TIME Healthcare

When Can a Person Be Forced to Receive Medical Care?

'We subscribe to the principle that people should get to make decisions for themselves almost all the time'

Last week, the case of a Connecticut teenager, identified as Cassandra C., 17, made headlines. Diagnosed with Hodgkin’s lymphoma, Cassandra wanted to forgo chemotherapy altogether—a decision her mother reportedly supported. But in early January, child services took the 17-year-old into custody and on Jan. 8 the state Supreme Court denied the teenager’s request to not receive the drugs.

The state’s interference in a personal decision about health care provides a rare lens into when and how health officials can mandate health care. Forced treatment is rare, but it happens when people, most often minors and the mentally ill, find themselves in extenuating circumstances.

“We subscribe to the principle that people should get to make decisions for themselves almost all the time,” says Paul S. Appelbaum, a psychiatry, medicine and law professor at Columbia University. “The exceptions to that rule are rare. What we’re seeing play out in Connecticut is really the exception, not the rule.”

Competent adults in the United States are almost always permitted to make their own health care decisions, even if that means forgoing a potentially life-saving treatment. Even in cases of highly infectious disease, state laws don’t typically allow forced medical treatment. Instead, sick individuals may be quarantined until they agree to comply with treatment procedures.

The most obvious exception to the principle applies to mentally ill patients deemed incompetent to make their own health decisions. Though laws vary for long-term involuntary treatment between states, most jurisdictions allow short-term hospitalization for individuals thought to be a risk to themselves or others.

Read more: Dangerous Cases: Crime and Treatment

Minors have no official say when it comes to decisions about their health care; parents or guardians are typically charged with making treatment decisions on their behalf. (Minors do have the right to petition the courts to show that they are “mature”—something Cassandra from Connecticut did—and therefore capable of making their own decisions. Cassandra’s petition was denied.)

If parents refuse a recommended treatment, the state typically works with parents to reach a mutually agreeable solution, says Appelbaum. If the parties still can’t agree, the case may go to the courts. “The legal principles here are fairly consistent, but their application is not necessarily straightforward,” said Appelbaum of the difficulty of resolving health care issues in court. “There is no algorithm.”

When brought to court, judges weigh a range of concerns, including the consequences of leaving an ailment untreated. Life-threatening conditions are much more likely to result in forced treatment than, say, a recommended cosmetic surgery, said Appelbaum.

“How long is a person actually supposed to live, and why? Who determines that?” Cassandra wrote in a op-ed in the Hartford Courant. “I care about the quality of my life, not just the quantity.”

The court, which had previously ruled Cassandra’s mother unfit to make decisions on her daughter’s behalf, rejected Cassandra’s explanation and ordered her to undergo chemotherapy.

“This is a curable illness, and we will continue to ensure that Cassandra receives the treatment she needs to become a healthy and happy adult,” said a statement from the Connecticut Department of Children and Families.

TIME justice

New York to End Solitary Confinement for Inmates Under Age 21

The move comes after a federal lawsuit against the city over its treatment of young inmates

New York City officials Tuesday said they would eliminate the use of solitary confinement for all inmates age 21 and under at the notorious Rikers Island prison in the wake of an outcry over the prison’s treatment of its inmates.

The city’s Board of Correction approved the policy change in a unanimous vote, 7 to 0, and the policy will go into effect January 2016 as long financing for additional officers and clinical staff members is secured, the New York Times reports.

The U.S. attorney’s office in Manhattan is suing the city over its treatment of adolescent inmates, after revelations of brutal treatment and neglect of inmates on New York’s Rikers Island. Corrections officers have used solitary confinement as a key tool in controlling inmate behavior, but critics say it can leave lasting psychological damage on young prisoners.

The new policy, which comes in the face of mounting criticism over the punitive technique, would put Rikers Island at the forefront of national jail reform efforts. Jails in the U.S. considered to be the nation’s most innovative still use solitary confinement as punishment for inmates over 18.

