Medicine court, II: Rivers in practice

The authors conducted a retrospective study of the initial impact (1986-1987) of the Rivers v. Katz decision involving patients' right to refuse treatment at New York State's largest forensic psychiatric hospital. Of 18 petitions submitted, 15 cases were adjudicated. All 15 patients were found incompetent, and all treatment plans submitted were approved by the court. Most patients selected for Rivers hearings were diagnosed as having chronic schizophrenia and/or were older than the hospital population. A comparison of the implementation of the Rivers decision with that of Rogers v. Commissioner of Mental Health in Massachusetts showed Rogers to be significantly more expensive in human resources, time, and money.