A Standardized Approach to Treatment Over Objection in Patients Lacking Decision-Making Capacity Secondary to Neurologic Disease.
Journal
Neurology. Clinical practice
ISSN: 2163-0402
Titre abrégé: Neurol Clin Pract
Pays: United States
ID NLM: 101577149
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
24
01
2022
accepted:
12
05
2022
entrez:
16
11
2022
pubmed:
17
11
2022
medline:
17
11
2022
Statut:
ppublish
Résumé
Neurologic diseases, ranging from Alzheimer dementia to mass lesions in the frontal lobe, may impair decision making. When patients with neurologic disease lack decision-making capacity, but refuse treatment, should they be treated over their objection? To address this type of ethical dilemma in medical illness, Rubin and Prager developed a standardized 7-question approach: (1) How imminent is harm without intervention? (2) What is the likely severity of harm without intervention? (3) What are the risks of intervention? (4) What are the logistics of treating over objection? (5) What is the efficacy of the proposed intervention? (6) What is the likely emotional effect of a coerced intervention? (7) What is the patient's reason for refusal? We describe the application of the standardized Rubin/Prager approach as a checklist to the case of a 50-year-old woman with a large frontal lobe meningioma, who lacked capacity as a result of the meningioma, but refused surgery. This approach may be applied to similar ethical dilemmas of treatment over objection in patients lacking capacity as a result of neurologic disease.
Identifiants
pubmed: 36380893
doi: 10.1212/CPJ.0000000000200064
pii: CPJ-2022-200064
pmc: PMC9647797
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e105-e111Informations de copyright
© 2022 American Academy of Neurology.
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