Oh dear, how disappointing. So close, so very very close, and yet you
just had to let yourself down at the end. Hopefully this is not Mr. Nelson's
normal state. He is under the influence of alcohol and drugs. His physical
examination is unreliable.
You cannot remove his spinal immobilisation. You cannot discharge him.
You can however discharge yourself from further responsibility for his care (and the care
of other patients in this institution).