55 Steps

Patients are now accustomed to signing their name multiple times before their blood is drawn or other medical procedures are undertaken. But up to 1985, mental patients were deemed incompetent, so decisions were made for them without consultation, as the opening scene vividly demonstrates.

Diagnosed with chronic paranoid schizophrenia and slight mental retardation after self-admitting, one day Eleanor Riese (played by Helana Bonham Carter) telephones Colette Hughes (Hilary Swank) from St. Mary’s Hospital in San Francisco, saying “I want a lawyer.” When Hughes goes to the hospital, Riese hires her after a peculiar conversation, one of many extraordinary encounters. A former nurse who once worked in a mental hospital, Hughes has found the perfect plaintiff whose case can liberate hundreds of thousands of patients being given medicines without their permission—lacking “informed consent.” She teams up with Mort Cohen (Jeffrey Tambor), a law professor at Golden Gate University, and files a case argued by the latter on Fifth Amendment grounds (lack of due process in determining treatment). They lose in Superior Court but win on appeal, when Hughes insists on the argument that involuntary treatment violates the First Amendment because patients are deprived of conversation with doctors regarding treatment, including objections to medicines with adverse side effects. Although the hospital appeals to the California Supreme Court, Riese wins again in 1989. The ruling allows patients committed for 3-14 days to object to antipsychotic medicines except in an emergency or after a court determines that a patient lacks legal (not medical) incompetence.

Fascinating are the antics of Riese, who counts the number of steps up to the courtroom, but also of Hughes’s personal life. The two bond, and Hughes overworks to the point of developing shingles. Hughes has been living with a physician, and their loving relationship is also revealed. Although the climax of the case is victory for Riese, who can remodel her apartment, an epilog concerns a personal tragedy that in effect validates the legal pursuit. Titles at the end inform what happened to the principals involved. Directed by Bille August, with some filming in Germany, the Political Film Society has nominated 55 Steps for best film exposé and best film on human rights of 2018. MH