Opinion ID: 1894515
Heading Depth: 1
Heading Rank: 1

Heading: Substantive Requirements

Text: In non-emergency cases before involuntary treatment with neuroleptic drugs may begin, two elements must be established: a. The patient lacks the ability to engage in a rational decision-making process regarding the acceptance of treatment and is unable to weigh the possible benefits and risks of treatment (the mere fact of disagreement about medication does not in itself constitute evidence of inability); and b. The patient's behavior has been observed and documented and the patient is found to be suffering from a major mental illness with severe functional incapacity   . Section XII-4030, 2.a., 2.b. After these elements have been established, one of the two following conditions must also be found before treatment can begin: (1) The patient has a documented history of clearly demonstrated reductions of symptoms during previous treatment with the [drug] and of clearly demonstrated deterioration of function when the [drug] was discontinued; or (2) The nature of the documented behavior of a committed patient is sufficiently severe and of such duration that the known benefits clearly outweigh the possible risks of the medication. Section XII-4030, 2.c.(1), (2) (emphasis added). If the second condition has been met, neuroleptics may be administered for a trial period, but: (a) The trial may not exceed 30 days in length; and (b) At the end of 30 days the treatment will be evaluated by the treatment team, and if the evaluation establishes the efficacy of the [drug] for that patient (using the criteria in XII-4030, 2.c.(1) above), the treatment team may initiate another request for involuntary administration of the [drug] for that patient. Section XII-4030, 2.c.(2)(a), (b). In assessing the risks and benefits of forced medication, the manual requires consideration of the possible non-physical side effects    such as anger, fear, and distrustfulness which may result from involuntary administration of medication. Section XII-4030, 2.c.(3).