Incompetence, treatment refusal, and hospitalization.

Psychiatrists have proposed broadened commitment statues based on need for care and treatment, and under which judges have no role in deciding cases of treatment refusal. The mental health bar has consistently opposed these proposals on constitutional and common law grounds. The authors propose new commitment criteria based on incompetency to decide about hospitalization, and inability to live safely in freedom. The proposed standards would meet the Constitutional requirements, and would permit hospitalization and/or treatment for many persons who are in need but who now go without. The authors recognize that new commitment law without adequate clinical resources will not greatly improve patient care.