HIV / AIDS

The ICU attending physician is taking care of a 40-year-old man with AIDS who is intubated with his third bout of pneumocystis pneumonia. His condition is worsening steadily and he has not responded to appropriate antibiotic therapy. The patient’s longtime partner, Richard, has a signed durable power of attorney (DPOA) and states that if the patient’s condition becomes futile the patient would not want ongoing ventilation. The ICU attending decides that ongoing intubation is futile. She consults with Richard and decides to remove the patient from the ventilator to allow him to die in the morning. The patient’s Roman Catholic parents arrive from Kansas and threaten a lawsuit if the ventilator is withdrawn.

• What determines death when there is conflict? Religion? Physicality? Science? Other?
• Who is the legal decision maker here?
• Are other staff members able to help make this decision?
• What are the legal and ethical obligations and determinants in this case?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)