Dennis A. DIXON, Appellant, v. Louis JACOBS, Superintendent of Saint Elizabeths Hospital.
No. 23378
United States Court of Appeals, District of Columbia Circuit.
Order Feb. 5, 1970. Opinion April 10, 1970.
138 U.S. App. D.C. 319 | 427 F.2d 589
A different disposition is required as to so much of the Board‘s order as requires the Company to cease and desist from (among other acts) “reclassifications.” It is possible that this wording is the product of an unreflecting transposition of some master form. However in view of the issue before us we cannot disregard as captious the possibility that it was intended to refer, or may be taken to refer, to an action like the 59.5-cent reclassification not alleged in the complaint as an illegal act. We think it in the interest of justice to remand the case to the Board so that it may either withdraw the word or explain, if some other meaning was intended, its appropriateness absent a finding that the reclassification was an unlawful act. We further deem it appropriate to direct the Board to reconsider the remainder of its remedy to determine if it is attributable, in severity or content, to the apparent improper finding of reclassification.
In upholding the ultimate finding of the Board we note that the presence of the reclassification issue in this case cannot be said to have “tainted” the proceedings in any sense. Although not charged as a separate illegal act, the reclassification was relevant both to the motives of the Company in instituting the 14-cent wage increase and to the impact of the 14-cent wage increase. As such it was a matter that was properly before the Board.
Our remand is to obviate any doubt that the Board‘s discretion in the choice of remedy was affected by an improper finding. We do not mean to suggest that the present remedy, apart from section 1(c), cannot be supported on review by the facts properly charged, litigated, and found. We merely require that the Board exercise its discretion as to the scope of its remedy without any possible influence from a slip of the pen or other mishap.
Our conclusions both in upholding the ultimate findings and conclusions of a violation of § 8(a) (3), and in remanding for a further examination of remedy in light of a circumscribed subsidiary finding, are supported by the principles set forth in Braniff Airways, Inc. v. C. A. B., 126 U.S.App.D.C. 399, 412, 379 F.2d 453, 466 (1967); N. L. R. B. v. Reed & Prince Mfg. Co., 205 F.2d 131, 139 (1st Cir. 1953), cert. denied, 346 U. S. 887, 74 S.Ct. 139, 98 L.Ed. 391 (1953).
Remanded for proceeding consistent with this opinion.
Messrs. Thomas A. Flannery, U. S. Atty., John A. Terry, Oscar Altshuler, and Gregory C. Brady, Asst. U. S. Attys., were on the motion, for appellee.
Before BAZELON, Chief Judge, and LEVENTHAL and ROBB, Circuit Judges, in Chambers.
BAZELON, Chief Judge:
This case presents several questions concerning the procedure to be followed by Saint Elizabeths Hospital and the District Court when a patient involuntarily committed desires his release. The appellant here was committed to the hospital in 1964, after his acquittal on grounds of insanity of charges of murder and assault with intent to commit carnal knowledge. On May 29, 1969, he petitioned the District Court pro se for a writ of habeas corpus, seeking release from confinement primarily on the ground that he had recovered his sanity and was no longer dangerous to himself or others.1
(1967);
I.
One preliminary matter requires mention. The government, conceding that nonexistent administrative remedies need not be exhausted, has moved that this case be remanded to the District Court to determine the existence and adequacy of the asserted remedies. We do not believe, however, that it would be proper for us so to dispose of this case. The government‘s concession of error does not relieve us of the responsibility for decision.5 And several factors make this case inapposite for an unexplicated remand. We should not require a mental patient to shuttle back and forth between courts as his case is disposed of in piecemeal fashion.6 Full treatment of this case will not require the decision of any constitutional questions.7 It appears that the District Court does not normally make a practice of appointing counsel to represent indigent patients seeking release until the questions involved here have been passed.8 Although the government has admitted that there is a serious question whether the claimed administrative remedies exist, it has continued to suggest to the District Court that petitions for release be summarily dismissed for
II.
