"The Daily Iowan", University of Iowa, Iowa City, IA, 12/12/1997
There is an ambiguous line separating professional opinion from a
patient's request. A doctor may think a patient needs further medical
attention, yet has no legitimate reason for retaining a patient longer
than they feel is necessary. When a patient asks to be discharged,
they are, even if it is against medical advice. A doctor does not have
the right to keep a patient against their will.
This current practice has its downfalls.
On Nov. 18, 1995, 36-year-old Lisa McPherson was involved in a minor
traffic accident in the small town of Clearwater, Fla. She was not
injured, but proceeded to take off her clothes and walk naked down the
street. A paramedic on the scene ushered McPherson into a nearby
ambulance and asked why she had taken her clothes off. McPherson
replied: "I wanted to help. I wanted to help."
She was taken to a nearby hospital for psychiatric evaluation, but was
released before a psychiatrist was able to see her. McPherson had
asked to leave and was released against medical advice.
She was dead 17 days later.
Granted, Lisa McPherson is an unusual case. She was a member of the
Church of Scientology and several Scientologists had arrived at the
hospital to explain that their religion opposes psychiatry. It was
after their arrival McPherson asked to leave and was released into
McPherson's death has placed the Church of Scientology under scrutiny
again, prompting a two-year criminal investigation into the church, as
well as a lawsuit from McPherson's family.
The McPherson estate is blaming the church for McPherson's death.
Church lawyers have responded by saying the church would never place a
member's life in danger. Whether they are responsible or not is a
ruling that won't be decided for some time still, but this case has
brought another issue into light.
When should a person be considered incapable of making their own
decisions? When do doctors have the right to step in and make those
decisions for them? These questions have plagued the medical
profession for years and answers have yet to be found.
Lisa McPherson was clearly incapable of caring for herself hours
before she was released into the church's care, but her request to
leave was honored and McPherson was released. She was subsequently
taken to a church-owned hotel room and monitored 24-hours a day.
Thirty-three pages of handwritten logs, released this summer, tell the
story of McPherson's final days.
Two days into her stay it was recorded that McPherson was spitting out
food and vomiting. By the fourth she had lost all color in her face
and was feverish. She soiled herself regularly and had hallucinations.
She was described as being violent, striking those who entered her
room and banging on the walls.
McPherson had mental medical problems so visible, a paramedic knew to
take her to a hospital for a psychiatric evaluation. Doctors should
have ignored McPherson's request to go home, and the fact that the
Church of Scientology opposes psychiatric treatment.
Hospitals are so concerned with following all guidelines of proper
patient care that they are unknowingly placing some patients' lives in
risk. A doctor does not have the right to play God, yet they have the
knowledge to know when a patient can be discharged without fear of
consequence. Patients should be able to trust health care professions
to properly do their job.
Meredith Hines is an editorial writer and a UI senior.
Title: When can a doctor override consent?
By: Meredith Hines