Doctor Knows Best?

At one time or another we have all said something we regret.  For Christina Schumacher that “something” happened last summer.  Christina was in the midst of separating from her husband, claiming reasons of domestic abuse.  At the time, she told her sister that if anything ever happened to her children she would kill herself.  Christina and her husband had a 17 year old daughter and a 14 year old son.

On December 18th Christina’s estranged husband and their 14 year old son were found dead in an apartment.  Dad had strangled his son and then hung himself.

The next day Christina went to her regularly scheduled appointment with her psychologist.  Her doctor had decided, before she arrived, that she should check herself into the hospital psych ward and had the police ready and waiting in case Christina disagreed. 

She didn’t agree, she wanted to be with her 17 year old daughter through their grief.  This however, was not an option and she was taken to Fletcher Allen Health Care where she remained for the next 5½ weeks.

Christina was released, by order of a judge, about a week ago.  The judge stated that he saw no legal reason she should have been committed or should remain in the hospital and ordered her immediate release.

Christina’s story raises some questions about the doctor/patient relationship in a mental health setting.  What rights do psych patients have?  How can we best assess their capability to make decisions?  What is the line where involuntary commitment becomes necessary?

I understand the concern the psychologist must have felt, and how difficult it must be to determine if a patient needs to be committed.  What if Christina had been unstable and harmed herself or her daughter?  I am sure the doctor felt there was enough information from their past meetings to warrant the decision of commitment.

However, we never really know how we will react to tragedy.  We often say things like: “I could NEVER do that.” Or “I would flip out if that were me.”  I am no stranger to this kind of thinking, before my dad ended up in the hospital last fall my internal monologue was: “I wouldn’t be calm talking about taking someone off of a ventilator…especially someone I loved…I would be a puddle…there wouldn’t be enough tissue in the world…”  Yet, there I was, in the exact situation I most feared, calm, collected, and making the tough decisions with tissue to spare.

What we say we will do and what we do are often worlds apart.  Christina’s psychologist would have been wise to keep this in mind during her appointment that December day.