• Health policy
• medical ethics/bioethics

Chen Weii will not leave the hospital. The doctors discharged him yesterday and again today and he still won’t leave. The reasons change but the answer is the same. Yesterday he said he couldn’t walk, today he doesn’t have the key to his apartment. Chen was unsteady on his feet when the physical therapist walked with him up and down the hall, but as soon as he was back in his room, he moved easily from bed to bathroom without assistance. He was unaware that he was being observed. The physical therapist says it’s malingering.

The social worker has a different explanation for Chen Wei’s intransigence. She and the doctor spoke to him with a translator. He is here because of an injury he sustained as a victim of a crime. The doctor carefully explained that he was ready to leave the hospital, yet Chen asked no questions. The social worker offered to arrange for a locksmith if he had lost his key, but he did not reply. She asked about his being assaulted. Again no response. The social worker concluded that his problem must be fear. Unwilling to give information about the assault, he must know his assailant and be afraid to return home in case he is victimized again. The world of the recent immigrant is filled with all types of dangers and this is one of them. And if this does not explain why a 23-year-old will not leave a hospital bed, it must be a psychiatric problem.

Day 4 and still no discharge.

Although newspapers are filled with stories about hospitals bullying people into a premature discharge, patients do have rights. By law, patients must be informed that they can appeal their discharge to an outside reviewer and hospitals must help in that process if …