Substitute decision making and code status at end of life : patient's loss of capacity highlights complexity

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SIEMENS, Isaac

This case involves an 80-year-old male patient, Mr B., who was admitted to hospital with delirium in the context of metastatic prostate cancer. Mr B.’s prior wishes were for a comfort approach to care involving a do-not-resuscitate (DNR) and do-not-intubate (DNI) code status and end of life in a palliative care unit (PCU). When the patient lost his capacity to make complex treatment decisions, his substitute decision maker (SDM) reversed his code status and advocated for full investigation and treatment of his underlying illnesses. These decisions led to a prolonged hospital stay for the patient, with admission to an intensive care unit (ICU), artificial hydration and nutrition, and eventual death after a cardiopulmonary resuscitation (CPR) attempt that was considered futile by the medicine team, which caused moral distress for all involved.

http://dx.doi.org/10.46747/cfp.6810743

Voir la revue «Canadian Family Physician % Medecin De Famille Canadien, 68»

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