Excerpt from the New York Times (article below):
He said he had come to the emergency room to preach. I encouraged him to check into the hospital for care. He refused, and I considered my options. I could allow him to leave, or I could admit him involuntarily. I knew, though, that if we gave him antipsychotic medication, he would realize that he was a homeless man with AIDS. Would he rather stay a prophet? Did he have the right to choose psychosis? Did I have the right to choose for him?
Psychosis refers to an experience of reality that is fundamentally different from the reality of others. As doctors, we expect those with psychosis to realize that their reality is false, and to agree that they need treatment. Perhaps unsurprisingly, they often don’t, exhibiting what we refer to as “lack of insight.”
The article proposes letting the patient decide. That seems appropriate, unless they are violent in the Psychotic state. However, the patient usually chooses by them-self whether or not to take the medication at home.
peace - John