Question

78 yo w/ deteriorating personal hygiene, significant weight loss. Signs voluntary admission form but later forgets doing this. Potentially resectable masses in lung and brain requiring further consent for surgical and oncological treatment. Consents but cannot explain reason for surgery. Legally, psychiatrist should:

Answer 1

A 78-year-old patient demonstrating cognitive impairment may have diminished capacity to consent. If this is confirmed, the psychiatrist must involve a legal guardian or a legally authorized representative to consent for treatment.

Step-by-step explanation:

The situation involves a 78-year-old patient with deteriorating personal hygiene and significant weight loss who has signed a voluntary admission form but later exhibits signs of forgetfulness regarding this action. The individual also has potentially resectable masses in the lung and brain, yet shows a lack of understanding concerning the reason for the surgery even after giving consent. In this scenario, the psychiatrist must recognize the possibility of the patient's diminished capacity to consent due to cognitive impairment and take appropriate steps to assess decision-making capacity.

If the patient is found to lack the necessary decision-making capacity, it would be the responsibility of the psychiatrist to involve a legal guardian or a legally authorized representative to give consent for further treatment on behalf of the patient. The priority is to ensure that the patient's autonomous will and wellbeing are respected while also ensuring that legally and ethically sound medical decisions are made.