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Since the patient had now discharged himself four times on one pretext or another, the Chairman of
the Health and Welfare Committee called a meeting of representatives of the hospital and the local
authority Legal and Health Departments. The patient himself was invited to attend. It was pointed out
to him that he was placing his own health and that of others in considerable danger by refusing to stay
in hospital. The patient agreed but said that he could not stand being confined. Although warned of
the possibility of legal action, he persisted in his refusal to co-operate.
In September an order was made under the above Act committing the man to hospital, but when an
officer of the Council visited his home he had disappeared. He was eventually found and an officer of
the Council accompanied by police and an ambulance crew entered the house and served the order, when
he was escorted to the ambulance and taken to the hospital.
Any notions that the local authority's responsibilities in this matter had been fulfilled were quickly
dispelled when it was learnt that the patient had on arrival at the hospital become extremely difficult to
control. The staff's difficulties in dealing with him were complicated by the reluctance of their legal
advisers to accept that the para (7) of the Section stating that "any officer of the hospital or institution
may do all acts necessary for giving effect to the Order" could include physical restraint. Later the
patient agreed to remain provided he was allowed to keep his clothes. Meanwhile, the Court Order,
which was close to its expiry date, was renewed. The man stayed for nine days, then surreptitiously
dressed himself ano left.
He was discovered a week later and appeared to settle down better, agreeing to hand in his clothes.
Bu the became difficult again when a request to be allowed home for Christmas was refused. One evening
his pyjamas and dressing gown were found lying on the floor. Once more he had run away and has not
been seen since.
The difficulties of the hospital should not be underestimated. A hospital is not guarded like a
prison, and wards tend to be under-staffed.
The moral problems in a case like this are considerable. Even though there is the support of the
law, it is difficult to forget that one is hounding a sick man. Yet a patient like this is a constantmenace,
especially to children, who may die from fulminant infections if exposed to the heavy doses or organisms
coughed up from the lungs. All the time, his own chances of cure, initially good, become progressively
less.
The liberty of the subject is a jealously guarded privilege in this country, though the law admits
that there are situations in which, for the protection of others, it is necessary to restrict the freedom of
one person. Since this piece of legislation isclearly insufficient when dealing with a markedly recalcitrant
individual, the alternatives are that is should be either strengthened so that hospital facilities are available
to contain this kind of situation or abandoned altogether and the risk to the community accepted, or
alternatively that some system of enticement is adopted sothat there is a stronger incentive toobtain
cure where the prospects are good.
A few days before this annual report went to the printers, there was a development which brought
the story to a tragic close. During June 1967, a doctor was called urgently to see the patient, who was
re-admitted the following day. He died just over a week later. A curiously ironic twist is given to this
by the fact that the cause of death was not tuberculosis, but a brain tumour, for which no means of
prevention is known.