An elderly patient is admitted under the care of an internal medicine specialist in a corporate hospital with the provisional diagnosis of COPD with acute exacerbation with multiple organ involvements. The patient gives his usual general consent for admission and invasive investigations. He does not respond to the standard empirical management and goes down progressively. A stage comes when he requires intubation for assisted ventilation, in other words, becomes critically ill.
Now, at this stage, the attendants refuse consent, become aggressive and when prognosis is explained to them, they refuse to carry on with the treatment of the first consultant. They demand that patient is transferred or handed off to another specialist in the same depth of the hospital. We could do that easily but at this juncture, the other specialist who is junior to this treating consultant refused to take…
