Rogers v. Okin
| Decision Date | 29 October 1979 |
| Docket Number | CA 75-1610-T. |
| Citation | 478 F. Supp. 1342 |
| Parties | Rubie ROGERS, Willie Wadsworth, Donna Hunt, James Colleran, Harold Warner, Elizabeth Bybel, Able Bolden, for themselves and on behalf of all persons similarly situated, Plaintiffs, v. Robert OKIN, M.D., Commissioner of the Department of Mental Health of the Commonwealth of Massachusetts, Richard Kahn, M.D., William Malamud, M.D., David Seil, M.D., Michael Gill, M.D., Elliot Schildkrout, M.D., Sanford Pomerantz, M.D., Jean Turnquest, M.D., Allan Siegel, Eugene Cacciola, M.D., Brian Mazmanian, M.D., Michael Osborne, M.D., John Szlyk, M.D., William Kantar, M.D., John Goodman, M.D., Defendants. |
| Court | U.S. District Court — District of Massachusetts |
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Greater Boston Legal Services, Roxbury, Mass., Richard W. Cole, Robert Burdick, Mary Ashbury, and Shubow, Stahlin & Bergstresser, Inc., Clyde D. Bergstresser, Boston, Mass., for plaintiffs.
Marvin C. Guthrie, Needham, Mass., for guardian ad litem.
Powers & Hall, Douglas Danner, Spencer J. Dreischarf, Marcia Sneden, Boston, Mass., for defendants Drs. William Malamud, Brian Mazmanian, Eugene Cacciola, Jeffrey Goldbarg, John Goodman, Michael Osborne, Sanford Pomerantz and Jean Turnquest.
Francis X. Bellotti, Atty. Gen., Stephen Schultz, Leah S. Crothers, Asst. Attys. Gen., Boston, Mass., for defendants Drs. Michael Gill, William Kantar, John Szlyk, Elliot Schildkrout, David Seil, Richard Kahn, William Malamud, Allan Siegel, Brian Mazmanian, Sanford Pomperantz, Jean Turnquest and Robert Okin.
Finnerty & Finnerty, John F. Finnerty, Jr., Boston, Mass., for Dr. Michael Gill.
Ficksman & Conley, David M. Gould, Boston, Mass., for Drs. John Szlyk, Richard Kahn and Allan Siegel.
Martin, MaGunson, McCarthy & Kenney, Charles Reidy, III, Raymond J. Kenney, Jr., Boston, Mass., for Drs. Elliot Schlidkrout, John Goodman, Jeffrey Goldbarg, Eugene Cacciola and Michael Osborne.
OPINION
This class action involves a multi-faceted attack against certain medication and seclusion policies allegedly followed at the May and Austin Units of the Boston State Hospital (Hospital), a state institution for the mentally ill. The named plaintiffs, all either voluntary or involuntary patients at one time or another at these facilities, seek injunctive relief for the class,1 and award of money damages for themselves.
Plaintiffs' basic grievance is that the defendants, all of whom have served on the Hospital staff, maintained policies of forced medication and involuntary seclusion in non-emergency circumstances. Plaintiffs allege that these policies infringed on the constitutional rights of Hospital patients. In addition, they allege that such policies violated standards of acceptable medical care.
With respect to the challenged medication practices, plaintiffs theorize that, although they have a right to receive treatment when confined at a state mental institution, they, nonetheless, have a constitutional right to refuse such treatment. Plaintiffs acknowledge, however, that their asserted right to refuse treatment is not absolute, and must yield to the Hospital's right to impose treatment in order to protect their safety or that of other patients and Hospital staff. Absent such emergency circumstances, plaintiffs maintain they are competent to decide whether or not to receive certain treatment, and that their decisions must be respected by Hospital staff.
As for the seclusion issue, plaintiffs maintain that state law permitted defendants to restrain patients in seclusion rooms only when there was a substantial threat of physical harm to patients or staff.2 Plaintiffs allege that, notwithstanding such statutory proscription, defendants routinely employed seclusion as a treatment modality, and not merely as an emergency restraint.
The defendants have primary and fall back positions with respect to plaintiffs' allegations and claims. Their fundamental defense is that patients committed to a state mental institution, whether voluntary or involuntary, are incompetent to make treatment choices. Defendants assert that mental patients are committed to mental hospitals for treatment, and that the state has a parens patriae obligation and right to provide that treatment, even in the face of opposition by the patient. In short, defendants argue that committed mental patients3 have no constitutional right to refuse treatment in either an emergency or non-emergency situation. Defendants concede, however, that any treatment provided must be consistent with reasonably accepted standards of medical practice.
In addition to their legal contention, defendants offer a factual defense to plaintiffs' medication claims. They maintain that none of the named plaintiffs was forcibly medicated in a non-emergency. Moreover, defendants assert that no patient at the Hospital was forcibly medicated unless there was at least a "psychiatric emergency," a term they define as the foreseeable deterioration of the patient absent medication.
Concerning the seclusion issue, defendants concede that M.G.L.A. ch. 123, § 21 is the controlling standard. They maintain, however, that no patient was secluded in violation of that standard.
The examination of these medication and seclusion issues involved 72 trial days, more than 8,000 pages of transcript and over 2,300 pages of post-trial briefs. The findings and conclusions of this court concerning these issues are set forth below.
This action was commenced on April 27, 1975, when several patients at the May and Austin Units...
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...altering in that they act upon thought processes. (Guardianship of Roe (1981) 383 Mass. 415, 421 N.E.2d 40, 52-53; Rogers v. Okin (D.C.Mass.1979) 478 F.Supp. 1342, 1360 affd. in part, reversed in part (1st Cir.1980) 634 F.2d 650; vacated Mills v. Rogers (1982) 457 U.S. 291, 102 S.Ct. 2442, ......
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