In an unsettling story reported in the July 25, 2014, edition of the Philadelphia Enquirer, an angry patient shot and killed a social worker and wounded a psychiatrist in his clinic office in Upper Darby, Pennsylvania, a Philadelphia suburb. 

     The patient, Richard Plotts, mid-forties, arrived for an appointment at the Sister Marie Lenahan Wellness Center carrying a concealed gun. He was escorted up to the third floor office of psychiatrist, Lee Silverman, age fifty-two, by a social worker, Theresa Hunt, fifty-three. Upon entering the office, Plotts opened fire killing Hunt and wounding Silverman. Silverman, apparently armed as well, produced a weapon and returned fire, shooting Plotts three times.

    “It was not clear why Silverman, a doctor for twenty-five years, was armed at the office,” the newspaper reported. 

     Plotts was subdued by clinic staff. Police arrived and quickly restored order. The victims were taken by ambulance to a nearby hospital.

     Plotts has a long history of mental illness and a lengthy criminal record for assault, drugs, weapons possession and other crimes. A worker commented, “There’s a sign on the door that says you have to check your weapons at the front. But you can’t expect every crazy person to do that.”

     Donald Malineaux of the nearby Yeadon Police Departments said that Silverman, “without a doubt saved lives.”

     Plotts’ neighbor, Cathy Nickel said (about Plotts), “You could tell there was something wrong. He needed help.”

     This incident raises some old questions. Why do mentally people have access to guns? Should mentally ill persons with a known history of violence be forced into treatment? What is the relationship of mental illness to mass killing? Do mentally ill persons have a second amendment right to “keep and bear arms”? How do those rights compare to the rights of others to be safe in their communities?

     It also raises some new questions. Should hospital personnel be armed? Is it right for a physician to attempt to kill a patient, even in self-defense? Does this shooting come under the heading of the Hippocratic Oath section that says, “First, do no harm?”

     I have no answers to any of these questions, but I’m very interested if you have something to say. E-mail me back with any answers. My contact information is contained below. I’ll summarize any responses in a later post.

About the Author

Stephen Seager

Stephen Seager, M.D., is a psychiatrist and the author of Behind the Gates of Gomorrah: Living with the Criminally Insane.

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