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What ethical and legal obligations interplay when a patient admits to mild memory lapses ...

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#1 Mon, 02/10/2014 - 14:37
Jean-Pierre Leung

What ethical and legal obligations interplay when a patient admits to mild memory lapses ...

What ethical and legal obligations interplay when a patient admits to mild memory lapses but claims good function, persistently refuses cognitive tests and imaging, yet spouse and children claim the patient is decompensating? Jean-Pierre (JP) Leung
Thu, 02/13/2014 - 07:28
Michael Gordon

memory problems noted but individual refuses investigation

This is quite a common problem. One cannnot force individual's to undertake medical investigations against their wishes. The only mandatory obligations physicians have is for example the motor vehicle act. So if from the family's history it appears for example that there might be risks in driving the physician can let the patient know that he will be reported to the MOT based on family's history-- that may motivate the patient to come for a proper assessment in the hope of avoiding such a report. If there is evidence of risks- such as fire that too could result in a request for an in-home assessment but that is not as easy to do unless the risk is material. If the patient comes to the doctor the art of discussion and negotiation must be employed and often one can get a very good idea about cognitive function without much formal investigations but by the discussion in the office including current events- imgaging is not required to make a tentative diagnosis of cognitive impairment. Hope this is helpful.
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