When the psychiatrist refused, John reassured him that he did not plan
to attempt suicide any time soon. However, when he went home, John
pinned a note to his shirt to explain his actions and to refuse any
medical assistance that might be offered, then, ingested all of his
antidepressant medication. His wife, who did not yet know about his
diagnosis, found him unconscious and rushed him to the emergency
room without removing the note.
·
• What should the care team at the emergency room do?
·
• Discuss this question using the following topics and
analyzing how these issues are applied to the decision made by
the emergency room care team. Use at least two scholarly sources
to support your discussion. Your initial post should be a minimum
of 250 words.
·
• Review of the topics within this case: − Medical
Indications: There are two diagnoses/prognoses that merit
consideration. The underlying chronic disease of Huntington's has
no available treatment and a bleak long term prognosis. However,
there are effective treatments available for the acute diagnosis of
drug overdose.
o How does the chronic diagnosis affect the team’s response to the
acute condition? − Patient Preferences: We know from the patient's
suicide note that he is refusing all medical
treatment. However, what do we know about these statements of
preference? o Weretheyinformed? oWasthepatientcompetenttomaket
hatdecision?
The answers to these questions remain unclear, but we do know that
the patient does not have decision making capacity for the present
decision of whether to proceed with the gastric emptying.
o Isthereasurrogatedecision-makeravailable? − Quality of Life: Life
with Huntington's can be difficult with the onset of spasms and
dementia.
John was familiar with the quality of life associated with living with
Huntington's as he watched his mother die of this disease. On the
other hand, John does have a supportive family and continues to be
able to work for the time being.