12-23-2014, 11:38 AM
A 37-year-old man is hospitalized in an intensive care unit after suffering major head trauma in a motor vehicle accident. The patient was struck by a car two days ago and was found on the scene to be non-responsive with a Glasgow Coma Score of 4. He was intubated at the scene and transferred to the hospital. In the prior two days, his mental status is unchanged and he remains intubated and ventilated. You have documented a discussion you had with the patient three months ago during an admission for pneumonia. During that discussion the patient clearly stated that he would want to be maintained on life support only if he were likely to regain a meaningful quality of life. You and the medical team believe that he does not have a significant chance of regaining an acceptable level of function. The brother and sister maintain that the situation is reversible while the wife continues to desire the withdrawal of care in fulfillment of her husbands' wishes. The most appropriate next step is to
A. arrange a family meeting hoping to resolve the patient's previously expressed wishes with those of
the children and husband
B. begin the withdrawal of care despite the reservation of the siblings after discussion with the
hospital lawyer
C. consult a psychiatrist to speak to the siblings
D. notify the department of social services for the question of spousal abuse
E. refer the case to the ethics committee for review
A. arrange a family meeting hoping to resolve the patient's previously expressed wishes with those of
the children and husband
B. begin the withdrawal of care despite the reservation of the siblings after discussion with the
hospital lawyer
C. consult a psychiatrist to speak to the siblings
D. notify the department of social services for the question of spousal abuse
E. refer the case to the ethics committee for review