## Facts

- Faith J. Myers, a long-time mental health patient, was involuntarily committed to the Alaska Psychiatric Institute (API) in February 2003 after concerns raised by her family and neighbors.
- After admission, Myers refused to discuss treatment options with API physicians.
- API petitioned the superior court for authorization to administer psychotropic medication without Myers’s consent.
- Myers challenged the statutory scheme as unconstitutional under Alaska’s liberty and privacy protections, asserting a right to refuse mind-altering medication absent a compelling state interest pursued by the least restrictive means.
- The superior court found Myers lacked capacity to give informed consent and interpreted the governing statute to require approval of API’s proposed medication plan upon a finding of incompetence, without assessing whether the plan was in Myers’s best interests or whether less intrusive alternatives existed.
- The superior court approved the plan but expressed concern that the statutory framework did not allow meaningful judicial testing of the treatment plan’s merits.
- Myers appealed.

## Issues

1. Whether, absent an emergency, Alaska’s liberty and privacy guarantees require an independent judicial determination that involuntary psychotropic medication is in the patient’s best interests and that no less intrusive alternative is available.
2. Whether a statute may constitutionally limit the court’s role to deciding capacity while leaving the decision to medicate entirely to the treating facility once incompetence is found.

## Decision

- The Alaska Supreme Court vacated the order authorizing nonconsensual psychotropic medication and remanded.
- The court held that Alaska’s constitutional guarantees of liberty and privacy recognize a fundamental right of a competent person to refuse psychotropic medication.
- The court concluded that nonemergency forced administration of psychotropic drugs implicates fundamental liberty and privacy interests because such drugs can have profound and lasting effects.
- In the absence of an emergency, a court may not authorize nonconsensual psychotropic medication unless it independently determines:
  - the proposed medication is in the patient’s best interests, and
  - no less intrusive alternative treatment is available.
- The superior court erred by treating the statutory “shall approve” language as eliminating judicial review of best interests and alternatives.

## Legal Principles

- Alaska’s liberty and privacy protections encompass a fundamental autonomy interest in refusing psychotropic medication.
- Nonemergency involuntary psychotropic medication requires independent judicial oversight; a treating facility’s request cannot be rubber-stamped based solely on a finding of incapacity.
- Before authorizing forced medication, the court must find both (1) best interests and (2) the absence of less intrusive alternatives.
- Procedural protections must be sufficiently robust to permit meaningful contest of the proposed treatment, including the ability to present contrary evidence on safety and effectiveness.

## Conclusion

The Alaska Supreme Court held that, outside emergencies, involuntary psychotropic medication may be authorized only after the court independently finds the treatment is in the patient’s best interests and that no less intrusive alternative exists, and it vacated the superior court’s order for failing to make those determinations.


Myers v. Alaska Psychiatric Inst., 138 P.3d 238 (Alaska 2006)