A therapeutic jurisprudence analysis attempts to determine the role of legal proceedings, lawyers, and judges in producing therapeutic or anti-therapeutic consequences. A 1-year study of the court review program initiated by the New York State Office of Mental Health consisted of multiple patient interviews and a review of records. The study sample consisted of 61 patients who met entry criteria of having an application submitted to the court for review of treatment over objection and gave written consent to participate in the research project. Characteristics of the review process, the effect on patient refusal, and the attitudes of treating psychiatrists were examined. Selected clinical characteristics of refusing patients, their attitudes toward mental illness, reasons for refusing medication, and satisfaction with court review were considered. Overall, the study found that the court review process was anti- therapeutic. It recommends a clinically oriented selection and monitoring of psychiatric treatments administered over patient objection, to be conducted by knowledgeable individuals who can foster negotiated agreements between refusing patients and their treating psychiatrists. Judicial review should be the last resort. 24 references