Ethical Dilemmas in Healthcare Decision-Making

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Questions and Answers

What is delirium characterized by?

Confusion and incoherence (correct)

Calmness and certainty

Agitation and anxiety

Clarity and coherence

What is the primary reason for Angela's delirium according to the text?

The medications she was taking

Lack of proper sleep

A chest infection (correct)

Her dementia

What did Dr. Khan determine about Angela's capacity during her delirium?

She lacked capacity due to dementia (correct)

She had the capacity to make urgent decisions

Her capacity was not affected by the delirium

She had the capacity to make all decisions

What approach to capacity considers a person's ability to make a particular decision at a particular time?

Functional approach Signup and view all the answers

Why did Dr. Khan hold off discussing home modifications with Angela when she was in a delirious state?

Angela lacked decision-making capacity Signup and view all the answers

What is crucial to a patient-centered approach based on shared clinical decision-making?

Capacity and consent issues Signup and view all the answers

What is the status approach to capacity based on?

'All or nothing' basis Signup and view all the answers

How can healthcare professionals help maximize decision-making abilities as mentioned in the text?

Using hearing aids and treating delirium Signup and view all the answers

When should non-urgent decisions be discussed with a patient?

When the patient's capacity is optimal Signup and view all the answers

'Capacity may come and go' refers to which condition mentioned in the text?

'Fluctuating capacity' Signup and view all the answers

What does the outcome approach judge capacity based on?

Whether or not the decision made is seen as wise or otherwise. Signup and view all the answers

Which of the following is important in helping patients articulate their will and preferences?

Maximizing decision-making abilities Signup and view all the answers

What is the main reason Dr. Khan decides not to discuss the need for modifications with Angela's daughter straight away?

Angela is often more lucid at other times and may be able to make her decision with support. Signup and view all the answers

Why is a coherent discussion impossible when Dr. Khan visits Angela in the afternoon?

Angela is disoriented and drowsy. Signup and view all the answers

What factors contribute to Angela being more confused in the afternoon?

Poor sleep and strong painkillers for her back pain. Signup and view all the answers

Why does Dr. Khan ask the ward staff if Angela has anyone who could support her in making the decision?

To ensure that Angela has someone to help her make the decision. Signup and view all the answers

What does Angela's attachment to her home indicate?

She is resistant to any changes in her environment. Signup and view all the answers

Why does Dr. Khan decide to visit Angela the following morning?

To give Angela a chance to make her own decision with support. Signup and view all the answers

What dilemma does Dr. Khan face regarding discharging Angela?

Modifications are needed for a safe discharge but Angela is unwilling to have them carried out. Signup and view all the answers

What role does Angela's daughter, Cecilia, play in supporting Angela?

She visits Angela every day and provides support. Signup and view all the answers

What do strong painkillers contribute to in Angela's condition?

Increased confusion in the afternoon. Signup and view all the answers

What does Angela's resistance to modifications imply about her decision-making capacity?

It indicates that she lacks decision-making capacity. Signup and view all the answers

Why does Dr. Khan find it important for Angela to be more lucid when discussing the modifications?

To ensure that Angela can fully understand and participate in the decision-making process. Signup and view all the answers

Study Notes

Delirium

Delirium is characterized by fluctuations in consciousness, attention, and cognition
Primary reason for Angela's delirium: not specified in the text

Capacity and Decision-Making

Dr. Khan determines that Angela's capacity is impaired during her delirium
The functional approach considers a person's ability to make a particular decision at a particular time
Healthcare professionals should help maximize decision-making abilities by providing clear information, minimizing distractions, and involving family members

Patient-Centered Approach

Crucial elements: shared clinical decision-making, respecting patient autonomy, and considering patient values and preferences
Status approach to capacity is based on a person's general cognitive or mental status
Outcome approach judges capacity based on the quality of the decision made

Communication and Support

Non-urgent decisions should be discussed with patients when they are most lucid
'Capacity may come and go' refers to delirium
Family members can help patients articulate their will and preferences
Dr. Khan asks the ward staff about Angela's support system to facilitate decision-making

Clinical Dilemmas

Dr. Khan delays discussing home modifications with Angela due to her delirious state
Dr. Khan faces a dilemma regarding discharging Angela, considering her capacity and decision-making abilities
Angela's daughter, Cecilia, plays a supporting role in helping Angela make decisions

Factors Affecting Delirium

Strong painkillers contribute to Angela's delirium
Factors that contribute to Angela's confusion in the afternoon: not specified in the text
Dr. Khan visits Angela the following morning to reassess her decision-making capacity

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Description

This quiz explores ethical issues related to decision-making capacity, consent, and confidentiality in healthcare, using a scenario involving a patient with dementia and the need for modifications to her home. It addresses the complexities of decision-making when the patient's capacity is compromised and examines the role of healthcare professionals in such situations.