The medical record contains a striking admission by UAMS physician Jordan Greer concerning the use of powerful sedating drugs on a patient who was trying to leave the hospital:

“Patient lacks capacity and continues to try and elope. Will give zyprexa, phenobarb, and ativan PRN. Will add precedex as needed for safety of patient and staff.”

The significance of this statement becomes clearer when the medications are identified.

Zyprexa (olanzapine) is an antipsychotic medication that can cause sedation. Phenobarbital is a barbiturate and central nervous system depressant used as a sedative and anticonvulsant. Ativan (lorazepam) is a benzodiazepine with sedating effects. Precedex (dexmedetomidine) is a sedative administered by infusion and used in intensive-care and procedural sedation.

In other words, Dr. Greer’s note did not merely describe an attempt to persuade a patient to remain in the hospital. It documented a plan to use multiple medications capable of depressing the central nervous system because the patient was attempting to leave and was considered unable to make his own decisions.

The medical record itself is therefore important. It uses the language of “safety,” but it also expressly connects the proposed administration of these drugs to the patient’s attempts to “elope.” When medication is used to prevent a person from leaving rather than to treat a medical condition, the question of whether the medication is functioning as a chemical restraint deserves careful scrutiny.

This is not an assertion that every use of these medications constitutes a chemical restraint. Their legitimate medical uses are well established. The question here is what purpose they served in this particular case—and the doctor’s own words provide unusually direct evidence of that purpose.

After a clear threat of litigation, the patient was allowed to leave the hospital against medical advice, without further battery by the UAMS staff. He rested comfortably at home and expressed his understanding that he was a prisoner at UAMS for the prior two weeks, despite the drug cocktail forced on him.