Care Of The Patient With Multi System Organ Failure

Mr. S was driving when he experience a stabbing chest and back pain for the first time. The pain was so severe he immediately went to his local ER. Pulmonary ventilation and perfusion (VQ) scan and Computed tomography angiography (CTA) was done at his local ER. VQ scan was negative for pulmonary embolism (PE). CTA of the chest revealed

A physician cannot force a patient to undergo a procedure or treatment against his or her will. Physicians must make informed refusal an integral part of their informed consent process. Physician should understand what patients' needs and balance between the psychological need and social and physical health. Sometimes, the stress environment of the doctor made him frustrated and they don't spend enough time with their patient to get the optimum information and don't show interest about patients’ psychosocial problems. When a patient feel that their doctors have a lack of knowledge of other treatment options may also contribute to why patients refuse our treatment plan. Good physician-patient relationship allows a trusting relationship to develop. Most patients will agree to doctors’ treatment strategies if they have a good communication and patients are kept fully informed by their

The process of consent should apply not only to surgical procedures but all clinical procedures and examinations which involve any form of touching. This must not mean more forms: it means more communication. As part of the process of obtaining consent, except when they have indicated otherwise, patients should be given sufficient information about what is to take place, the risks, uncertainties, and possible negative consequences of the proposed treatment, about any alternatives and about the likely outcome, to enable them to make a choice about how to proceed.”5

16. Except in the case of emergency, all patients must sign a consent form before undergoing a surgical procedure.

Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).

Obtaining an informed consent is a vital part of current health care. This document lists out several key pieces of information for both the patient, Provider, and the ancillary staff that also access the document during the procedure process. However, obtaining informed consent has not always been the practice norm and in research, informed consent carries different specifications.

“The poor we shall always have with us, but why the hungry?”- John van Hengel, founder, St. Mary’s Food Bank. John van Hengel was the founder of one of the largest food banks in the United States. His idea spread to other cities and eventually carried enough of an impact to cause other countries to follow suit and open food banks as well. John’s concept of a food bank is the same as a typical bank. This being born when overhearing a mother talking about how difficult it was to feed her family.

Charlies doctors acted unethically when they asked if Charlie wanted to do the operation. The doctors didn’t ask Charlie these questions. "Has the patient been informed of benefits and risks, understood this information, and given consent? Is the patient mentally capable and legally competent, and is there evidence of incapacity? If mentally capable, what preferences about treatment is the patient stating? If incapacitated, has the patient expressed prior preferences? Who is the appropriate surrogate to make decisions for the incapacitated patient? Is the patient unwilling or unable to cooperate with medical treatment? If so, why?"(Siegler). The doctors just told Charlie that the operation will make him smarter. This was very unethical by the doctors who kind of took advantage of Charlie just for research.

When a patient needs to have a medical procedure performed, they must first consent to the procedure. Before accepting or rejecting the treatment, the practitioner is required to give the patient information pertaining to the risks and benefits of the procedure, as well as available alternatives. Additionally, the patient must be mentally competent enough to make an informed decision, and not be manipulated or coerced into a decision.

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

The patient has the right to receive information necessary to give informed consent prior to the start of any procedure or treatment.

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

Electronic media is inferior to print media due to the fact that electronic media can be bias, selective, and evasive for the purpose of entertainment. Electronic media serves as a form of entertainment with a main goal of serving their ratings rather than serving the people. It would seem that Postman would agree with this theory since he describes electronic media as a form of entertainment rather than a reliable source of information and facts in his book Amusing Ourselves to Death.

To begin with, the client whose name is Mr. Sam Pilsudski has an obstructed airway secondary to cancer of the larynx. He is a 67-year-old widower, and a father of one son and two daughters, who is unconscious and terminally ill, if not for a much-needed operation to remove both his cancer and larynx to save his life. However, one of Mr. Pilsudski’s daughters has adamantly refused to consent to the surgical procedure despite the physician explaining that although the operation would unfortunately render his patient disabled without a voice consequentially, but ultimately surviving the procedure to live and recover. Moreover, the physician attempted with rational and clear communication to express the gravity of the rather poor prognosis of his illness to his daughter that in the event of foregoing the surgery, his patient would surely die (Ralph Dolgoff, Donna Harrington, and Frank M. Loewenberg (2012), Ethical Decisions for Social Work Practice. 9th Ed; p. 279).

Tyheem would benefit for continual IIH services to help with maintaining his mental health. Tyheem has made some improvement with all his goals, however lack the ability to show consistence in applying coping skills and other techniques taught to him when crisis situations arises. Per mom since last review Tyheem had had numerous aggressive outbursts and temper tantrum, and had applied coping skills on some occasion. Per mom, Tyheem is consistently reminded during crisis situations to use coping skills and the consequences for behavioral outbursts. Per mom, IIH services has been a positive impact in helping Tyheem cope with aggressive behavior, expressing his feelings and thoughts and communication. Per mom IIH services is helping her and Tyheem