It is clear on this record that disputed issues of fact and law were before the District Court. Confinement of the mentally ill rests upon a basis substantially different from that which supports confinement of those convicted of crime. In the latter case, with rare exceptions,10 the continuing validity of confinement rests solely on the validity of the initial commitment. Confinement of the mentally ill, however, depends not only upon the validity of the initial commitment11 but also upon the continuing status of the patient. Specifically, under our statutes,12 he must be released from the hospital if he is no longer mentally ill;13 if, although he remains mentally ill, he is no longer “likely to injure himself or other persons“;14 or, should the patient so desire, if a course of outpatient treatment can be fashioned that will adequately protect the interests both of the patient and the public.15
Therefore, when appellant sought his release from confinement, he brought those issues before the District Court.16 Since all of the issues related to appellant‘s present status,17 it could hardly be said either that the merits of his claim had been determined in prior proceedings18 or that appellant‘s failure to present these issues in such
III.
In its return to the order to show cause, the hospital pointed out that appellant had previously filed two petitions for release on habeas corpus, and that both had been determined adversely to him. The more recent of the two was decided in July of 1968 — some ten months before the instant petition was filed. Although the return does not so indicate, it appears from the records of the District Court that both adjudications reached the merits of appellant‘s claim that he was entitled to release from the hospital; that an evidentiary hearing was held in each case; and that appellant was represented in each case by assigned counsel. It is clear to us that the District Court was entitled to take notice of its own records, but even assuming the adequacy of the factfinding process in the previous hearings,20 sufficient time had passed since the last determination that appellant was entitled to raise the issue anew. Judicial guidelines in this area are admittedly vague;21 under the circumstances, we think it is best to rely upon the standard set by Congress in analogous proceedings under
IV.
This court has often urged upon Saint Elizabeths Hospital its responsibility for the creation and administration of internal procedures for the review of its own decisions, as well as its statutory responsibility23 for the maintenance of an adequate system of records to record and explain such decisions. See, e. g., Covington v. Harris, 136 U.S.App.D.C. 35, 44, 45, 419 F.2d 617, 626-627 (1969). Proper performance of these responsibilities will in many instances diminish the need for judicial review by enhancing the reliability of the decision-making process,24 and at the same time both aid and limit the judicial function in those cases where
judicial review is sought. Where the challenged decision relates essentially to the internal administration of the hospital — as, for example, when a patient seeks to enforce his right to adequate treatment;25 when he seeks transfer to a less restrictive ward within the hospital;26 and, perhaps, when he seeks conditional rather than unconditional release27 — we have recognized “the responsibility the law places also upon those in charge of the institution.” Covington v. Harris, supra at 47, 419 F.2d at 629 (Fahy, J., concurring). In such cases, judicial review is limited to the determination whether the administrator “has made a permissible and reasonable decision in view of the relevant information and within a broad range of discretion.” Tribby v. Cameron, 126 U.S.App.D.C. 327, 328, 379 F.2d 104, 105 (1967).
When the patient is seeking complete release from confinement, however, the scope of judicial review is broader. In such cases the function of the court is not simply to review the hospital‘s decision for unreasonableness, but rather itself to decide the ultimate question: whether the present status of the patient is such that continued confinement is justifiable.28 The patient need only establish, by the preponderance of the evidence,29 that he is no longer likely to injure himself or other persons because of mental illness. Bolton v. Harris, 130 U.S.App.D.C. 1, 12, 395 F.2d 642, 653 (1968). Correlative to the increased scope of judicial review is a more limited role for the doctrines requiring prior resort to administrative procedures. In the present case, the hospital suggested that dismissal was in order because of appellant‘s failure to exhaust two claimed administrative remedies. We examine each in turn.
