DESPERATE EFFORT TO AVOID JAIL ENDED IN MAN'S DEATH, POLICE SAY

San Jose's special weapons team had Willie Villalpando surrounded, guns
drawn. He knew he was in trouble, police said, so he ate the evidence --
what authorities believe was a half-ounce of methamphetamine.

Then he refused medical treatment, police said, telling them he'd just
"ride it out."

For nearly eight hours on Tuesday, the 20-year-old Milpitas man was at
Santa Clara Valley Medical Center until he died. A hospital spokesman
declined to discuss the case, but said that without a patient's consent
nothing can be legally done to save him.

Such decisions, medical ethics experts say, reside in a gray area. The key
lies in determining whether the patient is competent to know the risks of
refusing treatment. It's unclear what police and hospital officials did
Tuesday to determine if the 20-year-old, apparently high on methamphetamine
and in police custody, was able to offer informed consent.

Family members can't believe Villalpando, with a 2-month-old son and two
stepchildren, would refuse treatment. He was caught in an undercover sting
operation, said San Jose police. Because he was considered a threat to
himself and others, authorities arranged to have highly trained SWAT
officers help in his arrest. It was about 1:30 p.m. Tuesday when they
pulled him over in his Volkswagen Jetta at the busy intersection of
Hamilton Avenue and North Winchester Boulevard.

Police say a 2-year-old was in the back seat, but they would not identify
the boy.

As police approached Villalpando's car and ordered him to raise his hands,
at least one of the officers saw him put something in his mouth,
authorities said. Trying to preserve the evidence and keep the man from
hurting himself, the officer reached through the window, grabbed
Villalpando's arm and tried to open his mouth. The officer then yelled for
him to spit it out and tried putting pressure on the man's throat.

"We tried to prevent him from swallowing the drugs, suspected drugs, but we
can't force people to throw up," said San Jose police spokeswoman Catherine
Unger. "If a person wants to do that, unfortunately, it's their bad decision."

Villalpando got out of the car, and police drove him to the emergency room,
where he repeatedly refused treatment, according to San Jose police.

"I know I'll get a long time in jail," Villalpando reportedly said at the
hospital. "I'm going to ride this out."

With Villalpando still at the hospital about 7 p.m., a jail employee logged
him into the booking computer on a charge of possession of drugs for sale.
Police say he may have swallowed as much as a half-ounce of
methamphetamine. When a person overdoses on methamphetamine, body
temperature soars, heart and respiratory rates skyrocket and blood pressure
shoots up. Villalpando was pronounced dead at 9:10 p.m.

Because of patient confidentiality requirements, a Valley Medical spokesman
wouldn't say what happened at the hospital. Spokesman Matt Schenone said,
in general, a patient can refuse care.

Coroner's officials conducted an autopsy Wednesday on Villalpando, but
didn't determine a cause of death. Toxicology tests should confirm how much
drugs he had in his bloodstream.

Santa Clara County coroner Gregory Schmunk said that once a stimulant such
as methamphetamine enters the bloodstream, it's only a matter of minutes
before the heart is drastically affected.

Villalpando's right to refuse treatment -- rather than have potential
evidence pumped from his stomach -- has its roots in long established law.
But it's not always simple to apply, medical experts say.

If one is deemed competent he or she can refuse treatment. U.S. courts have
ruled, for example, that a Jehovah's Witness or Christian Scientist can
refuse potentially life-saving treatments, such as a blood transfusion,
because such a practice is against their religion.

If a doctor touches someone "without his or her permission," said Bruce
Hilton, director of the National Center for Bioethics in Sacramento,
"that's battery."

But if a patient is in dire need of medical aid and does not seem to be
rational or able to make an informed decision, the physicians must provide
treatment, Hilton said.

Howard Slyter, a neurologist and chair of the bioethics committee at Kaiser
Permanente in Sacramento, said it's called determining a patient's
"decision-making" power. In addition to ensuring patients understand the
risks, he also asks why they are refusing treatment.

The answer may not be one the doctor agrees with, but it would provide
further information about whether it's reasonable within the patient's
values and beliefs.

Moreover, Slyter said, the doctor should try to bargain with the patient,
cut a deal where the medical staff can intervene if the patient's condition
becomes life-threatening. Hospital officials will not say what happened in
Villalpando's case.

Dr. Rene Binder, director of the Psychiatry and Law program at the
University of California-San Francisco, also noted that not all emergencies
allow for such niceties.

"If someone comes into an emergency room and they're choking," she said,
"you save their life and talk about it later."

Doctors can involuntarily treat a patient who they deem mentally unfit or
suicidal, for up to 72 hours, but can only administer medication if the
patient is in imminent danger. But it wasn't clear if Villalpando intended
to die.

Because he died while in the custody of police, the Santa Clara County
Sheriff's Department sent homicide detectives to the hospital to
investigate. After interviews and witnessing the autopsy, the investigators
determined there was no foul play, according to sheriff's spokesman
Terrance Helm.

Villalpando's family isn't convinced.

They said they don't believe he refused treatment. They can't understand
what he was doing with drugs and said he had never been in trouble before.
They don't believe police took him immediately to the hospital, but instead
took their time filling out paperwork.

Police arrived at the family's home in Milpitas on Tuesday afternoon with a
search warrant, looking for methamphetamine, plastic bags, balloons and
scales. They took Villalpando's brother Joseph, 21, to the police station
and told him Willie was in custody but never mentioned his overdose, family
members say.

The first the family heard that Willie was in the hospital was about 7:30
p.m. when an officer returned to their home with the news.

They rushed to the hospital, but didn't arrive in time.

"He was like the oldest, because he was more responsible than I am," said
Joseph Villalpando, the eldest of seven siblings, who admits being a drug
user, but swears his brother was not. "He was a role model for the family.
Plus he has a 2-month-old baby.

"You think he'd want to die?"