The authors studied patients' refusal of medication during a three-
month period on an inpatient service of a community mental health center.
Although refusal of medication was common, most episodes were self-limited.
Only 5 of 72 episodes seriously impaired patient care; each of these cases
appeared to be delusionally motivated. Legal conceptions of a right to
refuse treatment may not accurately portray the realities of the clinical
situation, in which patients' refusal is determined by the dynamics of
their illness rather than reflecting a principled exercise of their legal