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This article argues that, if the MacArthur Treatment Competence Study (e.g., P. S. Appelbaum and T. Grisso, Grisso et al, and Grisso and Appelbaum; see records 82:39258, 82:35494, and 82:37814, respectively) is to be meaningfully operationalized, it is necessary to consider the ways that counsel is provided in individual cases to institutionalized individuals wishing to assert the right to refuse antipsychotic drug treatment. It looks at the role of counsel in individual right to refuse cases, examines the ways that counsel is assigned in 3 states, and considers the underlying questions through the filters of "sanism" and "pretextuality." It concludes that the issues of the availability and competence of counsel must be addressed by policy makers if the goals of the MacArthur study are to be met.


Special Theme: A Critical Examination of the MacArthur Treatment Competence Study: Methodological Issues, Legal Implications, and Future Directions