Case:The patient is a mid 40s male with early onset Alzheimer's. He is a fluent, although non native English speaker. While hospitalized for an indeterminate, but presumed unrelated diagnosis, the patient leaves the hospital against medical advice.
The weather is freezing.
The patient is found alive, but unconscious, outside and exposed.
A physician member of the medical team suggests the patient, in a moment of clarity, wished to spare his wife the burden of care. Suicide by way of running away. The doctor says: "if it were me, that's what I'd do..."
The patient is returned to the hospital and is treated for hypothermia.
The head of the medical team insists on reviving the patient at all costs, in spite of the terminal Alzheimer's diagnosis. He cites the possibility of more time with the patient's wife.
Elsewhere, a board member confronts the Cheif Medical Officer: "you dropped in the US News rankings...If you want my money, I'll need to see a five year plan..."
Does the patient have a right to run away? Did he know what he was doing?
What about providing expensive life saving measures to a relatively young patient with a terminal condition?
What do you think? What would you want as the patient? What would you want as the doctor(s)? What about as a spouse?
You are the administrator, what would you do? What is in your purview?
Does this sound familiar? It might if you watch House, M.D.
I have this thing about TV shows. I usually stop watching in the 3rd season. That's when they jump the shark. Somehow, despite the episode where Dr. House saved a plane full of sick patients mid-flight (Hawaiian shirt and all), I've stuck around to the 8th season. Generally, it's a cheesy soap, and that's what I like about it. I'm flawed, so sue me.
January 2012's episode was different. I couldn't just zone out. It made me think about the ethics of end of life care. It left me uneasy.
The episode raises questions about end of life care, patient rights, care vs ego, final wishes when wishes are unknown...
I'm anxious to hear how you would respond, what role you'd assume, and what your biases are.