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The patient's written will and the family asking to ignore it

La volontà scritta del paziente e la famiglia che chiede di ignorarla · Healthcare · Beginner

The case

A 68-year-old patient with advanced degenerative neurological disease, followed by your ward for years, has filed clear and recent advance directives: no invasive ventilation, no resuscitation, palliative sedation when the time comes. The time is coming: pneumonia is driving him toward respiratory failure, and he is no longer conscious. His wife and eldest son, facing the deterioration, beg you to intubate: he was not in his right mind when he signed, he changed, we know him better: and the son evokes going to a judge and accuses the ward of wanting to let him die. The younger daughter, silent until yesterday, told you: dad repeated it to me a month ago, please, honor it. The team is worn, a nurse is in tears, and the clinical decision cannot wait days. How do you proceed?

Un paziente di 68 anni con una malattia neurologica degenerativa in fase avanzata, seguito da anni dal tuo reparto, ha depositato disposizioni anticipate di trattamento chiare e recenti: niente ventilazione invasiva, niente rianimazione, sedazione palliativa quando arriverà il momento. Il momento sta arrivando: una polmonite lo sta portando all'insufficienza respiratoria, e non è più cosciente. La moglie e il figlio maggiore, davanti al peggioramento, ti supplicano di intubarlo: non era nel pieno delle sue facoltà quando ha firmato, è cambiato, noi lo conosciamo meglio: e il figlio evoca il ricorso al giudice e accusa il reparto di volerlo lasciar morire. La figlia minore, in silenzio fino a ieri, ti ha detto: papà me l'ha ripetuto un mese fa, vi prego, rispettatelo. L'équipe è provata, un'infermiera è in lacrime, e la decisione clinica non può aspettare giorni. Come procedi?

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Frequently asked questions

What is the "The patient's written will and the family asking to ignore it" problem-solving case on Grace?

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Is there one correct answer to "The patient's written will and the family asking to ignore it"?

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