Maine Medication Law Challenged

Friday, July 11, 2008 - Bangor Daily News

BANGOR, Maine - The Augusta-based Disability Rights Center of Maine on Thursday filed a lawsuit in U.S. District Court on behalf of an 83-year-old woman challenging the constitutionality of a new law that allows patients committed involuntarily to psychiatric facilities to be medicated against their will.

The lawsuit claims that the new law violates the due process rights of the woman --- identified only as Jane Doe --- that are guaranteed in the 14th Amendment of the U.S. Constitution. The 17-page complaint claims that the law does not give the patient proper notice of a hearing or an opportunity to be heard at a meaningful time and in a meaningful manner before being deprived of her "liberty interest."

The lawsuit also claims that under the new law people may be forced to take medications that can even cause death or have devastating and irreversible side effects, especially in elderly patients.

Attorneys are seeking to have the law set aside and to recoup legal fees and expenses.

The Disability Rights Center is a not-for-profit legal aid clinic that specializes in disability cases.

"Ms. Doe has a constitutionally protected fundamental liberty and-or a substantial liberty interest to refuse medical treatment that included the forcible administration of powerful psychotropic medication," the lawsuit argues. "This liberty interest includes refusing such medical treatment regardless of how unwise her sense of values may seem to her treating psychiatrists."

Efforts to reach the attorneys who filed the case were unsuccessful late Thursday afternoon.

The named defendants are Maine Attorney General Steven Rowe; Brenda Harvey, commissioner of the Maine Department of Health and Human Services; and David Proffitt, superintendent of Riverview Psychiatric Center, formerly Augusta Mental Health Institute.

An Act Regarding Clinical Review of Certain Requests for Involuntary Mental Health Treatment was passed by the Legislature and signed by the governor in April. It allows for a committee, according to the complaint, that includes at least two licensed professionals and two or more licensed professional staff who do not provide direct care to the patient, to issue a finding that a patient should be medicated against his or her will. At least one member of the panel must be licensed to prescribe medication.

The plaintiff in the case was involuntarily committed to Riverview on May 28, about a month after the new law went into effect. Doe was committed by order of the 7th District Court in Augusta for a period not to exceed 16 weeks, according to the lawsuit.

Doe was notified in writing on June 5 that the Clinical Review Panel was going to meet on June 10, but she was not told what course of treatment would be considered, according to the complaint. A peer support worker who was also a Riverview employee attended the meeting with Doe but allegedly told the panel that because she was not an attorney or a clinician she did not feel qualified to ask questions on Doe's behalf.

One panel member, according to the lawsuit, referred to a possible risk of death due to her advanced age from the recommended anti-psychotic drug. The Federal Drug Administration requires a warning on the box of the medication stating that elderly patients with dementia have a higher risk of death than those who do not take these types of drugs.

Doe's doctors had not ruled out dementia as the cause of her involuntary commitment, the lawsuit states. She was ordered to take an anti-psychotic medication on June 10, but the order was rescinded a week later. The lawsuit does not state whether or not Doe ever was administered the drug. It also does not explain any side effects she might have suffered.

Although the law says that patients have a right to be informed of, appear at, and comment at a meeting of the panel, the complaint claims that the law is unconstitutional because it:]

  • Provides patients a lay adviser rather than an attorney but does not outline any qualifications for such advisers.
  • Does not require the panel's proceedings to be recorded.
  • Does not outline any evidentiary standard by which the panel must make its decisions.
  • Does not allow for a timely judicial review of forced treatment orders.

The state has 30 days to respond to the lawsuit after it receives the complaint.