Question

A consultation-liaison psychiatrist is called to evaluate a patient who is in denial of a major illness. The most important obligation of the psychiatrist at the first evaluation is to:

A. Confront the denial forcefully
B. Tell the staff to "play along" with the patient's denial
C. Obtain neuropsychological testing
D. Meet with the patient's family
E. Make sure the patient has been informed about the illness and treatment

Answer 1

During the first evaluation, a consultation-liaison psychiatrist's primary obligation is to ensure the patient is fully informed about their illness and treatment options. This step is essential for respecting patient autonomy and enabling informed decision-making.

Step-by-step explanation:

The most important obligation of the consultation-liaison psychiatrist at the first evaluation is to ensure that the patient has been informed about the illness and treatment. This foundational step is crucial as it respects the patient’s autonomy and ability to participate in their own care. It is important to communicate effectively with patients about their diagnosis, even if they exhibit denial, allowing them to understand the reality of their condition and the treatment options available.

While confronting the denial forcefully could be counterproductive and telling the staff to "play along" may undermine trust, ensuring that patients have all the necessary information helps them to make informed decisions about their treatment. Similarly, while obtaining neuropsychological testing and meeting with the patient’s family could eventually be helpful, they are not the most critical steps during the first evaluation.