Question

An 80 -year-old man is admitted to the hospital with a massive intracranial bleed. He has been placed on a ventilator because of the respiratory failure associated with intracranial herniation. When you try to remove the ventilator, there are no respirations. The patient makes no purposeful movements. There is no pupilary reaction when you shine a light in his eyes. There is no nystagmus on cold caloric testing. Oculocephalic and comeal reflexes are absent. He left no specific wishes for his care. Which of the following is the most appropriate action regarding this patent? a. Remove the ventilator. b. Make the patient DNR. c. Place a nasogastric tube to prevent aspiration. d. Get a court order authorizing you to remove the ventilator. e. Do an EEG (electroencephalogram) three times separated by six hours each time.

    An 80 -year-old man is admitted to the hospital with a massive intracranial bleed. He has been placed on a ventilator because of the respiratory failure associated with intracranial herniation. When you try to remove the ventilator, there are no respirations. The patient makes no purposeful movements. There is no pupilary reaction when you shine a light in his eyes. There is no nystagmus on cold caloric testing. Oculocephalic and comeal reflexes are absent. He left no specific wishes for his care.
Which of the following is the most appropriate action regarding this patent?
a. Remove the ventilator.
b. Make the patient DNR.
c. Place a nasogastric tube to prevent aspiration.
d. Get a court order authorizing you to remove the ventilator.
e. Do an EEG (electroencephalogram) three times separated by six hours each time.
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Medical Ethics for the Boards
Medical Ethics for the Boards
Conrad Fischer 3rd Edition
Chapter 1, Problem 1 ↓

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The patient is an 80-year-old man with a massive intracranial bleed, respiratory failure, and no signs of brain activity (no purposeful movements, no pupillary reaction, absent reflexes). This indicates a severe neurological impairment.  Show more…

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An 80 -year-old man is admitted to the hospital with a massive intracranial bleed. He has been placed on a ventilator because of the respiratory failure associated with intracranial herniation. When you try to remove the ventilator, there are no respirations. The patient makes no purposeful movements. There is no pupilary reaction when you shine a light in his eyes. There is no nystagmus on cold caloric testing. Oculocephalic and comeal reflexes are absent. He left no specific wishes for his care. Which of the following is the most appropriate action regarding this patent? a. Remove the ventilator. b. Make the patient DNR. c. Place a nasogastric tube to prevent aspiration. d. Get a court order authorizing you to remove the ventilator. e. Do an EEG (electroencephalogram) three times separated by six hours each time.
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