Clinical medicine (London, England)
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The expansion of new forms of public media, including social media, exposes clinicians to more illness experiences/narratives than ever before and increases the range of ways to interact with the people depicted. Existing professional regulations and ethics codes offer very limited guidance for such situations. We discuss the ethics of responding to such scenarios through presenting three cases of clinicians encountering television or social media stories involving potential unmet healthcare needs. We offer a structured framework for health workers to think through their responses to such situations, based around four key questions for the clinician to deliberate upon: who is vulnerable to harm; what can be done; who is best placed to do it; and what could go wrong? We illustrate the application of this framework to our three cases.
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Letter Case Reports
Lesson of the month 1: Prolonged QT syndrome due to donepezil: a reversible cause of falls?
Prolonged QT syndrome precipitates cardiac arrhythmias such as torsades de pointes (TdP) resulting in cardiogenic syncope or sudden death. We report a case of prolonged QT syndrome caused by donepezil which resulted in a fall and hip fracture. ⋯ This case highlights a lesser known side effect of this dementia drug. It also reminds us of the importance of taking a thorough drug history while considering potential drug toxicity/interactions as part of the comprehensive geriatric assessment.