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Boston hospital holds teenager against her will

December 13, 2013 - Andrea Johnson
Here's a custody case that ought to raise some eyebrows.

Justina Pelletier, age 15, has been held in the psychiatric ward at Boston's Children's Hospital against her will for 10 months because doctors there claim she has a mental illness.

Her parents say she has been diagnosed with mitochondrial disease and was under treatment for it while under their care. She was admitted to Boston Children's Hospital following a bout with the flu last winter and, at that point, doctors decided she had a mental illness called somataform disorder instead. Essentially, they decided the pain was all in the girl's head. The Daily Mail had the most complete story about the case. It can be found at www.dailymail.co.uk/news/article-2513257/Shock-decline-Justina-Pelletier-kidnapped-doctors-use-guinea-pig.html

There's a gag order in the case, but previous stories said the girl is allowed only very brief hour-long visits with family members at the hospital once a week and two monitored phone calls each week. Her physical condition has deteriorated so that she is no longer able to walk unassisted. Before she was admitted to the hospital, she competed in ice skating competitions and attended high school. Unless there's more to this story than is being reported, this is an egregious violation of this girl's rights, not to mention her parents' right to make medical decisions on her behalf and raise her as they see fit.

The parents, Lou and Linda Pelletier, were in court today to try and regain custody of their youngest daughter from Social Services, which has placed her in the psychiatric ward. A decision is expected next week. Here's hoping the judge does the right thing and sends this kid home and that the parents then sue the doctors responsible for this travesty of justice for everything they're worth.

 
 

Article Comments

(32)

AndreaJohnson

Jan-03-14 6:11 PM

No, it is "guardian ad litem" and I do, indeed, have a real problem with a hospital that keeps a 15-year-old girl on a locked psych ward for 10 months against her will and against the will of her parents.

thinkharder2

Jan-01-14 1:11 PM

"And, unfortunately, the judge did not return this poor girl home. He assigned a guardian ad litem and scheduled another hearing for January 10." It's Guardian ET Litem....your ignorance of the mental health medical system, decision making is astounding.... keep cutting and pasting and ranting...that seems to suffice for reporting

thinkharder2

Jan-01-14 12:58 PM

What we cannot know is thehospital information, decision making and logic of all of this. They are bound by HIPPA to say NOTHING about patient care. There are two sides, and from my experience psych ward discharges TOO EARLY and are not eager to hold non compliant patients. Correction MANY SOCIAL WORKERS ARE MEDICAL PROFESSIONALS and are trained and licensed to diagnose and advise on treatment.

AShrink

Dec-24-13 11:52 AM

Andrea, I'll conclude our repartee. Thanks for listening. Muleskinner - Wow.

muleskinner

Dec-24-13 8:15 AM

From what I have read, she is being tortured, not treated.

This is health care in America? It's a lunatic asylum with the lunatics in charge of the asylum.

Maybe the doctors should order an Iron Maiden and put that to use somehow.

They can begin by using it on themselves. Sounds like they're flying over the cuckoo's nest and a nurse named Ratchet is on the staff.

Beam me up.

AndreaJohnson

Dec-23-13 6:12 PM

This appears to be a case where we should agree to disagree. The Globe has updated coverage of the case and other similar cases.

AShrink

Dec-23-13 5:54 PM

As far as the physical complaints sounding real we don't know much about them. Clearly this is the crux of the legal issues here. No MD would speculate on this without complete familiarity with the history and performance of an examination.

AShrink

Dec-23-13 5:51 PM

be asked. Leave the speculation without some background, exaggeration and minimization, fear mongering, and sensationalism to the Daily Mail.

AShrink

Dec-23-13 5:49 PM

This is getting to be more fun! 1) So the doctor kept her home? You described he recommended this, not ordered it. This seems to me to be a parental responsibility. 2) Your statement re CPS ordering or approving drugs is again not consistent with the manner this procedure works. Again I would beg you to please inform yourself before publishing. There are many providers in Minot who could help you provide accurate information to your readers. 3) Of course the parents behavior has been far more problematic than just demanding a second opinion. You have written as much yourself. This oversimplification is simply erroneous. I understand and support we should question what is going on with this situation. But again, with your opportunities to communicate with people, would encourage you to do this in an informed and logical manner. It seems to me that be sensational would be easy in journalism. You have a chance here to break away from the Daily Mail and ask the real questions that need to

AndreaJohnson

Dec-23-13 4:09 PM

The girl's doctor was quoted as saying he had recommended half days at school due to her symptoms and she resisted staying home. Her physical complaints sound real. As far as drugs go, I imagine Social services is now in charge and can authorize any treatment the doctors at Children's want because they have cut the parents out of her treatment. While it may be true that the parents' belligerence exacerbated this situation, it probably should not have led to them losing custody just for demanding a second opinion. I strongly question the actions of hospitals, social workers and the judicial system in this case.

