Mental Health Law

Question 1

1.A

Cho would not have met the standard for involuntary commitment under Mental Hygiene Law § 9.27 as Section 9.27 involuntary, requires that an application for involuntary care and treatment to be carried out in a period of ten days before any admission is carried (Reuters, 2013). In this case, no application had been made prior the incident. Moreover, the director of a hospital as required under the section could only admit the person after “certificates of two examining physicians, accompanied by an application for the admission of such person” (Raymond &Cornelius, 1998) are provided. Drawing from the report, there was no medical reports by two physicians which showed that Cho was mentally ill. The case could be supported by O'Connor v Donaldson, 422 U.S. 563, 576 [1975]) where the appellate courts of the State of New York, found that there lies a burden of proof by the State to prove that the person has eminent danger to others and himself. Moreover, mental illness signs alone could not be used to have a person admitted in a mental institution.

1.B

Under the Mental Hygiene Law § 9.60(c) Assisted Outpatient Treatment (AOT), a person is usually ordered to get AOT if the court establishes either of the elements have been met. For instance, element 2 requires that the person should be suffering from a mental illness (Reuters, 2013a). With reference to Cho’s medical records, Cho was diagnosed with severe social anxiety disorder and major depression which could be considered as types of mental illness. Element 4 revolves around lack of treatment compliance for mental illness. In regard to Cho’s report, he had failed to undertake counseling in a period of 36 months. Also, he had showed a series of violent behaviours to others and himself in a period of 48 months. For example, Cho stabbed the carpet several times in presence of his friends and send violent messages to his English teacher and some of the students. He also wrote poems and compositions characterized with “violent connotations”. Moreover, at one time he told a friend through writing that he felt like committing suicide. Therefore, Cho exhibited violent behaviour prior to the shooting took place. Element 6 of Law § 9.60(c) AOT states that a person may be ordered to receive treatment if based on current behaviour and her or his treatment history shows the need for assisted outpatient treatment so as to curtail further deterioration which may result to self or other persons (Reuters, 2013a). Drawing from Cho’s mental illness report, his behaviour in class and treatment history had exhibited a person with the need for AOT. Therefore, Cho would have met the standard for AOT in New York focusing on elements 2, 4 and 6 of the Mental Hygiene Law § 9.60(c) AOT standard.

Question 2

2.A

The prosecutor pursed the need for forced medication because Loughner posed a danger to himself and others within the facility, and that the use of the drugs could restore Loughner’s competency. For example, in all three cases (Washington v Harper (494 US 210 [1990]), Riggins v Nevada, 504 US 127 [1992]), and Sell v United States, 539 US 166 [2003), the use of antipsychotic medication proved beneficial as the competency of defendants was improved. Moreover, in Riggins v. Nevada case, the Court relied on Washington v Harper (494 US 210 [1990]) to rule that antipsychotic medication was deemed as medically appropriate and essential for the safety of others and that of the defendant (Shannon & Scarano, 2013). Moreover, in the Sell v United States, 539 US 166 [2003) case, the court established that “the government’s interest in bringing incompetent defendants to trial was sufficient to override their refusal of treatment” (Appelbaum, 2012, p. 630). Therefore, the prosecutor’s decision to pursue the use of forced medication was based on past rulings. The paper articles have portrayed Loughner as a violent person who at one time spat on his attorney, was a danger on others (APA, 2011), suffered from schizophrenia (Myers, 2011), and a person who required mental health intervention (Abcarian, Reston, &Hennessy-Fiske, 2011). Based on these facts, the Court was right when it permitted forced medication. In the case of forced medication solely on the desire to return Loughner to competency, the prosecutor would have showed evaluations of competence for the defendant to stand on trial and monitor his behaviour.

2.B

Loughner’s defense attorneys opposed the forced administration of antipsychotic medication as they perceived them as dangerous on a person on a pre-trial. Therefore, the defense attorneys were concerned with the health and safety of their client and his bill of rights as stated in the Fifth Amendment. Some ethical issues arise which could be referenced in State v. Perry case where forced administration of antipsychotic medication was considered as “antithetical to the basic principles of the healing arts” (Shannon & Scarano, 2013, p. 439). Also, a forced medication prompts a physician to act contrary and ethically to the objectives and purpose of medical treatment. In other words, medical interests of Loughner were violated as the state pursued its own interest, which was to enhance Loughner’s competency.

2.C

The New York’s Rivers v Katz (67 NY2d 485 [1986]) standard for forced treatment and the post-Rivers procedure for addressing refusal of medication claims, stipulate that a person could forcibly be treated so as to preserve life, prevent suicide, and protect third persons (New York Department of Health, 2011). Loughner’s decision to refuse treatment could be overridden under the NY standard because administration of antipsychotic drugs is carried to mentally ill patients involuntarily restrained to a State facility where Loughner was held (Court of Appeals of New York, 1986).