Medical and judicial perceptions of the risks associated with use of antipsychotic
H. Bursztajn, B. Chanowitz, E. Kaplan, T. G. Gutheil, R. M. Hamm and V. Alexander,
Bull. Amer. Acad. Psychiatry & the Law
19(3): 271-5, 1991.
To determine whether occupational perspective influences the decision to prescribe antipsychotic
medications, we presented a group of psychiatrists and judges with a hypothetical case involving a
potentially psychotic patient. The subjects were asked what probability of drug-induced tardive
dyskinesia they would accept in order to prevent psychotic decompensation. The subjects were then
asked to estimate the actual probability that tardive dyskinesia would occur if the patient received
antipsychotic medications. From the responses to these questions we inferred their treatment
decisions. Although the psychiatrists and judges agreed on an acceptable level of risk, they differed
significantly in their estimates of the actual risk involved and, by inference, their decisions
concerning treatment. Our findings have several implications for adjudication of cases involving
treatment decisions and the right to refuse treatment.