Commitment Proceedings Research Articles

The Right to Treatment: An Enchanting Legal Fiction?

The involuntary confinement of the mentally ill creates disquieting tensions for a society which in other ways of life values the liberty of the individual. Opposing wishes to neglect and to care, to protect and to abandon can be identified in involuntary commitment proceedings; therefore, no conflict-free resolution of the problems inherent in such deprivations of liberty is possible. Recently, in order to mitigate the deprivations suffered, the District of Columbia Circuit Court of Appeals in Rouse v. Cameron' has invoked the principle that individuals so confined have an enforceable to treatment. Some of the possible consequences of this right, however, bring into sharper focus the uneasiness about current practices of involuntary commitment.2 To the extent to which deprivations of liberty for mental illness are increasingly justified on the basis of being in need of treatment, the danger is very real that the right to treatment not only will serve the purpose of improving therapeutic opportunities but also will further support, or even aggravate, existing indiscriminate practices of incarceration on therapeutic grounds. If a right to treatment is to escape this fate, its ambit must be carefully defined, especially once treatment is elevated to a constitutional right.3