Ms Myers's second expert specifically testified that Zyprexa, despite being "widely prescribed," was a "very dangerous" drug of "dubious efficacy." He based his testimony on a "methodological analysis" of the studies that led to the approval of Zyprexa by the FDA.
At the end of the hearing, the lower court found that Ms Myers "lacked . . . insight into her own condition" and did "not appreciate that she suffers from a mental disorder."
Although the court noted that Ms Myers understood the debate about the advisability of medication and had articulated a "reasonable objection to the proposed medication," the court nonetheless ruled that she lacked the capacity to make informed decisions regarding her treatment.
Construing the statutes as not allowing it to make a determination of Ms Myers's best interests, the court did not consider her expert evidence on the point and authorized the API to administer the drugs based on its own assessment of Ms Myers's best interests.
The court did note that it found Ms Myers's case "troubling," so much so that it issued an additional order addressing in detail the arguments presented by the parties in pre-hearing briefs. In the order, the court found it troubling that Alaska's statutory scheme prevented it from considering the merits of API's treatment plan, or weighing the objections of Ms Myers's experts.
Because it believed that the statute limited the court's role "to deciding whether Ms. Myers has sufficient capacity to give informed consent," the court felt constrained to adhere to its meaning but emphasized that it found the limitation problematic stating:
"Where a patient, such as Ms. Myers, has a history of undergoing a medical treatment she found to be harmful, where she is found to lack capacity to make her own medical decisions and a valid debate exists in the medical/psychiatric community as to the safety and effectiveness of the proposed treatment plan, it is troubling that the statutory scheme apparently does not provide a mechanism for presenting scientific evidence challenging the proposed treatment plan."
On appeal, Ms Meyers argues that the provisions governing authorization of treatment with psychotropic medications violate the Alaska Constitution's guarantees of liberty and privacy and the Supreme Court agrees.
"In our view," the Court wrote, "before a state may administer psychotropic drugs to a non-consenting mentally ill patient in a non-emergency setting, an independent judicial best interests determination is constitutionally necessary to ensure that the proposed treatment is actually the least intrusive means of protecting the patient."
In reaching its decision, the Court noted that Alaska law recognizes and addresses a distinct class of drugs called "psychotropic medications."
"Because psychotropic medication can have profound and lasting negative effects on a patient's mind and body," the Court said, "Alaska's statutory provisions permitting nonconsensual treatment with psychotropic medications implicate
fundamental liberty and privacy interests."
The right to choose or reject medical treatment, the Court noted, finds its source in the fundamental guarantees of liberty and privacy. "The constitution itself requires courts, not physicians," the Court noted, "to protect and enforce these guarantees."
Psychotropic drugs, the Court said, "affect the mind, behavior, intellectual functions, perception, moods, and emotions" and are known to cause a number of potentially devastating side effects.
"Side effects aside," it stated, "the truly intrusive nature of psychotropic drugs may be best understood by appreciating that they are literally intended to alter the mind."
Under Alaska law, when the state files its petition to authorize psychotropic medication, a "visitor" must be appointed to assist the court when it considers the petition.
The visitor has a duty to provide information on two issues: first, the visitor must evaluate the patient's present condition by administering a "capacity assessment"; second, the visitor must conduct a search for any prior "expressed wishes of the patient regarding medication."
At the end of the hearing, the lower court found that Ms Myers "lacked . . . insight into her own condition" and did "not appreciate that she suffers from a mental disorder."
Although the court noted that Ms Myers understood the debate about the advisability of medication and had articulated a "reasonable objection to the proposed medication," the court nonetheless ruled that she lacked the capacity to make informed decisions regarding her treatment.
Construing the statutes as not allowing it to make a determination of Ms Myers's best interests, the court did not consider her expert evidence on the point and authorized the API to administer the drugs based on its own assessment of Ms Myers's best interests.
Because it believed that the statute limited the court's role "to deciding whether Ms. Myers has sufficient capacity to give informed consent," the court felt constrained to adhere to its meaning but emphasized that it found the limitation problematic stating:
"Where a patient, such as Ms. Myers, has a history of undergoing a medical treatment she found to be harmful, where she is found to lack capacity to make her own medical decisions and a valid debate exists in the medical/psychiatric community as to the safety and effectiveness of the proposed treatment plan, it is troubling that the statutory scheme apparently does not provide a mechanism for presenting scientific evidence challenging the proposed treatment plan."
On appeal, Ms Meyers argues that the provisions governing authorization of treatment with psychotropic medications violate the Alaska Constitution's guarantees of liberty and privacy and the Supreme Court agrees.
"In our view," the Court wrote, "before a state may administer psychotropic drugs to a non-consenting mentally ill patient in a non-emergency setting, an independent judicial best interests determination is constitutionally necessary to ensure that the proposed treatment is actually the least intrusive means of protecting the patient."
In reaching its decision, the Court noted that Alaska law recognizes and addresses a distinct class of drugs called "psychotropic medications."
"Because psychotropic medication can have profound and lasting negative effects on a patient's mind and body," the Court said, "Alaska's statutory provisions permitting nonconsensual treatment with psychotropic medications implicate
fundamental liberty and privacy interests."
The right to choose or reject medical treatment, the Court noted, finds its source in the fundamental guarantees of liberty and privacy. "The constitution itself requires courts, not physicians," the Court noted, "to protect and enforce these guarantees."
Psychotropic drugs, the Court said, "affect the mind, behavior, intellectual functions, perception, moods, and emotions" and are known to cause a number of potentially devastating side effects.
"Side effects aside," it stated, "the truly intrusive nature of psychotropic drugs may be best understood by appreciating that they are literally intended to alter the mind."
Under Alaska law, when the state files its petition to authorize psychotropic medication, a "visitor" must be appointed to assist the court when it considers the petition.
The visitor has a duty to provide information on two issues: first, the visitor must evaluate the patient's present condition by administering a "capacity assessment"; second, the visitor must conduct a search for any prior "expressed wishes of the patient regarding medication."
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