The hospital‘s return noted that “Hospital records reveal that the petitioner has not submitted a written request to the Chief of Service for a current medical examination within the last six months.”30 It cited Bolton v. Harris, supra at 12 n. 59, 395 F.2d at 653 n. 59, for the proposition that “patients must exhaust these administrative remedies before applying for a writ of habeas corpus.” We believe the hospital‘s position rests on a misunderstanding both of Bolton and of the statutory scheme. Periodic examination, with a view both towards eligibility for release and adequacy of treatment, is not a right available to patients only upon written request. It is a statutory duty imposed upon the hospital regardless of action taken by the patient.31 The remedy that must be exhausted is not the request, but the examination. If an examination has been conducted within the last six months, further request would likely be useless; the remedy has been exhausted.32 If the hospital has
The hospital‘s second suggestion was that appellant had failed to avail himself of his “right to be examined by an outside psychiatrist.”35 We likewise conclude that this response was insufficient to justify a delay in reaching the merits below. For the requirement that administrative remedies be exhausted before judicial decision is had presupposes both that the remedies exist36 and that they are adequate to protect the interests asserted.37 Both of these facts must be demonstrated to the District Court before it may defer to the administrative body.38 The present return is inadequate on both grounds.
The return gives no indication how such an examination might be requested, nor does it indicate that such a request, if made, would be honored. Papers filed in this court suggest that no funds are available to compensate outside psychiatrists for the examinations required by statute, and that in consequence no such examinations are being made.39 The government has not sought to dispute this claim; and in consequence, we would not feel justified in construing the return, filed under oath in the District Court, as swearing that outside examinations were in fact available. And unless so construed, the return cannot provide the District Court with the information necessary for it to conclude that the remedy to be exhausted in fact exists.
V.
We are compelled to close on a note of sadness. Procedures to determine the proper disposition of the mentally ill are among the most difficult that must be faced by the courts. The decisions that must be made are difficult at the very best; without full cooperation by all parties to the proceedings, they are nearly impossible. The District Court in particular faces an awesome task. It is charged not only with the ultimate responsibility for decision, but also with the duty of assuring, in the last analysis, that the interests of the patient and the public are properly protected. The appointment of capable counsel can serve to lift some of the burden from the shoulders of the court, and we urge the District Court to make fuller use of this tool. But even counsel cannot do the whole job.
It is in this regard that Saint Elizabeths bears a special responsibility for assuring that information regarding the patient‘s condition is fully presented to the District Court, and that the court understandingly considers the information presented. We can understand a defensive reaction from those whose professional judgment is challenged when a patient seeks release from the hospital; we can sympathize with a psychiatrist‘s distaste for appearing in court, both because of the time lost from other activities and because of the possibility that, either through failure of communication or through pressures inherent even in the less-than-adversary proceedings here involved, he will be made in public to appear a fool. But psychiatrists may not, for the sake of preference or convenience, avoid their duty to the patients entrusted to their care. It is no insult either to the integrity or to the professional skills of the doctors at Saint Elizabeths Hospital to point out again that the ultimate determination of eligibility for release is, under our statutes, a matter of law for the determination of the court. This determination cannot be properly made without the fullest explanation from the expert witnesses of the patient‘s mental condition. But once
It is hard to understand the behavior of the hospital authorities that is shown by this record. In response to appellant‘s petition for release, the hospital made no effort to ventilate the issues for decision; its reaction was only to attempt to avoid any review whatsoever of its action. Although it has conceded in this court — where appellant is represented by counsel — that the action below was improper, it has continued to urge the District Court to take precisely the same action on petitions filed by patients unrepresented by counsel. This is hardly the standard one would expect from a body dedicated to the welfare of its patients.
It is inevitable that those involved in the decision-making process will thereby obtain a stake in upholding the correctness of their decision once reached. Few, if any of us enjoy having our determinations changed by higher authority. But we must never lose sight of the fact that, whether the hospital‘s decision is overthrown or upheld, whether the District Court‘s judgment is reversed or affirmed, the strongest impact is not on the decision-maker but upon the patient. His interests, not those of the hospital or of the courts, must be the paramount factors bearing upon decision.
