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Forcible Amputation in Delusional Patients: A Narrative Analysis of Decisional Capacity
- Narrative Inquiry in Bioethics
- Johns Hopkins University Press
- Volume 9, Number 3, Winter 2019
- pp. 247-257
- 10.1353/nib.2019.0059
- Article
- Additional Information
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Abstract:
This case study concerns the predicaments faced by two women who each had been advised by her physicians to have a gangrenous foot amputated to prevent the potentially fatal spread of infection. In both cases, the determination of the patients' decisional capacity was a critical component in judging whether or not to honor their medical treatment decisions. The communicative complexity of navigating a double bind, a situation in which a person confronts a choice between two undesirable courses of action, is also discussed. The patients in these cases had no medically appropriate choice that also respected other valued outcomes, such as independence, a sense of dignity, or control over one's destiny. Taken together, these cases raise issues about the context-specific meaning of decisional capacity and its role in informed consent.