8 ms·

At urging of Minneapolis police, EMS workers subdued dozens with ketamine

34 points by tomohawk 8y ago

nextstep 8y ago
I’m very confused about the legal status of ketamine in the United States. It’s seemingly illegal (schedule 1?) but also there have been stories about ketamine therapy for depression symptoms and now this? I don’t understand US drug laws.
- stochastic_monk 8y ago
  Schedule III. Of course, there are studies on cannabis/psilocybin, which are both schedule I. It's still a terrible and terrifying drug for subduing people.
  - drb91 8y ago
    I’m not terribly familiar with ketamine. Thorazine is often used for this purpose, as an injection, a gas, or a pill. How does it compare in how it affects the target? I’m emphatically not in favor of police using this except as an alternative to other types of violence, but sedation is useful in other contexts.
    - stochastic_monk 8y ago
      Thorazine is an antipsychotic, for schizophrenia, stimulant overdoses, and stuff like PCP. Ketamine is more of a dissociative; it's a little like long-lasting injectable nitrous oxide. It causes hallucinations, but more like a loss of connection from reality than seeing things that aren't there.
  - JshWright 8y ago
    > It's still a terrible and terrifying drug for subduing people. It is commonly use for procedural sedation (i.e. sedating someone so you can reduce a joint dislocation).
    - stochastic_monk 8y ago
      Right, but when is using procedural sedation on unconsenting suspects acceptable?
      - JshWright 8y ago
        When they pose a threat to themselves or others.
        stochastic_monk 8y ago
        That’s fair. I just don’t trust police to be good judges of that. We can’t even get them to stop obstructing investigations by turning off their body cameras.
        JshWright 8y ago
        Sure, but that doesn't make it "terrible and terrifying". It is literally life saving in certain circumstances.
- deleted 8y ago
  [deleted]
- notadoc 8y ago
  Ketamine is an anesthetic with broadly valid medical use. There are many similar substances which are scheduled and controlled.
  - Synaesthesia 8y ago
    This is correct, it's actually a very safe drug, it's on the WHO list of essential medicines, it's given to infants, obviously in a appropriate setting. Very questionable that some people had to be resuscitated because they were given Ketamine while handcuffed - already a strain on your breathing and heart, when it's a depressant.
    - jfk13 8y ago
      Some years ago, I had a close friend who got drawn into ketamine (ab)use and spent an extended period seriously addicted to it. Having watched the devastation it wrought in her and her family's lives, and the struggle it took to break its hold, I find this highly disturbing. Yes, ketamine has its uses, but it also carries real risks and should not be used without proper controls and medical oversight.
      - Synaesthesia 8y ago
        Yeah it’s quite addictive. But for example anyone who undergoes surgery gets given opiates which are also highly addictive. That doesn’t result in millions of people suddenly being addicted.
- Jugglerofworlds 8y ago
  I've had ketamine infusions for depression. At the ketamine clinics, the drug is administered by an anesthesiologist, and insurance does not cover the cost since the drug is not FDA approved for depression.
staticautomatic 8y ago
As more and a wider variety of stories emerge about police malfeasance around the U.S., it should become increasingly difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents. It is ubiquitous? I don't know. But empirically it does seem to be pervasive.
- bootlooped 8y ago
  The biggest refutation of the few-bad-apples theory in my mind is that for each bad apple there are a dozen other officers that either did nothing or actively covered for them, plus the policeman's union which will zealously assert that basically no policeman is ever to blame for anything. It would be a whole different story if the police rooted out bad actors within their ranks on their own, but it seems like it takes a lot of kicking and screaming and, most importantly, public scrutiny, to get anything done.
  - XJOKOLAT 8y ago
    True. Fuck em.
  - digi_owl 8y ago
    Their theory seems to be that if i don't back him, then him or his cohort will throw me to the wolfs at a bad moment. Sadly this line of thinking just reinforce the mentality that the police is at war with the public, in that the only people they can "trust" (in a tit for tat sense) are fellow officers.
- Barrin92 8y ago
  >difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents the point of the metaphor is that a few rotten apples spoil the entire bunch, so this isn't really an excuse to begin with.
  - staticautomatic 8y ago
    It's funny you should bring that up because, come to think of it, I've never actually seen a bunch of apples spoiled by a bad one. They seem to rot from the outside in, maybe on account of their relatively thick skins. Softer skinned fruits like berries and those which tend to mold on the outside (like citrus) do tend to spoil the whole bunch, though.
adamnemecek 8y ago
Is the US a dictatorship yet
- kpil 8y ago
  It has a inadequately trained police force, apparently with some cultural and management issues, probably under-staffed and wearing down under a high workload and too many encounters with the worst kind of people in some districts, where there is absolutely no time to take it slow.
  - adamnemecek 8y ago
    It's not just the police force though, is it.
- sctb 8y ago
  Please stop doing this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- deleted 8y ago
  [deleted]
walterbell 8y ago
Is there an industry code of conduct for EMS personnel?
- ropeadopepope 8y ago
