The article presents a complex history of the disordered development of the to antipsychotic drugs and attempts to analyze the complex legal, medical, and ethical issues involved. The article begins by describing the dual nature of the medication in providing therapeutic benefits while posing a substantial risk of hazardous side effects. After depicting the circumstances which led to the initial right to refuse litigation, the article analyzes the various legal grounds on which courts have based the to refuse. Even when based on a constitutional source, the to is not absolute. The must be balanced against the government's reasons for infringement. The article examines this balancing process by taking into account the private interests at stake, the level of intrusiveness presented by antipsychotic drugs, and the government's objectives behind forced treatment.The article addresses the two governmental interests which are used to justify forced medication. First, the government’s police power interest in preventing a mentally ill individual from harming himself or others is explained. Second, the government’s parens patriae interest in caring for those individuals who are unable to care for themselves is examined. A traditional precondition to forced treatment based on the parens patriae authority is a finding that the patient is incompetent to make his own treatment decisions. The article examines the concept of competency and describes recent medical research which documents that many drug refusals by mentally ill individuals are the product of rational and considered decisions. An emergency exception to the competency limitation on the parens patriae authority is also discussed. In addition, the article addresses whether the least restrictive alternative doctrine is applicable as another restriction on the government's ability to compel treatment under either the police power or the parens patriae authority. Next, the issue of procedural due process is addressed. The article describes the various models of procedural review adopted by courts in refusal cases, ranging from the implementation of a full array of due process procedures to unqualified deference to institutional decision making. A detailed analysis of the appropriateness of these review systems is undertaken.Finally, the article analyzes the substantive and procedural components of the United States Supreme Court's recent opinion on the refusal issue in Washington v. Harper. Although this decision is limited to a convicted prisoner’s to antipsychotic drugs, its interpretation could impact thousands of mentally ill and developmentally disabled individuals confined in civil institutions.In addition, as one commentator noted, the ramifications of Harper could extend to even larger numbers of individuals residing in the community who are released from civil hospitals, diverted from the criminal justice system, or paroled from prison, on the basis that they accept treatment as a condition of their release. The article, therefore, concludes by examining the potential effects of the Harper decision on the of an individual to antipsychotic drugs outside the prison environment. This examination includes an analysis of the Supreme Court's recent opinion in Riggins v. Nevada in which the Court addressed the of a pretrial detainee to the administration of antipsychotic drugs.

Emotions abound when encountering a newborn with disabilities which will inevitably lead to an early death or to a less than whole and healthy life. It is especially painful when such disabilities were preventable. Anger swells, fingers are pointed, fault is assigned, initiatives are promised, tears are shed. To seek to assure that more humans are born with sound minds and healthy bodies seems as American as apple pie. Governmental efforts appear appropriate. For several years in the 1990s, an often heated and impassioned rational debate focused on the legal treatment of disabilities attributable to prenatal drug or alcohol use. What, if anything, may and should governments do to limit such disabilities? What non-financial constraints, if any, operate when such a mission is undertaken? And, as our understanding of the causes and cures of such disabilities grows, what in fact have we been doing? This paper addresses these questions, dwelling particularly on coercive laws designed to protect potential human life. It will be urged first that the widespread view that Roe v. Wade bars significant governmental protection of the unborn is misguided; that the case, in fact, suggests there are a variety of legitimate avenues for protective efforts (whether or not the unborn are deemed persons); and, that in the years since Roe, there have been many noteworthy initiatives. Recent reforms include coercive laws seeking to reduce drug or alcohol-related birth disabilities. Such laws require close scrutiny due to the constitutional interests of mothers. After generally reviewing contemporary initiatives on behalf of the unborn, efforts in Winnebago County, Illinois are examined in detail. These inquiries will reveal some of the difficulties with state protection of potential human life. Sexually discriminatory initiatives, as well as inconsistent enforcement of state policy, are noted. Suggestions for change are offered, including the view that the arming of the pregnancy policy should not be limited to an arsenal used only against pregnant women, but should encompass arms against all who act against the unborn. These are not outlandish concoctions, though called so by Professor Roberts in the Harvard Law Review.