Forced Administration Of Psych Meds: Court Says Anti-Dyskinetics May Be Given
Legal Eagle Eye Newsletter for the Nursing Profession
November 1995Quick Summary: Psychiatric medications may be forced upon a non-consenting patient only in an emergency, or in a non-emergency when the patient has been hospitalized involuntarily and the medications have been approved by a hearing panel convened under state law.
Under state law, the hearing panel must give the patient twenty-four hours notice, so that the patient can prepare his or her objections and/or consult with a legal advisor. The panel must consider the clinical need for the medications, along with risks, benefits and side effects.
Involuntary administration of psychiatric medications may be approved if the panel determines that the medication was prescribed by a psychiatrist for the purpose of treating the patient’s mental disorder, that the administration of the medication represents a reasonable exercise of medical judgment, and that without the medication the patient is at substantial risk.
This procedure applies to anti-psychotics, and to medications used to control the side effects of anti-psychotic medications.
COURT OF SPECIAL APPEALS OF MARYLAND, 1995.The Court of Special Appeals of Maryland has ruled that an involuntarily committed psychiatric patient may be required to take medications intended to combat the side effects of anti-psychotic medications which were also being administered to him on an involuntary basis.
The patient was getting Haldol and Depakote to control his psychotic symptoms. He had been offered these medications in oral form, but when he refused them, a panel was convened pursuant to the state’s mental health treatment regulations. The panel ruled that Haldol and Depakote could be given IM on a forced basis, with the dosage to be titrated according to the attending physician’s day-to-day orders, for a period of ninety days, while the patient’s involuntary hospitalization continued.
According to the court record, although the patient initially refused to take the anti-psychotic medications, the propriety of administration of these medications was not raised an issue in this particular case.
The issue was whether the patient could have Cogentin administered to him on a forced basis during is involuntary psychiatric hospitalization. Cogentin, as stated in the court record, is an anti-dyskinetic drug used to treat parkinsonism, which is a commonly-observed side effect of anti-psychotic medications.
The court upheld the decision of the administrative mental-health panel which had ruled that Cogentin could be administered involuntarily to this patient. To give an anti-dyskinetic medication involuntarily, it is necessary for the hospital to follow the full procedural format for involuntary administration of anti-psychotic medications to an involuntarily-committed patient.
Beeman vs. Department of Health & Mental Hygiene, 658 A. 2d 1172 (Md. App., 1995).More references from nursinglaw.com
http://www.nursinglaw.com/psychiatric-medication-patient-consent.pdf
http://www.nursinglaw.com/psychmed1.htm
http://www.nursinglaw.com/psychiatric-medication-involuntary-nurse-lawsuit.htm
http://www.nursinglaw.com/psychmed5.htm
http://www.nursinglaw.com/involuntary-mental-health-detention.htm