What are legal issues that may arise concerning Tourette syndrome (TS) and other tic disorders?

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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No reason exists to suspect that an individual has diminished capacity (eg, the ability to consent to treatment, participate in research, or make a will) because of a diagnosis of TS.

Parents of children with TS frequently ask whether TS causes diminished responsibility—for example, "When he hits his brother during a rage attack, is that him or is that the Tourette disease?" Occasionally the same question comes up in the legal arena, eg, "Should Mr A be exculpated for a crime he committed because he has TS?"

Group studies clearly show that TS can cause complex unwanted behavior. Sometimes, the answer is obvious, and sometimes, all that is needed is education about what is and is not typical of TS. The TSA and its local affiliates produce some excellent education materials addressed to family, friends, or teachers.

Convincingly answering what caused a specific complex act in an individual patient often is impossible. The author finds that discussions about whether the child is guilty tend to be fruitless. It is more helpful to focus on interventions and results: Are we likely to fix this problem by writing a prescription, by providing rewards and punishments, by instructing the patient to stop doing it, or by simply ignoring it?

The public does not necessarily credit the physician with indisputable authority regarding guilt, forgiveness, or legal culpability. However, physicians speak from a position of strength when they focus on available treatments and likely prognosis. Also, this approach focuses attention away from punishment and toward problem solving.

Some rights of people with TS are protected by US federal legislation. Examples include the right to public education in the least restrictive educational setting (Individuals with Disabilities Education Act) and the right to reasonable accommodations in public settings or the workplace (Americans with Disabilities Act). Legal advice and discussion with experienced support group members can be helpful in deciding when and how to pursue legal remedies under these laws.

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