Saturday, December 22, 2007

Mentally Ill Free to Die

How well are we serving our mentally ill fellow citizens? There is a very sad op/ed piece in the December 22, 2007 Wall Street Journal Free to Die in Iowa by Michael Judge.
Since a 55 old man was uncooperative, no medical services were provided and he froze to death under a bridge in Iowa. In Iowa, at least, the laws are in place to force him to be cared for. Judge writes:
■ “this man, who suffered from chronic schizophrenia. He wasn't standing on a bridge thinking of ending his life; he was huddled beneath one trying to stay alive” … “found [him], nearly naked, dead”

■ “Local police officers had tried to get [him] the care he needed just 48 hours before his death. But he was refused a bed at the local homeless shelter and then turned away from the Veterans Affairs Medical Center here because he was ‘uncooperative’."

■ “Given his debilitated state, the VA psychiatrist on duty could have forced [him] to receive the treatment that might have saved his life”

■ “Most states, including Iowa, have passed assisted outpatient treatment (AOT) laws. According to these statutes, "you must continue to take your medication or you may be committed," says Dr. E. Fuller Torrey”

■ “Iowa's commitment standard is better than many states', which demand that a person be an ‘imminent’ danger to himself or others. In Iowa, however, to be eligible for AOT a person must lack sufficient judgment to make responsible decisions concerning treatment; and be either (1) a danger to self/others or (2) unable to satisfy the need for ‘nourishment, clothing, essential medical care, or shelter so that it is likely that the person will suffer physical injury, physical debilitation, or death’."

■ “Nevertheless, civil libertarians seem more concerned with a patient's civil rights than his very survival”


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