Clinical Perplexities in the Treatment of Treatment-Refusing Forensic Patients

Abstract

For many, the right to refuse treatment in a forensic hospital is a contradiction in terms. Court systems require maximum security hospitals for the protection of society from the committed, psychiatrically ill individual whose rights to privacy and autonomy are thereby modified, yet the involuntary “patient’s” rights to privacy and autonomy are upheld by the courts in defense of treatment refusal. Court-committed patients are met on admission by a patient advocate who explains the treatment authorization form for signature — before the patient has contact with the admitting psychiatrist. Although the courts accept recommendations of competency to stand trial contingent upon continuation of antipsychotic medication [1], the same medications have been considered mind controlling [2] in support of the right to refuse treatment. The invasive nature of psychoses [2] has not been conceded by the legal system.