We assessed the records for 30 consecutive petitions for mental health commitment in which an involuntary medication order was requested from Anchorage, Alaska. In 29 cases, the commitment petition was granted. One patient requested a jury trial and the jury found in her favor. The forced medication order was granted in 27 of the 30 cases. In 26 cases, in violation of previous Supreme Court rulings, the patients' desires, fears, wishes and experiences were totally ignored even when the patients were afraid that the drugs used for psychosis might kill them or when they had experienced serious harms such as tardive dyskinesia. The ethical and legal imperative of offering a less intrusive treatment was ignored. Benzodiazepines were not offered. Psychotherapy was not offered or mentioned in fifteen of the 30 cases. The providers claimed it does not work, even though that statement is blatantly false. The legal procedures can best be characterized as a sham where the patients are defenseless. The power imbalance and abuse were extreme and several of the psychiatrists who argued for forced treatment obtained court orders for administering drugs and dosages that were dangerous. Forced medication should be abandoned.

The authors have declared no competing interest.

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