SENATE BILL 5672
State of Washington 52nd Legislature 1991 Regular Session
By Senators Niemi, McDonald, West, L. Smith and Sutherland; by request of Office of Financial Management and Dept. of Social & Health Services.
Read first time February 14, 1991. Referred to Committee on Health & Long‑Term Care.
AN ACT Relating to antipsychotic medicine; amending RCW 71.05.120, 71.05.130, 71.05.210, and 71.05.370; and adding a new section to chapter 71.05 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. A new section is added to chapter 71.05 RCW to read as follows:
(1) A person found to be gravely disabled or dangerous as a result of a mental disorder has a right to refuse antipsychotic medication unless it is determined that the failure to medicate may result in a likelihood of serious harm or substantial deterioration or substantially prolong the length of involuntary commitment and there is no less intrusive course of treatment than medication in the best interest of that person.
(2) The department shall adopt rules to carry out the purposes of this chapter. These rules shall include:
(a) An attempt to obtain the informed consent of the person prior to administration of antipsychotic medication.
(b) For short-term treatment, the right to refuse antipsychotic medications unless there is an additional concurring medical opinion approving medication.
(c) For continued treatment, the right to periodic review of the decision to medicate by the medical director or designee.
(d) Administration of antipsychotic medication in an emergency and review of this decision within twenty-four hours. An emergency exists if the person presents an imminent likelihood of serious harm to self or others, and medically acceptable alternatives to administration of antipsychotic medications are not available or are unlikely to be successful; and in the opinion of the physician, the person's condition constitutes an emergency requiring the treatment be instituted prior to obtaining a second medical opinion.
(e) Documentation in the medical record of the physician's attempt to obtain informed consent and the reasons why antipsychotic medication is being administered over the person's objection or lack of consent. If appropriate, documentation shall include the basis for a substituted judgment to medicate.
Sec. 2. RCW 71.05.120 and 1989 c 120 s 3 are each amended to read as follows:
officer of a public or private agency, nor the superintendent, professional
person in charge, his or her professional designee, or attending staff of any
such agency, nor any public official performing functions necessary to the
administration of this chapter, nor peace officer responsible for detaining a
person pursuant to this chapter, nor any county designated mental health
professional, nor the state, a unit of local government, or an evaluation and
treatment facility shall be civilly or criminally liable for performing duties
pursuant to this chapter with regard to the decision of whether to admit,
release, administer antipsychotic medications ((
on an emergency basis)),
or detain a person for evaluation and treatment: PROVIDED, That such duties
were performed in good faith and without gross negligence.
(2) This section does not relieve a person from giving the required notices under RCW 71.05.330(2) or 71.05.340(1)(b), or the duty to warn or to take reasonable precautions to provide protection from violent behavior where the patient has communicated an actual threat of physical violence against a reasonably identifiable victim or victims. The duty to warn or to take reasonable precautions to provide protection from violent behavior is discharged if reasonable efforts are made to communicate the threat to the victim or victims and to law enforcement personnel.
Sec. 3. RCW 71.05.130 and 1989 c 120 s 4 are each amended to read as follows:
judicial proceeding for involuntary commitment or detention, ((
administration of antipsychotic medication,)) or in any proceeding
challenging such commitment or detention, (( or administration of
antipsychotic medication,)) the prosecuting attorney for the county in
which the proceeding was initiated shall represent the individuals or agencies
petitioning for commitment or detention (( or administration of antipsychotic
medication)) and shall defend all challenges to such commitment or
detention (( or administration of antipsychotic medication)): PROVIDED,
That after January 1, 1980, the attorney general shall represent and provide
legal services and advice to state hospitals or institutions with regard to all
provisions of and proceedings under this chapter except in proceedings
initiated by such hospitals and institutions seeking fourteen day detention (( and
administration of antipsychotic medication)).
Sec. 4. RCW 71.05.210 and 1989 c 120 s 6 are each amended to read as follows:
person involuntarily admitted to an evaluation and treatment facility shall,
within twenty‑four hours of his or her admission, be examined and
evaluated by a licensed physician who may be assisted by a ((
physician assistant according to chapter 18.71A RCW or a nurse
practitioner according to chapter 18.88 RCW and a mental health professional as
defined in this chapter, and shall receive such treatment and care as his or
her condition requires including treatment on an outpatient basis for the
period that he or she is detained, except that, beginning twenty‑four
hours prior to a court proceeding, the individual may refuse all but emergency
life‑saving treatment, and the individual shall be informed at an
appropriate time of his or her right to such refusal of treatment. Such person
shall be detained up to seventy‑two hours, if, in the opinion of the
professional person in charge of the facility, or his or her professional
designee, the person presents a likelihood of serious harm to himself or
herself or others, or is gravely disabled. A person who has been detained for
seventy‑two hours shall no later than the end of such period be released,
unless referred for further care on a voluntary basis, or detained pursuant to
court order for further treatment as provided in this chapter.
after examination and evaluation, the licensed physician and mental health
professional determine that the initial needs of the person would be better
served by placement in an alcohol treatment facility, then the person shall be
referred to an approved treatment ((
facility)) program defined
under RCW 70.96A.020.
