The Jamison-Farabee consent decree in California mandates an outside
psychiatrist's review of involuntary medication of state hospital patients.
Patients' rights advocates presumably hoped the decree would facilitate
more frequent medication refusal, while clinicians predicted the procedure
would impair patient care. Outside review led to only a 1.1% rate of
medication denial; half of the patients involved deteriorated afterward.
Examination of a sample of patients subject to the decree and two
comparable samples 1 year and 10 years earlier suggests that patients'
successful medication refusal was no more frequent after implementation of
the decree and that the procedure had negligible effects on patient care or
outcome for patients not denied medication.