lawyer question

[HEIRESS]

what rights do psychiatric patients/their families have when it comes to the choices made regarding medications and/or the right to refuse treatment, or even just specific treatments.

are you not allowed to refuse the usage of certain drugs when under the care of hospitals
or are all bets off once you cross that threshold?

I know it relates to voluntary/involuntary admission, but it seems like that line can be so easily blurred.

Im just super fucking pissed off right now because I dont know the ins and out of peoples right to refuse treatment when it comes to psychiatrics, and everything I find online seems to run circles
and I hate being confused. argh!

when it comes to straight forward medical treatment it seems that these rights are pretty clear cut, but when its a mental illness I dont get who gave the doctor and medical staff the right to control all decisions. cause that hows its come across to me.

and when it comes to identifying a substitute decision-maker wouldnt this just automatically become the person's next of kin, especially if they are so heavily sedated that they are not actually capable of making such decisions
I hate that they use the mental illness as an excuse to disregard any patient requests. It should be purely based upon the individual and their situation.

any info the lawyer-types here, or experiences anyone else can offer would be greatly appreciated.

I goddamn hate psychiatrists, dont even debate upon the fact Im just as smart as you motherfucker.

[MC Moot]

The Right to Refuse Medical Treatment

"The law in British Columbia is clear that a mentally capable adult may refuse medical treatment, even if his doctors and family consider it to be in his best interests. The Supreme Court of Canada has recently said that the “right to refuse unwanted medical treatment is fundamental to a person’s dignity and autonomy.” There are a number of reasons why a patient may wish to reject his doctor’s recommended treatment: religious grounds, concern about side effects, or concern about risks. In fact, the law protects the right of a competent patient to make foolish decisions.

But what if the patient is mentally ill?

Professor Starson is not a college or university professor. He is a brilliant physicist who has published several papers in his field. Other physicists respect him, and refer to him as Professor Starson. He has also been diagnosed with bipolar disorder, and has been in and out of mental institutions in Canada and the United States. He was involuntarily committed to an institution in Ontario after he had uttered threats against others. He apparently suffers from delusions. He claims to be leading on the edge to build a starship, and that he is a world class skier and arm wrestler.

Professor Starson’s doctor prescribed various medications to alleviate his condition. The doctor is of the opinion that the medications might allow Professor Starson to function better outside of a mental institution and resume his scientific work, and that he would deteriorate without the medication.

The medication would slow down Professor Starson’s thinking. When Professor Starson had taken medications in the past, he found the side affects unbearable. His doctor was of the opinion that the new medications would not have as severe side affects as the medications Professor Starson had taken before. But Professor Starson was concerned that they would dull his thinking. For Professor Starson, the medication’s effects “would be worse than death for me, because I have always considered normal to be a term so boring it would be like death.”

Under the Ontario legislation (the Health Care Consent Act, 1996, S.O. 1996, c. 2, Sch. A) a patient has the right to refuse treatment if he has the ability “to understand the information that is relevant to making a decision about the treatment…and to appreciate the reasonably foreseeable consequences of a decision or lack of decision.” He must be able to understand the information, apply it to his circumstances, and weigh the risks and benefits of the proposed treatment.

A Consent and Capacity Board in Ontario determined that Professor Starson did not have the capacity to refuse treatment. However, the Ontario courts disagreed, and set aside the Board’s decision. The case went to the Supreme Court of Canda.

On June 6, 2003, the Supreme Court of Canada published its decision in Starson v. Swayze, 2003 SCC 32. In a 6 to 3 decision, the majority held that Professor Starson had the right to refuse the medication. According to the majority, although Professor Starson did not agree with the diagnosis of mental illness, he had a sufficient insight into his condition to have the ability to understand the relevant information. He knew that he was not normal, and that he had some problems. The majority also found that there was no basis for the Consent and Capacity Board’s finding that Professor Starson did not appreciate the consequences of refusing treatment.

In practice, it can be very difficult to determine if someone with a significant mental illness has the capacity to refuse treatment. All of the judges of the Supreme Court of Canada agreed on the legal principles to be applied, but three of them found on the evidence that Professor Starson did not have the capacity to refuse treatment."

[HEIRESS]

I totally read that article last night.

I was just wondering if there is anything we can do or say besides repeat "no" a million times, other than get a lawyer.
we cant afford to go that route, nor do we have the time

fuckfuckfuck.

[MC Moot]

Perhaps they may be able to aid/advocate....?

http://www.kamloops.cmha.bc.ca/advocacy

[HEIRESS]

yeah, good call.

its been hard to think rationally this last month.

[befsquire]

most of us lawyer types on the board are of the U.S. variety, which would be of no help to you. especially those of us who are me, and only know what relates to my clients and the jail trying to force medication on inmates.

try the legal aid route. if that doesn't work, find a high profile attorney who may want some free publicity that a fight like this might generate.

[Gareth]

Originally Posted by befsquire

most of us lawyer types on the board are of the U.S. variety, which would be of no help to you.

yep, most...but not all
i'm no help either though

[HEIRESS]

the strategy that worked: be very obnoxious and threaten to file a patient neglect complaint.

