Legal regulation of psychiatry

Question 1

Addington v Texas

Answer 1

USSC 1979
Held the constitutional MINIMUM standard of proof required for civil commitment is Clear and Convincing evidence. (WI still uses BRD due to Lessard.)

“One who is suffering from a debilitating MI and in need of tx is neither wholly at liberty nor free of stigma… It cannot be said, therefore, that it is much better for a mentally ill person to ‘go free’ than for a mentally normal person to be committed.”

Question 2

Jackson v Indiana

Question 3

Lake v Cameron

Answer 3

Established the Least Restrictive Alternative Doctrine. Held that the state must investigate lesser restrictive forms of tx, or alternative courses of tx, prior to invol hospitalization.

Catherine Lake found wandering, committed. Sued to be discharged to a nursing home, as she was non-dangerous, just at risk of wandering.

Question 4

Zinermon v Burch

Answer 4

USSC 1990
A pt who is incompetent to give informed consent for admission is denied constitutionally guaranteed procedural safeguards when he merely acquiesces to hospitalization.

Question 5

Lessard v Schmidt

Answer 5

WI Federal Court 1972
“Criminalization of civil commitment.” Set high watermark at state level for civil commitment procedures, holding the standard of proof to be Beyond a Reasonable Doubt and installing procedural safeguards similar to criminal process.

Question 6

Civil Rights of Institutionalized Persons Act (CRIPA)

Question 7

Protection and Advocacy of Individuals with Mental Illness (PAIMI)

Question 8

Olmstead v L.C.

Question 9

In re: Lifschutz

Answer 9

privilege

Question 10

Doe v Roe

Answer 10

confidentiality

Question 11

Jaffee v Redmond

Answer 11

psychotherapist-patient privilege

Question 12

Federal Rules of Evidence (FRE) 501

Question 13

exceptions to confidentiality/privilege

Answer 13

• police powers v confidentiality
• limitations in fraud investigation

Question 14

State v Andring

Answer 14

reporting acts override federal confidentiality law

Question 15

People v Stritzinger

Answer 15

degree of reporting required

Question 16

O’Connor v Donaldson

Answer 16

ISSC 1975
Avoided constitutional “right to treatment” issue, focusing on rejecting custodial care for nondangerous mentally ill who are not receiving tx.

Question 17

Youngberg v Romeo

Answer 17

professional judgment

Question 18

Wyatt v Stickney

Answer 18

consent decree/minimal hospital standards

Question 19

Rogers v Commissioner

Answer 19

judicial model of proxy decision making in the right to refuse MH tx

Question 20

Rennie v Klein

Answer 20

professional model of proxy decision making in the right to refuse MH tx

Question 21

Application of the President and Directors of Georgetown College

Answer 21

override of tx approval

Question 22

Washington v Harper

Answer 22

proxy decision making in prisoners’ right to refuse MH tx

Question 23

Tarasoff v Regents of the University of California

Answer 23

initial precedent of duty to warn/protect

Question 24

Lipari v Sears

Answer 24

duty to detain

Question 25

Jablonski v U.S.

Answer 25

foreseeable victim in duty to warn/protect

Question 26

Canterbury v Spence

Answer 26

elements of informed consent - standard set by law (vs reasonable person standard)

Question 27

Kaimowitz v Michigan

Answer 27

informed consent in research

Question 28

Cruzan v Director, Missouri Dept of MH

Answer 28

withdrawal of life-sustaining treatment

Question 29

National Practitioner Data Bank

Question 30

Washington v Glucksberg

Answer 30

physician-assisted suicide

Question 31

Thomas Sasz, MD

Answer 31

Published The Myth of Mental Illness in 1961. Prominent during the period during which the pendulum of change swung away from the need for tx (parens patriae) justification towards a dangerousness standard. Also at this time, Erving Goffman publshed Asylums: Essays on the Social Situation of Mental Patients and Other Inmates, Civil Rights Act of 1964, and Wyatt v Stickney 1971.

Question 32

Community Mental Health Act of 1963

Answer 32

Provided federal funding for community MH centers. Passed as part of JFK’s New Frontier, and furthered deinstitutionalization.

Question 33

Lanterman-Petris-Short Act

Answer 33

Passed in CA in 1969. Endorsed voluntary tx and repealed indefinite commitment, while including procedural protection in the case of involuntary interventions. Set a tone of reform across the US.

Question 34

Parjam v JR

Answer 34

USSC 1979
Held that constitutional minimum for civil commitment of MINORS is less than the full judicial review given adults. Parents’ rights to investigate illness in a child and seek tx outweigh child’s liberty interests. A NEUTRAL FACT FINDER is required to offset any parental decision risk for error.

Used Mathews v Eldridge analysis.

Question 35

Matter of Josiah Oakes

Answer 35

1845 Massachusetts case that introduced concept of DANGER TO SELF OR OTHERS