And On The Subject of Lines In The Sand and Wookie Suits…

…let's talk about how I transport people who have threatened – or allegedly threatened – to do harm to themselves to the Emergency Department for psychiatric evaluation.

In my Lines In The Sand post that torqued TJIC enough that he equated me with a Nazi death camp guard, I stated that words have consequences, and that the consequences of threatening to kill yourself may include the cops or EMT's holding you for a psychiatric evaluation against your will. Still, let's talk about how it happens.

When commenter Aaron suggested that I need to find a new line of work that doesn't require me to violate people's civil liberties, I replied that being a paramedic isn't just a line of work for me, it's who I am.

TJIC's rejoinder:

How is this argument not exactly the same one that a member of the religious police in Saudi Arabia would make?

"Worshipping Allah through my work is the most important thing in my life. Don't want me to beat you with a stick? Fine. Just don't speak your theological doubts out loud."

Why, exactly, is your self actualization more important than my liberty?

I see that you still haven't developed any sense of proportion to go along with your lack of manners, TJIC.

Because beating someone with a stick for apostasy is exactly like taking a psych patient to the Emergency Department for evaluation.

Because saying "1 down, 534 to go," is exactly like actually firing a shot at the President, right?

Still, let's talk about how it happens.

I have to have a credible threat, first of all. The patient has to admit to threatening self harm, or a credible witness has to attest to it. That means someone willing to sign an affidavit or otherwise give a sworn statement to police, or identify themselves by name on a 911 tape, etc.

Louisiana law carries substantial criminal penalties for swearing falsely in this regard; up to one year of imprisonment, which may include hard labor, and up to $1,000 in fines. I have seen people charged with this, when their part in the drama play included making false statements to the police.

But if the patient himself says, "Yeah, I said I was going to cut my wrists, but I didn't mean it," we have no way of knowing which part of that statement is false. You don't get to take it back.

Words have consequences. And no, those words have to constitute a credible threat, not something like the example you cited, "If I have to eat one more bite of this leftover soup I'd be better off dead."

There's your absolute lack of proportion again.

Likewise, if I have a specific threat but reported by an anonymous source - "Hey, 911? I just heard somebody shouting at 123 Anywhere Street that they were gonna off themselves by taking all their pills at once." – and I find a patient with slurred speech and lethargy denying they made such a claim, but with an empty vodka bottle and an empty bottle of prescription painkillers nearby that should still have 28 pills in the bottle…

… then yeah, I am going to cart that patient's lethargic ass off to the hospital, no matter what they say. And I'm going to sleep like a baby afterwards. If that makes me a moral coward and a tool of government oppression in your eyes, so be it. Your approval isn't necessary to my sense of self-actualization, either.

The law is messy, and it doesn't always work like it should. There are aspects of it that I am personally uncomfortable with, like transporting cutters to the hospital, for example.

I fully realize that, for some people, cutting themselves is a coping mechanism for stress. It helps them maintain clarity and focus. They are no more suicidal than the rest of us.

To my mind, it's a damned poor coping mechanism and there are plenty of healthier ways than self-mutilation, if for no other reason than to avoid getting taken to the hospital for a psych evaluation because someone who doesn't understand your coping mechanism thinks you're insane.

Still, I don't get to make that decision. A doctor does.

And in this situation, I am acting as a physician extender. In Louisiana, involuntary psychiatric holds can last up to 15 days. The physician usually orders it via a mechanism known as a Physician's Emergency Certificate. When *I* take you to the ED for that evaluation, it's done under that physician's auspices. You must be evaluated by a physician, psychologist, or mental health nurse practitioner within 12 hours to determine if a PEC is warranted. If one isn't warranted, or they don't evaluate you within 12 hours, you get to go free, with nothing more than an ED visit to show for it.

If the cops take you, it's generally under the auspices of the elected parish coroner. The effect is the same: to get you to the hospital for the PEC evaluation.

There are checks and balances, too. If the PEC orders you involuntarily committed – again, for up to 15 days – you are required to be evaluated by the elected parish coroner or designated deputy within 72 hours of admission. If their evaluation does not agree with the physician's, you go free. If the original involuntary commitment came from the coroner, you have 72 hours to be evaluated by a psychiatrist. If his evaluation does not agree with the coroner's, you go free.

So, effectively speaking, the most a sane person is going to be held against their will is 72 hours.

If an additional stay is required beyond those 15 days, you must be evaluated within 72 hours of the end of that 15 day period by the coroner and the psychiatrist, who both must be in agreement to extend the hold for another 15 days.

Beyond 30 days, the bar is set far higher, which brings us to my next subject:

Line 11f of ATF Form 4473 asks:

Have you ever been adjudicated mentally defective (which includes a determination by a court. board. commission, or other lawful authority that you are a danger to yourself or to others or are incompetent to manage your own affairs, OR have you ever been committed to a mental institution?

Note the phrases I placed in bold print.

This is NOT the same thing as a temporary psychiatric hold, or even a temporary involuntary commitment.

