Hospitals & Asylums
Steele v. Hamilton Cty. Community Mental Health Bd. (2000), 90 Ohio St.3d 176
1. On July 26, 1997, appellant, Jeffrey Steele, was taken by a police officer to University of Cincinnati Hospital (“University Hospital”) after appellant’s family reported that appellant was “seeing things and trying to fight imaginary foes.” appellant was detained at University Hospital. for the protection of others and for stabilization/treatment of psychosis. The probate court ordered a hearing, to be held on August 1. The court further ordered that appellant was to be detained at University Hospital pending the outcome of the hearing.
2. At the conclusion of the August 1 hearing, the probate court found, by clear and convincing evidence, that appellant was mentally ill, and the court ordered that appellant be committed to a hospital. Thereafter, University Hospital sought an order from the probate court permitting appellant’s transfer to the Pauline Warfield Lewis Center (“Lewis Center”). The motion stated that the transfer was in appellant’s best interest because, due to his mental illness, appellant was unable to comply with his required treatment and he needed long-term treatment and/or forced medication care. The probate court granted University Hospital’s motion, and appellant was transferred to the Lewis Center on August 12.
3. On September 26, appellee, Hamilton County Community Mental Health Board, sought a court order permitting the Lewis Center employees to administer antipsychotic medication1 to appellant without his informed consent. A hearing on the motion for forced medication was held on October 31. Three psychiatrists testified at the hearing: Dr. Michael Newton, appellant’s treating physician at the Lewis Center; Dr. Paul Keck of University Hospital; and Dr. Cyma Khalily, the psychiatrist appointed by the probate court. All three physicians testified that appellant was suffering from a form of schizophrenia, that in the hospital environment appellant was not an immediate danger to himself or others, that appellant lacked the capacity to give or withhold informed consent, that antipsychotic medication was the only effective treatment for appellant’s illness, that the benefits of the medication outweighed the side effects, and that appellant’s illness, without treatment, prevented him from being released from the hospital.
4. At the conclusion of the October 31, 1997 hearing, the magistrate orally denied the motion for forced medication. The magistrate’s rehearing was held on May 22 and May 29, 1998. Following the rehearing, the magistrate again denied appellee’s motion for court ordered medication of appellant. On November 9 the probate judge filed an opinion and entry upholding the magistrate’s findings of fact and conclusions of law on rehearing. In its opinion, the court held that Ohio policy only “authorize[d] the forced medication of psychotropic drugs upon a showing that the patient has a serious mental illness, is a danger to his or her self or to others within the institution, and the treatment is in the patient’s medical interest.”
5. On December 8, appellee appealed the probate court’s ruling to the Courtof Appeals for Hamilton County. The court of appeals reversed the judgment of the probate court and held that “an applicant need not prove that an involuntarily committeed [sic] patient poses a risk of danger to himself or others to obtain an order to forcibly medicate the patient, when the applicant has otherwise shown that medication is in the patient’s best interest, and when the patient lacks the capacity to give or withhold informed consent for such treatment.” This cause was brought before the Supreme Court of Ohio pursuant to the allowance of a discretionary appeal where it was found.
6. The right to refuse medical treatment is a fundamental right in our country, where personal security, bodily integrity, and autonomy are cherished liberties. These liberties were not created by statute or case law. Rather, they are rights inherent in every individual. Section 1, Article I of the Ohio Constitution provides that “all men are, by nature, free and independent, and have certain inalienable rights, among which are those of enjoying and defending life and liberty, acquiring, possessing, and protecting property, and seeking and obtaining happiness and safety.” (Emphasis added.) Our belief in the principle that “every human being of adult years and sound mind has a right to determine what shall be done with his own body.” The test for establishing of a tort claim is a lack of informed consent ie. Potentially lifesaving treatment for cancer could not be forced upon mentally ill person who had the capacity to give or withhold informed consent. Should a physician force the prescription of medication they are much more liable for deleterious side effects, allergic reactions that might occur than they would be if the patient consumed the medication voluntarily.
7. In Washington v. Harper (1990), 494 U.S. 210, the United States Supreme Court determined that persons suffering from a mental illness have a “significant liberty interest” in avoiding the unwanted administration of antipsychotic drugs. That liberty interest is protected by the Due Process Clause of the Fourteenth Amendment to the United States Constitution, which provides that no state shall “deprive any person of life, liberty, or property, without due process of law.” Likewise, Section 16, Article I of the Ohio Constitution encompasses due process language that provides substantially the same safeguards as does the Fourteenth Amendment. “Rights outlined in Section 1, Article I of the interference with one’s liberty interest is further magnified by the negative side effects that often accompany antipsychotic drugs, some of which can be severe and/or permanent. Riggins, 504 U.S. at 134.
