I attended a Reise hearing a few days ago. A Reise hearing is a court proceeding to obtain permission to give psych patients medication against their will. Essentially happens is an adult is stripped of the right to control what happens to his or her own body. It's a rather troubling thing to take responsibility for, despite the fact that the pt for this particular Reise hearing really did need treatment.
The ethical dilemma here is, how much of a right do people have to be psychotic. When their psychosis lands them in trouble of the law, then of course they get medicated up the wahzoo, but the subtext there is when they are disorganized enough to be a danger to themselves or other people, then they need medication. The problems lies in the fuzzy middle; which I felt like this patient belonged in.
There was also the issue of her public defender not really putting much effort into the Reise hearing. It was clear that he felt she was crazy, so he didn't try very hard. I take issue with that. I have to treat all patients to the best of my ability regardless of who they are, and so by the same logic, he should have to defend all clients with equal zeal. Of course, I understand that's not how medicine or law works, nevertheless, we don't have to purposely fall short.
Monday, June 22, 2009
Friday, June 5, 2009
Snapshot of Jail
It is 8:00am, I open the foodport located at the bottom of the 2 feet thick door of a cell at the County jail.
I peer into the cell. Unfortunately, because of the way the food port is situated and the way the patient is standing, I get an excellent view of his penis and testicles.
Yes, the patient (a flabby elderly man arrested for indecent exposure) is naked.
And yes, there IS a stale, dank odor wafting my way through the open foodport.
"MOTHERFUCKING BITCH, FUCK YOU ALL.", shouts the patient.
"Sir," i say, "that's not a nice thing to say. Why don't we talk about what's been going on?"
"FUCK YOU. I'M GOING TO SUCK YOUR BABY'S DICK," he screams through the door. A dribble of saliva slides down the corner of his mouth.
I decide to move on to my next patient. My next patient is a young woman, also naked, and also manic. She is currently squatting on the floor of her cell with her hand stuck down into her toilet. I hear water sloshing around the toilet bowl and I ALSO see bits of dark nuggety things (unmistakably poop) floating around.
I found it, she yells, holding up a squished dark brown nuggety thing.
At this point, I pointedly back away and head out of cell area for a much needed coffee break. And it's only 8:30.
I peer into the cell. Unfortunately, because of the way the food port is situated and the way the patient is standing, I get an excellent view of his penis and testicles.
Yes, the patient (a flabby elderly man arrested for indecent exposure) is naked.
And yes, there IS a stale, dank odor wafting my way through the open foodport.
"MOTHERFUCKING BITCH, FUCK YOU ALL.", shouts the patient.
"Sir," i say, "that's not a nice thing to say. Why don't we talk about what's been going on?"
"FUCK YOU. I'M GOING TO SUCK YOUR BABY'S DICK," he screams through the door. A dribble of saliva slides down the corner of his mouth.
I decide to move on to my next patient. My next patient is a young woman, also naked, and also manic. She is currently squatting on the floor of her cell with her hand stuck down into her toilet. I hear water sloshing around the toilet bowl and I ALSO see bits of dark nuggety things (unmistakably poop) floating around.
I found it, she yells, holding up a squished dark brown nuggety thing.
At this point, I pointedly back away and head out of cell area for a much needed coffee break. And it's only 8:30.
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