  From what I've seen, it's 'do what the cops say or go to jail.' https://nypost.com/2017/09/01/nurse-arrested-after-refusing-blood-test-on-unconscious-patient/ https://nypost.com/2017/09/01/nurse-arrested-after-refusing-...
  - Volundr 8y ago
    Whilst I suspect in general we agree about the systemic problems, in this particular case, the officer was fired and his supervisor demoted: https://www.cbsnews.com/news/detective-jeff-payne-fired-nurse-alex-wubbels-video/ https://www.cbsnews.com/news/detective-jeff-payne-fired-nurs...
- JshWright 8y ago
  EMS providers operate under a set of protocols that define what they can and can't do. Deviation from those protocols requires permission from a doctor.
- DanBC 8y ago
  This doesn't answer your question, but in England all trusts who perform rapid tranquillisation (mostly mental health trusts) need to have a policy. You can see some of them here. https://www.google.co.uk/search?source=hp&q=rapid+tranquillisation+nhs https://www.google.co.uk/search?source=hp&q=rapid+tranquilli... These are bureaucratic documents aimed at NHS managers and external auditors so they're full of jargon but some things to note are: 1) They often talk about the impact on SUs of rapid tranquillisation 2) They talk of the need to reduce and prevent it where possible, and link to external auditors (CQC) or national guidance. 3) They mention NHSLA (NHS litigation authority, the organisation that funds malpractice lawsuits) because RT sometimes causes death or other long lasting harm. The other sources of information are NICE and Royal College of Psychiatry. https://www.rcpsych.ac.uk/pdf/RT%20Algorithym%20(2).pdf https://www.rcpsych.ac.uk/pdf/RT%20Algorithym%20(2).pdf https://www.nice.org.uk/guidance/ng10 https://www.nice.org.uk/guidance/ng10 https://www.nice.org.uk/guidance/qs154 https://www.nice.org.uk/guidance/qs154 https://www.nice.org.uk/guidance/qs14 https://www.nice.org.uk/guidance/qs14 In England regulation of individual healthcare professionals is the GMC for doctors, the NMC for nurses and midwives, and the HCPC for everyone else. The HCPC standards of practice are here: https://www.hcpc-uk.org/aboutregistration/standards/standardsofconductperformanceandethics/ https://www.hcpc-uk.org/aboutregistration/standards/standard... On top of those all HCPs will be expected to know and follow law. There are some worrying interactions between English police and health care professionals, mostly around misuse of "lack of capacity" (but without using the Mental Capacity Act) or misuse of the Mental Health Act (eg misusing S136).
azernik 8y ago
Interesting and encouraging use of bodycams: "To evaluate how the sedative was being used, the Office of Police Conduct Review investigators looked for mentions of the word in police reports, and then reviewed body camera footage from those cases."
resu_nimda 8y ago
Minneapolis police previously had no policy addressing the drug, and the department manual classifies it as a “date rape drug” for its powerful sedative impact and ability to erase or alter memory. That's funny, because the World Health Organization classifies it as an "essential medicine." I'm being somewhat disingenuous as I do understand it has potential for abuse, but "date rape drug"? I've never once heard of ketamine used for that. Meanwhile it's being looked at for treating depression and other things. This over-the-top drug war rhetoric is so frustrating.
- eesmith 8y ago
  I am surprised as your surprise. For example, the term "date rape" occurs twice on the Wikipedia page for ketamine: > In December 2013, the government of India, in response to rising recreational use and the use of ketamine as a date rape drug, has added it to Schedule X of the Drug and Cosmetics Act requiring a special license for sale and maintenance of records of all sales for two years. > Because of its ability to cause confusion and amnesia, ketamine can leave users vulnerable to date rape. It's not hard to find things like: > "Tests for “date rape” drugs, such as Rohypnol and ketamine, were conducted. Those tests came back negative." - https://chicago.suntimes.com/news/attorneys-for-kenneka-jenkins-mother-file-motion-to-preserve-video/ https://chicago.suntimes.com/news/attorneys-for-kenneka-jenk... > "Three teenagers are being praised for a straw they invented to detect the presence of date rape drugs in drinks. ... two common drugs used in assaults — GHB and Ketamine" - https://www.sfgate.com/business/article/straw-detect-date-rape-drugs-teen-inventors-miami-11200401.php https://www.sfgate.com/business/article/straw-detect-date-ra... > It’s called ketamine, a class III scheduled drug .... The drug is the most commonly used among veterinarians for anesthetic purposes, according to Medical News Today, but is often illegally used in clubs and as a date-rape drug. - http://www.miamiherald.com/article206350184.html http://www.miamiherald.com/article206350184.html
  - resu_nimda 8y ago
    But did you actually know of it as a date rape drug before you googled "ketamine date rape?" Not one of those articles (including the two referenced in the Wikipedia quote) even attempts to substantiate any connection between ketamine and date rape. They just put the terms together, sometimes in the headline, to create an association without actually supporting it. One of them contains a statement from an Indian FDA official that "Its misuse is rampant. Its powdered form has been associated with sexual assault cases world over." Not exactly convincing. You may deduce that I am a user of ketamine. I do think it has potential and it is clearly deemed safe by health professionals. Putting "KETAMINE DATE RAPE" in headlines/subtitles of articles that have nothing to do with someone being date raped is not useful.
JshWright 8y ago
