07-28-2006, 09:53 AM
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The Jehovah's Witness and dementia: who or what defines 'best interests'?
Quote:
The Jehovah's Witness and dementia: who or what defines 'best interests'?
Hegde R, Bell D, Cole P.
Specialist Registrar in Anaesthesia, The General Infirmary at Leeds, Great George Street, Leeds, LS1 3EX, UK.
An elderly woman with dementia presented for repeat surgical management of fractured neck of femur. Although no advance directive had ever been generated, the patient was declared to be a strict Jehovah's Witness by her daughter, who vetoed the transfusion of any blood products. The fracture was managed conservatively but the patient suffered repeated chest infections, from which she died 4 months after admission. This case raised several clinical, ethical and legal issues and generated a spectrum of opinion as to the appropriateness of operative intervention, transfusion and provision of intensive care. We suggest that professional guidelines and the new Mental Capacity Act 2005 do not provide explicit and comprehensive guidance for practitioners. Further deliberation is required to bring about convergence between the law, ethical principles and professional guidelines.
Anaesthesia. 2006 Aug;61(8):802-6
PMID: 16867095 [PubMed - in process]
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An interesting situation presenting challenges for all involved - good reason for keeping even old copies of "Noblood" Cards or Advance Directives completed by elderly/mentally infirm? |
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