Monday, October 02, 2006

A Difficult Legal Question

What to do what to do?

You are a horribly ill though relatively young quadriplegic who recently signed a DNR/"Comfort Care Only" form and are in fact sick again with a very resistant bacterial infection. One problem, you are now suicidal.

Do I allow your prior wishes regarding the end of your life to be followed as they were written when you were not suicidal, or do I treat you against your stated wishes as you are now suicidal and can not make a decision regarding withholding current treatment?

"Sorry sir, we can't allow you to die because you want to, but as soon as you don't want to anymore then you can die."


  1. They gave us a very similar case from the 80's in our ethics class. Young quadriplegic (Bouvia) with cerebral palsy checks herself into the hospital for suicidal thoughts, and wants to die by withholding nutrition and hydration while on pain meds. The doc force feeds her and threatens to declare her incompetant and attempts to transfer her to another hospital without success. She gets the ACLU involved and in her second suit against the hospital eventually wins the right to die in the hospital.

    But the kicker is that she then changed her mind and lived for several more years in the hospital and as a ward of the state...tough stuff to deal with and the kind of legal nightmare that makes it a little bit tougher to sleep at night.

  2. tough cases make bad law right?

  3. Very easy, actually: let him die.

    The DNR was written when the patient was clear-headed and not in a medical crisis. It should be honored now. The patient obviously decided when he signed the DNR that he'd had enough. To treat him would be inhumane.

    Don't make decisions more difficult than they have to be.

  4. will you be signing that chart anonymous?