Razzak Aymun M, Mallya Meghan, Abdelaziz Omar, Miller Michael
Department of Psychiatry, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus. 2024 Oct 5;16(10):e70905. doi: 10.7759/cureus.70905. eCollection 2024 Oct.
Psychiatric care often presents ethical challenges, particularly when patients with severe mental illness refuse essential treatment. This case report examines the ethical complexities surrounding covert prescribing in a noncompliant psychiatric patient. A 54-year-old male with schizophrenia, admitted following an auto-pedestrian accident resulting in multiple fractures, illustrates these dilemmas. His refusal of medication despite experiencing severe psychosis led healthcare providers to administer antipsychotics covertly, with the consent of his medical power of attorney. The report explores the ethical implications of such practices, especially concerning patient autonomy and safety. It underscores the urgent need for interdisciplinary collaboration and the establishment of standardized guidelines to ethically navigate covert prescribing in psychiatric patients.
精神科护理常常带来伦理挑战，尤其是当重症精神疾病患者拒绝必要治疗时。本病例报告探讨了一名不配合治疗的精神科患者进行秘密给药所涉及的伦理复杂性。一名54岁患有精神分裂症的男性，在一场导致多处骨折的汽车与行人碰撞事故后入院，这一案例体现了这些困境。尽管他患有严重精神病，但仍拒绝服药，这使得医疗服务提供者在其医疗授权代理人的同意下，秘密给他服用了抗精神病药物。该报告探讨了此类做法的伦理影响，尤其是在患者自主权和安全方面。它强调了跨学科合作以及制定标准化指南以在伦理上指导对精神科患者进行秘密给药的迫切需求。
