A Massachusetts Rogers Order, more formally known as Rogers Guardianship Order is an order issued by the court allowing a healthcare provider to treat a mental health patient with extraordinary treatment. Extraordinary medical treatment includes the administration of antipsychotic medication, sterilization, abortion, electroconvulsive therapy, psychosurgery and removal of artificial maintenance of nutrition or hydration, as well as some other treatments and procedures. But the most common Rogers Order is issued for the administration of antipsychotic medications.

The order issued by the court is referred to as substituted judgement. Many view court intervention and the substituted judgement process as a form of forced treatment. But the judicial view and intent of this process is that it is more about informed consent than forced treatment.

Factors that the court considers include:

  1. Previous express statements from the patient about what they would want in this situation if it ever arose. A health care proxy would fit into this category;
  2. Religious convictions;
  3. Financial burden;
  4. Adverse effects of the medication;
  5. Impact of the decision on the person’s family;
  6. Prognosis for the person with and without treatment;
  7. Other issues such as a patient who has a concurrent criminal action and wants to testify without being on these medications.

Rogers Orders originated out of the case Rogers v. Commissioner of the Department of Mental Health, 390 Mass. 489 (1983), which put specific rules in place to ensure that each patient’s rights were fully considered with a heightened preponderance of the evidence standard. In order for the court to issue the order, it must first be shown that the patient is in fact incompetent. Since an incompetent person cannot legally give informed consent, the court steps in and makes the decision in that persons place. In doing so, the court takes into consideration the “totality of the circumstances” and decides based upon whether the patient would make such a decision to take a medication to alleviate personal illness if they were mentally competent to make the decision his/ herself.

For more information on Rogers orders, contact Linda at 781-272-8001.