A 72-year-old woman in a long-term care facility with advanced dementia and multiple comorbidities develops aspiration pneumonia. Her daughter request...

Question

A 72-year-old woman in a long-term care facility with advanced dementia and multiple comorbidities develops aspiration pneumonia. Her daughter requests full ICU care and resuscitation. The attending physician believes this is not in keeping with the patient's prior expressed wishes for comfort-focused care. Which approach best reflects ethical practice and CanMEDS roles?

Accepted Answer

Review the patient's prior expressed wishes and goals, discuss prognosis and options with the daughter, and attempt to align the plan with the patient's values

Answer

Unilaterally write a Do Not Resuscitate order without discussion

Answer

Follow the daughter's request regardless of prior wishes

Answer

Transfer care to another physician to avoid conflict

Answer

Initiate full ICU-level interventions immediately and discuss later

ca-mccqe1 MCQ (SBA): Goals of care and substitute decision-making