Refusal of medical assistence – Case report of fatality in an HIV- infected drug user and some reflections
Keywords:
Refusal of medical assistance, drug abuse, HIV infection, ethical and social perspectiveAbstract
The Authors rep he Authors report the case of a female HIV-infected drug user
who presented to the Emergency Room with irreversible septic
shock. This young woman had been an irregular outpatient and
attended a local center for drug rehabilitation on a daily basis, as
part of a methadone maintenance program. In spite of all medical
recommendations given, and her complete understanding of the
illness, she failed to attend scheduled appointments and complementary diagnostic tests, compromising any further treatment,
until the fi nal event. The AA.s refl ect on the refusal of medical
assistance and the problem of drug abuse, from an ethical and social perspective.
Downloads
References
Carta dos Direitos e Deveres dos Doentes. Direcção Geral da Saúde. 2002.
Barreto J. Doença psíquica. In Archer L, Biscaia J, Osswald W Eds. Bioética, Verbo, Lisboa. 1996.
World Psychiatric Association: Declaration of Madrid, 1996; http: // www.wpanet.org / madrid. htm.
Medical College of Georgia. Informed consent and confidentiality, 2000; http://www.mcg.edu//gpi/Ethics/ph2syllabus/lessons/lesson 3.htm.
Beauchamp TL, Childress JF. Principles of Biomedical Ethics, 4th Ed. 1994, Oxford University Press.
Roque Cabral. Ética e Religião. In Archer L, Biscaia J, Osswald W Eds. Bioética. Verbo, Lisboa. 1996.
Jonsen AR, Siegler M, Winslade WJ. Recusa competente de tratamento. In Ética Clínica. Uma Abordagem Prática de Decisões Éticas em Medicina Clínica, 4ª Ed. 1999, McGraw-Hill, Lisboa.
Layon AJ, Franklin C. Enigmatic refusals: the difference between a potential problem and one in a patient under our care. Chest 2004; 126 (2): 337-339.
Poças J. A Problemática da Infecção HIV nos doentes toxicodependentes. Rev Port Doenças Infecciosas 2000; 23 (3): 102-108.
Gonçalves Pereira J, Bentes de Jesus M. Toxicodependentes internados numa enfermaria de Medicina Interna: relato de uma experiência. Medicina Interna (Portugal) 2004; 11 (2): 75-81.
Anis AH, Sun H, Guh DP et al. Leaving hospital against medical advice among HIV-positive patients. CAMJ 2002; 167 (6): 633-637.
O’ Connor PG, Selwyn PA, Schottenfeld RS. Medical care for injection-drug users with Human Immunodeficiency Virus infection. N Engl J Med 1994; 331 (7): 450-459.
Rabkin JG, Jonhson J, Shu-Hsing L et al. Psychopathology in male and female HIV-positive and negative injecting drug users : longitudinal course over 3 years. AIDS 1997; 11: 507-515.
MacGowan RJ, Brackbill RM, Rugg DL et al. Sex, drugs and HIV counselling and testing: a prospective study of behaviour-change among methadone-maintenance clients in New England. AIDS 1997; 11: 229-235.
Langendam MW, Van Brussel GHA, Coutinho RA et al. Methadone maintenance treatment modalities in relation to incidence of HIV: results of the Amsterdam cohort study. AIDS 1999; 13: 1711-1716.
Moatti JP, Carrieri MP, Spire B et al. Adherence to HAART in French HIV infected IDU : the contribution of buprenorphine drug maintenance therapy. AIDS 2000; 14: 151-155.
Bluthenthal RN, Kral AH, Gee L et al. Effect of syringe exchange use on high-risk injection drug users: a cohort study. AIDS 2000; 14: 605-611.
Sarmento Castro R, Sousa Barros A, Gonzalez J et al. Tuberculose em doentes com SIDA. Tratamento completo sob observação directa. Rev Port Pneumol 2001; VII (2): 289-296.
Woods JW, Guydish JR, Sorensen JL et al. Changes in HIV- related risk behaviours following drug abuse treatment. AIDS 1999; 13: 2151-2155.
French MT, Mcgeary K, Chitwood DD et al. Chronic illicit drug use, health services utilization and cost of medical care. Soc Sci Med 2000; 50
(12): 1703-1712
Additional Files
Published
How to Cite
Issue
Section
License
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna