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J.D. is an 80-year old woman with diabetes. She is hospitalized in respiratory failure. She is...

J.D. is an 80-year old woman with diabetes. She is hospitalized in respiratory failure. She is placed on a ventilator and sometimes responds by opening her eyes. She has advanced directives that her husband brings to the hospital. He says that she must be taken off the ventilator and provide comfort care only. However, their only child, a daughter, tells you she will sue the hospital if her mother is not given all care possible. What should you do? What outcome should you expect?

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Expert Solution

What should you do?

In case of the advaced directives, the local laws of the state and country are considered as final judgement. In case as serious as this where the patient can succumb if the ventilator is removed. Majority ofnthe countries and even theblarge consensus if the medical ethics community recommends that ventilator being taken off in such conditions is not a good medical practice. The hospital in order to consider the request of advanced directives must consult an attorney who has the hold over such matter and the medical council before any such decisions are taken. So based on that the hospital has to follow the state and country laws, legal directives, relevant advices and then take appropriate decision. A sole decision based on the advanced directives should not be taken. So when the daughter objects to taking ventilator off and provide supportive care then above mentioned avenues are to be considered

What outcome should you expecting?

In this case if the ventilator is taken off then a legal suit can be expected from the daughter against the hospital and legal repercussions are to be faced by the physicians and the hospitals. The second outcome would be the husband taking legal stand on enforcement of the advanced directives implementation. The patient on ventilator cannot take sound decision regarding life and this should be considered for legality of the advanced directive when the patient is in distress and unable to take rational and sound decisions.

Nightingale answered 2 years ago
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