Coostietightner123
Established Member
The ability to consent and make informed decisions is affected in all patients with Traumatic Brain Injury. However, this is not an either/or issue. It is, rather, one that falls into a spectrum. In some cases, the ability to make decisions is obvious, as in those with severe TBI and neurological compromise. In patients with mild or moderate TBI, it may not be so clear:
A case study presented by Dr. Catherine Marco (2003) discusses a gentleman with a simple cut to his head who was mildly intoxicated but “alert and aware.” However, he became agitated when the doctor wanted to run a CT scan. Agitation is a sign of a more severe internal cranial bleed. Thus, the doctor had to make the decision of whether to run the diagnostic tests against the patient’s will, or let the patient leave against medical advice and risk progressing into a coma from a possible bleed.
A study published in Neurology (2012) assessed the treatment consent capacity of patients across a range of TBI severity. Even patients at the lowest level of TBI demonstrated a compromise of their capacity to appreciate or understand the questions being asked. At the next level in severity, where the patient demonstrates small injuries to the brain on CT scans, the patients demonstrated capacity compromise in all three areas assessed (understanding, reasoning and appreciation).
In summary, an interview performed in the setting of any level of head trauma should be taken with caution and may not hold up in court.
I WISH I HAD KNOWN THIS 3 YEARS AGO.
This goes to show, you really need a solicitor or barrister that actually gives a shit and knows what they are doing. According to my symptoms at the time, I was interviewed under the influence of severe concussion, and may even have had a small brain bleed.
And yet in my solicitors haste to plea bargain and hurry my case along as it was a legal aid case, so not worth much. I got the minimum of representation, because he rolled over to his mate the procurator fiscal. 3 years later its really not worth contesting. It would be the same biased sheriff that heard the case and my subsequent petition at the two year point for the removal of the disqualification. And took great pleasure in denying it.
Sheriff = entitled jobsworth bored middle aged no it all barsteward.
A case study presented by Dr. Catherine Marco (2003) discusses a gentleman with a simple cut to his head who was mildly intoxicated but “alert and aware.” However, he became agitated when the doctor wanted to run a CT scan. Agitation is a sign of a more severe internal cranial bleed. Thus, the doctor had to make the decision of whether to run the diagnostic tests against the patient’s will, or let the patient leave against medical advice and risk progressing into a coma from a possible bleed.
A study published in Neurology (2012) assessed the treatment consent capacity of patients across a range of TBI severity. Even patients at the lowest level of TBI demonstrated a compromise of their capacity to appreciate or understand the questions being asked. At the next level in severity, where the patient demonstrates small injuries to the brain on CT scans, the patients demonstrated capacity compromise in all three areas assessed (understanding, reasoning and appreciation).
In summary, an interview performed in the setting of any level of head trauma should be taken with caution and may not hold up in court.
I WISH I HAD KNOWN THIS 3 YEARS AGO.
This goes to show, you really need a solicitor or barrister that actually gives a shit and knows what they are doing. According to my symptoms at the time, I was interviewed under the influence of severe concussion, and may even have had a small brain bleed.
And yet in my solicitors haste to plea bargain and hurry my case along as it was a legal aid case, so not worth much. I got the minimum of representation, because he rolled over to his mate the procurator fiscal. 3 years later its really not worth contesting. It would be the same biased sheriff that heard the case and my subsequent petition at the two year point for the removal of the disqualification. And took great pleasure in denying it.
Sheriff = entitled jobsworth bored middle aged no it all barsteward.