thebonedoc
Forum Newbie
Topics: 12
Posts: 17
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Hi guys,
I need some advice re behavioral science:
In Australia if an alcoholic patient with a head injury comes into the ED after a car accident (with loss of consciousness) and says he wants to discharge himself we can hang on to him for his own protection against his will as the head injury would've impaired his ability to make a sensible decision.
However on some sample questions I have read that such a patient in america has the right to discharge himself.
Please clarify!
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| PsychDr2B
Forum Elite
Topics: 35
Posts: 197
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I have a two-part answer to this scenario:
1) If we look at this case from the patient's viewpoint on wanting to discharge himself, I would like to point out two definitions. I'm not sure that this is a consent issue. It seems more of a competency issue. Consent, or more appropriately, informed consent, taken from a competent patient is required by all physicians in order to perform any procedure. For the USmle, The U.S. courts determine competency, NOT the physician. To be legally competent to make health care decisions, an adult patient or emancipated minor must understand the risks, benefits, and likely outcome of any decision. The exceptions to this (for USMLE purposes according to Kaplan) are:
preserving life, preventing the "moral equivalent to suicide," protecting third parties, protecting the legal standards of the health profession. This leads to the second part of my answer...
2) From the physician's viewpoint, this is a matter of protecting others from harm. If a competent patient is a threat to himself or others he must be detained by the physician. Your example states he is an alcoholic, presumably driving under the influence. In this case he is a threat to himself AND others and it would be within physicians right to detain him, NOT letting him back on the streets.
Hope this made sense
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| thebonedoc
Forum Newbie
Topics: 12
Posts: 17
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ok say he wasnt an alcoholic but had a recent head injury. Can head injury/acute trauma be considered to impede consent?
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