The judgment of the District Court is reversed, and the case remanded for further proceedings consistent with this opinion.
So ordered.
LEVENTHAL, Circuit Judge:
I concur in the result and in so much of the opinion as explains why the hospital authorities, including appellee superintendent, could not validly claim in the District Court that appellant‘s petition for habeas corpus must be dismissed for failure to exhaust administrative remedies.
As to the rest of the opinion, I feel obliged to say that passages I believe to be dicta set forth views as to which I have grave reservations.
The paramount factor bearing on decision is not the interest of the patient, but rather the interest of society, which includes of course, as a key element, the interest of the patient in not being subject to confinement that is unreasonable or without foundation.
I concur in requiring some continuing review, by hospital authorities and courts, of the possibility that a criminal defendant no longer represents a danger to society.
What I find doubtful is the view of the majority opinion that because Congress has provided that a civilly committed person cannot be kept in confinement if he is not “likely to injure himself or other persons,”1 the same standard governs a man who has killed another, and is relieved of a conviction for that homicide only because of a doubt that this may have been the product of a mental disease.
Plainly the acquittal by reason of insanity reflects a jury determination, beyond a reasonable doubt, that except for the defense of insanity, defendant did do the act, e. g. kill the deceased, and have the intent, that constitutes the substantive crime without any exculpation or mitigation in non-insanity defenses (e. g. self-defense). Lynch v. Overholser, 369 U.S. 705, 714, 82 S.Ct. 1063, 8 L.Ed.2d 211 (1962). If a jury is not ready to make that determination it must acquit completely, without going on to consider the insanity defense.
Congress has provided in
The Code provides that the court shall release a person acquitted by reason of insanity “if the court finds that such person has recovered his sanity and will not in the reasonable future be dangerous to himself or others.”
This difference goes beyond the obvious point that the action that resulted in the trial will at a minimum be “strong evidence” that he may in the future be a danger to peace. Lynch v. Overholser, supra, 369 U.S. at 714, 82 S.Ct. 1063. It goes to the question of what society may reasonably provide when the evidence, though strong, establishes only that a substantial problem exists and does not show a likelihood that danger will recur. I think the existence of a substantial problem is not an adequate basis to confine or detain a man who has never harmed his fellow man, never committed the physical elements of a crime. But I would like at least to reserve the question whether the existence of a substantial problem may be enough basis to detain and confine someone who (except for the doubt as to mental responsibility) has committed a criminal act, at least if an act of violence was involved — unless the court is prepared to make some affirmative finding that it is at least more probable than not that he will not be violently dangerous in the future.2
I realize that I am now expressing a reservation on a point that was discussed in Bolton v. Harris, 130 U.S.App.D.C. 1, 395 F.2d 642 (1968). I fully agree with Bolton insofar as it concludes that subsection (d) may fairly be read — and in view of constitutional principles should properly be read — so that persons who invoke the insanity defense are not denied a judicial hearing and “procedures substantially similar to those in civil commitment proceedings.”3 What troubles me is that passage of Bolton which states that equal protection requirements dictate that the burden of proof in establishing eligibility for release for subsection (d) patients “must be the same as that for civilly committed patients.”4 Insofar as Bolton went beyond the procedural aspects of subsection (d) redeterminations and procedures for release, and discussed the standards governing judicial decisions on such applications, its expressions seem to me to be dicta, and as it happens dicta as to which I have grave reservations.
Congress might have thought, however, that having successfully claimed insanity to avoid punishment, the accused should then bear the burden of proving that he is no longer subject to the same mental abnormality which produced his criminal acts. Alternatively, Congress might have considered it appropriate to provide compulsory commitment for those who successfully invoke an insanity defense in order to discourage false pleas of insanity. We need go no further here than to say that such differentiating considerations are pertinent to ascertaining the intended reach of this statutory provision.