An evaluation and treatment center admitting any person pursuant to this chapter whose physical condition reveals the need for hospitalization shall assure that such person is transferred to an appropriate hospital for treatment. Notice of such fact shall be given to the court, the designated attorney, and the designated county mental health professional and the court shall order such continuance in proceedings under this chapter as may be necessary, but in no event may this continuance be more than fourteen days.
Sec. 5. RCW 71.05.370 and 1989 c 120 s 8 are each amended to read as follows:
Insofar as danger to the individual or others is not created, each person involuntarily detained, treated in a less restrictive alternative course of treatment, or committed for treatment and evaluation pursuant to this chapter shall have, in addition to other rights not specifically withheld by law, the following rights, a list of which shall be prominently posted in all facilities, institutions, and hospitals providing such services:
(1) To wear his or her own clothes and to keep and use his or her own personal possessions, except when deprivation of same is essential to protect the safety of the resident or other persons;
(2) To keep and be allowed to spend a reasonable sum of his or her own money for canteen expenses and small purchases;
(3) To have access to individual storage space for his or her private use;
(4) To have visitors at reasonable times;
(5) To have reasonable access to a telephone, both to make and receive confidential calls;
(6) To have ready access to letter writing materials, including stamps, and to send and receive uncensored correspondence through the mails;
Not to consent to the performance of ((
shock treatment, the administration
of antipsychotic medications,)) electroconvulsant therapy or
surgery, except emergency life‑saving surgery, and not to have (( shock
treatment, antipsychotic medications,)) electroconvulsant therapy or
nonemergency surgery in such circumstance unless ordered by a court of
competent jurisdiction pursuant to the following standards and procedures:
treatment and the administration of antipsychotic medication)) Electroconvulsant
therapy shall not be ordered unless the petitioning party proves by clear,
cogent, and convincing evidence that there exists a compelling state interest
that justifies overriding the patient's lack of consent to (( shock treatment
or the administration of antipsychotic medications)) electroconvulsant
therapy, that the proposed treatment is necessary and effective, and that
medically acceptable alternative forms of treatment are not available, have not
been successful, or are not likely to be effective.
(b) The court shall make specific findings of fact concerning: (i) The existence of one or more compelling state interests; (ii) the necessity and effectiveness of the treatment; and (iii) the person's desires regarding the proposed treatment. If the patient is unable to make a rational and informed decision about consenting to or refusing the proposed treatment, the court shall make a substituted judgment for the patient as if he or she were competent to make such a determination.
The person shall be present at any hearing on a request to administer ((
treatment or antipsychotic medications)) electroconvulsant therapy
filed pursuant to this subsection. The person has the right: (i) To be
represented by an attorney; (ii) to present evidence; (iii) to cross‑examine
witnesses; (iv) to have the rules of evidence enforced; (v) to remain silent;
(vi) to view and copy all petitions and reports in the court file; and (vii) to
be given reasonable notice and an opportunity to prepare for the hearing. The
court may appoint a psychiatrist, psychologist within their scope of practice,
or physician to examine and testify on behalf of such person. The court shall
appoint a psychiatrist, psychologist within their scope of practice, or
physician designated by such person or the person's counsel to testify on
behalf of the person in cases where an order for (( shock treatment)) electroconvulsant
therapy is sought.
An order for the administration of antipsychotic medications entered following
a hearing conducted pursuant to this section shall be effective for the period
of the current involuntary treatment order, any succeeding order entered
pursuant to RCW 71.05.320(1), and any interim period during which the person is
awaiting trial or hearing on a new petition for involuntary treatment or
involuntary medication. Upon a request timely filed, a review of any such
medication order shall be conducted by the court at the hearing on a petition
filed pursuant to RCW 71.05.300. If a succeeding involuntary treatment order
is entered pursuant to RCW 71.05.320(2), a person who refuses to consent to the
administration of antipsychotic medications shall be entitled to an evidentiary
hearing in accordance with this section. (e)
Antipsychotic medication may be administered to a nonconsenting person detained
or committed pursuant to this chapter without a court order under the following
A person presents an imminent likelihood of serious harm to self or others; (ii)
Medically acceptable alternatives to administration of antipsychotic
medications are not available, have not been successful, or are not likely to
be effective; and (iii)
In the opinion of the physician with responsibility for treatment of the
person, or his or her designee, the person's condition constitutes an emergency
requiring the treatment be instituted before a judicial hearing as authorized
pursuant to this section can be held. If
antipsychotic medications are administered over a person's lack of consent
pursuant to this subsection, a petition for an order authorizing the
administration of antipsychotic medications shall be filed on the next judicial
day. The hearing shall be held within two judicial days. If deemed necessary
by the physician with responsibility for the treatment of the person,
administration of antipsychotic medications may continue until the hearing is
(8) Not to consent to the administration of antipsychotic medication except as provided in this chapter;
(9) To dispose of property and sign contracts unless such person has been adjudicated an incompetent in a court proceeding directed to that particular issue;
(10) Not to have psychosurgery performed on him or her under any
NEW SECTION. Sec. 6. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.