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The patient lacks capacity and the feeding tube should be placed
0%
0/69
The patient lacks capacity and his healthcare proxy should be contacted regarding placement of a feeding tube
25%
17/69
The patient lacks capacity and the state should determine whether to place the feeding tube
4%
3/69
The patient has capacity and may deny placement of the feeding tube
55%
38/69
The hospital ethics committee should determine whether to place the feeding tube
9%
6/69
Select Answer to see Preferred Response
A history of a psychotic disorder does not preclude the ability to make medical decisions or give or refuse consent provided there is no evidence of current psychosis and the patient is exhibiting rational thought. Patients with capacity may refuse lifesaving hydration or nutrition. Although this patient has a history of a psychotic disorder, he is currently mentally stable and is able to understand the risks, benefits, and alternatives of the placement of the feeding tube. He thus has the capacity to make medical decisions on his own. Forcing the patient into making a decision that goes against his wishes because of his past medical history would represent coercion. Tunzi discusses the evaluating patient capacity. Patients with an abrupt change in mental status, who refuse recommended treatment, who consent hastily to treatment, or who have a known risk factor for impaired decision making capacity should be evaluated more carefully. The physician should conduct a mental status examination and also assess the ability of the patient to understand information about treatment, the ability to appreciate how that information applies to their situation, the ability to reason with that information, and the ability to make a choice and express it. Brown et al. discuss the assessment of mental capacity in psychiatric inpatients. The mental capacity act of 2005 was introduced in 2007 to protect vulnerable individuals who lack capacity to make decisions for themselves and provide a legal framework for professionals to assess incapacity. This study showed that capacity assessments are conducted in approximately 10% of psychiatric admissions. Incorrect Answers: Answers 1-3, 5: Despite the history of major depressive disorder with psychotic features, the patient is currently asymptomatic and has the capacity to make medical decisions for himself; therefore, placing the feeding tube would be unethical.
3.8
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