Medical and judicial perceptions of the risks associated with use of antipsychotic medication.

H. Bursztajn, B. Chanowitz, E. Kaplan, T. G. Gutheil, R. M. Hamm and V. Alexander,
Bull. Amer. Acad. Psychiatry & the Law 19(3): 271-5, 1991.
To determine whether occupational perspective influences the decision to prescribe antipsychotic medications, we presented a group of psychiatrists and judges with a hypothetical case involving a potentially psychotic patient. The subjects were asked what probability of drug-induced tardive dyskinesia they would accept in order to prevent psychotic decompensation. The subjects were then asked to estimate the actual probability that tardive dyskinesia would occur if the patient received antipsychotic medications. From the responses to these questions we inferred their treatment decisions. Although the psychiatrists and judges agreed on an acceptable level of risk, they differed significantly in their estimates of the actual risk involved and, by inference, their decisions concerning treatment. Our findings have several implications for adjudication of cases involving treatment decisions and the right to refuse treatment.