A patient cannot be given a psychotropic medication involuntarily unless stringent legal pre-conditions are satisfied. To illuminate how these legal conditions should be interpreted, the Appellate Court of Illinois in a recent case looked around the U.S. for guiding precedents from other state courts.

   The Wisconsin Supreme Court in 1994 ruled that if a patient has the capacity to identify the medication he or she is now refusing as one he or she has been given in the past, and can describe what happened in the past, that is, whether the effects were beneficial or harmful, and the patient does not hold any "patently false beliefs" about what happened with the medication in the past, but in fact is now trying to exercise a choice based on a legitimate understanding of the risks and benefits of the medication based on past experience, the patient’s right to choose must be respected.

   The New York Supreme Court in 1986 phrased it differently, but said essentially the same thing.

   According to the Appellate Court of Illinois, the patient in this case had the capacity to make treatment decisions for himself. Based on objective information concerning the benefits and risks of the proposed treatment and the alternatives, he made a rational choice to refuse to be treated with the medication in question, because of past side effects he did not want to risk again.

   The court was influenced to rule this patient had the capacity to make rational choices by the fact he had voluntarily signed himself into the facility which was seeking to medicate him against his will.