End-of-Life Management Where There Is Family Opposition to Physician Recommendations

Abstract

This patient at baseline was marginally functioning in his home. He underwent 4 months of hospitalization including 1 month in an ICU. During his multiple hospitalizations, he underwent tracheostomy and feeding tube implantations. He was unable to articulate his needs, other than to state that he wanted his physicians to “pull the plug.” After he lost a friend to ovarian cancer, he was left with no personal support. His treatment course at this point was disrupted by the problematic involvement of his grandson who insisted on a home death and hired an attorney who was equally uncompromising. A struggle resulted that was ultimately resolved by the hospital comfort care committee and illustrates the medical and legal issues that these situations can pose.