BOSTON, MA – In an usual move yesterday at Massachusetts Lieutenant General Hospital (MGLH), a medical team has consulted psychiatry to determine if their patient’s lungs have capacity.
“This is a great teaching case because, one, it makes the distinction between the legal term of competency and the medical term of capacity,” said hospitalist Jason Morgan, who eagerly awaits the recommendations of his psychiatry colleagues. “Second, it shows that there are different types of capacities: mental, decision-making, and lung. Even lung capacity can be subdivided. There’s total lung capacity, vital capacity, inspiratory capacity, and functional residual capacity. That’s a whole lot of capacity to determine and I definitely cannot do it alone!”
Morgan explained that in actuality any health care professional can determine capacity. However, in this particular pulmonary case, he deferred on making that determination. In fact, Morgan consulted pulmonary on admission and even they deferred on making that determination.
“If you really want to have the best assessment of capacity, even if it’s the lungs, you gotta call psych, that’s a no brainer,” insisted pulmonary & critical care attending Shannon Boucher. “Pulmonary function tests can prove very useful in answering those questions, no doubt, but it will never top the gold standard of a psychiatrist, his or her psychiatry couch, and taking the time to delve into the lungs’ deep and dark psyche.”
The patient has been NPO after midnight in preparation for today’s psychiatry evaluation.