Continue with ICU care – she is a spiritual being

Abstract

This case study discusses a dispute between the healthcare team and the patient’s surrogate decision maker at a cancer centre. While the healthcare team deemed further care to be futile, the patient’s husband argued that they should continue to try to reverse his wife’s acute decline. This case study illustrates the inertia and moral distress that can result when there are differences between patients/surrogates and the healthcare team in their goals for intensive care. The issues of moral distress and an inability to make decisions were addressed by involving an ethics consultant, and by creating institutional mechanisms to address end-of-life issues at an earlier stage

To have done everything

“…The subsequent conversation with Sam aligned with this process. The ethicist [2] facilitated an elucidating dialogue between the medical team and the surrogate to advocate for an appropriate treatment plan that would align with Bob's wishes.…”

“…This case focuses on the tension between different stakeholders (families and care providers) when there are divergent goals and expectations pertaining to the medical treatment. Some literature [2] focuses on how moral distress can lead to difficult decision-making amongst families and care providers, whereas this case study focuses on the value of allowing the family time to internalise what is going on, to make sense of the issues at hand. In most hospitals across the globe, the Palliative Care team facilitates end-of-life and goals-of-care conversations to support the decision-maker.…”