I see no reason to conclude that these words penned by Justice Harlan in 1963 were scrapped in 1966 by Baxstrom v. Herold5 in which he joined. What Baxstrom focused on were (a) procedures for civil commitment (need for jury determination) which were (b) extended on equal protection grounds to one whose prison term was about to expire (in fact did expire prior to the habeas proceeding), and who would thereafter be held on a new commitment. The applicable standard extended by the Court permitted release only if the person showed that he was sane.6
It seems to me likely that an important aspect of the 301(d) cases is that they are a class of cases in which the issue of mental irresponsibility is more doubtful. When the lack of mental responsibility is more clear the prosecutor himself is likely to invoke civil commitment rather than criminal proceedings. And if he does bring criminal proceedings the court may invoke insanity procedures without regard to or awaiting the motion of the defendant.
But if there is a greater doubt as to mental irresponsibility at the time of offense there may well be greater danger of calculated abuse of the defense. There is also a possibility — I am not well enough informed to say whether it is a probability — that the condition involved may be one which is less clearly defined and understood by the medical profession, that there is more doubt as to the existence of an illness, its connection with a past offense, and any future prognosis and forecast of danger.
There is an anomaly of sorts, but I think it may well be more surface than profound, in my willingness to consider further whether the class of persons more clearly ascertained as having serious mental problems (the civilly committed) may properly have a lighter burden for release. This could make very good sense if it turned out that in general that class is one as to which future predictions could be made with greater reliability and authority. The considerations suggesting reasonableness of a difference in standards are enlarged when we turn from purely medical considerations to others that are also involved, including the possibility that some part (unascertainable in extent) of the class of 301(d) patients may have meaningful elements of responsibility
This is not to suggest that there may be an indefinite hospital confinement based on doubt. There is an equal protection issue when a prisoner has served his prison sentence, and he may not thereafter be hospitalized on a different standard from that applicable to other citizens. Baxstrom v. Herold, 383 U.S. 107, 86 S.Ct. 760, 15 L.Ed.2d 620 (1966). The same considerations are, I think, fully applicable to one who has been confined in a mental hospital for a period equal to the maximum term permitted by law for the offense he committed (less mandatory release time provided by statute for those on good behavior during confinement). In that event the government cannot invoke a lesser standard to justify further confinement than that which it must meet for those never charged with crime.7
It may well be that there is another cut-off point in time of commitment — say the 5-year period presented by the Report of the A.B.A. Committee on Sentencing8 — which results in such a coincidence of both dilution of danger of abuse from those invoking the insanity defense and heightened reliability of prognosis, as to warrant condemnation of any further use of a different standard in 301(d) as arbitrary, an unreasonable perpetuation of commitment on the basis of substantial problems rather than likelihood of danger.
I do not believe or suggest, and do not consider that my reservation as to the majority opinion implies, that an individual is in any way to be “punished” because he was acquitted by reason of insanity. There is homely truth in the proposition that re-structuring of a person convicted of crime must begin with the determination, on his plea or on a verdict, that he was guilty of an antisocial act and bears responsibility for the commission of that act. I am also prepared to accept, at least as a working hypothesis, that the re-structuring of a person with mental illness, to the extent that such re-structuring may be possible, should begin with the explicit assumption that although he has engaged in conduct that is harmful to society he need not be trammeled by a sense of guilt in his effort to cope with the difficult task of changing his condition with treatment. But there is room for confinement without punishment because of danger, as is true not only of the mentally ill, but also of those who will infect others with disease (sometimes, as in the case of Typhoid Marys, though they are not themselves disabled by the disease). And in the case of confinement without punishment, I think there may be room for a difference in the standard that governs the issue of detention or release for the person who has already unhappily manifested the reality of anti-social conduct, perhaps even shifting to him the burden of proof that decides the doubtful case where we cannot have confidence in our predictions. In the last analysis the issue is one that inextricably intertwines public morality and public need.
