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首页> 外文期刊>Psychosomatics >The Medical Incapacity Hold: A Policy on the Involuntary Medical Hospitalization of Patients Who Lack Decisional Capacity
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The Medical Incapacity Hold: A Policy on the Involuntary Medical Hospitalization of Patients Who Lack Decisional Capacity

机译：医疗无效持有：关于缺乏抵决能力的患者的非自愿医学住院政策

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Background: Medically hospitalized patients who lack decisional capacity may request, demand, or attempt to leave the hospital despite grave risk to themselves. The treating physician in this scenario must determine how to safeguard such patients, including whether to attempt to keep them in the hospital. However, in many jurisdictions, there are no laws that address this matter directly. In this absence, psychiatrists are often called upon to issue an involuntary psychiatric hold (civil commitment) to keep the patient from leaving. Yet, civil commitment statutes were not intended for, and generally do not address, the needs of the medically ill patient without psychiatric illness. Civil commitment is permitted for patients who pose a danger to themselves or others, or who are gravely disabled, specifically as the result of a mental illness, and allows the transport of such individuals to facilities for psychiatric evaluation. It does not permit detention for medical illnesses nor the involuntary administration of medical treatments. Therefore, the establishment of hospital policies and procedures may be the most appropriate means of detaining medically hospitalized patients who lack capacity to understand the risks of leaving the hospital, in addition to mitigating the potential tort risk faced by the physician for acting in a manner that protects the patient. Objective: The purpose of this article is to identify the array of clinical and medical-legal concerns in these scenarios, and to describe the development of a "medical incapacity hold" policy as a means of addressing this unresolved issue.
机译：背景：医疗治疗患者缺乏判决能力的患者可能要求，需求或企图离开医院，尽管对自己严重风险。在这种情况下，治疗医师必须确定如何保护这些患者，包括是否试图将其保留在医院。但是，在许多司法管辖区中，没有任何法律直接解决这项问题。在这种缺席中，精神科医生经常被要求发出非自愿精神病患者（民事承诺），以使患者离开。然而，民事承诺法规没有意图，通常不会解决，而没有精神病疾病的医疗病患者的需求。对自己或他人构成危险或严重残疾的患者允许民事承诺，特别是由于精神疾病的结果，并允许将这些个人运送到精神病学评估的设施。它不允许拘留医疗疾病，也不是医疗治疗的非自愿管理。因此，医院政策和程序的建立可能是拘留医疗治疗的患者的最合适的手段，除了减轻医生面临的潜在侵权风险以以某种方式进行行为保护患者。目的：本文的目的是识别这些情景中的临床和医疗问题阵列，并描述了“医疗无能为力持有”政策的发展，作为解决这一尚未解决的问题的手段。

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