An Ethical Dilemma- Outstanding Warrants

[rkirk89]

Hi All,

I am currently a BSN student working on an ethics project, and I came across an interesting scenario that I am struggling to find concrete guidlines for. Basically I am wondering what the nurse's obligation is to a patient with multiple warrants out for his arrest. The crimes alleged are non-violent in nature. The patient is admitted for acute psychosocial and physiological impairments, so going AMA would be dicey regardless of the patient's legal status. As it stands, the plan is to discharge the patient into police custody. Due to a staffing issue, the police are unable to come to the hospital to retrieve the patient (seems odd but this is not the focus of my project).

So the questions are; When does the nurse inform the patient that they are going to be discharged into police custody? When providing reasons that the patient should not leave AMA is the nurse obligated to discuss the patients legal status? More importantly, if the patient wishes to participate in discharge planning, what should the nurse disclose to the patient as far as his treatment options after being released?

There is a large body of ethical research on the importance of honesty and transparency with terminally ill patients, but I am wondering if that applies to knowledge the nurse has that doesn't directly affect patient care.

[Daisy4RN]

Unless the patient is already in police custody, how would the nurse know about the warrants? The nurse's obligation is to tend to the patient's medical needs. If the patient is under arrest, there will be officers at the bedside and the patient will have at least one extremity shackled to the bed.

The patient is not already in custody, they have committed a crime but were brought to the hospital, so they are not shackled, when medically cleared the police come and pick them up at the hospital and place them under arrest, until then just a normal patient with no guard etc.

[KelRN215, BSN, RN]

Hi All,

I am currently a BSN student working on an ethics project, and I came across an interesting scenario that I am struggling to find concrete guidlines for. Basically I am wondering what the nurse's obligation is to a patient with multiple warrants out for his arrest. The crimes alleged are non-violent in nature. The patient is admitted for acute psychosocial and physiological impairments, so going AMA would be dicey regardless of the patient's legal status. As it stands, the plan is to discharge the patient into police custody. Due to a staffing issue, the police are unable to come to the hospital to retrieve the patient (seems odd but this is not the focus of my project).

So the questions are; When does the nurse inform the patient that they are going to be discharged into police custody? When providing reasons that the patient should not leave AMA is the nurse obligated to discuss the patients legal status? More importantly, if the patient wishes to participate in discharge planning, what should the nurse disclose to the patient as far as his treatment options after being released?

There is a large body of ethical research on the importance of honesty and transparency with terminally ill patients, but I am wondering if that applies to knowledge the nurse has that doesn't directly affect patient care.

As a nurse, I would not view it as my job to inform the patient of this. It's the police's job to inform the patient that he is under arrest and read him his rights.

I work in pediatrics so don't encounter any such situations but have certainly encountered many times where the state took custody of a child while the child was hospitalized and the child would not be going home with bio parents. What would happen is that the medical team and social work (+/- security depending on the situation) would tell the parents that they had reason to suspect abuse or neglect and that we, as mandated reporters, were obligated to file a report with CPS. If it was a suspected shaken baby, CPS would usually go to court to get custody within a day and the parents would be informed, by CPS and hospital security, that they were not allowed on the grounds of the hospital. It was in no way the nurse's role to tell the parents that the baby wouldn't be going home with them or anything of the sort. Our involvement in the social piece of things was fairly minimal, actually, other than reporting to security or social work if the bio parents showed up and telling people who called asking for information about Baby Doe that we couldn't speak with them (if the call got past the secretary).

[Daisy4RN]

As a nurse, I would not view it as my job to inform the patient of this. It's the police's job to inform the patient that he is under arrest and read him his rights.

I).

Yes exactly, we did not tell the patient anything, not only not our job, but (for obvious) reasons the police didn't want us to either.

[Here.I.Stand, BSN, RN]

As a nurse, I would not view it as my job to inform the patient of this. It's the police's job to inform the patient that he is under arrest and read him his rights. [/Quote]

This was my thought exactly.

[hppygr8ful, ASN, RN, EMT-I]

I've never heard of discharging someone into police custody. If they're in custody, the police are already there.

Did you make this scenario up or find it somewhere? It seems all sorts of crazy, to me.

In the OP's defense in psych we discharge people with warrants to police custody fairly ofte. Our local police refuse to give up their guns and we can't have armed police on the unit to monitor someone who will go into police custody. It is usually noted on the cardex rto notify the law enforcement agengy when the patient is ready to discharge .Sometimes the patients know sometimes they don't to tell or not to tell is up the the patients presentation. I am not a big fan of hiding this information from patients but our hospital policy is to not tell unless the patient asks.

Hppy

[BurnedoutICURN]

Ok I see this at work far more often than I thought I would. According to management and the legal department, if the patient is not under arrest at the time of admission, we are under no obligation to release to police custody. If lawenforcement wants to arrest the patient upon discharge, it's their responsibility to be there. Also, we were told we were not allowed to disclose any info to LEOS, including discharge date. So, as you can guess, this creates friction with local law enforcement. Inmates are easier, they come with DOC guards and leave with guards.

[JKL33]

According to management and the legal department, if the patient is not under arrest at the time of admission, we are under no obligation to release to police custody. If lawenforcement wants to arrest the patient upon discharge, it's their responsibility to be there. Also, we were told we were not allowed to disclose any info to LEOS, including discharge date. So, as you can guess, this creates friction with local law enforcement.

Yep. ^

[/username, BSN, RN]

If the cops wanted the patient arrested bad enough, it's their job, not mine.

Anyway, you're probably not going to come back anyways, so why do i even bother.

[ComeTogether, LPN]

My job is to care for my patient, I have no obligation to report them to anyone nor would I want anything to do with such a situation. I will care for you regardless unless the law requires me to notify authorities (not common) I will MMOB.

[KelRN215, BSN, RN]

Today I read an article about a guy who shot 2 police officers in my state who was arraigned by a judge in his hospital room. He is under arrest, shackled and handcuffed to his bed and guarded by police officers. The Boston Marathon bomber was also arraigned in his hospital room 5 years ago and guarded by the Boston Police until he was released into Federal Custody. If law enforcement wants to arrest the patient, they will find a way. It's not our job as nurses to in any way notify the patient of such or to be involved with the situation at all.

[Natkat, BSN, MSN, RN]

Unless the patient is already in police custody, how would the nurse know about the warrants? The nurse's obligation is to tend to the patient's medical needs. If the patient is under arrest, there will be officers at the bedside and the patient will have at least one extremity shackled to the bed.

I was thinking the same thing.

Sometimes I will get a hypothetical question about whether or not I would take care of a pedophile or a murder. I say yes. My job is not to figure out whether or not they are guilty of a crime or to decide their punishment. My job is to be their nurse and focus on giving them quality care.