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1.Cases
Treating People without their Consent
Handout 1: Cases
Please look at the following patients and say whether or not you believe they should be detained against their will as involuntary patients.
Don’t think too hard about them. If more information is needed to decide, make necessary assumptions and then decide your answer. The assumptions you make can then be highlighted in plenary discussion as relevant features.
Tick one box per case.
| Yes | No | |
|---|---|---|
Mrs. C R. Aged 47. Housewife. Refusing investigation of breast lump discovered on routine screening. Understands that she does not have to accept treatment if the lesion is found to be malignant. Normal mental state. | ||
Mr. A. Aged 50. Doctor. Developed thickening of lips, hoarse voice, and enlargement of skull over several years. Refused to accept that these changes were anything other than age-related and rejected his colleagues' diagnosis of acromegaly. Refusing investigation. | ||
Mrs. A G P. Aged 25. Housewife. Progressively house- bound over two years with agoraphobic symptoms. Refusing behavioural treatment despite threat to job and marriage | ||
Miss A N. Aged 21. Student. Four-year history of intermittent anorexia. Currently seriously under weight, exercising and using laxatives; amenorrhoeic. Refusing admission on the grounds that she is "too fat". | ||
Mr. S D. Aged 48. Bank manager. Presents in casualty with biological symptoms of depression and nihilistic delusions. History of attempted suicide. Asking for something to "help him sleep". He refuses to stay in hospital when he is told that he may be suffering from depression |
For further information on Treating People without their Consent:
- the UK Clinical Ethics Network web site has a detailed discussion around these issues.
- Hope T, Savulescu J, and Hendrick J - Medical Ethics and Law : the Core Curriculum. Edinburgh: Churchill Livingstone, Elsevier Science, 2003. The main text book used for the University of Oxford Medical Ethics and Law course provides more details for both teachers and their students.
- Hope T - Medical Ethics; a Very Short Introduction. Oxford: Oxford University Press, 2004.
- Ashcroft A, Lucassen A, Parker M, Verkerk M, and Widdershoven G - Case Analysis in Clinical Ethics. Cambridge: Cambridge University Press, 2005.