“I’ve never heard of anything like that happening anywhere else,” Ms. Herrman said, referring to the New York City plan. “It would definitely be an innovation.”

[NYT]

TIME Crime

Vietnam Vet Loses Bid to Stop Execution on PTSD Claim

Andrew Brennan was convicted of shooting and murdering a 22-year-old cop

A decorated Vietnam veteran who argued he was suffering from post-traumatic stress when he killed a sheriff’s deputy in 1998 lost a bid for clemency on the eve of his scheduled execution. The Georgia Board of Pardons and Parole declined to commute the death sentence of Andrew Brannan to life in prison after hearing from prosecutors and defense lawyers at a Monday hearing.

Brannan was convicted of murdering Laurens County deputy Kyle Dinkheller, who had stopped him for driving 98 mph. Dash-cam video showed Brannan dancing in the street and saying “shoot me” before he pulled a rifle from his car and…

Read the rest of the story from our partners at NBC News

TIME Terrorism

What Those Pentagon Twitter Hackers Posted

The Pentagon
Getty Images

An avalanche of almost-classified info sows confusion

The Pentagon held its breath Monday when Islamic State sympathizers hacked into U.S. Central Command’s Twitter and YouTube accounts and began posting internal U.S. military documents on the Twitter feed.

Could this be another Snowden job? Was any of the material classified? After all, they were posting the names, addresses and phone numbers of senior U.S. military officers.

Within an hour, the Pentagon’s sigh was audible. While there was a lot of official-looking, internal documents posted before both social-media accounts were shut down, none of it appears to have been classified.

 

"FOUO" can be found on many released Pentagon documents
“FOUO” can be found on many released Pentagon documents

Many sported the officious-sounding but non-classified For Official Use Only label.

Monday’s bullet-dodging highlights the U.S. government’s preoccupation with secrecy, and its downside: when nearly everything is classified, it can be harder to protect real secrets.

 

Central Command’s feed was back in operation Tuesday. Twitter

Think of the government’s penchant for secrecy like an iceberg: what’s showing above the water line is that tiny share that’s classified Confidential, Secret and Top Secret.

But underwater—where, strangely, you can’t see—are more than 100 different designations that boil down to “Don’t let the public see this.”

…but its feed still featured the CyberCaliphate avatar. YouTube

For example, the non-profit Project on Government Oversight grumbled last year about the Pentagon inspector general’s routine requirement that any member of the public wishing to see some of its more interesting reports file a formal Freedom of Information Act request. “As anyone familiar with the FOIA process knows, turnaround on a request can take anywhere from a few weeks to a few years,” POGO’s Neil Gordon noted. “So, it’s reasonable to assume that the DoD IG is indeed trying to bury the report to spare the Pentagon and … its … contractors the embarrassing publicity.”

The varying labels—and each agency’s rules for releasing non-classified information—is confusing, as the Obama Administration itself conceded in 2010:

At present, executive departments and agencies (agencies) employ ad hoc, agency-specific policies, procedures, and markings to safeguard and control this information, such as information that involves privacy, security, proprietary business interests, and law enforcement investigations. This inefficient, confusing patchwork has resulted in inconsistent marking and safeguarding of documents, led to unclear or unnecessarily restrictive dissemination policies, and created impediments to authorized information sharing. The fact that these agency-specific policies are often hidden from public view has only aggravated these issues.

That’s why it wants to toss all those agency-specific labels into the trash and designate them all as Controlled Unclassified Information. Perhaps the reduced profusion of almost-classified labels will help reduce confusion like Monday’s (the Pentagon, of course, has its own process underway for all its non-classified technical data). And having the word Unclassified in the designation should make it clear to even cable-news anchors what’s up.

The Administration plans to issue a proposed regulation to funnel all the labels into that single Controlled Unclassified Information designation this spring. It’s slated to be fully operational in 2018.

