Live or let die: ethical issues in a psychiatric patient with end-stage renal failure

Medical co-morbidities are very common in patients with psychiatric conditions. Although respecting one's autonomy to make treatment decisions is the ethical default position, the capacity to make such decisions may need to be assessed, especially when patients are in relapse of their psychiatr...

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Bibliographic Details
Published inAnnals of the Academy of Medicine, Singapore Vol. 38; no. 4; pp. 370 - 373
Main Authors Ang, Aaron, Loke, Peter C W, Campbell, Alastair V, Chong, Siow Ann
Format Journal Article
LanguageEnglish
Published Singapore 01.04.2009
Subjects
Adult
Female
Humans
Kidney Failure, Chronic - therapy
Mental Competency
Patient Care - ethics
Patient Participation - psychology
Personal Autonomy
Schizophrenia
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Summary:Medical co-morbidities are very common in patients with psychiatric conditions. Although respecting one's autonomy to make treatment decisions is the ethical default position, the capacity to make such decisions may need to be assessed, especially when patients are in relapse of their psychiatric condition, and/or when the decisions made are high-risk and possibly fatal. This case report highlights the ethical issues of refusing potential life-saving treatment in a patient who is in relapse of her schizoaffective disorder. In particular, the assessment of decisional capacity and the role of the doctors (if the patient lacks capacity) are discussed. Recommendations are also made on how to better manage such situations.
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ISSN:0304-4602
0304-4602
DOI:10.47102/annals-acadmedsg.V38N4p370