Forced Medication in Psychiatry: Patients’ Rights and the Law Not Respected by Appeals Board in Denmark

OBJECTIVE: We investigated if the law and the patients’ rights are being respected in Denmark when patients appeal forced medication orders. METHOD: We assessed 30 consecutive cases described on the webpage of the Psychiatric Appeals Board. RESULTS: No clear and convincing evidence was presented in any case that the proposed treatment was in the patient’s best interests. Furthermore, according to Danish law, forced medication should be with drugs with the fewest possible adverse effects, but this condition was violated in 29 of the 30 cases (97%). In seven cases (23%), where the board disagreed with an earlier decision made by the Psychiatric Patients’ Complaints Board and resolved that the conditions for forced treatment with an antipsychotic had not been met, the issues were formal and minor, and the Appeals Board argued, also in these cases, that force was justified because the patient was insane and that the prospect of cure or a significant and decisive improvement in the condition would otherwise be significantly impaired. This view lacks support in reliable science. The board seems mainly to have a cosmetic function, rubber stamping what the psychiatrists want. It focused on uncontroversial issues it could easily check and not on what is important for patients. CONCLUSIONS: Patients’ rights and the law were not being respected. We suggest forced medication be abandoned, in accordance with the United Nations Convention on the Rights of Persons with Disabilities.