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You be the Judge

1-Read the case study presented and answer the questions below:
You be the Judge: The patient was hospitalized for extreme low back pain so intense that he could not be scheduled for a magnetic resonance imaging (MRI) until his fifth hospital day. His physician explained to him that the Dilaudid and Ativan he would receive the next day to numb his pain for the MRI could cause respiratory depression or arrest in patients like himself who were on high doses of opiates. The patient agreed to be given the medications. At 8:15 A.M. the next day, a nurse gave the patient the medications, but the MRI had to be postponed. With the physician’s new orders and the patient’s verbal consent, the nurse gave a second dose of the same medications at 11:30 A.M. About 5:00 P.M., the patient became stuporous. Vital signs were taken, oxygen was initiated, and Narcan was prepared for injection. At 6:00 P.M., the critical care code team was called, as the patient was in full cardiopulmonary arrest. The patient was successfully resuscitated and was discharged the next day. The patient then sued, claiming residual psychological symptoms and failure to obtain valid informed consent for the second dosage of medications administered at 11:30 A.M.

• Was there informed consent for the initial medications given to the patient?
• How would you determine that informed consent had been given for the MRI and the medications needed for sedation for the test?
• Was the informed consent deficient to the degree that there was a lack of informed consent for the patient for the second dose of medications?
• How would you decide this case?

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