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End-of-life care for a man with developmental disabilities
Ghan-Shyam Lohiya1, Lilia Tan-Figueroa, Francis M Crinella
1Fairview Developmental Center, Costa Mesa, Calif 92626, USA.
The Journal of the American Board of Family Practice
|February 14, 2003
Summary
Artificial life support can prolong dying, not life, for incapacitated patients. Open communication between legal representatives and physicians is crucial for ethical end-of-life care decisions.
Area of Science:
- Medical Ethics
- Critical Care Medicine
Background:
- Science can artificially maintain life functions.
- The ethical implications of prolonged artificial support for incapacitated patients remain debated.
Observation:
- A patient with developmental disability and unknown healthcare preferences required extensive life support for severe sepsis and complications.
- Despite bioethics committee recommendations, the patient received intensive care for 104 days, incurring significant costs.
Findings:
- Intensive care for incapacitated patients presents complex clinical and ethical challenges.
- End-of-life decisions require active advocacy for the patient's best interests by legal representatives and physicians.
Implications:
- Frequent and open communication is vital for navigating end-of-life care in complex cases.
- This case highlights the need for clear guidelines in managing prolonged, intensive medical care for patients with diminished capacity.