EWL,
I know that this thread is drawing to its own natural conclusion, but I thought I would just add my two cents worth. Personally, I missed the ealrier entries at the time that you first posted.
I can speak from personal experience of the difficulties of caring for a family member with a lifelong significant disability. It is a draining, frustrating, maddening, scary and unrelenting existence. It is however, also at times joyous, deeply moving and highly rewarding. You never quite view the world the same way ever again. My biggest worry is how this family member will cope when I succumb to the inevtiable - as we all must.
Working out what action is in the best interests of your family member (or in your case, your customer) is a real tightrope. From a legal standpoint, I doubt whether there is even a legal process for the situation you found yourself in - I would love somebody with legal experience to add their comments on this point.
In today's world, we must forever tread the line between privacy and duty of care requirements. I recently operated a service ex Darwin for Singapore with a passenger who had a pre-existing medical condition. The CSM really did not want to take her, but when asked, the passenger informed the CSM that QF medical had cleared her to fly. From the privacy point of view, she was not required to tell us her condition and QF medical could not have disclosed it to us if we had asked them (unless they had her approval of course).
If something had happended to her on that flight, who would the authorities have held legally responsible? The passenger for travelling with a condition and not informing the crew of the full details? The CSM for allowing her to board against his gut instinct? The QF doctor for giving her a company medical clearance to fly? Or the crew for failing in their duty of care? I guess the legal eagles would have had a windfall in legal fees before a determination was made.
To come back to your situation EWL. In the situation you initially described, who should you have been most concerned about? The right of the passenger to privacy regarding her condition, but also the right to travel as a free individual? Or what about your duty of care to the other passengers? You asked about what legal avenues were open to you? I personally doubt that there is one and that you, yourself, would have had a pschiatric condition by the time you finished negotiating a way through the myriad government departments (state and federal) to try to get a definitive answer.
Governments at all levels avoid providing adequate levels of mental health care. It is easier (and far cheaper) to say that they have a right to individual freedoms and should be able to move freely in the community. Not that I am advocating that people should be institutionalised mandatorally - far from it in fact!! My point is that if they live in society, they must be adequately supported - and this is where all governments are failing these fragile mmembers of society (and obviously your client).
IMHO, in this particular situation, it would pay to take a lateral approach. Given the absence of hard guidelines to cover this situation, I would have "invented" a requirement to have a nominated contact person - presumably in this case, the lady's daughter - use your imagination as to why such a requirement might exist. I then would have called this "contact person" on some pretext - confirmation of flight number or some other mundane reason. I imagine the daughter's response would have been, "MY MOTHER'S FLIGHT TO CHINA????!!!???!!!"
While this approach might not be strictly in compliance with all of the privacy/EO/OH&S/Duty of care requirements, it probably would have gotten you off the hook.
This is not intended as a criticism - merely as food for thought. I congratulate you for treating the lady with compassion and respect in a world where we are all too quick to look down on those who do not fit the image of perfection that is forced on us by the mass media.
My apologies for the length of my reply.
Best regards.