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May 16, 2006

Comments

I'll never know given how he ditched me :(

Typical male, I am. I thought we agreed to see other people...

Typical male, I am. I thought we agreed to see other people...

I never promised exclusivity either -- but to completely throw me over for some hussy you'd been married to for years? That's just wrong, LJ, and you know it.

As an aside, since this seems the appropriate place for it: apparently "talking to", amongst the hip young crowd, is now a euphemism for oral sex. Which led to some serious confusion between myself and a student when I was trying to figure out why they were so drowsy in class the next day...

I'll be interested to see if Sebastian ever updates this to acknowledge that what initially looked to him like "political health care rationing" (on the basis of a pro-life site and an op-ed in a right-wing newspaper) was, in fact, nothing of the kind.

you may as well wait for Reagan to acknowledge that trees don't cause air pollution.

Yes, friends, this was another fine installment in the right-wing's "welfare queen" series of contributions to sound debate on public policy.

Find an incendiary anecdote--or at least something that looks, from a distance, like an incendiary anecdote--and use it to argue against programs that help millions of people. See if you can get everyone arguing about just how many Cadillacs she did or didn't own, while you walk away pleased at having smeared your target with negative associations.

Seenit: Sebastian is not "the right wing", and if it was meant to call government health care programs as a whole into question, I don't think it had the slightest bit of success, since virtually none of us, on whatever side of the argument, have drawn any such conclusion from this incident. Because, of course, it has nothing to do with whether or not the program was run by the government.

Hilzoy: Because, of course, it has nothing to do with whether or not the program was run by the government.

The point is that Sebastian, in his front page post, is claiming both that Edward Atkinson is being punished for his political views (not true: the best you can argue is that he has been put to extra trouble by expressing his political views in a criminal manner), and that this is "very close to government health care discrimination based on the political viewpoint of the patient" which is flatly untrue. Further, the title of Sebastian's post is an assertion which is flagrantly untrue. It would be appropriate for Sebastian to acknowledge in an update that the title of his post is misleading, because the op-ed in the Times led him to believe an untruth.

Jes: I agree that it's not all that close to "government health care discrimination based on the political viewpoint of the patient." I also think that the "government" in this sentence just reflects the fact that this is a government-run hospital. In another country, it could just as easily have been "private health care discrimination etc.", especially since I haven't seen any allegation that the government had anything to do with the hospital's decision.

Despite that, I think Seb has the right not to be conflated with the entire right wing.

was the post "meant to call government health care programs as a whole into question"?

the title certainly suggests that--"health care rationing" being one of the bugbears of anti-universal care side (though as keir points out, rationing is exactly what we have now).

also consider SH's response when "anystick" up above suggested, as you just did, that this story "has nothing to do with whether or not the program was run by the government":

"Sure. But government can't withhold what it does not control. Government can't abuse what it does not have."

That response certainly suggests that the real agenda is to keep government out of healthcare. After all, look at this horrible, shocking abuse. If we could only keep the evil government from having any role in healthcare, we could prevent abuses like this.

So--was it a good argument against universal health-care? No. Was it "meant to call government health care programs as a whole into question"? Well, it looks that way to me, and also to Bruce Baugh, who read it as "an argument that amounts to "poorer people don't deserve dignified deaths because see, sometimes overzealous officials might make life difficult for jerks."

But if the whole point was just to relate one isolated and unrepeatable incident about a sad pro-life git in England, I think it was highly un-newsworthy.

On preview: I withdraw any imputation that Sebastian Holsclaw is the entire right wing.

Despite that, I think Seb has the right not to be conflated with the entire right wing.

Wasn't disputing that.

Were you going to respond to any of my questions?

LAte to the party.

FWIW, I tend to agree with those who sided with the hospital. Medical providers in thsi country frequently refuse to provide care for patients based upon non-criminal actions.

My wife is a nurse in a very large family practice, and it is understood that iof any patient is abusive in any way to any of the staff, they are warned that if they repeat the behavior, they will no longer be tretaed in that practice. If the action is repeated, they are "fired" as patients.

Hospitals do the same thing. And this is not government run health care.

To me, the main points are that what this man did was considered criminal activity, he had been told to stop doing that behavior, he continued to do this behavior, he is now dealing with the consequences of his behavior.

Can he still obtain the treatment he is looking for? Yes he can.

And the analogy to pharmacists is irrelevant. If a pahrmacist refused to provide services for a customer that was constantly harassing them, then it would be an appropriate analogy, but only then.

And BTW, I would agree with the pharmacist's right to not have that person be a customer.

"I'll be interested to see if Sebastian ever updates this to acknowledge that what initially looked to him like "political health care rationing" (on the basis of a pro-life site and an op-ed in a right-wing newspaper) was, in fact, nothing of the kind."

A) He expressed his political views by posting photographs.

B) He was criminally punished for it--bad enough right there.

C) He was taken off the list for health care (there is as yet no evidence whatsoever for present tranfer) while currently experiencing a treatable and painful condition.

If he were an Afghan in the US medical system by capture and his treatment for a painful yet non-life-threatening disease was delayed for months for his political viewpoint (or cooperation level) that would correctly be called torture. The US doesn't have responsibility for the medical treatment of all Afghan men, but it does assume responsibility for those in its care. The UK has assumed responsibility for the health care of all its citizens. If the UK had decided not to treat this disease for all patients under its care, there would not be political viewpoint discrimination. It is in fact allowing the administrative delay of a painful medical condition which is treated under its system. It is doing so even though criminals are treated under its system. The fact that this particular criminal even if no longer incarcerated suggests viewpoint discrimination.

Jesurgislac, you would call it torture if US Army doctors did it.

But Sebastian, there is no evidence at all that his access any medical care was actually delayed by bein removed from a waiting list at one hospital.

This is a tempest in a teapot. It seems perfectly reasonable to me that a health care provider can refuse to provide care to an individual because that individual had engaged in a harassment campaign against the provider. The story, as linked, is not terribly detailed about precisely what Atkinson did and said (he mailed bloody pictures of aborted fetuses to various hospital employees. Was there accompanying text? What did it say?) You don't think that his actions amounted to harassment -- if I knew what they were in detail, I might agree with you, but without that knowledge (which you also lack) I don't see any reason to disagree with the hospital's judgment.

And of course this has absolutely nothing to do with 'rationing' -- I can't imagine how that word made it into the title of the post.

Jesurgislac, you would call it torture if US Army doctors did it.

Er, yes, because anybody being treated by US Army doctors who isn't a soldier probably isn't there voluntarily, and because the ethical standards for treatment of somebody you captured largely by jogging through loopholes in international law are somewhat different from those for treatment of somebody who committed a crime. This isn't rocket science.

One would note that within a ten mile radius, Mr. Atkinson can attend over a dozen different public hospitals other than the Queen Elizabeth in King's Lynn, all of which are quite willing to treat him once he's spent his time on the waitlist.

Oh, he was already on a waitlist? My word. Amazing how non-essential treatment can get delayed when you break the law and harass the people who are making you wait. It's simply shocking.

