Georgia law for involuntary meds

  1. Does anyone know where I can find information regarding forcing medications (routine) to mental health
    patients specifically those from the criminal justice system??

    The info I've found online is kinda unclear plus different states have different rules. It seems for regular mental health patients, they would need a court order or a doc's second opinion to have forced medications. But I work with IST (incompetitent to stand trial) patients and it seems there are more exceptions for them. For example I read that in order for forced medications to take place, there have to be four exceptions.
    a.Involuntary Medication in Response to an Emergency

    b. Involuntary Medication Because the IST Defendant Lacks Capacity to Consent

    c. Involuntary Medication because the IST Defendant is a Danger to Others

    d. Involuntary Medication to Restore Competency

    *from
    Disability Rights California | California's Protection and Advocacy System

    but this is California not GA. And do the courts still need to be involved when determining capacity to make decisions or using medications for competency restoration?

    I'm asking because the only thing I've seen is a doctor's order. We don't have many ppl refusing routine medications but I want to know the state's policy regarding the matter.
    •  
  2. 11 Comments

  3. by   elkpark
    Check GA mental health laws. The state laws should be online somewhere. Another option is to ask your facility's legal counsel for clarification.
  4. by   RN1485
    I did a search but can't find exactly what I'm looking for. I'll keep searching.
  5. by   softrbreeze
    Let us know if you do find what you're looking for. I live in GA and am considering a future career in Mental Health Nursing (previous degree in Psychology). Thanks!
  6. by   elkpark
    I would check with your employer's legal counsel. Clarifying these kinds of questions is part of what the employer is paying them for.

    Or, just start asking at work, and keep working your way up the chain of command until you get to someone who knows the answer and/or where to find it.

    Another option is to contact the GA department of mental health. I guarantee you they will know.
  7. by   Psych nerd
    I work for a state run facility in SC. I know you asked about GA but at my facility all you need is a doctors order. If the doc says shots if refuse then they get the shots
  8. by   elkpark
    Quote from Psych nerd
    I work for a state run facility in SC. I know you asked about GA but at my facility all you need is a doctors order. If the doc says shots if refuse then they get the shots
    That may be the practice in your facility, but are you sure that is allowed under the state law? I surveyed psychiatric hospitals and units in my former state for several years, and we ran into lots of units that were doing that -- but it was a violation of the state law on the subject, and facilities got cited for it and changed their practice. Every state has some sort of legal mechanism for medicating folks against their will outside of an emergency situation and the requirements vary among states, but it definitely is not that "the doc says shots." I would be extremely surprised if (even) SC law allows for that. Or it may be that there is further documentation/justification involved that you just aren't aware of.
  9. by   RN1485
    I looked into my organization's policy and all I could find was that doctors who order involuntary medications have to have another doctor agree with him from 72 hours to 30 days (up until 72 hrs he makes his own decision) with a review with the treatment team every week. From 31-60 days he would need two physicians concurring with him on forced meds. At the end of 60 days, the physician would need to set up a clinical review. Not sure if that involves forensics or not but I didn't see any additional info regarding forensics.
  10. by   MrChicagoRN
    Quote from Psych nerd
    I work for a state run facility in SC. I know you asked about GA but at my facility all you need is a doctors order. If the doc says shots if refuse then they get the shots
    Here are the SC statutes: Code of Laws - Title 44 - Chapter 22 - Rights Of Mental Health Patients

    A competent person may refuse medication except in emergency situations. And the mental illness does not in itself constitute an emergency.

    In Illinois that is defined as imminent danger to self or others.

    Sometimes a doc gets frustrated and says, if they won't take routine medicine call security & give them a shot. I remind them that this can't happen unless they take them to court, and get a court order.
  11. by   elkpark
    Quote from MrChicagoRN
    Here are the SC statutes: Code of Laws - Title 44 - Chapter 22 - Rights Of Mental Health Patients

    A competent person may refuse medication except in emergency situations. And the mental illness does not in itself constitute an emergency.
    Thanks for finding that. Actually, by my reading, the linked Title 44 says that a competent person may refuse medication except in emergency situations or "as permitted under applicable law for a person committed by a court to a treatment program or facility." But it says nothing about what or where the "applicable law" re: involuntary commitment is, and I haven't been able to find anything on line (I found the section of Title 44 regarding involuntary commitment, and that section says nothing about medications -- it's all about the involuntary commitment process itself).

    Interestingly, Title 44 does say, under the section about patient rights re: medication, that facilities are required to get written consent from the client for any and all psychiatric medications (again, outside of an emergency situation).
  12. by   Sunpuppy
    GA law regarding emergency medications depends on the status of the patient. If the patient is involuntary, the patient does not have the right to refuse medications because it is assumed that the patient is not cognizant enough to make determination. If the patient is voluntary, the patient has the right to refuse medications as long as they are not a danger to themselves or others.
  13. by   elkpark
    Quote from Sunpuppy
    GA law regarding emergency medications depends on the status of the patient. If the patient is involuntary, the patient does not have the right to refuse medications because it is assumed that the patient is not cognizant enough to make determination. If the patient is voluntary, the patient has the right to refuse medications as long as they are not a danger to themselves or others.
    Welcome to allnurses! Are you sure about that?? The Georgia state code, Title 37 - Mental Health states, under Article 6 - Rights and Privileges of Patients, Their Representatives, and Others Generally:

    (b) It shall be the policy of this state to protect, within reason, the right of every individual to refuse medication except in cases where a physician determines that refusal would be unsafe to the patient or others. If the patient continues to refuse medication after such initial emergency treatment, a concurring opinion from a second physician must be obtained before medication can be continued without the patient's consent. Further, in connection with any hearing under this chapter, the patient has the right to appear and testify as free from any side effects or adverse effects of the medication as is reasonably possible.

    SS 37-7-163. Recognition of patients' physical integrity; patients' right to refuse medication; obtaining consent to treatment and surgery; performance of emergency surgery, immunity of physician; direction of notice of actions taken under Code section :: 216 Georgia Code :: US Codes and Statutes :: US Law :: Justia

    It doesn't say anything about "unless you're an involuntary client." I've been Googling and reading over the Georgia state mental health laws for a while now, because what you describe would be highly unusual, and this is all I've found. There is a process outlined, as there is in every state, for forcing medications on a non-emergent basis, but I don't see anything anywhere that suggests that involuntary psychiatric clients have no right to refuse medications in non-emergent situations simply because they are being held on an involuntary basis.

    If you have some documentation that what you say is actually the law in Georgia, please post it. I'm happy to be educated. Mental health law has been an interest of mine for a long time, and I try to keep up.

close