The author describes the law and procedures at hearings concerning the further retention of mentally ill patients who are confined at a city hospital, emphasizing the role of psychiatrists and attorneys. It is shown that the hearings are not truly adversary since neither an attorney representing the hospital nor a psychiatric witness for the patient is present. Patients are too ill to participate in their own defense and most hearings result in continued retention. Dawidoff suggests certain changes which might result in greater attention being paid to the civil and due process rights of patients.