AShrink

Dec-23-13 1:25 PM

Sorry but a couple other things. The girl resisted being kept from school. Who kept her from school if not Mom and Dad? Is that not a harm? Munchausen's by proxy (again just speculation) is a very dangerous disorder effecting the child's emotional and social development, can be fatal if extreme, consumes the taxpayer's dollars, and injurious in the potential neglect of other illnesses. If the hospital was to violate a court order they would be subject to legal penalty including jail for contempt.

AShrink

Dec-23-13 1:18 PM

My point here is not to argue the rights or wrongs of this case. For all we know this may be a tragic miscarriage of the justice system. But we do not know. Speculations concluding that caretakers ought to be sued for everything they are worth are simply tirade. You have the training in communication in communication and wordsmithing and the forum to help the community of Minot to develop a balanced reasoning process about these issues. Not only this case but in a larger sense. Is this situation news? In my opinion it is and I believe important for people to know about. But repeating and amplifying a story from the Daily Mail is not very close to the truth I am sure you mean to present. I recently saw the Daily Mail referred to as “The International Journal of Health Scares”. Not certain what other articles you are referring to. I Thank you for allowing me to share your forum.

AShrink

Dec-23-13 1:17 PM

At least we have dropped the idea of drug experiments on her. That is really far beyond the real world and that kind of statement clearly frightens people from seeking help. If there are drug experiments it is in the treatment of mitochondrial disease as a search of PubMed will show. I don’t criticize that if ethics committees and Institutional review boards have established clear protocols, including informed consent by all parties involved. But it is almost impossible to do any drug studies in children/adolescents especially those with Intellectual Disability. Experiments on patients are otherwise assaults that have extremely serious consequences. It simply isn’t allowed by all the checks and balances among providers and multiple external agencies. Never. More Follows.

AShrink

Dec-23-13 1:16 PM

This hospital’s role in other cases may be due to many factors. They may be one of the few remaining places in the country that have a child/adolescent inpatient unit. They may be the only hospital that will work with the courts or CPS. There are a number of other speculations you and I could make. More Follows.

AShrink

Dec-23-13 1:16 PM

Let me be clear. Clearly this whole situation is unfortunate for all involved. But whether or not this intervention is the best thing for this young lady is simply speculation on both our parts. I would add that parents who are belligerent with CPS are less likely to have a good outcome and your readers should know that. The diagnosis of Somatoform disorder has not substantially changed for more than 40 years. The DSM 5 criteria add what may be a useful interpretive observation but like all medical, not just psychiatric, diagnosis these subjective criteria can be difficult to be confident in with children and adolescents. A further complication in this situation is also her intellectual limitations. None of these disqualify her narrative but do make for inconsistencies in different evaluators opinions. I wonder (speculate) if the concern here is not Munchausen’s by proxy – but we do not know. More Follows.

AndreaJohnson

Dec-20-13 10:37 PM

Other stories have also made it evident that this is a pattern at this particular hospital in cases where a kid has a "mystery illness" and the parents are seen as difficult. This is only the latest such case. Social Services, or the Department of Children and Families there, lacks medical experts and is all too likely to defer to the doctors at this particular hospital, even though they claim not to be in control of the situation. Add parents who got in everyone's face and weren't willing to defer to doctors or social workers and everyone was all too willing to believe they were suspect. But just because they were "difficult" doesn't mean they deserved to lose their daughter or that they aren't right.

AndreaJohnson

Dec-20-13 10:24 PM

The new DSM calls it "somatic symptom disorder." To quote the newest edition of the manual: "Individuals previously diagnosed with somatization disorder will usually meet DSM-5 criteria for somatic symptom disorder, but only if they have the maladaptive thoughts, feelings, and behaviors that define the disorder, in addition to their somatic symptoms." Another article quoted the girl's previous doctor as saying that the girl actively resisted being kept home from school, even though he had given her a legitimate excuse to attend only half days. She loved school and loved spending time with her friends and, up until a month before hospitalization, was skating in an ice show. That hardly sounds like a hypochondriac or someone making up symptoms of physical illness. In the care of the hospital, she can no longer walk unaided, according to most of the accounts.