These are large issues, and it may well be that the possibility of a difference in standards is more likely to provoke controversy in the abstract than ever will arise in disposition of particular cases. Perhaps the definition of the standard would be better developed in the light of particular cases, involving particular individuals and their prognoses, dangers, and histories (including the acts giving rise to the criminal charge or charges). It is certainly true that conclusions as to what should be done in particular cases will be most
The hospital‘s examination when made must be meaningful, and the conclusions subject to meaningful review. The exhaustion doctrine, established to ensure the essence of meaningful review, may not soundly be used to avoid such review, or to exhaust the patient rather than his remedies. On these matters I concur unreservedly in the opinion of the majority.
J. Garrett BEITZELL v. Bernard L. FRISHMAN. Belle F. Frishman, Appellant.
No. 22632
United States Court of Appeals, District of Columbia Circuit.
Argued Oct. 27, 1969. Decided April 14, 1970.
Mr. James C. Wilkes, Jr., Washington, D. C., for appellee.
Before BAZELON, Chief Judge, WILBUR K. MILLER, Senior Circuit Judge, and TAMM, Circuit Judge.
BAZELON, Chief Judge:
Appellant is the wife of one Bernard Frishman. She and her husband were defendants below in this suit to recover a broker‘s commission for an unconsummated sale of real property located in Maryland.1 Judgment was entered against both Mrs. Frishman and her husband; on this appeal, the husband‘s lia-
Notes
With formal matter omitted, the petition reads in full as follows:
Comes now Dennis A. Dixon, hereinafter to be referred to as the Petitioner, who deposes and says that he is of Legal age, and that he is a citizen of the United States, and that he is being held in violation of his rights. That the hospital is being Arbitrary & Capricious in his confinement of him.
Petitioner Dennis A. Dixon, is of sound mind and is no longer dangerous to himself or society:
Statement of Facts
(1.) Petitioner first entered this hospital on December 11, 1964, at which time he was suffering from Sexual Deviation, as so prescribed by Doctors of whom he was in the care of under a ninety (90) day observation period of time.
(2.) Petitioner now contends, he has used all treatment available to him, to cure him of said mental illness.
(3.) On or about the middle of January of 1968, the Petitioner Appeared in the United States District Court and the Attending Doctor, “Dr. Earl Baughman,” was asked a question by Petitioner‘s attorney, that if said petitioner was held in Saint Elizabeths Hospital for ninety nine (99)
(4.) Petitioner would like to have the transcript from this prior hearing on Writ of Habeas Corpus, to be made available as evidence in his behalf, that has not the money to get transcript as he has filed a paupers oath with Writ of Habeas Corpus.
(5.) Petitioner would also like to obtain for evidence in his behalf, a transcript from a Writ of Habeas Corpus, that was heard on or about the month of August of 1968, in which Petitioner‘s Doctor appeared and testified that said petitioner Dennis A. Dixon, had improved his mental condition much faster in such a short a period of time, as to the average person who has this type of mental illness and is committed or confined to this hospital, Saint Elizabeths Hospital.
(6.) Petitioner would also like to obtain for evidence in his behalf, the transcript of his trial on December 11, 1964.
(7.) Petitioner has been in Therapy since on or about October of 1968, and has also applied himself to all other therapy that he is able to use, which included environmental therapy.
The above stated should sustain in itself, that Petitioner is of complete recovery from his mental illness and should be granted by the Honorable Court his complete discharge from Saint Elizabeths Hospital.
Conclusion
Petitioner states in concluding, that his confinement as it is now being carried out under the present circumstances, constitutes “Cruel and unusual and or unjust punishment.”
Petitioner request[s] relief, due to the herein stated, in the kind and form of immediate release.
With formal matter omitted, the response reads in full as follows:
1. The petitioner, Dennis Allen Dixon (Dennis A. Dixon), alleges in effect that he is illegally detained in Saint Elizabeths Hospital, Washington, D.C. The respondent admits that the petitioner is confined in Saint Elizabeths Hospital, but denies that such detention is illegal.
