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David, a 27-year-old male is brought in by ambulance (BIBA) into the emergency department with a suspected drug overdose. The patient’s girlfriend Lauren, is present and tells you that he has a medical history of schizophrenia and Hepatitis C. His notes identify that he has previously received care from the Alcohol Tobacco and Other Drugs Service (ATODS) and as an in-patient in the Mental Health Unit. Whilst in the emergency department the patient becomes combative and refuses care. Security is called and the patient is then physically restrained due to being verbally and physically aggressive to staff. He shouts that you “don’t have the right to touch him”, he would “prefer to die than spend more time in the hospital” and that he wants to discharge himself, which would be against medical advice. Shortly after this outburst the patient starts to clinically deteriorate and loses consciousness. You begin emergency treatment, but Lauren yells at you to stop and says that you need to respect the patient’s wishes.
What are the ethical and legal issues relating to this case?
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