Forensic topics are discussed in relation to the right to refuse treatment among involuntary hospitalized patients. A clinical case is reported emphasizing the medical and legal dilemmas which the psychiatrist has to cope with. Different legal procedures are examined and their deficiencies discussed; the right to refuse treatment is discussed with reference to recent cases heard in the U.S., The Charter of Rights of the Canadian Constitution 1981 and the "Charte des droits de la personne du Québec". The recommended solution in cases of treatment refusal among involuntary patients centers on the judiciary determination of incompetency of such patients.