Opinion ID: 2062379
Heading Depth: 2
Heading Rank: 3

Heading: The Hospital's Procedures.

Text: Khiem contends that the procedures utilized by the hospital in this case fail to meet applicable constitutional requirements. We do not agree. The procedures for the involuntary administration of medication are governed by CMHS [22] Policy 50000.430 2A (April 18, 1990). This detailed nine-page single-spaced document provides in pertinent part that medication may be administered to a patient in accordance with this Policy [only] if the patient has been afforded a consultation with the Patient Advocate, and an independent administrative review of the treating physician's decision to involuntarily administer medication has been performed. A patient also has the right to request a review by the Chief Clinical Officer, or the administration ... medical director if he/she is not satisfied with the recommendation resulting from administrative review. The CMHS Policy provides the patient with notice of the proposed involuntary treatment, and assures that the patient is advised of his rights pursuant to it. The Patient Advocate is a mental health professional who is trained to advocate the patient's interest. The Advocate meets with the patient, informs him of the nature of the proposed treatment, and advises him of his procedural rights. It is also the Advocate's responsibility to convey the patient's concerns to the hospital's Medical Director. The CMHS Policy provides two levels of independent administrative review of the treating physician's recommendation. The first level of review is conducted by the Medical Director of the Division where the patient is housed. The second review is by the Chief Clinical Officer. Neither of these reviewing officials is a member of the patient's treatment team. The regime at the hospital is similar in most respects to that approved by the Supreme Court in Harper, supra, 494 U.S. at 228-35, 110 S.Ct. at 1040-44. It is true, as Khiem points out, that the procedure at issue in Harper included an adversarial hearing. [23] The Court gave no indication, however, that such a hearing was constitutionally required. Indeed, in Parham v. J.R., 442 U.S. 584, 607, 99 S.Ct. 2493, 2507, 61 L.Ed.2d 101 (1979), the Supreme Court held in a somewhat comparable context that, although such a hearing may be required as a matter of state law, due process is not violated by the use of informal, traditional medical investigative techniques. In Charters, supra, the court, relying on Parham, explicitly held that no adversarial hearing is constitutionally required. [24] We reach the same conclusion in this case. [25]