The petitioner, Dennis Allen Dixon (Dennis A. Dixon), was admitted to Saint Elizabeths Hospital December 11, 1964, by order of the United States District Court for the District of Columbia, in accordance with the provisions of Title 24, Section 301(d), of the District of Columbia Code, as amended, after having been found not guilty by reason of insanity on charges of Assault With Intent To Commit Carnal Knowledge and Murder In The First Degree, Violation of Title 22, Sections 501 and 2401, of the District of Columbia Code in Criminal Number 705-63.
Copies of his commitment paper are attached hereto, marked Exhibit “A“, and prayed to be read as a part of this return.
2. The petitioner, Dennis Allen Dixon (Dennis A. Dixon), does not allege that the respondent is acting arbitrarily and capriciously in failing to certify him for release.
3. For the information of the Honorable Court, the respondent respectfully invites attention to the fact that the petitioner, Dennis Allen Dixon (Dennis A. Dixon), has had previous appearances in Court on a writs of habeas corpus, viz., H.C. 399-66, heard on or about October 10, 1966, and H.C. 135-68, heard on or about July 8, 1968. In each instance, the Presiding Judge discharged the writ, dismissed the petition and remanded the petitioner to the custody of the respondent for further care and treatment.
4. The respondent moves to dismiss the petition on the ground that the petitioner has failed to exhaust his administrative remedies, including the right to periodic examination by the Hospital staff and the right to be examined by an outside psychiatrist, pursuant to
5. During petitioner‘s period of confinement in Saint Elizabeths Hospital, he has been under the care and observation of members of the medical staff of Saint Elizabeths Hospital, skilled in the care, diagnosis and treatment of nervous and mental disorders, who are of the opinion that he is mentally ill, suffering from Sexual Deviation, and that because of such illness is likely to injure himself or others if allowed to go at liberty.
WHEREFORE, the premises considered, the respondent prays that the writ of habeas corpus should not issue.
The return was signed by the Superintendent of Saint Elizabeths Hospital, and approved by the Assistant United States Attorney responsible for such matters.
130 U.S.App.D.C. at 10, 395 F.2d at 651, 653.In People v. Lally, 19 N.Y.2d 27, 277 N.Y.S.2d 654, 244 N.E.2d 87, 91 (1966) defendant challenged the validity of confinement “by alleging and showing that he is not in fact insane.” There was no provision for release because of the existence of doubt — or the failure to find a likelihood of danger.
The administrator of each public hospital shall keep records detailing all medical and psychiatric care and treatment received by a person hospitalized for a mental illness and the records shall be made available, upon that person‘s written authorization, to his attorney or personal physician.
[b]y articulating a plan of treatment and explaining the basis for important decisions affecting the patient, [such records] would fully inform the court at a glance. Incidentally, they would also enhance the integrity, reliability, and thoroughness of the hospital‘s own decision-making procedures. The bothersome incidental paperwork is a small price to pay for so many blessings. Besides, such paperwork is often bothersome precisely because the process of formal articulation forces busy administrators to confront problems and considerations their intuitive reactions might have overlooked.
A patient hospitalized pursuant to a court order obtained under section 21-545. * * * may, upon the expiration of 90 days following the order and not more frequently than every 6 months thereafter, request, in writing, the chief of service of the hospital in which the patient is hospitalized, to have a current examination of his mental condition made by one or more physicians. If the request is timely it shall be granted. * * *
The provisions of § 546 were made applicable to patients committed under
The chief of service of a public or private hospital shall, as often as practicable, but not less often than every six months, examine or cause to be examined each patient admitted to a hospital pursuant to this subchapter and if he determines on the basis of the examination that the conditions which justified the involuntary hospitalization of the patient no longer exist, the chief of service shall immediately release the patient. (emphasis added).
Except for the provision regarding release without judicial supervision, this section applies to § 301 (d) patients as well. See Bolton v. Harris, supra note 30 at 11, 395 F.2d at 652.