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Ethical dilemmas in drug treatments

Published online by Cambridge University Press:  02 January 2018

Peter Tyrer
Affiliation:
St Charles Hospital, Exmoor Road, London W10 6DZ
Jeanette Smith
Affiliation:
Fromeside Clinic, Blackberry Hill, Bristol BS16 1ED
Gwen Adshead
Affiliation:
Department of Forensic Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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A 45-year-old woman with a long history of schizoaffective symptoms associated with disruptive and antisocial behaviour refused to cooperate with out-patient treatment and particularly medication, having developed a strong distrust of psychiatrists. After discussions with the multidisciplinary team, the psychiatrist agreed to share treatment decisions with the patient and accepted her refusal of medication. This course of action is not always comfortable for professionals, especially when a patient challenges clinical judgement. However, this case illustrates how, by adopting a less paternalistic approach, the therapeutic alliance developed and, most importantly, the patient's health improved. The scenario described raises similar issues to those explored in the play Whose Life Is It Anyway?

Type
Original papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1994
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