A) He expressed his political views by posting photographs.
B) He was criminally punished for it--bad enough right there.

He engaged in a harassment campaign. He was warned that what he was doing was a criminal offense and asked to desist. He did not desist, and was convicted and jailed.

C) He was taken off the list for health care (there is as yet no evidence whatsoever for present tranfer)

He got out of jail last Friday, Sebastian. You've been told by several people with direct knowledge of how the NHS works that he can go on to the waiting list at another hospital. Do you think we're all lying to you?

If he were an Afghan in the US medical system by capture and his treatment for a painful yet non-life-threatening disease was delayed for months for his political viewpoint (or cooperation level) that would correctly be called torture.

And the relevance of this to Edward Atkinson's situation is... what? Atkinson is not (now) a prisoner: he is at liberty to ask his GP to put him on the waiting list for an appointment at another hospital. He isn't being denied treatment, and you have no evidence whatsoever that this change in hospitals will lead to a delayed hip replacement - if his appointment for assessment establishes that this is the appropriate treatment.

It is in fact allowing the administrative delay of a painful medical condition which is treated under its system. It is doing so even though criminals are treated under its system. The fact that this particular criminal even if no longer incarcerated suggests viewpoint discrimination.

Why? Do you have evidence that other criminals who harassed staff at a hospital by sending hate mail were treated at the hospital where they had harassed staff? You do realise that this is the issue: Atkinson was found guilty of sending malicious communications to staff at that hospital. If you can find another example of someone sending malicious communications to staff at an NHS hospital who was not removed from their waiting lists, then you would have some evidence that the issue was "viewpoint discrimination", rather than - as all the evidence suggests it is - criminal harassment.

Jesurgislac, you would call it torture if US Army doctors did it.

You think I would call it torture if a US Army doctor refused to treat a patient who had verbally abused him, and a different US Army doctor treated that patient instead? Answer: no.

I'm coming into this debate late (again) and haven't read the whole comment thread, so I apologize if I'm repeating an argument that has already been beaten into the ground. However...

While I disagree with the decision to ban Atkinson from the QEH, the decision can be justified ethically. A doctor or other health care provider is allowed, even ethically obligated, to refuse to enter into a treatment relationship with a patient if they feel that they can not treat that patient to the best of their ability for any reason. Reasons can be because they are too close to the patient emotionally (ie a close relative) or because they dislike the patient so strongly that they fear that their emotion may cloud their clinical judgement. If someone sent me pictures of aborted fetuses, I'd certainly have trouble looking at them strictly as a patient, ignoring their actions. (Their views are another matter. I've treated racists, sexists, homophobes, fundamentalist Christians, fundamentalist Muslims, etc without any problem. It's the semi-threatening behavior of sending the pictures that is problematic in my mind.) It does seem like stretching it to say that the whole hospital is too emotionally involved, but maybe no one at the hospital is willing to treat him any more.

It might be worth pointing out that Atkinson was only banned from one hospital, not all NHS hospitals. He's complaining because he'll now have to go to another hospital, further away, to get his hip replacements. I suspect he won't have to travel nearly as far to get them as, say, the average Kansan would have to travel to get a hip replacement. Almost certainly less far than she would have to travel to get an abortion.

And the relevance of this to Edward Atkinson's situation is... what? Atkinson is not (now) a prisoner: he is at liberty to ask his GP to put him on the waiting list for an appointment at another hospital.

I should say: standard procedure is that you go to your GP, and your GP asks the appropriate local health care provider to put you on a waitlist (long or short, depending on the urgency of your health needs). It's possible that Atkinson would have had to go back to his GP and ask: it's also possible the hospital will themselves have arranged to have Atkinson transferred to another hospital's waitlist. I don't have any direct experience with this, because I've never myself criminally harassed NHS staff nor known anyone who did. However, the picture Sebastian apparently has of an old man cast out from the government health care system to suffer without redress is just... well, wrong.

"he is at liberty to ask his GP to put him on the waiting list for an appointment at another hospital."

He is also at complete liberty, it should be said, to get medical help from any of the thousands of private providers of medical care in the UK. There's an entire industry of private practice MD's and clinics.

If Mr. Atkinson's champions in the US pro-life community want to put together a kitty for their martyred hero, he can get a new hip this week.

You see, there's nothing to stop people with a lot of money in the UK from getting special treatment at private hospitals. I recommend the Wellington, in St. Johns Woods NW--excellent service, first rate surgeons, even the food is good.

True, it is very exclusive, and you have to be wealthy to get into it. But that simply means that it's a lot like the US healthcare system (food aside). The difference is that if you *cannot* afford it, you are not left to die in poverty.

So here's another disanalogy from the Afghani prisoner scenario (whose aid in clear thinking almost makes me long for ticking time-bombs): people under a universal health care system are not prisoners of it.

Let us suppose an NHS hospital that was carrying out "female circumcision" on adult women. (This is, in fact, illegal, but let's suppose it's not.)

Let us suppose that I wished to protest the hospital doing this, and did so by sending photographs of FGM to hospital staff. And that, like Atkinson, I was warned that what I was doing was illegal and asked to desist.

If I decided that the issue was sufficiently important that I felt it was worth the risk of jail and being banned from that hospital, I would continue. What I would not do is then whine about it when I was landed with the consequences of my actions - consequences I'd been warned about and had decided to risk.

I don't agree with Atkinson's opinions about abortion: and as an activist, I think he's a bloody whiner.

"He got out of jail last Friday, Sebastian. You've been told by several people with direct knowledge of how the NHS works that he can go on to the waiting list at another hospital. Do you think we're all lying to you?"

And I acknowledged that YESTERDAY. That would explain why I've been talking about causing delay of his treatment since more than a dozen (of my own) comments ago.

Speaking of waiting lists, I saw Morat's objection but I see that I didn't respond. Morat wrote:

It is NOT an ordinary queue, set as first come/first serve. All other factors being EQUAL, the first in line will go first -- but hospitals treat the patient with the most urgent problems first, regardless of when they first sought treatment.

In short, this man's wait will have far more to do with the severity of his hip problems than with what hospital he choose to have it done at.

I suggest you adjust your argument to account for that. Citing a "12 to 15 month wait for hip surgery" as if it were a wait in line for tickets is quite simply false. Those who wait that long -- or longer -- are generally being treated for conditions that are stable and can be controlled (but not rectified) by other means.

I understand that waitlists at hospitals are generally by medical priority. But that doesn't suggest at all that going to another list won't create a very significant delat. Say there are 5 levels of medical priority and Atkinson is in the middle level of priority. All people at a higher level of priority will go ahead of him. All at a lower will go after him. All at his level who got in to line earlier will go ahead of him. If people at his priority level take about six months to be treated, that will be because that is how long it takes to get to the head of the line at your priority level. Starting over again at another hospital will start that entire timeframe over. The fact that people are listed in different priority levels will not effect the analysis unless he changes priority levels. The delay effect of changing lists will be worse and worse as you go down the priority types.

Do we know where he was in the original list? Do we know he'll lose his place on transfer?

