Don’t taze the mad: A needed, uneeded regulation.

New Zealand has the Ombudsmen inspect, under legal frameworks and accountable, by treaties, to international groups, all locked units of whatever sort in New Zealand. The reports are around privacy, occupancy numbers (too high) and use of locked bedrooms. The issues we have a minor, compared with this: we use restraint and seclusion (locked rooms) yes, but we don’t shoot people who are mad.

According to a report that appeared in the New York Times on February 12, Pean had sought care at the emergency department of St. Joseph Medical Center in Houston. He was admitted to the hospital and later became increasingly delusional while waiting overnight for treatment. At some point, nurses called security, and before the night was over, Alan was shocked with a Taser and shot in the chest by off-duty police officers.

Alan recovered, and today he is speaking out about what happened to him. He told the Times, “I thought of the hospital as a beacon, a safe haven. I can’t quite believe that I ended up shot.’ ”

Last month Alan’s brother, Christian Pean, M.D., an orthopaedic surgery resident at NYU Hospital for Joint Diseases, brought the issue to the annual policymaking meeting of the AMA House of Delegates. That led to the delegates’ approving a resolution—originally drafted by Pean and colleagues with the AMA Minority Affairs Section and supported by the AMA Section Council on Psychiatry—that advocates “that hospitals and other health care delivery settings limit guns and conducted electrical weapons [commonly known as Tasers] in units where patients suffering from mental illness are present.”

He said the use of firearms and Tasers on patients is becoming more common in American health care settings, one that disproportionately affects people with mental illness and, especially, racial and ethnic minority patients with mental illness.

According to the Times, “More and more American hospitals are arming guards with guns and Tasers, setting off a fierce debate among health care officials about whether such steps—along with greater reliance on law enforcement or military veterans—improve safety or endanger patients.”

We have our fair share of aggressive patients. Some of which have access to firearms. We manage this with memoranda with the police, with rules and protocols about restraining people, and by having secure units. People may not like these things: there has been a campaign locally about this being a violation of human rights for the most difficult people we have in the system.

But we don’t taze the mad. I’d suggest that having a psychiatric acute service and appropriate hospitals, together with assertive followup… and enough security people, means we can work without such things.

The AMA have made a wise recommendation. The fact that it is needed tells us how far we have fallen.

4 thoughts on “Don’t taze the mad: A needed, uneeded regulation.

  1. We cleared out our institutions decades ago. Now our largest treatment facilities for mental illness are the largest jails in the country.

    I can see a reason for armed security at hospitals, but if it was a late-night setting, there’s probably a need for better protocols for handling mental illness patients. (Plus, how do you Taser & Shot someone?)

  2. Plus, how do you Taser & Shot someone?)

    Dunno, maybe a cop will weigh in with an explanation. If American cops are experts at nothing else, it’s in creatively inflicting lethal wounds in the most over-the-top way imaginable.

  3. Looking behind this story … In dealing with violent male patients – to restrain them without excessive risk to either side – what was absolutely and minimally required was four or five strong, trained male nurses.

    Lacking these, somebdy is going to get hurt, one way or another, for sure.

    My guess is that the required personnel were/ are lacking – therefore somebody gets hurt.

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