The right to refuse antipsychotic medication is now more than a decade old. Its evolution has taken divergent forms, driven either by the needs of patients' treatment or the mandate of patients' rights. Regardless of the model employed, refusal is not uncommon, but refusing patients appear almost always to receive treatment in the end. These findings point up the essential illogic of allowing committed persons to refuse treatment that would permit their freedom to be restored. The future evolution of the right may proceed differently in federal and state courts, but whether at the level of legal theory or actual practice, some accommodation will restore the equivalence between the power to commit and the power to treat.