Thanks Rowley.... I am certainly aware of the
literature and the case you quote. My argument and
point was being made about the A&E setting
specifically. I was also trying to keep the issue as
simple as possible because in that situation one's
judgement requires a clear thought process.
That at the end of the day is what it comes down to. A
judgement call! I repeat....most of these cases will
respond to persuasion. A large proportion of the
others will be manipulative characters who are usually
well known to the service. Assessing capacity is a
complex affair and requires senior people to make
these judgement calls.
Giving doctors the impression that the law is waiting
to pounce and destroy them in such circumstances is a
little too much 'shroud waving' for me. I am much more
comfortable with the concept of detaining a tearful 18
yr old against her will because I do not believe she
has capacity (even if she trys to sue me afterwards)
then allowing her to die of liver failure.
I might get sued one day for this but it will probably
be once in a hundred blue moons.
Of course don't get the impression that I am not
worried about being sued. I just know its far more
likely to happen when ever I am trying to team lead in
a department which is horrendously busy and
understaffed with critical incidents ( depending on
how you define them)occurring at regular intervals. As
the Americans say...it comes with the territory!
Taj
=====
Dr Taj Hassan
Consultant in A&E Medicine
Dept of A&E Medicine
Leeds General Infirmary
Leeds LS1 3EX, UK
Work email: [log in to unmask]
Tel : (0113) 392 6470 Fax : (0113) 392 2810
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