Psychiatric Disability and Life Threatening Non-Adherence

EthicsLab

Imagine a patient who suffers from an underlying psychiatric disability and comes to a hospital with a critical illness after prolonged non-adherence to a medical treatment plan. Because of their inability to follow a treatment plan, the patient now faces an end-of-life situation, even though the condition would otherwise not be considered terminal. I am sure you can understand that such stories are both tragic and ethically complex. These stories not only cause moral distress for the healthcare team caring for the patient, but also alarm and confuse patients and their families. Ethics committees in hospitals are asked to consult on the ethics complexities in cases like these. Our guests will reflect on such patient stories and offer their ethical reflections on the challenges, naming the components of complexity, and what is important for ethics committee members to pay attention to in patient stories like these. Our guests in this episode are: Carol Taylor, a professor of Medicine and Nursing at Georgetown University, past Director of the Pellegrino Center for Clinical Bioethics. Carol is now a Senior Scholar at the Kennedy Institute of Ethics. Michael Pottash, Attending Physician in Palliative Medicine at MedStar Washington Hospital Center, He is also an Assistant Professor of Clinical Medicine at Georgetown University School of Medicine. Laura Guidry-Grimes, is an Assistant Professor of Medical Humanities in Bioethics, at the University of Arkansas for Medical Science. She is also a clinical ethicist at the Children’s Hospital in Little Rock, Arkansas. Sarah Kleinfeld, is a Geriatric Psychiatrist at the VA Medical Center in Washington DC. She works with elderly patients with a range of psychiatric illnesses like Bipolar disorder and Schizophrenia. Resources Referenced in this Episode: The Medical Incapacity Hold: A Policy on the Involuntary Medical Hospitalization of Patients Who Lack Decisional Capacity