I am an EMS provider with experience sedating patients (generally using Versed, but I have used Ketamine on occasion as well). In every instance it has been done out of concern for safety (my own, my crew's, or the patient's). Taking the article at face value, it seems likely this procedure was being abused (and I would not be surprised if that was proven to be the case). However... Many of the circumstances described do not necessarily mean it was inappropriate to sedate the patient. Just because someone is handcuffed does not mean they are not a danger to me. Just because someone is secured to the stretcher does not mean they are not a danger (I've been kicked in the head by someone who continued to fight after being secured to the stretcher and eventually worked his leg free). Just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily (generally after expressing an intent to harm themselves). I think the moral answer to "should we prevent someone who wants to hurt themselves from doing that" is worth some discussion, but the legal answer is quite clear... I am required to transport that patient to a hospital. In many cases is it safer for the patient to use chemical rather than physical restraints. Again, I am not defending every instance of sedation in Minneapolis. I am simply providing some examples of how this isn't always a cut and dry decision.
- eesmith 8y ago
  You appear to be downplaying the article. You write "just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily". The article certainly doesn't disagree with that statement. It states: "Hennepin Healthcare staff are authorized to use ketamine when a patient is “profoundly agitated,” unable to be restrained and a danger to themselves or others, according to their policy." Instead it is pointing out times where there does not appear to be a justifiable reason, and for situations where there seemingly should be a cut and dry decision. The morality point you brought up, while true, does not appear relevant to the topic at hand. As an example of downplaying, the article talks about being handcuffed and secured to the stretcher. You turned that into two distinct cases, and gave an example of where each one separately has come up in your work. But how often have ended up in danger from people who were both handcuffed and secured to the stretcher? The other use of "handcuffed" was from someone maced while intoxicated, who suffered an asthma attack as a result. The woman, who "was not actively resisting police, asked for an asthma pump. Instead they handcuffed her to a stretcher and gave her ketamine, the report said. ... It is also important to note that it appears no crime was committed, no threat to the safety of officer or paramedics was evident, ...". Again, your abstract question of the morality of taking someone to the hospital involuntarily under any circumstance does not seem to be relevant. You write "In many cases is it safer for the patient to use chemical rather than physical restraints." Certainly. Again, I don't think anyone disagrees. However, the article points out examples where both chemical and physical restraints were used. For example, a man secured to a chair, then "[w]hen the man began to regain consciousness .. [t]hey injected him with another dose of ketamine", causing him to stop breathing. I interpret your true but abstract observations as a way to blur the concrete examples of problems highlighted in this piece.
ggchappell 8y ago
It seems to me that this article is concentrating on the wrong thing. The biggest problem in the incidents in question is not misbehavior by police; it is misbehavior by EMS workers. Consider: a police officer and an EMS worker are dealing with someone who is difficult to subdue. The police officer -- who does not have the expertise to know whether it is a good idea -- requests that the person be injected with ketamine. The EMS worker -- who does have the expertise -- does so, knowing that it is a bad idea. What most needs to change here is the EMS system. ------------------- EDIT. I guess I mean to say that the people involved here (as opposed to the article) are concentrating on the wrong thing. The police are the ones that have changed their policies. But it seems to be the EMS system that has the more serious problem.
- JshWright 8y ago
  That's assuming the premise "it is a bad idea" is true. I also don't believe it is inappropriate for the police to suggest that physical restraint isn't working and that something else should be tried (as that is there area of expertise)
  - ggchappell 8y ago
    I don't think it's inappropriate either. But we should note that police do not have expertise regarding the administration of drugs. Someone with no expertise in a field can suggest anything they want to. Those with expertise who are actually making the decisions need to be held to account for them.
    - JshWright 8y ago
      I absolutely agree that the folks pushing the drugs are the ones responsible. My point is that it is reasonable for police to say "we're getting our asses kicked, this isn't working, can you sedate this person?"
- eesmith 8y ago
  How do you infer that the article concentrates on the misbehavior of police more than misbehavior by EMS workers? I have read it a few times now, and I don't get that interpretation. If anything, the medical system comes off worse. For example, compare: > Hennepin EMS Medical Director Jeffrey Ho and Minnesota Poison Control System Medical Director Jon Cole dismissed the findings of the report as a “reckless use of anecdotes and partial snapshots of interactions with police, and incomplete information and statistics to draw uninformed and incorrect conclusions.” with > Minneapolis Police Chief Medaria Arradondo would not comment on the specifics of the draft, but credited it for changing his department’s approach to interacting with EMS workers.

