Author: Admin

You explain that where no Power of Attorney has been assigned by the patient or a court, then decision-making authority falls to the next-of-kin. This would be a spouse, if there is one, then an adult child, then a parent.      “He’s not actually married, so I guess it’s his mom then.” You remind Mr. Garcia that if Mr. Black regains his ability to communicate or otherwise has an improvement in his cognitive state, the care team should consider assessing his capacity. If it is at all possible, Mr. Black should be included in discussions about his care. After recording the details of the consultation, you return to your other duties. A couple of weeks later you are lunching with a social worker friend in the hospital cafeteria. She mentions that morale in the ICU is very poor. “A lot of the nurses feel that the ICU docs don’t listen to them,” she tells you. “We had a patient die last week who really...

You ask Dora about her wishes regarding being treated in the hospital versus being discharged and attending appointments for her antibiotic treatment in a community health clinic near her house. She makes it clear that she would like to continue being treated in the hospital. The hospital is a safe environment and her needs are being attended to. Her caregivers are alarmed by the risks that she poses to them, but Dora is fairly happy in the hospital. Respecting her autonomous wishes would mean keeping Dora in the hospital. However, there is still the option of discharging her nonetheless since she is not fully adherent to treatment, and treating her is multiply risky (Hepatitis C positive; exposure to hidden needles; possible fentanyl exposure). Considering this option, her caregivers point out two things. First they point out that discharge contrary to Dora’s autonomous wishes would be bad for her. She would be unlikely to continue with her treatment. Second, they point out...