Anyway, this was an interesting topic, and I always appreciate an opportunity to disagree with hilzoy, so thanks, SH.

Sebastian: Starting over again at another hospital will start that entire timeframe over.

Can you cite the NHS guidelines which you looked up that told you that? Or are you just making it up?

The hospitals maintain their own lists.

Sebastian: The hospitals maintain their own lists.

Yes. But what NHS guidelines on how to place patients on waitlists were you citing when you asserted that you knew Edward Atkinson would definitely have to wait longer to get an appointment to have his need for a hip replacement assessed? I don't know that: I don't know how long the waitlist is at whatever hospital Atkinson has been transferred to. How do you know?

Made up fact of the day: 53% of people who wish for a paralyzed government think that Hilzoy and I should be dictators by unanimous consent.
You're only half right. ;)

Jes: However, the picture Sebastian apparently has of an old man cast out from the government health care system to suffer without redress is just... well, wrong.

I'm also puzzled by the concern for this man's possible lack of access to this treatment, yet seemingly little for those in, say, the US who cannot obtain the same treatment due to financial considerations.

Of course, I don't understand the US system very well, and while I assume that those without coverage or large amounts of money would not be able to get hip replacements, I could well be wrong. Are those without coverage able to get free treatment for this very painful condition?

*sigh* I was kind of hoping we could discuss medical ethics instead of politics, but...

He expressed his political views by posting photographs.

Regardless of what Mick Hume says, Atkinson's political views are not particularly relevant. If Atkinson had sent a heartfelt but polite letter, every single day, to the effect that he opposed abortion etc etc, he would still be on the list. By the same token, if he had sent pictures of dismembered Iraqis (or box turtle pron or whatever) he would still be off the list. And if he really wanted to make a statement of conscience he would refuse not only the hip treatment but all other treatment as well.

So please let's not get all misty eyed about Atkinson the brave civil disobedient, because in practice it's pretty clear that he's at least as much a garden-variety [deleted] as he is a political activist. My position is that the hospital is responsible for ensuring his "place in line" so to speak, even if he is an [deleted] of the first water, but any way you cut it the political aspect of his speech is not what got him in trouble.

it's also possible the hospital will themselves have arranged to have Atkinson transferred to another hospital's waitlist.

There is that bit about "alternative care arrangements" being "pursued with vigor by the appropriate clinician." It's not clear whether or not it applies to waiting lists though. It might just be for in-patients. But as I said, there are compromises available. Like allowing Atkinson to switch spots with someone at another hospital, so the other patient gets their hip done at QE and Atkinson at the other hospital.

d-p-u, I think we can all agree that the US system is terribly terribly broken and has far more serious and pervasive problems than the UK system. The lack of concern here is indeed puzzling (or not, if you think of it as a predictable outcome of unfettered capitalism), but the lack of concern seems mostly to be at the national level. There is, particularly in some states, a pretty substantial grassroots movement attempting to address it.

Ungood++ shoots...and it's good! A perfect score!

"I'm also puzzled by the concern for this man's possible lack of access to this treatment, yet seemingly little for those in, say, the US who cannot obtain the same treatment due to financial considerations."

That is why it is a discrimination issue. When you assume care for everyone you shouldn't get to discriminate against people who are cranky about expressing their political views.

As I said before, the government may certainly choose not to offer replacement hips for people at the same level of sickness as Mr. Atkinson. Prolonging his treatment based on his crotchey views isn't.

And with respect to some huge threat level, if the Court believed he had offered serious threats, isn't 28 days in jail a little bit short?

heh, 'crotchety'

That is why it is a discrimination issue. When you assume care for everyone you shouldn't get to discriminate against people who are cranky about expressing their political views.

To my way of thinking, an offended hospital staff refusing treatment to a single political crank is of less concern (by a magnitude) than hospital staff refusing treatment to hundreds of thousands because of their economic position within society.

When you assume care for everyone you shouldn't get to discriminate against people who are cranky

How is protecting your workers from Atkinson discrimination against Atkinson, exactly? Employers, and this is especially true in the public sector, have a legal duty to protect their employees. At least in Britain, and my country.

Atkinson made the choice here. He was officially warned, yet chose to continue to send the material, an act which was in violation of British law.

Let's not forget too that Atkinson's "cranky actions" do nothing to serve his "political goals". Medical staff don't write laws, politicians do. What was his purpose?

isn't 28 days in jail a little bit short?

Too long or too short, the relevant point is he was convicted by a court.

dpu:

You are more concerned about tens of thousands of deaths caused by the private market than about one man inconvenienced by the State?

You liberals make me sick.

I may have missed who these medical staff exactly were, but we live in a world where abortion workers have been murdered. The only abortion clinic I have been in had three "airlocks" you had to go through in turn to enter, complete with reinforced doors and bullet proof glass. That's for a reason.

"When you assume care for everyone you shouldn't get to discriminate against people who are cranky about expressing their political views."

Agreed. But that's not what happened here. People are not jailed (for any amount of time) for being cranky about expressing their political views. At least, I hope they're not.

Put it this way. There are two different ways of describing what this man did.

(1) He was cranky about expressing a political view;

(2) He committed the crime of harassment.

If he ONLY did #1, and did NOT do #2, then obviously both sending him to jail and taking him off the medical waiting list are WRONG and BAD and we would all be up in ars about them. But if that were the case, I would think that the more serious blow to his civil liberties would be sending him to jail! Why focus on the denial of medical care when the man was sent to jail when he hadn't even committed a crime? Makes no sense.

But it appears that #2 is a more accurate description of the facts -- given that he went to jail, and nobody is complaining about the jail term!

Therefore, describing his actions ONLY in terms of #1 is misleading.

Conclusion. The man committed a crime. The people against whom he committed the crime will, AS A RESULT OF HIS CRIME AGAINST THEM, not treat him. He can go somewhere else.

.....

Another way of putting the same conclusion.

(A) If this is a case of viewpoint discrimination, one would expect a series of similar decisions by hospitals based on viewpoint. People who express their viewpoint that abortion is wrong, in a whole host of different ways, will be systematically taken off of waiting lists at that hospital.

But

(B) If this is a case of "illegal harassment gets you taken off of waiting lists," then we would expect a series of similar decisions by hospitals based on illegal harassment. People who harass hospital staff, for whatever reason, political or non-political, will be systematically taken off of waiting lists at that hospital.

It is pretty obvious (to me, at least) that B is the correct analysis of the situation, and the mind-set within which the situation should be analyzed.

Coming in late, after sorted through the thread, my opinion now is pretty much the same as when I started. When you are abusive to any staff in my organization, especially when you repeat such abusive behavior, I have a right, and in many cases an obligation, to refuse you further services from my staff.

As an example, we receive many abusive parents here at my H.S. Quite a few of them have to be reprimanded for their abuse of teachers. Occassionally, we have to inform them that they will either need to tone it down or we will not allow them on campus for a set amount of time. Rarely (still a couple of times a year), we actually have to bar a parent from campus. This same procedure is followed for abusive students.

