This descriptive study surveyed the psychotropic drug therapy practices of 13 psychiatrists over a period of two months to record how they responded to refusers and to determine the degree to which their day-to-day practice conformed to the principle of informed consent. Ninty refusers were identified out of a population of 309 adult civil patients and 653 forensic patients for whom psychotropics were prescribed. Patients were interviewed and ward charts were analyzed to determine capacity to consent to drug treatment, level of dangerousness, pattern of refusal, diagnosis, reasons for refusal and other demographic data. Medical staff were interviewed and a hospital-wide Likert attitude survey on informed consent was administered to 218 medical staff. / Interviews with medical staff and the use of psychotropics with 89% of the study population both indicated that psychiatrists and nurses saw psychotropics as the major form of treatment. Eleven and a half per cent of the population refused psychotropics at some point and 40% of these refusers had episodes which lasted 7 days or less. Fifty-six per cent of the refusers were forcibly medicated, but the reasons for such coercive procedures were seldom adequately documented. The study showed that the large number of coerced patients was not meaningfully related to their capacity to consent to treatment or to the degree of danger they represented. A small group of 3 psychiatrists accounted for 51% of all of the patients who were coerced. Seventy per cent of the civil refusers were coerced compared to 47% of the forensic refusers. / The results are analyzed in terms of a legal doctrine and policies and procedures which are not widely accepted by medical staff. In general, many medical staff did not look favorably on the implicit transfer of power and decision-making to mental patients that is inherent in the principle of informed consent. In view of considerable risks posed by psychotropics (e.g., tartive dyskinesia), it is recommended that greater provisions be made in state law and hospital procedures for judicial or quasi-judicial review of cases where a patient has articulated a desire to not take these medications. / Source: Dissertation Abstracts International, Volume: 46-05, Section: B, page: 1747. / Thesis (Ph.D.)--The Florida State University, 1985.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_75585 |
| Contributors | WEHR, ROBERT JOSEPH., Florida State University |
| Source Sets | Florida State University |
| Detected Language | English |
| Type | Text |
| Format | 288 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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