In 1966, the pendulum swung … way too far.

Picture this, a mother with young children who was dragged from her home by the police and sent to an “asylum” because her husband said she was “crazy” and had her involuntarily committed, Meanwhile her children were sent to foster homes, separated and traumatized so that he could run away with his young “tart.” Yes this was a reality in 1935.


Fast-forward to 1966 when the case of Lake v. Cameron, was presented before a Washington, D.C., appeals court. Catherine Lake, a woman with mental illness, had been hospitalized against her will and kept involuntarily at St. Elizabeth's psychiatric hospital for many years. Lake petitioned the court on the grounds of “dangerousness” to herself or others. She was deemed to not be dangerous and won her release. The court decision stated that all patients who were not “dangerous” should not be confined if a less restrictive alternative is available.

Now here’s the conundrum. We are humans (even doctors) walking around this planet. We all have different perspectives, viewpoints and judgments. None of us is infallible or perfect. The lives of others are placed in the hands of those who decide, judge and otherwise determine the fate of those who may or may not be “dangerous to their selves or others.”

Add to dangerous to self or others the very important word “imminent.”

Ponder this, a woman walks away from a psychiatric treatment center, walking approximately 20 miles in 40-degree weather in little flat shoes and a lightweight coat. She is found cold and confused and taken to the emergency department.

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Is she an imminent danger to herself? Apparently the decision can be as simple as how badly you want her out of your emergency department. As the nurse who witnessed the multiple wanderings and unsafe behaviors there was no doubt in my mind. She was deemed “not dangerous” and sent out. When she arrived at another emergency department she was deemed a danger and admitted to the hospital.

This scenario happens every day across the country. The objective to protect all of us from those who may wish to take our rights and commit us against our will has pushed the limits and ultimately made us all less safe.

Here’s an example. The Virginia senator whose schizophrenic son was taken to an emergency department and eventually sent home because his rights would be violated to hold him longer to find an available bed in a psychiatric hospital. Despite his father’s attempts to have him held until he could get the appropriate psychiatric treatment, he was “dumped,” or sent out, only to pick up a knife and gun and attempt to kill his father and himself and end up dead.

Where does the fault lie, the law or the hospital?

Ah, and now we come full circle. Unless you don’t watch television, read a paper or otherwise are shielded from the news you have most certainly heard about the recent University of Maryland “dumping” scandal.

I must first issue a disclaimer. As a graduate of the University of Maryland School of Nursing and a former employee of University of Maryland Hospital, it is truly my first love. While across town at the highly praised yet not without their own scandals and issues, Johns Hopkins, we were also doing the tough jobs across town without the valor. I worked with the best, most compassionate, caring, and skilled nurses that I am proud to have worked beside. It breaks my heart to see the video of the place I credit to instilling in me a passion for caring for those who are often the most vulnerable and least heard.

I know after 35 years of nursing, that all is not as it seems and what we saw on the video does not touch the surface of what happened in that emergency department. HIPAA regulations restrict the hospital from telling the whole story but if we could hear it, what would we hear?

Would we hear a story of a hospital that was acting in accordance with a law that has likely endangered the very lives that it was supposed to protect? Would we hear a story of staff who tried their very best to care for and protect this young woman with mental illness and despite all their efforts she refused their help? Would we hear that the doctor/doctors decided that just like the woman who walked 20 miles in freezing temperatures wasn’t a “danger” to herself?

Does anyone watching that video have any doubt that standing in frigid temperatures in a hospital gown and socks endangers the human being who may not have been given a choice in the decision to be nearly naked in the street whether by being “dumped” or perhaps not having the judgment to make a good decision to not stand in the street exposed to the cold?

We may never have all the answers but one thing that I will emphatically tell you all and any and everyone who will listen is that something must change. The archaic law that was made to protect those who are not “dangerous to self or others” must be changed to swing the pendulum to the middle to protect those who lack the judgment and insight from a mental illness to protect themselves and those around them.


As much as I want to hear some plausible explanation for what happened that evening when we witnessed a human being left on the street while nonchalant staff walked back into the hospital, I know that this incident was not isolated. Some form of dumping takes place across the country every day.

Is it because the law mandates that we protect the rights of those even if they really can’t be responsible for those decisions or is it the financial bottom line that turns a blind eye to compassion and decency? Either way the blind eye was caught on camera this time. The message in this may be the impetus to make some real changes. Certainly no hospital or facility should ever want to be caught on camera appearing to be turning the blind eye and appearing so inhumane.