Medical restraining orders?

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					  CMAJ                                                                                                               News
For the record
Breakfast behind bars                           working to improve services further.”                always a concern about giving advice
                                                — Mary Helen Spooner, London,                        in nonclinical settings, where the

     nmates in Britain’s prisons eat            England                                              patient’s medical information and his-
     better than patients in National                                                                tory may be sketchy, Leighton says.
     Health Service hospitals. That             Medical restraining orders?                              As for those who need medical
conclusion was reached by researchers                                                                advice when emergency rooms are

from Bournemouth University’s Food-                      mergency room closures and                  closed and they aren’t allowed to accost
service and Applied Nutrition                            reductions in hours of opera-               a community’s doctor in the store,
Research Group after comparing the                       tion have become altogether                 relief may be a phone call away. The
nutritional intake of prisoners and hos-        common in several rural areas of Nova                provincial government has launched
pital patients.                                 Scotia, largely as a consequence of the              HealthLink 811, a 24-hour telecare ser-
    The raw ingredients and preparation         unavailability of physicians. Less                   vice that directs callers to registered
methods were similar, “with little salt,        common, though, were aspects of a                    nurses who assesses symptoms and
butter or margarine added to enhance            polite missive issuing from the Cum-                 advises on next steps. — donalee
flavour, as you might do in a commer-           berland Health Authority as it notified              Moulton, Halifax, NS
cial setting,” says John Edwards, head          area residents that their local emer-
of the group at the School of Services          gency department would be shut down
Management.                                     for 36 hours and then no longer be
                                                                                                     Psychiatric hospital closes
    But many hospital patients —                open around the clock.                               beds
including an estimated 40% who were                 In what could be viewed as the med-

malnourished upon admission — did               ical equivalent of a restraining order,                        he Alberta government is
not consume enough food and fluids.             the authority simultaneously urged resi-                       drawing fire for a plan to move
Most hospitals lack procedures for              dents not to accost physicians on the                          mental health beds out of a
monitoring patients’ actual food                street, in stores or in their offices. Nor,          major psychiatric hospital into the
intake and patients who need help               the authority added, is it appropriate to            community rather than redevelop the
with eating or drinking do not always           go to a physician’s office or private res-           facility, which has been in operation
receive it.                                     idence, or attempt to locate an individ-  
Description: Physicians don't appear to be concerned about a public relations fallout resulting from such admonitions, [Ann Keddy] says. The two family physicians in the town of Pugwash, along Nova Scotia's north shore, who saw the notice "were not concerned about perception."As for those who need medical advice when emergency rooms are closed and they aren't allowed to accost a community's doctor in the store, relief may be a phone call away. The provincial government has launched HealthLink 811, a 24-hour telecare service that directs callers to registered nurses who assesses symptoms and advises on next steps. - donalee Moulton, Halifax, NS
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