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10 - Mental capacity and restraints

Published online by Cambridge University Press:  05 December 2011

Valerie Page
Affiliation:
Watford General Hospital
E. Wesley Ely
Affiliation:
Vanderbilt University School of Medicine
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Summary

Catherine, 29, daughter of a doctor, suffered from severe asthma. She knew her illness well and while her attacks came on quickly she rapidly recovered and had never required intensive care. One Sunday morning she had a severe attack, her sister persuaded her to go to hospital on the understanding she would only be given oxygen. At the hospital she was given oxygen and a nebulizer which she said gave her a headache and she decided to leave the hospital. The clinical team looking after her were horrified having decided she needed intubation and ventilation from blood gas results. The emergency doctor contacted Catherine's father who asked her to wait until he arrived. In the meantime Catherine's condition improved and she tried to leave the hospital with her sister. She was taken back to her room, placed in four-point restraints and after 45 minutes was anaesthetized and intubated. The clinical team said later that after she was prevented from leaving she became more confused and combative, refusing treatment. She made a rapid recovery and was discharged the next day. Following this she had nightmares, cried constantly, was unable to return to work for several months and swore never to go back to hospital. Two years later she had another severe attack and became unconscious. Her brother called an ambulance and she was taken to a nearby hospital where she died after unsuccessful medical treatment.

(Adapted from Annas.)
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Chapter
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Publisher: Cambridge University Press
Print publication year: 2011

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References

UK Department of Health website, MCA guidance includes information on Deprivation of Liberty Safeguards. www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/MentalCapacity/index.htm.
US hospital governance website. www.jointcommission.org/.
Alzheimer's Society website with information on mental capacity issues. www.alzheimers.org.uk.
Royal College of Nursing (UK). Let's Talk about Restraint. London, Royal College of Nursing, 2008. www.rcn.org.uk/_data/assets/pdf_file/0007/157723/0003208.pdf.

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