AndreaJohnson

Dec-20-13 10:11 PM

How could you possibly think it is "fortunate" that this kid has been kept on a locked psychiatric ward against her will for over 10 months, restricted from access to her family and friends, and deteriorating physically by the day? All her phone calls are listened in on by hospital staff. The hospital also claims she could have been discharged last summer but Social Services can't find a place to put her ... and won't send her home. And taxpayers are footing the bill. Her original doctor hasn't been allowed to see her and objects to the treatment by these doctors. Her older sister has the same disorder she was being treated for. The criteria they used to diagnose "somataform disorder" was apparently also changed in the last edition of the DSM-5 since she was originally admitted to the hospital in February. This kind of attitude from medical professionals is bound to make other parents very leery of taking kids to Children's or to psychiatrists, for that matter.

AShrink

Dec-20-13 9:56 PM

You and I must have read different Boston Globe stories. Usually Chld Protective Services and the courts are criticized for not doing enough - see Spirit Lake. CPS has somehow managed to convince a judge or maybe more than one judge and the county/city attorneys there is something here. Now I do not say they are right or wrong but this is the process defined by law. I believe there is enough going on here to support saying "it's not as simple as all that." Clearly not enough information to cry for a law suit "for all they are worth." Perhaps we will find that it wass not unfortunate for this young lady that the judge did not let her go home. More likely we will never be given enough information to fairly judge.

AndreaJohnson

Dec-20-13 1:20 PM

And, unfortunately, the judge did not return this poor girl home. He assigned a guardian ad litem and scheduled another hearing for January 10.

AndreaJohnson

Dec-20-13 8:20 AM

I would add that the parents being belligerent or uncooperative with medical authorities or simply unlikable should not add up to a call to Social Services. Nor should disagreement with doctors who had treated their daughter for three days or an attempt to take their daughter to another hospital for treatment. The court is set to rule on this girl's custody today. I hope the judge sends her home and sanctions Children's Hospital for its actions in this case.

AndreaJohnson

Dec-20-13 8:15 AM

At the time, the Daily Mail article gave the most details and what the parents were claiming. The Mail is seen as rather low brow in the UK, for good reason, but it does have extensive coverage beyond celebrity coverage. The Globe coverage gives a more balanced portrait of the hospital's concerns. But, again, I think the Globe story also clearly shows that the hospital and its doctors have seriously overstepped their bounds. The girl does not want to be there, her parents don't want her to be there, and her original doctors have not been allowed to see her.

AShrink

Dec-18-13 7:21 PM

Sorry - just learned that the Daily Mail is England's version of the National Enquirer. Khloe Kardashian is on the front page of today's edition. It is most famous for it's Friday issue featuring a full figured female model with no shirt on the front page. I don't want to nag but isn't one of the top rules in journalism something about checking your sources?

AShrink

Dec-18-13 7:06 PM

And no, not everyone - in fact very rarely do families behave in this consistently belligernt fashion in these situations. Last, Doctors do not lock people in Psychiatric Units. Courts do. Doctors make recommendations regarding this. These require imminent dangerousness to self and others. Anyone who believes this is a rubber-stamp process has not endured the heartache of trying to getr a loved one help before they do hurt themselves or someone else. I'm saddened that such an opportunity to educate people was lost to the Minot Daily. Instead a misguided distillation of the sensational parts of a story from a sensationalist newspaper was presented which attacks Child Protective Services and a hospital that is following a court order. I love my job. I am aware of and accept these types of issues in my work.I do not know the rights and wrongs of this case. But I have learned about the Dailymail. Thanks for listening.

AShrink

Dec-18-13 7:05 PM

In fact, the consultant disagreed with this diagnosis. It is certainly possible she has both diagnosis mentioned. It is more common to have the diagnosis of somataform disorder in the presence of some "real" disease, but one that does not explain the complaints and functional problems. Next we have the bias of source. The Globe story presents more of the hospital's side than I thought we would hear. Simply put the patient's right to privacy prevents the hospital from defending itself in the press. This is almost always seen in malpractice cases where the plaintiff threatens or actually does get their side in the paper if the doctor won't settle. And again the provider can do nothing. The Globe story notes she has made cell phone calls to friends which is not consistent with the parents story. The Globe also notes bringing in needles to a visit. The Mother's explanation strains credulity and is in fact insulting to the intelligence of all. And no, not everyone - in fact very

 
 

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