Reference no: EM133591273

Question: Discuss Values and Ethical Principles: Respect for autonomy guides us to respect the refusal of decisional patients even if it is contrary to medical advice. As long as Mr. Peters has engaged in a robust informed consent conversation, we are to respect Mr. Peters's refusal, despite the serious risk of aspiration. However, if Mr. Peters does not have decision making capacity, beneficence requires us to turn to a substitute decision maker to use the patient's previously stated wishes and values to make a decision that is good for him or in his best interest. Given concerns about Mr. Peters's decision making, a repeat capacity evaluation is warranted, as well as a depression screening. The capacity evaluation can focus specifically on whether Mr. Peters can understand, comprehend, evaluate, and communicate regarding a feeding tube decision. In the meantime, his preference to engage in eating for comfort should be supported in balance with what is safe. • Make Recommendations and Follow Up: After discussing with the care team, the ethics consult team recommended a depression screening, a repeat capacity evaluation to focus on the feeding tube decision, and help for completing an advance directive if Mr. Peters wished. They also recommended