Civil Commitment & Civil Competencies Flashcards
Zinermon v. Burch (1990)
Florida’s law explicitly requires the patient to give “express and informed consent” and that “the very nature of mental illness makes it foreseeable that a person needing mental health care will be unable to understand any proffered ‘explanation and disclosure of the subject matter’ of the forms that person is asked to sign, and will be unable to make a ‘knowing and willful decision’ whether to consent to admission.”
“The characteristics of mental illness thus create special problems regarding informed consent. Even if the state usually might be justified in taking at face value a person’s request for admission to a hospital for medical treatment, it may not be justified in doing so, without further inquiry, as to a mentally ill person’s request for admission and treatment at a mental hospital.” ‘
Youngberg v. Romeo
Involuntarily committed individuals do have liberty interests in safe confinement and freedom from bodily restraint under the Fourteenth Amendment. The Court held that Romeo’s liberty interests required Pennhurst to provide adequate habilitation, but only as it related to Romeo’s right to safe confinement and freedom from undue restraint.
deference to qualified professionals is necessary because of their specialized knowledge and the specific circumstances and risks inherent in a mental hospital.
Wyatt v. Stickney (1971)
Patients “unquestionably have a constitutional right to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.” Further, he said that Bryce State Hospital “failed to conform to any known minimums established for providing treatment for the mentally ill.” Additionally, these practices violated the Due Process clause of the constitution because, “To deprive any citizen of his or her liberty upon the altruistic theory that the confinement is for humane therapeutic reasons and then fail to provide adequate treatment violates the very fundamentals of due process.”
Washington v. Harper (1990)
State court erred in ruling the state procedure unconstitutional, because the procedures in place for involuntary administration of medication did not deprive inmates of due process. The Court recognized that inmates had a 14th amendment right to refuse treatment, but believed the state had balanced the inmates’ rights and the state’s interests by allowing inmates to request a hearing before a committee to review the medication decision. The policy required the following criteria to be met:
- A psychiatrist needed to determine a prisoner needed antipsychotic medication. If the prisoner did not consent to the medication, the prisoner was entitled to a hearing with a psychiatrist, psychologist, and associate superintendent (none of whom could be involved in the inmate’s treatment or diagnosis).
- Involuntary medication had to be determined by the majority vote with the psychiatrist in the majority. The prisoner had to be diagnosed with a mental disorder and also be gravely disabled, or dangerous to self or others.
- The prisoner had the right to be notified of the hearing, was allowed to attend the hearing, present evidence, present witnesses, cross-examine witnesses, be assisted by a lay adviser, and appeal the decision and seek judicial review. The prisoner was also entitled to periodic review and to have a new hearing every 180 days.
US v. Salerno (1987)
1984 Bail Reform Act allowed the federal courts to detain an arrestee prior to trial if the government could prove that the individual was potentially dangerous to other people in the community. Prosecutors alleged that Salerno and another person in this case were prominent figures in the La Cosa Nostra crime family.
Court held that the Act was constitutional because when the government’s interest in protecting the community outweighs individual liberty, pre-trial detention can be “a potential solution to a pressing societal problem.” The Act only applied to a specific list of serious offenses, placed heavy burdens on the government to prove that the arrestee posed significant threats to others, and did not prevent the accused from enjoying a speedy trial. The Court also dismissed Salerno’s argument that the Act violated the Excessive Bail Clause of the Eighth Amendment.
Rogers v. Okin (1979)
committed mental patients are presumed competent to make decisions with respect to their treatment in non-emergencies. However, if the patient is adjudicated as incompetent to make such a decision, their legal guardian could exercise decisions making rights with respect to treatment. Thirdly, committed mental patients cannot be forcibly medicated except in emergency circumstances in which failure to do so would bring about substantial likelihood of physical harm. Additionally, patients cannot be placed in seclusion or restraints except in emergency situations in which there was occurrence or serious threat of extreme violence, personal injury, or attempted suicide.
Rennie v. Klein (1983)
An involuntarily committed patient who has not been found incompetent, barring an emergency, has a qualified right to refuse psychotropic medication, especially when forced treatment violates his First Amendment rights to freedom of speech or to practice his religion, or his Eighth Amendment rights to be free of cruel and unusual punishment. “The patient has a constitutional right to be free from treatment that poses substantial risk to his well-being.”
New Jersey’s administrative policies, which provide for a second psychiatric opinion in the case of refusing patients, must give adequate scope for the exercise of that right to satisfy constitutional requirements. Additionally, due process must be followed in order to forcibly medicate an individual against his will.
