Question

A young woman age 28 was committed to a local psychiatric hospital because she her paranoid delusions had taken a violent turn with family members and a caregiver. A physician at the institute administered Resperidone injections, an anti-psychotic medication, against her will to reduce her violent outbursts. The mother of the patient was given the medical power of attorney by a court who declared the woman mentally incompetent. The Resperidone worked to make the woman less prone to violent outbursts but did little to suppress her paranoia which includes people out to control her by giving her medications via pills. A consulting physician felt that Clozapine would work better only the Clozapine was only available as a pill. The drug, however, was only available in a pill form, and the patient’s paranoia increased as she felt people were trying to poison her with the new drug. The suggestion was made to grind up the pill and administer it by mixing it in pudding. The hospital checked with the mother and obtained informed consent from her. The mother's goal was to return her daughter to her home where she would be around those she loves and who had always taken care of her. This was the explicitly stated rationale for the mother agreeing to the proposal. The staff whose job it was to administer the drugs were not comfortable about deceiving the patient even though consents were given by the guardian. Given this case please answer the following questions:

1. In NY state does a patient who is declared mentally incompetent retain the right to refuse treatment i.e. retain autonomy? (this part should be referenced)

2. Is it ethically allowable to do this to a patient? Based on the concepts from this week pick your side and justify your answer
3. Did the ends( returning the woman to her family) justify the means(hiding her medication and thus hiding her treatment)? Is it possible that this could have negative effects? If so please explain how this could backfire

Answer 1

1 the NY city the court has retained the right to refuse medication for the patient who is mentally ill ( by special times of NY )

This is ethically justified to give medicine in a hidden ways because the patient has threats to self and also will harm the other in future so the hospital management has a protocol for these patient to attend them without their consent but the attendent should b there always but according to law this is illegal because every body has right to know what kind of treatment they are receiving

No, the end not justifies the means of hiding the medicines the patients paranoia justifies this

But this could have a negative effect on the patient because once he will know about this he will develop the mistrust more