From an EM perspective, patients are often stupid as fuck and wouldn’t know what was good for them if you beat them over the head with it. Sometimes their stupidity brings acute death if they leave my ward, and I don’t want that on my conscience, not to mention legal exposure. If I thought a patient was wanting to leave for some stupid reason and life and limb is on the line I would absolutely do everything short of directly lying to a patient to keep them under care until they are stabilized. Full stop. It is my ethical and legal obligation to treat patients, even if they are too ignorant or obtuse to understand that is the reason any of us are there. Call it mind games, manipulation, whatever; I do not want a sick patient leaving until I am sure that they won’t die from what they came to me with or be back within 24h for the same thing, and I will do whatever I can to keep a patient’s stupid ideas from getting them killed.

Protocol. Come into the hospital with SI or HI for example, your freedom gets temporarily revoked and you get to stay in the padded room with a sitter until a psych assessor deems you without risk of killing yourself or others. There are very few phrases that will land you in that position.