Now, a large part of me says that denial or delay of education is as bad as, if not worse than, denial of hip replacement surgery. However, if and when someone abuses the staff of our school, we must be able and willing to deny them service. This is especially true even when such conduct is illegal, and is true even if such behavior is not assault or threat thereof.

If I were receiving incessant mailings on private school vouchers from an irate parent and, after multiple attempts at resolution, they were eventually charged with a crime, I would expect to be able to say I no longer wish to deal with them. If it were a child, I would expect them to be removed from the school.

Spartikus: The only abortion clinic I have been in had three "airlocks" you had to go through in turn to enter, complete with reinforced doors and bullet proof glass. That's for a reason.

I know someone who worked in one of our local clinics. One of their work-related "benefits" was a top of the line home security system and regular police drive-bys and check-ins.

"I may have missed who these medical staff exactly were, but we live in a world where abortion workers have been murdered."

We live in a world where homosexuals have been murdered by Muslims yet even a terrorist in a UK prison would get medical treatment.

"If he ONLY did #1, and did NOT do #2, then obviously both sending him to jail and taking him off the medical waiting list are WRONG and BAD and we would all be up in ars about them. But if that were the case, I would think that the more serious blow to his civil liberties would be sending him to jail! Why focus on the denial of medical care when the man was sent to jail when he hadn't even committed a crime? Makes no sense."

I think putting him in jail was almost certainly wrong too. But I know that the UK has different views on free speech than the US. My point is that even if you believe that posting pictures of aborted fetuses is a punishable offense, it ought not be punishable by delaying medical treatment that the government has assumed responsibility for. I don't believe that non-violent picture harassment should be punishable by 28 days in jail (far too much punishment) and I don't believe that violent harassment should be punishable by only 28 days in jail (far too little punishment).

But in either case, if you offer treatment to the entire population you ought not discriminate against someone for expressing his political views with photographs.

Some of the crosstalk on this thread comes from people who really want to disagree with the law itself, not its application. I mean the debate about whether or not there was a threat is irrelevant--the English court thought there was a violation of their law and that's all that matters in their country. An Obwi reader might not like the law itself, but I don't think a case for discrimination can be made unless it turns out that the law was only applied to this man and not to others or applied to this man in a different way than the law was applied to others.

SH,

I have seen you refer to Mr. Atkinson's behavior as "posting pictures of aborted fetuses". I am guessing that you mean "putting them in the post" with this phrase, not hanging them in a public forum, correct. I just want to clarify this, because I am more familiar with using the term "mailing" in this context. "Posting" in the sense of displaying in a public forum, would be fine. What Mr. Atkinson did is harassment, even by U.S. standards. Every time I see you use the term "posting", it makes me feel like you are trying to understate what he did, and I just realized it might all be a misunderstanding, but one that others had as well.

dpu: "Of course, I don't understand the US system very well, and while I assume that those without coverage or large amounts of money would not be able to get hip replacements, I could well be wrong. Are those without coverage able to get free treatment for this very painful condition?"

Actually, anyone, with or without insurance and/or money, can get treated at a public hospital in the US. However, they will get a bill. If they ignore that bill their credit will be ruined, assets can be (but aren't usually) seized, and they get harassed in various ways. Apparently, people attempting to collect on hospital bills in the US imply that if the bill isn't paid the hospital will refuse to treat the patient in the future. This is utterly untrue and, indeed, would be illegal at a public hospital, but the threat is enough to make people pay and, periodically, keep them from getting proper treatment because they are afraid they might lose the possibility of getting treated in an emergency. Private hospitals can and do refuse to treat people on the basis of lack of funds/insurance. They're supposed to treat emergencies and stabilize for transfer to a public hospital regardless of financial status, but they don't always do it very well.

"I have seen you refer to Mr. Atkinson's behavior as "posting pictures of aborted fetuses". I am guessing that you mean "putting them in the post" with this phrase, not hanging them in a public forum, correct. I just want to clarify this, because I am more familiar with using the term "mailing" in this context."

Hmm, I was actually picturing hanging them in a private forum (i.e. trespass). But you are right, the reports probably mean "mailing". But mailing with pictures to a government entity ought not be punishable by having your treatment denied. Now I am open to the idea that if he mailed it to the homes of the individual administrative staff that I have totally misinterpreted the whole thing. But mailing to the hospital? Not a problem. And even if the UK doesn't want to protect speech as much as the US, administratively (i.e. not through the court system) denying public benefits on that basis is a bad idea in my opinion.

Sebaastion: HE WAS JAILED FOR IT. You don't seem to want to grasp that.

[i]He was thrown in jail for his actions against the hospital[/i]. Those actions were a [i]crime[/i].

The hospital responded by REFUSING non-emergency treatment to a man who [i]committed and was convicted of a crime against them[/i].

Do you think it shouldn't be a crime? Argue that, then! Do you think hospitals shouldn't be allowed to deny care to those who commit crimes against them? Argue that then!

As best I can tell, you're trying to have an argument about whether a hospital can deny non-emergency care for a man who merely sent them political literaure in the mail.

Who cares? That's not the case here, and no one has actually brought up a case of that happening.

Let's make it simple and VERY to the point for you:

1) Does a hospital -- private or public -- have the right to deny non-emergency treatment to someone who has been convicted of a crime against the hospital or it's staff? Not a "Pay a 100 dollar fine" crime, but a "90 days in jail" crime?

Yes or no? Everything else you're arguing is your invention, projected onto reality so you can argue whatever you really want to argue without having inconvienent facts clutter the situation. Address the facts, please. Crime, conviction, denial of non-emergency treatment. Which part are you having a problem with?

As I said before, the government may certainly choose not to offer replacement hips for people at the same level of sickness as Mr. Atkinson. Prolonging his treatment based on his crotchey views isn't.

this is nothing to do with the government. If Atkinson was as a result of the hospital's action unable to get NHS elective treatment others can get, or severely disadvantaged in getting it, then it would become a government matter, as some part of the government would have to step in, as he has a right to that treatment free at the point of entry. But patients here have no absolute right to NHS elective treatment at the hospital of their choice.

As for prolonging: we don't know. I doubt he'd be booted off the queue back to his GP, to start the process all over again. I imagine if someone did try to do that to him he'd try to sue under the Human Rights Act. But anyway it sounds as though that isn't going to happen.

FYI we have private hospitals here and I bet they'd turn a patient down in similar circumstances.

But mailing with pictures to a government entity ought not be punishable by having your treatment denied. Now I am open to the idea that if he mailed it to the homes of the individual administrative staff that I have totally misinterpreted the whole thing. But mailing to the hospital? Not a problem.

I think there would be a difference between mailing to 'Administrator of Hospital X' and 'Kathleen May, Administrator of GLUK hospital'. I don't believe that a person gives up all of their rights when they go to their office and sit down at their desk.

Assuming that procedure had been followed, the relevant authorities had contacted Mr. Atkinson and asked him to stop. That someone would continue to do that speaks to intention to threaten and intimidate. And the argument that he must not have been a threat because he only got a week in jail is rather tortured. I'm not precisely sure how punishments are meted out in the UK system, but I'm sure that the judge has the option of assigning an appropriately measured amount of punishment in order to encourage lawful behavior. That you argue that he must not have been a threat because the judge only had him locked up for a week seems like a last ditch effort to defend the argument. I also think that lily's point is excellent and it might help the discussion if you have a problem with UK law or if you have a problem because he was advocating against abortion and was subject to this punishment.

