Global Health Systems 1st Edition by Margie Lovett Scott ,Faith Prather

Exercise 3

Case Scenario
Raphael: Refusal of Treatment
Raphael, a 24-year-old Brazilian male was in a minor traffic accident where he collided with another car. Raphael recalls twisting his right arm as he swerved to avoid the collision. He recalls his chest hitting the steering wheel but denies loss of consciousness. He was treated at the scene by a doctor on the mobile emergency medical unit. Despite no obvious major injuries Raphael was taken to a nearby hospital to be further assessed. After waiting two hours, feeling a little sore on his left side but fine otherwise, Raphael left the packed hospital emergency room without being seen. He suspected his soreness would disappear after a few days. However, the next day, the previously vague, tolerable left sided pain he had been treating with ?herbal rubs,? became slightly worse. Raphael described his pain as a constant aching, much worse when breathing in than out. When Raphael became lightheaded on the third day and the pain was now more severe, his grandfather told him he needed much stronger medicine than he had been taking. Later the same day his grandfather summoned family members and presided over a family vigil where Raphael was given an unidentified herbal concoction to drink as his father and grandfather chanted harmonious, prayer-like lyrics. He was told only that the concoction would surely make him better. When Raphael began vomiting during the ceremony, he was taken to the hospital where they discovered he had been slowly bleeding from a small tear in his spleen that probably occurred when his chest hit the steering wheel during the accident. The doctor told Raphael and his family that had the tear in his spleen been larger he would not have survived without surgery.
Have you ever heard of someone leaving a hospital without being seen? If so, what were the circumstances involved? Describe the consequences of the person's actions?