NOTE: The Citizens Commission on Human Rights does not provide legal or medical advice. The information below is provided as a public service regarding the laws and regulations that can be reviewed with an attorney so action can be taken as appropriate.

There are certain rights for anyone regarding accepting or refusing any mental health treatment that has been suggested, prescribed, or ordered. Acceptance of mental health treatment, including drugs is nearly always voluntary. (In this document, CCHR is not providing any view regarding inoculations or vaccines given to active duty personnel, which may or may not be mandatory.)

Active duty military personnel have a right to informed consent before accepting treatment, as well as a right to refuse treatment if they disagree with such. The concept of “informed consent” means the right to:

• Full and honest information on all the risks of any proposed psychiatric treatment (information about the adverse effects of psychotropic medications can be gotten at cchrint.org/psychiatrydangers);
• Full and honest information on all risks of all alternative treatments;
• Full and honest information on all risks and benefits of no treatment at all. Based on this information, military personnel can then make an informed decision on what treatment is best.

Thus, they can take an informed decision on what treatment is best. And in case informed consent is refused, they have the right to seek the advice of an attorney. According to Department of Defense Instruction, Number 6000.14, September 26, 2011, entitled, “DoD Patient Bill of Rights and Responsibilities in the Military Health System (MHS),” military personnel are entitled to informed consent for any treatment and to refuse to receive treatment. That regulation states, in part, under the section, “PATIENT RIGHTS”:

“f. Informed Consent

“Patients have the right to any and all necessary information in non-clinical terms to make knowledgeable decisions on consent or refusal for treatments, or participation in clinical trials or other research investigations as applicable. Such information is to include any and all complications, risks, benefits, ethical issues, and alternative treatments as may be available.”

One should demand to be provided with easily understood information about all adverse reactions and side effects of psychotropic drugs, including the potential to alter behavior to such an extent as to cause violent or suicidal thoughts or behavior, and that withdrawal from such medication without medical supervision may exacerbate those thoughts and behavior. Enclosure 3 of the same regulation, under Procedures and MHS Compliance Guidelines states:

“d. Participation in Treatment Decisions. Each MTF/DTF [Medical/Dental Treatment Facility] shall ensure that MHS [Mental Health System] beneficiaries have the right and opportunity to participate fully in all decisions related to their healthcare, subject to readiness requirements for active duty Service members.

“(1) To the extent practical, MTF/DTF and TRICARE [Healthcare program of the United States Dept. of Defense Military Health System] Prime network healthcare professionals shall:

“(a) Provide patients with easily understood information and the opportunity to decide among treatment options consistent with the informed consent process.

“(b) Discuss all treatment options, including the option of no treatment at all with a patient in a culturally sensitive manner.

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“(e) Discuss all risks, benefits, and consequences to treatment or non-treatment.

“(f) Give competent patients the opportunity to refuse treatment and to express preference about future treatment.”

In an unusual case, the military doctor or commander may seek to override the active-duty soldier’s refusal to consent to treatment, but it must be done through medical board proceedings which provide various due process rights to the soldier. Soldiers need to ensure they review these regulations with a chaplain (because a soldier may refuse mental health treatment for religious reasons), an attorney or other advocate so that they can take the correct action for their situation.

[Note: One should seek attorney advice about filing any complaint to the Medical Board to ensure his rights are fully protected.]

Army Command Policy—600-20 Rapid Action Revision (RAR) Issue, 20 September 2012, addresses a refusal of a soldier to submit to medical or mental treatment. It indicates that if the military doctor insists upon the treatment and the soldier refuses, the matter is sent to a Medical Board proceeding. There, the soldier may contest the treatment order and the matter will be heard and then decided upon. He should ensure he seeks attorney advice if requesting a Medical Board adjudication.

Should the soldier disagree with the Medical Board’s recommendation, the soldier may appeal to the Surgeon General, and even if the Surgeon General agrees with the Medical Board, if the soldier continues to refuse, he or she may request or be subject to a court martial, including a full legal defense.

As noted above, treatment is nearly always voluntary. But military members should be aware of their rights so that they are not convinced by innuendo or suggestion that they may not refuse unwanted mental health treatment. And should they stand their ground and refuse such treatment in spite of orders from mental health practitioners, they must be aware of and granted the right of refusal mentioned above.

FOR VETERANS

For veterans of the armed services, there is no permissible enforced treatment.

Some veterans are concerned about losing their benefits if they refused psychiatric treatments recommended to them from a VA hospital or VA clinic. The code is unclear whether this could happen, but it would be grossly inappropriate if it did. In such a case, you could bring the matter to the attention of an attorney or your Congressional representative.

Per 38 CFR 17.107, “VA response to disruptive behavior of patients”, this section states:

“Although VA may restrict the time, place, and/or manner of care under this section, VA will continue to offer the full range of needed medical care to which a patient is eligible under Title 38 of the United States Code or Code of Federal Regulations. Patients have the right to accept or refuse treatment or procedures, and such refusal by a patient is not a basis for restricting the provision of care under this section.”

You should obtain advice from the VA regarding this. If their advice is unsatisfactory to you, seek legal advice.