An 81-year-old woman has a severe depressive episode with nihilistic delusions. She has refused all food and f…

Question

An 81-year-old woman has a severe depressive episode with nihilistic delusions. She has refused all food and fluid for four days and is dehydrated, saying that her insides have rotted away and that she is already dead. She cannot describe the purpose of any treatment offered and refuses everything, including intravenous fluids. The consultant psychiatrist recommends electroconvulsive therapy. Her daughter, appointed as her enduring guardian while her mother was well, says she knows what her moth…

Accepted Answer

Arrange assessment under the Mental Health Act

Answer

Accept the daughter's consent as enduring guardian

Answer

Ask the hospital ethics committee to authorise treatment

Answer

Obtain written agreement from two independent psychiatrists

Answer

Postpone treatment until she regains capacity

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