Note the term "adjudicated mentally defective."

Adjudicated, as in court proceedings. Judges, lawyers, juries and all that. In most cases, it requires more than a hearing before an administrative law judge. That means you get a civil hearing complete with jury, a chance to respond to the petitioner, your own choice of lawyer or a guardian ad litem appointed by the court, and time to prepare a case.

A 72-hour Physician's Emergency Certificate doesn't even come close to meeting that legal standard. In my state, court proceedings are usually required to hold a person beyond 30 days.

The instructions for Form 4473 define "Committed to a Mental Institution" as: 

A formal commitment of a person to mental institution by a court. board, commission. or other lawful authority. The term includes a commitment to a mental institution involuntarily. The term includes commitment for mental defectiveness or mental illness. It also includes commitments for other reasons, such as for drug use. The term does not include a person in mental institution for observation or a voluntary admission to a mental institution.

Louisiana RS 28:53 states:

A.(1)  A mentally ill person or a person suffering from substance abuse may be admitted and detained at a treatment facility for observation, diagnosis, and treatment for a period not to exceed fifteen days under an emergency certificate.

(2)  A person suffering from substance abuse may be detained at a treatment facility for one additional period, not to exceed fifteen days, provided that a second emergency certificate is executed.  A second certificate may be executed only if and when a physician at the treatment facility and any other physician have examined the detained person within seventy-two hours prior to the termination of the initial fifteen day period and certified in writing on the second certificate that the person remains dangerous to himself or others or gravely disabled, and that his condition is likely to improve during the extended period.  The director shall inform the patient of the execution of the second certificate, the length of the extended period, and the specific reasons therefor, and shall also give notice of the same to the patient's nearest relative or other designated responsible party initially notified pursuant to Subsection F.

After that, further detainment at the treatment facility requires that you be adjudicated mentally defective. The Form 4473 instructions go on to state:

A person who has been adjudicated as a mental defective or committed to a mental institution is not prohibited if: (I) the person was adjudicated or committed by a department or agency of the Federal Government. such as the United States Department of Veteran's Affairs ("VA") (as opposed to a State court, State board, or other lawful State authority); and (2) either: (a) the person's adjudication or commitment for mental incompetency was set-aside or expunged by the adjudicating/committing agency; (h) the person has been fully released or discharged from all mandatory treatment, supervision, or monitoring by the agency; or (e) the person was found by the agency to no longer suffer from the mental health condition that served as the basis of the initial adjudication. Persons who fit this exception should answer "no" to Item 11.f.

So much for the belief that Leviathan can deny you your 2nd Amendment rights if I haul you off for a psych evaluation. I know that those of you who live behind enemy lines in May-Issue Land are subject to the whims and capriciousness of local police chiefs, but out here in Free America, it's pretty cut-and-dried.

If it was only a 72-hour hold, you have nothing to worry about.

If it was only a transport to the ED, and a 72-hour hold was deemed unnecessary, you have nothing to worry about.

If you were committed for even 30 days, and fully discharged with no court-mandated requirement for outpatient care, you have nothing to worry about.

If the court determined that you were crazier than a shithouse rat, and that even though you committed no crime for which you could claim not guilty by reasons of mental defect, that the safety of yourself and society was deemed preserved by locking you up for six months or six years, after which you were deemed competent to manage your own affairs and were set free… you have nothing to worry about.

This is the United States of friggin' America. Even as bad as things are now, we don't just lock people up in the gulag because they're a little odd. If that were the case, TJIC would be writing his little anarchist missives in crayon, snail-mailing them to me and begging me to post them in my comments section.

So don't let the fear of Big Brother confiscating all your guns deter you from seeking mental health counseling, calling a Suicide Hotline, or deter you from calling 911 because you legitimately fear a loved one may harm himself, yet you don't want to see his civil rights trampled on.

The bar is set a lot higher than that.


  • David Neylon

    When TJIC had his run in with the MAssholes I was one of those that stood up for him.   However now he seems to be one of those people that give Libertarians a bad name.

    • Ambulance_Driver

      He got a raw deal from the Massholes, no doubt.

      I just find it amusing that he’s displaying the very lack of any sense of proportion that the government displayed when they took his guns over a blog post.

  • Old_NFO

    Good response, and you are correct…

  • ChasingFreedom

    AD, that was an excellent outline of the relationship between involuntary commitment and firearms.  Thank you for taking the time to explain the process and for clearing up some of the misconceptions regarding what Form 4473 is actually asking. 

    • J Simutis

      Please note that states are different.

      California, that wonderful Left Coast where I live, has Welfare and Institutions Code sections 5150 (72-hour hold) and 5250 (up to 14 more days hold).  W&I 8103(f) imposes a 5-year ‘no possession, no purchase’ of firearms on persons taken into custody and held under W&I 5150.

