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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 .