Question 56#

Under the principle of common law which of the following can be done without a patient’s consent?

A. Blood sample can be drawn after paracetamol overdose in an emergency

A. Common law principle of necessity allows medical interventions only if they are life saving, emergency measures. Irreversible procedures such as transplantation cannot be carried out. It is not good practice to administer depot under ‘emergency’ situations. Psychiatric detention must follow Mental Health Act principles whenever required.

Reference:

1. Hewson B. The law on managing patients who harm themselves and deliberately refuse treatment. British Medical Journal 1999; 319: 905–907.

Question 57#

‘Run amok’ involves sudden dissociative reaction which can lead to multiple homicide or suicide.

It is best classified under which of the following categories?

A. Dissociation reaction

C. Running amok (derived from Malay word amuk, meaning ‘mad with anger’) is a Malaysian culture bound syndrome. It usually affects a young male who will develop a sudden frenzy and acquire a weapon in an attempt to kill or injure anyone indiscriminately. Amok episodes can lead to serious violence or suicide.

Reference:

1. Gelder MG et al., eds. New Oxford Textbook of Psychiatry. Oxford University Press, 2000, p. 1063.

Question 58#

Who first used the word ‘psychiatry’ (or ‘psychiatrie’) to describe the profession?

A. Reil

A. Johann Christian Reil coined the term psychiatry to describe the practice of psychological medicine. He was a German doctor and used the word ‘Psychiatrie’ in 1808.

Reference:

1. Semple DM et al., eds. Oxford Handbook of Psychiatry, 1st edn. Oxford University Press, 2005, p. 20.

Question 59#

One of the following is a major proponent of the antipsychiatry movement?

A. William Osler

B. Thomas Szasz has expressed strong views against the current conceptual models of disease in psychiatry. Antipsychiatry refers to a heterogeneous school that challenges the fundamental theories and practices of psychiatry. Aubrey Lewis was an English psychiatrist associated with the Maudsley Hospital. Adolf Meyer proposed psychobiology.

Reference:

1. Johnstone EC et al., eds. Companion to Psychiatric Studies, 7th edn. Churchill Livingstone, 2004, p. 4 Table 1.2.

Question 60#

Which of the following is NOT routinely considered as boundary violations in a therapeutic relationship?

A. Touching except handshake

D. Interpretation is an interview technique and not a boundary violation. It is increasingly realized that subtle violations of doctor–patient boundaries often occur in psychiatric setting. Boundary crossing is defined as intentional or unintentional incursions occurring during a therapeutic relationship. When such boundary crossings produce harm to the patient, then they are called boundary violations. This can be both sexual and non-sexual violation.

Reference:

1. Kay J and Tasman A, eds. Essentials of Psychiatry. Wiley, 2006, p. 65, Table 5.5.