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NY: should psych. patient have been retained?: court outlines rules for 'retaining' psych, pts.

CASE FACTS: A psychiatric patient identified only as William Doe was brought before the New York courts to determine whether the should be retained pursuant to the state's Mental Hygiene Law. Mohawk Valley Psychiatric Center requested an order of retention for a two-year period. Doe, opposing the retention, sought an immediate release or order for a lesser retention period. Doe had an extensive criminal record. He carried the combined Axis I diagnosis of both schizophrenia and pedophilia. A Level I sex offender, he also was diagnosed as at borderline intellectual functioning. At the time he appeared before the court he was suffering from auditory hallucinations that directed him to kill. His treating Psychiatrist testified on behalf of the hospital that Doe was a danger to himself and others because of his hallucinating. Further he opined that there was a connection between the hallucinations and past acts of sexual abuse of children In 1998, as a result of a battery of psychological tests he was found to be at high risk to reengage in pedophilic activity. Doe complained that because the test results were stale, the court should not assume that he was a risk for pedophilic activity. Doe argued that psychological tests to determine future dangerousness are unreliable.

COURT'S OPINION: The Supreme Court of New York granted the petition for a two-year retention order. There were several reasons for the court to conclude that Doe remained immediately dangerous to himself and others. He continued to receive violent auditory command hallucinations. He failed to acknowledge his past history of pedophilia. Yet later in his testimony he admitted that history. He clearly lacked insight regarding his condition The court ordered that prior to any future discharge the hospital had a duty to engage in the treatment of Doe's pedophilia and to provide a pre-discharge diagnosis based on that treatment opining that Doe's pedophilia was sufficiently remedied so that he would not pose a risk to himself or others. The court concluded that since no exact standard or mechanism existed in New York for the taking of judicial notice in a case such as this, it would accept and apply The American Law Institute's Code of Evidence (Code). The court was satisfied that the Code set up adequate safeguards to ensure that the patient would not be released unless it could be proved that he no longer posed a threat of harm either to himself or to others. Editor's Note: Often, well-meaning psychiatrists and psychologists, intent upon proving that a course of treatment has been successful, facilitate the release of psychiatric patients before they should be released. Many times with catastrophic results! In re Application for Commitment by Mohawk Valley Psychiatric Center, 2005 WL2358325--NY

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who's Who in American Law, Who's Who in America and Who's Who in the World.
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Title Annotation:Hospital Law Decisions of Note
Author:Tammelleo, A. David
Publication:Hospital Law's Regan Report
Date:Sep 1, 2005
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