Bob Staples of Jay is president of the Brett M. Staples Brain Disorder Awareness Coalition.

A recent Maine court decision upholding a Progressive Treatment Program (PTP) order should prompt serious reflection — not just about the law, but about the direction of disability rights advocacy itself.

The case involved a middle-aged woman with a severe brain disorder, years of repeated psychiatric hospitalizations and a long history of refusing treatment outside court supervision. For two years under a court-ordered outpatient treatment program, she avoided hospitalization, stabilized medically and psychiatrically and lived more safely in the community. The record showed that when not under such an order, she rapidly deteriorated.

Yet Disability Rights Maine (DRM), representing her on appeal, argued that the statute authorizing the program was unconstitutional, vague and incompatible with due process. The Superior Court rejected those claims and affirmed the order. Still, the broader policy implications deserve attention.

Disability Rights Maine serves an essential role in protecting people with disabilities from coercion and abuse. That mission is rooted in a painful history that must never be minimized. But this case illustrates a growing problem within disability rights advocacy: an increasingly rigid opposition to involuntary treatment, even when evidence shows that structured care prevents harm and preserves community living.

At the heart of the issue is how autonomy is defined. DRM’s arguments rested heavily on the idea that any person has the right to refuse treatment. In theory, that principle is sound. In practice, severe brain disorders often erode insight itself. When a person cannot recognize their illness, treatment refusal is not an expression of meaningful choice — it is a symptom of the condition.

The court acknowledged this reality. It found that the individual denied having a mental illness, would not comply voluntarily with treatment and posed a likelihood of serious harm without structured care. These findings were based on years of documented history, not speculation or convenience.

Another weakness in DRM’s position was its failure to engage seriously with outcomes. Under the PTP, the individual experienced two years without psychiatric hospitalization — a rare achievement given her prior history. Her physical health improved. Her stability improved. These are not abstract benefits; they are concrete measures of reduced suffering and reduced system involvement.

Policy advocacy that ignores such outcomes risks elevating ideology over human experience. Opposing a treatment framework that demonstrably works, without offering a viable alternative, does not expand liberty — it often leads to crisis-based care: emergency room visits, police involvement and involuntary inpatient commitments.

Ironically, that outcome contradicts one of DRM’s stated goals: reducing institutionalization. Carefully designed outpatient treatment orders can function as a less restrictive alternative to repeated hospitalization. When those tools are weakened or eliminated, courts are left with fewer humane options.

DRM also challenged provisions allowing emergency hospitalization for treatment noncompliance, arguing they violate due process. While procedural safeguards are essential, this critique overlooks clinical reality. Psychiatric relapse can escalate rapidly. Requiring a full hearing before any emergency intervention may sound protective, but in practice it delays care until danger is undeniable — and sometimes irreversible.

Perhaps the most significant policy gap in DRM’s advocacy is the absence of a realistic replacement system. There was no proposal for fully funded, high-intensity voluntary services capable of ensuring treatment adherence. No guarantee of housing with on-site psychiatric care. No mechanism to intervene early when insight collapses. Without these, opposing court-ordered treatment becomes an exercise in negation rather than reform.

None of this is an argument for unchecked coercion. Civil liberties matter. Due process matters. Oversight matters. But so do outcomes, capacity and the real-world consequences of untreated brain disorders.

A balanced approach recognizes that autonomy is meaningless if illness destroys the ability to exercise it, and that preventing deterioration can be an act of compassion rather than control.

If disability rights advocacy is to remain both principled and humane, it must grapple honestly with cases like this — where structured treatment works, insight is impaired and the cost of rigid opposition is borne not in theory, but in human suffering.

Protecting rights should never mean abandoning people.