Medical Kidnapping. Wait. What?

You may have read about a young teenager named Justina Pelletier, from my town, West Hartford, CT. In 2013 Justina was kidnapped by a hospital where she had been admitted for treatment.  

I think there is not a more accurate term for what happened to her than kidnap.  Justina’s ordeal, and that of her family, is described here and here.  Her story is worth reading.  Fair warning:  The details will upset you, especially if you are a parent or a medical care professional

These sources are comprehensive so I’ll add only the following observations of my own. 

 (1)  the core issue in the Pelletier case seems to be a scientific and clinical fight about whether mitochondrial disease is actually a physical ailment vs. primarily psychological.   This type of issue may be present in other cases where there is potential overlap between the physical and the psychological.  Connection with insurance = Do insurers consistently consider a diagnosis of mitochondrial disease as either medical or psychological? 

(2)  It is clear that cases of Medical Kidnapping are on the rise. See here and here and here and here.   You can search for yourself by entering Medical Kidnapping and just start reading 

Connection with insurance = Will insurers benefits payable for mitochondrial disease change as the incidence of the disease rises?  

(3)  Justina’s parents sued Boston Children’s Hospital charging medical malpractice.  Nearly 7 years after Justina’s 2013 admission to BCH, a jury took fewer than 6 hours find BCH not guilty.

Connection to insurance = Will hospital and professional liability insurance coverage/ limits  be affected as the incidence of this diagnosis continues to rise?  

(4)  I have been unable to find any account of specific reasons the jury had for their verdict.  I think it’s likely the jury simply believed the hospital not the parents.  But consider.  Boston Children’s Hospital is widely believed to be America’s #1 pediatric hospital.  Its teaching affiliate is Harvard Medical School. BCH is also the primary source of professional expertise in child abuse cases before the Massachusetts Department of Children and Families.  Clearly there are many strong ties between and among BCH officials and physicians, influential Harvard alumni, and DCF officials in the areas of medical care, politics and even the courts. Especially in Boston.  And that influence extends over the general public from which jury members are selected.  One can appreciate how difficult it is for anyone not inside that circle of privilege, to prevail when taking action against it.

I suppose a teaching hospital anywhere has similarly widespread influence within its community and can be similarly immunized from scrutiny and full accountability – as appears true regarding BCH and the Justina Pelletier experience.  

Connection to insurance = Same as in (3).

(5)  Aside from medical and insurance issues, the growing number of medical kidnap cases is a social problem, increasingly encountered in the care of minor children.  The Pelletier case illustrates the kinds of problems encountered.  Here are a few that stand out to me, there must be others:

1.  Resolution of clinical differences among attending physicians when they disagree 

2.  Resolution of scientific disagreement over the nature of the condition(s) to be treated

3.  Legislative flaws e.g., do children & family services bureaucracies have too much power? 

4.  Ensuring adequate consultation among attending physicians

5.  Inconsistencies among insurers over terms of coverage for medical & legal liabilities

6.  HIPAA protections of minor children’s patient privacy can also be used to keep the parents 

from knowing what treatment their children are receiving.  This can effectively remove parents from participation in decisions involving their own minor children’s care.  

7.  Growing influence of the regulatory state, in which persons accused of regulatory violations

are presumed guilty, and have the burden of proving themselves innocent.  This negates the presumption of innocence historically imbedded in our legal system.