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A Fredericksburg doctor this week refused to treat a handcuffed inmate Date published: 1/14/2009
BY JIM HALL When Dr. Declan Burke, a Fredericksburg obstetrician/gynecologist, walked into his exam room Monday, he discovered that his patient, a female jail inmate, was in handcuffs. "Please take off the manacles," he said to the correctional officer who was with the inmate. "No, I can't," the guard replied. Burke insisted, so the officer called her supervisor at the Rappahannock Regional Jail. The supervisor agreed with the officer. The handcuffs would remain in place during the exam. Burke said he wanted the handcuffs removed to examine the patient completely. It was the first time in 20 years that he has refused to treat a jail inmate. The superintendent of the regional jail in Stafford County said that restraints are needed to prevent violent behavior. "I respect his office policy," said Joseph Higgs, "but I am not going to compromise the safety of that doctor, his nurse or my officer by removing restraints on an inmate that may well have created a problem." Health workers must sometimes restrain unruly patients. But what about the patient who arrives for treatment in shackles? Can a doctor insist that they be removed? Several hospitals, state legislatures and departments of corrections nationwide have debated the shackling of pregnant inmates during labor and delivery. At Mary Washington Hospital's emergency department, prisoners from the Rappahannock Regional Jail are not shackled while being treated. "The handcuffs are removed, and a prison guard sits one-on-one with the patient," said Kathleen Allenbaugh, hospital spokeswoman. When state inmates are taken for medical care, the decision whether to shackle during treatment is made on a case-by-case basis, said Larry Traylor, spokesman for the Virginia Department of Corrections. "Several factors come into play," Traylor said in an e-mail. "The most significant being the offender's history of behavior. When possible we will consider removal of either the handcuffs or the leg irons depending on the area that requires treatment." Burke described his patient as a "small, frail-looking woman" in her 30s. He said he did not know her criminal history. She was there because of complications of a hysterectomy. Burke said the guard removed the prisoner's leg shackles for the pelvic exam. He also said he wanted the handcuffs removed to do a breast exam. With the handcuffs in place, "I could have done a limited exam. I couldn't have done the adequate exam I wanted to do," he said. Burke said he did not fear for his safety. His nurse and the guard were in the room. The guard and inmate eventually left Burke's Central Park office without the inmate being treated. Higgs said the jail's policy is consistent for all prisoners, male or female, sentenced or accused. "Normally, when we take them out into the community, even to funerals, they remain cuffed," Higgs said. Burke's patient had been convicted in Stafford County and had a history of violence, Higgs said. "The doctor has no knowledge of the history of this inmate at this facility. We do," he said. The inmate will see another doctor and will be handcuffed during the exam, he said. Jim Hall: 540/374-5433
A more gentle and caring soul you won't find in medicine.Dr. Burke had sound medical reasons to insist that the shackles be removed.He is also a stubborn Scotsman who will stand up for his patients.You go Doc..
it looks like ithis was a "control" issue. A doctor concerned about the patients health would have conducted an exam as well as they could and then protested. This doctor was apparently more concerned that the "lowly" corrections staff did not comply with his directions. The fact that the prisoner looked like a "small, frail-looking woman" means nothing. Desire and opportunity, coupled with the element of surprise allows people like that to maim or kill people like the doctor and his staff.
If Dr. Burke was so concerned with patient care he would've worked around the restraints. It sounds a power trip to me because he was willing to let her leave without treatment to prove a point. Speaking from experience, breast exams are not rocket science.
When I worked in DC, we brought a prisoner into the DC General Emergency Room for treatment. The guy could not have been more than 120 pounds. The call started off as a suicide attempt and he wound up assaulting several officers and firemen before he was subdued.
Once we were at the hospital, we tried to use leg shackles and cuffs on both sides of the bed, but the hospital staff said no. The prisoner, only cuffed on one side, attacked the doctor and took a 300 pound ER bed across the room with him.
I can see the good doctor's point - you can't do a full breast exam if the patient is handcuffed. Perhaps a better suggestion would have been to remove the leg shackles, to do the pelvic exam, then replace the leg shackles, and remove the handcuffs for the breast exam. Either way, I agree with LMS - this is not really news.
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