• Forecast
  • News Tip
  • Categories
Temperature Precipitation
Estimated read time
3m 52s

Patient rights vs. treatment: A complex question

By Bonney Bowman 6:08 AM February 28, 2014

Medical professionals say they're held to strict guidelines when considering involuntary commitment.

ANCHORAGE – Court documents shed more light on the case of Bret Bohn, a 27-year-old Alaskan whose parents claim he’s being held captive by Providence Alaska Medical Center.

Bohn’s parents took him to Providence in October, suffering from insomnia, delusions and seizures.

Soon after, doctors declared Bret mentally incompetent. He was stripped of all his rights and appointed a state guardian to oversee his care.

Court documents show his parents were denied guardianship due to concerns for his safety.

A witness claims she heard his mother say she’d rather he died than be institutionalized. Records show she was also overheard encouraging Bret not to take his medication.

Lorraine Phillips-Bohn denies the accusations, but the case shows just how complex mental health issues and treatment can be for doctors and families.

When a person has a physical illness, like heart disease or diabetes, the treatment options are usually straightforward.

But when a person is battling mental illness, they may not be able to clearly articulate their wishes, or get anyone to listen.

That’s when doctors start deciding what’s best for a patient, whether or not that person agrees.

Patients at the Anchorage Psychiatric Institute — API — struggle with a variety of mental illnesses.

Medical Director Dr. Jenny Love says the first step to treatment is getting to know the person.

“We’re looking for their symptoms, we’re looking for diagnosis, we’re looking for opportunities to help that individual, but ultimately we’re not treating their diagnosis, we’re treating them,” Love said.

Doctors at API use a patient’s decision-making process to diagnose their mental capacity.

They work to decide if the patient’s thought process is logical, or if they’re using a magical type of thinking leading to illogical conclusions.

If a doctor declares someone mentally incapacitated, the patient starts to have less of a say in their treatment options.

“I think it has to be an ongoing dialogue and it is a tenuous line that you have to walk and it’s a balance that you have to reach,” Love said.

Not everyone believes doctors work hard enough to find that balance.

Jim Gottstein is an Anchorage lawyer and president of advocacy group Psych Rights.

He says involuntary drugging and commitment have become the easiest route for doctors dealing with a difficult patient.

“This stuff is all hidden and when the light of day is not shone on these kinds of things, you really have abuses go on and that’s what we’re seeing,” Gottstein said.

Love says her staff has to meet strict guidelines when considering involuntary commitment.

Doctors have to be able to prove in court that a patient can’t care for themselves, or would hurt themselves or others.

“It is not an easy route to take whatsoever,” Love said. “It takes a lot of background work.”

Gottstein says he’s known doctors to exaggerate in court, and judges tend to trust medical professionals.

“The doctor walks in and says, ‘Oh, regrettably this person is mentally ill and dangerous to himself or others and we need to lock him up so we can drug him,’” Gottstein said.

Once a person is found “incompetent” by the court, a guardian is appointed.

It could be a family, friend, a private professional or a state guardian who is tasked with balancing their patient’s wishes with their best interest.

“Just because you have a guardian appointed, doesn’t mean that you’re not capable of expressing your wishes and then it becomes a question of whether or not what you are expressing could cause you substantial harm,” said Elizabeth Russo, the supervising attorney for the Public Guardian Section of the Department of Health and Human Services.

But Russo admits those wishes aren’t always honored, saying, “it’s difficult when you’re mentally ill to have your voice heard.”

What’s concerning for many in the case of Bret Bohn is how he went from seemingly healthy to medicated — with no right to his own person — in a matter of months.

It begs the question, could this happen to me? Absolutely, Gottstein said.

“This could happen to anybody and it does happen to people and I get calls at least once a week from someone who’s been impacted by something like this and said I had no idea this was going on,” Gottstein said.

Love could only speak to the practices used at Anchorage Psychiatric Institute, not the other hospitals in town.

Bohn is at Providence Hospital.

“To be clear, hospitals don’t control guardianship,” representatives for the hospital said in a written statement. ”The best source of information on guardianship is the Office of Public Advocacy.”

Latest Stories

  • Crime

    Police: Women attacked on East Anchorage trail

    by KTVA CBS 11 News on Jul 28, 22:49

    The Anchorage Police Department is investigating an attempted sexual assault on a trail near East High School. According to a release, on Wednesday the woman was running on the trail, south of Bragaw Street and Northern Lights Boulevard, in a wooded area when a male attacked her from behind. Police said the male attempted to […]

  • News

    Mat-Su Farm Tours teach lessons in Alaska agriculture

    by Shannon Ballard on Jul 28, 21:48

    When it comes to tours of Alaska the options are abundant, but the focus of a new tourism business isn’t glaciers or reindeer, but agriculture. “It’s about general education to the public and getting to teach people from both in the state and Outside all about the diversity of agriculture here in Alaska,” Margaret Adsit, […]

  • Politics

    Hillary Clinton: ‘America is once again at a moment of reckoning’

    by CBS News on Jul 28, 21:31

    Last Updated Jul 28, 2016 9:19 PM EDT PHILADELPHIA – With her speech formally accepting the Democratic nomination Thursday night, Hillary Clinton capped off a week of oratory defending the strength of the American spirit and outlining the general election argument against Republican nominee Donald Trump. “America is once again at a moment of reckoning,” Clinton […]

  • News

    Alaska National Guard Day celebration on JBER

    by Bonney Bowman on Jul 28, 21:26

    National Guard members and their families celebrated on base Thursday. Alaska National Guard Day is officially July 30. The legislature passed an act a few years ago declaring the day as a way to show their appreciation. Thursday’s event included food and fun for families, as well as National Guard displays. Organizers say it’s a […]

  • Crime

    APD: Mother of 4-year-old reported missing charged with child neglect

    by KTVA CBS 11 News on Jul 28, 21:16

    The mother of a 4-year-old girl, who went missing in Spenard on Wednesday, is charged with child neglect, according to Anchorage Police Department spokesperson Jennifer Castro. According to Castro, the child’s mother was intoxicated and had passed out. A family friend saw it and took the girl to her home. The friend texted the child’s […]

  • News

    UN: Freedom of assembly in US threatened by inequality

    by Associated Press on Jul 28, 19:18

    UNITED NATIONS (AP) – A United Nations expert says the right of freedom of assembly in the United States is threatened by racial, social and economic inequality. Maina Kiai, U.N. special rapporteur on the rights to freedom of peaceful assembly and of association, said in a statement issued Thursday that “racism and the exclusion, persecution […]

  • News

    Condition of abandoned fishing vessel off Alaska unknown

    by Associated Press on Jul 28, 19:08

    ANCHORAGE, Alaska (AP) – The condition of a fishing vessel abandoned is unknown days after the crew abandoned ship. The Alaska Department of Environmental Conservation says a salvage vessel is expected to arrive at the last known location of the Alaska Juris late Thursday. Officials said heavy fog has created low visibility concerns, and prevented […]

  • News

    What to know before you head to Arctic Thunder this weekend

    by Bonney Bowman on Jul 28, 17:52

    Preparations are under way for Arctic Thunder 2016, but there are a few things organizers want you to know before you go. The Boniface Parkway and Richardson gates will open to the public at 9:00 a.m. Saturday and Sunday. Volunteers will be on hand to help direct traffic to parking. Remember: All vehicles will be […]