Ethical Debate: Case history: head injury and drunkenness

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Abstract
Authors' comment The main subject for debate is whether this patient was competent to make a reasonable decision regarding the need for admission, observation, and possible further investigations. He had probably ingested alcohol, had sustained a skull fracture in a fall, and had presented with abnormal behaviour. Such a patient is at considerable risk of developing an intracranial haemorrhage or of having sustained cerebral contusions. Should this patient have been held against his will for observation, or sedated until he became compliant, or was he competent to make the decision to discharge himself? He was clearly not suffering from a psychiatric illness that would warrant a compulsory admission order. Should this patient have been physically restrained against his will in the accident and emergency department or on the ward?

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