Question

Case 1:

Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair bound and spends most of his days sleeping in his wheelchair near a window facing the garden. He needs to be spoon fed but has recently started to refuse to eat. Mr. Parker has three children, one of whom is very involved in the care of her father. The team approaches the daughter about her father refusing to eat, and feels that his refusal is legitimate. Thus, they propose changing the plan of care to palliation. The daughter absolutely refuses, claiming that “you cannot kill my father, I want everything done to keep him living!”

• What are some of the ethical issues in this case?
• Do we know whether the resident is capable to make his own health care decisions?
• Are there any known wishes from Mr. Parker? What would he want? What are his values?
• Is his daughter the substitute decision-maker? Can she, in this role, demand treatment and expect that you comply?

Answer 1

Answer: The ethical issues in this case is the making decisions regarding the healthcare as well as the end life care. As the patient' s daughter is not agree for the palliative care whereas she is also unable to take right decision for his father. The patient is also not in the healthy mental condition to make his own decision regarding the treatment.

The patient's wishes as well as his values should be considered while decision making process. It is important to intervene about the living wills or any kind of advance directive the patient has.

The healthcare professionals need to explain the patient's family about the importance of the palliative care where the patient can be treated and better care can be provided. Explain about the advantages and disadvantages of the health care regarding the patient, so that the client's family can take proper decision.