Advocacy, Inc. - IR8 — Your Legal Right To Refuse Medication

IR8 — Your Legal Right To Refuse Medication

December, 1997

You have certain legal rights while committed to a mental health hospital. One of these rights is the right to refuse medications for the treatment of mental illness. Under certain circumstances, your right to refuse medication may be restricted by a doctor or a judge.

When You Can Refuse Medication

You can refuse medication if you are in a hospital for psychiatric care (either a state facility or private psychiatric hospital) under an emergency commitment, a voluntary commitment, or under an order of protective custody.

When You Can Be Required To Take Medication

You can be required to take medication under the following circumstances:

There is an emergency because your recent behavior shows you are likely to hurt yourself or others; or
You are under 16 years-of-age and your guardian or parent consents for you; or
You are involuntarily committed under a 90-day commitment order and a judge decides you are likely to hurt yourself or others, cannot make this decision for yourself, and that the medication will help you get well.

Before You Decide To Take Medication

You must be told certain information about the medication before you are given the medication. You must be told this information both orally and in writing, in the language you understand best, or if you are visually or mentally impaired, in the way you communicate best. If you have a guardian or you are under 16-years-old, then your guardian or parent must also be given this information. You must be told:

What specific condition is being treated with the medication;
How the medication will help you;
What might happen to your mental health if you refuse the medication;
Any significant side effects and risks you may have if you take the medication;
Any alternatives to taking the medication and why the doctor thinks they will not work as well for you;
How long and how often you will be taking the medication; and
If you decide to take the medication, you can change your mind at any time.

If someone other than the prescribing doctor gives you the above information, the prescribing doctor must meet with you personally within two (2) days (excluding weekends and holidays) to answer your questions.

You also have the right to have an independent examination or evaluation by another doctor of your choice at your own cost. If you ask for an independent examination or evaluation, it must be arranged for you by the hospital.

Staff must note in your records whether you agree to take the medication or not, or whether it is given to you under emergency conditions or under a judge's order.

If You Agree To Take Medication

If you consent to take medication, your consent must be voluntary and without feeling pressured to agree. If you have a guardian, your guardian can consent to the medication.

If You Decide To Refuse Medication

You cannot be forced to take medication unless it is an emergency. In a non-emergency situation, if you refuse medication, your doctor must file an application with the court for an order authorizing the administration of medication. A hearing will be held.

You must be allowed to attend with an attorney--one will be appointed by the court, if necessary. You have the right to a court-appointed attorney; if you wish to hire your own lawyer, you may do so.
The judge will listen to what you and your doctor have to say, and determine if you lack the capacity to make a decision about whether to take the medication, and if treatment with the medication is in your best interest.
The judge has to consider:
1. your expressed preferences regarding treatment with psychoactive medication (If you have an advanced directive, the judge has to consider it. Please see Advocacy, Inc.'s handout regarding Advanced Directives.;
2. your religious beliefs;
3. the risks and benefits, from the perspective of the patient, of taking psychoactive medication;
4. the consequences to you if the psychoactive medication is not administered;
5. your prognosis if you are treated with psychoactive medication; and
6. alternatives to treatment with psychoactive medication.

After the judge makes a decision, you can appeal the decision. (1)

If You Are Required To Take Medication

If a judge has decided that you must take medication, you have to take it until your 90-day commitment order has ended. Your doctor can increase or lower the dosage of your medication, and can give you another medication in the same class without additional approval from the court. But the class (or classes) of medication you have been ordered to take cannot be changed without a court order. The class (or classes) of medications approved by the court will be attached to the order.

If You Think Your Rights May Have Been Violated

If you believe any of these rights may have been violated, you should first contact your treatment team at the facility where you are located. Additionally, you have the right to talk to any of the following:

the Client Rights Officer, located at all mental health facilities;
the TDMHMR Office of Consumer Services and Rights Protection;
the Public Responsibility Committee;
Texas Mental Health Consumers (1-800-860-6057); and/or
Advocacy, Incorporated (see Regional Offices page for toll free numbers to each office).

For further information, see Advocacy, Incorporated's brochure, Rights of People Receiving Involuntary Inpatient Mental Health Services. Advocacy, Inc. also has the following related brochures available:

For further information, please contact any Advocacy, Inc. office at the address and/or telephone number listed on our Regional Office page.

Endnotes

(1) Under § 74.106(b), an order authorizing the administration of medication--irregardless of the refusal of the patient--is effective until a decision is issued regarding an appeal of the order.

Advocacy, Incorporated's goal is to make each handout understandable by and useful to the general public. If you have suggestions on how this handout can be improved, please contact Advocacy, Inc. at the address and telephone number shown on Advocacy's home page or e-mail Advocacy, Inc. at infoai@advocacyinc.org. Thank you for your assistance. This handout is available in Braille and/or on audio tape upon request. Advocacy, Inc. strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate. The handout is not intended to and does not replace an attorney's advice or assistance based on your particular situation.