Can emergency room personnel hold you against your will?

Recently on our legal forum a user asked, “I went to the hospital for treatment last night. I decided I was fine. The hospital did not want me to leave. What are my legal rights to leave and can a hospital hold me against my will?”

Although this question may seem a bit odd, the issue of whether or not you are free to leave a hospital actually arises quite often. Just ask Joseph Wheeler, a Maryland resident who sued Prince George’s Hospital in Maryland for detaining him against his will. At the core of Wheeler’s personal injury claim was whether or not hospitals have the right to hold patients against their will, and if they do, can they be held liable for false imprisonment.

Can I leave the hospital?

So back to the question at hand: Can you leave the hospital against the will of your doctor? According to George Annas, chairman of Health Law, Bioethics and Human Rights at Boston University, "A hospital is not a prison, and usually a patient can always leave.”

Although there are some exceptions, which will be discussed below, legal experts claim the starting position for doctors and hospitals should be that they have little excuse for keeping a patient against their will or attempting to force treatment.

Alan Meisel, a professor of law and bioethics at the University of Pittsburgh School of Law, agrees claiming that all doctors and hospitals should “operate under the assumption that they can never hold a patient against their will. Although there are exceptions, that assumption is the starting point." Meisel goes one step further claiming that hospitals should be held liable if the detainment is unreasonable, potentially leading to a civil wrong of false imprisonment.

Exceptions to unlawful detainment

Legal experts, however, are quick to argue that doctors might have legitimate reasons for detaining a patient. For example, the doctor or hospital may have had the legal right to keep you under their care if you were considered a danger to yourself or others, you were delirious, you had a diminished capacity to make decisions for yourself, or you were intoxicated.

Without more information about your case it’s impossible to say if any of these exceptions apply to your case, but it’s likely the hospital has the burden of proof to prove you should be held.

The most common reason a patient is held is because the doctor believes they are mentally ill and a danger to themselves or others. State laws vary with regards to how long a patient can be detained for mental health reasons, when the medical evaluation for detainment must be performed, and who makes the detainment determination. For example, in some states, the patient has a right to request a hearing for detainment within 24 to 72 hours with a judge who will evaluate their case. If you have were held for mental health reasons you can review your state's laws for more information.

An important point to note, however, is that doctors are often put in a very difficult position. If they allow a patient to leave they could face liability for medical negligence. Often doctors have to weigh the risk a false imprisonment charge will be filed against a potential charge for wrongful death (i.e., the patient walks out the door but later dies from a heart attack).

Hospitals may ask you to sign a Discharge against Medical Advice Waiver

In order for doctors and hospitals to cover their potential risk of liability for a discharge, they may ask you to sign a Discharge against Medical Advice Waiver. This form is generally only given if they have determined the patient has the decision making capacity to refuse care. If the patient is deemed fit to make a legal decision this form is generally one of the best ways to notify the patient of all the potential risks or refusing care and release the hospital from future liability. This form, however, should be accompanied by a discussion with medical personnel to ensure the patient is making their decision with informed consent. Informed consent includes 1) a full disclosure of information, 2) comprehension by the patient, and 3) voluntariness.

Bottom line:

Most patients who want to leave the hospital are legally allowed to refuse treatment and leave (although exceptions exist). You may be asked, however, to sign a document stating you are leaving against medical advice. If you are held against your will without cause you may have a case for false imprisonment.

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