Navajo Nation: Proposal Would Force Treatment of Communicable Diseases

The Navajo Nation Council's Ethics and Rules Committee has approved a proposal that expands an old tuberculosis commitment statute to cover other communicable diseases, including AIDS and syphilis, plus substance abuse and mental health problems. Navajos have fought to control rising syphilis and AIDS cases on their reservation for years. Under the measure, affected tribal members who refuse treatment could be forced into it.

The rules committee passed the proposal 4-0 and sent it consideration by the full 88-member council in the fall; majority approval would send the measure to President Joe Shirley Jr. for signature or veto.

Under the proposed process, anyone could petition the family division of a tribal court to have a judge order an individual "to undergo further medical evaluation and course of treatment" if a traditional peacemaking process of "facilitating a healthy recovery plan is not a viable alternative." The petition must include the type of illness or disorder; a description of the individual's behaviors or actions that present the likelihood of harm; and a statement of the least restrictive treatment. Petitioners must get a signed, notarized statement from at least two licensed or certified health care professionals confirming the problem and offering observations and solutions. At least one of the experts must have seen the patient in person.

The court may commit the person for up to five days for evaluation and schedule a hearing open only to participants in the case, including family members. The patient would retain the right of legal help and independent expert medical evaluations. A judicially mandated treatment decision would require clear and convincing evidence. Treatment progress must be court-reviewed every three months, and the patient could request early release.

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