Medicine court: Rogers in practice

Area of Science:

• Forensic Psychiatry
• Medical Law
• Mental Health Law

Background:

• The Rogers decision (1983) addressed the right of psychiatric patients to refuse treatment.
• Implementation of this decision required judicial review of patient competence.
• This study examines the initial impact within a specific forensic facility.

Purpose of the Study:

• To assess the practical application and outcomes of the Rogers decision in its first year.
• To analyze the criteria used by the court in determining patient competence to refuse treatment.

Main Methods:

• Prospective study design.
• Analysis of probate court case submissions and hearings.
• Review of court findings regarding patient competence.

Main Results:

• 98 cases were submitted; only 39 were heard by the court.
• Of those heard, 35 patients (90%) were deemed incompetent to make treatment decisions.
• Hearings were delayed (2-7 months post-petition).
• Court decisions appeared influenced by reports of patient violence.

Conclusions:

• The initial implementation of the Rogers decision led to a high rate of incompetence findings.
• Court reliance on violent incidents over clinical assessments raises concerns about the evaluation process.
• Delays in judicial review may impact timely treatment decisions for patients.