Guarding against discriminatory treatment decisions.
This article studies a case in which a 52-year-old male patient has early onset dementia, Down's syndrome and an associated heart condition, for which he is prescribed warfarin and digoxin. A district nurse, who is an independent prescriber, monitors and adjusts his medication and takes the required blood sample. The staff at the care home where the patient lives report that the patient is spitting out his medication and they have not been able to persuade him to swallow his tablets for a week. Despite the patient being assessed as lacking capacity to decide treatment decisions, the care home staff argue that his refusal to take medication should be respected and the medication discontinued. Although withdrawing the medication would make caring for the patient less challenging, the district nurse assesses the legal obligations that must be considered before this decision can be considered lawful.
School of Health Science, Swansea University. richard.griffith@swan.ac.uk
Richard
R
Griffith
D000328:Adult; D003704:Dementia / Q000451:nursing; D004314:Down Syndrome / Q000451:nursing; D006331:Heart Diseases / Q000188:drug therapy; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D055118:Medication Adherence; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*; D006113:United Kingdom