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Developing a Behavioral Box for Assessing Prepulse Inhibition and Neural Activity in Psychiatric Animal Models
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Homeless, Ill, and Psychiatrically Complex: The Grueling Carousel of Cassandra Lee

Laura Guidry-Grimes

    The Hastings Center Report
    |August 21, 2019
    PubMed

    Insights

    This case study highlights a patient with complex medical and psychiatric needs whose repeated hospitalizations reveal critical system failures. Addressing these systemic issues is crucial for improving patient care and ethical decision-making.

    Area of Science:

    • Clinical Ethics
    • Medical Sociology
    • Healthcare Systems Analysis

    Background:

    • A patient with a history of nonadherence and complex psychiatric issues presented for her thirtieth admission within a year.
    • The case involves challenges common in healthcare, including psychiatric comorbidities, treatment refusal, and end-of-life considerations.

    Observation:

    • The patient exhibited a pattern of removing medical devices (lines and tubes) and a aversion to standard comfort measures.
    • Her frequent admissions suggest a chronic, unresolved set of issues impacting her well-being.

    Findings:

    • The patient's suffering was directly linked to failures within the healthcare system, rather than solely individual noncompliance.
    • Ethically complex situations arose from the intersection of psychiatric illness, patient autonomy, and medical advice.

    Implications:

    • Highlights the need for integrated care models addressing both medical and psychiatric needs.
    • Emphasizes the importance of systemic improvements in patient management and ethical support for clinicians.
    • Suggests that patient suffering in such cases is often a symptom of broader healthcare system deficiencies.

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