In the medical field today, whenever a procedure is going to be done on a patient, informed consent must be given to the doctor from the patient prior the procedure taking place. Informed consent is the approval given by the patient to the doctor for treatment. In the case being discussed today, an 80 year old patient, with a history of congestive heart failure, is in the doctor's office complaining of chest pains. After an examination, the doctor believes the best course of treatment would be to have a surgical procedure, in an attempt to save the patients life. During the examination however, the patient expresses the wish to just be able to die. There is no Living will or Do Not Resuscitate (DNR) on file. The patient’s wife is afraid of the surgery, while the daughter is for anything that could save her dads life.
The first thing that needs to take place in this situation is the determination of the competency of the patient. By using the Understand-and-Appreciate method of determining competency, if the patient understands the situation and all the options that are available to him; but also appreciates the options and understand the side effect of treatment or lack there of treatment , the patient is deemed confident. On the flip side, if the patient’s requests fall too far outside the realm of what would be considered normal, that could help in determining whether or not to override the patient’s wishes due to no longer being considered competent. It is the belief that “it is ethically justified to overrule the seriously irrational decision of a competent patient.” (Fredrick Adolf Paola, 2010)
Under the assumption that during the last five years of treating Patient X for congestive heart failure, he never mentioned the fact that he did not want any live saving measures, otherwise, he and the doctor would have already discussed having a Living Will or a DNR on file. Since there is not one on file, and assuming this is not the normal attitude of the patient over the last five years, depression could be playing a factor and therefore giving reason to deem this patient as not competent to make their own medical decisions. Locating the next of kin or court appointed surrogate of care is vital to be able to make a plan for treatment.
One hard objection to overcome could be the spouses fear about surgery. These fears must not be ignored. Instead, the time must be taken to address each and every concern the family has. Utilize the fact that the daughter is accepting of the surgery; maybe by the daughter verbally agreeing to the option of surgery will persuade the spouse to agree to it as well. Another option is to again explain the diagnosis, the options for treatment and the expectations of with holding treatment to the family, allows the daughter to also help explain anything that may be confusing to the spouse. It may be better understood when it comes from a loved one.
The daughters’ willingness to do whatever necessary to...