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Administrative Medical Decisions via policy statements


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  • Moderator

In another thread it came up about admin setting schedules or other policy which might be interpreted as a medical decision....

on that thread, what bout this???

 

What about this scenario. 

 

Sheriff (she does not hold any type of license to practice medicine) states “no suboxone or methadone in a jail because I don’t believe in  them, I believe in abstinence”

 

so people coming in (even those stable for years) are forced detox.  

 

Is this his person practicing medicine with out a license?   

 

 

Is this admin making medical decisions?

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  • Administrator

Not sure.  Ask a lawyer, and they'd say "definitely maybe".  While those narcotics are clearly used as medicine, in the ways you describe and others, they are also clearly substances of abuse and traditionally things that can be excluded from jails.

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To extend the analogy to an extreme just for discussion...what if the Sheriff believed in stopping insulin because diabetes is just a disease of fat people and they just need to eat right and exercise? Or what if she was an herbalist and wanted to substitute plant remedies for medicine?

I covered a small poor local jail when I worked at a Community Health Center and there was endless pressure (and complaints) to switch people off meds that were working fine and put them on something cheap. Once they wanted me to stop an expensive anti-psychotic and give the patient Prozac "because it's the same thing like and we looked it up."

Yes it is medical decision making. Is it legal? Probably

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I guess my biggest question in all of this is when does a sheriff decide to give these meds (including insulin mentioned above)?  He/She is not a medical professional, so to give any "med" requires very specific exemptions.

Overall, my guess is that it boils down to ensuring patients get medical attention when needed.  A prisoner/patient going through withdrawals sucks for that individual, but is not necessarily a medical emergency.  If it becomes an emergency then the prison is required to have that person evaluated by a medical professional or face significant liability.

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