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Prep4USMLE Forum » USMLE Step 2 CK Forum » Psychiatry & Ethics

hospital or house

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9 Posts

drduck
Forum Guru

Topics: 82
Posts: 529

01/20/08 - 09:45 PM

patient brought by his wife to the hospital with complains of headache......diagnosed to have acute bacterial meningitis....doctors keen to start therapy....but then pateient says that HE SHUD BE TREATED AT HOME.
what will be the next best step...

-start treament against his wish..
-talk to his wife and ask her to pursue husband.
-discuss with the hospital ethic committee
-follow patients wish and arrange for home based tretment
-tell the patient that he will be responsible for the complications
-order courts permission to treat the patient

anuba
Forum Elite

Topics: 6
Posts: 449

01/21/08 - 08:26 AM

start tx. against his wish.

Ivonne
Forum Guru
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Topics: 51
Posts: 1,394

01/21/08 - 11:41 AM

Yup i think it is UW Q--------->A

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drduck
Forum Guru

Topics: 82
Posts: 529

01/21/08 - 10:43 PM

oh...strange....i thought if someone refuses for therapy u cant force...even if it is an emergency situation??

plz clear out my doubts...is it so that u gotta save the life even if he is in normal state of mind and orientation....

patients have the right to refuse any therapy or procedure??

hero
Forum Elite

Topics: 37
Posts: 397

01/21/08 - 11:39 PM

there is such a thing as guidelines rolling eyes

Criteria for Outpatient Antimicrobial Therapy in Patients with Bacterial Meningitis
Inpatient antimicrobial therapy for >6 days
Absence of fever for at least 24-48 h prior to initiation of outpatient therapy
No significant neurologic dysfunction, focal findings, or seizure activity
Clinical stability or improving condition
Ability to take fluids by mouth
Access to home health nursing for antimicrobial administration
Reliable intravenous line and infusion device (if needed)
Daily availability of a physician
Established plan for physician visits, nurse visits, laboratory monitoring, and emergencies
Patient and/or family compliance with the program
Safe environment with access to a telephone, utilities, food, and refrigerator

drduck
Forum Guru

Topics: 82
Posts: 529

01/22/08 - 09:33 AM

thanks so much HERO,
but i want to ask u all, that if someone refuses treatment and is awake and legaly competent to take decisions about his health....
what shud a physican do then??

plz answer this i m in real confusion

Korotkoff
Forum Senior
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Topics: 14
Posts: 164

01/23/08 - 01:47 PM

This is the issue of saving others not about the patient. The diagnosis is bacterial meningitis ( N.Meningitidis). The reason he should be treated against his wishes: fear of epidemics.

hero
Forum Elite

Topics: 37
Posts: 397

01/23/08 - 01:54 PM

Korotkoff wrote:
This is the issue of saving others not about the patient. The diagnosis is bacterial meningitis ( N.Meningitidis). The reason he should be treated against his wishes: fear of epidemics.

if it is the reason, this disease would be reportable but it is not

Korotkoff
Forum Senior
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Topics: 14
Posts: 164

01/23/08 - 02:01 PM

^^^ are you sure? It is reportable even in my home country.

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