AAPL Landmark - Right to Refuse Treatment Flashcards
Does the imminent danger of death trump an incompetent patient’s religious objections to emergency medical treatment in the District of Columbia?
Yes.
Application of the President and Directors of Georgetown University - Jehovah’s witness found incompetent due to state of health and given a blood transfusion to save her life.
Is substituted judgment an appropriate decision-making standard for a legally appointed guardian to employ when making medical decisions for her ward?
Yes.
Superintendent of Belchertown State School et. al v. Joseph Saikewicz (1977). IQ of 10 gets Leukemia. Mass. SC ruled that substituted judgment for incompetent patients was the appropriate decision-making standard and that “to presume that the incompetent person must always be subjected to what many rational and intelligent persons may decline is to downgrade the status of the incompetent person by placing a lesser value on his intrinsic human worth and vitality.
Can a legally appointed guardian of a non-hospitalized individual in Massachusetts with mental illness consent to the nonemergent administration of antipsychotic medication for that individual?
No.
In The Matter of The Guardianship of Richard Roe, III (1981). Absent an emergency, in a noninstitutionalized patient, antipsychotic medications may be administered forcibly only when ordered by a judge using a substituted judgment standard.
In New Jersey, Is a court order required for the non-emergency administration of antipsychotic mediation for individuals civilly committed for psychiatric treatment?
No.
Rennie v. Klein (1983, on remand). The USSC instructed the 3rd Circuit to reconsider the case given the decision in Youngberg v. Romeo, which adopted a standard of “professional judgment” instead of the “lease restrictive means.” Upon reconsideration, the Third Circuit found that the NJ regulations satisfied the professional judgment standard. This case represents a treatment-drive approach to establishing a patient’s right to refuse treatment.
In Massachusetts, does treatment of an involuntarily committed patient who is refusing psychiatric medication require a court order?
Yes.
Rogers v. Commissioner (1983).
The USSC remanded the case to the court of appeals to decide whether there was a likelihood of physical harm and to consider if a patient’s health would significantly deteriorate without medications.
The Mass court responded as follows: 1) competency and substituted judgment determinations must be made in court by a judge; 2) a substituted judgment treatment decisions must be made before a hospitalized patient can be forcibly medicated; and 3) emergencies are exceptions. This is a decision in contrast to Rennie v. Klein that demonstrates a treatment driven approach.
