Abstract
This article examines the impact of the New York court decision, Rivers v. Katz, which in June 1986 dramatically changed the state procedure for responding to involuntarily committed psychiatric patients who formally refused psychopharmacologic treatment. The court rejected the medically administered review process that had been used to respond to involuntarily committed psychiatric patients who formally refused medication, and replaced it with a judicial determination of competent and “substituted judgment” provided by the court. Post-Rivers, the rate of patients consistently refusing treatment decreased, and the time from refusal to resolution increased. The clinical, legal, and economic implications of the Rivers procedure are discussed.
Footnotes
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Dr. Ciccone is professor of psychiatry and director, Psychiatry and Law Program; Dr. Tokoli, instructor in psychiatry; Dr. Clements, assistant professor of psychiatry ; and Dr. Gift, associate professor of psychiatry, University of Rochester School of Medicine and Dentistry. Dr. Gift is also executive director of the Park Ridge Mental Health Center. Address reprint requests to: Dr. Ciccone, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 300 Crittenden Boulevazd, Rochester, New York 14642.
- Copyright © 1990, The American Academy of Psychiatry and the Law
