Termination of Life-Sustaining Treatment:
The prognosis of full recovery from long-term mechanical ventilation is poor, particularly in patients like Mr. S with minimal pulmonary reserve. The approach to his request should start with an evaluation of his decision making capacity. Even though he is awake and alert, you should carefully probe the reasons for his request, with particular attention to making sure he understands the consequences of his decision. If you're concerned about depression or other mental illness affecting his thinking about this decision, you might request a psychiatry consultation. You should ask Mr. S if he's discussed this with his spouse or family. If his decision making capacity is intact, you should honor his request.
Case 1 Discussion
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