Response to Washington v. Harper: Involuntary Administration of Psychotropic Medication in the Context of Corrections Health

• NCJ Number: 158301
• Journal: Corrective and Social Psychiatry and Journal of Behavior Technology Methods and Therapy Volume: 41 Issue: 1 Dated: (1995) Pages: 9-16
• Author(s): E S Dewey
• Date Published: 1995
• Length: 8 pages
• Publication Format: Article
• Publication Type: Legislation/Policy Analysis
• Language: English
• Country: United States of America

Annotation

In 1990, the U.S. Supreme Court considered limits of the informed consent doctrine in the psychiatric setting; Washington v. Harper addressed the issue of whether a psychiatric patient in a State penitentiary had an absolute constitutional right to refuse prescribed psychotropic medication.

Abstract

Harper returned to prison after violating his parole by assaulting two nurses. The assaults occurred while Harper was civilly committed during his parole. When he returned to Washington's Special Offender Center, he voluntary accepted medication for 11 months but then began refusing medication. The treating psychiatrist successfully requested authorization to administer medication without consent. Harper filed a Federal civil rights suit 3 years later, and the Washington Supreme Court ruled that the State's policy violated his constitutional rights because a judicial hearing was not provided before involuntary medication was authorized. The State appealed to the U.S. Supreme Court which found that a liberty interest was created by the State policy and the due process clause of the 14th amendment. The U.S. Supreme Court held that an inmate's liberty interest in refusing treatment has to be balanced against both the State interest in prison security and the State's obligation to provide for inmate health and safety. Where the inmate's conduct presents a danger to himself or others and the involuntary administration of medications is in the inmate's medical interest, the State may request a hearing before an independent medical decisionmaker who can authorize or deny involuntary medication. The inmate's due process rights must be protected by ensuring the decisionmaker's independence, providing a competent lay advisor, allowing the inmate to present evidence and examine witnesses, and providing an avenue of appeal. Rulings in Washington v. Harper and other cases decided by the Supreme Court that pertain to the involuntary administration of psychotropic medication in the correctional setting are analyzed, particularly with respect to due process protections for mentally ill inmates. 36 footnotes