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Refusal of Care by Patients
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To the Editor: In his Grand Rounds discussion, Dr Carrese1 described the difficult ethical problem posed by a patient's insistence on returning home from the hospital to an unsafe situation. Pursuit of legal options, though not applicable for Mrs A, was discussed as one possible response.
In England and Wales, legislation permits compulsory removal to suitable premises for persons who (1) "are suffering from grave chronic disease, or being aged, infirm or physically incapacitated, are living in insanitary conditions" and (2) "are unable to devote to themselves, and are not receiving proper care and attention." A medical officer appointed by local government may apply to the court to remove such persons from their residence if it is considered in "their interests" or "for preventing injury of or serious nuisance to other persons."2 The legislation is Section 47 of the National Assistance Act of 19482 and the Amendment Act of 19513 . . . [Full Text of this Article]
Catherine Quigley, MB, MSc, FFPH
Catherine.Quigley@HPA.org.uk
Health Protection Agency North West
Liverpool, England
Janet Atherton, MB,BS, MSc, FFPH
South Sefton Primary Care Trust
Liverpool, England
Alison Rylands, BSc, MA, MB,BS, MPH, MFPH
Wirral Hospital NHS Trust
Birkenhead, England
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