      “(f) (1) No person who has been (A) taken
      into custody as provided in Section 5150 because that person is a danger
      to himself, herself, or to others, (B) assessed within the meaning of
      Section 5151, and (C) admitted to a designated facility within the
      meaning of Sections 5151 and 5152 because that person is a danger to
      himself, herself, or others, shall own, possess, control, receive, or
      purchase, or attempt to own, possess, control, receive, or purchase any
      firearm for a period of five years after the person is released from the

      • Ambulance_Driver

        That’s why I differentiated “occupied territory and May Issue Land” from “Free America.”
        It was a joke, but that was the point I was making, that some of the states with the more restrictive firearms laws limit place more restrictions on mental health patients as well.
        Still, it’s a far cry from, “Get admitted to a psych ward, lose your gun rights forever.”

      • Rogue Medic

        “(f) (1) No person who has been (A) taken 
        into custody as provided in Section 5150 because that person is a danger
        to himself, herself, or to others, (B) assessed within the meaning of 
        Section 5151, and (C) admitted to a designated facility within the 
        meaning of Sections 5151 and 5152 because that person is a danger to 
        himself, herself, or others, shall own, possess, control, receive, or 
        purchase, or attempt to own, possess, control, receive, or purchase any 
        firearm for a period of five years after the person is released from the

        It appears that the 5150 is not enough, there appears to be a requirement for progress to a 5151 or 5152 hold.

        Taking the person to the hospital for evaluation, under a 5150 hold, may not be enough to meet the criteria.


  • Divemedic

    Capacity is a legal minefield. Here is a post I did on that subject two years ago:

  • Ambulance_Driver

    I’ve read it, and it was a good one. I did an EMS1 column on the same subject a while back.

  • Kristopher

    ( sarcasm ) You are such a nazi, AD.

    David: Dealing with Massholes can leave you with the urge to kill them with fire. I’ll cut TJIC some slack. Hopefully the wookiesuiters will calm down after a bit, and find a better hill to die on.


    • Matt Radcliffe

       ”can leave you with the urge to kill them with fire”
      This is a clearly worded and publicly displayed claim of your desire to murder someone with fire. I believe it is protected speech under the first amendment.

      Why would you believe that it is appropriate to express a desire to kill others without consequence but expressing a desire however fleeting to kill oneself is grounds to drag someone away against their will?

      • mpatk

        Again, context is your friend.

        It’s not like we’re restraining every person with a hangover who says “I wish I was dead,” or people having a bad day who say, “FML, just shoot me now.”. Generally, the expression of wanting to die has to have some specifics (e.g. “I’m going to take this bottle of pills”) or some sort of impairment like alcohol or drug intoxication.

        Yes, there are. borderline cases, but that’s true for every law and every situation where people’s life and health are concerned.

        • Matt Radcliffe

           Actually that is exactly the kind of statement he described restraining people for, and I quote:

          “I wish I was dead”"Say those things, and I can guarantee you one outcome: You. Will. Go. To. The. Hospital.”

          “Your only choices are whether you go restrained or unrestrained. You don’t get to say no any more.”
          In later comments he has advocated more moderation but the original post was advocating heavy handed responses, to say the least. We are not all just wookies shouting slogans and calling people fascists. The article was overly authoritarian and engendered many comments, some more polite than others.

          • mpatk

            Fair enough. AD has recognized how his initial words might have sounded, and you recognize that he has clarified his position.

            Unfortunately, the Wookies got here before you and set the tone of the discussion.

      • Rogue Medic

        “can leave you with the urge to kill them with fire” 

        There is a big difference between that and stating “I want to kill them with fire.” 

        “can leave you with the urge to kill yourself with fire”
        There is a big difference between that and stating “I want to kill myself with fire.”

        One is an expression of frustration, not intent.

        The other is an expression of intent.


  • emt613

    I may not be an expert in this field, but I did happen to get my degree in psych before going into EMS (not that I need it to diagnose most of the crazies we pick up). I just had a 20 year old patient in the ER the other night for a psych eval. She said that she had a history of depression and anxiety and that she her boyfriend had just left her after convincing her to have an abortion. She said that she spent the past 2 days online looking up ways to kill herself. Now, in my opinion, that is no death wish. It is a cry for help, and this is the very person that these laws are in place to protect. She was held for a few hours until someone from mobile crisis could come talk to her at which point she was released with a contract to follow up with a psychiatrist so that she can get the help she needs. Do people really think that this girl would have been better off left to her own devices – namely dead – when all she really needs is some time, therapy and possibly drugs?!

    • Matt Radcliffe

      Do you think that someone that has a history of (mild)mental illness admitting that she spent two days planing a suicide is a good example of grey areas? I could give an example of a person who shot their brother in front of ten witnesses and a video camera as proof of why we don’t need jury trials but it is the questionable cases where the most protection is needed. Do you think that dragging a person in her situation to the hospital with threats of violence and locking her up for an indeterminate amount of time is a better option than having a counselor talk to her or visit her without the necessity for threats, violence, or any curtailment of liberty?

