Mentally ill woman loses battle to refuse compulsory treatment

A mentally ill woman has lost a year-long court battle over her right to refuse treatment, with Tasmania’s Chief Justice upholding mandatory treatment orders.

Attorney-General Elise Archer intervened in a case where a woman with schizophrenia fought a court order allowing her to be treated against her will. Picture: NIKKI DAVIS-JONES

A SCHIZOPHRENIC woman has lost a year-long court battle over her right to refuse medical treatment or forced hospitalisation, with the stoush over Tasmania’s mental health consent laws ending after an intervention by the state’s Attorney-General.

The state’s Chief Justice, Alan Blow, this week released his judgment after the controversial case thrashed out issues regarding the “inherent rights, liberty, dignity, autonomy and self-respect” of patients under Tasmania’s Mental Health Act.

The case, involving a woman refusing medication and hospitalised three times in as many months with suicidal ideation, also clarified how the same legislation allows patients to be treated against their will, with their rights and wishes “by no means absolute”.

Last March, the woman’s doctor was granted a six-month treatment order by the state’s Mental Health Tribunal after it heard she was shirking her antipsychotic medication and suffering “distraught and tortured” psychotic relapses.

Supreme Court Judge, Justice Alan Blow

The order allowed the woman to be treated or detained without her informed consent, with the tribunal finding she lacked insight and decision-making capacity and that without treatment, her mental illness was likely to seriously harm her own health or safety or the safety of others.

The woman filed an appeal that the order be discharged, before appealing again when the tribunal agreed to a second doctor’s request to extend compulsory treatment powers until March 2020.

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Chief Justice Blow said the woman “inappropriately” took action against the tribunal, which he said had to act impartially, but noted it was undesirable for her correct opponents, the two doctors, to take part in litigation while also treating her.

“In this case, the Attorney-General has intervened in the proceedings and has acted as the sole contradictor. It was very appropriate for that course to be taken,” he said.

The woman’s lawyer argued several grounds of appeal during a December hearing in Hobart, including that she’d clearly expressed her wishes in a signed document two years prior when she’d been capable of consenting to treatment.

But the Chief Justice upheld a previous finding that while the woman’s wishes must be given weight, they didn’t limit the tribunal’s jurisdiction under the Mental Health Act.

He also rejected claims that it was a battery at common law to force the woman into taking medication against her will and a contravention of Mental Health Act provisions about respecting a patient’s wishes.

Chief Justice Blow said the act clearly gave the tribunal power to make or continue treatment orders that contradicted a patient’s wishes and that legislative requirements respecting the rights and wishes of individuals were “by no means absolute”.

“I am not satisfied (the tribunal) ignored or lost sight of the relevant principles,” he said.

“Rather, it decided to give substantial weight to its conclusion that the appellant was likely to be a risk to herself and others if she were not given antipsychotic medication.”