Dr. Bloom is Clinical Professor, Department of Psychiatry, Banner University Medical Center Phoenix, University of Arizona College of Medicine-Phoenix. Dr. Kirkorsky is a Forensic Psychiatry Fellow at the University of California-Davis.
J Am Acad Psychiatry Law. 2019 Jun;47(2):233-239. doi: 10.29158/JAAPL.003840-19. Epub 2019 May 2.
In 2003, Arizona began a jail-based restoration to competency program for detainees in its largest jail system in Phoenix. Today, jail-based competency programs have become the rule statewide to the degree that very few incompetent detainees are now referred to the Arizona State Hospital for restoration services. This article focuses on the topic of treatment refusal and the use of forced medications for detainees who are in these jail-based restoration programs. We describe Arizona's novel statewide jail-based programs, Arizona's statutory and case law approach to treatment refusal, and the restoration to competency programs in one large county jail that has no legal mechanism outside of civil commitment for the determination of whether forced treatment will be permitted. We conclude with a discussion of specific override procedures that might apply directly to incompetent detainees in a jail-based competency restoration program and whether the use of these procedures is prudent in a jail environment.
2003 年，亚利桑那州在其最大的凤凰城监狱系统中启动了一项基于监狱的恢复能力计划，以恢复被拘留者的能力。如今，基于监狱的能力恢复计划已成为全州的惯例，以至于现在很少有能力不足的被拘留者被送往亚利桑那州立医院接受恢复服务。本文重点介绍了治疗拒绝问题以及对参与这些基于监狱的恢复计划的被拘留者使用强制药物的问题。我们描述了亚利桑那州新颖的全州性基于监狱的计划、亚利桑那州的法定和判例法对治疗拒绝的处理方法，以及一个大型县监狱的恢复能力计划，该监狱除了民事承诺之外，没有其他合法机制来确定是否允许强制治疗。最后，我们讨论了可能直接适用于基于监狱的能力恢复计划中的无能力被拘留者的具体豁免程序，以及在监狱环境中使用这些程序是否谨慎。
