Reference no: EM132713507

Susan, a 75 year old retired accountant, wife, mother of two and grandmother of three, has Alzheimer's disease. Now six years into the diagnosis, her family finds that Susan can have a relatively comfortable life by attending an adult day center during the day while they work, and then they care for her in the evenings and weekends. Susan has mood swings and sometimes angry outbursts, but usually, she enjoys singing and dancing at the day center. She cannot make new short or long-term memories, and she does not recognize friends and family. She cannot be left alone. Further, certain aspects of her health are beginning to fail. Most importantly, the muscles she uses to swallow are beginning to atrophy. Doctors tell her family that Susan will lose the ability to swallow in the new few months. Her physician has offered to insert a feeding tube into her abdomen. Such a tube would, he believes, allow her to live several more years. The family is not sure whether to have the tube inserted.

Questions:

Discussion a. Susan's family consults a family friend about whether to insert the tube who is a nurse with significant experience in end of life care. The nurse advises the family that, in his experience, inserting such a tube for a patient like Susan would be futile. Using Wicclair's categories of futility, what might the nurse mean by this statement? In what sense(s) might the treatment be reasonably considered futile? Please explain.

Discussion b. What might the U.S. Bishop's Committee say as to whether it would be ethical for Susan's family to not insert a feeding tube for Susan? Please briefly explain your answer, and refer to their text to support your answer.

Discussion c. After Susan had kids in her early 30s, she and her husband filled out living wills, gave them to one another, and filled them with their providers. In Susan's living will, she explained that she did not want to be kept alive through life-sustaining medicaltreatment if she is terminally ill and the treatment would provide little benefit other than keeping her alive. What might be good reasons to not use this living will to make the family's current decision regarding Susan's care?

Discussion d. Which of the ethical factors above do you find most compelling for the family in making this treatment choice as Susan's surrogates? Please briefly explain. Is there one or two other ethical issues that you think are important for the family to consider in making this choice