Case and Commentary
Jan 2005
Mr. Jonsen has been steadfast in his demands that Ahmed leave the room during his interaction with Dr. Macklin and his quick observation that Ahmed probably did not need to be in the room for his care indicates that his decision is resolute. Accordingly, option C (instructing Ahmed to leave the room) is the preferable option at this point. If Mr. Jonsen had been less persistent in his pursuit of maintaining privacy, option D (convincing Mr. Jonsen to allow Ahmed to remain) would have been preferable. Given Mr. Jonsen's opposition, option D is only an acceptable alternative in this case.
Because Mr. Jonsen has a right to privacy and rebuking his attempts to exercise it is unnecessarily confrontational, option A (insisting on Ahmed's presence) should be avoided. Simply sending Mr. Jonsen to another ER (option B) and thereby refusing care because of his attempt to protect his privacy implicitly denies his right to privacy. Furthermore, sending him away without verifying that his condition is not emergent could also constitute neglect (see Opinion 8.11, "Neglect of Patients") and violate EMTALA. Accordingly, option B should also be avoided.
Preferable: Option C
Acceptable: Option D
Avoid: Options A and B
Additional discussion and information