      • Bobball

         I don’t know that she would need to be dragged to the hospital with threats of violence. Nor would she need to be locked up for an indeterminate period of time. You’re assuming facts not in evidence.

        Now, if EMS and/or police are involved…there are limits to what can be done. The public safety world does not have counselors available to respond. In addition, as AD and others have pointed out, we in EMS are not in a position to be able to “contract” with a patient to have them follow up on their own. If they legitimately pose a threat to themselves or others, we’re have no choice but to err on the side of safety (for everyone) and bring them to the hospital. I can tell you that in my 29 years in EMS in a high-volume urban environment; bringing suicidal patients to the ED for evaluation by force is a rarity. Even when such items as physical or chemical restraint are necessary, it’s done with as little “violence” as possible, and with as little threat as possible. Our job is not to threaten, punish or harm people. Our tasks, while sometimes unpleasant, are done in a manner to be as respectful as possible to the patient.

        Like many of the other folks who seem to lack a grasp on this topic, you have this lack of  proportion. The police and EMS (and even the hospital)  are held to a high level of responsibility in the event someone is on a hold. Contrary to what many of the TJIC/Aaron ilk are saying, these patients do have rights; and it’s one of the things provided them as soon as they reach the hospital. In addition…indeterminate “locking up” is done by the courts in public hearing. In my state, the transport hold placed by police or health officers only allows EMS to transport the person to the hospital and be seen by a physician. The physician can see the patient and immediately release them if they like. The physician at the hospital can place the patient on a 72 hour hold. This compels the patient to remain at the hospital for 72 hours for observation/evaluation/treatment. If that’s not long enough, it’s a matter for the courts. The only times I’m aware of in Minnesota Courts where someone is committed for an indeterminate time is when they not only are a threat, but have demonstrated that threat (various killers, serial sex offenders, etc.). Most cases are a 30, 60 or 90 day commitment for treatment. Notice that except for those who have done something completely horrifying…there is no “indeterminate” time. There certainly isn’t in EMS… Hyperbole does not bolster your argument.

        • Matt Radcliffe

           Well this is the words of detroit EMT.
          “these 5 security guards are going to have their chance at you. Then,
          while they’re holding you, this cute 90 lb nurse is gonna inject you
          with what we call STFUSS (shut the f*** up and sit still). Then, we’re
          gonna tie you into an uncomfortable position and you’re STILL going to
          the behavioral center”. ”

          It doesn’t sound peaceful, non threatening, respectful or professional to me.

          In the original article by Ambulance driver:
          “Fighting with me is pointless. I will win that fight, every single time”   

          “And no, I don’t really give a rat’s ass if you get a mental health
          record or if you have class/work/social engagements in the morning that
          you just can’t miss.”    
          “Neither am I going to lose sleep over the fact that a 48-hour stint
          in the psych ward ruins your chance at that law enforcement career
          you’ve been so zealously pursuing, or takes you out if the running for
          Man Of The Year at the local Rotary Club.”   

          ” I don’t get to decide whether it is credible, nor do I want that responsibility”   

          We are talking about an ALLEGED suicidal thought reported by a third party and a professional worker saying he doesn’t care if it is credible and doesn’t care how his dragging them off interferes with the persons life. In subsequent posts he appears to take more information into account as to the credibility of the report but this still worries me. And what grave words would he consider inspiration for this: “I wish I was dead.” 

          • Ambulance_Driver

            Okay, I can see how my words in that regard could be taken out of context.
            So here’s the context: That post was a rant directed against those people who make suicidal threats as a form of emotional extortion, and then think they can take it back when I arrive. It wasn’t meant for the person who gets the cops called on them because the OTHER party is making false claims against them as their own form of emotional extortion.
            Does that clear things up for you?

          • Matt Radcliffe

             I can perfectly understand the frustration of that situation but my issue is that you have no way to know which group is which.

          • Ambulance_Driver

            No I don’t.

            And so my default position in that situation is to take them
            to the hospital. I weigh it as a risk of occasionally depriving a same person of, at most, 72 hours of their liberty, versus allowing a temporarily mentally incompetent person take an irreversible step.

          • Bobball


            AD explains his position best himself, as far as his words and context. As for me, I take a much harder look at the “suicidal” patient where a 3rd party is calls and they’re wondering why we’re here. That said, if there’s any doubt to that person’s self-safety; they go to the hospital first.

            I can’t and won’t speak for some unnamed winner from Detroit that uses such behavior. I would not be so naive to suggest that my medics have *never* behaved inappropriately, but it is most certainly the exception rather than the rule. It’s also something that can have significant consequences for the medic who does if it’s discovered.

    • Bobball

       Actually, spending 2 days trying to develop a plan raises some pretty big red flags. If I remember correctly, it’s not uncommon for most people to contemplate suicide on some level at some point in their lives. For most, it’s a passing glimpse…one that gives them the absolute willies and just as quickly discarded as a poor choice. Spending more than a glimpse at the monster is reason to worry.

