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from Part IV - Withholding Therapy with a Twist
Published online by Cambridge University Press: 17 May 2025
In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the author describes an 83-year-old woman with dementia who sustained jaw and other minor fractures post motor vehicle accident. A DNR order was written by the trauma surgeon upon her arrival. Her attending still decided to put her on oxygen (nasal cannula) because she was struggling to breathe and jaw surgery was planned. The patient’s daughter supported comfort care based on substituted judgment, but nurses were skeptical of her motives. A nurse refused a physician’s order to discontinue oxygen and begin comfort care and the author was called again. The author reflects on the responsibility of ethics consultants in patient outcomes, self-doubt, and the case’s unsettling impact on the author.
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