Drug refusal: a study of psychiatric inpatients

The authors studied patients' refusal of medication during a three-month period on an inpatient service of a community mental health center. Although refusal of medication was common, most episodes were self-limited. Only 5 of 72 episodes seriously impaired patient care; each of these cases appeared to be delusionally motivated. Legal conceptions of a right to refuse treatment may not accurately portray the realities of the clinical situation, in which patients' refusal is determined by the dynamics of their illness rather than reflecting a principled exercise of their legal rights.