Obviously, in addition to craving secrecy, the government abhors alacrity.

Read next: Twitter Hacking Gives Pentagon a Black Eye

Listen to the most important stories of the day.

TIME Crime

Mistrial Declared in Case of South Carolina Cop Who Killed Unarmed Black Man

Former Eutawville Police Chief Richard Combs sits with lawyers on the second day of testimony in his trial for the murder of Bernard Bailey in Orangeburg, South Carolina, Jan. 8, 2015.
Former Eutawville Police Chief Richard Combs sits with lawyers on the second day of testimony in his trial for the murder of Bernard Bailey in Orangeburg, South Carolina, Jan. 8, 2015. Reuters

Richard Combs, the former police chief of Eutawville, S.C., charged with murder of Bernard Bailey in May 2011

A judge in South Carolina declared a mistrial in the case of a white ex-police chief charged with murder in the killing of an unarmed black man in 2011.

The jury deliberated for 12 hours before failing to reach a consensus over the verdict, according to the Associated Press. Richard Combs, the former police chief of Eutawville, S.C., shot Bernard Bailey three times outside of the town hall in May 2011.

Combs, the small town’s only officer on patrol, said he fired in self defense and that Bailey was attempting to run him over with a truck when he tried to arrest him. Throughout the trial, according to the New York Times, state prosecutors attempted to paint Combs as spiteful and was arresting Bailey on a trumped-up charge.

The Department of Justice declined to file charges after a yearlong investigation into Bailey’s death, according to Bloomberg. State prosecutors say they will attempt to try Combs again.

[AP]

TIME People

Donald Trump Says Air Traffic Controllers Deliberately Flying Planes Over His House

Donald Trump in 2014.
Donald Trump in 2014. Paul Morigi—WireImage/Getty Images

Sues Florida county for $100 million over noise pollution

Real estate mogul Donald Trump claims that Palm Beach County, Florida is deliberately directing air traffic over his ritzy Palm Beach club, and he’s suing—for $100 million.

Trump says in the lawsuit filed last week against Palm Beach County that his history of conflict with Palm Beach International Airport has led officials to vindictively redirect air traffic over his historic Mar-a-Lago estate in south Florida.

Noise and vibrations from the planes are causing damage to the antique Spanish tiles, roofing and stone construction, Trump’s lawsuit says. Trump says his own Boeing 757 has been redirected, too.

“I am saving one of the great houses of this country and one of its greatest landmarks,” he said Monday, “and it’s being badly damaged by the airplanes.”

The reality show honcho and two-time presidential hopeful has sued the county twice before, the Associated Press reports, with one case ending in a lease agreement and another dismissed.

[AP]

Read next: Donald Trump Fired Someone From ‘Celebrity Apprentice’ for Not Calling Bill Cosby

Listen to the most important stories of the day.

TIME College football

Police Use Tear Gas on Rowdy Ohio State Fans

Police officers try to disperse the crowd of Ohio State fans trying to block High Street in Columbus, Ohio, as they celebrate the Buckeye's 42-20 win over Oregon following the National Championship football game between Ohio State and Oregon, Jan. 12, 2015.
Police officers try to disperse the crowd of Ohio State fans trying to block High Street in Columbus, Ohio, as they celebrate the Buckeye's 42-20 win over Oregon following the National Championship football game between Ohio State and Oregon, Jan. 12, 2015. Paul Vernon—AP

At least a dozen fires started after team's national title win

Police in riot gear used tear gas to break up crowds of revelers in Columbus early Tuesday after Ohio State’s national title win over the Oregon Ducks.

At least a dozen small fires were reported after thousands poured out of bars to celebrate the Buckeyes’ victory, authorities said.

Columbus Police Department spokeswoman Denise Alex-Bouzounis told NBC News that about 8,000 students forced their way into The Horseshoe stadium and tore down a goal post.

