (March 1977).Google ScholarPubMed
See Michels, R., Competence to Refuse Treatment, in Refusing Treatment in Mental Health Institutions—Values in Conflict, supra note 3, at 115, 117–18.Google Scholar
Annas, G., Glantz, L., Katz, B., Informed Consent to Human Experimentation: The Subject's Dilemma (Ballinger Publishing Co., Cambridge, Mass.) (1977) at 152.Google Scholar
Appelbaum, P.S., Gutheil, T.G., Drug Refusal: A Study of Psychiatric In-Patients, American Journal of Psychiatry 137(3): 137, 342 (March 1980) [hereinafter referred to as Drug Refusal].Google Scholar
Id. at 342–43 (emphasis added).Google Scholar
Id. at 345.Google Scholar
Hassenfeld, I., Grumet, B., A Study of the Right to Refuse Treatment, Bulletin of the American Academy of Psychiatry and the Law 12(1): 65 (1984) [hereinafter referred to as Hassenfeld & Grumet].Google ScholarPubMed
The refuser group had a much longer average hospital stay. Id. at 70. Appelbaum and Gutheil in their study state: “Only for the symptomatic refuser [their term for ones who refused consistently] … did the act of refusal result in serious clinical consequences.” Drug Refusal, supra note 9, at 345.Google Scholar
One died, one was never discharged, and one made a marginal adjustment outside the hospital with frequent visits to the emergency service. Hassenfeld & Grumet, supra note 13, at 72.Google Scholar
Id. at 71–72.Google Scholar
Id. at 72.Google Scholar
Drug Refusal, supra note 9, at 344.Google Scholar
Hassenfeld & Grumet, supra note 13, at 73.Google Scholar
See Rhoden, N.K., The Right to Refuse Psychotropic Drugs, Harvard Civil Rights—Civil Liberties Law Review 15(2): 363, 388–96 (Fall 1980) (discussing M.H. Shapiro's theory that involuntary treatment violates the first amendment by infringing upon freedom of thought).Google Scholar
Drug Refusal, supra note 9, at 345Google Scholar
Michels, supra note 5, at 253.Google Scholar