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Medicine court, II: Rivers in practice.

F H DeLand1, N M Borenstein

  • 1Department of Psychiatry, SUNY Health Sciences Center.

The American Journal of Psychiatry
|January 1, 1990
PubMed
Summary
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The Rivers v. Katz decision impacted psychiatric treatment refusal rights. In New York, all patients in Rivers hearings were deemed incompetent, with courts approving treatment plans, unlike a more costly Massachusetts case.

Area of Science:

  • Forensic Psychiatry
  • Mental Health Law
  • Patient Rights

Background:

  • The Rivers v. Katz decision (1986-1987) addressed patient rights to refuse treatment in psychiatric settings.
  • Legal precedents significantly influence clinical practice and patient autonomy in mental healthcare.
  • Understanding the impact of landmark legal decisions is crucial for forensic psychiatric hospitals.

Purpose of the Study:

  • To evaluate the initial impact of the Rivers v. Katz decision on patient rights.
  • To assess the adjudication process for patients exercising their right to refuse treatment.
  • To compare the implementation costs of Rivers v. Katz with the Rogers v. Commissioner of Mental Health decision.

Main Methods:

  • Retrospective study of cases at New York State's largest forensic psychiatric hospital.
Keywords:
Central New York Psychiatric CenterLegal ApproachMental Health TherapiesProfessional Patient RelationshipRivers v. KatzRogers v. Commissioner of Department of Mental Health

Related Experiment Videos

  • Analysis of 18 petitions submitted, with 15 cases adjudicated.
  • Comparison with the implementation of the Rogers decision in Massachusetts.

    • Main Results:

    • All 15 adjudicated patients were found incompetent.
    • All submitted treatment plans were approved by the court.
    • Patients in Rivers hearings often had chronic schizophrenia or were older.
    • The Rogers decision proved significantly more resource-intensive (human resources, time, money).

    Conclusions:

    • The initial implementation of Rivers v. Katz resulted in court approval of all treatment plans for incompetent patients.
    • The Rivers decision appeared less resource-intensive compared to the Rogers decision.
    • This study highlights the practical implications of legal decisions on forensic psychiatric care.