At the end of the day (when the review process was over) Rennie v. Klein established that an involuntarily committed, legally competent patient who refused medication had a right to professional medical review of the treating psychiatrist’s decision. In contrast to the Rogers case, which provided for judicial review, Rennie left the decision-making process to medical professionals. (had a lot of other issues looked at but this seems to be the main info from the court case)
Parham v. J.R. (1979)
Due process does not require a formal or quasi-formal hearing prior to commitment; however, due to the “risk of error inherent in the parental decision to have a child institutionalized,” an inquiry by a neutral fact-finder to determine if statutory requirements have been met for admission, is required by due process. The Court identified that the minimum due process requirements for the voluntary commitment of minors includes the following:
- Inquiry by a “neutral factfinder” to include interviews with the child and parents, and an investigation of the child’s background using collateral sources, such as schools, social service agencies, and any additional sources available. The Court indicated that the neutral factfinder could be medical staff working at the hospital.
- The decision-maker must have the authority to refuse to admit a child who has not satisfied medical standards for admission, and once admitted, continuing need for commitment must be reviewed periodically by an independent procedure.
- When the child and parents are determined to be at odds in regard to commitment, the state can elect to provide adversary hearings, preceded by a written notice, at which a child is represented by counsel. However, nothing in the United States Constitution compels such procedures.
O’Connor v. Donaldson (1975)
A finding of mental illness alone cannot justify a state’s locking a person up against his will and keeping him indefinitely in simple custodial confinement if they are dangerous to no one and can safely live in freedom independently, or with the help of willing and responsible family members.
Lessard v. Schmidt (1972)
Wisconsin civil commitment procedure was constitutionally defective on the following grounds: it failed to require effective and timely notice of “charges” under which a person is sought to be detained, it failed to require adequate notice of all rights (right to jury, right to counsel), it permitted detention longer than 48 hours without hearing on probable cause, it permitted detention longer than two weeks without a full hearing on the necessity of commitment, it permitted commitment based on a hearing in which the person charged is not represented by counsel, it permitted commitment without proof beyond a reasonable doubt that the person is both mentally ill and dangerous, and it failed to require those seeking commitment to seek less restrictive alternatives.
Lake v. Cameron (1966)
court held that the state had the obligation to explore these less restrictive alternatives when considering involuntary hospitalization for a patient. The court opined about the balance that might be obtained from protecting Ms. Lake’s liberty interests by enlisting family or community services to keep her safe. They wrote, “Deprivations of liberty solely because of dangers to the ill persons themselves should not go beyond what is necessary for their protection.”
U.S. v. Jones (1983)
The court heard the case en banc and affirmed the original judgment.
Supreme Court Decision: for NGRI, due process clause permits the Government, on the basis of the insanity judgment, to confine him to a mental institution until such time as he has regained his sanity or is no longer a danger to himself or society. A verdict of not guilty by reason of insanity establishes two facts: (i) the defendant committed an act that constitutes a criminal offense, and (ii) he committed the act because of mental illness. These constitute an adequate basis for hospitalizing the acquittee as a dangerous and mentally ill person. He can also be confined to a mental hospital for a period longer than he could have been incarcerated had he been convicted.
Heller v. Doe (1993)
Kentucky’s procedures for involuntarily committing IDD did not violate the Equal Protection Clause or due process. ID is a developmental disability which is diagnosed early on in life and is a permanent condition; therefore, there is more evidence of the existence of disorder, and it is more easily and accurately diagnosed. They argued mental illness manifests later in life and can have a fluctuating course; therefore, it is more difficult to diagnose. Treatments for the ID are, on average, less intrusive. Because of these differences, Court concluded it was rational to have a higher burden of proof for the civil commitment of the mentally ill as compared to ID people. The Court also concluded that the guardians and parents ability to act as parties in the cases of ID individuals would be helpful because they could offer valuable insights, which would not be the case with the mentally ill.
Foucha v. Louisiana (1992)
Court ruled that potential dangerousness was not a justification to retain a person found NGRI if no mental illness was present. To maintain that an insanity acquittee remain civilly committed to a psychiatric institution until he is no longer a danger to himself or others is unconstitutional. For involuntary commitment to continue, an acquitee must remain both ill and dangerous. Commitment must be based on standard principles of civil commitment, including proving that the individual is mentally ill.
Estelle v. Gamble (1976)
Reviewed the evolution of 8th case law, tracing its roots in barring torturous acts to ensuring provision of basic care. Here, access to medical care is seen as a constitutional right of inmates because they cannot otherwise seek such care. However, the justices distinguish between a duty to provide care and the lack of adequate care. The 8th amendment requires that care be provided to inmates but stop short of calling medical malpractice unconstitutional. A claim that medical staff did not provide the most appropriate diagnosis, assessment, or care is a medical decision and better subject to civil suit as a medical malpractice claim.
Deliberate indifference to serious medical needs of prisoners constitutes unnecessary and wanton infliction of pain proscribed by the Eighth Amendment, regardless of whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed; regardless of how evidenced, deliberate indifference to a prisoner’s serious illness or injury states a civil rights cause of action under 42 USCS 1983.
