A 76-year-old man is brought to the hospital after having a stroke. Head CT is done in the emergency department and shows intracranial hemorrhage. Upon arrival to the ED he is verbally non-responsive and withdraws only to pain. He does not open his eyes. He is transferred to the medical ICU for further management and intubated for airway protection. During his second day in the ICU, his blood pressure is measured as 91/54 mmHg and pulse is 120/min. He is given fluids and antibiotics, but he progresses to renal failure and his mental status deteriorates. The physicians in the ICU ask the patient’s family what his wishes are for end-of-life care. His wife tells the team that she is durable power of attorney for the patient and provides appropriate documentation. She mentions that he did not have a living will, but she believes that he would want care withdrawn in this situation, and therefore asks the team to withdraw care at this point. The patient’s daughter vehemently disagrees and believes it is in the best interest of her father, the patient, to continue all care. Based on this information, what is the best course of action for the physician team?
ACall other family members and consult them for their opinions
BListen to the patient’s daughter’s wishes and continue all care
CCompromise between the wife and daughter and withdraw the fluids and antibiotics but keep the patient intubated
DListen to the patient’s wife’s wishes and withdraw care
EConsult the hospital ethics committee and continue all care until a decision is reached
A 19-year-old woman is diagnosed with metastatic Ewing sarcoma. She has undergone multiple treatments without improvement. She decides to stop treatment and pursue only palliative care. She is of sound mind and has weighed the benefits and risks of this decision. The patient’s mother objects and insists that treatments be continued. What should be done?
ATry to seek additional experimental treatments that are promising.
BFollow the wishes of the patient’s mother as she has decision making power for the patient.
CContinue treatments until the patient has a psychiatric evaluation.
DContinue treatment because otherwise, the patient will die.
EHalt treatments and begin palliative care.
A psychiatrist receives a call from a patient who expresses thoughts of harming his ex-girlfriend. The patient describes a detailed plan to attack her at her workplace. Which of the following represents the psychiatrist's most appropriate legal obligation?
AWarn the ex-girlfriend and notify law enforcement
BOnly notify the patient's family
CWarn only law enforcement
DMaintain patient confidentiality
+ 7 more in the PDF
Browse all chapters