Discussion 7- Ch 15 Therapy Discussion Topic

Updated

Read and respond to the following questions by making an original post. Afterwards, come back and reply to at least 2 other students. (Please be aware that you will not be able to see the other student's posts until you have made your own post). Reference!

Questions:

http://www.cnn.com/2011/CRIME/07/27/arizona.loughn…

There has been An interesting turn in the case against Jared Loughner, the young man charged in the shooting of former U.S. representative Gabrielle Giffords, along with nearly two dozen others outside a Tucson Arizona, supermarket back in January 2011. Now, in jail, he’s been receiving antipsychotic medication. He doesn’t want to take it, and his lawyers asked a federal judge to stop having Loughner take it against his will. The judge has ruled that it is in the hands of his doctors. According to Jeffrey Toobin, CNN senior legal analyst, the important thing to recognize is that the defense has a different goal (to keep Loughner from getting executed) than the doctors do (which is to get Loughner better, which might restore his mental competency and end up getting him executed as a consequence).

Dr. Jeff Gardere, clinical psychologist, summarized what was known about Loughner’s case. Loughner was examined by two psychologists and a psychiatrist in May, and they found that he has schizophrenia. Gardere wasn’t exactly sure which medications Loughner might be receiving, but he did know that it would be an antipsychotic medication, either in an oral or injectable form. Because Loughner is being forcibly medicated, the first course of action would be to try to convince him to take oral medications. Failing that, Loughner would be injected using the minimum amount of force necessary to hold him down so that he is not a danger to himself or others.

Can prison doctors literally hold Loughner down and force medication into him? Is this ethical? If you were a doctor on Loughner’s case, would you feel that it was an ethical conflict for you to treat him so that he got better, which might possibly make him well enough so that he can stand trial and possibly be executed? Would it be more in line with the doctors’ pledge to “do no harm” to let him remain in his untreated, mentally ill state so he will not face the death penalty?

United States – Supreme court rulings

In 1975, the U.S. Supreme Court ruled in O'Connor v. Donaldson that involuntary hospitalization and/or treatment violates an individual's civil rights. The individual must be exhibiting behavior that is a danger to themselves or others and a court order must be received for more than a short (e.g. 72-hour) detention. The treatment must take place in the least restrictive setting possible. This ruling has severely limited involuntary treatment and hospitalization in the United States. The statutes vary somewhat from state to state.

In 1979, the United States Court of Appeals for the First Circuit established in Rogers v. Okin that a competent patient committed to a psychiatric hospital has the right to refuse treatment in non-emergency situations. The case of Rennie v. Klein established that an involuntarily committed individual has a constitutional right to refuse psychotropic medication without a court order. Rogers v. Okin established the patient's right to make treatment decisions.

Additional U.S. Supreme Court decisions have added more restraints to involuntary commitment and treatment. Foucha v. Louisiana established the unconstitutionality of the continued commitment of an insanity acquittee who was not suffering from a mental illness. In Jackson v. Indiana the court ruled that a person adjudicated incompetent could not be indefinitely committed. In Perry v. Louisiana the court struck down the forcible medication of a prisoner for the purposes of rendering him competent to be executed. In Riggins v. Nevadathe court ruled that a defendant had the right to refuse psychiatric medication while he was on trial, given to mitigate his psychiatric symptoms. Sell v. United States imposed stringent limits on the right of a lower court to order the forcible administration of antipsychotic medication to a criminal defendant who had been determined to be incompetent to stand trial for the sole purpose of making them competent and able to be tried. In Washington v. Harper the Supreme Court upheld the involuntary medication of correctional facility inmates only under certain conditions as determined by established policy and procedures.^[2]