Patient admitted with blood ETOH .8, unresponsive progresses to need for intubation/ventilation......for the 3rd time in 2 weeks!
Doctor was asked for 72 hour hold and direct transfer to detox with inpatient treatment to follow upon patients stablization. He "could understand how this overindulgence could easily happen with someone who is truely an alcoholic used to drinking huge quantities" (whiskey is poison of choice). When asked when this might be considered a suicidal gesture, he responds, "I hate to antagonize him and he will do much better in treatment if it's voluntary".
This topic is under much debate (he has been with us for more than a week now) and I wonder how this is viewed in other places. We have more leaning toward suicidal gesture requiring mandatory intervention than a mistake. What's your take?