Appelbaum P S, Gutheil T G
Am J Psychiatry. 1980 Mar;137(3):340-6. doi: 10.1176/ajp.137.3.340.
The authors studied patients' refusal of medication during a three-month period on an inpatient service of a community mental health center. Although refusal of medication was common, most episodes were self-limited. Only 5 of 72 episodes seriously impaired patient care; each of these cases appeared to be delusionally motivated. Legal conceptions of a right to refuse treatment may not accurately portray the realities of the clinical situation, in which patients' refusal is determined by the dynamics of their illness rather than reflecting a principled exercise of their legal rights.
作者们研究了社区心理健康中心住院部三个月期间患者拒绝服药的情况。虽然拒绝服药很常见，但大多数情况是自限性的。72例情况中只有5例严重影响了患者护理；这些病例中的每一例似乎都有妄想动机。拒绝治疗权的法律概念可能无法准确描述临床实际情况，在临床实际中，患者的拒绝是由其疾病动态决定的，而非反映其对法律权利的有原则行使。
