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  #1  
Old 03-20-2012
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Medicolegal and Ethics Suicidal Patient wants to go home!

A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting suicide by taking an overdose of antidepressant medications. On the third day of her hospital stay, she insists,
under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she "can go home and finish the job." Her sensorium is clear. Her physician should

A. discharge her against medical advice (AMA)
B. honor her request and release her immediately
C. obtain an emergency order of detention
D. release her to go back to her parents' home
E. sedate her
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  #2  
Old 03-20-2012
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C? I dont think u can let someone go home and "finish the job".. not sure tho i hate these lol
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Old 03-20-2012
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I think C , " finishing job" indicates being in danger to herself.
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Old 03-20-2012
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A,B & D are definitely not correct.

I think its between C or E.

It could be E) Sedate her ... because with option C) Obtain an emergency order of detention, you will need to time to do that, the patient will probably become violent in this time no ? I am not sure. I always end up with two choices!
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Old 03-20-2012
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I used to work at psych hospital and they have an option of an "emergency" hearing within 24 hours or less. A lot of patients refuse treatment, so that is a common practice...
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Old 03-21-2012
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Its E ........ if a patient is a threat to herself or others she can be forcefully kept in the hospital ....... since sedating her is a similar option thats the ans .. obtaining a emergency order is not needed .......
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Quote:
Originally Posted by Hitman View Post
Its E ........ if a patient is a threat to herself or others she can be forcefully kept in the hospital ....... since sedating her is a similar option thats the ans .. obtaining a emergency order is not needed .......
C is a better answer than E. The reason E is wrong is because the patient is not acutely agitated enough to warrant it. You don't just sedate people because they'd rather be dead. She is threatening to file a lawsuit, not stab you. Where my sphere of knowledge ends is what to do if she then tried to leave anyway. I think in that case you would get security to stop her and sedate her and/or lock her in a padded room if she physically resisted.

D is wrong because she's not a minor from a medical perspective (18 for full autonomy, 13 in some states for gynecological issues). A and B are wrong because she has indicated she has an imminent plan to go kill herself and physicians are obligated to try to prevent that. Usually autonomy trumps beneficence, but a patient who is going to go kill themself is not considered to be competent enough to have autonomy.

Last edited by Tephros; 03-21-2012 at 05:27 AM.
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Old 03-21-2012
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C seems more practical and reasonable.
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Old 03-21-2012
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C! lock that gal!!

but you cannot sedate her just like that...
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Quote:
Originally Posted by Tephros View Post
C is a better answer than E. The reason E is wrong is because the patient is not acutely agitated enough to warrant it. You don't just sedate people because they'd rather be dead. She is threatening to file a lawsuit, not stab you. Where my sphere of knowledge ends is what to do if she then tried to leave anyway. I think in that case you would get security to stop her and sedate her and/or lock her in a padded room if she physically resisted.
.

well I feel she is pretty acutely agitated ....... and asking for an emergency order is usually not a correct ans as we are suppose to take decisions our self .. nice idea that if she walks away call the security and sedate her ... tell her that we are arranging for a order to detain you so you better wait for a while till we get it .......

just joking ...... anyways what the ans ......
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  #12  
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A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting suicide by taking an overdose of antidepressant medications. On the third day of her hospital stay, she insists,
under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she "can go home and finish the job." Her sensorium is clear. Her physician should

A. discharge her against medical advice (AMA)
B. honor her request and release her immediately
C. obtain an emergency order of detention
D. release her to go back to her parents' home
E. sedate her
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  #13  
Old 03-21-2012
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Quote:
Originally Posted by bunny View Post
A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting suicide by taking an overdose of antidepressant medications. On the third day of her hospital stay, she insists,
under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she "can go home and finish the job." Her sensorium is clear. Her physician should

A. discharge her against medical advice (AMA)
B. honor her request and release her immediately
C. obtain an emergency order of detention
D. release her to go back to her parents' home
E. sedate her


Screwed one more BS Qs .......
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  #14  
Old 03-21-2012
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Quote:
Originally Posted by Hitman View Post


Screwed one more BS Qs .......
At least you're not the only one, I'm right there with you
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  #15  
Old 03-21-2012
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Sedation is only done in USMLE when the patient i sthreatening to the life of medical staff or fellow patients
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  #16  
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Quote:
Originally Posted by Hope2Pass View Post
At least you're not the only one, I'm right there with you

thanks buddy , definitely need some company ......
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