Ethics in the ER

My recent experience on call in the ER the other night prompts me to offer the following scenario:

The patient is a 40-year-old, mildly mentally retarded woman accompanied by an employee from the group home where she lives.  You decide to conduct the interviews separately.

The patient claims to be pushed and choked by the group home staff.  It is somewhat difficult to understand her speech presumably due to complications of Down syndrome, but her nodding and response to your questions seem to indicate she comprehends the conversation fully.

The group home staff member claims the resident throws tantrums, yells loudly, and for the most part makes life difficult for others.  She claims she never laid a hand on anyone.

What do you do?

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Steve Phillips

I would do several things. Find out why the patient was brought to the ER. Ask the staff member of someone else may have harmed the patient (she may be telling the truth that she did not harm the patient, but neglecting to tell all she knows). Examine the patient for any evidence of trauma that would confirm what she is saying or confirm whatever other reason is given for why she was brought in. If there is still concern that she may have been mistreated get the appropriate social service agency involved in evaluating the patient’s care in the… Read more »