#january2020mccqe1
A 74-year-old woman with dementia has been in the intensive care unit (ICU) for 14 days following acute respiratory decompensation and renal failure. She is receiving continuous hemodialysis, and her electrolytes have been stable. Her oxygen saturation has been maintained on mandatory mechanical ventilation. She remains in critical condition, but the ICU team believes that she has a reasonable chance of recovering. A living will shows that she has agreed to intubation and resuscitation if necessary. However, her daughter, who is her designated health care proxy and who until now has been in contact with the medical team only by phone, arrives stating that she has power of attorney and asking that her mother be taken off the ventilator. Which of the following is the best course of action?
(A) Discuss with the daughter her reasons for withdrawing care
(B) Maintain current management based on the patient’s prognosis
(C) Obtain a court order mandating continuation of ventilatory support
(D) Obtain an ethics consultation
(E) Withdraw ventilatory support based on the daughter’s power of attorney
A 74-year-old woman with dementia has been in the intensive care unit (ICU) for 14 days following acute respiratory decompensation and renal failure. She is receiving continuous hemodialysis, and her electrolytes have been stable. Her oxygen saturation has been maintained on mandatory mechanical ventilation. She remains in critical condition, but the ICU team believes that she has a reasonable chance of recovering. A living will shows that she has agreed to intubation and resuscitation if necessary. However, her daughter, who is her designated health care proxy and who until now has been in contact with the medical team only by phone, arrives stating that she has power of attorney and asking that her mother be taken off the ventilator. Which of the following is the best course of action?
(A) Discuss with the daughter her reasons for withdrawing care
(B) Maintain current management based on the patient’s prognosis
(C) Obtain a court order mandating continuation of ventilatory support
(D) Obtain an ethics consultation
(E) Withdraw ventilatory support based on the daughter’s power of attorney
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