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What is a Rogers Guardianship for extraordinary treatment?

Most guardianship hearings focus on whether to allow a guardian to make ordinary personal and medical decisions. How does the court make guardianship decisions if the adult needs someone to make extraordinary medical decisions?

In Massachusetts, those hearings are called Rogers Guardianship hearings, named after the 1983 decision Rogers v. Commissioner of the Department of Mental Health.

What is a Rogers Guardianship?

Extraordinary treatment includes sterilization, abortion, psychosurgery, electroconvulsive therapy and removal of maintenance of nutrition or hydration for a person who has become incapacitated. An incapacitated person is an adult who, due to a diagnosed medical condition, can’t make effective decisions about their care, safety and health.

In the 1983 Rogers decision, the court decided that administration of antipsychotic drugs is also considered extraordinary treatment. If a judge and a guardian agree that antipsychotic medication should start or continue to be administered, then the judge will issue a “Rogers” order for treatment.

What medicines are included?

Psychotropic medication such as antidepressants or mood stabilizers do not fall under this rule. Antipsychotic medications that fall under this rule include:

  • Haldol
  • Loxitane
  • Prolixin
  • Stelazine
  • Thorazine
  • Abilify
  • Clozaril
  • Geodon
  • Risperdal
  • Seroquel
  • Zyprexa

When deciding on a Rogers Guardianship, a judge will try to determine what the incapacitated person’s interests and preferences would be if they were competent. The court will consider the person’s previously expressed preferences regarding antipsychotic medication, the person’s religious convictions, the impact of the decision on the person’s family, and the prognosis of the person if they didn’t receive treatment.

The incapacitated person has rights as well. They include the right to an attorney and independent representation, the right to notice that a petition has been filed, the right to a hearing and to attend the hearing and the right to object to the appointment of a guardian.

A Rogers Guardianship is a very serious undertaking requiring a qualified, experienced attorney to handle the needs of the guardian or the incapacitate person.


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