Near the end of the workday, you get a call from a nurse in the ICU. He’s been asked to call by one of the ICU doctors. They have a patient who is probably terminal and the family don’t agree about withdrawing treatment. Who gets to decide?
The nurse, Gabriel Garcia, seems rushed, but you take a moment to ask a couple of questions about the patient and note his Medical Record Number. Aaron Black is a 28-year-old male with a diagnosis of glioblastoma (an aggressive brain cancer). His condition has deteriorated suddenly. Mr. Black is in and out of consciousness. He cannot answer simple questions when he regains consciousness.
“Are you in doubt about whether he has Capacity to make his own decisions?”
They are not. He clearly lacks capacity.
“Is there a Power of Attorney?”
“There’s nothing on paper. He’s so young—I don’t think they were expecting this.” Your hospital has a policy regarding decisions made for adults who lack decision-making capacity. It follows a provincial statute that lists a next-of-kin hierarchy of decision-makers for cases where a patient lacks capacity and does not have an appointed substitute decision-maker.
Do you provide the information from the policy?
Or inquire further about the decision to be made and the basis of the disagreement?