Riese v. St. Mary's Hospital & Medical Center

751 P.2d 893
Brief Filed: 8/88
Court: Supreme Court of California
Year of Decision: 1989

Read the full-text amicus brief (PDF, 566KB)

Issue

Whether civilly committed mental patients could refuse the administration of antipsychotic medication absent a judicial determination of incompetence

Index Topic

Medication (Right to Refuse)

Facts

The issue before the California Supreme Court was whether a patient involuntarily committed to a mental health facility could be administered antipsychotic medication over his objection and absent a judicial determination of incompetence. The Lanterman-Petris-Short Act (LPS Act) guaranteed the right to treatment. Unlike many previous right to refuse treatment cases, the Reise case presented the issue of alternative treatment modalities within a hospital setting. The hospital in this case argued that the only available treatment for involuntary patients was medication and therefore, if medication were not provided, the hospital would be in violation of the LPS Act.

APA's Position

APA agreed to participate as amici with the California State Psychological Association. The brief argued that: (1) antipsychotic drugs are beneficial for many patients, but they also cause substantial physical side effects, severely affect mental processes, and may be unnecessary in some cases because effective alternative treatments are available; (2) involuntary patients have a right to refuse antipsychotic drugs guaranteed by the LPS Act, common law and the California Constitution; (3) a hospitalized patient has a federal constitutional right to refuse antipsychotic drugs unless the patient has been found incompetent to make treatment decisions or is imminently dangerous to self or others; and (4) judicial determinations of competency and substituted judgment are constitutionally required to protect an individual's right to refuse antipsychotic drugs.

Results

Prior to hearing the case, the California Supreme Court determined that it had improvidently granted review and unanimously reinstated the landmark 1987 Court of Appeal decision that granted thousands of involuntarily committed mental patients the right to make their own decisions concerning psychotropic medications. The ruling allowed patients committed for three or 14 days to exercise informed consent to antipsychotic medications with two exceptions: (a) in an emergency, or (b) following a court determination of the patient's legal incompetence to make a treatment decision regarding the drugs.