title: Catch 22: manipulative family members.
abstract: When a Medicare patient from another state, who is not deemed mentally incompetent, vehemently demands treatment but then defers all procedures and treatment to her questionably competent son who, in turn, curtails any progress toward diagnosis, what are the hospital's and attending physicians' rights to continue basic care to the tune of $90,000 and beyond? Such multifaceted and complex dilemmas are illustrated by this case study which outlines the challenges and restraints encountered in dealing with an unusual situation. Also, it offers guidelines as a framework for action when a manipulative family member or patient is encountered.
authors.forename: A P
authors.initials: AP
authors.lastname: Edwards
mesh_terms: D000368:Aged; D030881:Disclosure; D005190:Family / Q000523:psychology*; D005260:Female; D005773:Gastroscopy / Q000451:nursing; D006801:Humans; D007872:Legal Guardians; D008257:Machiavellianism; D028681:Moral Obligations; D010348:Patient Care Team; D011368:Professional-Family Relations; D012017:Referral and Consultation; D040841:Resource Allocation; D012947:Social Work