Max Perrin, a 55-year-old male, was brought to the ER by the local rescue squad following a suicide attempt by means of consuming rat poison. The ER physician, Dr. Christopher LeMarke, recognized him immediately, as did the ER nurses. He had been a regular in the facility, having visited for his primary medical care and for two previous suicide attempts within the past eighteen months. During the previous visits his history had been explored completely. He was divorced, alienated from his adult children, and chronically depressed, but was not considered sufficiently impaired that he could be declared incompetent.
On the basis of state law such patients could be held for up to seventy-two hours on the signature of two physicians, if they were deemed dangerous to themselves or others. Mr. Perrin had never before engaged in any behavior that would suggest he was dangerous to others, but he surely was a danger to himself. He had on past admissions received short-term psychotherapy and prescriptions for anti-depressant drugs, but he had stopped taking them because he said they made him feel sleepy. He was now in the ER, incoherent and semiconscious.
Should Dr. LeMarke sign the involuntary commitment and initiate another round of therapy?
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