34 points by tomohawk 8y ago

I’m very confused about the legal status of ketamine in the United States. It’s seemingly illegal (schedule 1?) but also there have been stories about ketamine therapy for depression symptoms and now this? I don’t understand US drug laws.

stochastic_monk 8y ago
Schedule III. Of course, there are studies on cannabis/psilocybin, which are both schedule I. It's still a terrible and terrifying drug for subduing people.
- drb91 8y ago
  I’m not terribly familiar with ketamine. Thorazine is often used for this purpose, as an injection, a gas, or a pill. How does it compare in how it affects the target? I’m emphatically not in favor of police using this except as an alternative to other types of violence, but sedation is useful in other contexts.
  - stochastic_monk 8y ago
    Thorazine is an antipsychotic, for schizophrenia, stimulant overdoses, and stuff like PCP. Ketamine is more of a dissociative; it's a little like long-lasting injectable nitrous oxide. It causes hallucinations, but more like a loss of connection from reality than seeing things that aren't there.
- JshWright 8y ago
  > It's still a terrible and terrifying drug for subduing people. It is commonly use for procedural sedation (i.e. sedating someone so you can reduce a joint dislocation).
  - stochastic_monk 8y ago
    Right, but when is using procedural sedation on unconsenting suspects acceptable?
    - JshWright 8y ago
      When they pose a threat to themselves or others.
      - stochastic_monk 8y ago
        That’s fair. I just don’t trust police to be good judges of that. We can’t even get them to stop obstructing investigations by turning off their body cameras.
        JshWright 8y ago
        Sure, but that doesn't make it "terrible and terrifying". It is literally life saving in certain circumstances.
deleted 8y ago
[deleted]
notadoc 8y ago
Ketamine is an anesthetic with broadly valid medical use. There are many similar substances which are scheduled and controlled.
- Synaesthesia 8y ago
  This is correct, it's actually a very safe drug, it's on the WHO list of essential medicines, it's given to infants, obviously in a appropriate setting. Very questionable that some people had to be resuscitated because they were given Ketamine while handcuffed - already a strain on your breathing and heart, when it's a depressant.
  - jfk13 8y ago
    Some years ago, I had a close friend who got drawn into ketamine (ab)use and spent an extended period seriously addicted to it. Having watched the devastation it wrought in her and her family's lives, and the struggle it took to break its hold, I find this highly disturbing. Yes, ketamine has its uses, but it also carries real risks and should not be used without proper controls and medical oversight.
    - Synaesthesia 8y ago
      Yeah it’s quite addictive. But for example anyone who undergoes surgery gets given opiates which are also highly addictive. That doesn’t result in millions of people suddenly being addicted.
Jugglerofworlds 8y ago
I've had ketamine infusions for depression. At the ketamine clinics, the drug is administered by an anesthesiologist, and insurance does not cover the cost since the drug is not FDA approved for depression.

