A 55 -year-old man has been admitted to the hospital for worsening of his mental status, poor nutrition and inability to eat when fed. The patient has Creutzfeld-Jakob disease and will not likely improve. Over the last several months the patient has told you repearedly that he does not want to be "kept alive as a vegetable" whth artinclat nutrition and hydration by any method. The health-care proxy form specifically states there is to be "no placement of a nasogastric or gastric tube for enteral feeding." The health-care proxy agent is a nurse. The proxy insists that you have a jejunostomy (J-tube) placed for feeding telling you the proxy form only excludes the NG and G-tubes.
What should you do?
a. Place the J-tube.
b. Tell the proxy she needs to get a court order for the J-tube.
c. Tell the proxy she needs an ethics committee evaluation.
d. Do not place any form of tube for artificial nutrition or hydration.
e. Transfer the patient's care to another physician who feels comfortable placing the J-tube.