Involuntary hospitalization of individuals with mental health disorders raises legal and ethical issues, particularly concerning the balance between the right to due process and patient autonomy, and the need to ensure optimal care while preventing harm. In Israel, the right to legal representation in involuntary hospitalization proceedings aims to mitigate the infringement on patients’ rights. This Article examines the current Opt-In model of legal representation in some U.S. states and presents the advantages of the Opt-Out model in Israel, in which representation is provided by default, preserving the patient’s right to refuse. Findings from a unique empirical study indicate that the Opt-Out model increases access to legal representation and enhances procedural fairness. The Article also compares various legal approaches by examining models implemented in the U.S. It offers practical recommendations for adopting the Opt-Out model in Israel and U.S. states in which the Opt-Out model is implemented. It proposes oversight mechanisms to ensure informed decision-making and points out the importance of balancing patients’ rights and the need to safeguard their health and well-being.
Cohen et al., From Opt-In to Opt-Out: Legal Representation in Involuntary Hospitalization in Israel and the United States, 29 J. Gender, Race & Just. 207 (2026).