staticautomatic 8y ago

As more and a wider variety of stories emerge about police malfeasance around the U.S., it should become increasingly difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents. It is ubiquitous? I don't know. But empirically it does seem to be pervasive.

bootlooped 8y ago
The biggest refutation of the few-bad-apples theory in my mind is that for each bad apple there are a dozen other officers that either did nothing or actively covered for them, plus the policeman's union which will zealously assert that basically no policeman is ever to blame for anything. It would be a whole different story if the police rooted out bad actors within their ranks on their own, but it seems like it takes a lot of kicking and screaming and, most importantly, public scrutiny, to get anything done.
- XJOKOLAT 8y ago
  True. Fuck em.
- digi_owl 8y ago
  Their theory seems to be that if i don't back him, then him or his cohort will throw me to the wolfs at a bad moment. Sadly this line of thinking just reinforce the mentality that the police is at war with the public, in that the only people they can "trust" (in a tit for tat sense) are fellow officers.
Barrin92 8y ago
>difficult to credibly say it's just a few bad apples here and there responsible for isolated incidents the point of the metaphor is that a few rotten apples spoil the entire bunch, so this isn't really an excuse to begin with.
- staticautomatic 8y ago
  It's funny you should bring that up because, come to think of it, I've never actually seen a bunch of apples spoiled by a bad one. They seem to rot from the outside in, maybe on account of their relatively thick skins. Softer skinned fruits like berries and those which tend to mold on the outside (like citrus) do tend to spoil the whole bunch, though.

adamnemecek 8y ago

Is the US a dictatorship yet

kpil 8y ago
It has a inadequately trained police force, apparently with some cultural and management issues, probably under-staffed and wearing down under a high workload and too many encounters with the worst kind of people in some districts, where there is absolutely no time to take it slow.
- adamnemecek 8y ago
  It's not just the police force though, is it.
sctb 8y ago
Please stop doing this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
deleted 8y ago
[deleted]

walterbell 8y ago

Is there an industry code of conduct for EMS personnel?

ropeadopepope 8y ago
From what I've seen, it's 'do what the cops say or go to jail.' https://nypost.com/2017/09/01/nurse-arrested-after-refusing-blood-test-on-unconscious-patient/ https://nypost.com/2017/09/01/nurse-arrested-after-refusing-...
- Volundr 8y ago
  Whilst I suspect in general we agree about the systemic problems, in this particular case, the officer was fired and his supervisor demoted: https://www.cbsnews.com/news/detective-jeff-payne-fired-nurse-alex-wubbels-video/ https://www.cbsnews.com/news/detective-jeff-payne-fired-nurs...
JshWright 8y ago
EMS providers operate under a set of protocols that define what they can and can't do. Deviation from those protocols requires permission from a doctor.
DanBC 8y ago
This doesn't answer your question, but in England all trusts who perform rapid tranquillisation (mostly mental health trusts) need to have a policy. You can see some of them here. https://www.google.co.uk/search?source=hp&q=rapid+tranquillisation+nhs https://www.google.co.uk/search?source=hp&q=rapid+tranquilli... These are bureaucratic documents aimed at NHS managers and external auditors so they're full of jargon but some things to note are: 1) They often talk about the impact on SUs of rapid tranquillisation 2) They talk of the need to reduce and prevent it where possible, and link to external auditors (CQC) or national guidance. 3) They mention NHSLA (NHS litigation authority, the organisation that funds malpractice lawsuits) because RT sometimes causes death or other long lasting harm. The other sources of information are NICE and Royal College of Psychiatry. https://www.rcpsych.ac.uk/pdf/RT%20Algorithym%20(2).pdf https://www.rcpsych.ac.uk/pdf/RT%20Algorithym%20(2).pdf https://www.nice.org.uk/guidance/ng10 https://www.nice.org.uk/guidance/ng10 https://www.nice.org.uk/guidance/qs154 https://www.nice.org.uk/guidance/qs154 https://www.nice.org.uk/guidance/qs14 https://www.nice.org.uk/guidance/qs14 In England regulation of individual healthcare professionals is the GMC for doctors, the NMC for nurses and midwives, and the HCPC for everyone else. The HCPC standards of practice are here: https://www.hcpc-uk.org/aboutregistration/standards/standardsofconductperformanceandethics/ https://www.hcpc-uk.org/aboutregistration/standards/standard... On top of those all HCPs will be expected to know and follow law. There are some worrying interactions between English police and health care professionals, mostly around misuse of "lack of capacity" (but without using the Mental Capacity Act) or misuse of the Mental Health Act (eg misusing S136).

