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This elective provides the student with an opportunity to undertake in-depth scholarly study of some of the critical legal issues involving persons with mental disabilities.

There will be a general overview of mental disability law and a review of some of the major cases affecting mental health services. The elective will focus on three issues: 1) the role of the psychiatrist in the implementation of the death penalty, such as participation in the insanity defense, competency to stand trial, testimony concerning fitness to be executed; 2) the effect of the major "patients' rights" lawsuits on the quality of state mental health services, the impact of landmark court decisions in improving institutional conditions, and Supreme Court case law that sets out a standard for violation of constitutional rights in institutions and assesses the impact that such suits may have had directly or indirectly on the quality of care in state institutions; and 3) the development and implementation of the right to refuse psychotropic medication in Illinois and other states, with emphasis on major cases defining such a right as well as studies on the impact of such a right on the delivery of mental health services.

Each issue will be examined with emphasis on the interaction between law and psychiatry. The death penalty cases involve a potential moral dilemma of a psychiatrist asked to perform an evaluation and thereby become part of a legal process he or she may find objectionable. The institutional quality cases show the effect of law on public policy, both on the state bureaucracy as well as on the daily treatment and living conditions of the patients. The right to refuse cases are the paradigm of a conflict between the "medical model" and the "rights model" in mental health service delivery.

As a result of participating in this elective and by using assigned cases [e.g., Youngberg v. Romeo, 457 U.S. 307 (1972), Wyatt v. Stickney, 344 F Supp. 373 (MD Ala. 1972)] and readings, which may include Michael L. Perlin, Law and Mental Disability (1994), John Q. LaFond, Back to the Asylum (1992); and David B. Wexler and Bruce J. Winick, Essays in Therapeutic Jurisprudence (1992), the student will be able to:

Discuss the development of mental disability law in the areas of civil commitment, a right to treatment in the least restrictive environment, and rights in institutions.
Describe the constitutional rights asserted as the basis for increased procedural rights in civil commitment, the right to treatment, and the right to refuse treatment.
Describe the legal criteria for insanity and fitness to stand trial and to be executed in capital crimes.
Discuss the case law involving psychiatric evaluation for aggravating and mitigating circumstances in death penalty cases.
Outline some effects of lawsuits involving patients rights on the delivery of mental health services, at both a statewide and hospital level.
Discuss the constitutional and statutory bases for a right to refuse treatment for patients in mental health facilities.
Discuss the clinical aspects of a right to refuse treatment.
Outline the effects of implementing the right to refuse treatment in state operated facilities in Illinois.

Evaluation will consist of daily participation in seminar sessions, oral assessment of assigned readings, and performance on an essay examination covering material studied during the course of the elective.

Completion of all third-year clerkships
Enrollment in the M.D./J.D. Dual Degree Program

Faculty Responsible for Elective	David E. Goldman, D.O., J.D. Psychiatrist/Attorney Goldman Group, LLC 4000 Westgate Springfield, IL 62707
Telephone	217/793-3200
Additional Faculty	Theodore R. LeBlang, J.D. tleblang@siumed.edu
Enrollment Maximum number of students	4 per experience
Schedule	1 week; Full-time
Credit Hours	1 non-clinical credit awarded

MD/JD Electives
Medical Humanities Electives