What are the medicolegal concerns associated with discharging a patient who has been given a shot of morphine or similar medication? Can I, for example, discharge an elderly patient to a taxicab driver and have him be responsible? Or must the patient be discharged to a friend or family member?
—Felix N. Chien, DO, Newport Beach, Calif.

There are very real medical and legal concerns with discharging patients who have received narcotic pain medication. The test is, “What is reasonable under the circumstances?” a question that jurors tend to interpret as “how would I like to be treated (under the same circumstances)?” Applying this test probably means that a patient should be discharged to the care of a friend or relative who has been given adequate discharge instructions rather than to an uninvolved cab driver. Of course, patients can discharge themselves against medical advice if they are unwilling to accept these restrictions, which are for their own good, as well as for the protection of the clinician.
—David S. Starr, MD, JD (104-4)

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