Insistentwife

Given the circumstances in this case, it would be highly unethical for me to go against the patients will due to the informed consent, refusal of treatment and decision-making capacity documents. These documents require us to respect the patient autonomy. Even though we know that this 65 year old man will die if he is not placed on a ventilator and his oxygen runs low, there is absolutely nothing we can do. Based on the information provided to me, I would rule him as a competent patient who can make his own decisions. Therefore I would respect the patient’s wishes.

It is clear that the patient’s wife does not agree with his decision. However, it is not up to her. She is only doing what every wife would do, help their spouse to the best of their ability and try to make the best decisions for them. Unfortunately, there is no sign or information that states this patient is mentally ill or on medications that may impair the ability of the patient to make decisions about their health. It was neither stated that the physician ordered mental status examinations to determine if the patient were ill. Therefore, we cannot assume.

On the other hand, the physician gave me orders to intubate the patient, which I refused. I believe the physician is being unethical in this situation. I understand that he/she is trying to do the right thing and beneficence requires him/her to act in the patient’s best interest. However, that is only allowed when the individuals lack decision making capabilities. Sadly, the patient was not decision free from coercion or undue influences thanks to the physician and his wife. The physician should have respected the patient’s wishes as he should.

As a physician or healthcare provider we have to respect a patient’s decision and accept the fact that although, we want to do our best to save their lives, they have the right to refuse treatment. It is also my duty to abide by those rules and laws in place to protect the patient. We can try our best...