House MD-informed consent
assalamualaikum..peace be upon you..
i keep counting on days for me to finish my last paper for this final examination 2008-Psychology..even its seems “ala..kacang jer..u jwb based on knowledge yg u dah ade”..thats not my word,but my friends owned it..hehe..but its actually need lots of effort to grasp and hold every knowledge gathering it..i like psychology and i never underestimated it..learning psychology make yourself know about the exact way how to deal with the individual patient and society surrounds you..so,please don’t burden yourself while studying this course..it’s kind of amazing piece of science art..kind a cool precious course related to human psichophysiology..
i did my own research just now about informed consent by ‘telescoping’ House MD movie-season 3-informed consent..the story told me about the real condition occuring to this principle. Ezra Powell who is a retired physician and was currently doing researches about enhancing and remodified the fruitful knowledge of medicine in his textbook and apparently to publish them for all the medical students all over the world..every doctors look him through great aspiration and admiration especially Dr Cameron.
first,after doing a differential diagnosis(DD) on Dr Powell,the team tend to do some stress test on him referring to that the amount of fluid in his lungs and made him susceptibility to breath properly..but then,they found nothing on that stress test..Dr Powell is an old man..he was realized that life could’nt do anything for him..he thought that he might die rather than living in agony..then,he told Dr Cameron about his intention..for a moment,of course Cameron was schock!unbelievable about what his saying..eventually,he told the teammates..
What do you think Dr House’s action when he heard this terrible news?
fine..i got it! Dr Chase gave his brave idea..he suggested that injecting the morphine to the patient will lead him to die..that’s the only way to let him die..but oh no!there’s a risky way that we call it KILLING a patient right?we dont want to kill the patient eventhough the patient itself refused to get any treatment anymore..but Dr Chase got his theory..he said that in medical ethical principle..not to harm or non-malificence has to mean allowing nature to take its course not stubbornly standing in the way of it..but Dr Foreman disagree..he said”injecting the patient with morphine and let him die do not mean the nature took it..but we kill him”..
the trail of the story was so hillarious and made me wondered..hmm..finally Dr House get into his considerable action by making a deal with the patient-Dr Powell..the deal was- they need 24 hours to do the test on him and confirmed his disease and find a treatment on it..but alas..finally,they found nothing..Dr House on his way trying to get another consent from the patient to make more test on him..for me it was a tortorus manner for the old guy like him..but never mind..Dr House know well..Dr Powell refused to do more test on him instead he wanna die..he kept asking from the team to discharge him and let him die peacefully..
so,what was happened next?
Dr House did something againts rules..in fact,he wanted to save this patient-his admiration,Dr Powell..so,he used to make something illegal-because its againts with the consent of the patient-the patient himself didnt want to have any treatment and wanna die..but due to highly respectation to Dr Powell,House has to do something prohibited..he seduced Dr Powell and putting him in a coma..so that he can do whatever test to that patient..but hopelessly,they found nothing..
what a story right?..Dr House actually has his own reason why he act like that..”what we give,we get back”..this is because Dr Powell during his practise as a physician long time ago,he had make something iilegal in medical practise..he wrote on his medical journal about radiating the infant without informed consent from the parents first and to no surprised,he discovered technique that prevent fatal kidney failures in hundreds of thousands of other kid..so,who are actually supposed to be blamed off?
the end of the story..eventually,they found the disease that attacking Powell and made him miserable-amylaidosis..but they were late because he was in a terminal stage..and the ECG turns——— (long straight line,you know what i mean right?)
so,to be summarize,informed consent is widely practising in medical field nowadays..with development and advancing facilities of medical perspective,informed consent has been used totally in the patient that are fully informed and can participate in choices about his health care..
valid informed consent requires satisfying three essential elements:
1. the patient should be fully informed about the nature of his condition(diagnosis),the nature of the proposed treatment,the prognosis and the reasonable alternatives to the proposed treatment..
2.the patient should be competent to make a decision with rational judgement without influence from outsiders
3.the patients decision should be voluntary-not under pressure and irrationality..
Exception to the requirement of informed consent
1.emergency situation which a patient in unconscious state.
2.incompetency to make decisions such as the patient is a child or his cognitive capacity is impaired.
3.cases in which fully informed the patient would seriously worsen his condition.