Recently our hospital had a patient, an elderly lady with COPD and CHF who was an Indian but an American citizen, who had come home for a wedding. At the wedding, she became short of breath, was taken to hospital and ventilated. When she did not immediately improve her family told us that they wanted her taken off the ventilator. They said she had been previously ventilated in the US and had expressly stated that she did not want to go through the same experience again. She would rather die than be ventilated again.
The patient could not say anything; we had no documentation of the patient's desires in the form of a will or other legally accepted document. We did not know of any such medico-legal precedent. So we continued care and in a few days the patient passed away as expected and in spite of treatment. Now, did we ignore a dying person’s last wish? Did we waste badly needed ICU…
