Zinkler & De Sabbata argue that we did not go far enough when calling for the immediate cessation of the use of CTOs in people who competently refuse psychiatric treatment. They do so on the basis of the controversial interpretation of the Convention for the Rights of Persons with Disabilities (CRPD), adopted by the UN Committee charged with reviewing its implementation. This interpretation argues that the text of the CRPD demands that decisions made by individuals who are unable to understand pertinent information or use and weigh it despite maximal support should nonetheless be regarded as valid. Under this bizarre regime, a man with mania who walks naked through the high street to save the world should not have his modesty preserved, and a woman who kills her baby believing it to be the devil should be prosecuted with the full force of the law.

The CRPD was created by international consensus. Like all such documents its language is often byzantine and opaque, but the Committee's reading of the meaning of the text is extremely strained. It has been roundly criticised and largely ignored. ^{Reference Callaghan and Ryan1–Reference Freeman, Kolappa, de Almeida, Kleinman, Makhashvili and Phakathi3} Part of the Committee's argument, repeated by Zinkler & De Sabbatta, is that we cannot presume to be able to accurately assess the inner workings of the human mind, but this blithely ignores that this is exactly what psychiatry, the law, and indeed all humans do all the time. Reports of hallucinations are equated to an experience of a person's inner world. Deliberate affirmations made contrary to facts are adjudged to be lies. And heartfelt declarations of abiding love are accepted to form the basis of our most important relationships.

When individuals competently refuse treatment, we must respect their decision. However, when people make perilous decisions because they cannot understand or use the relevant information, we should first do all we can to assist that understanding; if that proves futile, a proxy decision-maker will be required, acting as far as possible so as to respect their rights, will and preferences.