A Sticky Situation: Answered

Answered ..... well, not really. It's a no win situation. Admit the patient and you might end up in court facing false imprisonment charges. Discharge the patient and you could end up there for medical malpractice after the man dies of an MI.

Aside from getting a good lawyer who shows well at the dog and pony show, a well documented evaluation of the patient's medical decision making capacity may come in handy. This assessment should consider the patient's ability to:

  • understand their medical problem

  • understand pros/cons of proposed treatment

  • understand pros/cons of refusing proposed treatment

  • understand pros/cons of alternative treatments

  • and to make a decision free of depression, delusions, and psychosis


These pointers are derived from a formal, structured assessment tool used to evaluate capacity, the Aid to Capacity Evaluation (ACE) , conceived at the University of Toronto Centre for Bioethics.

Source

Tunzi, M. MD. "Can the Patient Decide? Evaluating Patient Capacity in Practice." Am Fam Physician 2001; 64: 299-306.