Right to refuse treatment: impact of Rivers v. Katz.
J. R. Ciccone, J. F. Tokoli, C. D. Clements and T. E. Gift,
Bull. Amer. Acad. Psychiatry & the Law
18(2): 203-15, 1990.
This article examines the impact of the New York court decision, Rivers v. Katz, which in June 1986
dramatically changed the state procedure for responding to involuntarily committed psychiatric
patients who formally refused psychopharmacologic treatment. The court rejected the medically
administered review process that had been used to respond to involuntarily committed psychiatric
patients who formally refused medication, and replaced it with a judicial determination of competent
and "substituted judgment" provided by the court. Post-Rivers, the rate of patients consistently
refusing treatment decreased, and the time from refusal to resolution increased. The clinical, legal,
and economic implications of the Rivers procedure are discussed.