A 60-year-old black female with chronic paranoid schizophrenia was admitted to the Medical Service for a workup because of severe iron deficiency anemia ; she refused the workup.
She was found to be acutely psychotic and incapable of informed medical decision making.
The management of her medical workup by her medical/C-L psychiatrist led to a diagnosis of colon cancer, and subsequent surgery.
The case is discussed here by a consultation-liaison psychiatrist and a lawyer bioethicist.
It illustrates the role of medical/C-L psychiatrists as physicians for chronically mentally ill patients with serious medical illness in the general hospital, who guide the medical/surgical care of these patients without powerful negative countertransference bias, thus balancing respect for patient autonomy with advocacy for medical « best interests. ».
Mots-clés Pascal : Schizophrénie paranoïde, Chronique, Rôle thérapeutique, Psychiatre, Psychiatrie liaison, Diagnostic, Tumeur maligne, Côlon, Relation médecin malade, Incapacité, Prise décision, Etude cas, Vieillard, Homme, Femelle, Personnel sanitaire, Santé mentale, Psychose, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie
Mots-clés Pascal anglais : Paranoid schizophrenia, Chronic, Therapeutic role, Psychiatrist, Liaison psychiatry, Diagnosis, Malignant tumor, Colon, Physician patient relation, Disability, Decision making, Case study, Elderly, Human, Female, Health staff, Mental health, Psychosis, Digestive diseases, Intestinal disease, Colonic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0194577
Code Inist : 002B18H04. Création : 11/09/1998.