Morat20, if you find it hard to spell "Sebastian", allow me suggest you try cutting-and-pasting or using my solution, writing "SH".

lj, time flies when one is having fun, but still I don't think of 28 days as a week.

SH,

In essense, this is just to draw your attention to and(hopefully) summarize my http://obsidianwings.blogs.com/obsidian_wings/2006/05/political_healt.html#comment-17383175>above long and tortured post.

I work at a public school. If someone repeatedly sent me literature, even if it was at my work address, and even after they were repeatedly requested to stop, I would expect them to be reprimanded, possibly jailed (depending on the severity and longevity) and would also expect them to be refused service (contact if a parent, lessons taught by me and possibly anyone else at the school, if a child).

This strikes me as an analogous situation. Is there a reason it is not? If not, is there a reason I am being unreasonable?

"This strikes me as an analogous situation. Is there a reason it is not? If not, is there a reason I am being unreasonable?"

I don't think it is particularly analougous (hip problems produce a daily and high level of pain) and I think you are probably being unreasonable in any case especially with ("lessons taught by me and possibly anyone else at the school, if a child").

That is for letters that are gross or inappropriate but not threatening.

In a public school setting I can imagine a student inappropriately sending relgious literature to a teacher (suggesting that they need to repent for example). I do not believe it would be appropriate for the whole school to refuse to teach her.

Now say she kept on doing it. And she sent literature to other people at the school. And the school asked her to stop and she didn't. And the nature of her communications was egregious enough that she was convicted of a crime and jailed on the basis of those communications.

You still think evicting her from the school would be an odd thing to do?

lj, time flies when one is having fun, but still I don't think of 28 days as a week.

He was sentenced to 28 days, but released after a week. He seems to be used to it:

Although the ex-labourer, who spent two years in the Royal Air Force during his National Service, describes himself as a "law-abiding citizen", he has been imprisoned previously for similar offences, serving 13 sentences in Norwich and five in London prisons.

Also, it’s worth noting that the staff afffected were not hands-on medics:

Atkinson, who was jailed for four weeks, enclosed the offensive pictures with replies to routine inquiries from the hospital.

When managers complained that secretaries who opened his letters had been upset by the contents, he responded by sending a package of further photos to the chief executive of the trust, Ruth May, followed by a video of an abortion.

I tend to agree with Bruce Baugh. The guy was pretty determined to be “victimised”.

This breaks down into multiple issues.

A) I don't think it should have been a crime.

B) If a crime he should be punished by the court.

C) The court could have ordered him to cease having any contact (including treatment) at that hospital if it felt he was a threat. It didn't so order.

The hospital should not deny care on the basis of speech, nor should it deny care on the basis of some general idea of "crimes". A hospital should (and does) treat jaywalkers, tax cheats, embezzlers, and rapists. At no point in the reports does the hospital mention threats or even a more amorphous 'feeling threatened'. The reports mention things like "feeling sick", "being upset" and "being disturbed" by the pictures of the aborted fetuses. That sounds like a reaction to seeing pictures of "fetuses" that look a lot like pictures of "babies". That has the same intention as pictures from Abu Gharib. You are supposed to FEEL badly about it and THINK that it is wrong. If the pictures were accompanied by theats, it would be one thing. There is no mention of that and the way things played out afterwards suggest otherwise. If there were threats, I am very surprised that the hospital didn't bother to mention that. It makes their case so much stronger that its omission (if true) is shocking. (This is especially the case by the time we get to the report of the hospital union supporting the decision. At that point they knew it was becoming a controversy and still did not mention threats).

We live in a world where homosexuals have been murdered by Muslims yet even a terrorist in a UK prison would get medical treatment.

Atkinson isn't being denied necessary medical treatment. Full. Stop.

This has been pointed out many times in this thread, no?

And yes, a terrorist who abused medical staff, even medical staff in the prison system (and I point that out because comparing a situation occurring outside the prison system with one occurring in it is not analogous), would be denied non-critical care.

This is going in circles, so I'll leave it at that.

"And yes, a terrorist who abused medical staff, even medical staff in the prison system (and I point that out because comparing a situation occurring outside the prison system with one occurring in it is not analogous), would be denied non-critical care."

Criminals can't get hip replacements? If true I'm very surprised. Please confirm.

And just for the record "abused staff" as the only way you will refer to "sent photographs of fetuses" is very much shying away from the issue.

If he was hitting people, call that abuse. If he was slapping people, call that abuse. If he was pulling their hair, call that abuse. If he was torturing their pets, call that abuse. Mailing photographs is not the same kind of "abuse".

Out of curiosity, what would the analogous context in the US be, and what would the law (which I presume is state-by-state) dictate?

First we would have to come up with an analogous state entity. A VA hospital? I know for a fact (I lived 5 blocks from a VA hospital for 2 years in college and I knew people who worked there) that the doctors and nurses took a lot of crap from the patients.

SH: Mailing photographs is not the same kind of "abuse".

You seem barely able to refer to the act as a crime - it seems unfair to chide someone about "abused staff". Perhaps we can all agree, since they are victims of a crime, on "victimized staff"?

Why does Sebastian keep saying that Mr. Atkinson has been denied health care and put in prison "for expressing his political views", as if all he did was write a snippy letter to The Times?

He is a criminal. Sending disturbing pictures to someone after you have repeatedly been asked to stop is not free speech, it it harassment. It is a crime and he was rightly punished for it.

Even in the US, which (thankfully) has greater protections for free speech, I can't imagine that what Mr. Atkinson did would recieve any protection under the First Ammendment. A US hospital might have to jump through a few more hoops, getting a formal restraining order and such, but the end result would be the same.

Criminals can't get hip replacements? If true I'm very surprised. Please confirm.

Criminals might not be able to get non-critical free medical assessment and treatment from staff at the institution whose staff they abused. They remain entitled to it and have rights to it under the Human Rights Act etc..

I hope that's clear.


Criminals can't get hip replacements? If true I'm very surprised. Please confirm.

Criminals might not be able to get non-critical free medical assessment and treatment from staff at the institution whose staff they abused. They remain entitled to it and have rights to it under the Human Rights Act etc..

I hope that's clear.

Sebastian: This breaks down into multiple issues. A) I don't think it should have been a crime.

Okay, so you feel that it ought not to be a crime for one person to harass another by sending offensive letters to them. But ritish law disagrees, and finds malicious communications to be a crime. Further, Edward Atkinson was well aware that by continuing to send malicious communications he was committing a crime.

B) If a crime he should be punished by the court.

He was: the court jailed him for 28 days for 3 counts of malicious communications, plus 14 days for an unpaid fine for a similiar offense in 2002. Because he had already spent 5 weeks in prison on remand, that time was counted against his sentence (standard procedure) and he therefore spent only a week in jail after his trial. link

C) The court could have ordered him to cease having any contact (including treatment) at that hospital if it felt he was a threat. It didn't so order.

