Praesidium

Friday, February 11, 2011

Drunk Patients

Apparently a Scottish patients' group has suggested that people admitted to A&E while drunk ought to pay for their hospital treatment. It's not really clear from the BBC story what the justification for this is. It could be either a) that they may be at fault for the injury causing their admission and/or b) that they are more likely to be abusive towards staff while there. In either case, however, I'd worry that targetting all drunk people is both over- and under-inclusive.

That someone is drunk does not mean that they are responsible for an injury that they have suffered or that they will abuse hospital staff. Moreover, other people may be responsible for their injuries or be abusive towards hospital staff, though not drunk. If our concern is to charge those who are responsible for their injuries and/or abusive towards hospital staff, then we ought to focus directly on those criteria, rather than taking drunkenness as an imperfect proxy.

For the record, though, I think I'd be opposed to such measures. It's rather hard to go around assigning responsibility or fault for injury and, while I wouldn't be so tolerant of those who abuse the staff caring for them, there is a rather grey area as to what counts as abuse - it runs the risks that those who feel offended could claim to have been abused. There are good reasons, I think, to avoid delving into issues of responsibility (or means testing, etc) and to keep the NHS free at point of access. (This wouldn't prohibit taking other measures against seriously abusive patients.)

For what it's worth, Aristotle thought that penalties could be increased for those who committed crimes while drunk (para. 3 of NE III.5), and J. S. Mill thought that drunkenness - in some cases - could be fit subject for social interference, despite his celebrated 'harm principle.'

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