Re: Release of Patients Rece

[mozley@darius.pet.upenn.edu (P. David Mozley)]

>        Reply to:   RE>Release of Patients Receiving Therapeutic Doses of...
>
>I don't believe you can restrain them unless it is clear that the patient is
>mentally incompetent.
>
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>Michael J. Bohan, RSO   |  e-mail: mike.bohan@yale.edu

Incompentence is a legal term.  The label can only be applied by the
courts.  There is no such word in medicine.  Perhaps you mean "unless it is
clear that the patient is UNABLE TO RENDER INFORMED CONSENT."

Regardless, your belief is unlikely to withstand systematic scrutinization.
To wit, Typhoid Mary was in full possession of her mental faculties.  A
patient who impulsively insists on signing out AMA will almost always fail
to meet criteria for rendering informed consent, because an informed
decision to endanger the public against medical advice requires
deliberation by definition.  Deliberation requires senescence.  With the
passage of time, the issue becomes moot as exposure rates drop.

Incidentally, in this country, no one but the polity can "restrain" people.
Very limited powers are granted for very short times to physicians
operating in extreme emergencies.  The system requires health care
professionals to petition the courts to impose the court's own legislated
powers of restraint.


>
>--------------------------------------
>Date: 15/08/96 11:47 AM
>To: Mike Bohan
>From: radsafe@romulus.ehs.uiuc.edu
>Recently, the question arose at our facility as to what legal recourse we
>have in preventing a patient from voluntarily leaving the hospital before
>meeting release criteria. A query to our NY State Health Department
>representative brought the response that we cannot prevent a patient from
>leaving if they insist. This would also apply to patients receiving
>permanent sealed source implants. Your comments/suggestions/advice would be
>most appreciated.
>
>Charles C.Chamberlain,Ph.D.
>RSO, SUNY Health Science Center
>Syracuse, NY