Psychiatric Advance Directives

Do you want to be treated over your own objection?

There may be times when you are very ill in which you could fear or refuse treatment that normally you would find acceptable. In a hospital, with the consent of your health care agent or someone else appointed to make decisions for you, you can be treated over your own objection. In an emergency situation, however, it is important to understand that doctors have the authority to make decisions that are necessary to ensure your safety and that of other patients and hospital staff.

You can express your wishes about being treated over your own objection in your psychiatric advance directive. You may decide that you should be able to refuse treatment, even when you are very ill. In that case, you would choose to make your advance directive revocable. This means that if your state law allows it, you can reserve the right to cancel your advance directive even during a mental health crisis. This must be stated in writing. However, if you choose to revoke your advance directive, your agent will no longer be able to advocate for you. Before you decide whether to make your advance directive revocable, you should thoroughly discuss this with your friends, family and health care professionals and an attorney (lawyer) that is knowledgeable about these issues.

You may also decide to make your psychiatric advance directive irrevocable, and that it is best that you be treated according to your psychiatric advance directive, even if you object at the time. Your advance directive cannot be revoked by you while you lack capacity to make decisions, even if you object to treatment at the time. You can include a statement giving your agent the responsibility to make health care decisions for you, even over your objections.

The statement that you allow treatment over your own objection is sometimes known as a "Ulysses clause."