Sunday, October 11, 2009

informed consent

on a wednesday in late August she was home for the first time in months from the residential place for what i deemed the new, "spaghetti wednesday". it was clozaril blood draw day. i created a standing order at the local lab where she was comfortable and they knew her for a decade. this meant a long driving day. it was a great day to get the standing blood draw order in for once a month for Clozaril vs. once every 2 weeks, for obvious reasons.

one week later, on the following thursday, the residential place had her involuntarily committed to the psych ward. that was august 27, and that is where 'spaghetti wednesday' was interrupted, by my rambles here, the last 6 weeks it's apparent life changes that fast.

Wikipedia describes it:

"Informed consent is a legal condition whereby a person can be said to have given consent based upon a clear appreciation and understanding of the facts, implications and future consequences of an action.

In order to give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts at the time consent is given.

Impairments to reasoning and judgement which would make it impossible for someone to give informed consent include such factors as severe mental retardation, severe mental illness, intoxication, severe sleep deprivation, Alzheimer's disease, or being in a coma.

This term was first used in a 1957 medical malpractice case by Paul G. Gebhard."...
~

when my daughter says "hi, mom" on the telephone" and then later in person today says, "you fucking bitch, Barbie Doll ",-- "get out of here, there are snipers", --"i feel enormous anxiety"; one would wonder how "informed consent" works in the mental health world behind locked inpatient, involuntary doors of a psychiatric hospital.

--
i sat in a chair. yellow, plastic. soft yellow, pale, in color the sun rose this morning. the elevator door opened, and i gave my daughter the yellow banana and a chocolate chip cookie. her hair looked clean, yesterday when i arrived it was covered in toothpaste. she told me to leave because snipers were on the unit. today, was different. but i know her.

she has appeared many shades and hues of 'wellness' during each inpatient hospitalization. there are no concrete boundaries or definitions when it comes to mental illness. it is defined as mental illness because we know nothing more than to define what we don't see as our self as something or someone different.

today, i waved my hand so she would see that i was leaving.

"do the best that you can do", she said.

i stood there and answered back.

"do the best you can do too.".
--
the leaves on the trees are brilliant as i drove the road home, and i remembered how she had a dog washing kit when she was about 9 or 10 years old. she loved dogs.

this afternoon at the dog park, her dog played with other dogs and walked through the wooded trail, "independently". i followed the dog through the trail and thought about all of this.
--


she knows she takes Clozaril.

informed consent.

An honor society student at age 17 with hundreds of hours of volunteer work charted, a 4.0 GPA in high school, art awards, and an aspiring writer, i'm pretty damn sure in spite of what professionals think, she is fully aware of herself and her mind, though it might just be a different shade of yellow.