Wish - Two version Flashcards
58y M Mervin aggressive lymphoma. Starting treatment
indicated he was keen to be treated.
Before remission progressive pulm infiltrate. Resp function progressively deteriorated. Long term partner
says he enough & he did not any more treatment.
ICU reg has intubated & MV.
Religious beliefs, opinions made in the past, Organisations to which he belongs.
Difference btw preference (state of mind, feelings) & choices ( actions with consequences).
M values & preference pivotal than partners or clinicians. M decision making ability, now & future.
Partners decision making capacity.
Two versions of M wishes.
one he made when well.
2nd more recent & could be based on experience of illness.
May be was hypoxic.
Early decision was considered & latter is sudden, unconsidered & impulsive
Had M talked abt having ‘had enough’ before last night?
Do u think he was clear in his mind when he said that?
He did seem very keen to fight this when he started.
Do u think it could be reasonable to give him a little while to see if he turns the corner quickly - he is asleep now & isn’t aware of what is going on.
Decision of M not partners or intensivists.
