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Incompetent Patient & No informed conset

2K views 7 replies 7 participants last post by  Hope2Pass  
#1 ·
An 88-year-old male complaining of abdominal pain enters the emergency room with his wife. A mini-mental status exam reveals pronounced forgetfulness and confusion. The patient is discovered to have acute appendicitis requiring immediate surgery. He is unable to understand the situation and cannot provide informed consent. Which of the following further actions must the physician take?

A. Do not perform surgery
B. Have another doctor confirm the necessity of surgery
C. Obtain a court order to perform surgery
D. Obtain consent from his wife to perform surgery
E. Try to persuade the patient to consent to surgery
 
#8 ·
D) Obtain consent from his wife to perform the surgery

The correct answer is D) Obtain consent from his wife to perform the surgery

Explanation -

In cases in which an emergency exists, the patient is incompetent to give consent, and the withholding of treatment would be potentially life-threatening, the physician must seek out close relatives of the patient to supply consent. The physician should proceed with treatment, assuming the patient would want the treatment had he or she understood the situation.

Not performing surgery (choice A) could cost the patient's life.

Having another doctor confirm the necessity of surgery (choice B) is favorable (if done immediately) but not mandatory and does not change the patient's consent status.

Obtaining a court order (choice C) is not necessary with the patient's wife immediately accessible.

Trying to persuade the patient to consent to surgery (choice E) would not only waste time and prove futile but might agitate the patient as well