إعلان
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لحظة من فضلك!
أهلا بكم معاً وإلى أن تشرق شمس يوم جديد مشاريع 
هدية الابتسامة كلمة معروف من غير حروف الفعاليات القادمة
 استطلاع الرأي إلى أي مدى تعتبر أنّ الدراسة النظريّة للطبّ في كليتنا ستخدمك سريرياً في المستقبل؟ أعتبر أنّ الفائدة معدومة في ظل النظام التدريسيّ الحالي. 28% الفائدة كبيرة جداً، وهي أساس التميز العملي. 6% الأمر نسبي، يختلف من طالب لآخر، ومن مادة لأخرى. 66% عدد الأصوات: 238 أهلاً بك ! تفضل الإبحار |
Informed consent-2
DAM - الأربعاء, 2007-08-08 09:38 |
الوصف الكامل Background: A 42-year-old Caucasian man presents to the emergency department complaining of a two-day history of fever to 40C (104F), headache, and vomiting. Physical examination reveals petechiae and purpura on his trunk and lower extremities. Examination of his cerebrospinal fluid is consistent with bacterial meningitidis. The patient is told of his diagnosis and the need for antibiotics and hospitalization is discussed. The patient refuses to be admitted to the hospital, however, and insists upon being treated at home. What is the most appropriate next step?
A. Treat the patient against his wishes الشكوى الرئيسية CC: القصة المرضية HPI: الأجهزة الأخرى ROS: السوابق المرضية الشخصية PMH: السوابق المرضية العائلية FMH: الوضع الصحي والاجتماعي SH: الفحص السريري Clinical Exam: التشخيص التفريقي DD: الاستقصاءات Investigations: التدبير Managment: كتابة حرة وطرح موضوع النقاش!: |
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i would try to convince or at least talk to the patient about the hospitalization issue , but there is no such an option here.
so i would go for B ?
أيضاً طرح الدكتور طريف مثل هذه الحالة، يحق للمريض أن يقرر قبوله للعلاج أم لا، لكن هنا المريض يمثل خطراً على غيره لذلك يجب أن يخضع للعلاج رغماً عنه A.
Normally, adult patients enjoy the right to refuse treatment, even if it would be life saving. However, if not treating the patient would endanger the health and welfare of others, then the patient should be treated against his wishes. In this case, the patient is suffering from meningococcal meningitis (as suggested by his rash). He should be educated about the potential for harming others if he were to be treated at home. If he continues to refuse, he should be treated against his wishes by hospitalizing him in an isolation room with contact precautions.
(Choice B) Involving the wife is unnecessary because it is mandatory that the patient's communicable disease be treated immediately.
(Choice C) The hospital ethics committee is to be consulted when there is an ethical dilemma. Since it is clear that this patient must be treated to protect the health and welfare of others, the physician should simply proceed with hospitalization without delay.
(Choice D) Because there is a grave risk to others with delayed treatment of this patient's meningitis, this is one of the rare instances when patient autonomy should not be observed. Instead, he should be hospitalized against his wishes.
(Choice E) A court order is not necessary in this situation, as the medical community has already agreed it is imperative that a patient stricken with a communicable disease be treated, even if it is against his wishes.