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  • The Case of Freda: Nursing Staff in Moral Distress When Patient’s Wishes Not Followed

    Case Study – The Case of Freda Freda is a thirty-two-year-old woman in an advanced fixed stage of multiple sclerosis. She is no longer able to move independently or feed herself. She is able to speak with great difficulty. Her decisional capacity is intact. Freda’s inability to swallow has caused her to lose weight to…

  • The Case of Claire Conroy

      Must Patients Always Be Given Food and Water? An eighty-four-year-old non-ambulatory nursing home patient was confined to semi-fetal condition with “severe organic brain syndrome.” She had necrotic gangrenous leg ulcers and no bowel control. The patient was not in a vegetative state; her life expectancy could not be predicted but it was thought to…

  • Case Study – My Patient’s Dying

    Case Study – My Patient’s Dying I had never seen it before. I had no experience on which to base my unsettling suspicions. And yet, it was unmistakable. My patient, Ms. P, was dying right in front of me, and I was a third-year medical student. She told me “I just don’t want to be…

  • Case Study – Mr. Jay’s Case

    Case Study – Mr. Jay’s Case Mr. Jay, a 71-year-old man with severe chronic obstructive pulmonary disease, was convalescing at a skilled-nursing facility after a hospital stay for pneumonia.  Mr. Jay and his doctor discussed the likelihood that his bouts with pneumonia would recur and the possibility that his lungs might stop working during a…

  • Case Study – Matter of Quinlan

    Case Study – Matter of Quinlan Karen Ann Quinlan, a twenty-two-year-old who ingested a harmful mix of drugs and alcohol, suffered two fifteen-minute periods of interrupted breathing which left her in a chronic vegetative state without any cognitive functions. Evidence in the case included statements the patient made earlier referring to her “distaste for continuance…

  • Case Study – Managing Pain, A Family Affair

    Case Study – Managing Pain, A Family Affair Mrs. W is a sixty-year-old African American woman with a recent diagnosis of breast cancer with metastases to the bone and lung. Will she become addicted to the prescribed pain medication?

  • Case Study – “If you prick me, do I not bleed?”

    Case Study – If you prick me, do I not bleed? Elizabeth is over 100 years old, with little cognitive decline. Her blood-thinning medication requires monthly blood draws, which are painful and distressing to Elizabeth. Is continuing the monthly blood draws the right thing to do? How can healthcare providers clearly state what they believe…

  • The Case of Grace: Why Are They Doing All This?

    Case Study – Grace – Why Are They Doing All This Grace H. has spent all her life teaching high school English in Pine Junction. She retired ten years ago when she began to suspect that she was suffering the early stages of dementia. Shortly after she retired, Grace, who has never married, sold her…

  • Case Study – Good Death or Assisted Suicide?

    Case Study – Good Death or Assisted Suicide The case of Mr. Perry and his pacemaker Mr. Perry (not his real name) was 83 years old and had several medical problems, having spent the past several months in and out of hospitals and rehab. Prior to that, he lived independently in a small Midwestern town.…

  • Case Study – What Should We Do? DNR for an Adult with Down Syndrome

    Case Study – George – DNR for an Adult with Down Syndrome George is a twenty-three-year-old young man with Down’s syndrome, who lived independently in a group home. Unfortunately, an accident resulted in George suffering a severe brain injury, with no signs of consciousness after a year. He’s dependent upon a feeding tube. George and…