Consent, Informed: Rethinking Informed Consent & Competency for Patients with Schizophrenia & Anosognosia

Abstract

Anosognosia is a common symptom of schizophrenia and schizoaffective disorder that renders individuals unable to understand that they are living with a disease. This symptom often leads people to refuse anti-psychotic medication, and may increase an individual’s likelihood of becoming homeless or incarcerated. When courts find individuals to be a danger to others or themselves, states can impose involuntary commitment. When a state grants involuntary commitment, however, a court may find the individual remains competent to refuse medication. This Note argues that documented anosognosia requires a finding of incompetency, whether people are a danger to themselves or not. Science suggests that a person with severe anosognosia lacks the insight to refuse treatment. This Note proposes a novel statutory definition of competency, encompassing the specific needs of people with anosognosia, and grapples with the significant interests at stake in taking away an individual’s right to choose or refuse treatment, including antipsychotic medication.