A 56-year-old university lecturer has been diagnosed with inoperable lung cancer and has been admitted to an oncology ward to receive intensive radiotherapy. He also had an episode of psychosis in his 20s which required him to be sectioned under the Mental Health Act. Fortunately, following this episode he has remained well and has had […]
A 27-year-old man with schizophrenia, is admitted with severe psychosis which is manifested by auditory hallucinations telling him to harm himself. He has refused antipsychotic medication in the community and has been sectioned for treatment of his mental disorder under Section 3 of the Mental Health Act (MHA). During his admission he develops pneumonia, requiring […]
Robson is in his 40s and has paranoid schizophrenia. He has been assessed to lack capacity with respect to decision making about treatment for his condition. Over the past 20 years he has been detained under Section 3 of the Mental Health Act (MHA 1983, as amended 2007) many times but has never gained insight […]
A 27 and lives at home with her parents and younger brother. She studied anthropology at university and had been in a long-term relationship. After leaving university with a good degree, she struggled to get a job. She eventually found work in a restaurant, which she seemed to enjoy. Last year her boyfriend moved out […]
You are doing a home visit with the hospice nurse to a patient who has advanced metastatic pancreatic cancer. You have been asked to visit with the hospice nurse to provide support to the patient whilst difficult decisions are discussed. You are aware that the patient has recently refused to see both the gastroenterology consultant […]
You are an FY2 doctor on your 4-month cardiology rotation. You are coming to the end of a long day shift on the ward. One of your patients is a diabetic suffering from heart failure. As listed on the drug chart, you give him his evening dose of insulin, but you forget to record this […]
An FY1 doctor is on her orthopedic surgery rotation. Over the past week, she has noticed that her registrar frequently turns up late and has often not shaved. He has a reputation for enjoying a good night out and has occasionally turned up with a hangover. However, the FY1 is concerned that there are incidents […]
This FY1 doctor is currently on call on a night shift in a busy hospital. An FY2 and a registrar are working alongside him. FY1 is midway through his shift when he receives a bleep saying that he is required to take an arterial blood gas (ABG) from a new admission. The patient is a […]
This patient was very excited to be pregnant with her first child but was not having an easy pregnancy. She is naturally petite and had developed gestational diabetes, which was not detected until 30 weeks into her pregnancy. She was then referred to a specialist obstetrician as her pregnancy was considered high risk. As this […]
The resident is on a busy ward round with his consultant. The round is post-take and he has seen 23 patients so far. One of his patients is septic and needs a prescription for intravenous antibiotics. The consultant tells this resident to put him on ciprofloxacin. However, the resident MD is aware that the hospital […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director