- Preface
- Contributors
- 1 “Send Me the Pictures”: Patient Confidentiality in a Digital World
- 2 EMTALA and Deferred Care
- 3 Assessment of Decision-Making Capacity
- 4 “Thanks, But No Thanks!” Patient Refusal of ED Diagnosis and Treatment
- 5 On the Edge of Death—To Intervene or Not
- 6 Who Decides?
- 7 Saving Grandpa?
- 8 Failed Suicide Attempt in the Terminally Ill
- 9 Self-Inflicted Gunshot Wound/Self-Reported No Code Status: The Doctor’s Dilemma
- 10 Hide and Seek
- 11 The Drunken Drug Lord
- 12 No Country for Sick Men
- 13 The Reluctant Consultant
- 14 Managing Bias and Belligerence
- 15 Very Important Patients
- 16 Frequent Flyer
- 17 “12/10” Abdominal Pain
- 18 Fear and Loathing in the ED: When Staff Are Afraid to Provide Compassionate Care
- 19 Everyday J.
- 20 “I Want a Baby, But Not With Him”
- 21 Risky Behavior
- 22 Little Secrets, Big Lies
- 23 Like, Comment, Post . . . Lawsuit?!
- 24 An Industrial Accident
- 25 Doctors Police Your Own Expert Witness Testimony
- Index
(p. 65) Self-Inflicted Gunshot Wound/Self-Reported No Code Status: The Doctor’s Dilemma: Suicidal Patients
- Chapter:
- (p. 65) Self-Inflicted Gunshot Wound/Self-Reported No Code Status: The Doctor’s Dilemma: Suicidal Patients
- Author(s):
Raquel M. Schears
and Markayle R. Schears
- DOI:
- 10.1093/med/9780190066420.003.0009
Suicidal ideation and attempted suicide are important presenting complaints in the emergency department (ED). The juxtaposition of a self-inflicted gunshot wound and self-reported no code status may serve to amplify the moral distress of attending emergency providers. Imagine caring for a terminal yet capable patient, who independently attempts suicide unsuccessfully and is brought to the ED with an advance directive (AD) requesting no treatment. The exceptional consideration in this suicidal context is whether the treatment can be effective. In a case with a very low likelihood that any intervention could produce a good outcome, clinical judgment becomes the basis for withholding or withdrawing treatment, not the AD.
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- Preface
- Contributors
- 1 “Send Me the Pictures”: Patient Confidentiality in a Digital World
- 2 EMTALA and Deferred Care
- 3 Assessment of Decision-Making Capacity
- 4 “Thanks, But No Thanks!” Patient Refusal of ED Diagnosis and Treatment
- 5 On the Edge of Death—To Intervene or Not
- 6 Who Decides?
- 7 Saving Grandpa?
- 8 Failed Suicide Attempt in the Terminally Ill
- 9 Self-Inflicted Gunshot Wound/Self-Reported No Code Status: The Doctor’s Dilemma
- 10 Hide and Seek
- 11 The Drunken Drug Lord
- 12 No Country for Sick Men
- 13 The Reluctant Consultant
- 14 Managing Bias and Belligerence
- 15 Very Important Patients
- 16 Frequent Flyer
- 17 “12/10” Abdominal Pain
- 18 Fear and Loathing in the ED: When Staff Are Afraid to Provide Compassionate Care
- 19 Everyday J.
- 20 “I Want a Baby, But Not With Him”
- 21 Risky Behavior
- 22 Little Secrets, Big Lies
- 23 Like, Comment, Post . . . Lawsuit?!
- 24 An Industrial Accident
- 25 Doctors Police Your Own Expert Witness Testimony
- Index
