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You are assigned to do a blood draw on a patient who is in the locked psychiatric ward. Since you have a key to this ward, you go to the patient's room and find that they are currently being held down by security guards and nurses. You proceed to ask the patient to identify themselves and find that they are able to state their name, spell their name, and state their date of birth. However, they state that they refused the draw and they say, "No".

The nurse explains that the patient's mother has power of attorney and is requesting the draw. You should do which of the following?

1 Answer

7 votes

Respect the patient's refusal, unless there is an immediate threat to their life. Consult with the psychiatric team for guidance.

In this situation, it is crucial to prioritize the patient's autonomy and rights while also considering their safety and well-being.

The patient's clear refusal to the blood draw raises ethical and legal concerns that must be carefully addressed.

Firstly, respect for the patient's autonomy is fundamental in healthcare.

If a patient refuses a procedure, even if requested by someone with power of attorney, their decision should be honored unless there is an imminent threat to their life, and the refusal may cause harm.

However, in psychiatric wards, there are situations where patients may lack decision-making capacity due to mental health issues.

In such cases, it's important to follow legal procedures and ethical guidelines.

Check the patient's mental health status and consult with the psychiatric team to determine if the patient has the capacity to make decisions about their healthcare.

If the patient lacks capacity, efforts should be made to involve the patient's designated decision-maker.

In this case, the patient's mother, holding power of attorney, has legal authority.

Collaborate with the psychiatric team, inform the mother about the situation, and seek her input. It's essential to balance respecting the patient's autonomy with ensuring their safety and addressing the concerns of their legal representative.

Communication and collaboration among healthcare professionals, security personnel, and the patient's representative are key to navigating this complex scenario.

Question

What fundamental principle in healthcare should be prioritized when addressing the patient's refusal of the blood draw?

User Kushan Gunasekera
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