Alaska Supreme Court Moves To Protect Psychiatric Patient Rights
In a decision delivered on 30 June 2006 in the case of Myers v. Alaska Psychiatric Institute, the Supreme Court of Alaska has set an important precedent for the right to personal self-determination of people who are labeled mentally ill. The court reversed an earlier superior court decision, which had confirmed the legality of forced "treatment" with psychotropic drugs.
Faith Myers, the appellant in the case, reacted to the decision saying, "It makes all of my suffering worthwhile." Myers' attorney, Jim Gottstein, said "By requiring the least intrusive alternative to forced psychiatric drugging, this decision has the potential to change the face of current psychiatric practice, dramatically improving the lives of people who now find themselves at the wrong end of a hypodermic needle."
Jim Gottstein, the lawyer who argued the case
The Court's decision, which can be found here (pdf) concludes that
" ... the Alaska Constitution’s guarantees of liberty and privacy require an independent judicial determination of an incompetent mental patient’s best interests before the superior court may authorize a facility like API to treat the patient with psychotropic drugs. Because the superior court did not determine Myers’s best interest before authorizing psychotropic medications, we VACATE its involuntary treatment order. Although no further proceedings are needed here because Myers’s case is now technically moot, we hold that in future non-emergency cases a court may not permit a treatment facility to administer psychotropic drugs unless the court makes findings that comply with all applicable statutory requirements and, in addition, expressly finds by clear and convincing evidence that the proposed treatment is in the patient’s best interests and that no less intrusive alternative is available."Alaska is setting a very positive precedent with this decision. There might well be a domino effect in other US States, where forced drugging is routinely performed and upheld by the courts. And hopefully, the effect will not be limited to the North American continent alone.
Psychiatry and its treatments, especially the widespread use of mind-altering medication, are tools of control - they are a means to put those we don't agree with in a state of mind where they cannot argue back. Those social outcasts are labeled "crazy" and when given the drugs, the self-fulfilling prophecy comes true.
A bit more tolerance might not be such a bad thing...
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Vera Hassner Sharav, of the Alliance for Human Research Protection comments the decision as follows:
In a historic and precedent-setting decision, the Alaska Supreme Court affirmed that the forced administration of psychotropic drugs to patients is unconstitutional!!!
The decision restores personal rights to patients in psychiatric facilities and opens the way for overturning fifty-two illegitimate state statutes sanctioning forced psychotropic drugging.
"In keeping with most state courts that have addressed the issue, we hold that, in the absence of emergency, a court may not authorize the state to administer psychotropic drugs to a non-consenting mental patient unless the court determines that the medication is in the best interests of the patient and that no less intrusive alternative treatment is available."
The court's thoughtful, clear and informed ruling took into account both the constitutional right to personal freedom and privacy:
"To place these arguments in perspective, we must begin by considering Alaska's statutory provisions governing treatment of mental patients."However, the Court also took note of these drugs' profound adverse effects -- effects that are not in patients' best interest.
Psychotropic drugs "affect the mind, behavior, intellectual functions, perception, moods, and emotions" and are known to cause a number of potentially devastating side effects. [M]ost common . . . are the temporary, muscular side effects (extra-pyramidal symptoms) which disappear when the drug is terminated; dystonic reactions (muscle spasms, especially in the eyes, neck, face, and arms; irregular flexing, writhing or grimacing movements; protrusion of the tongue); [and] akathesia (inability to stay still, restlessness, agitation) . . . Additionally, there are numerous other nonmuscular effects, including drowsiness, weakness, weight gain, dizziness, fainting, low blood pressure, dry mouth, blurred vision, loss of sexual desire, frigidity, apathy, depression, constipation, diarrhea, and changes in the blood.]Courts have observed that "the likelihood [that psychotropic drugs will cause] at least some temporary side effects appears to be undisputed"9 and many have noted that the drugs may - most infamously - cause Parkinsonian syndrome and tardive dyskinesia. Parkinsonian syndrome consists of "muscular rigidity, fine resting tremors, a masklike face, salivation, motor retardation, a shuffling gait, and pill-rolling hand movements."11 Tardive dyskinesia involves "slow, rhythmical, repetitive, involuntary movements of the mouth, lips, and tongue";12 it is permanent, and its symptoms cannot currently be treated.
Side effects aside, the truly intrusive nature of psychotropic drugs may be best understood by appreciating that they are literally intended to alter the mind. Recognizing that purpose, many states have equated the intrusiveness of psychotropic medication with the intrusiveness of electroconvulsive therapy and psychosurgery."
The Court noted that Alaska law recognizes and addresses a distinct class of drugs called "psychotropic medications." The Court tacitly recognized that these drugs' severe adverse effects legitimize patients' refusal to ingest them.
Thus, the Court decision requires mental health professionals not only to obtain informed consent but to justify the recommended treatment and fully disclose all aspects of the proposed treatment in relation to the patient's best interest based on personal history, condition, and choice:
"In order to make informed decisions possible, the law requires treatment facilities to give their patients certain information concerning their situation and need for treatment, including advice about: their diagnosis; proposed medications, including possible side effects and interactions with other drugs; their medical history; alternative treatments; and a statement describing their right to give or withhold consent.""Because psychotropic medication can have profound and lasting negative effects on a patient's mind and body, we now similarly hold that Alaska's statutory provisions permitting nonconsensual treatment with psychotropic medications implicate fundamental liberty and privacy interests."
IV. CONCLUSION
"We conclude that the Alaska Constitution's guarantees of liberty and privacy require an independent judicial determination of an incompetent mental patient's best interests before the superior court may authorize a facility like API to treat the patient with psychotropic drugs. Because the superior court did not determine Myers's best interest before authorizing psychotropic medications, we VACATE its involuntary treatment order. Although no further proceedings are needed here because Myers's case is now technically moot, we hold that in future non-emergency cases a court may not permit a treatment facility to administer psychotropic drugs unless the court makes findings that comply with all applicable statutory requirements and, in addition, expressly finds by clear and convincing evidence that the proposed treatment is in the patient's best interests and that no less intrusive alternative is available."See full 36 page referenced decision at:
http://psychrights.org/States/Alaska/CaseOne/MyersOpinion.pdfThe plaintiff, Faith Myers, who had been threatened with involuntary treatment by the Alaska Psychiatric Institute, challenged the constitutionality of the practice so that others would not face similar maltreatment.
We congratulate her lawyer, our colleague, Jim Gottstein, for his magnificent advocacy for the civil and human rights and personal dignity of individuals who are confronted with institutionalized psychiatric abuse.
Faith Myers and Jim Gottstein have earned their place in the annals of civil rights history.
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posted by Sepp Hasslberger on Sunday July 2 2006
updated on Monday March 3 2008URL of this article:
http://www.newmediaexplorer.org/sepp/2006/07/02/alaska_supreme_court_moves_to_protect_psychiatric_patient_rights.htm
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