RESUMO
Purpose: The novel coronavirus, SARS-CoV-2, emerged from Wuhan, China, causing a pandemic. Access to outpatient psychiatric care was limited. We conducted a pilot study of telepsychiatry during a national shutdown. Adult patients with post-traumatic stress disorder (PTSD) participated via Zoom. Patient preference comparing televisits to face-to-face visits was assessed. Recent findings: Telemedicine has emerged as new technological tool in the evolution of the patient-physician relationship, changing the way we interact. Physicians and patients now have access to the electronic medical record, remote point-of-care testing, and each other. The present epidemic allows us to test the limits of technology in combating limited access to care for patients with psychiatric illness. Summary: Twenty (90% male) patients with PTSD participated. Most (90 %) were moderately to severely depressed, and 50% used medical cannabis and increased their dosage during the study period. Patients preferred face-to-face meetings for its ease of use (p < .01) and general satisfaction from therapy (p < .01). However, given continued outbreak-limiting access to care, most patients stated they would continue with telepsychiatry. While most patients preferred face-to-face visits, telepsychiatry can be used during times of outbreak-limiting access to care. Future research and development should be directed at improving technological ease of use.
RESUMO
INTRODUCTION: The case presented discusses a prisoner, Y, in his mid-sixties with longstanding medical conditions, who was sentenced to prolonged incarceration. Y refused conventional medicine because he believed that his medical condition was exacerbated by this treatment and only complementary alternative medicine (CAM) would be helpful. He therefore demanded to be treated only by CAM. He was ready to pay for the treatment out of his own pocket. In the prison where Y was previously incarcerated over the course of 12 years, he had access to CAM remedies which were purchased by his family. After being transferred to the current facility, Y was denied access to these remedies by the prison physicians. He appealed in court against this decision and was supported by a CAM specialist, who ascertained that the remedies under consideration were not hazardous to Y's health. This case report discusses the ethical aspects of a prisoner's autonomy to choose medical treatment even when his/her autonomy has been severely curtailed by virtue of the incarceration.
