I was recently involved in a multidisciplinary team evaluation of a patient who attempted suicide by placing a shotgun in his mouth. He survived the attempt but was left with only half a face. I was consulted as my department does advanced 3D imaging work to include prosthetic reconstruction of such profound defects.
As I was sitting in this team meeting a question was raised by a social worker on the visitation rights for his wife. The social worker reported that this woman had been married twice before and both previous husbands had successfully committed suicide. This was husband number 3 who had survived his suicide attempt and the wife wanted to visit her husband to "comfort" him.
The question raised to the care team was the wife a danger to her husband knowing the general history as outlined above. We were not privy to all the details but there was some suspicion that the patient's wife may have been a contributing factor to the suicide attempt. I was surprised to see that the care team had differing opinions on this matter that pretty much split down gender lines. I found this interesting.
The men on this particular care team felt that visitation for the wife should be carefully monitored until it could be determined that the wife was not a contributing factor to the patient's suicide attempt. The women on the care team felt that since she had not been arrested by law enforcement that the question was irrelevant. In fact one member stated that perhaps the only thing she is guilty of is making bad choices. It wasn't her fault that the men she chose to marry kept killing themselves.
Since this BB is a wonderful place to sample such diverse, well educated and experienced opinion I thought it would be an interesting case study to present.
ok...i'm thinking innocent until proven guilty. unless there is some legal action that is in the process of barring her visitation who can dissallow her visits? she is legally his wife.
How many Doctor's orders have you seen to restrict visitors? I believe there is some kind of duty to protect the patient from potential harm if the patient consents. If the patient can't consent then the issue becomes a bit more complicated.
An abuser can smell the weakness in a person. They hunt just like any other preditor. if you need more proof that she at least contributed to his suicide attempt. the fact that she cleaned out the bank account and ran off should do it. But without proof how could you deny a wife acess to her husband
This patient care case study presented some interesting challenges and decision making that involved the principles of ethics, duty and law. As you can see by the many responses many individuals had radically different views on how best to approach this problem. Of course there were others who thought it best to avoid the issue entirely.
We all have choices in our lives and daily practice. It is not always easy making the "right" choice but as you can see there are consequences to the choices we make in both our professional and personal lives.
I wish I could answer all your questions but the facts as I know them are there before you to read and ponder. The point of this anecdotal case study was to make us think about the choices we make in our professional and personal lives. I hope I have achieved that.
statistical analysis- what are the chances that 3 men would attempt suicide with the same wife...I don't know, but I bet it would be amazing. Say, in Australia, there are 20 male suicides per 100 000 people. That's 1 in 5000 chance of a random man committing suicide. OK, assume the third guy was successful- there is a 1 in 125 000 000 chance of three guys, picked at random, committing suicide successfully. I think that wife should quit gettig married and go out an buy a lottery ticket.
Interesting comments. I'm curious about the concerns that this could be a (HIPAA) violation. How is this different from other situations that are posted on this board? Is it because the circumstances are so unusual it could lead to identification? ...
Yes to your second question, IMO.
As to the OP's original concern, I think the wife's visits should be monitered, at this point.
This would be my opinion, assuming I did not know this was a case study.
statistical analysis- I think that wife should quit gettig married and go out an buy a lottery ticket.
Well she did empty husband #3's joint savings and checking accounts and then ran off with her girlfriend. Beyond that God only knows.
The facts as revealed to the care team are presented as they were known at the time and as later events that soon followed. I thought this was a good case for a critical thinking skills application but looking at the number of responses that this thread generated it appears that there is more to this case than meets the eye.
If interest in this thread hasn't died yet I have just added a practitioner poll to measure certain perceived influences in nursing practice. You should see that poll at the beginning of the original post.
I would definitely keep a close eye. What can it hurt? Better to be safe than sorry, particularly if the patient is unable to answer for himself right now. He is, after all, the number one priority here, and he tried to commit suicide......... I would think it would be pertinent to keep someone in authority close at hand whatever the weather!
As a fellow peer mentioned, this poor woman may be one of those types who tries to rescue poor souls. I was involved with 3 boyfriends in a row who were physically and mentally abusive to me.............. it took me a long time to get out of that habit/routine. We can fall into the trap of being attracted to the same people over and over, whether it be a good or bad situation.
I wish you luck with this. Do let us know how it turns out!
hbscott
416 Posts
How many Doctor's orders have you seen to restrict visitors? I believe there is some kind of duty to protect the patient from potential harm if the patient consents. If the patient can't consent then the issue becomes a bit more complicated.
-HBS