MENTAL 2

The doctor who was admitted against his will

Physician: This was a doctor who was suffering from a mood disorder. His wife, who had two
children, came and saw me in the OPD. She complained that her husband was spending money,
wandering about and had sexual relationship with other women. There was an unacceptable
behaviour and sometimes he had aggressive outbursts. She believed that her husband was not in a
normal condition. She said that her husband, being a doctor, would never accept that he had a
psychiatric problem. Earlier, she had come to our ex-professor at his private clinic without the
patient. She had received some medication for him from that medical doctor, but her husband never
took the prescribed medicine, even though she tried to hide the medicine in the meals he took.
Questions
Q Think about this case. Do you think it was justified to attempt to give medicine in this
secretive way in this case?
Q Consider the fact that the patient had not been medically examined and the possibility that
the wife might want to avenge her husband's extramarital affairs. Discuss various options
and identify their ethical implications.

Physician: When she came to me she said that her husband could not be managed at home and
that he needed admission. First I had to see the patient. She had to bring the patient to me at the
OPD. After having talked with the patient, and depending on his condition, I might admit him. She
said that he would never come and see the psychiatrist in that environment, because he said he had
no illness. But I said to his wife, "With any kind of action you must take the patient to me to see and
interview him."
She then discussed with her brother-in-law and they told her husband that she was in a state of
depression, and that he should discuss her treatment with the doctor in that hospital. Then the
patient - that doctor - he drove in his car to the OPD and saw me and discussed about his wife. He
said that he would consent to do anything on his wife, including ECT (Electro-Convulsive Therapy).
After talking about fifteen minutes with him I found that he was suffering from a little bit of mood
disorder and hypomania. But I never said directly to him that he was suffering from a mental illness. I
told him to see his wife in the hospital ward. This was not actually true. I told him to discuss about his
wife with the ward staff and Medical Officer concerned. I sent him to the ward along with the ward
attendant and his brother. In the ward, he was physically and chemically restrained by the staff.
Questions
Q Discuss the indication for admission of this patient against his will. Do you find this
procedure ethically justifiable in this case? Why/why not?