The topic for this weeks discussion is informed consent and competence. Review the three elements of informed consent pages 90-92, the assessment of patients competence on page 99, and informed refusal page 100. Case Scenario: A Medicaid patient has confided in the nurse that he took an illegal drug prior to being admitted because he was nervous about the surgical procedure he is to undergo. The patient has a history of mental illness related to his drug abuse. At present, he is not acting inappropriately, but now he is having second thoughts about undergoing the procedure. The nurse is concerned about the effects of the drug when mixed with the psychiatric medications. Can the patient sign an informed consent form? How would you test the patients competence? Can the patient sign themselves out against medical advice (AMA)?
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