Problem
I. Scott is a 32-year-old man admitted to an acute psychiatric hospital for suicidal ideation in the setting of noncompliance with his psychotropic medications. Scott voluntarily presented to the hospital that he knew from many years of coping with his chronic schizophrenia as he was becoming increasingly psychotic. Scott is refusing to take the recommended psychotropic medications that the weekend staff prescribed. He has begun yelling and throwing medication cups back to the nurses stating, "You guys know you can't make me take this junk! This is what is made me crazy in the first place. Get the hell out of here before I call my lawyer." Scott's mental status has been fluctuating greatly, and you arrive to care for him. The medical team asks you to try to convince him to "be compliant" and take some medications to help get his condition back under control.
• What do you think about Scott's case? How can the team ensure informed consent in this patient?
• Can you ethically justify medicating Scott against his will? If so, explain.
II. Suppose you are asked to serve on a national commission to develop guidelines for informed consent for adolescents.
• What age do you think an adolescent should be viewed as capable of providing full and independent informed consent for treatment?
• What reasons do you have for your position on the matter?
• Why are these reasons important from the standpoint of the professional's liability? Of the adolescent patient's well-being?