In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the authors discuss a circumstance of a request by a family to withdraw life-sustaining surgery only three days after open-heart surgery. The surgeon both wanted to respect family and to advocate for life for the patient. Although chances of recovery were slim, the surgeon struggled with the timing. The family had experienced a rocky postoperative course and were convinced that continuing was not what patient would want.

In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the author discusses a dying patient’s adult children in disagreement about a care plan. The issue of when home herbal remedies can be provided for a patient was central to the discussion. In addition, the ethics consultant had family members see a counselor to attempt to resolve their dispute, which is not a common approach.

A 40-year-old nulligravid woman with developmental disabilities presents to the office with her mother. She is being followed for a long-standing history of heavy menstrual bleeding and pelvic pain. She had previously been treated with depot medroxyprogesterone acetate but had persistent light bleeding that presented hygiene issues. Her past medical history is significant for hypertension and constipation. She has never had abdominal or pelvic surgery. She has never been sexually active. She is not employed. She lives with her mother who is her caregiver.