Tomorrow morning I am scheduled to fix a broken hip on a woman who is demented and the family cannot be reached. This puts the doctor in the awkward position of deciding if the show must go on, or do we wait for a family member or a court to say go ahead. As physicians we like to share our concerns and be sure the patient and family understand the risks and benefits-as well as why this is the right thing to do.
Surgeries are often delayed waiting/ struggling to get consent and actually increase the risks of complications. The are both ethical and legal implicationsAlso, some scientists claim that Vinpocetine is viagra 100 mg important for boosting your memory retention force, especially for people who are on weight loss program. It boosts strength and improves general debility naturally without inducing http://valsonindia.com/investor-relations/ discount cialis any adverse action on user. Be the reason for putting one in a pre-diabetic state – making one viagra in india online feel hungry even after having already eaten. Overcoming ED with Kamagra Impotence When it comes to treating erectile dysfunction, although there are other treatments such as penile implants, vacuum devices and vascular surgery. tadalafil online australia . So I ask the question: who should we ask? Is it enough knowing the urgent surgery is the standard or care, or do we need something more? I welcome your thoughts.
This is an unresolved and under-examined problem.
I tried to outline some answers in a recent NEW ENGLAND JOURNAL OF MEDICINE perspective piece.
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2355937
I also examined the issue more thoroughly here:
http://www.ncbi.nlm.nih.gov/pubmed/22822709
Dear Mr. Pope:
Thanks for your comments and the references. This is a very challenging problem. As a physician and surgeon, I want to do the right ethical thing for my patients. The standard of care, in some cases, is to proceed with a surgical procedure, and I feel justified in doing so for the ‘good of the patient’ as I would do it for my own family member, and yet still feel uneasy as the decision to do so becomes solely mine and a colleague – 2 physician consent. Complex questions come up: What happens when the patient becomes coherent a few weeks or months later and asks ‘why did you do that?’ I would greatly appreciate the chance to read both articles in their entirety and welcome any other thoughts you may have from your expertise on the topic. Thanks again. Your ideas and writings are much appreciated.