She described the crowds as being “intense” after the game. Three canisters of tear gas were used in front of the Ohio Union at around 1:15 a.m. …

Read more from our partners at NBC News

TIME Crime

Arrests in New York City Increased Significantly Last Week

A NYPD patrol vehicle is seen near the Marcy Houses public housing development in the Brooklyn borough of New York
A New York Police Department patrol vehicle is seen near the Marcy Houses public housing development in the Brooklyn borough of New York January 9, 2015. Stephanie Keith—REUTERS

But they're still far lower than they were during the same week last year

The number of arrests by the New York Police Department rose during the last week, following two weeks of rapid decline amid talk of a deliberate slowdown by the city’s law enforcement.

New numbers released Monday revealed that 4,690 arrests had been made during the week ending Jan. 11, compared to 2,401 between Dec. 29 and Jan. 4, the New York Times reported.

That number still pales in comparison to the 7,508 arrests made during the same week last year, but indicates police officers have heeded last week’s stern message from Commissioner William Bratton.

Bratton told police commanders and union leaders that he expected an end to the slowdown, which took place following the shooting of two officers in apparent retaliation for the deaths of Eric Garner and Michael Brown

[NYT]

TIME georgia

Judge Could Rule in Dispute Over MLK Bible and Nobel Medal

US civil rights leader Martin Luther King, display
Martin Luther King, displays his Nobel Peace Prize in Oslo on Dec. 10, 1964 AFP/Getty Images

Both relics reside in a safe deposit box, the keys held since March by an Atlanta judge

(ATLANTA) — The Rev. Martin Luther King Jr.’s traveling Bible hasn’t gone on regular display since President Barack Obama used it while taking his second oath of office two years ago. The public hasn’t seen the slain civil rights icon’s 1964 Nobel Peace Prize medal in recent years, either.

Both relics reside in a safe deposit box, the keys held since March by an Atlanta judge presiding over the latest — and in many eyes, the ugliest — fight between King’s heirs.

The Estate of Martin Luther King Jr. Inc., which is controlled by Martin Luther King III and his younger brother, Dexter Scott King, asked a judge a year ago to order their sister Bernice to turn over their father’s Nobel medal and traveling Bible. The brothers want to sell them to a private buyer.

Fulton County Superior Court Judge Robert McBurney could decide the case at a hearing Tuesday or let it go to trial. He said when he ordered Bernice to hand over the Bible and medal to the court’s custody that it appeared likely the estate will win the case.

This is at least the fifth lawsuit between the siblings in the past decade, but this one crosses the line, Bernice argued in February from the pulpit of historic Ebenezer Baptist Church in Atlanta, where her father and grandfather preached. Her father cherished these two items, which speak to the very core of who he was, she said.

The Rev. Timothy McDonald, who served as assistant pastor at Ebenezer from 1978 to 1984 and sides with Bernice but describes himself as a friend of the whole family, told The Associated Press: “You don’t sell Bibles and you don’t get but one Nobel Peace Prize. There are some items that you just don’t put a price on.”

The estate’s lawyers have not responded to requests for comment from the King brothers. At a hearing last year, a lawyer who represented the estate at the time said they want to sell the two items because the estate needs the money.

Paying lawyers to enforce the rights to King’s words and image is expensive, attorney William Hill reminded the judge, drawing chuckles.

The estate is a private entity, so its finances aren’t public, and court records don’t elaborate on the estate’s need for cash.

Whether to sell the Bible and the medal is not up to the judge, or even part of the lawsuit, which is purely an ownership dispute.

Lawyers for Bernice have argued, among other things, that King gave the Nobel medal to his wife as a gift, meaning that it is part of Coretta Scott King’s estate. Bernice is the administrator of her mother’s estate.

King’s heirs have previously parted with parts of his legacy. They sold a collection of more than 10,000 of his personal papers and books in 2006 for $32 million, a collection now housed at Morehouse College, King’s alma mater.

