South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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A woman with paranoid psychosis and terminal breast cancer refused palliative radiation, demanding pain-killers and permission to leave hospital to go into the mountains and die on her own. Was it ethical to allow her to do so, or should a court order have been sought to impose hospital treatment on her? Should she have been persuaded to accept hospital care? When do those in charge deem a terminally ill patient unable to understand the issues, and dictate treatment? Our aim in this article is to highlight a number of ethical matters regarding patient care, as well as to try and determine the role a hospice should play with regard to the terminally ill patient with associated psychiatric disorder.
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Case Reports
Quadriplegia following venous air embolism during posterior fossa exploration. A case report.
A frequent complication of posterior fossa exploration with the patient in the sitting position is venous air embolism. Spinal cord deficits following such a mishap have rarely been reported. We report a case in which a patient who suffered venous air embolism developed quadriplegia from the C6 level. The mechanisms of passage of air into the arterial system are discussed.