Mental Hospital Drugs, Professionalism and the Constitution

This article explores the medical and legal characterizations of the "right to refuse drugs." The implications that these characterizations hold for present-day state psychiatry and judicially mandated change also will be explored. Part I argues that the legitimacy of state drugging must be based on a choice between "professional" and "political" charters. Both the outcome of constitutional "interest weighing" and the subsequent fashioning of a remedy depend upon this choice. Part II then examines state drugging in light of the considerations enumerated in Part I. Without suggesting that either choice is compelled, the article argues that there is unprecedented strength in the case for a political charter, rather than a professional one, in state drugging matters. Part III turns to the judicial decisions concerning the right to refuse drugs and examines the seemingly unworkable combinations of legalistic substantive standards and medical procedures that have appealed to thoughtful courts. Part IV takes issue with the courts' basic orientation and concludes with a plea for judicial candor about state drugging of the mentally ill.