EXACTLY John McCain! As an RN x the past 32 yrs - who has worked in ER since 2000 - there ARE individuals who do require regular injections in order to maintain the ability to live independent, safe lives. Many times, once these individuals are treated and maintained on medication, they figure they don't need the medication anymore. The individual then "crashes", and sometimes end up, at worst, causing harm to themselves or others. At best, they slowly become unable to cope well or function well day to day - and end up back in the doctor's office somewhere. CTO's are instituted when patients DEFINITELY require medication to remain stable - AND - they have demonstrated they are not able to, or are not willing to take it on their own. Each patient is individual. Did this fellow have a valid CTO in effect at the time of this incident? We don't know. There is  much speculation and facts that need to be verified and clarified. Unfortunately, in the meantime, the patient is in limbo. :(