[TurdBerglar]

so who's the nutter?

[checkyourprez]

i saw on law and order you dont have to take your pills if you dont want to.

[JohnnyChavello]

Not a source of law in Canadian courts, but the US Supreme Court officially endorsed the view that the Due Process Clause guarantees competent individuals the right to reject unwanted medical treatment as an aspect of individual liberty in Cruzan v. Glucksberg. Prior to this, most state and federal courts recognized it either on these grounds or as a right within the penumbras of constitutional protections of the right to privacy.

The interesting question from my point of view would be whether the government could regulate medical decisions for incompetent individuals against the wishes of the family. Don't know any cases directly on point, but in Cruzan, the Supreme Court held that the state could impose a standard of clear and convincing evidence on a family to establish that the decision to refuse medical treatment was what the incapacitated party wanted. The decision to reject life-sustaining medical treatment is a decision many people foresee potentially making, although a lot of people never clearly express their wishes; however, refusing psychiatric medication in the case of individuals committed to an institution is not a decision people are likely to go over with their families, nor would they be able to express specifically what they would and would not approve. Imposing a clear and convincing evidence standard in a case like that would probably be an insurmountable barrier.

I know nothing about Canadian law, but I would be shocked if the law were less protective of these decisions than they are in the US.

[Loppfessor]

Originally Posted by HEIRESS

its been hard to think rationally this last month.

That's cus you keep refusing to take your meds....ROFL LMAO OMG!!!!

[HEIRESS]

seriously, what the fuck is wrong with you?

I try to ignore you, but it doesnt stop me from wondering what exactly is the purpose of you making comments like this towards me and only me.

the fact that you seem to find joy in the knowledge that I have hardships in my life is just so unbelievably retarded that I can believe I even just typed that sentence.

you berate me for making stupid meaningless threads (which you are just as much guilty of doing) but i thought it was obvious that I do so because alot of times what im actually dealing with in life is nothing that I wish to share with entire world on here. but the rare occasions that I do (such as this thread) you still fucking have to make some lame ass derogatory comment at my expense, therefore making you nothing but a useless hypocrite.

put me on ignore please, as I appear to bother you to no end.
unless of course other people here enjoy seeing you make a childish fool out of yourself daily whenever its in regards to me, then maybe dont.

I dont know why im letting an internet comment bother me this morning, but perhaps its the fact that in the past month ive had my family ripped apart and Ive lost whatever remnants I had of a social life dissolved due to so called "Friends" betraying me over the entire situation im dealing with right now.

[abcdefz]

I'm sorry it's been a hard time. I'm glad that at least one not-so-little corner of it got worked out, though.

[MC Moot]

"Be kind, for everyone you meet is fighting a hard battle..."

[Documad]

Lopp, it's kind of weird that you're nice to everyone but Heiress.

Anyhow, Heiress, I've found that when you get in the way of the medical system and ask lots and lots of searching questions and ask them to back things up, the answers sometimes change. Whatever is going on, I am happy that you're advocating for your loved one. There is nothing more frustrating than watching someone you love get squashed in the system, but without strong friends and family the patient is really in trouble.

[Lyman Zerga]

nah he also treats joel like shit and everyone else

everyone but me but only cause he wants into my pants

[RobMoney$]

Originally Posted by Documad

Lopp, it's kind of weird that you're nice to everyone but Heiress.

I beg to differ.

[Knuckles]

Originally Posted by RobMoney$

I beg to differ.

Dude, I thought your avatar was Grace Slick for a second there.

Sorry Kane.


Oh, and I hope things start to get better for you and your family Heiress. Mental illness is so tough to deal with. It's hard to find what exactly will make the sick person better. Therapy, drugs, a combo of both, it's so much trial and error.

[Loppfessor]

Originally Posted by HEIRESS

I dont know why im letting an internet comment bother me this morning, but perhaps its the fact that in the past month ive had my family ripped apart and Ive lost whatever remnants I had of a social life dissolved due to so called "Friends" betraying me over the entire situation im dealing with right now.

See my signature….also and this is a legitimate piece of advice that you can take or leave. You might get your “serious” threads taken more seriously if the majority of all your threads weren’t so “woe is me…will I ever find happiness? Why is the world out to get me”. I dunno what your deal is in your personal life and I’m not that concerned but I will say that in this particular thread I posted what I woulda posted regardless of who said it. I mean c’mon that joke was begging to be made…

Originally Posted by Documad

Lopp, it's kind of weird that you're nice to everyone but Heiress.

That’s not even close to true…

Originally Posted by Lyman Zerga

nah he also treats joel like shit and everyone else

everyone but me but only cause he wants into my pants

But that is!

