the reality is if someone is intent on disrupting the court they will-
we are expecting poorly paid people to potentially get hurt and also to be held to account for any injuries they cause to the defendant.
also, when someone claims chest pains-of course in 99% of the time they are lying (people like this spend their lives lying)..do you ignore it and risk your own career, liberty etc if it is an actual medical emergency?
I agree the defendant should be there for sentencing but should only be given one chance before they are returned to their cell and then the sentence can be increased accordingly.