azernik 8y ago

Interesting and encouraging use of bodycams: "To evaluate how the sedative was being used, the Office of Police Conduct Review investigators looked for mentions of the word in police reports, and then reviewed body camera footage from those cases."

resu_nimda 8y ago

Minneapolis police previously had no policy addressing the drug, and the department manual classifies it as a “date rape drug” for its powerful sedative impact and ability to erase or alter memory. That's funny, because the World Health Organization classifies it as an "essential medicine." I'm being somewhat disingenuous as I do understand it has potential for abuse, but "date rape drug"? I've never once heard of ketamine used for that. Meanwhile it's being looked at for treating depression and other things. This over-the-top drug war rhetoric is so frustrating.

eesmith 8y ago
I am surprised as your surprise. For example, the term "date rape" occurs twice on the Wikipedia page for ketamine: > In December 2013, the government of India, in response to rising recreational use and the use of ketamine as a date rape drug, has added it to Schedule X of the Drug and Cosmetics Act requiring a special license for sale and maintenance of records of all sales for two years. > Because of its ability to cause confusion and amnesia, ketamine can leave users vulnerable to date rape. It's not hard to find things like: > "Tests for “date rape” drugs, such as Rohypnol and ketamine, were conducted. Those tests came back negative." - https://chicago.suntimes.com/news/attorneys-for-kenneka-jenkins-mother-file-motion-to-preserve-video/ https://chicago.suntimes.com/news/attorneys-for-kenneka-jenk... > "Three teenagers are being praised for a straw they invented to detect the presence of date rape drugs in drinks. ... two common drugs used in assaults — GHB and Ketamine" - https://www.sfgate.com/business/article/straw-detect-date-rape-drugs-teen-inventors-miami-11200401.php https://www.sfgate.com/business/article/straw-detect-date-ra... > It’s called ketamine, a class III scheduled drug .... The drug is the most commonly used among veterinarians for anesthetic purposes, according to Medical News Today, but is often illegally used in clubs and as a date-rape drug. - http://www.miamiherald.com/article206350184.html http://www.miamiherald.com/article206350184.html
- resu_nimda 8y ago
  But did you actually know of it as a date rape drug before you googled "ketamine date rape?" Not one of those articles (including the two referenced in the Wikipedia quote) even attempts to substantiate any connection between ketamine and date rape. They just put the terms together, sometimes in the headline, to create an association without actually supporting it. One of them contains a statement from an Indian FDA official that "Its misuse is rampant. Its powdered form has been associated with sexual assault cases world over." Not exactly convincing. You may deduce that I am a user of ketamine. I do think it has potential and it is clearly deemed safe by health professionals. Putting "KETAMINE DATE RAPE" in headlines/subtitles of articles that have nothing to do with someone being date raped is not useful.

