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Author6 Posts
  #1

A hospitalist on duty for the weekend is called to consult on a case involving a 53-year-old woman in the medical intensive care unit. The patient has been hospitalized for 5 weeks. Her initial injury was a massive subarachnoid bleed complicated by an ischemic infarct of her brain 3 days later. Since that time, she has been persistently vegetative. She requires mechanical ventilation and external feeding to maintain her vital functions. It is discovered that, during a previous admission to the hospital, the patient clearly stated that she would want to be maintained on life support only if she were likely to regain a meaningful quality of life. The medical team believes that she does not have a significant chance of regaining an acceptable level of function. The children maintain that the situation is reversible and want to continue care, whereas the husband wants to withdraw care in fulfillment of his wife's wishes. Which of the following is the most appropriate next step?
A. Arrange a family meeting, hoping to resolve the patient's previously expressed wishes with those of the children and husband
B. Begin the withdrawal of care, despite the reservations of the children, after discussion with the hospital lawyer
C. Consult a psychiatrist to speak to the children
D. Notify the department of social services for the question of elder abuse
E. Refer the case to the ethics committee for review


  #2

is it E


  #3

i say 'a'...... most important is always to have a consult with the family first.


  #4

I would personally agree with A.

Doesnt this situation closely resemble the Terri Schiavo case?

Let us know the answer soon,

Thanks,

Amit Joshi.


  #5

ans is A


  #6

This question is from Kaplan q bank and is with a clear cut answer A.





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