Issues involved:
(1) The right of the patient for self-determination.
(2) The competence of the patient to make an informed decision.
(3) The risk of serious harm to the patient after leaving the hospital.
(4) The likelihood that serious harm may occur to others if the patient leaves the hospital.
(5) The liability of the hospital in letting the person leave the hospital.
A person may need to be involuntarily hospitalized if:
(1) the patient is mentally incompetent
(2) an unemancipated minor whose parents or guardians desire continued care
(3) the patient is at risk for serious harm
(4) the patient is a serious risk to others (intoxicated, violent, highly contagious)
Involuntary hospitalization may require a court order and/or police intervention.
A family who insists that a minor or elderly patient be discharged despite imminent danger may be interpreted by a judge to be a form of abuse.
A patient who does not meet the criteria for involuntary hospitalization may be allowed to leave provided:
(1) s/he has been advised of the hazards of leaving the hospital
(2) s/he has been told of the benefits of staying
(3) s/he has considered all possible alternatives to leaving (see below)
(4) s/he sign a release form accepting responsibility for the decision (if the person refuses to sign the form, then this should be documented and witnessed in the chart)
Options that can be offered to the patient prior to discharge may include:
(1) transfer to the care of another physician
(2) transportation to another hospital
(3) an alternative treatment plan
(4) temporary discharge (for a few hours or days)