      “Death wish” sounds a little over the top…but “cry for help” appears to be a gross understatement. But yes, these are the people the law is trying to protect. The person who is set on self-destruction will do so, without bothering to tell anyone ahead of time. In fact, most of the really successful adult suicides I’ve dealt with over the decades; the person specifically planned the attempt in a manner that would help ensure that they could succeed before being found. Adolescents are something completely different.

  • mpatk

    Because beating someone with a stick for apostasy is exactly like taking a psych patient to the Emergency Department for evaluation.

    Because saying “1 down, 534 to go,” is exactly like actually firing a shot at the President, right?

    Nicely done, showing how he is using EXACTLY the same lack of proportion that the MAssholes used to take away his guns.

  • Aaron

    I’m surprise at how difficult it is for people to follow logic.

    Let’s say I’m friends with a guy named Bob–and one day Bob tells me he’s going to kill himself.

    If I go over to Bob’s house, drag himself back to my place, and handcuff him to my radiator and then talk with him about why he wants to kill himself for 72 hours before releasing him….that’s unlawful imprisonment and violates Bob’s rights.  It’s immoral and I should be imprisoned.

    If I call up a psychologist, we go over to Bob’s house, drag him back to the psychologists office, handcuff him to the radiator, evaluate him over 72 hours, and finally decide he’s sane and release him….it violates Bob’s rights.  It’s immoral and the psychologist and I should be imprisoned.

    If I call up a bunch of my buddies, we all go over to Bob’s house, drag him back to my place, handcuff him to my radiator, and then we all discuss with him about why he wants to kill himself, hold him for 72 hours, re-evaluate, hold him for just less than a month and finally decide he’s sane and release him….that’s unlawful imprisonment, and it violates Bob’s rights.  It’s immoral and everyone involved should be imprisoned.

    If I call 911, and Ambulance Driver and his buddies in blue come over, handcuff him, drag him off to a psych ward, hold him for 72 hours, and finally decide he’s sane and release him…..suddenly it’s moral because the government does it?

    • Old Windways

      No, its moral because the person making the decision is a trained mental health professional (who is not the government).

      And No, AD and the cops are not the ones holding him for 72 hours, its the MD. All that AD is doing is making access to mental health evaluation more streamlined, since I don’t know many Psych doctors who will drive out to your home in the middle of the night to determine your sanity.

      • Brian Dunbar

         No, its moral because the person making the decision is a trained mental health professional

        I’m not very comfortable with that the how well trained our ‘trained mental health professionals’ are.

        Maybe it’s the best we have .. but the best we have in the mental health profession in the past have hammered ice picks into people’s brains to cure them.

        One wonders what compassionate, state of the art practices we have today will look like barbaric voodoo to the next generation.

        • Speakertweaker

           It’s not a matter of morality at all.  It’s a matter of legality.  The law doesn’t allow you to grab your friend and cuff him to the radiator.  The law does require a psych evaluation if you come out in the open and threaten to kill yourself.

          (Note* I’ll leave aside the apples-to-oranges comparison of being kidnapped and cuffed to a radiator to riding in the back of an ambulance to a hospital.)

          If you kill yourself, so be it.  You come outside and hold yourself hostage, then you’re going for a ride.  That’s the law, and it’s part of a paramedic’s/EMT’s job whether they want to or not.

          But the involuntary psych eval is no more comparable to being cuffed to a radiator than AD’s taking you to the hospital is to hearding Jews onto the trains.

          • Brian Dunbar

             You replied to the wrong guy. 

            I’m the one who questioned how much head bangers actually know about their craft.

          • Speakertweaker

             My bad.  Kept inadvertently backing out of the comment window and clicked back into the wrong one.

      • Matt Radcliffe

         Actually even if they are a medical school graduate they would be working for/on behalf of the government. Making someone certified doesn’t make them right all the time and it certainly doesn’t make them above corruption. If ninety nine out of a hundred doctors act reasonably and one “professional” thinks anyone who would buy an ar-15 is obviously paranoid and a danger to someone. Or decides that someone with high functioning autism is a danger to others because they resent their social difficulties.
        We don’t let “expert” detectives decide if someone is a criminal without a jury trial and we shouldn’t let an expert doctor commit someone against their will without clear evidence that would convince a jury of laymen and that the “expert” is welcome to testify before.

        • Old Windways

          I agree, and that is why the system has significant restrictions on what a lone doctor can do (72 hours) before second opinions need to be brought in.  That being said, it is as system made up of human beings, so it is inherently imperfect.

          To quote the wikipedia article on “Involuntary commitment”:
          Criteria for civil commitment are established by law, which varies between nations and, in the U.S., from state to state. Commitment proceedings often follow a period of emergency hospitalization during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals – who may then determine whether further civil commitment is appropriate or necessary. If civil commitment proceedings follow, the evaluation is presented in a formal court hearing where testimony and other evidence may also be submitted.[citation needed] The subject of the hearing typically is entitled to legal counsel and may challenge a commitment order through habeas corpus rules.”

