Question

Scenario

Background: A third generation rancher, Angus Hostein suffered a stroke at 77 years of age. During his last visit to the hospital for unrelated reasons, he learned of something called Advance Directives. He filled out some paperwork and a Do Not Resuscitate desire was documented so that if a procedure was performed to save his life, but the life would consist of remaining in a vegetative state or a state requiring life sustaining equipment for eh duration of life, his desire would be to not receive the life saving measure. This document was appropriately witnessed and included in his medical record. Now that Angus is hospitalized with a stroke, he also developed pneumonia. If his physician does not treat the pneumonia, Angus will die. If he treats the pneumonia and Angus recovers, the stroke will leave him bed-bound and paralyzed. The physician is aware of the advance directive and is unsure what to do.

Implications: First of all, Angus awake? Is he to refuse or request treatment? We assume he is not. One of the positive aspects concerning advance directives are the fact that the process of actually establishing a directive can create a map, of sorts, for expressing thoughts and feelings about life, death, and treatment options in an established, formal manner. Different people have widely varying beliefs and values. An Advance directive can provide direction of care and allow an individual to make decisions at a time of decreased competence or consciousness. The formation of an advance directive can also relieve family stress at a time of emotional struggle. If decision makers, who could be more than one person (such as parents), are unable of health care providers or the courts.

Question: What should the physician do in this case where the treatment is for the pneumonia and onto the stroke?

Answer 1

This is a dilemma.

If his physician does not treat pneumonia, Angus will die. SO the doctor must treat the patient for pneumonia to save his life.

Now after the treatment of pneumonia, there is a risk that if Angus recovers, the stroke will leave him bed-bound and paralyzed. But this simply does not mean that the physician should not try and give up. Remember that trying is always better than giving up. Maybe during the treatment, there could be any miracle.