The court gave him a five-year ASBO (Anti-Social Behaviour Order) prohibiting him from sending any such malicious communications to hospitals in the next five years. link

The hospital should not deny care on the basis of speech, nor should it deny care on the basis of some general idea of "crimes".

The hospital is doing neither. Atkinson wasn't denied care at that hospital on the basis of speech, but on the basis of criminal harassment of the staff. Nor was he denied care at that hospital on the basis of "some general idea of 'crimes'", but because he had committed a specific crime against the staff at that hospital.

Atkinson was banned from receiving treatment at that hospital - you do seem to want to ignore this point - because he had been criminally harassing the staff. He has not, for all his self-pitying comments, been banned from receiving treatment.

You are supposed to FEEL badly about it and THINK that it is wrong.

And perhaps they did, for all you know. The hospital administrator may herself be personally opposed to abortion. She has no power herself to prevent the hospital from providing necessary medical care to all patients, including women who need abortions. And that too is something Atkinson would have known, as he got sacked from one job as a hospital porter after he refused to push a woman into surgery for an abortion. link

Sorry about the double post. I don't know what happened. Firefox has been playing up, that may be it.

"The court gave him a five-year ASBO (Anti-Social Behaviour Order) prohibiting him from sending any such malicious communications to hospitals in the next five years."

Yes. And it DID NOT bar him from going there for treatment.

Criminals can't get hip replacements? If true I'm very surprised. Please confirm.

I'm not sure how this has anything to do with what I said, being as it's clearly not what I said.

Mailing photographs is not the same kind of "abuse".

If a prisoner was mailing hospital staff of a prison photographs of decapitated corpses, then yes, that's "abuse". "Against the law", even.

If a prisoner mailed to prison doctors, pictures of prisoners beaten and otherwise abused by guards would that be closer to "abuse" or "political statement"?

And it DID NOT bar him from going there for treatment.

The NHS Zero Tolerance Policy can be used -- and has been -- to bar him from elective treatment at that hospital. At that hospital. I have my doubts about the ZT Policy but warm towards it as you grow more obdurate in your attacks on its implementation in this case!!

In a public school setting I can imagine a student inappropriately sending relgious literature to a teacher (suggesting that they need to repent for example). I do not believe it would be appropriate for the whole school to refuse to teach her.

If it were an offense that were corrected and then resolved, I agree. At the point that a person refuses to correct their behavior, the issue escalates.

I guess we just have fundamental disagreement about whether or not harrassment is a crime. I am not sure why you think violence must be threatened for it to be criminal and, likewise, whether that means things like burning a cross in someone's yard should be a criminal offense.

Additionally, I don't understand why you seem to believe that the court is the only entity with the authority to call a halt to interactions between the two parties. If my school only causes a student's classes to be moved around for harrassing me, what we have taught a student is that your teacher has no rights, dignity nor authority. If you allow this man back into the hospital, you have sent that same message about any staff this man has criminally abused.

Like it or not Mailing photographs is not the same kind of "abuse". only tells me that what he did is abuse. And abuse, especially repeated abuse, of employees is unnacceptable.

"At the point that a person refuses to correct their behavior, the issue escalates."

Escalates into what? Simply sending religious tracts to a teacher (even if asked to stop) ought not be a reason to expel someone from a school.

If a prisoner mailed to prison doctors, pictures of prisoners beaten and otherwise abused by guards would that be closer to "abuse" or "political statement"?

If he had been told to cease and desist because his letters were not appreciated not desired, then it would be abuse. It would be harrassment, which is a crime. Just the same as that creepy stalker sending you loving messages about how wonderful you are is abuse. The content is irrelevant. In your example, it might also be a political statement, but that doesn't mean it is not abuse.

SH,

Why not? It is a criminal act of harrassment perpetrated against a member of that school's staff. Why is victimizing someone not reason enough for their organization to refuse service to you? WHy is it that you can act in a criminal behavior towards a person through their place of work and still expect to receive any sort of service from that organization. I don't care how vital the service provided, if you cannot comport yourself well enough to stay within the bounds of the wall, then you have forfeited your right to be served by them.

Would you still feel the same way if they were innappropriate sexual advances that had been requested to stop? Even if the advances offered no threat of assault, only wishful rumination and flattery?

"Why is victimizing someone not reason enough for their organization to refuse service to you?"

Because not all responses to 'victimization' are equally appropriate. Shall we agree that a life sentence would be too harsh of a response? Then, I can argue that considering the history of the medical profession and the state action involved in government-run health care refusing medical care is not an appropriate level of response to the mere unwanted sending of pictures with a rather obvious political point. You can disagree with the amount of punishment received, but retreating to 'victimization' as if it solved all problems doesn't answer any questions.

Further I prefer punishments of citizens to be administered by government courts whenever possible.

"Would you still feel the same way if they were innappropriate sexual advances that had been requested to stop? Even if the advances offered no threat of assault, only wishful rumination and flattery?"

Excellent example. If a 16 year old female student made repeated advances to a high school teacher would it be appropriate to remove her from the whole school? No. Does it happen? Maybe. But I don't think it is appropriate.

On the one hand, a 74-year-old repeat offender moralist unwilling to admit the evident intent of his work. "Educating", right. Pfeah.

On the other hand, millions of children overcrowding emergency rooms and using resources intended for other kinds of cases, for want of affordable basic care on a regular basis. This is not a problem the children can fix, either; it depends on the actions of adults.

One of these troubles me much, much more than the other.

>If a 16 year old female student made repeated advances to a high school teacher would it be appropriate to remove her from the whole school?

Or course it would. If a student repeatedly breaks a school's rules and refuses to stop even after warnings have been issued, then it's completely appropriate for the school to deny her access to that particular school. It's called being expelled and it rarely requires any sort of judicial oversight.

I'm not sure what your point is here. Denial of access to government services due to bad behavior by isn't anything shocking or rare. If I were to repeatedly make a nuisance of myself at the local DMV I'm sure that the manager or whoever is in charge would be well within his rights to deny me access to the building.

Just to expland briefly on a point:

Someone who was serious about educating the public about what he saw as the risks and evils of abortion would want to take into account the response he's getting. All good teaching must include provision for judging the results. If he is repeatedly giving so much offense that his targets wish him jailed, then he is not teaching well, and no quantity of pure intention excuses that failure. His own rationale condemns him.

Now if his aim is something else, then that's another matter. But what he's saying does not, as far as I'm concerned, amount to the slightest excuse for his conduct.

Sebastian: Yes. And it DID NOT bar him from going there for treatment.

Since (as far as I know) Atkinson has not attempted to harass the hospital staff in person by violating the hospital's ban, it would have been wholly inappropriate for the court to do so. The hospital has, as is their right, removed him from their waiting list because he criminally harassed the staff. If Atkinson then shows up at the hospital and begins to harass the staff in person, at that point a court could act to prevent that behaviour.