          It pretty much sounds like exactly what you are demanding is already in place.  The 72 hour evaluation period is actually quite similar to the demand that persons under arrest must be presented in court on a charge within 72 hours or cut loose.

    • mpatk

       If I think “Bob” has stolen property in his house, and I enter against his will and find stolen property, that’s illegal on my part and I can go to jail.  If the police get a search warrant from a judge for “Bob’s” house, enter against his will and find stolen property, it’s legal and “Bob” goes to jail.

      In other words, yes, the state is empowered to do things that individual citizens are not allowed to do, as long as the appropriate “due process” is followed.  Anything else is not a state, it’s anarchy.

      I do find it interesting how you rely on violent imagery (“drag him off”, “handcuff him”) without any evidence.  The only time patients are handcuffed in an ambulance is if they are violent towards others; every EMT school portrays handcuffing patients as an absolute last resort if the EMT is in physical danger from the patient.

    • JB on the Rocks

      I’m surprised at what you consider logic.  

      T’was a required class when I went to college.  Maybe not the same where you went.

  • Brian Dunbar

    Your approval isn’t necessary to my sense of self-actualization, either.

    You’re spending a lot of time on this topic, however.

    Perhaps the whole ‘taking a free citizen to the funny bin against their will’ thing bothers you more than you realize.

  • Bobball

    I’m not trying to harm myself…I’m just biting my tongue. The lack of killfile capability is tough on a guy.

    Great post AD.

    Side note…when you spoke of people “going wookie”…what the heck does that mean? Do capital-L libertarians require such costuming? Was Chewbacca a Libertarian? Do they realize that “Wookie” is not how Chewbacca (or George Lucas)  spells his race? I’m so confused…

    • Ambulance_Driver

      Inside gun blogger joke, Bob.

      Tamara of “View From The Porch” coined the term, as she opined that some Libertarians were so strident and out of touch with the rest of society that they resembled a Star Wars geek wearing a Wookie suit standing on a street corner, hysterically shouting, “SHALL NOT BE INFRINGED!”
      Kelly Grayson

      • Matt Radcliffe

         Some people have used hyperbole to illustrate an idea as they did to illustrate the difference between legal and moral and some made an over reaction to insult you for having opinions that they disagree with but on the whole I think those of us taking the libertarian side of this issue are somewhat more well spoken than a Wookie.

        • Brian Dunbar

           are somewhat more well spoken than a Wookie.

          What are you, some kind of speciest?

          Chewbacca is a highly articulate, sentient being.  It is a simple matter of biology: a Wookie is unable by nature to form the sounds that make up human speech.

          Claiming a Wookie is inarticulate is a gross insult to all beings who will not or cannot conform to the dominate social-human archetype.

          Our lawyers will be in touch.

        • Ambulance_Driver

          I consider myself libertarian, but I suppose I fail your ideological purity test.
          Besides, Chewbacca was quite articulate. It’s just that very few spoke his language. ;)
          Kelly Grayson

          • Matt Radcliffe

            You may be libertarian on average and very possibly more libertarian than me on some subjects, hell, for all I know you are more libertarian than me in general.
            All I am saying is on this one very narrow subject you are arguing for the power of a representative of the government being able to exert control over and against the will of some of the people. You are arguing for a limitation on freedom with law as a justification. It isn’t a question of “ideological purity” and I am not judging what  party I think you should be a part of but on this argument you are arguing against libertarianism.

            Your stance may be right or wrong but it is certainly not libertarian when you are advocating one person imposing their will on another even if it is “for their own good”

          • Rogue Medic

            The person has been determined to not have the capacity to make informed decisions for himself/herself. That decision is made by the police, or by a doctor.

            The patient is then transported to the hospital for further assessment, where a doctor may determine that the person does have the capacity to make informed decisions, or may agree to the person signing in for voluntary commitment, or may continue the involuntary commitment.

            Self-destruction is one thing that is not considered to be a decision in our own best interest. There are exceptions, but an impulsive decision to commit suicide results in a response that does not require a warrant, because of the imminent threat to life and the lack of reversibility if that threat is carried out.


        • Bobball

          “…more well spoken than a Wookie.” And yet, this “Wookie” is capable of not only piloting (or co-piloting anyway) a spaceship capable of hyperspace…but is also readily adept at making repairs to said ship.

          Most of our greatest minds couldn’t pull that off. Well, none of them so far…but you get the drift.

          • Matt Radcliffe

             Just because Da Vinci couldn’t make an internal combustion engine doesn’t mean that the people working at Jiffy Lube are smarter than him.

      • Bobball

         Ah, got it. That’s funny right there. Of course, in my mind, they’re only holding a sign that says (in hysteric lettering) “SHALL NOT BE INFRINGED”, while shouting “Rawr! Grrrr-RAw! (and making the gargling noise at the end).

      • Rogue Medic

        A pun on infringed?


