case study #2 beneficence & non-maleficence sandra brownstein, pharmd marianne mccarthy, phd,...
TRANSCRIPT
CASE STUDY #2
BENEFICENCE &NON-MALEFICENCE
Sandra Brownstein, PharmDMarianne McCarthy, PhD, GNP
Sue Sisley, MDLori Waldberg, LCSW
CASE #2
• CD, 76 yo widowed female with severe chronic paranoid schizophrenia along with major depression (schizoaffective disorder)
• Presents to office with son, who has concerns about treatment regimen
• Has developed several new medical conditions prompting new management options
CASE #2 (cont.)
• New conditions include:• Diabetes• Coronary artery disease• Hyperlipidemia• Essential tremor• Uterine cancer• Hypothyroidism
CASE #2 (cont.)
• Has been on lithium for decades• Primary care physician (PCP) and
consultants have recommended:– Thiazide diuretic– Anti-platelet agent– Diabetes medication– Cholesterol medication– Thyroid replacement– Anti-tremor medication (beta-blocker)– Total hysterectomy
CASE 2 – QUESTION #1
CD is incompetent1. TRUE2. FALSE
CASE 2 – QUESTION #2
Only a psychiatrist can assess CD’s capacity to make decisions regarding her medical care
1.TRUE2.FALSE
CASE 2 – QUESTION #3
Only a psychiatrist can assess CD’s capacity to make decisions regarding her psychiatric care
1.TRUE2.FALSE
CASE 2 – QUESTION #4
Goals of care questions should include:1.Adherence/compliance concerns2.Beneficial effects of
medications/surgery3.Financial cost of treatments4.Side effects of medications
CASE 2 – QUESTION #5
Potential complications of the new recommendations include:
1.Drug-disease interactions2.Drug-drug interactions3.Peri-operative complications4.All of the above
CASE 2 – QUESTION #6
The psychiatric treatment option with the smallest side effect burden is:
1.Anti-depressant medication2.Anti-psychotic medication3.Electro-convulsive therapy4.Mood stabilizer medication
CASE 2 – QUESTION #7
The medical treatment option with the smallest side effect burden is:
1.Cholesterol medication2.Diabetes medication3.Diuretic4.Surgery5.Tremor medication
CASE 2 – QUESTION #8
CD’s most likely cause of death will be:1.Cerebrovascular accident (stroke)2.Coronary artery disease (heart
attack)3.Schizophrenia
(accident/homicide/suicide)4.Uterine cancer