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Medical Ethics Without the Rhetoric - Case 10 Timmy the Torch


The parents of a teenager, Timmy, with behavior problems request an in-patient psychiatric admission for their son. Timmy has taken to lighting living things on fire, starting with centipedes and  spiders and progressing to his pet hamster. The parents are  frightened that he will light the house on fire or torch someone’s pet dog or cat, as he has threatened. Their family physician concludes that Timmy’s behavior, though problematic, may not warrant in-patient treatment. It is a behavior associated with teens trying to get the attention of their parents and usually doesn’t  escalate. When he informs the family of this, the mother breaks down sobbing, saying she can’t take it anymore. The father says  that if they don’t get a break from Timmy, it will jeopardize their marriage. The physician wonders if admitting the son to the psych unit for a few days might be justified based on the total set of circumstances. Would you admit Timmy the Torch?