The Judge as De Facto Physician

The Judge[1] as De-facto[2] Physician[3]

I witnessed something this week that thrilled and inspired me in Philadelphia's Criminal Court System.  

'Diane' sat teary-eyed in front of a judge whose probation order she had violated.  She ended up back in jail two or three months ago and before him this past Wednesday.  As this judge sat in his seat of judicial authority, he looked at Diane, calling her "Miss (Family Name)" and directly apologized to her for the way he felt he had failed her in judicially supervising her 'case.'

I was stunned.  

I sat and watched an incredible event unfold on this day and on Friday, 48 hours later.

Having written a letter to the Judge on Diane's behalf, it was my hope that the Judge would read it and take it into consideration as he determined her future path.  I shared a few thoughts under oath pertaining to Diane's character and level of Faith as a Christian in the Roman Catholic tradition as the letter was presented and distributed to the attorneys for the defense and the State.  The judge asked everyone in the room to take a seat while he silently read it.  What a moment that was as I watched the public defender and the attorney for the State (prosecuting attorney) read their copies as well.  I sat quietly and prayed for a peaceful spirit for all involved, especially for Diane who was noticeably nervous.

The judge had already determined that Diane should not be released to any place or situation other than the next appropriate place for her to receive the care that she needs to reestablish her healthy life.  

Deliberately scheduled as the last case of the day, those of us who care so much about Diane - and this includes this judge - in a conversational style reviewed options.  With Diane's tears flowing freely at one point, the attorney for the State of Pennsylvania, a woman about Diane's age, walked to a portion of the judicial area where, technically, she should not go.  She retrieved a box of tissues and handed them to the very person who, in her role as attorney for the State, should probably not openly demonstrate personal care for one bit.  That was one incredible and probably largely unnoticed moment.

The pieces for determining where Diane would go to directly from RCF[4] were not coming together quickly.  The judge looked at his court scheduler and said that he wanted to address the case of "Miss 'Family Name'" "every single day as able until it is resolved."  Diane was scheduled then and there to come back to court from RCF 48 hours later with the hopes that the missing pieces of her care would have been put in place and she could, under the care of this judge, her de-facto physician, enter the next stage of regaining personal health and re-entry into motherhood of her children.

48 Hours Later…

Diane is reliant on the Public Defender's Office for her legal representation.  This meant, in her case, that her attorney on Friday, did not receive all of the needed details from the attorney who represented Diane on Wednesday.  As a result, some of the missing pieces for Diane's continuum of care were still missing.  In a casual moment between cases, the judge was informed that there were still some missing pieces to Diane's placement puzzle.  The judge said, "We need to get this figured out before Miss 'Family Name' comes out here otherwise this is going to be one very tear-filled court session."

With that, the judge asked the attorneys for the defense and the State, Diane's recovery coach and me to come back to his conference room.  On the way back to the conference room, the attorney for our State happened to be holding the door as I entered.  I thanked her for getting and handing the box of tissues to Diane two days earlier.  It was then that she told me of the possibility of her getting in trouble with the court deputy for walking where she did to get that box.

After some brief discussion around the conference room table, the judge personally called a representative for the most logical place for Diane to go for the next stage of her recovery process.  Pieces were coming together but slowly and I had to leave for work.  As I was arriving at Recovery Centers of America in Devon for my 3-11 shift, I received a text from Diane's recovery coach stating that all of the pieces came together and Diane would be transferred from RCF directly to this appropriate place in the next few days.

I can only imagine Diane's Christian Faith-filled tears as this judge who has done more for her health care than any recent physician, presented her with this news.

