Mr. Levi, an 87-year-old man with advanced dementia, is admitted to the hospital with severe pneumonia. He cannot communicate verbally, depends on support for all ADLs, and has a history of multiple hospitalizations. The medical team recommends a palliative approach focused on comfort measures only, citing evidence that aggressive interventions such as mechanical ventilation or feeding tube placement would not improve his quality of life and may cause additional suffering. However, Mr. Levi’s family insists on “doing everything possible” to prolong his life, including inserting a feeding tube and considering intubation if necessary.
Discussion Question:
As his provider, how would you advocate for an evidence-based, comfort-focused plan of care for Mr. Levi? What strategies would you use to address the familys insistence on aggressive interventions while ensuring that the patients dignity and quality of life remain central to the decision-making process? Consider the ethical, emotional, and cultural factors that may influence the conversation.
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