Mr. Duane, Sir: Please read again my posting and respond to the positions I presented. Solipsistic thoughts do not carry any weight. I did not say, or even implied, that the so-called minority groups do not adhere to psychiatric treatments “due” to lack of support but “because” of lack of support in the community. “Non-adherence” is not only with Psychiatry treatments in particular but with Medical treatments in general and thus not adhering to different treatments: Cardiovascular (like hypertension and cholesterol control,) Metabolic (diabetes, obesity) Eye and Ear (glaucoma, retinopathies, decreased hearing,) Gastroenterological (from perforated duodenal ulcers to bleeding hemorroids,) Infections (from complex dermatological suppurative lesions to HIV advancing into AIDS) and so on and so forth. These minorities that refuse every kind of treatment have shortened life spans and, goes without saying, constitute the majority of the homeless and street people that present with severe untreated illnesses, both mental and physical (a silly difference but that is vastly used) and populate the emergency rooms. The “right” to refuse treatment should not stop with Psychiatric treatments but with ALL treatments. Is it not true? There is no question that everybody, patients or not, must be protected in their rights and nobody denies that. You do not need to quote every Constitutional amendment to support this notion. But as important as the protection to refuse treatment is so is the right to be treated and when a person lacks the ability to understand this need then the society must intervene to facilitate treatment, at times above the wishes of the patient. Mentally ill patients can certainly be dangerous TO THEMSELVES, and they are unable, in many cases, of controlling their impulses and their lack of insight supersedes rationality and that that takes them to refuse treatment and therefore put themselves in a vulnerable state. To obtain a permission to treat above objections under the AOT guidelines (Kendra’s Law) a lawyer is assigned to the patient to defend his/her right to refuse treatment, the Psychiatrist presents the case and requests treatment over objections based on three main instances: Dangerous to self, dangerous to others, inability to care for self. A judge weights the arguments and issues a decision. Yes, to obtain an order of treatment over objections the Psychiatrist must PROVE in court any or all of the above mentioned three instances. You should witness these court procedures and see how many times the Psychiatrist fails to PROVE his/her case for treatment over objections and the request is denied. I agree that the rights protected by the Constitution applies to the mentally ill and should be defended, including the right to vote and to redress grievances in court, like refusing treatment. But then the resulting questions are: – Should we defend the right to own a gun for protection under the second amendment as the NRA interprets it or, as the NRA states, we should deny it to people with mental illness. – If a mentally ill person commits a crime, should we do away with the M’Naughten rule (ability to tell right from wrong)? Well, if the patient refused treatment and the society does not consider him mentally ill and he is considered able to refuse treatment then the society can refuse to consider that any crime he commits in the absence of treatment has been done with total free will and years of legal proceedings that protect the mentally ill will be trashed. – If the patient can refuse psychotropics, so can the Psychiatrist refuse to administer them without fear that the results of The Osheroff vs Chestnut Lodge case applies to him/her? – If a Psychiatrist learns of the threat on somebody’s life verbally made by a patient under his/her care, should the therapist forsake warning the potential victim, without suffering consequences from cases like the Tarasoff vs Regents of University of California because the patient is exercising unimpeded free will and you are violating the patient’s rights to conduct treatment and to privacy? These arguments, directly or indirectly related to the right to refuse treatment, can be even more complex and extend forever and cannot be encapsulated in ideological bromides. Finally, let me say that the implications of “racism” of the AOT program are totally false. The program was based on the outrage generated by one very white paranoid schizophrenic that, having refused treatment and following command hallucinations, pushed a very white person into the path of the subway, producing the death of the person. Are there psychiatric abuses being committed? Yes. Should we ignore them? No. Does this mean that all of Psychiatry is abusive and should be dismissed? Absolutely not, but Psychiatry has to be corrected, not eliminated. Forums like this one are good to discuss issues, but people should not argue with vacuous diatribes and set forth arguments based on what one thinks has been said and not to what was actually postulated. This distortion of thought belongs to the Beck/Limbaugh School of Willful Distortions and not to what should be a civilized exchange of ideas. I do not think that I am correct in every aspect that I present and I find that starting a polemic in sites like this could be useful to develop common understandings. As it stands, pseudo-arguments do not protect psychiatric patients but make them more vulnerable.