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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 414RIGHTS AND PROTECTIONS OF PERSONS RECEIVING MENTAL HEALTH SERVICES
SUBCHAPTER ICONSENT TO TREATMENT WITH PSYCHOACTIVE MEDICATION--MENTAL HEALTH SERVICES
RULE §414.403Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise:

  (1) Capacity--A patient's ability to:

    (A) understand the nature and consequences of a proposed treatment, including the benefits, risks, and alternatives to the proposed treatment; and

    (B) make a decision whether to undergo the proposed treatment.

  (2) Imminent--Ready to take place within seconds.

  (3) Informed consent--Consent given by a person or the person's legally authorized representative when each of the following conditions have been met:

    (A) Comprehension of information. The person giving the consent has been provided the information outlined in §414.404 of this title (relating to Information Required To Be Given) and has the capacity to give consent; and

    (B) Voluntariness. The consent has been given voluntarily.

  (4) Legally authorized representative (LAR)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, who may be a parent, guardian, or managing conservator of a minor, the guardian of an adult, or the legal representative of a deceased individual.

  (5) Medication class--A group of medications with similar actions and indications for use, as outlined in the department's most recent "Classes of Psychoactive Medications Determined by the Texas Department of Mental Health and Mental Retardation." A copy of which may be obtained by contacting TDMHMR, Office of Office of the Medical Director, P.O. Box 12668, Austin, TX 78711-2668, or the TDMHMR website, www.mhmr.state.tx.us.

  (6) Mental health facility--A facility that can provide 24-hour residential and psychiatric services and that is:

    (A) a TDMHMR mental health facility that is a state hospital or state center operated by the Texas Department of Mental Health or Mental Retardation (TDMHMR);

    (B) a psychiatric hospital licensed under Texas Health and Safety Code, Chapter 577, and Chapter 134 of this title;

    (C) an identifiable mental health service unit of a hospital licensed under Texas Health and Safety Code, Chapter 241, and Chapter 133, Subchapter A of this title;

    (D) a crisis stabilization unit (CSU) licensed under THSC, Chapter 577, and Chapter 134; or

    (E) a facility operated by a local mental health authority or under contract to a local mental health authority.

  (7) Minor--A person under 18 years of age who is not and has not been married or who has not had his or her disabilities of minority removed for general purposes.

  (8) Order for temporary or extended mental health services--A court-ordered commitment to mental health services Texas Health and Safety Code, §574.034 or §574.035.

  (9) Psychiatric emergency--A situation in which, in the opinion of the physician, it is immediately necessary to administer medication to ameliorate the signs and symptoms of a patient's mental illness and to prevent:

    (A) imminent probable death or substantial bodily harm to the patient because the patient:

      (i) is threatening or attempting to commit suicide or serious bodily harm; or

      (ii) is behaving in a manner that indicates that the patient is unable to satisfy the patient's need for nourishment, essential medical care, or self-protection; or

    (B) imminent physical or emotional harm to others because of threats, attempts, or other acts the patient makes or commits.

  (10) Psychoactive medication--Medication whose primary intended therapeutic effect is to treat or ameliorate the signs or symptoms of mental disorder, or to modify mood, affect, perception, or behavior, consistent with THSC, Chapter 574, Subchapter G, §574.101.

  (11) Refusal to consent to administration of psychoactive medication (refusal)--Actions which include the following behaviors:

    (A) The patient or legally authorized representative communicates orally, through sign language, or in writing that he or she refuses psychoactive medication.

    (B) The patient communicates through behavior that he or she refuses psychoactive medication, e.g., refusing to swallow oral medication or refusing to submit to hypodermic injection of psychoactive medication.

    (C) The patient pretends to swallow oral psychoactive medications, and the attending physician determines that the pretending behavior is due to an unwillingness to take the medication.

    (D) The patient gives either no response or a noncommittal response after he or she has received the standard risk-benefit explanation.

  (12) Service setting-An entity to which this subchapter applies, as described in §414.402 of this title, relating to Application, or a service site contracted to one of these entities.

  (13) TDMHMR mental health facility--A state hospital or state center operated by the Texas Department of Mental Health and Mental Retardation.

  (14) Ward--A person for whom a guardian has been appointed.


Source Note: The provisions of this §414.403 adopted to be effective August 31, 2004, 29 TexReg 8317

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