A 73-year-old man has been brought to a chronic-care facility for long-term ventilator management. The patient has advanced COPD and is unable to be weaned from the ventilator. A tracheostomy has been placed. A nasogastric tube is in place to deliver tube feeding. The patient is fully alert, and understands the situation. He is asking to have the nasogastric tube removed because of discomfort.
What should you tell him?
a. "I will get that tube out right away, sir."
b. "Let's see how much you are able to eat first."
c. "I will pull it out if you let me put in a gastric tube."
d. "Let me talk to your family first."
e. "Do you have a health-care proxy?"
f. "No way dude, we make the decisions around here, not you."
g. "Only if you promise not to sue me."
h. "Are you crazy? Do you think I am going to let MY patient starve to death?"