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Court Upholds Judges' Right to Compel Medication

New York Times
February 18, 2004

ALBANY, Feb. 17 - The state's highest court on Tuesday upheld the constitutionality of a law that gives judges authority to force mentally ill people to comply with treatment.

The statute, commonly known as Kendra's Law, was originally passed in 1999 after Kendra Webdale, 32, was killed when she was thrown in front of an oncoming subway train. The assailant was a man who had been found to be schizophrenic and prone to violence, but who did not take his antipsychotic medicine.

By passing the law, New York joined nearly 40 other states that had similar statutes, the state's Court of Appeals said in its decision.

Lawyers for a mental patient, identified only as K. L., had challenged the law on the ground that it violated the constitutional guarantee of due process because it did not require that a court declare a psychiatric patient mentally incapacitated - an established and substantial legal threshold - before forcing the patient into treatment.

They also argued that it was unconstitutional to allow patients who refused to take their medicine to be detained for up to 72 hours for evaluation without a hearing.

K. L. suffered from a bipolar type of schizo-affective disorder, had a history of hospitalization, at times refused to cooperate with treatment and was occasionally aggressive with family members.

The case was the first challenge of the law to reach the state's top court, which ruled unanimously, 6-0, to uphold the statute.

"The state's interest in immediately removing from the streets noncompliant patients previously found to be, as a result of their noncompliance, at risk of a relapse or deterioration likely to result in serious harm to themselves or others is quite strong," Chief Judge Judith S. Kaye wrote in the decision.

Dennis B. Feld, a court-appointed lawyer for K. L., said he did not want to abolish Kendra's Law but only wanted to assure additional rights for the mentally ill.

The court said, however, that requiring a court declaration of incapacity "would have the effect of eviscerating the legislation."

As a lawyer for the Mental Hygiene Legal Service, which is part of the court system, Mr. Feld said he and his associates represented the majority of the mentally ill people in New York affected by the law.

Mr. Feld estimated that roughly 1,500 to 2,000 people are now under court order to receive outpatient treatment. "The numbers are increasing," he said. Altogether, since the law was passed, courts have ordered that more than 3,000 people receive treatment, said Roger F. Klingman, a spokesman for the State Office of Mental Health.

Under the law, a family member or caseworker could seek a court order requiring treatment. A court hearing must meet a set of criteria established under the law before what is known as an assisted outpatient treatment order can be issued. The appeals court found that the "statute's procedure for obtaining an A.O.T. order provides all the process that is constitutionally due."

Mr. Feld argued that patients should be granted a hearing before being detained, but the speed with which a mentally ill person could be removed from the general public was a central reason why Ms. Webdale's family lobbied so hard to have the law passed.

"A preremoval hearing would significantly reduce the speed with which the patient can be evaluated and then receive the care and treatment which physicians have reason to believe that the patient may need," the court ruled.

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