The Mental Health Services have been accused of providing a ‘soft option’ to offenders and this charge is highlighted in cases where the mentally disordered offender absconds (hereafter called the absconder) from the hospital. Society just about manages to accept the disposal of disturbed offenders to hospital, which it sees as providing at least some limited incarceration, but in the event of an offender absconding the whole dilemma of offenders considered to be in need of treatment is thrown into question. The Responsible Medical Officer (RMO) is concerned with issues of treatment, public safety and his/her responsibility to the Courts and society; and thus finds himself/herself in the conflicting roles of a doctor and an agent of social control. This paper attempts to address some of the issues surrounding the areas of the rights of the patient, the dilemma faced by the clinicians and the rightful use of the powers of the doctor and of the State in relation to Hospital Order and the absconder.