End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer
Medical practitioners are confronted daily with decisions about patients’ capacity to consent to interventions. To address some of the pertinent issues with these assessments, the end-of-life decision-making capacity of a 72-year-old female with treatment-resistant schizophrenia and terminal cancer...
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| Format: | Article |
| Language: | English |
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AOSIS
2020-08-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/5111 |
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| author | Carla Kotze Johannes L. Roos |
| author_facet | Carla Kotze Johannes L. Roos |
| author_sort | Carla Kotze |
| collection | DOAJ |
| description | Medical practitioners are confronted daily with decisions about patients’ capacity to consent to interventions. To address some of the pertinent issues with these assessments, the end-of-life decision-making capacity of a 72-year-old female with treatment-resistant schizophrenia and terminal cancer is discussed, as are the role of the treating clinician and the importance of health-related values. There is a recommendation that the focus of these assessments can rather be on practical outcomes, especially when capacity issues arise. This implies that the decision-making capacity of the patient is only practically important when the treatment team is willing to proceed against the patient’s wishes. This shifts the focus from a potentially difficult assessment to the simpler question of whether the patient’s capacity will change the treatment approach. Clinicians should attend to any possible underlying issues, instead of focusing strictly on capacity. Compared to the general populations people with serious mental illness (SMI) have higher rates of physical illness and die at a younger age, but they do not commonly access palliative care services. Conversations about end-of-life care can occur without fear that a person’s psychiatric symptoms or related vulnerabilities will undermine the process. More research about palliative care and advance care planning for people with SMI is needed. This is even more urgent in light of the coronavirus disease-2019 (COVID-19) pandemic, and South African health services should consider recommendations that advanced care planning should be routinely implemented. These recommendations should not only focus on the general population and should include patients with SMI. |
| format | Article |
| id | doaj-art-6bcb5c3276c945b2af83f93bdec8ec06 |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-6bcb5c3276c945b2af83f93bdec8ec062025-08-20T03:43:58ZengAOSISSouth African Family Practice2078-61902078-62042020-08-01621e1e410.4102/safp.v62i1.51114062End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancerCarla Kotze0Johannes L. Roos1Department of Psychiatry, Weskoppies Psychiatric Hospital, University of Pretoria, PretoriaDepartment of Psychiatry, Weskoppies Psychiatric Hospital, University of Pretoria, PretoriaMedical practitioners are confronted daily with decisions about patients’ capacity to consent to interventions. To address some of the pertinent issues with these assessments, the end-of-life decision-making capacity of a 72-year-old female with treatment-resistant schizophrenia and terminal cancer is discussed, as are the role of the treating clinician and the importance of health-related values. There is a recommendation that the focus of these assessments can rather be on practical outcomes, especially when capacity issues arise. This implies that the decision-making capacity of the patient is only practically important when the treatment team is willing to proceed against the patient’s wishes. This shifts the focus from a potentially difficult assessment to the simpler question of whether the patient’s capacity will change the treatment approach. Clinicians should attend to any possible underlying issues, instead of focusing strictly on capacity. Compared to the general populations people with serious mental illness (SMI) have higher rates of physical illness and die at a younger age, but they do not commonly access palliative care services. Conversations about end-of-life care can occur without fear that a person’s psychiatric symptoms or related vulnerabilities will undermine the process. More research about palliative care and advance care planning for people with SMI is needed. This is even more urgent in light of the coronavirus disease-2019 (COVID-19) pandemic, and South African health services should consider recommendations that advanced care planning should be routinely implemented. These recommendations should not only focus on the general population and should include patients with SMI.https://safpj.co.za/index.php/safpj/article/view/5111end-of-lifedecision-making capacityolder peopleserious mental illnessschizophrenia |
| spellingShingle | Carla Kotze Johannes L. Roos End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer South African Family Practice end-of-life decision-making capacity older people serious mental illness schizophrenia |
| title | End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer |
| title_full | End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer |
| title_fullStr | End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer |
| title_full_unstemmed | End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer |
| title_short | End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer |
| title_sort | end of life decision making capacity in an elderly patient with schizophrenia and terminal cancer |
| topic | end-of-life decision-making capacity older people serious mental illness schizophrenia |
| url | https://safpj.co.za/index.php/safpj/article/view/5111 |
| work_keys_str_mv | AT carlakotze endoflifedecisionmakingcapacityinanelderlypatientwithschizophreniaandterminalcancer AT johanneslroos endoflifedecisionmakingcapacityinanelderlypatientwithschizophreniaandterminalcancer |