Reference no: EM133787566

Question

Ms. J.F. does not respond to chemotherapy. Her pain increases to the point that she can assume no comfortable position and is in constant pain despite all analgesic therapy, including increasing doses of morphine. She becomes more nauseated despite receiving different anti-emetics. Her ascites continues to accumulate rapidly and requires repeat paracenteses to help alleviate increasing pain and dyspnea. Her serum albumin continues to drop despite replacement. She develops thrombophlebitis, for which she receives heparin therapy. At this point, the patient is fatigued, dyspneic, and restless and must sleep in a sitting position. However, she remains conscious, alert, and oriented. Her competency is never in question, although she is partly sedated with lorazapam. One morning she speaks to the attending physician. After inquiring about her disease's extent and outcome and being reassured that everything possible is being done, she asks that all treatments be stopped. She states she is at the 'end of the road' and does not wish to go further. "I can't bear it anymore. Please help me be comfortable. Make me sleep." Throughout her illness, she is supported by her companion, who loves her dearly. He has wanted everything done to restore her health. However, when confronted.