ASSIGMENT ATLEAST 300-400 Words all togather
Ann, an 86-year-old woman with a past medical history of osteoporosis, is in good health until the evening of her hospital admission when she falls, hitting her head and losing consciousness. Friends observing her fall and call paramedics. Ann is intubated on site and transported to the hospital where her treatment, including ventilator support, is continued. The trauma surgery team diagnoses her with rib fractures causing a partial flail chest and a subdural hematoma and admits her to the ICU. The trauma team communicates to Ann’s family that she won’t survive the trauma largely due to her age. Treatment is continued overnight, and the following morning, the trauma team meets with the grieving family and together they decide to place a do not resuscitate (DNR) order in her chart and to withdraw her from the ventilator with the help of the palliative care service. But, when the palliative care service arrives, they find her awake and able to communicate with insight. The palliative physician asks and is told that Ann has not been involved in the decision-making for her care. Therefore, an ethics consultation is requested.
The trauma team continues to operate on the assumption that Ann will not survive, despite her improved mental state. In questioning the patient, her family, and her friends, it becomes clear that Ann is a remarkable 86-year-old woman. She lives independently and easily performs all activities of daily living. She continues to drive and travel, as part of an active social life. No definitive answer is given as to whether her vibrancy as an elderly patient changes her prognosis. Ann does not have a written advance directive or living will, nor has she previously communicated her treatment options.
Response to each question must be in the form of a 100 to 200-word well-developed paragraph, with well-developed sentences, correct spelling, and proper grammar. Please include data, facts, key terminology, specific examples and direct quotations from the textbook and other resources to support your main point. For assistance with writing, please visit the Online Writing Lab or visit the Tutoring page.
Cite all sources of information, including your textbook, using last name and page numbers in parenthesis in the text; for example: (Author’s last name, year, p. ###). Provide a resource list at the conclusion of the assignment formatted as in this example: Author’s last name, first name. (year). Title in italics. Location of publisher: Publisher.
- How does the concept of medical futility apply to this case, based upon the reading you have done for this assignment?
- Based upon the reading for this lesson, now that the patient has regained consciousness, must she be involved in her medical decision-making? Why or why not? Please defend your answer using specific examples and data from the textbook and outside research.
- How might it have helped to resolve the ethical dilemma if the patient had advanced directives in place?
