Faculty Bibliography

The side effects that may occur during treatment of schizophrenia with neuroleptic drugs are fully examined. Included are autonomic, extrapyramidal, other CNS, endocrine and metabolic, allergic, and skin and eye side effects. The differences between the side effect profiles of various antipsychotic drugs are noted. The restrictions imposed by laws designed to protect the patients's rights are evaluated with regard to the side effects of neuroleptic drugs. The meaning of informed consent is delineated.

The paper addresses some of the ethical and legal issues involving the rights of psychiatric patients to refuse treatment. Particular attention is focused on two recently decided cases--Rogers v. Okins, and Rennie v. Klein--that deal with the rights of involuntarily committed patients to refuse psychotropic medications. Both cases approach this issue in different ways, but inevitably point to some very complicated philosophical concepts such as the meaning of self-determination, autonomy and identity of personhood, especially as these concepts are applied to mentally ill patients

Defensive medicine--the use of diagnostic and end-treatment measures explicitly for the purposes of averting malpractice suits--is frequently cited as one of the least desirable effects of the current rise in medical litigation. Many physicians and policy-makers claim that defensive medicine is responsible not only for the increasing costs of health care but the exposing of patients to significant risks of harm from unnecessary procedures. Very little solid information is available about defensive medicine. The studies that have been conducted have been fraught with statistical difficulties and are by no means definitive. Even more important than the issue of defensive medicine is the more basic problem of our system of compensation for medical injuries