(a) A person may not administer a psychoactive medication to a client receiving voluntary or involuntary residential care services who refuses the administration unless:
(1) the client is having a medication-related emergency;
(2) the refusing client's representative authorized by law to consent on behalf of the client has consented to the administration;
(3) the administration of the medication regardless of the client's refusal is authorized by an order issued under Section 592.156 ; or
(4) the administration of the medication regardless of the client'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 client or by a person authorized by law to consent on behalf of the client 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 provides the following information, in a standard format approved by the department, to the client and, if applicable, to the client's representative authorized by law to consent on behalf of the client:
(A) the specific condition to be treated;
(B) the beneficial effects on that condition expected from the medication;
(C) the probable health care 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 client and, if appropriate, the client's representative authorized by law to consent on behalf of the client are informed in writing that consent may be revoked; and
(4) the consent is evidenced in the client's clinical record by a signed form prescribed by the residential care 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 client and, if appropriate, the client's representative who provided the consent, to review the information and answer any questions.
(d) A client's refusal or attempt to refuse to receive psychoactive medication, whether given verbally or by other indications or means, shall be documented in the client'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 client's condition.
(f) If a physician issues an order to administer psychoactive medication to a client without the client's consent because the client is having a medication-related emergency:
(1) the physician shall document in the client'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 client with the psychoactive medication shall be provided in the manner, consistent with clinically appropriate medical care, least restrictive of the client's personal liberty.
Added by Acts 2013, 83rd Leg., R.S., Ch. 504 (S.B. 34 ), Sec. 3, eff. September 1, 2013.
