[Problem of patient's consent to surgical treatment in life-threatening situations]

A case of a self-injury in a 19-year man is presented. The patient stabbed his thorax with a needle (a wire 9 cm long) which penetrated the right lung near the heart. The patient did not agree to the operation. Left cardiac auricle laceration with hemothorax and pericardial tamponade developed within 13 days. The authors suggest immediate surgery despite patient's disagreeing or even rebel in all situations threatening the lives of the prisoners or convicts. Two ++sub-periods might be distinguished in the above mentioned situation: (a) potential, and (b) real life-threat. Surgery should have been performed in the potentially life-threatening ++sub-period in this particular patient.