Brushwood D B, Fink J L
Am J Hosp Pharm. 1985 Dec;42(12):2709-14.
The law regarding refusal of psychiatric patients to take psychotropic medication is reviewed. The law in this area is traced through its evolution beginning in the 1960s when failure to administer medication to psychiatric patients was considered mistreatment of the patient. The legal basis for forcible administration of drugs is reviewed, and a discussion of cases in which patients refused to accept treatment on religious grounds is presented. When children are involved, the courts are generally in accord that the parents' right to freedom of religion ends where the child's right to life begins or when there is a threat to public health and safety. In cases involving adults, without a threat to public health or safety, relevant opinions rule that medical treatment should not be ordered against the patient's religious beliefs because it would constitute a violation of the First Amendment. Two leading cases involving the forcible administration of medication, Rennie v. Klein and Rogers v. Okin, held that administration should be limited to emergency situations when there is substantial risk of injury to the patient or others in the hospital. The Supreme Court made it clear that the right to refuse must be derived from state law, not from the federal Constitution, apparently giving health-care professionals broad leeway in exercising professional judgment in this area.
本文回顾了有关精神病患者拒绝服用精神药物的法律。这一领域的法律演变可追溯到20世纪60年代,当时不给精神病患者用药被视为对患者的虐待。本文审查了强制给药的法律依据,并讨论了患者以宗教为由拒绝接受治疗的案例。当涉及儿童时,法院普遍认为,父母的宗教自由权在儿童的生命权开始之时或在公共健康和安全受到威胁时终止。在涉及成年人的案例中,在没有对公共健康或安全构成威胁的情况下,相关意见裁定,不应违背患者的宗教信仰下令进行治疗,因为这将构成对第一修正案的违反。两起涉及强制给药的主要案例,即伦尼诉克莱因案和罗杰斯诉奥金案,裁定给药应限于存在对患者或医院其他人员造成重大伤害风险的紧急情况。最高法院明确表示,拒绝权必须源自州法律,而非联邦宪法,这显然赋予了医疗保健专业人员在这一领域行使专业判断的广泛自由裁量权。