Re: RE2>Release of Patients

["Mike Bohan" <mike.bohan@yale.edu>]

        Reply to:   RE>RE2>Release of Patients 

>        Reply to:   RE>Release of Patients Receiving Therapeutic Doses of...
>
>I don't believe you can restrain them unless it is clear that the patient is
>mentally incompetent.
>
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>Michael J. Bohan, RSO   |  e-mail: mike.bohan@yale.edu

>Incompetence is a legal term.  The label can only be applied by the
>courts.  There is no such word in medicine.  Perhaps you mean "unless it is
>clear that the patient is UNABLE TO RENDER INFORMED CONSENT."
 
I didn't mean to imply in my response that it would be easy or possible on these
grounds to declare the patient incompetent either in a medical or legal sense. 
In fact, our counsel has made it abundantly clear that if a patient wants to go,
to let them go.  Prior informed consent and the preliminary assessment of the
patients ability to understand and cooperate in their treatment is essential,
but exceptions to this general rule can and do happen.  Two prior incidents in
which I have been involved come to mind. 

The first was a retarded patient who had thyroid disease needing I-131 therapy
but who couldn't follow directions consistent with the treatment protocol.  A
medical decision was made to use an alternative therapy.  The second was a woman
who had signed an informed consent, knew the restrictions before treatment, but
after receiving the dose ~100 mCi I-131 became claustrophobic and wanted to
leave.  This is what caused me to request counsel.  Fortunately the nursing
staff was able to provide enough support to the patient to relieve her symptoms
and she fortunately was able to complete treatment and be released normally.

Although most patients cooperate fully, every once in a while a difficult case
appears to test your mettle, so if your involved in these cases, make like a Boy
Scout and "Be Prepared".

Cheers,

Mike Bohan

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Michael J. Bohan, RSO   |  e-mail: mike.bohan@yale.edu
Yale-New Haven Hospital |    Tele: (203) 785-2950
Radiological Physics    |     FAX: (203) 737-4252
20 York St. - WWW 204   |    As usual, everything I say may be plausibly
New Haven, CT    06504  |    denied at my employer's convenience ...
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