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I just finished glancing through the NLJ for Dec. 20-27, 2004, and the editorial on Page 35, “A Deadly Living Will” caught my eye. Is this the same Florida where Governor Jeb Bush helped keep Terri Schiavo on life support, despite her husband’s entreaties and the doctors (and presumably, the hospital’s) best medical advice? Is poor Alice Pinette a (gasp) Democrat, therefore deserving of no intercession on her behalf? I’m still shaking my head here. Jean Bolton Kent, Wash. Professor carl tobias’ opinion piece ["Judicial Nominations: breaking the logjam," NLJ, Jan. 3, Page 27] suggests that President Bush, in an effort to placate Senate Democrats on the Judiciary Committee, should voluntarily diminish his constitutional right and duty to name federal judges. The article completely ignores the minority’s remarkable use of the filibuster process and the fact that each of the nominees, if afforded an up or down vote of the full Senate, would be confirmed. I suggest that the minority reconsider its truculence, afford greater deference to the Constitution and pursue on its own each of the options described by Professor Tobias. Russell Falconer New York As a psychiatrist long interested in providing a reasonable balance between clinical realities and civil liberties for the severely mentally ill, I was encouraged by “Mental health law: States allow courts to force treatment,” by Tresa Baldas [NLJ, Jan. 3, Page 4] reporting that 42 states have enacted laws to permit mandated treatment on an out-patient basis when necessary for certain seriously ill psychiatric patients. But I was discouraged to read the remarks of a “civil rights” attorney that such treatment is “heavy handed” and “without evidence that it will make people’s lives any better or make society any safer.” Those comments ignore mounting evidence of the benefits of assisted outpatient treatment for patients and society. For example, among the first 1,409 persons who received assisted outpatient treatment under Kendra’s Law in New York, 63% fewer experienced hospitalization, 55% fewer had episodes of homelessness, 75% fewer were arrested, and 69% fewer were incarcerated. Fewer hospital stays, less homelessness, fewer arrests and remaining in the community instead of being in jail or prison do qualify as “making people’s lives better.” Studies also show significant reductions in the risk of violence and victimization of the mentally ill so “society is safer” as well. Wisconsin has one of the most progressive mental illness treatment laws in the country. The Wisconsin Supreme Court upheld the law when it was challenged, as have other courts, explaining that “[b]y permitting intervention before a mentally ill person’s condition becomes critical, the legislature has enabled the mental health treatment community to break the cycle associated with incapacity to choose medication or treatment, restore the person to an even keel, prevent serious and potentially catastrophic harm, and ultimately reduce the time spent in an institutional setting.” In Re Dennis H., 647 N.W.2d 851 (Wis. 2002). For years I have been concerned about cases in which the mentally ill are “dying with their rights on”-circumstances where scrupulous concern for patient rights unreasonably overshadowed appropriate concern for the patient’s life. The recent trend toward better balancing the right to be free with the right to be rescued is to be commended because it does afford people who need our help the right to a better life. Lawmakers in Michigan and Florida deserve tremendous credit for using their legislative powers, and wisdom, to build a more compassionate and sensible system of care. (Readers are referred to Donald A. Treffert, “The MacArthur Coercion Studies: A Wisconsin Perspective,” 82 Marq. L. Rev. 759 (Summer 1999) for further reading.) Darold A. Treffert, M.D. Fond du Lac, Wis.

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