blog.bioethics.net

Sometimes You Get the Bear, and Sometimes the Bear Gets Lucky

In the middle of Joshua Bush's forehead, two inches above his eyes, lies the evidence that prosecutors say could send the teenager to prison for attempted murder: a 9 mm bullet, lodged just under the skin.

Prosecutors say it will prove that Bush, 17, tried to kill the owner of a used-car lot after a robbery in July. And they have obtained a search warrant to extract the slug.

But Bush and his lawyer are fighting the removal, in a legal and medical oddity that raises questions about patient privacy and how far the government can go to solve crimes without running afoul of the constitutional protection against unreasonable searches and seizures.

"It's unfortunate this arguably important piece of evidence is in a place where it can't be easily retrieved," said Seth Chandler, a professor at the University of Houston Law Center. "You have to balance our desire to convict the guilty against the government not poking around our bodies on a supposition."

Investigators say that Bush was part of a group of gang members who broke into a used car lot and tried to steal vehicles. According to police, Bush tried to shoot businessman Alan Olive, and when Olive returned fire, a bullet struck the teenager and burrowed into the soft, fatty tissue of his forehead.

Prosecutor Ramon Rodriguez said gang members who took part in the robbery identified Bush as one of those involved. When he was questioned about a week later, Bush admitted taking part in the robbery but not the shooting, police said.

"The officers noticed the guy looks like hell. One of his eyes is black and he has a big old knot on his forehead," Rodriguez said. "He tells police he got hurt playing basketball."

A few days later, Bush went to the hospital and told doctors he had been hit by a stray bullet as he sat on a couch in an apartment.

"Officers started putting events together," Rodriguez said.

A judge took the unusual step of issuing a search warrant to retrieve the bullet from Bush's head in October. But a Beaumont doctor determined that small pieces of bone were growing around the slug, and he did not have the proper tools in the emergency room to do it. The doctor said that removal would require surgery under general anesthesia and that no operating rooms were available.

Police then obtained a second search warrant and scheduled the operation for last week at the University of Texas Medical Branch hospital in Galveston. It was postponed again, however, after the hospital decided not to participate for reasons it would not discuss.

Prosecutors said they continue to look for a doctor or hospital willing to remove the bullet.

All sides agree that removing the bullet would not be life-threatening. But Bush's family and attorney say it would be a violation of the teenager's civil rights and set a dangerous precedent.

"When the medical profession divorces itself from its own responsibility and makes itself an arm of the state, it's a dangerous path," said Rife Kimler, Bush's lawyer.

The used car lot owner, Olive, told police that after officers had left the scene following the robbery and he began cleaning up, a man appeared in a nearby alley and threatened to kill him if he helped authorities in their investigation. The man fired at Olive and a shootout followed.
"I just can't believe I missed him at that distance," Olive, a competitive pistol shooter, said in court papers. Olive told authorities he never saw the man's face in the dark alley.

Bush is in jail on charges related to the robbery, but not the shooting.

Tammie Bush, the teen's mother, disputed allegations her son is a gang member.

"We know he's not a criminal," she said. "He's a good kid."

Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, predicted Bush's rights as a patient will trump the state's desire to get the bullet, and said authorities might have a hard time finding someone willing to extract the slug.
"It truly is a moral quandary," Caplan said. "Doctors are caught between wanting to help solve crimes and their responsibility to patients' rights to refuse a procedure."

Labels: CSI, medical oddities, right to refuse