Patient Rights and Advocacy Commission, Inc.

The following is a patient brochure that was prepared by P.R.A.C. for
consumers confined at the Oregon State Hospital.

WARNING: No one should stop taking any psychiatric drug without the advice and assistance
of a competent medical doctor.

THE PATIENT’S RIGHT TO REFUSE
In most cases you have the right to refuse any medication or other treatment that is offered to
you if you provided Informed Consent (see section How Can the Doctor Force me to Take
Drugs?).

YOUR RIGHTS ARE CLEAR
Oregon Administrative Rule 309-114-0010 states that individuals confined at the Oregon State
Hospital have the right to:
“Refuse any significant procedure and may withdraw at any time consent previously given to a
significant procedure.” A significant procedure is a “diagnostic or treatment … which poses a
material risk of substantial pain or harm … including psychotropic medication or
electro-convulsive therapy”. OAR 309-114-0005(10). See OSH Policy 7.005(I)(1)(K).
You have the right to refuse medication or other treatments “without any form of reprisal or
punishment”. OSH Policy 7.005(I)(1)(Q).

WHAT DOES ‘INFORMED CONSENT’ MEAN?
Informed Consent is defined as, “Voluntary consent given by a person for participation in a
treatment regimen [e.g., psychiatric drugs] after being informed of the purpose, methods,
procedures, benefits, and risks. The essential criteria of Informed Consent are that the person
has both knowledge and comprehension, that consent is freely given without duress or undue
influence and that the right of withdrawal at any time is clearly communicated” (Stedman’s
Medical Dictionary, ©2000).
Some consumers at the Oregon State Hospital have complained that they have been lied to and
provided false information regarding medications by their psychiatrists and other staff. When a
psychiatrist provides incomplete or inaccurate information to a consumer regarding a
medication, especially the potential damage that it may cause, he or she may be breaking the
law.
Informed Consent means that (a) you are aware of the potential damage and benefits of the
drug; (b) that you make a free and voluntary choice to take the drug, and; (c) that you know
that you can stop taking the drug at any time without any fear of punishment or reprisal from
the treatment team.

HOW DOES THE HOSPITAL OBTAIN ‘INFORMED CONSENT’?
The Oregon State Hospital has a form called ‘Informed Consent, Treatment with Psychoactive
Medications’. If you are taking psychiatric medications, then you probably signed this form to
give informed consent. This Hospital form states in part, “The exact reason for the
effectiveness of psychoactive medications has not been clearly established; however, the
effects appear to be related to their alteration of certain chemical processes within the brain …
Psychoactive medications have potential side effects in many systems of the body … in some
cases, adverse reactions are serious and may not be reversible, such as tardive dyskinesia, a
movement disorder which may be permanent … for which no effective treatment is available … I
[the patient] also understand that the continuous use of these medications may hide or worsen
symptoms of tardive dyskinesia. The symptoms may not appear until the medication is
withdrawn.” Form # OSH-STK 04351-MR.
Many consumers are not aware of the many serious and potentially permanent brain damage
that psychiatric drugs cause. If consumers were truly aware of these hazards, many would
choose to preserve their physical and mental health.

HOW CAN THE DOCTOR FORCE ME TO TAKE DRUGS?
Oregon law states that a person at the Oregon State Hospital can be forcibly medicated “only if
the person currently demonstrates an inability to comprehend and weigh the risks and benefits
of the proposed [medication or treatment]”. OAR 309-114-0010(2)(a). In other words, you can
only be forced to take drugs if you do not understand the risks and benefits of taking the drug
that the psychiatrist believes you should take.
Prior to you being forced medicated there shall be a “consultation and approval from an
independent examining” psychiatrist. The independent psychiatrist must not be an employee of
the hospital and he or she must discuss the matter with the consumer. OAR
309-114-0020(2)(a).
The only other time you may be forcibly medicated is when there is an emergency and a
“substantial likelihood of immediate physical harm to the patient or others … and it’s
impracticable to obtain informed consent [e.g., suicide attempt]”. OAR 309-114-0015(1)(b).
Simply, there are ONLY 2 WAYS THAT YOU MAY BE FORCED TO TAKE PSYCHIATRIC DRUGS, and
they are:
You don’t understand or comprehend the benefits or consequences of the drug; or
There is a true emergency.

DO PSYCHIATRISTS AND STAFF MANIPULATE PATIENTS?
The Patient Rights and Advocacy Commission has received many complaints from consumers at
the hospital regarding psychiatric abuses. It has been reported that hospital staff have
threatened consumers with forced injections or other consequences if they did not take the
prescribed medication. If the individual is capable of providing Informed Consent as described
above, then this is against the law and is considered “duress and undue influence” in violation
of Informed Consent as contemplated in the Oregon Administrative Rules. Patient abuse will not
be tolerated.

WHAT IS AGAINST THE LAW?
No staff member at the hospital may threaten you for refusing to take medication that the
psychiatrist has ordered.
You CANNOT be forcibly medicated for refusing medications unless you meet the criteria under
the section titled ‘How Can the Doctor Force Me to Take Drugs?’.
No staff member may lie to you in order to manipulate you to take medication.
You cannot be punished or retaliated against for asserting your right to refuse medication. OSH
Policy 7.005(I)(1)(Q).

CAN I WITHDRAW MY ‘INFORMED CONSENT’?
YES, under OAR 309-114-0010(1) you have the right to “withdraw at any time consent
previously given” for psychiatric medications or other treatments. Sometimes consumers are on
psychiatric drugs for long periods of time with no benefits— only disabling side effects. For
example, some consumers feel emotionally drained and weak, while others have shaky hands
and sleep all day. Whatever the reason you want to ‘say no’ to psychiatric drugs, if you have
given Informed Consent, then you have the right to revoke it.

HOW DO I WITHDRAW MY ‘INFORMED CONESNT’?
The most effective way to revoke your Informed Consent is to write a brief letter addressed to
the psychiatrist that reads something like this:
“I hereby revoke my Informed Consent to take the following psychoactive medications: [state
the medications].”
Make sure to date and sign this note. IMPORTANT: KEEP A COPY!

WHAT IF MY RIGHTS ARE VIOLATED?
If your rights are violated, you may (a) file a hospital grievance (b) file a complaint with the
Oregon Advocacy Center (c) file a complaint with the Governors’ Advocacy Ombudsman, or (d)
file a complaint with the Patient Rights and Advocacy Commission by calling the number below.
If you file a complaint with P.R.A.C. be sure to state whether or not you have provided
Informed Consent.

HOW TO FILE A COMPLAINT
Deborah Howard, Associate Director 503-945-7132
Marvin Fickle, M.D., Superintendent 503-945-2850
Oregon Advocacy Center 1-800-452-1694
Email P.R.A.C. with your forced treatment complaint