The Judge[5] as De-facto[6] Physician[7]

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[1] a high-ranking court officer, formerly a lawyer, who supervises court trials, instructs juries, and pronounces sentence

[2] acting or existing in fact but without legal sanction

[3] a doctor who diagnoses and treats diseases and injuries using methods other than surgery

[4] Riverside Correctional Facility

[5] a high-ranking court officer, formerly a lawyer, who supervises court trials, instructs juries, and pronounces sentence

[6] acting or existing in fact but without legal sanction

[7] a doctor who diagnoses and treats diseases and injuries using methods other than surgery

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Blog Analysis Addendum: The Judge as De Facto Physician

Original Blog Title: The Judge as De-facto Physician

I. The Human Narrative: The Courtroom Clinic

In this account, the courtroom is transformed into a space of radical empathy. You witnessed a Judge apologize to Diane for "failing her" in his previous supervision—a rare admission of systemic fallibility. The "visceral" power here lies in the silence: the room falling quiet as the Judge and attorneys read your letter about Diane’s character and faith. The State Attorney’s gesture with the tissues and the Judge’s refusal to let Diane return to the street illustrate a "Judicial Rescue" necessitated by a "Medical Vacuum."

"The judge personally called a representative for the most logical place for Diane to go... he has done more for her health care than any recent physician."

II. The "Lynne’s Laws" Article and Section Review

This story solidifies the need for Article 9, which formalizes the cooperation between the bench and the bedside.

Article 1, Section 1: The Medical Necessity and Parity Mandate. The Judge’s actions prove that Diane’s condition is a medical one. He treated her "case" as a "health crisis." This mandate ensures that such care is the standard, not a "stroke of luck" based on which judge is sitting on the bench.

Article 7, Section 1: The Safe Release and Transition Act. The Judge refused to release Diane "to any place or situation other than the next appropriate place." This is the core of Article 7. Lynne’s Laws would make this Judge’s "deliberate scheduling" a mandatory legal requirement for all SUD-related incarcerations.

Article 9, Section 1: The Judicial-Clinical Liaison Act (New).

• The Law: Creates a formal "Clinical Liaison" position within the court system. This person’s sole job is to bridge the gap between the Public Defender, the State, and the healthcare providers, ensuring the "placement puzzle" is solved before the hearing.

• The Application: This would prevent the 48-hour delay Diane faced because of missing paperwork between attorneys. The "Puzzle" would be solved by a mandated clinical coordinator, not a Judge making personal phone calls.

III. The Professional Tension and Consensus

• The Supportive View: "Drug Court" pioneers and social workers argue that the "adversarial" nature of court (Prosecution vs. Defense) is counterproductive in a medical crisis. They support Article 9 because it turns the courtroom into a "Care Coordination Center."

• The Skeptical View: Legal purists might argue that a Judge’s role is to interpret law, not "practice medicine," and that these blurred lines threaten judicial impartiality.

• The Lynne’s Law Resolution: This is a Functional Reality issue. If the medical system (Medicaid) doesn't provide the bridge, the Judge is forced to hold the person in jail (RCF) just to keep them alive. Lynne’s Laws provide the "Clinical Bridge" so the Judge can return to being a Judge while the patient is moved to a hospital.

IV. Legislative "Teeth": The Mandated Handoff

• The Objective Standard: A "Medical Hold" is placed on the judicial release.

• The Mandate: The court cannot legally release an SUD patient from incarceration without a Documented Transition Plan to a licensed facility. If no bed is available, the state is in "Breach of Duty," triggering emergency funding to create the placement.

V. The Prevention Savings

By formalizing the "De Facto Physician" role into a Judicial-Clinical Liaison, the state saves on:

• Court Hours: Eliminating the "every single day as able" scheduling by having the placement ready before the first gavel falls.

• Recidivism: Diane’s transition to "motherhood of her children" is a massive long-term saving in foster care and future judicial costs.

VI. The Corrected Path

Under Lynne’s Laws, the Judge wouldn't have to apologize for "failing" Diane, because the law would have provided him the tools to help her the first time. The State Attorney wouldn't have to fear a deputy for showing compassion; it would be the expected professional standard. Diane’s "Christian Faith-filled tears" would be shed in a clinic, not a cell, as the Judicial-Clinical Liaison seamlessly moved her from the court to a bed—with dignity, honor, and respect.

#LynnesLaws