msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
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A 55-year-old man has a 3-month history of chest pain and fainting spells. You feel his symptoms merit cardiac catheterization. You explain the risks and potential benefits to him, and include your assessment of his likely prognosis without the intervention. He is able to demonstrate that he understands all of this, but refuses the intervention.
Can he do that, legally? Should you leave it at that?
2.A 64-year-old woman with MS is hospitalized. The team feels she may need to be placed on a feeding tube soon to assure adequate nourishment. They ask the patient about this in the morning and she agrees. However, in the evening (before the tube has been placed), the patient becomes disoriented and seems confused about her decision to have the feeding tube placed. She tells the team she doesn't want it in. They revisit the question in the morning, when the patient is again lucid. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure.
Is this patient competent to decide? Which preference should be honored?
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| drk1980
Forum Guru
Topics: 147
Posts: 1,038
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case 1, he can refuse the cath, patient's rights. but the doctor can continue with other appropriate diagnostic aid and treatment.
case2, the patient is competent until the court rules otherwise, or if very obviously not so. the patient probably had one delirious episode, so i think the preference of agreeing for the feeding tube shd be honoured.
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| mistral92
Forum Senior
Topics: 4
Posts: 185
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agree with drk1980 ;-)
case 1. we should respect the patient desire...he has the rights to refuse such procedure...we can try to convonce him to change opinion but if he still refuse we ve got to respect his decision.
2nd case. place the feeding tube.
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