Thursday, September 22, 2011
Should vent be stopped?
A 51 year old man has a progressive degenerative muscle disease that has caused him to lose use of his legs and much of his upper body. He entered the hospital with pneumonia and wanted full treatment. During treatment he suffered respiratory failure and now needs a vent. He is unable to respond to others, possibly due to the pneumonia, the meds, or a combination of the two. He has left no advance directive or durable power of attorney. His wife wants the care team to remove the vent, but his brothers and sisters want full treatment and accuse the wife of wanting her husband dead. What should the care team do?
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According to his last request for full treatment and potential for return to a competent state, we feel the care team should continue to provide full treatment at this time and not remove the vent. However, after proper treatment according to protocol and if deemed unlikely to recover or respond to others for reasons other than meds and/or pneumonia, the care team should reevaluate the situation with the family. Following such steps, we feel the wife should be the logical proxy for her husband to make the decisions following the care team's prognosis.
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