ABSTRACT
The question of the right to refuse antipsychotic medication remains the most important and volatile aspect of the legal regulation of mental health practice (Plotkin 1977; Gelman 1984; Brooks 1987; Perlin 1999, § 3B-2; Perlin 2000). The issues that are raised – the autonomy of institutionalized individuals with mental disability to refuse the imposition of treatment that is designed (at least in part) to ameliorate their symptomatology; the degree to which individuals subjected to such drugging are in danger of developing irreversible neurological side effects; the evanescence of terms such as informed consent or competency; the practical and administrative considerations of implementing such a right in an institutional setting; and the range of the philosophical questions raised (dealing with autonomy, freedom, self-governance, and utilitarianism) (Perlin 1990; Perlin 1991; Perlin and Dorfman 1996; Perlin 1999, § 3B-2) – mark the litigation that has led to the articulation of the right to refuse treatment as ‘a turning point in institutional psychiatry’ (Rhoden 1980) and ‘the most controversial issue in forensic psychiatry’ (Brant 1983).
