Judicial Review of Unnecessary Psychotropic Prescriptions: The Right to Refuse Treatment and Patient Cognitive Autonomy

This research addresses the legal protection of patient autonomy in their therapeutic refusal to psychopharmacological prescription, highlighting respect for fundamental rights and neurocognitive diversity. It is contextualized in the Brazilian and international scenario, where excessive medicalization and the vulnerability of neurodiverse patients impose ethical, legal and clinical challenges. The central problem refers to the lack of effective guarantees for the therapeutic refusal to be respected, in the face of a legal and medical system that is still poorly integrated. The main objective was to analyze how the legal system ensures this autonomy and to identify mechanisms that promote its effectiveness. The research adopted the neoperspectivist Giftedean paradigm, integrating theories of criminal guaranteeism, bioethics, comparative law and human rights. The hypothetical-deductive method was used and a rigorous narrative bibliographic and documentary review was conducted, consulting databases such as Scopus, Web of Science, SciELO and PubMed, with specific descriptors related to autonomy, therapeutic refusal and neurodiversity, resulting in 78 final studies analyzed. The main findings revealed the growing legal recognition of patient autonomy, supported by Brazilian constitutional legislation (Art. 5 and 6, BRAZIL, 1988) and international legislation, as well as protective jurisprudence. It was concluded that judicial mediation and interdisciplinarity are crucial to guarantee rights and reduce abuses. The gaps identified refer to the lack of empirical data and specific clinical protocols. Methodological limitations include the exclusion of studies not indexed in the consulted databases. The research contributes theoretically and empirically to the debate, expanding the dialogue between law, health and ethics, adding social, academic and scientific value by promoting respect for diversity and justice.