Which Way Down the Slippery Slope?

Abstract

A case that came before a recent meeting of a hospital ethics committee was troubling, but not uncommon. The patient, about 70 years old, had been brought to the emergency room with a fever of 107°. Following her admission to the hospital seven months earlier, she was given a diagnosis of “status epilepticus.” Now she is in the Intensive Care Unit, on a respirator from which she cannot be weaned. Brain damage is far-reaching. The doctors are having difficulty gaining access for the insertion of intravenous lines. The patient does not respond to stimuli, has already developed large decubitus ulcers, and requires regular suctioning and turning. A private duty nurse carries out these tasks of daily maintenance.