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18. Case: When the “Truth” is Painful
View Case Study: 18. Case: When the “Truth” is PainfulMrs. Sally Parrot, a 73-year old widow, has mild dementia of a presumed neurovascular type. She resides in her own small apartment in Serenity, a private continuing care community in Bedford, where she receives some assistance with housekeeping, meal preparation and organization of her medications. Sally is actively engaged in Serenity’s structured activities and, in…
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15. Case: Acceptable Judgement?
View Case Study: 15. Case: Acceptable Judgement?Sara Thornton, an unemployed 19-year old woman, lives with her 28 year old sister, Fran, and Fran’s boyfriend, Alan. Both sisters were diagnosed with bipolar I disorder in their mid-adolescence. They are both estranged from their alcoholic mother, the only living parent. Fran has learned to manage her illness reasonably well through lifestyle changes, participation…
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13. Case Mind Over Matter?
View Case Study: 13. Case Mind Over Matter?Essie Marshall is well-known in the community for her many years of dedicated volunteer work and leadership. She is also well-known in the emergency department for her frequent visits. As one of the doctors describes her, “She’s a challenging patient, but not in the medical sense.” Today Essie is back in the emergency department, saying…
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12. Case: Should Steve Go Home?
View Case Study: 12. Case: Should Steve Go Home?Throughout his life, Steve was the athlete that everyone admired. He played all sports well, especially excelling at basketball. While being quite competitive, Steve was a team player who enjoyed being a part of the team experience. Unfortunately, while ‘horsing around’ with his friends last summer, Steve dove off a dock into water that was…
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11. Case: Truth-Telling
View Case Study: 11. Case: Truth-TellingThe patient is an 89-year-old gentleman with moderate dementia and a history of COPD, swallowing difficulties, a CVA, and recent aspiration. The investigation of his aspiration uncovered a lesion in his lung- the physicians felt it was likely to be cancerous. Thoracic surgery verified that it was lung cancer and a determination was made that…
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9. Case: Right to Treatment
View Case Study: 9. Case: Right to TreatmentA 54-year-old male patient has been treated for cancer for 2 years, but his illness has not responded to the major lines of treatment. He has been admitted to hospital with worsening nausea and vomiting, abdominal pain, and failure to thrive. A CT scan showed progression of disease as evidenced by new ascites along with…
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8. Case: Who Should Decide?
View Case Study: 8. Case: Who Should Decide?This case concerns a 35-year-old developmentally delayed female patient (functional age about 5 years old); her mother is her legal guardian. The patient tested positive for a BRCA gene mutation. Her mother is concerned that her daughter may develop ovarian cancer and wants her to have preventive surgery. Her physician does not believe this is…
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6. Case: To Feed or Not to Feed?
View Case Study: 6. Case: To Feed or Not to Feed?You receive a call on the ethics line about a patient’s relative (next-of-kin and legal decision-maker) force-feeding her sister who is a patient on the unit (pushing food into the patient’s mouth and then holding her mouth closed, pinching her nose, etc. until she swallows). Apparently, this was not an uncommon approach to getting her…
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5. Case: Caring for a “Difficult” Patient
View Case Study: 5. Case: Caring for a “Difficult” PatientA female patient in her mid-forties has been on the GI service for several months now due to severe Crohn’s Disease, which has left her with multiple draining abdominal fistuli. She has recently moved out of the province but her condition could not be treated adequately in the local hospital so she was transferred back…


