The Case
John is first year intern at St. Michael’s Hospital. He is currently on a rotation in the Cardiology Unit. John’s first patient is Edgar Martin, a 66 year old man with heart disease. He has said on several occasions that “when my time comes, let it come!” He does not want to be resuscitated either.
Edgar discussed this with John as well as several of the nurses on the unit. His wife of 42 years, Elizabeth, tells everyone that she wants "everything done for my husband." There have been team conferences and sensitive counseling. Still each of them is firm and John and the nurses are concerned over what is right to do if Mr. Martin goes into cardiopulmonary arrest. The attending on the unit is a cousin of Elizabeth’s and refuses to write a "do not resuscitate" order.
Discussion Questions?
- How would you react if you were “John” in this situation?
- Why do you think the attending has decided to not sign a “DNR” for Mr. Martin?
- What other options are available here? Are there other options of care?
- What are the pros and cons of each of the points of view presented? Mr. Martin’s wish to not be resuscitated? Mrs. Martin’s wish to do “everything possible?”
- Do you see any problems in the language used by the Martins?
- Consider the impact of decisions on the emotional, psychological and social issues faced by the family and staff?