A Leg to Stand On: Working With Marginal Decision-making Capacity in a Patient With a Severe Leg Infection and Schizophrenia.
Journal
Journal of psychiatric practice
ISSN: 1538-1145
Titre abrégé: J Psychiatr Pract
Pays: United States
ID NLM: 100901141
Informations de publication
Date de publication:
01 03 2023
01 03 2023
Historique:
entrez:
17
3
2023
pubmed:
18
3
2023
medline:
22
3
2023
Statut:
epublish
Résumé
Assessment of a patient's capacity to make treatment decisions and working with the wishes of a patient with mental illness against the best medically indicated plan is a complex and dynamic task. It is particularly challenging when the course of deterioration of the illness is meandering and slow, and the time horizon for recovery is uncertain, providing no clear point of entry for definitive crisis intervention. High-impact decisions concerning body integrity, such as the amputation of a leg, further complicate the task. To highlight these challenges and complexities, we present the case of a man who suffered from schizophrenia, with a worsening diabetic foot ulcer and suboptimal acceptance of proper wound care. The patient died as a result of his refusal of a proposed amputation to address his life-threatening infection. Medical system and cultural issues are also considered.
Identifiants
pubmed: 36928203
doi: 10.1097/PRA.0000000000000692
pii: 00131746-202303000-00009
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
154-159Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
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