In the UK, you see, the legal principle is that a person has to commit an offense before a court can deal with that offense. Atkinson couldn't be banned from the hospital by court order until he violates the hospital's request for him to stay away.

Bruce, "If he is repeatedly giving so much offense that his targets wish him jailed, then he is not teaching well, and no quantity of pure intention excuses that failure. His own rationale condemns him."

Does that apply to say anti-Vietnam War protestors?

Jesurgislac, "In the UK, you see, the legal principle is that a person has to commit an offense before a court can deal with that offense. Atkinson couldn't be banned from the hospital by court order until he violates the hospital's request for him to stay away."

I don't believe that is an accurate representation of UK law. Even in the 1700s courts in the UK could have ruled as I outlined. It is theoretically possible that they have had that power yanked from them, but I really think I would have heard of it.

Yes, Sebastian, I've written many times over the years that I think the worthiness of the cause in the protestor's mind should force an elevation of the means, not justify their degredation. Protest should aim to be effective; if it doesn't, then the participants should skip the public scene and go straight to the masturbation, which is cheaper and consumes fewer resources.

Not caring about results is a luxury for those who don't actually care if their cause gets anywhere.

Sebastian: Then, I can argue that considering the history of the medical profession and the state action involved in government-run health care refusing medical care is not an appropriate level of response

...which is irrelevant, since he hasn't been refused medical care...

to the mere unwanted sending of pictures

...to the crime of repeated harassment by malicious communications...

with a rather obvious political point.

Actually, it would appear that far from being political, Edward Atkinson's campaign is religious. I know that in the US the two are frequently blurred, but there is actually a clear distinction between the two in British law - for example, it is anyone's right under British law to hand out political material on the public street, but unless you have specific permission from the police (or a licence from the local council) you do not have the right to hand out non-political material, which includes religious material.

Edward Atkinson's feeling about abortion appears to be religious, not political - as one might figure, since he's not trying to get local voters to write to their MPs or to local councillors, but apparently trying to get hospital staff to repent, or at least to feel revulsion.

Bruce: If he is repeatedly giving so much offense that his targets wish him jailed, then he is not teaching well, and no quantity of pure intention excuses that failure. His own rationale condemns him.

Much like Sebastian, I'm not convinced this holds at the margins. Preaching abolitionism in the South antebellum, or civil rights in the postbellum one, both seem to be (fairly straightforward) failures of this doctrine, as do most things Godwinizable.

Sebastian: I don't believe that is an accurate representation of UK law. Even in the 1700s courts in the UK could have ruled as I outlined. It is theoretically possible that they have had that power yanked from them, but I really think I would have heard of it.

I really think you're misunderstanding the legal principle involved.

Atkinson committed crimes of malicious communication, of which the court could (and did) convict him. Because the offense he had committed was harassment by mail, the court could (and did) give him an Asbo requiring him not to repeat this behavior.

In order for the court to issue a restraining order barring Atkinson from the hospital, two steps are necessary: first, the hospital would have to formally notify Atkinson that, except for emergency medical treatment, he was not to enter the hospital. This the hospital has done. Then, if Atkinson attempts to enter the hospital despite the hospital's request for him to stay away, a court can issue a restraining order against him. Does this really strike you as an odd or unusual way of going about things?

>If a 16 year old female student made repeated advances to a high school teacher would it be appropriate to remove her from the whole school?

Geez, at my high school, it was zero tolerance. Students wearing clothes that advertised beer or were unacceptable to the principal were sent home and weren't allowed to come back if they were wearing the same or a similar shirt. Removed from the whole school.

Ah, the good old days. I guess conservatives just don't think much about them...

I feel like the point of this post ought to be that once you criminalize this sort of behavior, which SH feels should not be a crime, then you create unfortunate side effects like keeping people from receiving their government health care. At least, it seems like that ought to be the point, but apparently it's not.

I assume in the hypothetical case where the guy committed a "real" crime against the hospital staff - let's say he stabbed one of the administrators, and did his time - it would be ok for the hospital to exclude him from the premises. Or am I wrong?

But the reason we apparently keep going in circles is that some people accept this guy's conduct as a crime, and argue that it's fine to deny hospital services to someone who commits a crime against the hospital, while SH believes that the guy's conduct shouldn't be a crime and that it's just an expression of a political viewpoint.

I'm not the first person to make this observation but we don't seem to be spending any time discussing the threshold issue of whether we think this guy's conduct should really be a crime. If we somehow came to agreement on that, I'm not sure we'd have much left to argue about.

"Because the offense he had committed was harassment by mail, the court could (and did) give him an Asbo requiring him not to repeat this behavior.

In order for the court to issue a restraining order barring Atkinson from the hospital, two steps are necessary: first, the hospital would have to formally notify Atkinson that, except for emergency medical treatment, he was not to enter the hospital. This the hospital has done. Then, if Atkinson attempts to enter the hospital despite the hospital's request for him to stay away, a court can issue a restraining order against him. Does this really strike you as an odd or unusual way of going about things?"

Yes. If the Judge believed Atkinson was a threat to the hospital he could have ordered him not to engage in any dealings with the hospital at the time of sentencing. If the hospital believed he was a threat they could have requested the same at that time. Of course the hospital isn't claiming he is a threat even now.

Steve: I feel like the point of this post ought to be that once you criminalize this sort of behavior, which SH feels should not be a crime, then you create unfortunate side effects like keeping people from receiving their government health care. At least, it seems like that ought to be the point, but apparently it's not.

It might be the point if Atkinson was being kept from receiving health care, but, after all, he's not.

Anarch: Okay, good point. Sometimes better results aren't to be had. But it's important to ask the question of oneself, and from available accounts, he isn't, he's just saying that his intentions were good so this is other people's problems.

"But the reason we apparently keep going in circles is that some people accept this guy's conduct as a crime, and argue that it's fine to deny hospital services to someone who commits a crime against the hospital, while SH believes that the guy's conduct shouldn't be a crime and that it's just an expression of a political viewpoint.

I'm not the first person to make this observation but we don't seem to be spending any time discussing the threshold issue of whether we think this guy's conduct should really be a crime."

No.

Even if we accept that this ought to be a crime, it is not a given that all possible punishments are ok for all possible crimes.

A) I don't believe it ought to be a crime.

But accepting that the US idea of free speech is very expansive and that other countries have a more limited idea of it,

B) I think that even if it is a crime, it isn't a fitting punishment to prolong health care based on speech (even unwanted).

and

C) even if that is a fitting punishment, it should be a punishment imposed by a court not just an administrative decision by the offended hospital administrator.

Note I say "punishment". The hospital administration has not alleged that he is a threat.

it is anyone's right under British law to hand out political material on the public street, but unless you have specific permission from the police (or a licence from the local council) you do not have the right to hand out non-political material, which includes religious material.

Now this is interesting. Jes, could you expand on this or point me towards an explanation? Was it an attempt to control commercial speech?

Well, SH, it seems like you're saying "even if it's a crime, it's still just speech," which is sort of a roundabout way of saying it shouldn't be called a crime at all. To the others in this thread, if it's a crime then it's a crime, which is why we're not finding common ground.

