(a) A person may not administer a psychoactive medication to a patient receiving voluntary or involuntary mental health services who refuses the administration unless:
(1) the patient is having a medication-related emergency;
(2) the patient is younger than 16 years of age, or the patient is younger than 18 years of age and is a patient admitted for voluntary mental health services under Section 572.002 (3)(B), and the patient's parent, managing conservator, or guardian consents to the administration on behalf of the patient;
(3) the refusing patient's representative authorized by law to consent on behalf of the patient has consented to the administration;
(4) the administration of the medication regardless of the patient's refusal is authorized by an order issued under Section 574.106 ; or
(5) the administration of the medication regardless of the patient's refusal is authorized by an order issued under Article 46B.086 , Code of Criminal Procedure.
(b) Consent to the administration of psychoactive medication given by a patient or by a person authorized by law to consent on behalf of the patient is valid only if:
(1) the consent is given voluntarily and without coercive or undue influence;
(2) the treating physician or a person designated by the physician provided the following information, in a standard format approved by the department, to the patient and, if applicable, to the patient's representative authorized by law to consent on behalf of the patient:
(A) the specific condition to be treated;
(B) the beneficial effects on that condition expected from the medication;
(C) the probable health and mental health consequences of not consenting to the medication;
(D) the probable clinically significant side effects and risks associated with the medication;
(E) the generally accepted alternatives to the medication, if any, and why the physician recommends that they be rejected; and
(F) the proposed course of the medication;
(3) the patient and, if appropriate, the patient's representative authorized by law to consent on behalf of the patient is informed in writing that consent may be revoked; and
(4) the consent is evidenced in the patient's clinical record by a signed form prescribed by the facility or by a statement of the treating physician or a person designated by the physician that documents that consent was given by the appropriate person and the circumstances under which the consent was obtained.
(c) If the treating physician designates another person to provide the information under Subsection (b), then, not later than two working days after that person provides the information, excluding weekends and legal holidays, the physician shall meet with the patient and, if appropriate, the patient's representative who provided the consent, to review the information and answer any questions.
(d) A patient's refusal or attempt to refuse to receive psychoactive medication, whether given verbally or by other indications or means, shall be documented in the patient's clinical record.
(e) In prescribing psychoactive medication, a treating physician shall:
(1) prescribe, consistent with clinically appropriate medical care, the medication that has the fewest side effects or the least potential for adverse side effects, unless the class of medication has been demonstrated or justified not to be effective clinically; and
(2) administer the smallest therapeutically acceptable dosages of medication for the patient's condition.
(f) If a physician issues an order to administer psychoactive medication to a patient without the patient's consent because the patient is having a medication-related emergency:
(1) the physician shall document in the patient's clinical record in specific medical or behavioral terms the necessity of the order and that the physician has evaluated but rejected other generally accepted, less intrusive forms of treatment, if any; and
(2) treatment of the patient with the psychoactive medication shall be provided in the manner, consistent with clinically appropriate medical care, least restrictive of the patient's personal liberty.
(g) In this section, "medication-related emergency" and "psychoactive medication" have the meanings assigned by Section 574.101 .
Added by Acts 1993, 73rd Leg., ch. 903, Sec. 1.09, eff. Aug. 30, 1993. Amended by Acts 1995, 74th Leg., ch. 322, Sec. 3, eff. Aug. 28, 1995; Acts 1999, 76th Leg., ch. 1477, Sec. 31, eff. Sept. 1, 1999; Acts 2003, 78th Leg., ch. 35, Sec. 14, eff. Jan. 1, 2004.
