PsychRights
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Advance Directives

Advance Directives can be a very important and effective tool to combat forced drugging and other forced psychiatric treatment.  There is a good discussion  of Advance Directives, by the Australian Mental Health Legal Centre and there are a couple of chapters about Psychiatric Advance Directives in the Alternatives Beyond Psychiatry: "Upholding psychiatric advance directives: 'The rights of a flea,'" by Laura Ziegler and "Advance directives: A step towards self-help" by Miriam Krücke.

PsychRights has enthusiastically joined the MindFreedom Shield Program of  MindFreedom/Support Coalition International.  This program involves a solidarity network of people who will take direct, non-violent action in support of people faced with forced psychiatric treatment with people encouraged to have state-specific Advance Directives in place to help with that effort.  The below links have general information about Advance Directives and Duke's site has state specific information.  PsychRights also has some state specific information.  PsychRights will be adding other state specific information as it can. 


Law Struck Down That Established Method to Override Advance Directives of Individuals Civilly Committed or Imprisoned and to Involuntarily Medicate Them

Hargraves v. Vermont

The Second Circuit struck down a Vermont law that allowed the state to involuntarily medicate individuals who had been civilly committed or judged mentally ill while imprisoned, notwithstanding a pre-existing durable power of attorney (DPOA) for health care to the contrary.  The Second Circuit ruled that such a law discriminated against individuals with a mental disability in violation of the Americans with Disabilities Act.  The Vermont law allowed a health care professional to petition a court for authority to involuntarily medicate an individual civilly committed or judged mentally ill while in prison.  When the proposed medication contravened the individual's DPOA, the directions in the DPOA were to be honored for 45 days.  After 45 days, if the individual had not experienced a significant clinical improvement and remained incompetent, the court could order treatment without regard to the DPOA.  The Second Circuit determined that this law violated the ADA because only individuals with a mental illness could have their DPOAs revoked, while equally incompetent individuals who are physically ill or injured could not.  The court rejected as immaterial the state's argument that the statute only applied to a subset of the mentally ill, namely, those who are mentally ill, dangerous, committed to state custody, and incompetent to make treatment decisions.  The court responded that anti-discrimination provisions become applicable when a program treats an individual with a mental illness in a particular set of circumstances differently than it treats individuals who are not mentally ill in the same circumstances.  Hargrave v. Vermont, 340 F.3d 27 (2d Cir. 2003). 

 Settlement Agreement Requiring Vermont State Hospital to Honor RR's Advance Directive, November 30, 1999.


Last modified 11/19/2013
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