Herman is a 55-year-old farmer with worsening, chronic back pain refuses surgery and states he will go to the local chiropractor, instead His doctor is faced with a dilemma. He does not feel he can contact the chiropractor, but feels that the manipulation could worsen Herman’s injury. What is the physician’s obligation to the patient? […]
An 84-year-old non-ambulatory nursing home patient was confined to semi-fetal condition with “sever organic brain syndrome.” With chronic, non-healing ulcers, bowel incontinence, and very limited conscious movement, her nephew requested removal of her nasogastric tube. Her physician declines, and the courts are involved. What are some reasons her physician would decline to respect her nephew’s […]
John is a 92-year-old who was recently admitted to a long-term care facility after being discharged from the hospital after a stay for pneumonia. He is nonverbally refusing meals, and with no obvious family members to relay his wishes, staff are finding it hard to determine what the next step should be in his care. […]
A 49-year-old male came into the cardiac care unit with an inferior wall myocardial infarction, and shortly thereafter coded. Resuscitation attempts succeeded; however, over the course of a few days he went into multi-system failures. Is the provision of artificial nutrition and/or hydration a medical treatment option in this case? In what situation should artificial […]
Helga, 86, fell in her Minneapolis home and broke her hip. After the fracture was successfully set, she was discharged to a nursing home. On January 1, 1990, she was readmitted due to developing respiratory failure and placed on a ventilator. During the next five months repeated attempts to wean her from the respirator were […]
Jennie is a 79-year-old woman who had suffered from hypertension, diabetes and many strokes. She had an advance directive, which indicated that she did not desire any surgery, antibiotics, resuscitation or tube feeding. When it becomes very difficult for her to eat, requiring an aide for a couple of hours each meal, her daughter decides […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director