The other night, my father, a lawyer, sat down with a fistful of hospital-related news clippings—as he often does when we haven’t seen each other for a while—and began to read aloud this headline from a blurb in the New York State Law Digest:
Hospital owes no general duty to drunk patient, brought in by friend, to bar him from leaving hospital.
You know that sound effect they play on kiddie shows, the one that sounds like a record being yanked off a turntable? That’s what I heard over my father’s voice as he continued reading. The blurb summarized a June New York State Court of Appeals decision that, although it changes absolutely nothing about the way healthcare providers and hospitals care for intoxicated patients, offers valuable insights into the moral and ethical underpinnings of our pubic health philosophy, which values autonomy over paternalism—even when people might not be making the best decisions for themselves.
A little digging revealed a bounty of legal and insurance trade coverage and analysis of the case, but almost nothing in the way of consumer press. Two reporters for small New York newspapers figured the case of Kowalski v. St. Francis was at least important enough to cover as the local news that it was. Chris Valdez, an investigative reporter at the Poughkeepsie Journal, and Hudson Valley Reporter editor Bob Dumas wrote the only two non-trade pieces about the case I could find since the June 26th ruling.
Briefly, the 2006 case involved a severely alcohol-intoxicated man (Kevin Kowalski) who was brought to the St. Francis Hospital ED in Poughkeepsie, NY by a friend to be voluntarily admitted to the hospital’s detox program. While waiting for a transfer to the program, he told a nurse that he wanted to take a taxi and leave. She told him to call a friend to come pick him up and he agreed, but walked out of the building when the nurse wasn’t looking.
An hour or so later, he was hit by a car and severely injured. Lawsuits against the hospital and the ED physician followed, alleging medical malpractice and negligence. The plaintiffs argued that, given his condition, the patient should have been detained at the hospital to protect him from, well, himself. The defense claimed that, according to New York mental health law, the hospital had no authority to hold him against his will because he came voluntarily, and because he was lucid and steady enough on his feet to express his desire to leave and to do so on his own accord.
This June, the New York State Court of Appeals found there was no basis for a trial, finding in favor of the defense’s motion for summary judgment. The key to the whole case was that Kowalski, although he was, initially, intoxicated, was a voluntary patient from the start, and demonstrated no imminent danger to himself or others at that particular time.