77 yo bed-bound pt sent to ED from home with police initiated Order of Protective Custody secondary to comments made to neighbor about his desire to "kill himself with a gun." Pt is bed-bound after CVA several years ago with recently dx advanced lung CA. Palative care only. Hospice involved. Full code. I evaluate pt, dx with SI and UTI. Stable SaO2 low 90s on 3 liters. Base line hypotension 90s/50s. AOx3. Denies SI to us when he learns of intent to admit. Clear for transfer to our sister free-standing geropsych unit. psych kicks the guy back to me via EMS. State he is "too sick to be there". I politely ask them what they expect me to do about it. Crickets. Reeval. No change. Discuss condition with pt. Now DNR by my order and his wishes. Psych insists on medical consult to "follow along" in psych unit. Consultant agrees. Sent back to unit for eval of SI. Now that he is DNR they are comfortable accepting. My hands are tied because I have a police OPC as above requiring psych eval. He just wants to go home and die. In summary, terminally ill pt with low quality of life wants to die. I can't let him. Pt is sick enough for DNR order but not too sick for psych eval. Once the psych is able to note that the pt doesn't really want to die he will be allowed to go home and do just that. Our system is idiotic.