The scenario

• A senior officer has received a dream assignment at an embassy in a remote country with a less developed health care system.
• During a routine medical examination prior to confirmation of the assignment, the physician notes a remote history of uveitis. She realizes that the patient has had recurrent uveitis of unknown origin for 10 years. An episode occurred approximately every 3 years. Several ophthalmologists have documented high intraocular pressure during the uveitis, and the patient's right optic nerve is thinning.
• The physician refers the patient to an ophthalmologist who notes that the patient needs to be seen every 6-12 months and is at moderate to high risk of requiring treatment requiring evacuation during the mission.
• The patient is distressed because he feels perfectly well and has not had an attack in over two years. He is convinced that he is fit for duty and does not understand the problem.
• The command is upset that the medical services are interfering with a decision that has already been made. They insist that the patient is the best candidate for the job and should be allowed to continue.
• The embassy feels they can probably handle the problem, but they would have to work with a downtown clinic with limited capabilities. Evacuation could be arranged if necessary, but would likely take days and involve a third country.
• A meeting is arranged between the medical authority, the patient and the embassy. The medical report has been made available to all relevant parties, as the patient has consented to disclosure.

Source: Report by a course participant. Link to scenario collection.

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Additional resources

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Proposed solution

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