This article examines the enactment of community treatment orders (CTOs) in Alberta, Canada to illustrate how civil law is used to constitute and govern psychiatric patients in the community. I argue that the logic of CTOs constitutes the psychiatric patient as a fractured subject who is simultaneously capable/incapable of making medical decisions and at risk/risky. These paradoxical characterizations highlight how depictions of rationality and choice are contingent on consenting to a pharmacological regime designed to normalize these patients. This construction functions to eliminate opportunities for rationally informed types of non-compliance and promotes hospitalization as the only way to manage harmful, risky and non-conforming individuals. I contend that CTOs are a flawed instrument of regulation that cannot manage ‘legally’ capable but non-compliant individuals.