A middle-aged man was involuntarily committed to a state psychiatric hospital because he was considered dangerous to others due to severe paranoid thinking. His violent behavior was controlled only by injectable medications, which were initially administered against his will. He had been declared mentally incompetent, and the decisions to approve the use of psychotropic medications were made by his adult son, who had been awarded guardianship and who held medical power of attorney.

While the medications suppressed the patient's violent agitation, they made little impact on his paranoid symptoms. His chances of being able to return to his home community appeared remote. However, a new drug was introduced into the hospital formulary, which, if used with this patient, offered the strong possibility that he could return home. The drug, however, was only available in a pill form, and the patient's paranoia included fears that others would try to poison him. The suggestion was made to grind up the pill and surreptitiously administer the drug by mixing it in the pudding.

Hospital staff checked with the patient's son and obtained informed consent from him. The "personal values and...personal goals" of the son and other family members were seen to substitute for those of the mentally incompetent patientand these goals included the desire for the patient to live outside of an institution and close to loved ones in the community.

1. In the case study above, do you think the ends justify the means? In other words, does the goal of discharging the patient from an institutional setting into normal community living justify deceiving him?

2. Do you think severely mentally ill people retain any rights "to determine what shall be done with [their] own [bodies]?" Why or why not?IF YOU IDENTIFY A LEGAL ISSUE in the question AND A CASE THAT YOU HAVE READ, THEN determine the legal issue, IDENTIFY THE CASE, and use IRAC analysis

3. To what degree should family members or legal guardians have full capacity to make decisions or give consent on behalf of those under their care?IF YOU IDENTIFY A LEGAL ISSUE in the question AND A CASE THAT YOU HAVE READ, THEN determine the legal issue, IDENTIFY THE CASE, and use IRAC analysis.

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