This case comes from Elaine Liu and Larissa Hattin.
Elaine Liu is a 4th-year medical student from the University of British Columbia, Vancouver Island site. Dr Larissa Hattin is a staff Emergency physician in Victoria, BC, Clinical Instructor at UBC and Simulation Director for the Victoria EM Residency Program.
Why It Matters
Intentional overdoses are common and require close attention to both the physical and mental health care of the patient. Mental health crises often complicate treatment and providers must be aware of their obligations and limitations of mental health laws in their jurisdiction. While many places require physicians to hold patients involuntarily for mental health assessment, compelling specific medical treatments involuntarily is much more fraught.
Clinical Vignette
A 25-year old man presents to the emergency department after intentionally ingesting a significant amount of acetaminophen. He says that he was trying to kill himself and remains irritable and resistant to treatment.
Case Summary
In this case, it is clear that the patient has taken an intentional overdose in an attempt to die but the physician must recognize both the physical and mental health aspects of the case and balance treating both while considering the legal and ethical aspects of involuntary medical care.
EM Sim Cases 