Reference no: EM133374578

Ms. Georgia, exhausted and frustrated, asked her daughter's nurse how she could have an ethical concern addressed. Directed to the office of the hospital ethics committee nurse co-chair, she found an empathic and listening ear as she shared her daughter's story. Her daughter, Mena, now 35 years old, suffered with liver disease among other comorbidities for more than 20 years. A liver transplant 7 years ago brought only a few years of relative well-being. With full knowledge that her transplant had failed and that she was not a candidate for a second transplant, Mena continued to want all aggressive care to sustain her life. Despite multiple admissions to the medical intensive care unit (ICU) over the past year, her overall health continued to deteriorate. A few brief discharges to home only prompted another readmission for complications, and Mena continued to agree to, or even request, transfer to the ICU when sepsis or respiratory distress developed. Many physician trainees recommended referral to hospice over the past year to Mena, recommendations that she adamantly rejected. Ms. Georgia reported that this last episode infuriated her daughter and that her daughter felt "bullied" by these repeated, and at times strident, recommendations for referral to