[HEIRESS]

Originally Posted by Loppfessor

See my signature….also and this is a legitimate piece of advice that you can take or leave. You might get your “serious” threads taken more seriously if the majority of all your threads weren’t so “woe is me…will I ever find happiness? Why is the world out to get me”. I dunno what your deal is in your personal life and I’m not that concerned but I will say that in this particular thread I posted what I woulda posted regardless of who said it. I mean c’mon that joke was begging to be made…

ah geez, is this the ONLY reason you dont like me?
fuck man, too bad you didnt send a friendly little email to my life a year ago and tell it that you hate my "woe is me" threads. and therefore you would please ask my good ole life that I not get the house i lived in robbed twice within 3 months, that I not try to get back together with my prior boyfriend of 4 years who then ditched me for some other chick, not have my uncle die a homeless crack addict in the middle of a field next to an industrial park and then get robbed so he was unidentifiable so it took a further week for us to find out about it because the cops labeled him as a "john doe" and then the newspaper in the city ran a front page story about "the nameless homeless man that didnt have a single person who loved him", not have me finally get back together with previously mentioned boyfriend just to find out a month later that he got accepted to grad school in montreal which is an 800 dolar plane ticket away from me, anddddddd then not have my brother go insane and be in and out of psych wards the last month and a bit (which the last time included him being arrested first because he was off meds and acting like a nutjob in public and dragged to the hospital in hand cuffs.

maybe next year I wont have to make a SINGLE unhappy thread because none of these types of things will happen to me. that. would. be. so. rad.

then i could be nothing but entertaining and positive and insightful with no underlying worries behind a single thought I post on this message board.
because I am only here for YOU, oh yes.

and i guess also to appease you (and anyone else who thinks this way), since you think the rest of my threads are meaningless and self serving, Ill also try to only post threads about the current political state in ethiopia, maybe a few other things but mostly only that.
and one other thing, you havent given me any feedback on all the threads I start in the cooking forum, do those meet your approval or should I stop with that silliness as well?

I wasnt opposing a "why is my oh so serious thread being taken oh so seriously" dipshit. most times I just need somewhere to type out my feelings and get it off my chest, and too fucking bad if its here and some people dont want to read it. we all know what we are signing up for when we come here, all of us. so I dont know why you have to focus on me alone and point it out every, fucking, time that I post somewhere.
you probably "find post by user" each time you log in here for all I know.
im just telling you (as you are telling me what you want) that the gig is getting old lopp. not that you are going to stop.
but its getting real fucking old.

[TAL]

Originally Posted by Knuckles

Dude, I thought your avatar was Grace Slick for a second there.

I hope you meant Grace Jones.

[Knuckles]

Originally Posted by TAL

I hope you meant Grace Jones.

wrong grace, my bad.

[Loppfessor]

Why do you even give a shit what I think or say?? Can't you handle not being every single person on the board's sweetheart? You should follow your own advice and put ME on ignore if it's that big a deal to you...

[befsquire]

heiress, i'm not sure which treatment or medication is objectionable, who in your family agrees or disagrees or anything else regarding what is going on with him. i would just like to tell you about 4 clients i had.

client one was not any better on his medications and they made him sick. so they tried a new combo that didn't work. they tried another combo, and that didn't work either. so with that combo, they made a little adjustment, and it worked. and he was a totally different person -- like night and day. he's never been arrested since, and he's so happy and feels like his life that mental illness stole has been given back to him.

client two loves his medications while he's on them. the problem is, once he gets out of jail and no one is there to make sure he takes them every day, he either forgets to pick up the prescription, or forgets to take the pills if he has them. he then ends up getting arrested for being crazy, and calls me from the jail to beg me to take his case (which i can't because case assignments don't work like that). i've been at the office a little over 2.5 years. he's been arrested at least 9 times during that time span, and shows no signs of being able to break out of that pattern.

client three denies he has a mental illness. while in jail, they give him meds and he takes them, but he believes it is for a regular health problem. he's absolutely the sweetest person you could ever meet while he's on the medications. i arranged for our office to help him get disability payments, but that can only be done once he's out of jail. he was off his meds for a week before he came to the office, and he was talking like he was going to kill people, he needed to get away from our office because we had a leak that was going to the FBI to tell about the bodies lying in the street and that every time he walks out of his house, there's a red dot that blinds him and he's going to have to get a gun and shoot in the direction of the dot. he is back in jail on a charge that is about 5 times more violent than the charge i had him for.

client four knows he is schizophrenic. he takes his meds for a while, but once he starts feeling better, he thinks he's cured and that he doesn't need to take medicine anymore because he feels fine. so he goes off his meds and then he ends up back in jail (usually for some form of theft). he has been arrested about 47 times over his lifetime, and he's not yet 40 (though he looks at least 50). because he has a lot of convictions (about 20), he's been sent to prison for 5 years for stealing a t-shirt worth $8.

obviously i wouldn't know about people who don't take meds and who do just fine and never get arrested, since all of the above examples are clients and therefore have been arrested. this is not even the tip of the iceberg with my clients with mental illness. one takes his meds, but a part of his illness causes him to lash out at people, and unfortunately, he keeps escalating the violence when he lashes out. i have 3 who are in the state hospital. i've never met them, because they were cases i took over from other attorneys. when it comes to my mentally ill clients, there are few success stories, and even fewer who could make a rational decision about taking or not taking medication and knowing whether that's the best choice. families are usually well-meaning, but sometimes are too emotionally involved to make the best decision regarding treatment.