I did say above that I think it would make more sense to require the hospital to get a court order before denying treatment to someone, as a general matter.

Sebastian: Yes. If the Judge believed Atkinson was a threat to the hospital he could have ordered him not to engage in any dealings with the hospital at the time of sentencing.

Um... no. At this point, Atkinson is guilty of malicious communications. Under British law, the judge cannot issue a restraining order against behavior which the defendent has not yet committed. Really, honestly, and truly, Sebastian, it's so. I'm surprised that in the US it's possible for a judge to issue a restraining order in advance of the subject of the order actually committing the offense against which the restraining order is issued - can you link me to an example of this kind of restriction - a court order preventing someone from an action the court thinks they might commit even though they haven't done it yet?

It's a significant problem dealing with stalkers/serial harassers, in fact: in order for the court to prohibit them from committing an offense, they have to actually commit the offense.

I'm surprised that in the US it's possible for a judge to issue a restraining order in advance of the subject of the order actually committing the offense against which the restraining order is issued

Well, for example, the Michigan statute which governs personal protective orders says the following:

The court shall issue a personal protection order under this section if the court determines that there is reasonable cause to believe that the individual to be restrained or enjoined may commit 1 or more of the acts listed in subsection (1). In determining whether reasonable cause exists, the court shall consider all of the following:
(a) Testimony, documents, or other evidence offered in support of the request for a personal protection order.
(b) Whether the individual to be restrained or enjoined has previously committed or threatened to commit 1 or more of the acts listed in subsection (1).

So whether the person has previously committed the act in question is certainly an important factor to be considered; but it's not a required element.

Jackmormon: Now this is interesting. Jes, could you expand on this or point me towards an explanation? Was it an attempt to control commercial speech?

In general, you are not allowed to stand around on the public highway (sidewalk or road) obstructing traffic, unless it's a political demonstration or you're handing out political material (or you've got permission from the police/a licence from the local council). The principle is that distributing political material is protected, but distributing any other material is not. If you receive a religious tract on the street in the UK, it's likely to be from someone walking briskly by, since if they stop to hand it to you they are, in theory, committing an offense.

Steve: Well, SH, it seems like you're saying "even if it's a crime, it's still just speech," which is sort of a roundabout way of saying it shouldn't be called a crime at all.

Actually, what Sebastian seems to be saying is that telling someone that they can't go to one hospital because they've harassed the staff there, but will have to go to another hospital instead, is "punishment".

@SH:
Atkinson, who was jailed for four weeks, enclosed the offensive pictures with replies to routine inquiries from the hospital.

When managers complained that secretaries who opened his letters had been upset by the contents [...]

I think this is a point worth making. He was not simply mailing the offending photos piecemail to administrative staff. He was enclosing them in corrospondence that the staff would have to open and read in order to provide service to him. Hence, the staff had no way of "opting-out" of recieving the harrassment without also refusing him treatment. As long as they were treating him, they would presumably be required to corrospond with him. The only way of shielding the harrassed personel from the harrasser in this case would be to alter the circumstances such that the personel would no longer be obliged to read corropsondence from him except as absolutely required by dire necessity. Which presumably would entail refusing him non-essential treatment.

Given the nature of the harrassing behavior (which as noted, was targeting people who were not necessarily capable of even superficially altering hosptial policy; this makes it IMO far easier to characterize his behavior as purely harrassment, particularly given the staff's limited recourse in avoiding such, well, abuse), I don't think it would be inappropriate to draw an analogy between what he was doing and accosting random hospital staff in the corridors of the facility to thrust unasked photographs into their faces. One expects that the latter behavior would get him warned, then removed from the premises. One also suspects in that case you would not object so strongly to the facility refusing to allow him to return for less than life-threatening reasons. Given that he was enclosing these photographs in corrospondence that the staff was required to read, I don't see how this analogy would be inappropriate...

Steve: So whether the person has previously committed the act in question is certainly an important factor to be considered; but it's not a required element.

But, presumably, it is a required element that the person has been notified that the act in question is unwelcome, yes? You appear to be arguing that the first step in telling someone that they're not wanted has got to be a court order - according to what you're saying, the person being harassed isn't allowed just to tell the person doing the harassment to stay away, because only a court can do that. Is that right?

Actually, what Sebastian seems to be saying is that telling someone that they can't go to one hospital because they've harassed the staff there, but will have to go to another hospital instead, is "punishment".

Well, that's a separate point. It seems to me that the argument presumes human beings to be incapable of making distinctions; if we accept the right of a pharmacy to turn a customer away for harassing the pharmacy's employees, we must also accept their right to turn a customer away for religious reasons. Personally I don't quite see the logic.

You appear to be arguing that the first step in telling someone that they're not wanted has got to be a court order - according to what you're saying, the person being harassed isn't allowed just to tell the person doing the harassment to stay away, because only a court can do that. Is that right?

I think the analogy between the personal and business scenarios breaks down a little here. In the personal scenario, of course you're allowed to tell someone to not bother you any longer, and then wait and see what they do, if you feel like it.

But when you operate a business that is presumed to be open to the public, if you tell someone that they're not welcome, that statement is tantamount to a denial of services. I think it would be a better system if they had to get a court order before denying someone services, at least in this situation. If you think there's a difference between the hospital telling the guy not to come by any more, and actually denying him services, you need to explain to me what you mean.

It seems to that the extent of the injury isn't really known (here). Is there a longer waiting list at all the near spots? How much trouble is it for him to get there?

Assuming that the ban at the facility he was using imposes a non-trivial level of harm, and assuming that the guy wasn't an actual threat, I guess I'm still of the view that the NHS professionals ought to suck it up, and treat the guy.

Businesses have a right to refuse service to anyone in most countries, as long as it's not done in violation of anti-discrimination laws. It's generally known as the "Shopkeeper's Right to Refuse".

Of course, we're talking about hospital. But since Atkinson hasn't been denied medical treatment, the point is moot.....

It seems to that the extent of the injury isn't really known (here).

Correct.

Is there a longer waiting list at all the near spots?

Don't know; but I'm fairly sure there'll be a way of arranging it so he doesn't have to wait substantially longer.

How much trouble is it for him to get there?

Again, no idea. He may well be entitled to free transport there provided by the NHS.

There are quite a number of hospitals pretty close to the Queen Elizabeth.

What he did is bad enough under the British system (on the whole a lot less harsh than the US system) to send a 74 year old man to jail for over a month. You can argue about how you don't think sending pictures should be punished that harshly, but since no one knows *what* exactly he sent, and to whom, we have to assume it is pretty bad to warrant this punishment.

Different countries have different laws and quite a number of those seem silly to foreigners. I mean... going to prison for selling sex toys???? But that is a different discussion from wether a hospital can refuse someone who commited a crime against them - if that person does not have something life threatening and if that person knowingly commited the crime.

My husband was kicked out by his new dentist when he was to late for the second time. Which I thought was stupid, but I never assumed they were not entitled to do that. This is way more serious that being late, and the offender was fully aware of the consequences. I don't have a problem with him facing them than, especially since there are plenty of options for treatment left.

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