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081103L - CASE ANALYSIS: AWANG ROSLI

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Background material by Professor Omar Hasan Kasule Sr. for Year 1 Semester 1 Med PPSD session on 03rd November 2008


Background
Awang Rosdi a soldier was admitted to the psychiatric ward of RIPAS Hospital for psychiatric observation and treatment after threatening to shoot his colleagues at the army base. He has been known to be a case of paranoid schizophrenia for many years but the army did not discharge him because he was the military band leader and there was yet no replacement. While on the ward he developed a chronic cough. He refused to provide a sample of sputum or undergo any form of examination. He refused all treatment suspecting the doctors of attempting to give him poison in the form of medicine.  The doctors put a sedative in his drink and while under sedation took him for chest x-ray. They started him on treatment for tuberculosis the drug being hidden in either his food or his drink. Meanwhile the army started proceedings about discharging him and asked the hospital to provide a report on his condition. Awang Rosdi suspecting the army to be plotting against him refused to agree to the release of information.

Discussion
  1. List ethico-legal issues arising in this case;
  2. Discuss whether the patient is competent to make autonomous decisions about his treatment and mention the criteria you use;
  3. What would be your response to a request by army authorities to provide information about the soldier’s treatment.