A Retrospective Study about Autonomy of the Patients with Neurological Disorders: A Record base Analysis

AbstractIn the case of neurological disorders, patient autonomy is a fundamental principle which must be taken into consideration. In the case of this pathology, fluctuating mental deterioration is encountered most frequently in the case of mild forms of dementia. In the case of severe forms of dementia, the patient loses any autonomy and requires permanent medical care, as well as a permanent legal representative.

Aim of this study was to know autonomy of the patients with certain neurological disorders about ability of making decisions for their medical care.

Material and method: It is a quantitative retrospective observational study and data for which is gathered  from  the observation  charts  of  323  patients  attended  in  either  emergency  or  outpatient, between April to December 2006, in “Prof. Dr. Nicolae Oblu” Clinical Hospital of Emergency,  Iasi, Romania. Study subjects were split into 2 groups: Group 1 (with a number of 215 cases) – a group of patients with the diagnostics of acute cerebrovascular accident, aphasia and dementia. Group 2 (with a number of 108 cases) – patients known or recently diagnosed with amyotrophic lateral sclerosis, multiple sclerosis and myasthenia gravis. Consent informed given by patient in the observation charts of above two groups was observed and number of patients who has given consent was compared in both the groups.

Results: On the cases under study, only for 13.6% of the patients of the first group there is consent informed in the observation chart, while for the patients in the second group this percentage was slightly smaller (9.3%).

Conclusions: As very few patients have given written informed consent and more sever the neurological disorder less the chances to have written informed consent by patients. So it can be concluded that medical performance brings indisputable benefits, however it should be done by a careful selection of the subjects and by following ethical principles.

Keywords: Autonomy, Neurological Disorders, Competency

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