There probably should be a formal system for this to prevent abuse but hitting a nurse on purpose (not becuase you’re pyschotic from sepsis), using coccaine in hospital, beating up another patient, dealing drugs from the hospital room, 10 AMAs in a year for the same problem, defacating on your roomate on purpose should have come consequences.

There should be a basic level of civilized behavior expected from people who are competant and capable of controlling their behavior, even if they are sick.

Try acting like a complete moron in any other public place – even a church, and then demanding service the next day and see what happens.

Doesn’t work very well. In the scenario described, they don’t report how the nurse or hospital responded. She and the hospital should have come down on that guy like a ton of bricks.

And EMTALA shoud allow the hospital the right to add him to a “no treatment here for you” list.