Medical Terminology Case Study Gretchen is a 42 year old female that has a medic
ID: 94780 • Letter: M
Question
Medical Terminology Case Study
Gretchen is a 42 year old female that has a medical history of cardiovascular disease. She has just been admitted due to a suspected stroke. She is suffering from paralysis of her left side and is aspirating food. She seems to be struggling with decisions and this causes concern because she can only respond with “no and “yes.” In addition, her responses are not consistent. This is causing a split between the attending physician, who feels that she has lost the capacity to make decisions, and the patient’s husband and son, who feel that she is still capable of making her own decisions. Furthermore, after looking at her brain, there is obvious dense damage to the cerebral cortex. This leads the staff to believe that recovery, if possible, would be minimal and severe disability will be the result.
Gretchen and her husband never discussed what to do if one of them were in a position to require life-sustaining treatment. He is conflicted because he doesn’t believe she would want to live in a disabled state and is unsure of he should ask for a feeding tube for her. Her 4 children are split in the decision. Two of them are completely against it and the other two say that no doing so would “seal her fate.” This makes it even harder for Gretchen’s husband to decided but in the end he asks that they use the tube.
To add to the scenario, the treatment team along with the attending physician do not see placing the feeding tube as a solution. They believe that because patient has minimal alertness and consciousness that the will not improve. They do not see a realistic scenario for recover. Gretchen’s previous hospitalization history also plays a role. Two nurses mention that in these previous stays, Gretchen stated that she would not want to have life sustained through artificial processes, including renal dialysis, tube feeding, and ventilator. The staff views this as Gretchen expressing what her preferences are in a dire situation. The family has now requested an ethics consultation to come to a conclusion.
Using critical thought, research and respond to the question below with a minimum of 3-5 sentences.
1. There is a great deal to consider in this case. First, we should decide on the communication ability of the patient. How should this be done? What should be considered?
2. There is a great deal of discussion over the feeding tube. Are the comments by Gretchen in her previous hospital stay enough to make the decision? What about Gretchen’s husband and 2 children that want the tube put in?
3.What conclusion do you foresee the ethics consultation leading to?
Explanation / Answer
1. There is a great deal to consider in this case. First, we should decide on the communication ability of the patient. How should this be done? What should be considered?
Answer: The communication ability of the patient should be decided by the doctors. Since, her cerebral cortex is severly damaged, her sensory and reflex responses will be poorly working. Her responses to external stimili and her ability to recognize her surroundings including her family members.
2. There is a great deal of discussion over the feeding tube. Are the comments by Gretchen in her previous hospital stay enough to make the decision? What about Gretchen’s husband and 2 children that want the tube put in?
Answer: If there are no chances of her recovery, then, comments by Gretchen in her previous hospital stay should be enough to make the decision. The family is emotionally attached to the patient. There decision should be considered if there are any chances of her recovery.
3.What conclusion do you foresee the ethics consultation leading to?
Answer: The ethics consultation is leading to a decision to not keep Gretchen alive on artificial systems, if there are no chances of her recovery.