Two separate appraisers, Leila Dunbar and Clive Howe, told the AP they would expect the medal to sell for about $5 million to $10 million, and possibly more, based on what other Nobel medals have gone for and King’s place in history.

Dunbar said she would expect the Bible to sell for at least $200,000 and possibly more than $400,000. Howe said it would probably go for about $1 million.

If they are sold through a private sale, which can bring substantially higher sums from buyers who want to secure items before they get to auction, the medal alone could fetch $15 million to $20 million, Howe said.

Both items have enormous societal value and should be on public display, said Barbara Andrews, director of education and interpretation at the National Civil Rights Museum in Memphis, Tennessee. The Bible is important because of who King was, and the Nobel Peace Prize because of what it signified — that the fight for civil rights was being recognized on a world stage, she said.

While museums and books can talk about the medal, being able to see it renders it tangible, “more than a photograph, more than us just talking or writing about it,” Andrews said.

“We like to own things. We like to touch things. We like to see them with our eyes. It satisfies that need in us to see the physical manifestation of the award.”

Even in the hands of Bernice, though, neither item has regularly been available to the public.

A replica of the medal has been on display at the King Center for about 17 years, but it’s unclear when the medal itself was last shown, King Center spokesman Steve Klein said.

Martin Luther King Jr. was assassinated in Memphis in 1968. Among his children, Martin III got his father’s name, while Dexter got his looks. Bernice followed her father into the ministry and shares his gift for public speaking. And the firstborn, Yolanda, was known as a peacekeeper.

Even before she died in 2007, though, the siblings had taken their quarrels public and gone through periods where they didn’t speak to each other.

In December 2005, Bernice and Martin successfully fought a push by Yolanda and Dexter, who along with other trustees of the Martin Luther King Jr. Center for Nonviolent Social Change wanted to sell it to the National Park Service. In 2008, two years after the death of their mother and a year after Yolanda died, a long-simmering dispute between the surviving siblings boiled over, with three lawsuits filed between them in as many months.

In August 2013 — on the 50th anniversary of King’s “I Have a Dream” speech — the estate asked a judge to stop the King Center, where Bernice is the CEO, from using his image, likeness and memorabilia, arguing that the center wasn’t caring for King artifacts properly.

That case is pending.

TIME Accident

Former NFL Player Says He Swam 9 Miles to Shore After Falling Off Boat

Rob Konrad, Tammy Konrad
Former Miami Dolphins fullback Rob Konrad, left, listens while his wife Tammy, right, responds to a question during a news conference on Jan. 12, 2015, in Plantation, Fla. Lynne Sladky—AP

Konrad was fishing when a wave knocked him overboard into the ocean

A former Miami Dolphins player said Monday that he spent 16 hours swimming to shore after falling off a boat last week.

Rob Konrad held back tears during a news conference in Plantation, Fla., as he explained his unusual nine-mile swim to safety, during which he says he encountered stinging jellyfish and a shark, CNN reports.

Konrad, 38, said he was fishing when a wave hit his boat, which was set on autopilot, and knocked him overboard. He was not wearing a flotation device and decided to swim to shore, alternating between the breast stroke and backstroke, knowing he was hours away from the onset of hypothermia.

“I quickly realized I was in a real bad situation,” he said. “I made a decision that I was going to start swimming toward shore, west.”

He was almost found a twice. Konrad said approached a fishing vessel but no one saw or heard him, and he recalled that a U.S. Coast Guard helicopter, which was searching for him, flew right over him. After hitting shore early Thursday, a security guard alerted police and he was taken to a hospital, where he was treated for hypothermia, dehydration and rhabdomyolysis.

“If you’re a good swimmer and you’re faced with an emergency, you could be capable of doing what he did,” said Sid Cassidy, an accomplished distance swimmer who has trained in the area where Konrad swam.

[CNN]

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