scholarly journals Should they have a percutaneous endoscopic gastrostomy? The importance of assessing decision-making capacity and the central role of a multidisciplinary team

2014 ◽  
Vol 14 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Gemma Clarke ◽  
Sarah Galbraith ◽  
Jeremy Woodward ◽  
Anthony Holland ◽  
Stephen Barclay
Keyword(s):  
Decision Making ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Multidisciplinary Team ◽  
Endoscopic Gastrostomy ◽  
Decision Making Capacity

scholarly journals Using a multidisciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110270
Author(s):  
Ruth Maxwell ◽  
Michelle O’Brien ◽  
Deirdre O’Donnell ◽  
Lauren Christophers ◽  
Thilo Kroll
Keyword(s):  
Decision Making ◽  
Multidisciplinary Team ◽  
Team Approach ◽  
Term Care ◽  
Multidisciplinary Team Approach ◽  
Decision Making Capacity ◽  
Health And Social Care ◽  
Functional Assessments ◽  
Health Nursing ◽  
Communication Approach

Formal assessments of cognition that rely on language may conceal the non-linguistic cognitive function of people with aphasia. This may have detrimental consequences for how people with aphasia are supported to reveal communicative and decision-making competence. This case report demonstrates a multidisciplinary team approach to supporting the health and social care decision-making of people with aphasia. The case is a 67-year-old woman with Wernicke’s type aphasia. As the issue of long-term care arose, the speech and language therapist used a supported communication approach with the patient who expressed her wish to go home. A multidisciplinary team functional assessment of capacity was undertaken which involved functional assessments and observations of everyday tasks by allied health, nursing, catering and medical staff. In this way, the patient’s decision-making capacity was revealed and she was discharged home. A collaborative multidisciplinary team approach using supported communication and functional capacity assessments may be essential for scaffolding the decision-making capacity of people with aphasia.

scholarly journals “I would prefer not to”: Assessing competence to consent in a case of refusal of cancer treatment

2019 ◽  
Vol 14 (1) ◽  
pp. 42-45
Author(s):  
Gustavo B Castellana ◽  
Lilia B Schraiber ◽  
Talita R de Oliveira ◽  
Daniel M de Barros
Keyword(s):  
Decision Making ◽  
Forensic Psychiatry ◽  
Patient Relationship ◽  
Ethical Conflict ◽  
Actual Case ◽  
Clinical Issue ◽  
Case Presentation ◽  
Decision Making Capacity ◽  
Forensic Psychiatric

Background Based on an actual case in which a psychiatrist was called in to assess a patient’s capacity to refuse treatment, the aim of this study is to discuss how to manage this ethical and clinical issue and the dilemmas faced by the medical team. Case presentation: The case involved a 45-year-old female patient diagnosed with breast cancer who refused treatment. Since the mastology team had doubts about the patient’s mental state and given that she refused to consent to surgery, a forensic psychiatric consult was requested. Conclusion The forensic psychiatry team concluded that the patient’s decision-making capacity was preserved. The team suggested some actions to help the specialists deal with the ethical conflict. A reflection is proposed about the role of psychiatrists when an ethical dilemma involving decision-making capacity emerges in clinical situations, elucidating their work not only as physicians who determine diagnoses and conducts, but also as agents of transformation in the doctor–patient relationship.

Matter over Mind. What Support for Families with Intersex Children Exist?

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 23-23
Author(s):  
Daria Abrosimova ◽  
◽  
Martin Gramc ◽  
Keyword(s):  
Decision Making ◽  
Peer Support ◽  
Multidisciplinary Team ◽  
Peer Groups ◽  
Implementation Strategies ◽  
Psychosocial Interventions ◽  
Decision Making Process ◽  
Parental Concerns ◽  
The One

"The complex treatment of intersex people in medicine has for too long neglected the support for their families. Decision-making process included parental concerns and wishes, but the emotional and peer support of families with intersex people may not always be provided. We investigate access and availability of psychological and peer support for families with intersex children. Even though the 2005 Consensus statement on DSD strongly recommended new protocol in which families should be provided psychological and peer support during decision-making process, we claim that this is still not the case. Even if there is a psychologist or psychiatrist in the multidisciplinary team during the process, that does not mean that families are provided with psychological support. Based on the scoping review method we want to identify existing professional-peer support and intervention tools for parents with intersex children. We investigate the implementation strategies for professional psychosocial interventions and examine the literature assessing their effectiveness. Our claim is that psychological and peer support are not fully implemented in the treatment process of intersex people, because the role of psychologist, psychiatrist or peer groups is seen as secondary in comparison to the one on surgeons within the multidisciplinary team of medical professionals. This leads to lack of psychosocial and peer support and to mental distress of families and their intersex children. "

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