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Chapter 11 - Misjudging Needs

A Messy Spiral of Complexity

from Part III - Diversity of Desires and Limits of Liberty

Published online by Cambridge University Press:  17 May 2025

By
Paul J. Ford
Edited by
Paul J. Ford  and
Denise M. Dudzinski
Paul J. Ford
Affiliation:
The Cleveland Clinic Foundation, Cleveland
Denise M. Dudzinski
Affiliation:
University of Washington School of Medicine, Seattle
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Summary

In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the author describes a case involving multiple interactions between a patient’s family and the healthcare team surrounding "futile" therapy. Each new team believes that the family does not understand and tries to educate them, leading to exhaustion and lack of trust all around. The case demonstrates the complexity that arises in communication in the current healthcare system.

Keywords

hauntingend of lifeICUcommunicationfamily meetingssurrogate decision makingconsciousnesssufferingfutilityDNR

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Type
Chapter
Information
Complex Ethics Consultations
Cases that Haunt Us
 , pp. 90 - 95
Publisher: Cambridge University Press
Print publication year: 2025

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References

Moss, A. for the Renal Physicians Association and the American Society of Nephrology Working Group. Shared decision making in dialysis: A new clinical practice guideline to assist with dialysis-related ethics consultations. J Clin Ethics, 2001; 12(4): 406–14.CrossRefGoogle ScholarPubMed
Council on Ethical and Judicial Affairs, American Medical Association. Guidelines for the appropriate use of do-not-resuscitate orders. JAMA, 1991; 265(14): 1868–71.Google Scholar
Cohen, NH. Assessing futility of medical interventions: Is it futile? Crit Care Med, 2003; 31(2): 646–8.CrossRefGoogle ScholarPubMed
Hinshaw, DB, Pawlik, T, Mosenthal, AC, Civetta, JM, Hallenbeck, J. When do we stop, and how do we do it? Medical futility and withdrawal of care. J Am Coll Surg, 2003; 196(4): 621–51.CrossRefGoogle Scholar
Kurent, JE. Case presentation: Medical decision-making in hopeless situations: The long-lost son. J Pain Symptom Manage, 2003; 25(2): 191–2.CrossRefGoogle ScholarPubMed
Zaner, RM. Ethics and the Clinical Encounter. Englewood Cliffs, NJ: Prentice Hall, 1988.Google Scholar
Miller, RB. Extramural ethics consultation: Reflections on the mediation/medical advisory panel model and a further proposal. J Clin Ethics, 2002; 13(3): 203–15.CrossRefGoogle Scholar

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