Ethics for Lunch Discusses Decision-Making Capacity and Mental Illness

The monthly Ethics for Lunch discussion used a case in which a young man with a complex history of mental illness is refusing treatment for a blood infection as the basis for a broader discussion of decision-making capacity and mental illness.

The healthcare team is concerned about how to manage his care if he were to go into septic shock after having refused the needed interventions. Given the background of his mental illness and past self-injurious behavior, they request an ethics consult to discuss whether they would be obligated to allow him to die or if it would be ethically permissible to go against his wishes and treat him once he lost decision making capacity.