  • Steve Hillson

    I’m willing to bet that if Aaron’s loved one makes “the threat”, EMS arrives and after a discussion with said loved one, decides that said loved one “didn’t really mean it” and leaves, only for said loved one to commit suicide shortly thereafter…

    Aaron would be the first in line screaming about how “they should have done something!”.

    Aaron (et al) – Do you HONESTLY think that people in EMS LIKE taking people to the hospital against their will?  If I really wanted to browbeat people into doing things they didn’t want to do, I’d be a moonbat democrat!

  • ILTim

    Here you are now, three posts into this subject, apparently reeling back and trying to justify your original post.  The points made since that original post are sensible and rational, but lets not forget why we’re here (I paraphrase):

    “I don’t care what you say, who you are, what the heck happened, how cogently the situation is explained, or what effect my actions will have.  I’ve got a chance to wrap your ass up and haul you into pseudo-prison for three days using any amount of force I feel like.  You can’t take it back, I will NOT be denied this chance.  Will.  Not. 


    Yowser.  Left to me, YOU’d be hauled in and locked up for psyche eval for asserting such desires and making threats like that.  Good thing its not up to me, eh?  Take and moment here and revel in your freedom from my whims. 

    All this psyche eval stuff rubs me wrong too, I’m only “allowed” to live outside an institution if I continue to qualify by some doc’s standards?  No, I’m not anybody’s property and nobody gets to decide if I should be free or not.  THAT’s not a valid definition of freedom.  Imprisonment (on matter hoe long, or in what kind of facility) can only result from lawful due process.  If this situation does technically qualify (does it really?), its a shocking twist, abuse, or loophole to most people.  This form of imprisonment does not pass the smell test. 

    • Ambulance_Driver

      What you call “paraphrase,” most people would call “misinterpret, project, fold, spindle and mutilate beyond all recognition.”
      I stand behind the original post, and all the ones that followed. If you don’t like the way it was written, go read someone else.

      • Matt Radcliffe

         I can see why his comment could bother you but I think that the people reading the words of your original post read much differently than how you see them/ how you meant them.
        Your disinterest in the credibility of the suicide claims nature or to the accuracy of third parties claiming it took place was disturbing.
        Even beyond that questionable way you described judging who to haul off your comments that I believed you meant to come across as derision for the excuses of genuinely disturbed/suicidal people was read my many people as a complete lack of compassion or concern for the results of hauling people off to the hospital for a while.
        It did read somewhere between enthusiastic goon and someone gleeful at the chance to use force as it was first written.
        Lines like these below I believe you intended as refering to someone who is in obvious crisis and you view it as a balance to saving their life. We do not have the benefit of that, we have only your word that it applies to anyone that has one “witness” claim they said: “I wish I was dead.” And your claim that you don’t try to or want to determine if it is credible didn’t help much.


        “Pleading with me for lenience is only going to fall on deaf ears”
        ” I don’t really give a rat’s ass if you get a mental health record or if
        you have class/work/social engagements in the morning that you just
        can’t miss”
        “Neither am I going to lose sleep over the fact that…”

        I expect that anyone that knows you and how you deal with these sorts of situations would view it as a rant against those who make careless statements and end up wasting important resources even if it wasn’t worded very carefully. Someone coming on the article without any context about you could easily misinterpret what you meant to the extent that you sound like a totalitarian pig with a Napoleon complex to them.

        When I first read your article it came across much as ILTim describes.
        Without body language or tone of voice it is even more important than usual to try to look at how the others are seeing things for both sides. There is too much opportunity for miscumunication even when we are patient and understanding.

        • Ambulance_Driver

          Fair points. I can see how it might come across to someone who is unfamiliar with me and my writing style.
          Kelly Grayson

          • tjic


            I took a break from this thread for a few days, and I think it was a good thing.

            I’ll admit that I’m unfamiliar with your writing style, but that Matt Radcliffe above has put his finger on the issues that raised my hackles, and managed to do so in a less incendiary tone than I was using.

            Matt does a good job – both above and below – of pulling some quotes that – as I read them – really sounded like a power trip in which you were expressly announcing that you didn’t care about the rights of mere mortals who aren’t vested with special powers by the government / the law / their position.

            I’ll back up a bit and reserve judgement until I’ve read some more of your writing.

          • Ambulance_Driver

            Two people can back away from an argument, TJIC.

            And thus, I’ll follow your lead and declaring it all water under the bridge as well.
            No hard feelings.

        • ILTim

           Thank you Matt, I think you’ve thoroughly and correctly summarized my points in all your responses. 

          I *AM* and inflammatory asshole, especially when poked with a stick. 

  • ILTim

    I’ve gotta leave one more comment, this is just cracking me up. 

    Ambulance Driver Post #1: “I’m boss, ya’ll belongz to ME!  Muwahahaha!  Submit fool, I don’t care about your explanations!”

    AD Comments, post #2, and post #3: “But, but, I didn’t MEAN IT LIKE THAT”

    Ironic, no?  No mulligans.