8. The most common side effects of the antipsychotic drugs are Parkinsonian syndrome, akathisia, dystonia, and dyskinesia. “Parkinsonian syndrome * * * consists of muscular rigidity, fine resting tremors, a masklike face, salivation, motor retardation, a shuffling gait, and pillrolling hand movements. Akathisia is a feeling of motor restlessness or of a compelling need to be in constant motion * * *. Dystonia involves bizarre muscular spasm, primarily of the muscles of the head and neck, often accompanied by facial grimacing, involuntary spasm of the tongue and mouth interfering with speech and swallowing, oculogyric crisis marked by eyes flipping to the top of the head in a painful upward gaze persisting for minutes or hours, convulsive movements of the arms and head, bizarre gaits, and difficulty walking. The dyskinesias present a broad range of bizarre tongue, face, and neck movements.” Experts disagree as to the percentage of patients who will develop tardive dyskinesia after being treated with antipsychotic drugs. ten to twenty-five percent of patients treated with antipsychotic medication developed tardive dyskinesia and among that group, sixty percent had mild symptoms while ten percent demonstrated more severe symptoms. Another potential side effect of antipsychotic medication is neuroleptic malignant syndrome. This is a rare but potentially deadly syndrome that develops quickly and leads to death in twenty-five percent of those who develop it. when an involuntarily committed mentally ill patient poses an imminent threat of harm to himself/herself or others, the state’s interest in protecting its citizens outweighs the patient’s interest in refusing antipsychotic medication. “Traditionally, an adjudication of incompetency rendered an individual generally incompetent—he was placed under total legal disability and a guardian was appointed to make all decisions on his behalf. The law has moved strongly away from this notion of general incompetency in favor of an approach requiring adjudications of specific incompetency. Under the more modern view, the law determines an individual to be incompetent to perform only particular tasks or roles, such as: to decide on hospitalization; to manage property; to consent to treatment; or to stand trial. This adjudication of specific incompetency does not render the individual legally incompetent to perform other tasks or to play other roles.”
9.. A court’s determination that a person is mentally ill and subject to involuntary commitment in a hospital is not equivalent to a finding that the person is incompetent. The mere presence of psychosis, dementia, mental retardation, or some other form of mental illness or disability is insufficient in itself to constitute incompetence.” In fact, a person’s involuntary commitment to a hospital due to a mental illness does not even raise a presumption that the patient is incompetent patients, retain all civil rights The rights retained include, among others, the right to contract, hold a professional license, marry, obtain a divorce, make a will, and vote. R.C.5122.301.
10. Mental illness and incompetence are not one and the same. The Due Process Clause of the Fourteenth Amendment to the United States Constitution protects each person’s liberty interest in refusing medication. As used in this case, the term “antipsychotic medication” refers to medications such as Haldol, Prolixin, and Trilafon that are used in treating psychoses, especially schizophrenia. These drugs were introduced into psychiatry in the early 1950s and are effective in treating psychotic disorders because they can bring about chemical changes in the brain. They also often produce adverse side effects, some of which may be controlled by additional medications. The seriousness of the possible side effects of these types of drugs cannot be overstated. Cogentin, alleviate side effects caused by the antipsychotic medication. Psychotropic drugs are “compounds that affect the mind, behavior, intellectual functions, perception, moods, and emotions.”
MOYER, C.J., RESNICK, F.E. SWEENEY and LUNDBERG STRATTON, JJ., concur.
PFEIFER, J., concurs in part.
COOK, J., concurs in judgment.
SANDERS, Tony J. went to the hospital where they convincingly reported that there was no patient by the name of Jeffrey Steele. Jeffrey Steele appears to have been a fabrication of AJ Stephani Professor of Law and Psychiatry at the University of Cincinnati, who, wanted to appeal the case of Sanders v. Kravetz S. Ohio USDC C-1-98-411 (1998) with his rich friends D. Shannon Smith and James R. Bell at Faulkner & Tepe and A. Norman Aubin, without bringing up his friend’s $75,000 civil tort for the torture inflicted by the staff of the state supervised by Dr. Newton, mentioned above, who had the wherewithal to wipe the State Mental Institution Library Education (SMILE) buildings off the calendar of the Probate Judge while on trial at the US District Court, before the goal of a slavery free Justice of the Peace and the full extent of the folly of the drug enforcement come to the light of day, in this case – don’t push drugs, push community shelters.
The objective of this Judgment of Mental Health is to get AJ Stephani to write the US Supreme Court to contract for writing the footnotes of Chapter 4: SMILE of HA with SANDERS, Tony J. in hopes of exploring the curriculum and market for Hospitals & Asylums as a law school textbook. Writing for Hospitals & Asylums (HA) the author now apologizes for not doing the May revision of Chapter 4 State Mental Institution Library Education (SMILE) as promised in the Constitution of Hospitals & Asylums Non Governmental Ethics (CHANGE). Due to the workload presented by the transfer of statute from Chapter 1: Military Department (MD) in pursuit of judgment in Anthony J. Sanders v. Anthony J. Principi for the revision on Memorial Day to Chapter 10: Armed Forces Retirement Home (AFRH) for review on Veteran’s Day it has come to light that the Alleged Mentally Ill (AMI) are not May, at all. People need a more auspicious day to pursue the US Supreme Court case and SMILE of AJ Stephani v. AJ Sanders, than Warfield has to provide, wherefore the question is posed, what is AJ Stephani’s birthday or does he know of a better day to SMILE for mental health, when I am not otherwise occupied?
To tell the ORACLE the whole truth, I will now disclose the dream I had. 14 May 2006 I had a dream that AJ Stephani Professor of Law and Psychiatry and the Glenn M. Weaver Institute for Law and Psychiatry had opened a storefront on Ludlow Ave. where I live, but he was nowhere to be seen. After waiting for some time, silently in the lobby I went to play with the cords strung along steel pegs and accidentally undid the ropes on the left side, but whereas the artwork was, in its entirety, encased in plastic and AJ Stephani was nowhere to be seen, I left. I walked passed a pretty typist in the storefront window, down the street, with some friends. Hundreds of children of all races were hurrying down the cobblestone, canal-side, alley. We arrived at the house where an elderly gentleman with gray hair and several nicely dressed women were living. I told the gentleman of the folly of drugs and he went to his neighbor to purchase some. Then, all the families in the suburbs were dancing in conga lines on the street, dressed for prom.
Stephani, AJ. Steele v. Hamilton Cty. Community Mental Health Bd. (2000)http://www.sconet.state.oh.us/rod/newpdf/0/2000/2000-ohio-47.pdf