Does number determine rationality?
As in Nancy's case (case1), did the police and the intervention unit chose the rationality of her parents because of greater number and hence the psychiatrists at the hospital on the rationality of the parents, police, intervention unit etc...(Cumulative)
Same can be said for Ed’s case when the hospital rationalized (if they ever did from the story) from the sheer number of the wife and the mental health intervention unit staffs.
Is consent static?
People normally take consent to just the verbal consent prior to the act or a signed consent. But as was in the case of Nancy, she initially agreed but as she realized what she was doing she disagreed. Isn't consent dynamic?
Insight (lack of insight = Anosognosia)- Some (psychiatrist and psychologists) argue that if patients are involuntarily admitted to hospital, they must lack insight into their condition. Therefore, they reason that due to this lack of insight such individuals can't/shouldn't decide for themselves (whether they ought to receive medication).
The author asks:-
How would the champions of the position (lack of insight to their condition and hence can't decide on medication) explain the fact that patients who voluntarily admit themselves (having irrefutable insight) are given little say?
The author mentions some cases:
Mills vs. Rogers 1982:-
The Judge stipulates circumstances for medication "involuntarily committed patients might be competent to make treatment decisions - unless a judge determines the patient's competence".
Rogers vs. Commissioner of Dept.of Mental health 1982, 1983:-
Patients can be given antipsychotics despite opposition to medication or without prior court approval to prevent "immediate, substantial and irreversible deterioration of a serious mental illness".
Sell vs. US (2003):-
Federal judges must review evidence before authorizing involuntary medication for the purpose of restoring the defendant's competency.
US vs. Gomez 2004:-
70 %(is sufficient) prediction rate of confidence by the psychiatrist to restore an individual's competency using medication.
I guess after these court rulings you are also asking yourselves-
How can a judge determine competency when psychiatrists have a hard time doing so?
How can we have a cut-off point for determining confidence in medication when we all know that there are variety of medication and even more variability on how our body would breakdown medicine, not to mention variability among humans?