Dangerous behavior in a demented patient. Preserving autonomy in a patient with diminished competence.
When a cognitively-impaired elderly man nearly caused a serious fire at home through his inappropriate use of a gas oven, the incident raised questions about his capacity to live alone. Although he clearly wanted to preserve his independence, the health care team felt obligated to assure his safety. The following discussion of dangerous behavior in a demented elderly man elicits and portrays these conflicting values, and highlights the physician's obligations in such ethically and legally complex situations.
Watts
D T
DT
Department of Medicine, University of Wisconsin, Madison.
Cassel
C K
CK
Howell
T
T
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003617:Dangerous Behavior; D003704:Dementia / Q000523:psychology*; D004992:Ethics, Medical; D006699:Home Care Services; D006801:Humans; D008297:Male; D026706:Paternalism; D010349:Patient Compliance; D010358:Patient Participation; D026684:Personal Autonomy; D018570:Risk Assessment; D012945:Social Values; D014754:Violence