PBS’s Religion and Ethics NewsWeekly filmed a story recently at Grant Medical Center. They followed Dr. Gordon on rounds and filmed two end-of-life conversations with patients who had not previously discussed the issues. They also spoke with an RN who is in hospice care and the ICU director at Grant. Betty Rollin reported for PBS and the story will be on their web site starting October 9th around 6 pm. You can find where it will show in your area on their site.
On Oct 13th I got one of my community clients squaded to the ER at Doctor’s Hospital, a 58 year old man w/4th stage lung cancer and metastasis to the brain. I had found him at home, where he lived alone and had no relatives whose whereabouts he knew, and I suspected he was in R and L sided heart failure and/or pneumonia. He was extremely short of breath, and told me later he had thought he would die there, alone.
On Oct 14th he was stable in a step-down unit, and I explained in detail what would occur if he did not sign a Living Will, and he did not want to be kept on machines, nor did he want his heart re-started, “like on TV.” He wanted to sign a Living Will, but there was no chaplain response in the next 1/2 hour, and I was told to return the next afternoon. This man knew he was dying, and had known for some months.
On Oct 15th and 16th he was sedated w/Ativan, due to meeting some criteria, and was unresponsive. I protested the Ativan on the 15th ( a 2mg dose) and on the 16th ( a 1 mg dose). His medicated state made signing any legal documents not possible.
I left him about 6Pm on the 16th, and sometime after 7PM he was found “unresponsive.” He was put on a vent, etc, and transferred to the ICU.
I spoke w/the oncologist on the 17th, who told me he was planning to get a 2nd signature and would then be able to intervene based on some type of “compassionate care” status, so the man could be taken off life support.
This did not occur, as the Ethics Committee overruled such a plan based upon lack of written advanced directives, and the statement of a resident doctor (never named) who supposedly was told by this man on the eve of his admission, that he wanted “to be a full code.”
After advocating for this “harm” to cease, and for all these useless painful interventions to be discontinued, after speaking w/chaplains, doctors, social workers, nurses, administrators and risk managers to no avail, over the course of the next week, finally on Oct 23rd, I engaged an attorney for him, who would seek that all these extraordinary, painful interventions which had no chance of success be stopped.