Despite their importance, the discussion of remedies for state hospital drugging has been largely ad hoc and uninformed. This study attempts to fill that gap. It explores four such remedies, attempting to identify the vision of the drug problem that underlies each one; to evaluate that vision and its plausibility; and to determine what the actual effects of imposing the remedy would be. Part I distinguishes between two approaches to remedy-"structural" and "atomistic"-and, as a basis for testing the two, describes a state hospital's handling of the most serious drug side effect. Part II explores a family of atomistic remedies. Part III explores a rather different kind of atomistic remedy, one which conditions drugging on either the patient's competent consent or, assuming the patient is incompetent, on the prosecution of full-fledged incompetency proceedings and the subsequent consent of a guardian. Part IV discusses a structural remedy that looks beyond the narrow confines of the state doctor-patient relationship and uses commitment hearings as a vehicle for ensuring that post-commitment drugging comports with high medical standards. Although an elegant and internally coherent scheme, I argue that it imposes an untenable choice on society in practice and will prove futile or worse in operation. Part V analyzes another structural remedy, though one with a different vision of the problem and a different solution to it. In Rennie v. Klein, the district judge developed an elaborate procedural system to address what he perceived to be the organizational root of state hospital drugging excesses. This section attempts to show, however, that the theory underlying this solution to the problem is mistaken and that, as a result, the system simply did not work when put into place.
Sheldon Gelman, Mental Hospital Drugging - Atomistic and Structural Remedies, 32 Clev. St. L. Rev. 221 (1983-1984)