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NES Seizure: A Case Study

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An Analysis of the Dilemma Before analyzing this dilemma, it is important to distinguish the difference of epileptic and non-epileptic seizures (NES). An epileptic seizure has a sudden onset and is involuntary with a time-limited change in behavior. This includes motor function, autonomic function, sensation, or consciousness and is clearly visible by an abnormal EEG. A psychogenic or NES seizure is a convulsive type of event in which there is an absence of electrographic ictal pattern. Therefore, obtaining an EEG is essential in order to determine an accurate diagnosis (Thompson, Osorio, & Hunter, 2005). The ethical implications of this dilemma are better understood through the use of an ethical decision making model. Burkhardt and Nathaniel (2014) discuss using a five step process, one in which each step can be evaluated as often as needed and adapt to any changes that occur in the situation. These five steps include: articulate the problem, gather data and conflicting moral claims, explore strategies, implement the appropriate strategy, and evaluate the outcome of the action.
Articulate the Problem …show more content…
However developing a policy for treating AMA patients might offer assistance with this dilemma. The frequent AMA patient needs to have a social service consult initiated upon admission and daily competency assessments. As with all patients, communication is essential and important, but increasingly more so for the AMA patient. These patients need to be updated on a daily bases about the plan of care, treatments, testing, and discharge planning. Furthermore, they need to be informed of delays that have or could occur and how they are being resolved. Not surprisingly, many of these patients having history of substance abuse or psychological issues, that would best be addressed upon admission and treatment initiated if needed (Bartley,

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