Pediatrics MCQ 38

Your 6-year old patient is visiting his grandparents. You are rounding in the hospital when the grandfather, a 72-year-old male, is brought by ambulance to the emergency department with weakness and numbness of his left side that began earlier this morning. While in the emergency department he becomes comatose with infrequent, gasping breaths and is quickly intubated and placed on a ventilator. A full evaluation shows an acute ischemic right-sided stroke. His wife states that she wishes to have the ventilator stopped, as she believes this would be consistent with her husband's wishes in this circumstance. She understands that this would precipitate the patient's death. The wife presents a legally valid advance directive confirming her as the patient's health-care proxy.

As you are known by the family, the emergency department physician seeks your advice. Which one of the following responses to the wife's request is most ethically appropriate?


A) Withdraw the ventilator as requested.
B) Contact the hospital ethics committee to initiate the legal requirements to process the wife's request.
C) Inform the wife that all life-sustaining care should be given until the patient's condition has been determined to be irreversible.
D) Inform the wife that intubation may have been avoided in the emergency department, but once life sustaining care has been initiated it should not be withdrawn.
E) Promptly contact hospital security or the local law enforcement agency to report the wife's request.

Answer

Tags: MCQ, Pediatrics, Ethics

Category: Pediatrics MCQs