Psychosurgery

As Modified on Denial of Rehearing Jan. 15, 1988. Involuntary mental health patient brought petition for writ of mandate, on behalf of herself and others similarly situated, seeking determination that patients' informed consent was required before antipsychotic drugs could be administered. The Superior Court, City and County of San Francisco, Raymond D. Williamson, Jr., J., denied the writ. On appeal, the Court of Appeal, Kline, P.J., held that absent judicial determination of incompetency, involuntary mental health patient's informed consent would be required before treatment with antipsychotic drugs.

[1] Mental Health Persons subject to control or treatment

Person is considered civilly “gravely disabled,” and may be involuntarily detained in mental health facility for 72 hours, if peace officer or one of certain specified professionals finds probable cause that person is danger to self or others, or as result of mental disorder, is unable to provide for his basic personal needs of food, clothing or shelter. West's Ann.Cal.Welf. & Inst.Code §§ 5008(h) (1), 5150

Opinion

NOURSE, P.J

.Plaintiff sued for damages for alleged malpractice. At the close of plaintiff's case the trial court granted defendant's motion for non suit. The plaintiff has appealed on a bill of exceptions.

This is the third trial of this cause. The first resulted in a verdict for plaintiff, which was reversed by the Supreme Court on the grounds of insufficient evidence. Nicholasv. Jacobson, 205 Cal. 577, 271 P. 1057. The second trial terminated through the disagreement of the jury.

Plaintiff consulted Dr. L.P. Gilbert for medical attention to a condition resulting from varicose veins. He had previously been operated on by Dr. Ottinger for the same condition, but insisted that the operation had been unskillfully performed and had demanded money damages from Dr. Vecki, under whose direction the Ottinger operation had been performed. Dr. Gilbert took plaintiff to Dr. Jacobson, the defendant, who examined plaintiff and advised an operation. Some few months later plaintiff returned to defendant, submitted to a further examination, ...

A comparatively new technique—prefrontal lobotomy—is now being employed in the treatment of people who are mentally ill. By partially severing the two frontal lobes of the brain from their connection with another part of the brain,spectacular results have been achieved with persons suffering from advanced stages of disabling psychoses. While many such patients have been returned to society or partially relieved of their more distressing symptoms, unfortunate use of these prefrontal lobotomies can so disintegrate a patient's personality as to leave a mere “human vegetable.” The thought-provoking aspect is that the operation is still experimental in theory and technique, and the experimentation must be done on human beings. Thus, a suggestion for some sort of legislation regulating lobotomies comes as no surprise.

This note will consider the feasibility of legislative control over the application of lobotomies to mental cases. Attention will be directed not only to the desirability of limiting use of lobotomies,...

Mental Health

Involuntary treatment or medication

County public guardian's practice of routinely imposing temporary conservatorships including Lanterman–Petris–Short (LPS) Act medical treatment decisional disabilities ex parte violated due process, even though guardian gave notice to conservatees that the disability might be imposed, the notice included contact information for the public defender's and patient's advocate's office, and the conservatees failed to affirmatively object, where the conservatees were unrepresented by counsel or a trained patient's advocate, and they were not informed about the limits of the court's power to impose the disability. U.S.C.A. Const.Amend. 14; West's Ann.Cal.Prob.Code § 2250.2; West's Ann.Cal.Welf. & Inst.Code § 5357(d)..

See Cal. Jur. 3d, Incompetent, Addicted, and Disordered Persons, § 153; Cal. Civil Practice (Thomson Reuters 2011) Probate and Trust Proceedings, § 30:28; 3 Witkin, Cal. Procedure (5th ed. 2008) Actions, § 112.

*1 THE HONORABLE DALE H. FARABEE, M.D. DIRECTOR OF THE DEPARTMENT OF MENTAL HEALTH

THE HONORABLE DALE H. FARABEE, M.D., DIRECTOR OF THE DEPARTMENT OF MENTAL HEALTH, has requested an opinion on the following questions:

1. Does a patients' Advocate, if he is a county mental health employee assigned pursuant to Title 9, California Administrative Code section 860, et seq., have the right of access to the records in all facilities specified in welfare and Institutions Code section 5325, whether the facility is operated under contract with the county (including federal facilities) or is privately operated?

2. Does a Patients' Advocate, who is operating under contract with the county have access to confidential records to the same degree as the county-employed advocate?

3. Does the right of access to records extend beyond the discharge date of the patient? The conclusions are: 1. A patients' advocate has a right of access to records in the

Mental health care in the 1950's was characterized by extreme overcrowding in the hospitals/asylums. This lead to the development and/or overuse of extreme forms of treatment such as the lobotomy, insulin shock and electroshock therapy. The development of psychotropic drugs lead to the elimination or very limited use of these invasive treatments and allowed outpatient care to relieve the overcrowding. Insulin shock therapy...

FACTUAL BACKGROUND

On May 22, 2003, Hoffman presented to the Emergency Medical Department at MMC and was examined and treated by Dr. Tonnemacher, a board certified emergency department physician.2 Defendant's Undisputed Material Fact ("DUMF") No. 1. Hoffman had a fever of 102.3°, a pulse of 126, respiration of 24, a blood pressure of 159/87, and it was reported that Hoffman had a temperature of 106° when she was with the ambulance crew shortly before admission. Plaintiffs Opposition to Undisputed Facts (hereinafter "PODUMF") at p. 6; Tonnemacher Declaration Exhibit A.3 Hoffman was noted to have a medical history of hypertension, hypothyroidism, Hodgkin's lymphoma, a prior splenectomy, and a heart murmur at the time of her admission. Id.; Tonnemacher Declaration at ¶ 4. The medical records indicate that Hoffman's chief complaints were chills with hyperventilation, nasal congestion, cough, chest pain, and numbness in her hands.4 PODUMF at p. 6; Tonnemacher Declaration at ¶ 4 & Exhibit A....

In June 2000, Mr. Jerden was referred to Dr. Amstutz, who was called upon to evaluate an unknown illness. After examining MRI reports of Mr. Jerden, Dr. Amstutz made a diagnosis that Mr. Jerden had a brain tumor and recommended a craniotomy. On July 10, 2000, Dr. Amstutz performed a craniotomy on Mr. Jerden, who was thereafter correctly diagnosed with multiple sclerosis based on pathology analysis of the brain tissue removed during the operation.

Plaintiffs, in their action for medical negligence, asserted that a less invasive biopsy would have had fewer physical implications and would have allowed a greater possibility of recovery from the effects of the plaques formed in the brain by the demyelination associated with multiple sclerosis. Plaintiffs alleged that Defendant failed to review adequately the diagnostic MRI reports, radiology reports, and Mr. Jerden's medical history and symptoms, which indicated signs of...