    Aside from the rather more rational addendum’s, the only justifications offered for the original post are “But everyone else is doing it!”.  Legal permissions, certification jeopardy, and lawsuits can pretty much be grouped as crowd mentality.  I understand that the so-called crowd has very real and specific personal impact, and that allowances for this must be made in our decisions.  I’m certainly not suggesting these allowances make a person theologically ‘impure’ and damnable. 

    This was not the stance of the original post, it was not written in the light of a necessary evil, but rather it appeared to be something that gives AD the giggles. 

    A pure power lust.  Complete authority over his fellow man, with the weight of the whole legal establishment behind him, an ambulance full of tools, drugs, and restraints at his disposal, and the eager sparkle in his eyes. 

    Kelly, honestly, I think your learning to howl.  Those (LE and other G-men) are wolves your running with.  

    • Ambulance_Driver

      Tim, I’d reply, but your comment made no sense.

      • Matt Radcliffe

         The irony he is trying to refer to is your holding people to a strict literal interpretation of their words regarding suicide then being somewhat bothered when people took your words strictly literally and got tweaked.
        Especially your move from the first article where you don’t judge or want to judge credibility to this one where you are more critical of circumstances.

        His paragraph about your justifications seems to focus on the claim that your pulling up a defense of law to a question of morality is no more than an appeal to the authority of the masses and not much of a response to the logical and ethical/moral questions of the situation. Again this is probably as much the confusion of text only conversation as anything.

        For the rest of his comments it looks like an impolite way of saying that what seems to be wry humor or an attempt to be witty about a depressing subject did make it seem inappropriately enthusiastic/gleeful/indifferent

        • mpatk

           As an additional comment on that last part, the comments section in the original article can be very instructive.  The initial responders, most of whom are active in EMS, recognized the post for what is was: a rant against the emotional blackmailers who are suddenly saying “I didn’t mean it” when their targets involve EMS/Police rather than simply submitting to the blackmail.  It’s something that anyone in EMS is familiar with; and often those people are not only trying to backtrack, they’re being verbally and sometimes physically abusive.  AD’s post was what all of us sincerely would like to say, but don’t for reasons of professionalism and because we’re not sure that this person isn’t an unusual case.  Sort of like how you’d like to tailgate, rant at, and cut off the obnoxious jerk who just weaved through four lanes of traffic; but you don’t because you know that road rage is a bad thing.

          Then, when the libertarians get the link to the page, things go downhill.  Where there could have been a very good discussion of the practical aspect of psych holds and what medics can and can’t do, instead we got the trolls with the “ZOMG, NAZI” and “I’ll kill you before you take me away!!11!!!” crap that destroys any hope of reasonable discussion.

          • Matt Radcliffe

             They may not have stated it in a polite matter but some of the ideas expressed were alarming. If you are trying to kidnap someone (even with law behind you) it can be dangerous. These people might be all bluster or they may be people who would rather fight than be drug hither and yon like a dog on a leash until they check out OK. Some of the ideas of innocent until proven guilty and being secure in ones person against unreasonable seizure are held in very high regard. Some of us would rather see a requirement for a warrant to be able to detain someone, unless it is necessary to stop their imminent harm to others or immediate criminal act.

          • Rogue Medic

            The US Supreme Court has decided on this. I wrote about it at my blog using the same title as Kelly’s second post on this topic - 

            In Which a Bunch of Libertarian Types Go Full Wookie….

          • Matt Radcliffe

             And the supreme court also requires clear and convincing proof that they a danger to themselves or others. One biased witness claiming that they made one comment is not very “clear and convincing” to me.

    • Matt Radcliffe

       I may agree with some of your ideas but I most certainly do not agree with your manner of expressing them. A little more explanation and a little less imagery would make people more likely to understand you and more inclined to agree with you. Insulting people and caricaturing them is rarely helpful.

    • mpatk


      *sigh*  It’s so sad that the internet trolls have found Ambulance Driver’s blog.

      Tell you what, should we take everything YOU say on the internet literally?  Should we contact the police to inform them that you’re going to use lethal force on anyone who tries to exercise LEGAL WARRANTS on you?

      Have you never ranted against something and said some things that could be interpreted as antisocial, or even violent, and had some little troll come along and start hurling insults and insane labels based on a ridiculous, literal interpretation of your words?

      …and the most pathetic part of this?  This could have been a real discussion at one point.  If maybe Matt Radcliffe had responded first, there could have been the discussion about what a psych hold really means, what the medic in the field can and cannot do, and so on.  Instead, we get pathetic little trolls like you and the TJ idiot irresponsibly (and irrationally) throwing around remarks like “Nazi”, “religious police”, and “lethal force”; remarks that were absolutely batshit insane no matter how literally you read AD’s initial post.

      Congratulations on once again dragging the level of discussion on the internet down into the sewers.

      • Ambulance_Driver

        I don’t think he’s a troll.

        I am beginning to suspect he’s incapable of abstract thought, though. Very black and white kind of thinker.

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