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Case 7

An 89-year old resident in a long-term-care facility is referred by the doctor for physiotherapy for gait analysis and instruction on the use of appropriate assistive device(s). Ms Wong, PT enters the patient's room, introduces herself, and states that she is there to evaluate the patient's ambulation and make appropriate recommendations for assistive devices.

The patient is alert, listens to the brief informed consent disclosure information, and declines to proceed. Ms Wong repeats the disclosure information to the patient; she then asks for and satisfactorily answers the patient's questions about the proposed intervention. Finally, she asks the patient to "please reconsider and work with me to help you to walk". The patient shrugs her shoulders and agrees to commence the evaluation.

Does Ms Wong's imploring attitude constitute impermissible coercion of the patient?

Did Ms Wong breach the patient's right of autonomy to refuse treatment?

What should Ms Wong do, if after reiteration and imploring, the patient decline evaluation and therapy?

Answer