Ex-cons have right to refuse medication
URL: sfgate.com/article.cgi?file=/c/a/2004/01/06/BAGJO442GN1.DTL
Mentally ill former prisoners who are held in state hospitals after completing their sentences have the right to refuse psychiatric medication unless they are incompetent or dangerous, the state Supreme Court ruled Monday. In a 6-1 decision, the court said ex-cons held for treatment under the state's Mentally Disordered Offender Act have the same right as current prisoners to reject drugs unless a judge decides they are incapable of making an informed decision, or recent incidents show they are dangerous to themselves or others. The ruling, in a case from Alameda County, adds a judicial voice to the intense and long-running debate over involuntary psychiatric treatment. A recent state law, unrelated to Monday's decision, allows local authorities to order treatment, which may include medication, for people who are severely mentally ill and have refused voluntary services. But counties have almost uniformly declined to use that law, for financial as well as political reasons. More than 800 people are held at mental hospitals under the 1986 Mentally Disordered Offender Act, which requires prisoners who have been convicted of violent crimes related to mental disorders, and who are judged to pose a danger to society, to undergo psychiatric treatment during and after their parole. The case before the state Supreme Court involves Kanuri Qawi, who was sentenced to prison in 1991 for assault and battery. Officers quoted him as saying, during an unprovoked attack on a couple, that a blond woman had started the Vietnam War. He was paroled in 1993 but was soon returned to prison for parole violations, the last one for stalking a sales clerk who he insisted was his wife. Qawi's parole ended in 1997, but he has remained hospitalized in a series of one-year commitments under the 1986 law. His ailment was diagnosed as paranoid schizophrenia, and against his will almost continuously since 1995 has been given drugs that he says cause serious side effects, including high blood pressure, impaired thinking and "permanent nightmares.'' State mental health authorities said Qawi's current medication, Olanzapine, is safe and effective, and contended he would be dangerous without the drug. But the court said Qawi was entitled to a hearing on his competence and his dangerousness. Under state law, any competent adult, including a prison inmate, has the right to refuse medical treatment, Justice Carlos Moreno said in the majority opinion. He said state law also gives patients covered by the Mentally Disordered Offender Act the same rights to veto medication as other involuntary mental patients who have not been convicted of crimes. In dissent, Justice Janice Rogers Brown said the majority had misinterpreted state law and virtually guaranteed that those who refused needed medication would be "warehoused indefinitely because their treatment program will likely be ineffective.'' But Qawi's former lawyer, Renee Torres, said Qawi is already being "warehoused'' while under medication that gives him little prospect of ever leaving the hospital. E-mail Bob Egelko at begelko@sfchronicle.com
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