Re: Release of Patients Receiving Therapeutic Doses of Radionuclides

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

In practice the issue is easily rendered moot.  True, committment criteria
vary from state to state.  Most, however, allow involuntary committment
when patients present an immanent danger to themselves or others.
Quarentine post radioablative therapy is legislated because of a belief
that the radioactive material within the patient carries a risk to the
public.  Discharge from the hospital can be legally prevented by petitions
from two physicians to the local court stating their professional opinion
that the patient constitutes a risk.  A court officer is available on a
24/7 basis to review the petition.  If a patient is denied the liberty to
leave the hospital, it is by the due process and authority of the court,
not be the physicians who petition.  It is true that in New York State,
like most others, the legislature requires the court to grant a hearing
within 72 hours.  This time lag is what makes your issue effectively moot.
By the time you get a patient to court, they are unlikely to meet the
criteria for committment any longer.

One note for New Yorkers is that your process is not that which is used to
committ psychiatric patients.  It is a parallel process that goes through a
different court mechanism.  You still have to document a patient's capacity
to render informed consent, etc, but you will not be dealing with the
(relatively physician friendly and practiced) mental health magistrates.

A caveat:  Committment laws in New York are currently in transition because
of your problem with multidrug resistant TB.  However, the changes are
expected to make it easier to coerce patients into accepting treatment.

A final disclaimer:  it is highly unlikely that the most ardent civil
libertarian would have rendered the opinion you stated based on the
information you provided.  I suspect something is missing from the story.

>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