My second priority is that our patients have a right to quality treatment. In the world of health care, patients have many rights that must be carefully respected, monitored, and protected: the right to be heard, to receive full access to culturally sensitive and unbiased care, and to be treated with dignity and respect, and the right to choose whether to accept or decline recommended treatment. But we don't as often hear advocates arguing in support of a patient's right to receive quality treatment. In extreme situations, however—and these are fortunately relatively rare—we must not shy away from active intervention when clearly indicated. I have always remembered an occasion when I was a major in the Air Force evaluating a colonel who was depressed and suicidal. He had a loaded shotgun at home and planned to kill himself after finalizing one more bank transfer of assets to his wife. I told him that he was going to be admitted to the hospital, which he then refused. I can still recall my relief at having the military structure at my back when I said, "Colonel, that's an order." Though he outranked me in all other circumstances, I was the ranking officer in charge when he was my patient within the walls of the medical center. He knew the rules. He was hospitalized, and he recovered and returned to active duty. Of course, we have all had such clinical emergencies, and we do our best to deal with them appropriately. But there are other times when bureaucratic obstacles, inadequate resources, or even legal constraints tilt decisions in the wrong direction. Just read, for example, the court papers from the tragedy at Virginia Tech, and I think you would agree that the judicial decision to "commit" the patient to outpatient treatment (which, of course, is usually unenforceable), instead of to issue an order for the patient to be hospitalized, inappropriately overvalued his right to personal freedom above his right to quality treatment. Many lives were lost as a result, and, of course, the patient's life was ruined. I realize that this is a slippery slope, with many compelling, valid, and sometimes competing interests. We do not hesitate, however, to intervene actively when a brain disorder called epilepsy leads to a grand mal seizure or when a toxic delirium produces combative behavior. I also believe that there are many situations that are not so extreme as the Virginia Tech example, where the brain disorders that we call psychiatric disorders are not recognized, and patients are blamed for "behaving badly" instead of being guided to appropriate treatment to help them overcome disruptive or distressing illness-driven behavior.