Beyond "self-paternalism": response to Rosenson and Kasten

Two mental health consumers, both of whom have been involved in the movement for the right to refuse forced psychotropic drugging, respond to the article in this issue by Rosenson and Kasten on their proposal to have consumers use so-called Ulysses wills to authorize psychiatric treatment in advance. The consumer authors urge the development and use of what they term "Mill's wills," providing for both the acceptance and the rejection of particular forms of psychiatric treatment. Based on recent Federal and State court cases on the right to refuse and the right to die, as well as State "living will" statutes, the authors argue that mental health consumers have the same rights to "just say no" and/or affirm their own treatment choices as do other citizens in the context of unwanted medical treatments and the right to die. The two consumers suggest that, rather than engage in needless controversy and attacks, consumers, families, professionals, and advocates all need to work together, because they are really not so far apart on the issue of prearranged treatment consent and refusal.