JshWright 8y ago

I am an EMS provider with experience sedating patients (generally using Versed, but I have used Ketamine on occasion as well). In every instance it has been done out of concern for safety (my own, my crew's, or the patient's). Taking the article at face value, it seems likely this procedure was being abused (and I would not be surprised if that was proven to be the case). However... Many of the circumstances described do not necessarily mean it was inappropriate to sedate the patient. Just because someone is handcuffed does not mean they are not a danger to me. Just because someone is secured to the stretcher does not mean they are not a danger (I've been kicked in the head by someone who continued to fight after being secured to the stretcher and eventually worked his leg free). Just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily (generally after expressing an intent to harm themselves). I think the moral answer to "should we prevent someone who wants to hurt themselves from doing that" is worth some discussion, but the legal answer is quite clear... I am required to transport that patient to a hospital. In many cases is it safer for the patient to use chemical rather than physical restraints. Again, I am not defending every instance of sedation in Minneapolis. I am simply providing some examples of how this isn't always a cut and dry decision.

eesmith 8y ago
You appear to be downplaying the article. You write "just because someone has not committed a crime does not mean they cannot be taken to the hospital involuntarily". The article certainly doesn't disagree with that statement. It states: "Hennepin Healthcare staff are authorized to use ketamine when a patient is “profoundly agitated,” unable to be restrained and a danger to themselves or others, according to their policy." Instead it is pointing out times where there does not appear to be a justifiable reason, and for situations where there seemingly should be a cut and dry decision. The morality point you brought up, while true, does not appear relevant to the topic at hand. As an example of downplaying, the article talks about being handcuffed and secured to the stretcher. You turned that into two distinct cases, and gave an example of where each one separately has come up in your work. But how often have ended up in danger from people who were both handcuffed and secured to the stretcher? The other use of "handcuffed" was from someone maced while intoxicated, who suffered an asthma attack as a result. The woman, who "was not actively resisting police, asked for an asthma pump. Instead they handcuffed her to a stretcher and gave her ketamine, the report said. ... It is also important to note that it appears no crime was committed, no threat to the safety of officer or paramedics was evident, ...". Again, your abstract question of the morality of taking someone to the hospital involuntarily under any circumstance does not seem to be relevant. You write "In many cases is it safer for the patient to use chemical rather than physical restraints." Certainly. Again, I don't think anyone disagrees. However, the article points out examples where both chemical and physical restraints were used. For example, a man secured to a chair, then "[w]hen the man began to regain consciousness .. [t]hey injected him with another dose of ketamine", causing him to stop breathing. I interpret your true but abstract observations as a way to blur the concrete examples of problems highlighted in this piece.

ggchappell 8y ago

It seems to me that this article is concentrating on the wrong thing. The biggest problem in the incidents in question is not misbehavior by police; it is misbehavior by EMS workers. Consider: a police officer and an EMS worker are dealing with someone who is difficult to subdue. The police officer -- who does not have the expertise to know whether it is a good idea -- requests that the person be injected with ketamine. The EMS worker -- who does have the expertise -- does so, knowing that it is a bad idea. What most needs to change here is the EMS system. ------------------- EDIT. I guess I mean to say that the people involved here (as opposed to the article) are concentrating on the wrong thing. The police are the ones that have changed their policies. But it seems to be the EMS system that has the more serious problem.

JshWright 8y ago
That's assuming the premise "it is a bad idea" is true. I also don't believe it is inappropriate for the police to suggest that physical restraint isn't working and that something else should be tried (as that is there area of expertise)
- ggchappell 8y ago
  I don't think it's inappropriate either. But we should note that police do not have expertise regarding the administration of drugs. Someone with no expertise in a field can suggest anything they want to. Those with expertise who are actually making the decisions need to be held to account for them.
  - JshWright 8y ago
    I absolutely agree that the folks pushing the drugs are the ones responsible. My point is that it is reasonable for police to say "we're getting our asses kicked, this isn't working, can you sedate this person?"
eesmith 8y ago
How do you infer that the article concentrates on the misbehavior of police more than misbehavior by EMS workers? I have read it a few times now, and I don't get that interpretation. If anything, the medical system comes off worse. For example, compare: > Hennepin EMS Medical Director Jeffrey Ho and Minnesota Poison Control System Medical Director Jon Cole dismissed the findings of the report as a “reckless use of anecdotes and partial snapshots of interactions with police, and incomplete information and statistics to draw uninformed and incorrect conclusions.” with > Minneapolis Police Chief Medaria Arradondo would not comment on the specifics of the draft, but credited it for changing his department’s approach to interacting with EMS workers.